VAERS 2021 Database www.vaers.hhs.gov

Main Page | All 2021 Deaths | Videos
VAERS Updated: 10/01/2021
** VAERS DATABASE Last updated: October 1, 2021**
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Manufacturers

Total Manufacturer
187,133MODERNA
33,878JANSSEN
2,321PFIZER\BIONTECH
1,091GLAXOSMITHKLINE BIOLOGICALS
983UNKNOWN MANUFACTURER
363MERCK & CO. INC.
229SEQIRUS, INC.
45DYNAVAX TECHNOLOGIES CORPORATION
41NOVARTIS VACCINES AND DIAGNOSTICS
29SANOFI PASTEUR
18EMERGENT BIOSOLUTIONS
8PAXVAX
7TEVA PHARMACEUTICALS
4PFIZER\WYETH
3BERNA BIOTECH, LTD.
2SMITHKLINE BEECHAM
2INTERCELL AG
2PROTEIN SCIENCES CORPORATION
1CSL LIMITED

Incidents per State

State Total
77,548
AK1,869
AL5,581
AR3,688
AS47
AZ14,288
CA61,984
CO11,665
CT8,149
DC1,663
DE1,807
FL37,749
FM5
GA15,058
GU120
HI2,453
IA4,625
ID2,692
IL20,334
IN24,007
KS4,615
KY7,696
LA4,887
MA14,654
MD12,514
ME3,129
MH11
MI18,739
MN12,528
MO9,710
MP29
MS2,790
MT2,375
NC16,368
ND1,356
NE2,880
NH3,100
NJ17,634
NM3,916
NV4,239
NY34,355
OH19,081
OK6,195
OR8,636
PA23,083
PR2,370
QM2
RI2,088
SC6,411
SD1,212
TN9,131
TX35,174
UT4,273
VA14,937
VI64
VT1,676
WA14,909
WI11,259
WV2,388
WY861
XB5
XL1
XV2

ID: 1061336
Sex: F
Age: 54
State: OH

Vax Date: 02/20/2021
Onset Date: 02/21/2021
Rec V Date: 02/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Tetracycline and compazine.

Symptom List: Dysphagia, Epiglottitis

Symptoms: No side effects the day of the 1st vaccination. On Sunday 2/21, I wok up with an extremely sore arm at injection site and it felt like there was a knot the size of a golf ball underneath my skin. On Monday, 2/22 I developed a large red circle around the injection site which grew in size along with the sore "knot" growing in size. The red circle was not an outline. It was a large red circle completely filled int. The circle grew to about 3.5 - 4 inches in circumference and itched. It peaked on 2/24. The size of the circle and the "knot" started to reduce and by 2/28 the circle was gone and only a slight tightness at the injection site remained. We took a photo on the "peak" day.

Other Meds: Metformin 2x/day 1000 mg each.. Trulicity .075 injection weekly. Pravastatin 40 mg. daily.

Current Illness: None

ID: 1061337
Sex: F
Age: 29
State: VA

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 02/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Peanuts, fish

Symptom List: Anxiety, Dyspnoea

Symptoms: Soreness around injection site beginning within two hours; peak soreness within eight hours, lasting 24-36 hours; soreness decreasing rapidly 48 hours after onset. At worst: pain rating 10/10, significant impact on daily function. Onset of mild fatigue and body aches overnight ~12-18 hours after injection; symptoms subsided same day; minimal impact on function.

Other Meds: Zyrtec, Alprazolam 0.25mg, biotin

Current Illness:

ID: 1061338
Sex: F
Age: 28
State: NY

Vax Date: 02/27/2021
Onset Date: 02/28/2021
Rec V Date: 02/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: I have celiac disease so I can?t have gluten, but it is not an allergy.

Symptom List: Chest discomfort, Dysphagia, Pain in extremity, Visual impairment

Symptoms: Sore arm (a few hours after the shot and still have it) Exhaustion (a few hours after the shot and still have it) Chills (1 am) Fever (1 am-10 am) Muscle aches (1 am-current) Headache (1 am-2 pm)

Other Meds: Calcium Multivitamin Birth control (nortriptolyne)

Current Illness: None

ID: 1061339
Sex: F
Age: 67
State: NY

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 02/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data:

Allergies: NKDA

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Patient reported a vaccine reaction from 1st dose and was advised by her physician not to take 2nd dose. Her reaction was severe swelling of the upper extremities where her rings had to be cut off.

Other Meds: Unknown

Current Illness: Unknown

ID: 1061340
Sex: M
Age: 68
State: ID

Vax Date: 02/28/2021
Onset Date: 02/28/2021
Rec V Date: 02/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Immediately after injection patient received a 2cm hematoma with no known leakage of vaccine.

Other Meds:

Current Illness:

ID: 1061341
Sex: F
Age: 58
State: NY

Vax Date: 02/19/2021
Onset Date: 02/19/2021
Rec V Date: 02/28/2021
Hospital:

Vax Type: FLUC4
Manufacturer: SEQIRUS, INC.
Vax Name: INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT)
Lot: 276563
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Feraheme

Symptom List: Chills, Confusional state, Eye inflammation, Headache, Laboratory test

Symptoms: develop generalized itching and feeling of warmth as well as cough. W orsening of these symptoms, presented to ED c/o diffuse itching, feeling warmth, bronchospastic cough, as well as feeling like she is unable to breathe and not feeling right. Anaphylactic reaction. Seen immediately upon arrival. Benadryl, Solu-Medrol, Duo-neb, and Epinephrine given with rapid improvement in her symptoms. Observed in ED for 2.5 hrs. No recurrence of symptoms. Cough improved. Itching improved. No longer feels difficulty breathing.

Other Meds: biotin, coreg CR, hydrochlorothiazide, metformin XR, n, omeprazole, rosuvastatin

Current Illness:

ID: 1061342
Sex: F
Age: 43
State: OK

Vax Date: 02/20/2021
Onset Date: 02/27/2021
Rec V Date: 02/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Headache after injection, itchy bump/rash on injection site 1 week after first dose

Other Meds: Pristiq, zyrtec, vitamin D, fish oil, birth control, ambien

Current Illness:

ID: 1061343
Sex: F
Age: 56
State: NY

Vax Date: 02/28/2021
Onset Date: 02/28/2021
Rec V Date: 02/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Sulfur Drugs Mycin Drugs

Symptom List: Pharyngeal swelling

Symptoms: Throat Swelling Difficulty Swallowing Rapid Heart rate Dizzy, Weak

Other Meds: Prednisone Hydroxychloroquine

Current Illness:

ID: 1061344
Sex: F
Age: 48
State: PA

Vax Date: 02/26/2021
Onset Date: 02/27/2021
Rec V Date: 02/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: 100.4 fever for first 24 hours 99.1 - 99.6 temp for second 24 hours headache for 48 hours body aches and joint pain for 48 hours diarrhea for first 12 hours injection arm (left) swelling and redness: 2 inch x 2 inch after 24 hours, 3 inch x 3.5 inch after 48 hours

Other Meds:

Current Illness:

ID: 1061345
Sex: M
Age: 62
State: AZ

Vax Date: 02/27/2021
Onset Date: 02/28/2021
Rec V Date: 02/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Red rash on arms and legs

Other Meds: Losartan 50 Mg Tablet, amLODIPine 5 MG tablet, simvastatin 20 MG tablet, montelukast 10 mg tablet, milk thistle 175 mg tablet, omega 3-dha-epa-fish oil 900-1,400 mg CpDR, cetirizine 10 MG tablet, timolol 0.25 % ophthalmic solution, latanop

Current Illness: None

ID: 1061346
Sex: F
Age: 70
State: PA

Vax Date: 02/27/2021
Onset Date: 02/27/2021
Rec V Date: 02/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Vaccination site erythema, Vaccination site pruritus, Vaccination site swelling

Symptoms: Very tired, achy, 15 hours after shot, developed chills and fever 101 for about 9 hours.

Other Meds: Tylenol,

Current Illness: None

ID: 1061347
Sex: F
Age: 62
State: VA

Vax Date: 02/25/2021
Onset Date: 02/26/2021
Rec V Date: 02/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies: Penicillin, sulphate, seafood (get a headache)

Symptom List: Rash, Urticaria

Symptoms: Experiencing swollen, very tender lymph nodes under armpit. Taking Tylenol for pain. Symptoms are getting better.

Other Meds: Synthroid, HCTZ, Bostolic

Current Illness: None

ID: 1061348
Sex: F
Age: 57
State: MD

Vax Date: 02/22/2021
Onset Date: 02/25/2021
Rec V Date: 02/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: Lightheaded and dizzy. Became nauseaous and 2 hours after onset, got sick. Slight fever and chills. Dizziness lasted about 2 more hours after getting sick. Then just fatigue for the rest of the day. Only slight fatigue and achiness the next day.

Other Meds: Atorvastatin Montelukast Centrum silver chewable vitamins Lumigan

Current Illness:

ID: 1061350
Sex: F
Age: 89
State: CA

Vax Date: 02/28/2021
Onset Date: 02/28/2021
Rec V Date: 02/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: NONE

Symptom List: Dyspnoea, Fatigue, Feeling abnormal, Head discomfort, Headache

Symptoms: AFTER INJECTION, THE INJECTION SITE BEGAN TO BLEED IMMEDIATELY. HELD COTTON BALL TO APPLY PRESSURE FOR A GOOD MINUTE AND STOPPED BLEEDING. AFTERWARDS, THE INJECTION SITE BEGAN TO BULGE AND FORMED A BUMP OF ABOUT A SIZE OF A QUARTER. THE SITE SEEMED BRUISED AROUND THE BUMP. PATIENT REMAINED IN PHARMACY FOR 15 MINUTES AND THE BULGE DID NOT GET ANY BIGGER.

Other Meds: N/A

Current Illness: NONE

ID: 1061351
Sex: M
Age: 79
State:

Vax Date: 02/22/2021
Onset Date: 02/22/2021
Rec V Date: 02/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Dilaudid, levofloxacin, statins

Symptom List: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: Redness and swelling

Other Meds: Carvedilol, carbidopa/levodopa, midodrine, pantoprazole, Paroxetine , 81 mg aspirin

Current Illness: Cardiomyopathy, congestive heart failure, Parkinson?s

ID: 1061352
Sex: F
Age: 37
State: PA

Vax Date: 01/12/2021
Onset Date: 01/22/2021
Rec V Date: 02/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: Developed shingles approximately 10 days after first dose of Covid moderna vaccine.

Other Meds: None

Current Illness: None

ID: 1061353
Sex: M
Age: 74
State: WA

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 02/28/2021
Hospital:

Vax Type: DTAPHEPBIP
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: DTAP + HEPB + IPV (PEDIARIX)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies: sulfa based products

Symptom List: SARS-CoV-2 antibody test, SARS-CoV-2 test negative

Symptoms: I am a 74 year old male in good health with NO prior reactions to the annual flu, pneumonia, or shingles vaccinations. Because of a scheduled prostate biopsy in early April 2021, I wanted to complete the vaccination for COVID-19 in advance of this procedure. Within 5 mins of receiving the vaccination shot in my left arm, my left elbow and forearm began to swell into a large ball shape near the elbow joint. At the same time, my left hand became noticeably swollen as well. Fortunately, I did not experience trouble breathing or have any numbness in my fingers at that time. The observation staff nurses took me to a separate room to check my blood pressure and heart rate which were both in the normal range.

Other Meds: Dose 1 Pfizer-BiONTech COVID-19 Vaccine

Current Illness: None

ID: 1061354
Sex: F
Age: 35
State: NY

Vax Date: 02/26/2021
Onset Date: 02/27/2021
Rec V Date: 02/28/2021
Hospital:

Vax Type: HIBV
Manufacturer: MERCK & CO. INC.
Vax Name: HIB (PEDVAXHIB)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies: Sulfa/cefzil

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Covid arm. Red raised circle growing in size for the past 36 hours at injection site. Itchy. 13 weeks pregnant at time of vaccination. Other than ?advanced maternal age? no complications . EDD 9/2/21

Other Meds: Nature made pre natal vitamin

Current Illness: Impetigo on face

ID: 1061355
Sex: F
Age: 70
State: WA

Vax Date: 02/26/2021
Onset Date: 02/26/2021
Rec V Date: 02/28/2021
Hospital: Y

Vax Type: PNC13
Manufacturer: PFIZER\WYETH
Vax Name: PNEUMO (PREVNAR13)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies: none

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: within 1 hour started throwing up, continued for the next 12 hrs. Blood Sugar went to 700 and would not come down with long term and short term insulin. called 911, taken to Hospital ER. on feb. 27 @ 8:00 am Admitted and still is in ICU today 2-28-2021.

Other Meds: lisienpril, hydrochlorthiazide, potassium,

Current Illness: diabetes, high blood pressure, basal ganglia stroke

ID: 1061356
Sex: M
Age: 47
State: NJ

Vax Date: 02/26/2021
Onset Date: 02/26/2021
Rec V Date: 02/28/2021
Hospital:

Vax Type: RV1
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: ROTAVIRUS (ROTARIX)
Lot:
Dose Series: 1
Vax Route: PO
Vax Site: MO

Lab Data:

Allergies: Denies/ NKA

Symptom List: Blood pressure increased, Chest discomfort, Heart rate increased

Symptoms: 1:54 pm Post vaccination, reports feeling episode of chest tightness w/ no additional or associated symptoms; Monitor x 30 min w/ po hydration; BP 149/95 P123 RR 19 2:05pm BP 112/ 90 P90, reports "feels better and no longer anxious" ;post monitoring released from facility to home w/self

Other Meds: None reported

Current Illness:

ID: 1061357
Sex: F
Age: 82
State: CA

Vax Date: 02/23/2021
Onset Date: 02/26/2021
Rec V Date: 02/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Bacitracin Not Specified Rash Neomycin Not Specified rash Neosporin [neomycin-polymyxin] Not Specified Rash. Polymyxin B Not Specified rash Sulfamethoxazole Not Specified 2003-01-13;RASH PER PT

Symptom List: Injection site erythema, Injection site pruritus, Injection site swelling, Lymph node pain, Lymphadenopathy

Symptoms: Redness on arm, painful and itching

Other Meds: Prior to Admission Medications Outpatient Home Medications Taking? Alvesco 160 mcg/actuation Inhl HFAA Sig: Inhale 1 Puff by mouth 2 times a day for asthma prevention and control. Rinse mouth well after use Atorvastatin (LIPITOR) 20 mg Ora

Current Illness: no acute illnesses

ID: 1061358
Sex: M
Age: 74
State: HI

Vax Date: 01/25/2021
Onset Date: 02/15/2021
Rec V Date: 02/28/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NKA

Symptom List: Unevaluable event

Symptoms: Pericarditis with pericardial effusion.

Other Meds: Valsartan, ursadiol, citalopram, Montalukast, ASA, Ativan, tamsulosin, fluticasone

Current Illness:

ID: 1061359
Sex: F
Age: 29
State: VA

Vax Date: 02/26/2021
Onset Date: 02/26/2021
Rec V Date: 02/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Peanuts, fish

Symptom List: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

Symptoms: Onset of soreness around injection site within two hours; lingering soreness remains after ~60 hours; at peak, pain rating 6/10. Onset of general "ill" feeling within 4 hours (mild fatigue and body aches, sensitivity to sound). Physical discomfort increased overnight, reaching peak ~15-20 hours after injection but remaining severe throughout day 2 (unable to perform daily activities). 400mg ibuprofen every 6 hours helped to alleviate symptoms. ~15 hours after injection, sleep was interrupted by severe body aches along with nausea; followed within 30 minutes by vomiting.

Other Meds: Zyrtec, alprazolam 0.25mg, biotin

Current Illness:

ID: 1061360
Sex: F
Age: 49
State: NM

Vax Date: 02/27/2021
Onset Date: 02/27/2021
Rec V Date: 02/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: sulfa, keflex, shellfish

Symptom List: Injection site pain, Pain

Symptoms: arm swelling to the point I could not use it. It has now been 29 hours and movement is improving slightly. I went to bed at 630pm (4 hours after injection) and slept all night...woke for 3 hours and slept all day. I've experienced body, joint aches. This was my 1st dose. I'm hoping tomorrow is better. I read that the Moderna dose may be higher than what is needed. I am only 120lbs. I am afraid to get the second dose because I've read the 2nd dose is usually more intense reaction for most people.

Other Meds: none

Current Illness: none

ID: 1061361
Sex: F
Age: 55
State: CA

Vax Date: 02/24/2021
Onset Date: 02/25/2021
Rec V Date: 02/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Celiac

Symptom List: Injection site pain, Menorrhagia

Symptoms: Dizziness

Other Meds: none

Current Illness: none

ID: 1061362
Sex: M
Age: 35
State: TX

Vax Date: 02/26/2021
Onset Date: 02/27/2021
Rec V Date: 02/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Penicillin Cellcept Prograf Red cabbage Grapefruit

Symptom List: Arthralgia, Chills, Headache, Mobility decreased, Myalgia

Symptoms: Right shoulder pain (where I received the vaccine) Very very tired post 48 hours

Other Meds: Cyclosporine (Kidney/pancreas transplant) Prednisone Carvedilol Lisinopril Flomax

Current Illness:

ID: 1061363
Sex: F
Age: 68
State: NY

Vax Date: 01/21/2021
Onset Date: 01/23/2021
Rec V Date: 02/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: rash about the size of a baseball that both itched and was irritated. Nausaus

Other Meds: Hydrochlorothiazide Atorvastin Almodipine Bosylate Ezetimibe Klor-can Estrodial Metoprolol succer Estrodial Medroxyprogesteron Amitripiline iron

Current Illness: non

ID: 1061364
Sex: F
Age: 55
State: MA

Vax Date: 02/26/2021
Onset Date: 02/26/2021
Rec V Date: 02/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: CT dye Imodium Codeine

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Around 8-9 PM on 2/26 I began to experience tachycardia and could feel my heart racing. I went to bed hoping to sleep, but my sleep was restless. I checked my blood pressure around 3:30 AM on the 27th and it was 124/70 Pulse 113. At that point I decided to wait until the morning to contact my doctor rather than go to the hospital. I got up around 8 AM and my pulse was still fast, but had slowed down from the night before. By around 9:30 AM my heart rate had normalized. I did not go to the hospital or call my doctor as I believed things had subsided.

Other Meds: Atorvastatin 10 mg. Rainbow Light Women?s One Multivitamin Rainbow Light Calcium with Magnesium and Vitamin D3 Everyday Wellness Vitamin D-3 Psyllium Husk 500 mg

Current Illness: None

ID: 1061365
Sex: F
Age: 62
State: AL

Vax Date: 01/29/2021
Onset Date: 02/06/2021
Rec V Date: 02/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Everything subsided by 02/14/2021 Morphine and Demorol - Rash Cipro - indigestion Spinal nerve block: rash along spine and bad headache; 2nd spinal nerve block - badly swollen left thigh and leg. Antibiotic unknown - shin shed/peeled over entire body including hands and feet

Symptom List: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: 1st dose. - Moderna - rash around injection occurred 1 week later and progressed down injection side of upper arm including hard lump at injection. Area felt hot. Entire arm ached.

Other Meds: Vitamins daily: D3, B12, E Teas daily: Green, chai, Tumeric, Chamamil Bluegrass Zertec D

Current Illness: None

ID: 1061366
Sex: F
Age: 47
State:

Vax Date: 02/24/2021
Onset Date: 02/26/2021
Rec V Date: 02/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Keflex, nifedipine, penicillin

Symptom List: Nausea

Symptoms: nausea, vomiting, headache, fatigue

Other Meds: tacrolimus, prednisone, lisinopril, azathioprine, diltiazem

Current Illness: none

ID: 1061367
Sex: F
Age: 71
State: CA

Vax Date: 02/22/2021
Onset Date: 02/23/2021
Rec V Date: 02/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Keflex, yellow jackets venom

Symptom List: Injection site pain

Symptoms: Headache, muscle ache, nausea, injection site sore. Lasted 36 hours

Other Meds: None

Current Illness: None

ID: 1061368
Sex: F
Age: 66
State: NJ

Vax Date: 02/17/2021
Onset Date: 02/17/2021
Rec V Date: 02/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Bactrim, tree fruit (apples, peaches, pears, plums, etc.), green peas

Symptom List: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Headache began about 5 hours after getting vaccine. Chills, fever ranging from 100 - 102 degrees, terrible body aches and pain, and worsening headache lasted until about 10:00 p.m. the following day and then started to subside. Weak and tired on 2/19. Felt like having Covid all over again only worse because it came on suddenly. (Had Covid in March 2020).

Other Meds: Toprol XL, Folbic, Calcium, Viviscal, Vitamin C, Prolia

Current Illness: Cyst on my finger

ID: 1061369
Sex: F
Age: 28
State: CA

Vax Date: 02/26/2021
Onset Date: 02/27/2021
Rec V Date: 02/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: N/A

Symptom List: Chills, Dizziness, Nausea, Pain, Tachycardia

Symptoms: Mild fever, body aches, nausea, sore arm/red splotchiness/puffiness at injection site

Other Meds: Amitriptyline, orthotricylin lo, Claritin, citrucel, omeprazole

Current Illness: N/A

ID: 1061370
Sex: M
Age: 67
State: TX

Vax Date: 02/27/2021
Onset Date: 02/27/2021
Rec V Date: 02/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: PCN

Symptom List: Tremor

Symptoms: 1114 C/O SOB 4 MINUTES AFTER RECEIVENG SECOND MODERNA DOSE 1123 98% ROOM AIR 137/74 BP 72 HR PPT C/O SOB 4 MINUTES AFTER RECEIVING SECOND DOSE OF MODERNA VACCINE VITALS STAABLE, OC SAT 98R/A. PATIENT DOES NOT APPEAR TO BE IN DISTRESS. PATIENT GIVEN WATER TO DRINK. WILL CONTINUE TO MONITOR 1127 PATIENT REPORTS HE FEELS BETTER. INSTRUICTED PATIENT TO STAY IN OBSERVATION FOR AT LEAST 30 MINUTES, WILL FOLLOWUP WITH HIM BEFORE LEAVING. PATIEN ADVISED IF CHANGE IN PHYSICAL CONDITION ONCE LEAVING, NOTIFY PCP, IF LIFE THREATENING CALL 911 OR GO TO NEAREST ER

Other Meds: DM, CHOLESTEROL, HIV MEDICACION AND VITAMINS

Current Illness:

ID: 1061371
Sex: F
Age: 68
State: NY

Vax Date: 02/18/2021
Onset Date: 02/19/2021
Rec V Date: 02/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Erythema, Pruritus

Symptoms: sore arm, fever of 102, every muscle ached and it felt like I had been it by a mack truck, and slept most of day

Other Meds: Hydrochloorothiazide Atorvastin Almodipine Bosylate Ezetimibe Klor-can Metoprolol Succer Estrodial Mddroxyprogesteron Amitripiline iron

Current Illness: None

ID: 1061372
Sex: F
Age: 31
State: NC

Vax Date: 02/27/2021
Onset Date: 02/27/2021
Rec V Date: 02/28/2021
Hospital:

Vax Type: UNK
Manufacturer: UNKNOWN MANUFACTURER
Vax Name: VACCINE NOT SPECIFIED (NO BRAND NAME)
Lot:
Dose Series: UNK
Vax Route: SYR
Vax Site: UN

Lab Data:

Allergies: lanolin, cockroaches, pollen, rizitriptan, Beeswax, Diclofenac, Atenolol, Lyrica, fragrance 2, adhesive

Symptom List: Injection site erythema, Injection site induration, Injection site pruritus, Injection site swelling, Myalgia

Symptoms: At first dizzy. That subsided. Then feeling tired. I got my shot at 11:11am. By 5pm on 2/27, I was feeling malaised and then nauseous. By 8pm, I started having diarrhea, vomited, whole body itching. On 2/28 at 9:06pm, still having whole body itching treated with Benadryl and azelastine spray, running a low-grade fever of 99.8, body aches, occasional sweating, chills, warmth at injection site, knot at injection site, sore arm, fatigue, vomiting. Drinking Gatorade.

Other Meds: bacatracin, Vitamin D3, Magnesium, One a Day Prenatal with DHA, Xyzal, famotidine (missed dose), Florinef, Meloxicam, Azelastine, Montelukast, Clindamyacin swab, Montulukast (Missed dose), Clobetsol solution, Protonix, Santura, Betaxalol,

Current Illness: Minor Respiratory virus 10 days prior

ID: 1061373
Sex: F
Age: 59
State: TX

Vax Date: 01/28/2021
Onset Date: 02/19/2021
Rec V Date: 02/28/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NKDA

Symptom List: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: Patient had gradual onset of urinary retention and a mix of upper/lower motor neuron dysfunction. Currently going under workup for acute demyelinating polyneuropathy. Currently admitted to Medical Center, receiving Solumedrol, undergoing plasma exchange.

Other Meds: Flonase 1 spray into each nostril daily as needed Cetirizine 10 mg 1 tablet by mouth daily Fenofibrate 160 mg 1 tablet by mouth nightly Montelukast 10 mg 1 tablet by mouth daily Aspirin 81 mg 1 tablet by mouth daily Magnesium OTC Probiotic

Current Illness: None

ID: 1061374
Sex: M
Age: 84
State: MA

Vax Date: 02/05/2021
Onset Date: 02/25/2021
Rec V Date: 02/28/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Cephalexin

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Severe Vertigo lasting 12 hours requiring confinement to bed. Called ambulance and taken to Emergency Room. Treated with fluids and meclazine. Vertigo attributed to Vestibular Neuritis/labyrinthitis. This condition is often caused by a virus, however patient did not have any known virus prior to onset of symptoms.

Other Meds: Simvistatin 40 mg and 20 mg Mirtazipine 45 mg Levothyroxine 150 mcg Valsartan and hydrochlorothiazide 80 mg/12.5mg Venlafaxin hcl 25 mg Lamotrigne 100 mg Tamsulosin hcl .4 mg

Current Illness:

ID: 1061375
Sex: F
Age: 67
State: WA

Vax Date: 02/01/2021
Onset Date: 02/03/2021
Rec V Date: 02/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Clinoril

Symptom List: Injection site erythema, Injection site pain, Injection site swelling

Symptoms: I experienced onset of a severe headache and vomiting (x2, small amounts) the day after (2/2/2021)receiving the vaccine at noon-3pm. That evening as the headache resolved, i noticed that the corners of my mouth and the area below my lips were sore and hard to the touch. These are all areas where i had fillers injected in the past (August 11, 2020). Restylane was the filler, i think. The symptoms i experienced felt exactly like when i received the injections in August 2020. The symptoms were gone by the next evening. I called my dermatologist when i saw on the CDC Moderna training site (i'm a Public Health Nurse volunteer vaccinator) that this "rare" side effect should be reported. She refused to file a VAERS report and told me that my symptoms were because i had vomiting and the muscles around my mouth were irritated, and that it was not from inflammation or a side effect of the vaccine.

Other Meds: None

Current Illness: None

ID: 1061376
Sex: F
Age: 25
State: NJ

Vax Date: 02/19/2021
Onset Date: 02/27/2021
Rec V Date: 02/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Zithromax Sulfa Bactrim Imatrex Benzoyl peroxide

Symptom List: Chills, Feeling cold, Feeling hot, Myalgia, Pain

Symptoms: 1 week and 1 day later it was noted while showering that there was a 2 in red raised mark surrounding the injection site that was itchy. 2 days prior to red mark appearing I was experiencing extreme headaches, fatigue, sore throat, and swollen lymph nodes. At this time on 2/28/2021, I still have the raised red mark on my area but it has lightened and it is still itching. My lymph nodes are still swollen and a headache is still present as well as fatigue but the sore throat has mostly resolved.

Other Meds: Sharobel 0.35mg tablet once daily Propranolol ER 80 mg capsule once daily Topiramate 50 mg tablet twice daily

Current Illness: N/A

ID: 1061377
Sex: F
Age: 51
State: AL

Vax Date: 02/28/2021
Onset Date: 02/28/2021
Rec V Date: 02/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: ?

Symptom List: Pain in extremity

Symptoms: Patient had a mild reaction to the first injection. There was no apparent distress upon arrival in parking lot. At 15:30 the patient wants to leave and denies complaints with no apparent distress. The patient is instructed to continue medicine if necessary and if conditions worsen go to the ER.

Other Meds: ?

Current Illness: ?

ID: 1061378
Sex: F
Age: 36
State: VA

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 02/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: none known

Symptom List: Abdominal pain upper, Abnormal behaviour, Adverse reaction, Anger, Asthma

Symptoms: metallic taste in mouth numbness in left side of face, mostly cheek area from approximately 2PM and resolving around 8PM. 400mg Tylenol was taken at 5PM.

Other Meds: VItamin D Vitamin C Zinc

Current Illness: none

ID: 1061379
Sex: F
Age: 79
State: AZ

Vax Date: 02/26/2021
Onset Date: 02/27/2021
Rec V Date: 02/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Iodine

Symptom List: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: Began running low grade fever next morning, by evening the temp was 100 . I had no energy an began to fall asleep in the early evening.. Woke up in a sweat. Felt exhausted all the next day but temperature left. Should be almost normal by tomorrow. I hope.

Other Meds: Hydroxurea, mesalamin, Irbesartan,carvedilol, Travatan, vitamin, calcium, Vitamin D, Adult 50+ eye vitamin

Current Illness:

ID: 1061380
Sex: F
Age: 76
State: IA

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 02/28/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: ciprofloxacin, hydrocodone, indomethacin, levofloxacin, menthol, methyl salicylate, morphine, plastic tape, penicillin, vancomycin

Symptom List: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: Received the vaccine & the next day became very weak and ill with throwing up. Her sister came to visit and noticed her right face was drooping & her balance was off so she called ambulance. Subsequently has been hospitalized for a month with a heart failure exacerbation that has led to ICU care, sepsis with Klebsiella pneumonia, acute kidney injury now with long term dialysis, hyponatremia, & elevated liver enzymes

Other Meds: aspirin, atorvastatin, calcium, vit. D, diltiazem, doxycycline hyclate, Jardiance, furosemide, gabapentin, novolog, lantus, levothyroxine, magnesium oxide, potassium chloride, spironolactone, warfarin

Current Illness: Had Covid October 2020 with only symptoms reported being weakness. Had a small stroke with no residual effects at the time, unsure if related to Covid.

ID: 1061381
Sex: F
Age: 17
State: LA

Vax Date: 02/27/2021
Onset Date: 02/27/2021
Rec V Date: 02/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: Moderna COVID-19 Vaccine EUA Underage patient was inappropriately vaccinated with Moderna product; no adverse effects

Other Meds:

Current Illness:

ID: 1061382
Sex: F
Age: 41
State: CO

Vax Date: 02/19/2021
Onset Date: 02/25/2021
Rec V Date: 02/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Injection site red, swollen, itchy, painful a week after injection.

Other Meds: None

Current Illness: None

ID: 1061383
Sex: F
Age: 65
State: TX

Vax Date: 02/27/2021
Onset Date: 02/27/2021
Rec V Date: 02/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Back pain, Cold sweat, Headache, Nausea, Vomiting

Symptoms: SHE FELT PAIN WHEN THE NEEDLE WAS STUCK IN THE BONE AND FELT NUMBNESS IN HER FINGERS FOR ABOUT 10 MINUTES. BP 169/83 PULSE 76 O2 96% REPEAT BP AFTER 10 MINUTES 144/73 HR 76 O297% PATIENT STAYEDN IN OBSERVATION FOR 30 MINUTES, STATES AFTER 30 MINUTES, NO NUMABNESS NOTED ANYMORE. PT VSS. PT DENIES SOV OR C/P GIVEN INSTRUCTIONS TO NOTIFY PCP IF NUMBNESS RETURNS

Other Meds:

Current Illness:

ID: 1061384
Sex: F
Age: 52
State: NY

Vax Date: 02/28/2021
Onset Date: 02/28/2021
Rec V Date: 02/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NO

Symptom List: Injection site swelling, Limb discomfort

Symptoms: This is my 3rd time trying to complete the form. Quick version. 8 hours later I'm experiencing soreness and discomfort in the my left arm. Pain occured when shot was administered. I felt needle moving in mass/muscle. The pain increased the longer the needle was inserted. I actually let out a muffled yell at the same time the nurse removed needle. The pain is a 6/7 on a scale of 10. I cannot lift my arm without experiencing pain. When I walk my left side/shoulder is lowered. The left side feels weighted.

Other Meds: Eye prescription -- Timolol 0.5%

Current Illness: NO

ID: 1061386
Sex: F
Age: 62
State: PA

Vax Date: 02/08/2021
Onset Date: 02/26/2021
Rec V Date: 02/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Chills, Diarrhoea, Fatigue, Feeling abnormal, Headache

Symptoms: Itchy red Rash on neck started c. 18 days after 2nd shot (unclear if related to vaccine but highly unusual for me)

Other Meds:

Current Illness:

ID: 1061387
Sex: F
Age: 27
State: NJ

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 02/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Amoxacilian

Symptom List: Hot flush, Myalgia, Nausea, Tension headache

Symptoms: Stomach pain. Diarrhea. Headaches. Nausea. Wheezing. Troubling breathing. Mucus. pain in lungs when breathing.

Other Meds: none

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm