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: 1063071
Sex: F
Age: 37
State: NJ

Vax Date: 02/03/2021
Onset Date: 02/04/2021
Rec V Date: 03/01/2021
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: codeine, benadryl

Symptom List: Dysphagia, Epiglottitis

Symptoms: skin rash in multiple parts of body, arms, inner thighs, behind legs, foot, forearm, shoulder, behind legs, -rash is red and raised and still present as of today. it does not itch, burn, sting or ooze.

Other Meds: flecainide acetate 50mg daily, larin 24 fe, 1 tablet daily

Current Illness: none

ID: 1063072
Sex: M
Age: 78
State: MT

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 03/01/2021
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: none

Symptom List: Anxiety, Dyspnoea

Symptoms: Muscle pain - since day after injection. 3 or 4 200mg ibuprofen eases pain, when moving, for 4 or 5 hours.

Other Meds: none

Current Illness: none

ID: 1063073
Sex: F
Age: 73
State: TX

Vax Date: 02/26/2021
Onset Date: 02/26/2021
Rec V Date: 03/01/2021
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: NO known drug allergies

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

Symptoms: Patient called after getting home that she has pain at the injection site, and a golfball sized amount of fluid collecting at her elbow.

Other Meds: unknown

Current Illness: none

ID: 1063074
Sex: F
Age: 64
State:

Vax Date: 02/09/2021
Onset Date: 02/09/2021
Rec V Date: 03/01/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Patient presented to the post vaccine observation room. After 30 minutes c/o chills and headache 5/10. vitals where taken as noted and patient assessed. Pt was encouraged to check in to urgent care here at the hospital. Patient refused to further assessment and treatment. Patient stated "I am calling my husband to pick me up". Patient was advised to wait sitting and notify medical personal of any worsening feeling immediately.

Other Meds:

Current Illness:

ID: 1063075
Sex: F
Age: 78
State: VA

Vax Date: 02/25/2021
Onset Date: 02/26/2021
Rec V Date: 03/01/2021
Hospital:

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

Lab Data:

Allergies: Latex, milk (mild)

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

Symptoms: After the second shot, I expected mild side effects and experienced some: mild headache, sore left arm around injection site, fatigue, brain fog. I was walking to my garage with a small package of papers when suddenly my lower back spasmed sharply. The pain was intense. I thought it would subside so I managed, with difficulty, to make it into my car. When I was seated in the car, the spasms subsided. I considered not driving to my two errands but decided that I felt well enough seated in the car to drive and deliver the papers to my tax preparer and the carful of donations to Goodwill. At the tax office, I called an assistant to come to the parking lot to pick up the papers, which she did. At Goodwill, one of the attendants emptied my car. When I got home at about 10:50, I had to call my husband to help me into the house. I spent the next several hours in agony (11 on a scale of 1-10) with spasms, punctuated by absolutly not moving. The spasms were so bad I could not breathe. My doc prescribed a muscle relaxer, then the next day prednisone, which has helped. Today I will have an mri to determine if the spasms herniated a disc.

Other Meds: Symbacort, levothyroxine, welchol, nuedexta

Current Illness: spinocerebellar ataxia type8

ID: 1063076
Sex: F
Age: 67
State: OH

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 03/01/2021
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: unknown

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

Symptoms: RN was staffing a Covid clinic at HS. One of our other nurses gave her the 1st Moderna vaccine at 1:45 PM on 2/12/21. At 1:55 PM, the nurse who had given her shot noticed that patient was pale, and said she was not feeling well. Her BP was 179/110, and she said she usually has low BP. She c/o of "feeling hot and was having difficulty breathing." She was seen by our medical director. After 30 minutes, her BP was 120/82. She said she ?felt a little better and called her sister to pick her up.? Later that evening, patient texted me saying I didn?t feel well when I got home, had trouble focusing literally and had a crying jag and felt shaky on the inside. I kept hydrating, took 25 of Benadryl and slept for 2 hrs., now feel close to normal. It was definitely a reaction to the shot-just weird!? Patient texted me on 2/13/21 that ?the FDA thinks one vaccine may be enough for 80?90% effectiveness, so I might not get the 2nd dose? On 2/15/21 patient texted, ?My PCP thinks what I had was a side effect & recommends taking Benadryl, Zyrtec, or Tylenol before the 2nd injection, and doesn?t seem to be worried about it!? On 2/19/21, I received a text from patient at 5:28 AM as she was scheduled to staff a Covid clinic that day, beginning at 7:30 AM. She said, ?I have been up for a couple hrs w/severe eye pain and can?t hardly open my eye but it hurts to close it too! At 10:37 AM she texted, ?I just got home from eye doctor and was prescribed drops 4X/day. Apparently, there are pin holes in my sclera & cornea which hurt so bad I had lavender cold pack on all day & couldn?t stand the light. It is a corneal abrasion & I have no idea why that would happen suddenly?. The following day, she texted me a picture of her L arm injection site which she said was ?very itchy and hot! Not painful-? It was about 6 inches in diameter, red, inflamed, delayed cutaneous rx.

Other Meds: unknown

Current Illness: unknown

ID: 1063077
Sex: F
Age: 74
State: CA

Vax Date: 02/27/2021
Onset Date: 02/28/2021
Rec V Date: 03/01/2021
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:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Pt presented to hospital via ambulance with cardiac arrest after a CC of SOB. Pts sister who spoke with her two days ago stated she was in normal state of health and just got her 2nd dose of the covid vaccine. Unknown which manufacturer.

Other Meds: ASA 81mg, Atorvastatin 40mg, Lasix 20mg BID, Lisinopril 5mg, Metoprolol XL 25mg, Nitroglycerin Acetaminophen, Albuterol Inhaler, B complex Vitamine, Calcium Carbonate, Vitamin D, Claritin, Ketoconazole 2% cream, Nystatin Powder, triamcinolo

Current Illness:

ID: 1063078
Sex: F
Age: 71
State: CA

Vax Date: 02/26/2021
Onset Date: 02/26/2021
Rec V Date: 03/01/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: patient received incorrect dose. Not sure exactly how much but it was less than the required 0.3ml.

Other Meds:

Current Illness:

ID: 1063079
Sex: F
Age: 74
State: MD

Vax Date: 02/13/2021
Onset Date: 02/25/2021
Rec V Date: 03/01/2021
Hospital:

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

Lab Data:

Allergies: Decadron

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: lightheadness, palpitations, hypertension

Other Meds: Vit D3, Macuhealth, Osteo Bi-Flex, Mature vitamin, Calcium600mg Krills okl 500mg,

Current Illness: none

ID: 1063080
Sex: F
Age: 47
State: OH

Vax Date: 02/27/2021
Onset Date: 02/27/2021
Rec V Date: 03/01/2021
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: Sesame

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Patient experienced headache, fatigue, muscle aches, joint pains, nausea, and local injection site pain

Other Meds: Zyrtec, esidrix, Imitrex, Lexapro, azelastine

Current Illness: None

ID: 1063081
Sex: F
Age: 57
State:

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

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

Lab Data:

Allergies:

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

Symptoms: 57 year old female who presents for brief focused urgent care visit, with a complaint of lightheadedness after receiving COVID vaccine. She reports she is diabetic and on insulin, and only had a small salad for lunch today. Her husband checked blood sugar and was found to be hypoglycemic in the low 50's. Patient began drinking orange juice and felt better after. She denies chest pain, SOB, difficulty breathing or swallowing, itching, swelling in throat, rash, visual disturbances, slurred speech, numbness or tingling of extremities. Patient re-checked blood sugar with her own glucometer and it was 103 prior to discharge. Symptoms completely resolved. Appropriate actions taken; no further action at this time.

Other Meds:

Current Illness:

ID: 1063082
Sex: F
Age: 41
State: AZ

Vax Date: 01/26/2021
Onset Date: 01/28/2021
Rec V Date: 03/01/2021
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: no known allergies

Symptom List: Rash, Urticaria

Symptoms: 2 days after my first injection I was having a lot of knee pain and trouble walking. I got the second injection and am having increasing pain and swelling in both knees.

Other Meds: tylenol

Current Illness: none

ID: 1063083
Sex: F
Age: 69
State: KS

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 03/01/2021
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: Swelling in joints. Unable to raise arms or use hands for several days. Pain threw out body, Length of time was 2/10/2021 to 2/27/2021. On 2/28/2021 just feeling better and off Tylenol Extra Strength.

Other Meds: Benazepril, 20mg daily Amiodipine Besylate, 5mg, daily Atorvastatin, 40mg, daily Omeprazole, 20mg, 2 daily Buspirone, 10mg, 2 daily Famotidine, 40mg, daily Extra Strength Tylenol, as needed Vitamin C, 500mg daily Vitamin D3, 25mcg, daily Am

Current Illness:

ID: 1063084
Sex: F
Age: 66
State:

Vax Date: 02/12/2021
Onset Date: 02/19/2021
Rec V Date: 03/01/2021
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: Latex

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

Symptoms: Feb. 19: onset of itchiness at injection site Feb 20: itchiness with red swollen patch (3.25"x2.25") at injection site Feb 22: severe itchiness with red, hot to the touch, increased swollen patch at injection site Feb 23-Feb 24: milder itchiness with red swollen patch and vicious looking rash at injection site Feb 25-Feb 28: slowly decreasing itchiness and swelling as well as less vicious looking rash at injection site Mar 1: No longer itchiness, swelling and very mild lingering rash at injection site

Other Meds: glucosamine chondroitin; bone strength vitamin; biotin; Alendronate (weekly)

Current Illness: None

ID: 1063085
Sex: F
Age: 67
State: TX

Vax Date: 03/01/2021
Onset Date: 03/01/2021
Rec V Date: 03/01/2021
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: NKDA or to any other things

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

Symptoms: Patient reported that she was dizzy, SOB, blurred vision, rapid heart beat.

Other Meds: Olmesartan, omeprazole, levothyroxine was taken this morning.

Current Illness: none

ID: 1063086
Sex: M
Age: 17
State: OR

Vax Date: 02/26/2021
Onset Date: 02/26/2021
Rec V Date: 03/01/2021
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:

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

Symptoms: Patient received both doses of Moderna Vaccine and he is under 18 (17 years 8 months),

Other Meds:

Current Illness:

ID: 1063088
Sex: F
Age: 72
State: CO

Vax Date: 02/26/2021
Onset Date: 02/26/2021
Rec V Date: 03/01/2021
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: can't take tylenol

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

Symptoms: I ache all over, have no energy my chest hurts, bloody nose, sweating, fever and chills.... in general I feel like I have been poisoned.

Other Meds: levothyroxine 25 mcg,, Pentoprazole sodium ec 20 mg tab, Montelukast Sodium tablets 10 mg

Current Illness: no

ID: 1063089
Sex: M
Age: 66
State: WA

Vax Date: 02/26/2021
Onset Date: 02/27/2021
Rec V Date: 03/01/2021
Hospital:

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

Lab Data:

Allergies: No

Symptom List: Ear pain, Hypoaesthesia

Symptoms: At 12:30 that night I woke and I felt like to throw up and diarrhea at the same time. I had a terrible headache, dizziness, nausea. I had chills. The next day I was still very, very sick and had a fever of a hundred degrees. And I was sick all day Saturday. Unable to hold down any water. Sunday morning it broke and I was starting to come out of it. Today I'm not feeling 100% but much, much better.

Other Meds: losyonepril 40 mg

Current Illness: No

ID: 1063090
Sex: F
Age: 48
State: TX

Vax Date: 02/24/2021
Onset Date: 02/25/2021
Rec V Date: 03/01/2021
Hospital:

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

Lab Data:

Allergies: Metformin

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Pt. received second dose of Pfizer vaccine on 2/24/2021, on 2/25/2021 at 12:30 pm she stated she became flushed and was nausea's. Went to put her head down on desk, head hit desk and she fell to her knees. Pt. unsure if she lost consciousness. She described going form extremely hot to cold. Ambulance called and taken to ER

Other Meds: Atorvastatin 20 mg daily Prilosec 40 mg daily Losartan 25 mg daily Calcium 500 mg daily Vitamin C 500 mg daily Potassium 20 meq 3 times daily Omega 3-6-9 1200 mg daily Vitamin E 400 mg daily Iron 65 mg daily Glimiperide 4 mg daily Prozac 20

Current Illness: UTI, 3 weeks prior to second dose.

ID: 1063091
Sex: F
Age: 60
State: PA

Vax Date: 02/27/2021
Onset Date: 02/28/2021
Rec V Date: 03/01/2021
Hospital:

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

Lab Data:

Allergies: Penicillin, Ibuprofen, Ceclor

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

Symptoms: Dizziness, feeling like in fog, chills, fatigue, fever to 100.9, headache, pain in arm of injection. Began about 04:00 AM on 2/28/21 and lasted until about 11:30 on 3/1/21 AM

Other Meds: Benedryl

Current Illness: None

ID: 1063092
Sex: M
Age: 57
State: OH

Vax Date: 01/18/2021
Onset Date: 01/19/2021
Rec V Date: 03/01/2021
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: Contact reaction to antibacterial soaps

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

Symptoms: Developed diarrhea, joint aches and fever leading to being unable to work for the next two days

Other Meds: Unknown

Current Illness: Unknown

ID: 1063093
Sex: F
Age: 68
State: LA

Vax Date: 02/07/2021
Onset Date: 02/08/2021
Rec V Date: 03/01/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List: Unevaluable event

Symptoms: severe chills nausea low grade fever stomach cramps PASSED OUT/Fainted

Other Meds: vitamin B12 vitamin D3 zinc sulfate Aleve

Current Illness: cold symptoms with stuffy nose and sore throat - no fever

ID: 1063094
Sex: F
Age: 80
State: NH

Vax Date: 02/19/2021
Onset Date: 02/23/2021
Rec V Date: 03/01/2021
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: penicillin sulfa antibiotics

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

Symptoms: Intense itching and redness in a 4 to 41/2 inch circle on upper left arm around injection site. Very warm to the touch. Used Benadryl, Tylenol for first two days. Also wet wash cloth on red area at frequent intervals. After 2 days redness began to disappear.

Other Meds: Propranolol Levothyroxine

Current Illness: none

ID: 1063095
Sex: F
Age: 25
State: NY

Vax Date: 01/15/2021
Onset Date: 02/26/2021
Rec V Date: 03/01/2021
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: None

Symptom List: Injection site pain, Pain

Symptoms: Patient sustained a delayed hypersensitivity reaction to hyluronic acid filler injections in her tear trough. She was injected with Restylane-L on 2/23 and on 2/26 her right eye was red and itchy. She was given theratears lubricating eye drops when the symptoms presented themselves, which made the redness go away within 2 hours. After 24 hours all redness and itching was gone.

Other Meds: Junel FE birth control

Current Illness: None

ID: 1063096
Sex: F
Age: 79
State: KY

Vax Date: 02/24/2021
Onset Date: 02/25/2021
Rec V Date: 03/01/2021
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: Injection site pain, Menorrhagia

Symptoms: Rash started the day after and generalized body pain at this time.

Other Meds: vitamin D 50,000 units once a week Meclizine 25mg as needed levothyroxine sodium 75 mg once per day potassium chloride once per day atorvastatin 10 mg once per day hydrochlorothiazide 12.5 mg per day

Current Illness: None

ID: 1063097
Sex: M
Age: 63
State: LA

Vax Date: 02/13/2021
Onset Date: 02/27/2021
Rec V Date: 03/01/2021
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: N/A

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

Symptoms: Rash on the upper left arm around injection. Red, warm slightly itchy.

Other Meds: Toujeo Metformin Avastatin 81mg aspirin Fish oil

Current Illness: None

ID: 1063098
Sex: F
Age: 56
State: IL

Vax Date: 02/03/2021
Onset Date: 02/09/2021
Rec V Date: 03/01/2021
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 known

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: On February 9, my right arm began to itch and when I went home at lunch, I looked and there was a small rash forming. On February 10, the rash was larger, so I went to my workplace walk-in clinic. They suggested Benadryl, Zyrtec, and prescribed an antibiotic. The rash got larger - almost from my shoulder to elbow. After 3 - 4 days, the rash started to go away. My skin was yellowish for 3 - 4 more days before it finally cleared to normal around February 17, 2021. On February 19, I woke up and had a rash over my entire body with the exception of where the earlier rash was on my right arm. That spot was perfectly clear. About 2:00 I went to Urgent Care. I received a steroid injection, was prescribed prednisone and levocetirizine and told to take Benadryl, soak in oatmeal baths and use Aveeno lotion. MD said it was hives. It worsened Sunday, February 20, and then gradually began to fade Monday and through the week. Today, March 1, 2021, I still have splotches on my skin but it is mostly clear.

Other Meds: None

Current Illness: None

ID: 1063099
Sex: M
Age: 23
State: MS

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

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

Lab Data:

Allergies: NA

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Patient fainted post injection. He stated that he had anxiety and felt like his blood sugar might have dropped. EMTs checked him over and patient declined treatment.

Other Meds: NA

Current Illness: NA

ID: 1063100
Sex: F
Age: 70
State: FL

Vax Date: 02/26/2021
Onset Date: 02/27/2021
Rec V Date: 03/01/2021
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: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: Day after vaccine L arm red, swollen, and itchy at the injection site and mild achiness. Third day post vaccine I had hives. Took benedryl as had been recommended through out the day.

Other Meds: Ursodiol. Escitalopram. Biotin Hydroxyzine multivitamin CoQ10 Sucralfate. Calcium Trazadone. Vit E Premprexidol. Vit D3

Current Illness:

ID: 1063101
Sex: M
Age: 63
State: MN

Vax Date: 02/03/2021
Onset Date: 02/16/2021
Rec V Date: 03/01/2021
Hospital:

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

Lab Data:

Allergies: No allergies

Symptom List: Nausea

Symptoms: Diagnosed with Bells Palsy

Other Meds: Metformin; Victoza. lisinopril; lasix; farxig a; Lipitor

Current Illness:

ID: 1063102
Sex: F
Age: 32
State: MI

Vax Date: 01/06/2021
Onset Date: 01/07/2021
Rec V Date: 03/01/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Injection site pain

Symptoms: Sore arm, fever of 100.0

Other Meds: None

Current Illness: None

ID: 1063103
Sex: F
Age: 53
State: WI

Vax Date: 02/08/2021
Onset Date: 02/08/2021
Rec V Date: 03/01/2021
Hospital:

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

Lab Data:

Allergies: demurral, vancomycin, codeine

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

Symptoms: Nausea, chills, vertigo, tired, rash over body developed two days after vaccine

Other Meds: Allegra, 81 mg aspirin, D3, multi vitamin, vitamin C, Zinc, montelukast, verapamil, probiotic, spironolactone

Current Illness:

ID: 1063104
Sex: F
Age: 76
State: CA

Vax Date: 02/13/2021
Onset Date: 02/20/2021
Rec V Date: 03/01/2021
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: Augmentin pill (rash), Sulfa drug (? childhood note), ciprio (dizziness)

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

Symptoms: Initial day not problematic. On the 8th day I developed a 2 inch oval spot of redness at the injection site, plus heat and itching , swellling and soreness. This all dissapated after 4 more days.

Other Meds: Levothyroxin, Metformin, Ibuprophin, "Move Free", One-a-day Women's vitamin, Lasartan

Current Illness: 0

ID: 1063105
Sex: F
Age: 70
State: TN

Vax Date: 02/24/2021
Onset Date: 02/26/2021
Rec V Date: 03/01/2021
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: Predisone

Symptom List: Tremor

Symptoms: Headache after injection- 2/24/21 Lasted for 2 days Headache/ extreme fatigue, neck pain, extreme left arm soreness, back pain, 2/25/21 Headache/ fatigue/ body aches - morning of 2/26/21 Rapid heart rate up to 128 bpm sitting still, rapid breathing, tight throat, low blood pressure. These symptoms began afternoon of 2/26/21 and lasted at least 5 hours.

Other Meds: Allopurinol, Enalaparil Maletate, Hydorclorthyzide,Levothroxine Sodium Tab, Metformin

Current Illness: None

ID: 1063106
Sex: F
Age: 76
State: IN

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 03/01/2021
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: Prevnar 13

Symptom List: Erythema, Pruritus

Symptoms: 2 rash spots; dark red fading to medium red; itching; fluish symptoms for 4 days.

Other Meds: Gabapentin 600mg 3xper day. These prescriptions are all for 1x per day: Tradjenta 5mg; Metoprolol Succinate ER 50mg; Lisinopril 40 mg; Chlorthalidone 25mg; Myrbetriq ER 50mg

Current Illness: None

ID: 1063107
Sex: F
Age: 70
State: CA

Vax Date: 02/01/2021
Onset Date: 02/27/2021
Rec V Date: 03/01/2021
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: Penicillin, bee stings

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

Symptoms: This was my second dose. The reaction began during the night after my 2:00 PM vaccination. Bright red rectangular spot about 5 inches wide by 2 inches tall an inch below vaccination site. Arm is swollen and tender to touch, and it Itches severely, This also happened after my first dose but I mistakenly thought I?d been bit by a spider after the vaccination. The first time, it took about five days to stop itching, and for the swelling to go down.

Other Meds: Synthroid, keppra

Current Illness: None

ID: 1063108
Sex: F
Age: 70
State: OR

Vax Date: 02/23/2021
Onset Date: 02/23/2021
Rec V Date: 03/01/2021
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: sulfa

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

Symptoms: sore arm, headache, tired, stomach cramps, diarrhea-2 days, has subsided

Other Meds: n/a

Current Illness: n/a

ID: 1063109
Sex: M
Age: 77
State: WA

Vax Date: 02/15/2021
Onset Date: 02/21/2021
Rec V Date: 03/01/2021
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:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Developed Belle's Palsey on left side of face exactly one week after first shot. Doctor says it may or may not come from the vaccine.

Other Meds: 81 mg Aspirin, 20mg Omeprazole, 25mg Losartan, 1200/25D3mcg Calcium, 1000mg Vitamin C, 20mg Simvastatin, 2mg Terazosin, 1200mg/360 Omega 3 Fish Oil, 1000mg Flax Oil

Current Illness:

ID: 1063110
Sex: F
Age: 53
State: MD

Vax Date: 02/13/2021
Onset Date: 02/21/2021
Rec V Date: 03/01/2021
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: NA

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

Symptoms: Covid Arm: Lump, warm, redness, and itch around injection site on days 8-12

Other Meds: Elderberry, Vitamin D, Biotin, Fish Oil

Current Illness: NA

ID: 1063111
Sex: F
Age: 50
State: KY

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 03/01/2021
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: Viaxin, Leviquin

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

Symptoms: Almost immediately after I got a massive firey headache, numbness and tingling down the left arm and down the left side of my face. I developed a massive stomach ache which all lasted about 3 hrs. I reached out to my pcp who advised benedryl, pepcid and claritin to help and the benedryl and pepcid took away the numbness and tingling but the headache lingered along with terrible dizziness also. The next day and still since I still have terrible headaches an dizziness, the dizziness has gotten better but is still there.

Other Meds: Gavapatin, Topomax, Zoloft, Cyntroid, Baby Aspirin

Current Illness: No

ID: 1063112
Sex: F
Age: 66
State: NJ

Vax Date: 02/12/2021
Onset Date: 02/24/2021
Rec V Date: 03/01/2021
Hospital:

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

Lab Data:

Allergies: Levaquan

Symptom List: Pain in extremity

Symptoms: Red rash surrounding injection site. Rash is about 4 inches by 6 inches

Other Meds: Atorvastaton Ramipril Travatan Z 81MG Aspirin

Current Illness:

ID: 1063113
Sex: F
Age: 65
State: OH

Vax Date: 02/26/2021
Onset Date: 03/01/2021
Rec V Date: 03/01/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: Presents with nosebleed and diffuse petticae. Also has epistaxis and thrombocytopenia. Pateitn reports symptoms for 2 days.

Other Meds: pravastain, lisinopril/HCTZ, levothyroxine

Current Illness:

ID: 1063114
Sex: F
Age: 83
State: OH

Vax Date: 02/23/2021
Onset Date: 02/26/2021
Rec V Date: 03/01/2021
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: None

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

Symptoms: 3 days after the second COVID-19 vaccine the patient developed a large painful, red, and hot rash on the left upper arm. This included around the injection site but it also occurred lower on the arm with normal skin in between. Treatment will include ice and antibiotics due to the patient's extreme neutropenia.

Other Meds:

Current Illness: Neutropenia

ID: 1063115
Sex: F
Age: 62
State: OR

Vax Date: 02/16/2021
Onset Date: 02/16/2021
Rec V Date: 03/01/2021
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: "cisytic acid" rash typhoid -> hospital, 2nd shot, no third

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

Symptoms: Client received at 21 days instead of 28 days. Scheduling error.

Other Meds: not reported

Current Illness: none

ID: 1063116
Sex: M
Age: 80
State: IL

Vax Date: 02/22/2021
Onset Date: 02/26/2021
Rec V Date: 03/01/2021
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: no

Symptom List: Vomiting

Symptoms: i HAD RADIATION ON MY SKIN IT WAS HEALING AND AFTER I TOOK THE SHOT IT BECAME INFLAMED. tHE DOCTOR TOLD ME TO TURN IT IN

Other Meds: folic acid , b12, thyroid med

Current Illness:

ID: 1063117
Sex: F
Age: 73
State: CO

Vax Date: 02/19/2021
Onset Date: 02/19/2021
Rec V Date: 03/01/2021
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:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Syringe/Needle malfunctioned during injection. Pt. was given a half dose as the syringe/needle did not make a good connection and only half the dose went into the patient arm. (The syringe and needle kept spinning). An 11th dose was able to be pulled from the vial, and the patient was given another half dose to complete her vaccination series.

Other Meds:

Current Illness:

ID: 1063118
Sex: F
Age: 94
State: MN

Vax Date: 02/26/2021
Onset Date: 02/26/2021
Rec V Date: 03/01/2021
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: unknown - says may have had reactions in the past to other shots such as a swollen tongue and fast heartbeat

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

Symptoms: States had felt her heart beating fast, had a swollen tongue and a weird feeling. PHN checked BP and was 142/84, pulse 94 apically, O2 sats 94% on RA. Patient stated that the feeling lasted for just a minute. PHN gave juice to patient after checking vitals and she stated she felt much better. Asked if would like some Benadryl and she said she took an allergy medication this morning as part of her normal routine. Patient also stated she has a history of an irregular heart rhythm. She stated she ate well for breakfast this morning to ensure she did not have a low blood sugar while waiting for her shot. Note time of incidence at 1139am and had not eaten since breakfast. Patient stated she was fine to go home after her 30 minute wait time. Her VS were good at this time. PHN requested that patient contact her PCP if there were any further concerns following her leaving the site for the vaccination.

Other Meds: medications for irregular heartrate, diabetes, allergy pill

Current Illness:

ID: 1063119
Sex: F
Age: 26
State: NJ

Vax Date: 02/26/2021
Onset Date: 02/26/2021
Rec V Date: 03/01/2021
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: Sulfa based antibiotics

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Fever, severe shaking, muscle aches, severe headache, pain in chest and abdomen, nausea, vomiting. Started around 10pm 12/26, mostly subsided by 9pm the next day.

Other Meds: None

Current Illness:

ID: 1063120
Sex: M
Age: 38
State: IL

Vax Date: 01/08/2021
Onset Date: 01/11/2021
Rec V Date: 03/01/2021
Hospital:

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

Lab Data:

Allergies: penicillin (?)

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

Symptoms: 1/8 vaccination Almost 72 hours later, fatigue, itching in a few spots, I saw hives/welts on couple different areas on upper arms, upper thighs. Very big and itchy. I took some Claritin. Those welts continued to grow and spread; Upper inner arms, flanks, inner thighs. Continued throughout the night *took pictures of welts Took some Benadryl at night. Woke up; symptoms still there and extended even more to include hands. I went to work. I wasn't feeling ill but uncomfortable. Took some more antihistamines. It got worse thru the day. No SOB. 1/12 noon Different kind of rash, petechia in appearance.; shins. My knees, ankles, feet were starting to swell. Hives had gone from the thighs and up, But below, shins to feet, were swelling. 1/13 I woke up to a lacy rash over all extremities. Bruising on shins. Knees, hands and feet still swollen. Started Oral steroid. By noon that day, pretty much everything had cleared up. Six day course treatment, no symptoms came back. No fever. No SOB. I did miss work the 1/13 as it was at its worse.

Other Meds: n/a

Current Illness: n/a

ID: 1063121
Sex: M
Age: 65
State: WI

Vax Date: 02/25/2021
Onset Date: 02/26/2021
Rec V Date: 03/01/2021
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:

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

Symptoms: sore arm, body aches, chills, low energy - symptoms for 2 days then all ok. did not seek medical attention

Other Meds: ? atorvastatin 20 MG tablet ? cloNIDine 0.2 MG tablet ? furosemide 40 MG tablet ? potassium chloride SA 20 MEQ tablet ? doxazosin 4 MG tablet ? metFORMIN ER 500 MG XR tablet ? glipiZIDE 5 MG tablet ? doxycycline 100 MG capsule ? eplerenone

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm