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: 1068862
Sex: F
Age: 50
State: MN

Vax Date: 02/27/2021
Onset Date: 03/01/2021
Rec V Date: 03/03/2021
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: Citalopram Hydrobromide Nortriptyline Hcl Bupropion

Symptom List: Dysphagia, Epiglottitis

Symptoms: EXTREME dizziness and nausea. Heart palpitations and chills. And one of the worst headaches of my life. I called the nurse line and they had me go to the hospital. I received the vaccine on Saturday evening. Symptoms started Monday morning and increased in severity throughout the day until they were unbearable Monday evening.

Other Meds: Sertraline Buspirone

Current Illness: none

ID: 1068863
Sex: F
Age: 27
State: WI

Vax Date: 03/02/2021
Onset Date: 03/02/2021
Rec V Date: 03/03/2021
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: Amoxicillin

Symptom List: Anxiety, Dyspnoea

Symptoms: Swelling underneath the chin, initially had tingling in the area before swelling started

Other Meds: oral contraceptive

Current Illness: None

ID: 1068864
Sex: F
Age: 47
State: AZ

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

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

Symptoms: Blotchy rash at injection site on shoulder, going all the way down the left arm and up into left side of my neck. . Almost looks like a sunburn. I had the same neck blotches with the first dose, but didn?t attribute them to the vaccine then. Now I see that it is the same anomaly as with the first dose. I called my doctor to let him know and I will monitor the rash for the next several hours. I first noticed the rash in the morning after waking, 19 hours post Pfizer #2. The rash accompanies the normal pain and slight heat at injection site, as well as armpit pain. The left side of the body is quite sore. No fever or other complaints.

Other Meds:

Current Illness:

ID: 1068865
Sex: F
Age: 34
State: VA

Vax Date: 02/22/2021
Onset Date: 02/24/2021
Rec V Date: 03/03/2021
Hospital:

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

Lab Data:

Allergies: PEN VK, Percocet

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: 2 inch diameter red rash and pain around the injection site, chills, lethargy, body aches, and dehydration. 24 hours later the rash was gone, but the other symptoms remained. 48 hours later all resolved except for lethargy.

Other Meds: MIralax, Omeprazole

Current Illness:

ID: 1068866
Sex: F
Age: 54
State: NJ

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

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

Lab Data:

Allergies: amoxicillin (reaction not documented) sulfa antibiotics (reaction not documented)

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

Symptoms: Patient received first Moderna COVID vaccine. While waiting in the observation area, patient complained of itching at the injection site, hives on chest and mild SOB approx 5-10 minutes post vaccine. Paramedic present in vaccine clinic responded ASAP and called a Rapid Response overhead, which was cancelled when patient stated that she was comfortable to walk to the Emergency Dept. She was escorted to ED by a paramedic. ED physician assistant evaluated patient and noted the following: mild redness on her upper chest, upper left upper arm and back. Patient denied chest discomfort, throat discomfort, no SOB, no n/v. Physical exam documentation: Physical Exam General: Alert, no acute distress, Not ill-appearing, Skin: Warm, dry, intact, mild redness to the anterior chest and back. No urticarial rash noted., - edema . Head: Normocephalic. Neck: Supple. Ears, nose, mouth and throat: throat clear; -edema able to swallow saliva -stridor -tongue edema -hoarse voice -hot potato voice. Cardiovascular: Regular rate and rhythm. Respiratory: Lungs are clear to auscultation, respirations are non-labored, breath sounds are equal, no retractions. Gastrointestinal: Soft, Nontender, Non distended. Musculoskeletal: Normal ROM. Neurological: Alert and oriented to person, place, time, and situation. Psychiatric: Cooperative. Patient prescribed diphenhydramine 50 mg IM x1 dose and observed in ED for approx 1 hour afterward. Noted that itching and redness was resolved. Pt denied SOB, chest/throat discomfort. Pt was discharged and asked to follow-up with PMD.

Other Meds: atenolol 50 mg PO daily chlorthalidone 25 mg PO daily meloxicam 15 mg PO daily olmesartan 5 mg PO 2xday

Current Illness: COVID positive on 12/18/2020

ID: 1068867
Sex: M
Age: 47
State: DC

Vax Date: 03/02/2021
Onset Date: 03/02/2021
Rec V Date: 03/03/2021
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: Penicillin

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

Symptoms: Approximately 45 minutes after injection mild onset of anaphylaxis response. Numb tongue, tingly lips, mild throat constriction but no issues swallowing or breathing. About 60 minutes post-injection, the patient self-administered two 25 mg tablets of Benadryl. Symptoms subsided 120 minutes later.

Other Meds: Losartan-HTC, Biktarvy, Psyllium Husk

Current Illness: none

ID: 1068868
Sex: F
Age: 65
State: IA

Vax Date: 02/23/2021
Onset Date: 02/23/2021
Rec V Date: 03/03/2021
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: Severe headache, joint pain, nausea, muscle pain, tiredness, chills with second shot. four days later: itching, redness and welts on over both elbows, knees and ankles.

Other Meds:

Current Illness:

ID: 1068869
Sex: F
Age: 26
State: MA

Vax Date: 02/11/2021
Onset Date: 03/15/2021
Rec V Date: 03/03/2021
Hospital:

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

Lab Data:

Allergies: Amoxicillin and benadryl

Symptom List: Pharyngeal swelling

Symptoms: Patient got the COVID vaccine (first dose) last Thursday the 11th, and had some reaction to it. I felt itchy all over, my right heel has been red and swollen, a couple of nights I had chills but was sweating when I woke up and felt hot, the tops of my hands and fingers were red, irritated and extremely itchy until this morning, the injection site has been itchy but the red rash went away last night. I?ve been waking up puffy/swollen in my hands, face (eyelids, lips(not severe), today my feet are a bit swollen and my hands don?t seem red or itchy now.

Other Meds: N/A

Current Illness: Migraine

ID: 1068870
Sex: M
Age: 72
State:

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

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

Lab Data:

Allergies: Allergy to animal dander and morphine.

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Severe chills. Couldn't stop shaking. Went away in approximately 2 hours after getting in warm bed.

Other Meds: None.

Current Illness: None.

ID: 1068871
Sex: F
Age: 78
State: NH

Vax Date: 02/19/2021
Onset Date: 02/20/2021
Rec V Date: 03/03/2021
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: no allergies, although I do react to insect bites

Symptom List: Diarrhoea, Nasal congestion

Symptoms: On Saturday 02/20 twenty four hours after receiving the injection I felt fatigued with loss of appetite and some chills. At the same time I noticed a 2inch red ring around the injection site. The next day I felt fine ,but had a very sore arm with the red circle and a large pink blush running down to my elbow which never disappeared. The following week the red circle disappeared but the pink blush remained. On Sunday, 02/28 I noted that the blush disappeared but I now had a 3inch red circle around the injection site. On Monday 03/1, the red circle grew and spread, and by 03/2 it was no longer in circular form but spread down my arm to 3inches by 6inches. It remains the same 0n 0/3. It is not painful or itchy. I am worried. I know this is called covid arm but my reaction does seem extreme. I do have some photos beginning on 02/28

Other Meds: Eliquis, Metformin, Levothyroxine, Januvia, lisinipril multivitamins

Current Illness: no illness

ID: 1068872
Sex: F
Age: 71
State: NC

Vax Date: 02/23/2021
Onset Date: 02/23/2021
Rec V Date: 03/03/2021
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: Ran fever of 102`102.5 Through out the night. Chills, Head hurt, eyes hurt. Nauseated, Arm extremely painful. Kept Symptons up un til 02/26/2021. All symptoms seem to be gone now but arm is still sore and painful. Do not plan to get second shot. I did have Covid in April 2020 and was in the Hospital for 9 days. I don't know if that may have made me have the symptoms after receiving this shot.

Other Meds: Rosuvastatin 10 mg D-3

Current Illness: None

ID: 1068873
Sex: F
Age: 76
State: OH

Vax Date: 02/18/2021
Onset Date: 02/21/2021
Rec V Date: 03/03/2021
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: adhesive

Symptom List: Rash, Urticaria

Symptoms: Pfizer-BioNTech Covid 19 Vaccine EUA Started getting light headed and dizzy on early morning Sat. Have been having off and on since then. Have not been able to shower, drive for fear of having it happen again. I did have a B12 injection on 2/15/2021 after checking with my physician to see if would be a problem with getting vaccine.

Other Meds: Omeprazole 20mg. venlafaxine Hel Er 150mg, Losartan 100mg, Pregabalin 150mg 2 times a day. Alprazolam 0.25mg 1/2 to 1 a day, and B12 shots monthly

Current Illness: none

ID: 1068874
Sex: F
Age: 48
State: AZ

Vax Date: 02/26/2021
Onset Date: 02/26/2021
Rec V Date: 03/03/2021
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: Redness to the neck

Other Meds:

Current Illness:

ID: 1068875
Sex: F
Age: 79
State: FL

Vax Date: 01/29/2021
Onset Date: 02/11/2021
Rec V Date: 03/03/2021
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: sulfa

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

Symptoms: ON FEBRUARY 11, I AWOKE WITH A RUNNY NOSE WITH HEADACHE, EYE ACHE, TEOOTHACHE ON RIGHT SIDE OF MOUTH--UPPER AND LOWER. I ALSO FELT A COLD SORE COMING ON. I TOOK SUDAFED PE AND VALCYCLOVIR, WHICH USUALLY SOLVES THE ISSUE. THESE SYSMPTOMS CONTINUED AND I CONTINUED WITH SUDAFED AND VALCYCLOVIR. I SAW MY DENTIST ON FEBRUARY 11 AND WAS TOLD THERE THERE WERE NO ISSUES AND PERHAPS THE PAIN WAS CAUSED BY SINUS ISSUES. I INCREASED THE VALCYCLOVIR TO THREE TABS A DAY RATHER THAN ONE. THE TEETH ISSUE SPREAD TO THE LEFT SIDE OF MY MOUTH AND TWO MORE COLD SORES APPEARED, ANOTHER ON MY UPPER LIP AND ONE AT THE EDGE OF MY LEFT NOSTRIL. I HAD A ZOOM MEETING WITH MY DOCTOR ON MARCH 1. SHE INCREASED THE VALCYCLOVIR TO 1000M. THREE TIMES A DAY. THE COLD SORES HAVE DISAPPEARED, BUT THE OTHER SYMPTOMS CONTINUE, BUT THE PAIN HAS LESSENED SOMEWHAT. I TAKE TYLENOL WHEN THE DISCOMFORT BEGINS TO INTERFERE WITH MY DAILY LIFE.

Other Meds: Armour Thyroid, Cerefolin NAC, multivitamin, Allegra, baby aspirin, Protandim

Current Illness: N/A

ID: 1068876
Sex: M
Age: 82
State: ME

Vax Date: 02/25/2021
Onset Date: 03/03/2021
Rec V Date: 03/03/2021
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: None

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

Symptoms: Body aches with fever 100. Degrees

Other Meds: Pantoprazole acid reducer 40mg 1a day Simvastatim 10mg 1 per day

Current Illness: None

ID: 1068877
Sex: M
Age: 79
State: CT

Vax Date: 01/25/2021
Onset Date: 02/01/2021
Rec V Date: 03/03/2021
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: right sided facial palsy, consistent with Bell's palsy, grade 3 treatment with prednisone and valacyclovir for 7 days with improvement to grade 2 by 1 week

Other Meds: ? amLODIPine (NORVASC) 5 mg tablet, TAKE 1 TABLET(5 MG) BY MOUTH DAILY, Disp: 90 tablet, Rfl: 3 ? apixaban (ELIQUIS) 5 mg tablet, Take 1 tablet (5 mg total) by mouth 2 (two) times daily., Disp: 180 tablet, Rfl: 3 ? ascorbic acid, vitamin

Current Illness: None

ID: 1068878
Sex: F
Age: 73
State: CA

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

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

Symptoms: 6 patients were given Pfizer vaccine that was diluted with bacteriostatic normal saline. Issue was discovered and remaining vaccine was discarded. We are unable to identify which 6 people were given the wrong diluent but able to identify the timeframe and narrow it down.

Other Meds:

Current Illness:

ID: 1068879
Sex: F
Age: 67
State: IL

Vax Date: 03/01/2021
Onset Date: 03/01/2021
Rec V Date: 03/03/2021
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 medications, Cat dander

Symptom List: Ear pain, Hypoaesthesia

Symptoms: About 1 hour after administration, patient experienced flushing that lasted about 30 minutes

Other Meds: None

Current Illness:

ID: 1068880
Sex: F
Age: 57
State: MO

Vax Date: 02/05/2021
Onset Date: 02/19/2021
Rec V Date: 03/03/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Patient accidentally received two Pfizer vaccinations within 14 days of each other. She was a walk in to a booster clinic within our hospital and was not asked if it had been 21 days since her previous vaccination. She saw others getting their booster and just followed the lead. She has did not have any adverse events or side effects.

Other Meds:

Current Illness:

ID: 1068881
Sex: F
Age: 46
State: TX

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

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

Lab Data:

Allergies: NKDA

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

Symptoms: Patient described burning sensation down right arm and the back of neck. Observed skin blotching below the elbow on the right side.

Other Meds: Propanolol 10mg three times a day Levothyroxine 100mcg once a day

Current Illness: None

Date Died: 01/25/2021

ID: 1068889
Sex: M
Age: 84
State:

Vax Date: 12/29/2020
Onset Date: 01/25/2021
Rec V Date: 03/03/2021
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:

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

Symptoms: death Narrative: no other details available, as nothing documented in record

Other Meds:

Current Illness:

Date Died: 02/11/2021

ID: 1068890
Sex: M
Age: 76
State:

Vax Date: 01/13/2021
Onset Date: 02/11/2021
Rec V Date: 03/03/2021
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: Unevaluable event

Symptoms: death Narrative: unclear of details, s/p spine surgery on 2/2/21 and discharged on 2/6/21

Other Meds:

Current Illness:

ID: 1068891
Sex: M
Age: 52
State: CO

Vax Date: 02/23/2021
Onset Date: 02/25/2021
Rec V Date: 03/03/2021
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: isoniazid

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

Symptoms: Swelling in right armpit. Edemas to about the size of half an orange. Was consistent with a hematoma instead of glandular swelling. Swelling spread out throughout the entire left side over the week until it dissipated. I did take pictures and have them available if so desired.

Other Meds: topiramate 75 mg daily,

Current Illness: none

ID: 1068892
Sex: F
Age: 44
State: KY

Vax Date: 02/23/2021
Onset Date: 03/02/2021
Rec V Date: 03/03/2021
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: Delayed onset of very sore and itchy area at injection site. Started a week after I received the vaccine. Injection site is swollen, hot, hard, painful, and itchy.

Other Meds: Synthroid, coumadin.

Current Illness: None

ID: 1068893
Sex: F
Age: 67
State: MD

Vax Date: 03/03/2021
Onset Date: 03/03/2021
Rec V Date: 03/03/2021
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: Injection site pain, Menorrhagia

Symptoms: Hives/rash

Other Meds:

Current Illness:

ID: 1068894
Sex: F
Age: 69
State:

Vax Date: 03/02/2021
Onset Date: 03/02/2021
Rec V Date: 03/03/2021
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: None.

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

Symptoms: Started with severe chills. Developed headache and stomach upset. Very tired and fatigued.

Other Meds: None.

Current Illness: None.

ID: 1068895
Sex: F
Age: 84
State: TX

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

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: No adverse outcome.

Other Meds: Patient was administered the second dose of vaccine. Post-vaccination, it was discovered the patient had received other covid vaccine for the first dose. No adverse outcome.

Current Illness:

ID: 1068896
Sex: F
Age: 45
State: MA

Vax Date: 02/25/2021
Onset Date: 02/27/2021
Rec V Date: 03/03/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: increased swelling and redness and neck tenderness and pain

Other Meds: Enalapril with HCTZ, lactobacillus, melatonin

Current Illness:

ID: 1068897
Sex: M
Age: 66
State: MD

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

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: Presented to the ED on 3/1/21 with progressively worsening SOB with cough for past 1.5 weeks. He also reported having bright red blood per rectum for the past 6 months. He denied fever, N/V, abdominal pain, etc. He reports that he stopped smoking ~2 weeks ago and this is when his symptoms started. Per the EUA, hospitalizations are to be reported irrespective of attribution to the vaccine

Other Meds:

Current Illness:

ID: 1068898
Sex: F
Age: 67
State: OH

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

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

Lab Data:

Allergies: Sulfa

Symptom List: Nausea

Symptoms: Immediate localized swelling at the injection site about the size of a small grape. Provided the patient diphenhydramine 50mg to treat the localized reaction. Monitored the patient for 30 minutes and she left in good health accompanied by her husband

Other Meds: Losartan, Amlodipine, Aspirin, Alprazolam, Clopidogrel

Current Illness: None

ID: 1068899
Sex: M
Age: 23
State: MI

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

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

Lab Data:

Allergies: Codeine

Symptom List: Injection site pain

Symptoms: Patient felt synope/fainting. Onsite EMS was called vitals BP 108/66 BG 108 99% O2 room air HR 58. Patient was treated and released agianst medical advice.

Other Meds:

Current Illness:

ID: 1068900
Sex: M
Age: 76
State: DE

Vax Date: 02/23/2021
Onset Date: 02/24/2021
Rec V Date: 03/03/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: body ache, chills, fever 103.9

Other Meds: Body ache, chills, fever 103.9 lasted full day

Current Illness: none

Date Died: 02/21/2021

ID: 1068901
Sex: F
Age: 67
State: NH

Vax Date: 01/30/2021
Onset Date: 02/21/2021
Rec V Date: 03/03/2021
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:

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

Symptoms: ER admit for CP and Jaw pain, exhaustion, Aortic arteritis normal SED rate found on CT scan hospital admit IV medications required Solumedrol and Actemra questionable how much medications received d/t IV's not working. Released from care on 2/19 with prednisone . Symptoms still present off and on. 2/21 922pm CP Jaw Pain severe EMT's called EKG done reported no heart attack, pain better, EMTs left. 10/15 severe Pain collapsed with no pulse and no breathing, EMTs returned unable to obtain a shock-able rhythm time of death pronounced. reason for death on certificate Aortitis - hospitalist thinks aortic dissection d/t severe inflammation

Other Meds: Prednisone BP medication

Current Illness: COVID prior to vaccination - still having symptoms SOB, Tired, foggy head -thinking

ID: 1068902
Sex: F
Age: 65
State: PA

Vax Date: 02/03/2021
Onset Date: 02/04/2021
Rec V Date: 03/03/2021
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: Tremor

Symptoms: Excessive pain and muscle weakness lasting 28 days (day of second shot).

Other Meds: Unknown

Current Illness: Unknown

ID: 1068903
Sex: F
Age: 28
State: TX

Vax Date: 03/02/2021
Onset Date: 03/02/2021
Rec V Date: 03/03/2021
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: sumatriptan, tiotropium bromide, doxycyline, midrin

Symptom List: Erythema, Pruritus

Symptoms: 2 hours after the vaccine I started getting hives down both of my arms. I took 1, 25mg Atarax. 6 hours later the hives came back on my arms and were also across my neck and chest. It became hard to breathe. I took 2, 25mg Atrax and the symptoms went away. 18 hours after the vaccination I am still itchy all over my body but the hives are gone. I have a headache and the injection site is sore.

Other Meds: duloxetine, lisinopril, pravastatin, novolog, pantoprazole, methocarbamol, gabapentin, amitriptyline, zantac, montelukast, cetirizine, calcium, viatmin d3

Current Illness: Sinus infection one week prior

ID: 1068904
Sex: F
Age: 17
State: KY

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

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

Symptoms: patient is younger than 18 yo

Other Meds:

Current Illness:

ID: 1068905
Sex: M
Age: 60
State: NM

Vax Date: 02/23/2021
Onset Date: 02/24/2021
Rec V Date: 03/03/2021
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: Penicillin

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

Symptoms: Day after getting injection, my right side (leg, foot, hand, arm) went numb (feeling asleep). After a week, the symptoms are still the same. My feet were already numb from type 2 diabetes and MS, now the right side is numb.

Other Meds: Avonex, metformin, amlodipine, aspirin, liptor, synthroid, cozaar, omeprazole, tamsulosin, amantadine, Trulicity, vitamin D, C

Current Illness:

ID: 1068907
Sex: F
Age: 51
State: TN

Vax Date: 01/19/2021
Onset Date: 01/20/2021
Rec V Date: 03/03/2021
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: N/A

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: 1st vaccination 12/23/2020 2nd vaccination 1/19/2020 *in between vaccinations, diagnosed with Shingles 1/7/2020 *I have had consistent pain. The Shingles presented itself I had rash on right side, abdomen and back. The dr. gave antiviral, stated I have Shingles, and she also gave me narcotic pain med for pain. I had the pain and rash for 3 weeks. 1/19 I was recovered, had 2nd vaccination, a week later presented rash on both arms, itching. I take Ibuprofen daily, the pain on my back is same location. 10-15 days of constant pain, LEVEL 7-8/10. I also had another rash in between my breasts, arms, and nipples. Using over the counter hydrocortisone cream.

Other Meds: Amlodapin 5mg, fish oil, multivitamins, zinc, magnesium, vitamin D, elderberry syrup, vitamin C, metamucil dietary fiber

Current Illness: Hypertension 1/7/2021 Diagnosed with Shingles

ID: 1068908
Sex: F
Age: 38
State:

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

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

Symptoms: Chest tightness/throat tightness/anxiety

Other Meds:

Current Illness:

ID: 1068909
Sex: F
Age: 46
State: FL

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

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

Symptoms: Shoulder pain after 2nd vaccination.

Other Meds:

Current Illness:

ID: 1068910
Sex: F
Age: 74
State: AZ

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

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

Lab Data:

Allergies: none

Symptom List: Pain in extremity

Symptoms: Fever 99.6, headache (similar to sinus headache) body aches, chills all day, next day headache remains took Tylenol

Other Meds: Lovastatin, calcium, vitamin d, vitamin B-12

Current Illness: none

ID: 1068911
Sex: F
Age: 36
State: PA

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 03/03/2021
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: Chlorhexidine Hibiclens Amoxicillin Methylphenidate Sulfa Omalizumab Dust Mite Compazine Peach Shellfish polysorbate added after COVID 19 vaccine administered.

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

Symptoms: Patient experienced redness, hotness, itchy, SOB, tightness of chest, swollen lips, redness to face/neck. Administered epinephrine 0.3 mg IM and diphenhydramine 50 mg IV x 1. Monitored on sight for 45 minutes and transferred by EMS to emergency department. In ED administered methylprednisiolone 125 mg IV x1 and pepcid 20 mg IV once. Patient was discharged from the ED; however, developed facial pruritus, chest tightness and dyspnea and returned to ED. Admitted to obs unit on /5 at 0845 and discharged the next day on 2/6 at 1018.

Other Meds: unknown

Current Illness: unknown

ID: 1068912
Sex: M
Age: 50
State: PA

Vax Date: 03/02/2021
Onset Date: 03/02/2021
Rec V Date: 03/03/2021
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: No

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

Symptoms: I arrived and was let into a tent, I sat down and the nurse (no name tag) asked which arm. I pulled up my sleeve and I relaxed my arm and she stuck the needle in my arm and nurse proclaimed "uh-oh, the syringe didn't work and the needle didn't pop in. That has never happened before. Let me find out what to do." Very little if any of the vaccine in the syringe went into the arm. I saw other syringes on a table nearby and the syringe use on me had the same amount as the vials on the table. She left the tent and came back a few minutes later and said "someone is checking with the pharmacy to see what we can do. Please wait in the observation area." I got up and went to the observation area. After about 10 minutes another employee and the nurse walked up to me (no name tags) and they said " so, the FDA does not allow us to administer partial doses." I said "Ok, I didnt receive the dose though..." Nurse looked at her phone and was looking at text messages ( I could see because I was standing and she was sitting.) and then she said the exact same thing to me again. I said "Are you going to give me the second dose, or not?" the nurse saind " Probably not. Its been 15 minutes, so you can leave." So I left and drove 2 hours home. My daughter found on the CDC website an article "Interim Clinical Consideration for use of MRNA Covid 19 Vaccines Currently Authorized" from Feb 10th 2021 under Dosage it says "if lower than dose required is administered, or patient pulls back, or it leaked out, or there is a needle/syringe malfunction, if less than half the dose was administered, administer the authorized dose immediately in the opposite arm."

Other Meds: Homaro Lipitor Flomax

Current Illness: No

ID: 1068913
Sex: F
Age: 65
State: FL

Vax Date: 02/27/2021
Onset Date: 02/27/2021
Rec V Date: 03/03/2021
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: PNC

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

Symptoms: Patient stated she started feeling numbness 14 minutes after she got vaccinated on her upper lip. At 3:37 pm patient stated numbness is gone on its own. She stated she feels OK and wants to go home.

Other Meds: none

Current Illness: none

ID: 1068914
Sex: F
Age: 33
State: MI

Vax Date: 03/03/2021
Onset Date: 03/03/2021
Rec V Date: 03/03/2021
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: Amoxicillin Bactrim Ciprofloxin Diflucan Sulfa

Symptom List: Vomiting

Symptoms: Patient started to have hives and itching within a few minutes of the injection given. She has a history of allergies to medications and other things however not to a vaccine. She was given Benadryl 50mg (08:36) right away and had no vomiting. Her vital signs remained stable. She continued to progress with throat itching, tightness, and coughing. She was given an EPI PEN 0.3mg autoinjection at 08:42 and EMS was called. Her pulse ox decreased to 89% on RA until about 1.5 minutes after the EPI was given. Then it improved for a short time. At 08:50 her symptoms started to return and she had some audible stridor. EPI PEN 0.3mg autoinjection was repeated at 08:52. Ems arrived and she was transported.

Other Meds: unknown

Current Illness: None

ID: 1068915
Sex: F
Age: 38
State:

Vax Date: 02/12/2021
Onset Date: 02/26/2021
Rec V Date: 03/03/2021
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: Initially with severely sore arm, headache, cough, chest tightness/congestion, and heartburn unrelieved by medication that began approx 24 hours after vaccination. Then, per patient: "Almost 2 weeks to the day after getting my first shot, on Friday 2/26, I suddenly and unexpectedly went into Rapid Ventricular Response atrial fibrillation. I was admitted to the ER department at Northwestern. I was there 10 hours and multiple tests were completed. At this time, no causes have been found that would have contributed to my going into RVR A-fib. I am wearing a heart monitor for 2 weeks and will undergo a stress echo exam on my heart. I do not have a cardiac history."

Other Meds:

Current Illness:

ID: 1068916
Sex: M
Age: 76
State: NC

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 03/03/2021
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: statins protein pump inhibitors

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

Symptoms: Have had muscle pain in left arm since 3 days after shot. Second shot on February 10 in right arm. Have had muscle pain in right arm since three days after shot. Muscle pain in both arms continues. Have had elevated blood pressure coincident with the first shot. Am being evaluated by my doctor for high blood pressure currently, although I suspect it is being caused by Covid vaccination. Keeping BP record.

Other Meds: Telmisartan 80mg Amiloride 5mg

Current Illness: none

ID: 1068917
Sex: F
Age: 70
State: NY

Vax Date: 02/11/2021
Onset Date: 02/18/2021
Rec V Date: 03/03/2021
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

Symptom List: Injection site swelling, Limb discomfort

Symptoms: After the second injection, my face swelled up. Where I have Sculptra injection, hard bumps began to form and which are still there today.

Other Meds: Timoptic, Pantroprazole, Advair

Current Illness: None

ID: 1068918
Sex: M
Age: 73
State: IN

Vax Date: 02/17/2021
Onset Date: 02/27/2021
Rec V Date: 03/03/2021
Hospital:

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

Lab Data:

Allergies: none known

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

Symptoms: enlarged, swollen, very sensitive lymph nodes under right arm into right breast...did not occur until 10 days or so after date of vaccine

Other Meds: fish oil; multi vitamin: eliquis 2.5 mg 2X day: symbicourt 160-4.5 mcg 2X day: chlorthalidone 25mg: clotrimazole 1% cream: finastride 5mg : ketoconazole shampoo M/W/F: rosuvastatin 10 mg: topiramate 25mg 2X day: hydrocortisone 2.5

Current Illness:

ID: 1068919
Sex: F
Age: 65
State: DC

Vax Date: 03/02/2021
Onset Date: 03/02/2021
Rec V Date: 03/03/2021
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: None

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

Symptoms: Pronounced pain at injection site started around 6pm, the day of the shot, 3/2/2021. After 8pm, started going downhill with chills and some sneezing. Managed to get to sleep, but woke up at 1:15 am and could not get back to sleep. Feeling chilled all night. At 5:30 am, got out of bed to take Tylenol and experienced dizziness (briefly blacked-out), sweats, nausea (vomited) and slight diarrhea. After that episode, started to feel a little better, though still a bit woozy and exhausted from lack of sleep.

Other Meds: Zyrtec 10 mg tablet daily Estradiol 0.5 mg tablet daily Bisoprolol HCTZ 2.5-6.25 mg tablet daily Lunesta 3 mg tablet at night

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm