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**
PLEASE CHECK BACK SOON
Download the files above while you wait.






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: 1069727
Sex: M
Age: 29
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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Dysphagia, Epiglottitis

Symptoms: sweating, apple juice, observation, resolved, discharge home

Other Meds:

Current Illness:

Date Died: 03/03/2021

ID: 1069728
Sex: M
Age: 47
State: TX

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: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Anxiety, Dyspnoea

Symptoms: Patient Started having dizziness, feeling faint at around midnight on 3/3/2021. He then lost consciousness, had seizure-like activity and was taken to hospital via EMS. In the hospital patient was unresponsive and received resuscitation attempts unsuccessfully. Per family, after about 45 minutes, code was called and patient expired.

Other Meds: None

Current Illness: None

ID: 1069729
Sex: F
Age: 52
State: NC

Vax Date: 03/03/2021
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: Keflex (itching)

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

Symptoms: 15 minutes after receiving her first dose of COVID-19 vaccine in her L arm, patient developed numbness in the L side of her face down to her shoulder. Her CN2-12 were grossly intact, her muscle strength was 5/5 in her UE. Patient denied any SOB, difficulty swallowing (able to swallow water), or swelling of neck. Her airway was patent and she had a normal oropharynx. Patient had another 10 minutes of additional observation. Her symptoms slightly improved prior to leaving.

Other Meds: Flonase nasal spray Ibuprofen 800mg q8hrs prn pain

Current Illness:

ID: 1069730
Sex: M
Age: 76
State: SC

Vax Date: 02/05/2021
Onset Date: 02/10/2021
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: none

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: first episode of shingles (herpes zoster) in L 3 dermatome. (mild)

Other Meds: clopidogrel, candesartan, atorvastatin, finasteride, tamsulosin, asa, montelucast, metoperol, cetirizine, vitamin D

Current Illness: none

ID: 1069731
Sex: M
Age: 69
State: MN

Vax Date: 02/27/2021
Onset Date: 02/28/2021
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: Lisinopril, external allergies

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

Symptoms: emesis, cough

Other Meds: Miralax, Oxycodone, ASA, Tylenol, Zanaflex, Lasix, Allopurinol, PCN, Hytrin, Trazadone, Lopid, Senna, Celecoxib

Current Illness: None

ID: 1069732
Sex: F
Age: 82
State: NC

Vax Date: 02/11/2021
Onset Date: 02/17/2021
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: morphine

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

Symptoms: upon rising from a sitting position my legs would not hold me up. I could not walk without someone helping to keep me from falling. My legs around the knees and lower thigh area were having spasms just momentarily. I went to bed, slept well and next day everything was fine. No pain associated with episode.

Other Meds: vesicare 10 mg 1x daily, nexium 40 mg 1x dailym, estrace 0.1 mg 2x week, vit. D 5,000 units 1x daily, baclofen 10 mg 1x daily, clonazepam 0.5 mg-1/2 tab as needed

Current Illness: none

ID: 1069733
Sex: F
Age: 35
State: IN

Vax Date: 02/18/2021
Onset Date: 02/19/2021
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: Cestin, Adhesive

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: After my second dose vaccine, I experienced fever and chills. No rash as in first vaccine.

Other Meds: Pre-natal vitamins

Current Illness:

ID: 1069734
Sex: F
Age: 37
State: KY

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Benadryl Latex Molds

Symptom List: Pharyngeal swelling

Symptoms: Hives, flushing, headache, itchiness began about an hour after administration of the vaccine Tylenol, Famotidine Symptoms began to subside about 20 minutes after administration of medication

Other Meds: OCP-Camila

Current Illness: None

ID: 1069735
Sex: M
Age: 73
State: TN

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: LA

Lab Data:

Allergies: Iv iodine

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Lightheadedness, fell down a flight of stairs

Other Meds: Atorvastatin, finasteride,omeprazole, fiber supplement

Current Illness:

ID: 1069736
Sex: F
Age: 72
State: CA

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: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Ibuprofen, Povidone iodine, Some foot ointment

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Becomes Dizzy and almost faint twice and Vomit a little bit

Other Meds: Atorvastatin, Levothyroxine, Valsarti, Amlodipine, Flouxetine, Letrozole, Bayer Aspirin, Caltrate, iron supplement, Centrum Multivitamins

Current Illness:

ID: 1069737
Sex: F
Age: 16
State: NM

Vax Date: 02/20/2021
Onset Date: 02/20/2021
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: 16 year old patient received a Moderna vaccine at a community vaccination clinic but the minimum age is 18 for Moderna

Other Meds: Unknown

Current Illness: Unknown

ID: 1069738
Sex: F
Age: 80
State: FL

Vax Date: 01/26/2021
Onset Date: 01/27/2021
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: Allergy to any Mycin medicine

Symptom List: Rash, Urticaria

Symptoms: First dose was in the right arm and it it became inflamed about a week after the shot. Itchy, hot, inflamed, and pink. I visited the doctor advised warm compresses and the problem subsided in a few days. After the second dose I woke up in the middle of the night with the chills and chattering teeth. It was uncontrollable shaking. My temperature of 102 degrees in the morning. I had shooting pains in my arms and legs. Felt terrible all day. Took Tylenol no effect. Advil worked better. The lymph nodes were sore under my arm. On the third day I felt a little better but on the fourth day I felt a little better.

Other Meds: Atenenol 25mg daily Centhroid 5 times weekly Rosuatastatin 3 times weekly Melatonin Calcium, Vitamin D3

Current Illness:

ID: 1069739
Sex: F
Age: 24
State: MN

Vax Date: 02/26/2021
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: LA

Lab Data:

Allergies: Penicillin

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

Symptoms: Saturday at 1:00am, I was feeling extremely nauseous, shivering, and achey. I had trouble sleeping and finally at 7:00am got up. I was nauseous, achey, fatigued, and shivering all morning. I had a temperature of 99.4 degrees. Between 11am-1pm on Saturday 02/27, I vomited three times. I had a horrible headache, stomach ache, and felt achey, cold, and weak all day. On Sunday, 02/28, my fever resided, and I did not vomit but still had stomach aches and slight nausea. I had eaten nothing out of the ordinary on Friday (made pizza at home like I do every Friday), and there were no other abnormalities during the day.

Other Meds: -Lexapro 10mg -Zytrec -Women's Daily Multivitamin -Kyleena IUD

Current Illness: N/A

ID: 1069740
Sex: F
Age: 66
State: LA

Vax Date: 02/08/2021
Onset Date: 02/12/2021
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: None

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

Symptoms: Loss of appitite resulting in 5 lbs weight loss within 3 weeks

Other Meds: Mobic 15 mg, rosuvastatin 10 mg, synthroid 88mg, daily vitamin, vit c, vit b complex, Zinc 50 mg, vit d 5000 I, vit e, cranberry

Current Illness: Hypothyroid, high cholesterol, back pain

ID: 1069741
Sex: F
Age: 46
State: KY

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: 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: Patient described feeling strange and remained at facility for observation for 30 minutes. 2 Benadryl administered. She went back to work at a high school. When still feeling unwell, went to see school nurse. Felt faint, syncope, numbness of right cheek, tachycardia. Ambulance called and patient was taken to ED. Later that night had flu like symptoms at home.

Other Meds: None

Current Illness: none

ID: 1069742
Sex: F
Age: 71
State: CA

Vax Date: 02/05/2021
Onset Date: 02/05/2021
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: codeine

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

Symptoms: about 8 hrs after shot stomach ache, unable to eat dinner. a few hours later, mild chills. next day, fatigue, lots of napping, and repeat of evening stomach ache, more severe, and also ache at kidneys on back. later chills. third day still fatigue, another evening stomach ache, no dinner, bland snack, less severe. later chills. 4th day, less fatigue, stomach ache but milder, no chills. 5th day no symptoms, more energy, almost normal.

Other Meds: fluoxetine

Current Illness: none

Date Died: 02/27/2021

ID: 1069743
Sex: M
Age: 89
State: OH

Vax Date: 02/25/2021
Onset Date: 02/26/2021
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: none

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

Symptoms: Cardiac arrest- death

Other Meds:

Current Illness: none reported

ID: 1069744
Sex: M
Age: 61
State: AZ

Vax Date: 01/22/2021
Onset Date: 01/23/2021
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: NONSTEROIDAL ANTI-INFLAMMATORY

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Cranial nerve 6 (Abducens) palsy, left side

Other Meds: 1) ACETAMINOPHEN 325MG TAB TAKE TWO (2) TABLETS BY MOUTH ACTIVE EVERY 6 HOURS AS NEEDED FOR PAIN OR FEVER *TAKE NO MORE THAN 8 PER DAY* 2) AMMONIUM LACTATE 12% CREAM APPLY A SMALL AMOUNT TO ACTIVE AFFECTED AREA

Current Illness: episodic high blood pressure 1/25/21 medicine note, meds adjusted.

ID: 1069745
Sex: M
Age: 69
State: IN

Vax Date: 01/28/2021
Onset Date: 01/29/2021
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: no allergies

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Persistent cough, sore throat and general lethargy and difficulty sleeping developed the day after my second COVID dose and continues at this time

Other Meds: Rosuvastatin 20mg daily at bedtime. Protonix 40mg daily. Hyzaar 100/12.5mg daily. Coreg 12.5mg twice daily. Spironolactone 25mg daily. Naproxen 500mg twice daily and amlodipine 2.5mg daily at bedtime

Current Illness: none

ID: 1069746
Sex: F
Age: 64
State: NJ

Vax Date: 02/19/2021
Onset Date: 02/22/2021
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: No

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

Symptoms: Throwing up and diarrea.

Other Meds: Spiriva , Saxenda

Current Illness: No

ID: 1069747
Sex: F
Age: 31
State: MI

Vax Date: 01/06/2021
Onset Date: 02/18/2021
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: None

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

Symptoms: Became pregnant end of December. Received first dose January 6 and second dose January 27. Had very bad side effects. Felt pregnancy symptoms up until February 10th. Symptoms started to linger off. Had ultrasound that showed fetus February 10. Cramping started feeling days later. Had ultrasound again February 18 showed fetus had grown. Had another ultrasound February 21 after going to ED for bad cramping and pain. fetus had no heart beat. Miscarried February 26. Contents did not pass completely, had D&C February 27.

Other Meds: Prenatal

Current Illness: None

ID: 1069748
Sex: F
Age: 74
State: CA

Vax Date: 02/28/2021
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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Unevaluable event

Symptoms: Patient had the second Moderna vaccine shot at 9.10 am on Sunday 02/28/21. Patient felt dizziness at 10.00 am on Monday 03/01/21. She felt the ceiling and wall around her were spinning. She rest in bed for half an hour and dizziness was gone. Patient felt dizziness again at 2.30 am on Tuesday 03/02/21. Body temperature was 97.1 degrees F. Patience rest in bed for few hours, dizziness was gone. No blood pressure values were recorded. Patient felt dizziness again at 10.00 am on Wednesday 03/03/21. Body temperature was 96.8 degrees F, Blood pressure was 128/68.

Other Meds: None

Current Illness: None

ID: 1069749
Sex: F
Age: 29
State: MN

Vax Date: 02/25/2021
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: unknown

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

Symptoms: Syringe leaked vaccine down the arm of the patient. Much of the vaccine was perceived to be lost. Offered patient another vaccine in the other arm, but she declined/refused. The syringe was either faulty or the hub/needle attachment wasn't on tightly

Other Meds: unknown

Current Illness: unknown

ID: 1069750
Sex: F
Age: 33
State: MO

Vax Date: 02/18/2021
Onset Date: 02/28/2021
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: Almonds, Bactrim, Morphine

Symptom List: Injection site pain, Pain

Symptoms: Injection started feeling sore and itchy with visual redness around site. Next day very swollen arm with extreme stabbing pain and numbness in fingers if left arm used. Second day swelling had reduced but redness had spread. Same on day three, redness spread. Started antibiotics on Day three of symptoms after doctor visit.

Other Meds: Orilissa, Nexplanon, Xyzal, multivitamin, omeaperazole

Current Illness: None

ID: 1069751
Sex: F
Age: 71
State: NY

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: SYR
Vax Site: LA

Lab Data:

Allergies: Shell fish Pignoli nuts

Symptom List: Injection site pain, Menorrhagia

Symptoms: Pain and soreness at injection site and down my arm

Other Meds: Losartan potassium 25 mg Multivitamin Calcium D3 Iron

Current Illness:

ID: 1069752
Sex: F
Age: 34
State: NV

Vax Date: 01/07/2021
Onset Date: 01/07/2021
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: no

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

Symptoms: The first day, I had a lot of pain in my arm and I was getting a headache and every day I had a headache and fatigue. About two weeks after I got the vaccine, I was vomiting and had nausea and couldn't eat and had to take medicine. I had telehealth phone call and that was on January 24th. I had a fever and I experienced that nausea and vomiting for about two days on January 24 and January 25th. I took Zofran and Tylenol - it helped some. Ever since, I have still had bad headaches and fatigue. This is my second pregnancy - normal pregnancy so far.

Other Meds: Pre-natal supplements - Multi-vitamin

Current Illness: no

ID: 1069753
Sex: F
Age: 74
State: NY

Vax Date: 03/01/2021
Onset Date: 03/02/2021
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: Penicillin, Tetanus vaccine

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: 12 hrs after shot I was suddenly sicker than I?d ever been in my life: body shaking chills, fever, headache, body aches. Today I still have fever, body aches, head ache, diarrhea. Haven?t been able to eat.

Other Meds: Atorvastatin 10mg. NP Thyroid 45mg. Mulitivitamin. Calcium

Current Illness: ME/CFS

ID: 1069754
Sex: M
Age: 49
State: NM

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: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Vaccine administration error: Technician administered Moderna COVID-19 vaccine to a patient using a prepackaged pre-assembled syringe. At the time of immunization, the connection of the needle to the syringe was not tight and subsequently some vaccine escaped and ran down the patients arm. According to the technician, "a substantial amount of the vaccine ran down the arm and did not go into the muscle" After discussion with supervisor and chief physician, review of CDC guidelines and call to DHA Immunization healthcare branch, decision made in concert with patient to administer another dose of the vaccine as less than half dose was given. Pt received a second dose of vaccine and event was explained in full. Pt was contacted in the following days, denied adverse effects and was feeling healthy and well.

Other Meds: None

Current Illness: None

ID: 1069755
Sex: F
Age: 88
State: IA

Vax Date: 02/18/2021
Onset Date: 02/27/2021
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: Codeine, Morphine

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

Symptoms: Patient completed vaccine series 2-18-2021. Was admitted to the hospital diagnosed with COVID-19 2-27-2021

Other Meds: Aspirin 81 mg Calcium with Vitamin D Lisinopril 10mg Claritin 10 mg Metoprolol 50mg Omeprazole 20mg Artificial tears Ester-C

Current Illness: unknown

ID: 1069756
Sex: F
Age: 46
State: IL

Vax Date: 02/24/2021
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: RA

Lab Data:

Allergies: Penicillin, Cephalexin, Levofloxacin, Sulfa, Biaxin, Poly trim eye drops

Symptom List: Nausea

Symptoms: About 5 hours after the second dose I started feeling very fatigued, chills, and had a fever. I had these symptoms and flu-like symptoms for about 36 hours before they subsided. I then started to get over the hump and feel better. I also had a very sore, swollen, itchy injection site and arm. Then, Mon. evening, 3/1/21, 5 days after the second dose I was feeling somewhat dizzy, right before bedtime. So I just went to sleep. Today, 3/3/21, I am extremely dizzy and lightheaded and struggling to doing my daily activities. I'm not sure if this is still related to the 2nd injection or not, but I'm concerned.

Other Meds: Aubagio, Advair Diskus, Topiramate, Fluticasone nasal spray, Cryselle Tablets 28, Bupropion XL, Montelukast, Losartan, Multi-vitamin,

Current Illness:

ID: 1069757
Sex: F
Age: 40
State: CA

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NONE

Symptom List: Injection site pain

Symptoms: post vaccine - c/o sharp pain in head Tues and now "feels like crmps in head" and still had pain in LA radiates to back. denies hx of heart disease or HTN, denies DM, "low white cells per family hx". CG excluded, declined to be tested or MD eval. Advised G to f/u with MDfor symptoms and eval, and to F/U with CL regarding pay

Other Meds: zyrtec 10mg takes 2 pills everynight

Current Illness: NONE

ID: 1069758
Sex: F
Age: 76
State: WI

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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Numbness and swollen face on left side only.

Other Meds:

Current Illness:

ID: 1069759
Sex: F
Age: 73
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: IM
Vax Site: RA

Lab Data:

Allergies: none

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

Symptoms: dizzy, feeling funny, and shallow breathing. vital signs stable, x 3 02 sat 98% . Physician discharged to home

Other Meds:

Current Illness: none

ID: 1069760
Sex: F
Age: 22
State: OH

Vax Date: 01/20/2021
Onset Date: 02/12/2021
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: Hard lump on posterior upper arm

Other Meds: None

Current Illness: None

ID: 1069761
Sex: M
Age: 72
State: PA

Vax Date: 02/09/2021
Onset Date: 02/17/2021
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: Erythema, Pruritus

Symptoms: A 1.5 inches x 4.0 inches large red and itchy patch occurred on the left arm 8 days after the first dose of the Moderna vaccine had been administered. The rash disappeared after 6 - 7 days.

Other Meds: TYLENOL 1000MG

Current Illness: NONE

ID: 1069762
Sex: F
Age: 74
State: MN

Vax Date: 02/26/2021
Onset Date: 02/26/2021
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: nuts, oxycodone, adhesive

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

Symptoms: Patient states that she felt "woozy" and itchy left hand. 30 min after vaccine.

Other Meds: Vitamin D, calcium, chlorthalidone, pravastatin sodium, levothyroxine sodium, Advair diskus, ferrous sulfate, omeprazole, losartan.

Current Illness: Unknown

ID: 1069763
Sex: F
Age: 81
State: NY

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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: dicylcomine, olanzapine, risperidone

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

Symptoms: Patient received the COVID Moderna vaccination on 3/1/21. On 3/2 she reported chills, nausea and an arm ache Spoke with patient today, she is feeling much better, has a slight headache that is resolving as the day goes on Advised on supportive care (fluids, rest, good nutrition) and to call back if symptoms returned or worsened.

Other Meds: amlodipine, aspirin, folic acid, methotrexate, omeprazole, prednisone, sertraline, Vitamin B12, Vitamind D3

Current Illness: none

ID: 1069764
Sex: F
Age: 65
State: NJ

Vax Date: 02/16/2021
Onset Date: 02/16/2021
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: Latex

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Numbness to her nose, mouth, and cheeks for 3 days.

Other Meds: D3, Tumeric, Collagen , Omega3, Glucosamine

Current Illness: No

ID: 1069765
Sex: F
Age: 66
State: NY

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: 011J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: About 24 hours after 2nd dose of Moderna Covid-19 vaccine Fatigue Headache

Other Meds: None

Current Illness: None

ID: 1069766
Sex: M
Age: 47
State: AL

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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

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

Symptoms: Chills, Headache, and body aches.

Other Meds: Metoprolol 25mg and Atorvastatin 20mg

Current Illness: none

ID: 1069767
Sex: F
Age: 23
State: CA

Vax Date: 03/01/2021
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: latex, natural rubber

Symptom List: Pain in extremity

Symptoms: On Wednesday AM after Monday PM injection, patient awoke with numbness and tingling down whole right (injected) arm. Mild bruising but no erythema or swelling. paresthesia is positional and has improved slightly as the day progresses

Other Meds: Wellbutrin, buspar, loratadine, antivert, loestrin 1.5/30

Current Illness: cat bite 1/15/2021

ID: 1069768
Sex: F
Age: 45
State: CT

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 03/03/2021
Hospital:

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

Lab Data:

Allergies: shellfish

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

Symptoms: short of breath to the point that I had to go to the ER, symptoms lasted for about 10 days and I still not feeling 100%, dizziness, unable to function for 10 days, only laying down make me feel better

Other Meds: Valsartan 60mg, Sprintec, Colace 100mg, vitamins, Singulair, BREO inhaler, omeprazole 40mg, Claritin 10mg

Current Illness: none

ID: 1069769
Sex: F
Age: 70
State: OH

Vax Date: 02/07/2021
Onset Date: 02/14/2021
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: Bactrim (reaction: hives) meformin (reaction: gas/abdominal pain) Neosporin (reaction: blisters) PCN (reaction: unknown)

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

Symptoms: Severe arthralgias, Bell's palsy, nausea, vomiting, palpitations

Other Meds: Aspirin 81 mg Enteric Coated (ASPIRIN) 81mg/1, 90 for 90 days / one po daily - Prescribe Again Pyridium 200mg, 6 tablets for 2 days / 1 PO TID prn - Prescribe Again Vitamin B Complex 300mg, 90 for 90 days / one po daily - Prescribe Again Vi

Current Illness: Z85.3 (Personal history of malignant neoplasm of breast) I10 (Essential (primary) hypertension) E55.9 (Vitamin D deficiency, unspecified) H02.423 (Myogenic ptosis of bilateral eyelids) Z12.31 (Encounter for screening mammogram for malignant neoplasm of breast) E11.9 (Type 2 diabetes mellitus without complications) H81.10 (Benign paroxysmal vertigo, unspecified ear) R10.2 (Pelvic and perineal pain) M85.80 (osteopenia)

ID: 1069771
Sex: F
Age: 68
State: NY

Vax Date: 02/17/2021
Onset Date: 02/17/2021
Rec V Date: 03/03/2021
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: Penicillin, epinephrine

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

Symptoms: Severe headache, extremely high blood pressure 220/120, low blood sugar, anxiety, insomnia

Other Meds: Multi vitamin, vitamin D

Current Illness: No

ID: 1069772
Sex: F
Age: 63
State: CA

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: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Tetracycline; Codeine; Glucophage

Symptom List: Vomiting

Symptoms: I experienced Tingling across my face, more predominantly around my mouth and forehead. There also was tingling across the front of my collar bone down both arms to my fingertips. I got a mild headache and felt overall "wrung out"; a sense of weakness and lethargy. These feelings began as I was leaving the Vaccination Clinic (approximately 17 minutes after receiving my shot) and was walking to my car. They lasted about 2 & 1/2 hours from beginning to end. After that I felt just fine.

Other Meds: Atorvastatin; Lisinopril; Dicyclomine; Januvia; Jardiance; Lantus; Pantoprazole; Levothyroxine; Glipizide; Augmentin; Womens Health Daily Vitamin; Day Quil; Womens Health, Hair Skin & Nails supplement.

Current Illness: Urinary Tract Infection

ID: 1069773
Sex: M
Age: 77
State: AL

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: SYR
Vax Site: LA

Lab Data:

Allergies: Shellfish

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: I developed serious hives all over my body, my throat closed up and my tongue swelled up. We called in 911 and the paramedics gave me benadryl and prednisone.

Other Meds: atorvastatin

Current Illness: NO

ID: 1069774
Sex: F
Age: 67
State: DC

Vax Date: 02/11/2012
Onset Date: 02/13/2021
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: sulfa, coumadin

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

Symptoms: shortness of breath, dyspnea on exertion that started after 2nd vaccine, found to have pulmonary embolism 2 weeks later

Other Meds: losartan, alendronate

Current Illness:

ID: 1069775
Sex: F
Age: 71
State: VA

Vax Date: 02/16/2021
Onset Date: 02/27/2021
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: None

Symptom List: Injection site swelling, Limb discomfort

Symptoms: 11 Days after vaccine, three small, welt like red spots appeared at the injection site and the next day one large red area. The next day the size of redness increased up to shoulder area in circular pattern. Area was swollen and warm to the touch. No fever.

Other Meds: Simvastain, Vitamin C, Vitamin D, Fish Oil

Current Illness: None

ID: 1069776
Sex: F
Age: 47
State: NY

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: RA

Lab Data:

Allergies: Sulfa Medication

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

Symptoms: Flush, body aches, fatigue, scratchy throat - all mild but present

Other Meds: Ziac, Cholesterol, Ambien

Current Illness:

ID: 1069777
Sex: F
Age: 53
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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Penicillin Peanuts Hay fever

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

Symptoms: Increased heart rate. About 20 minutes after vaccine shot, my heart rate rose to 120 bpm, and it stayed about 100 non all night. (Normal resting heart rate is 70-74). Very difficult to rest/sleep that night, and today my heart rate is still quite high, between 85-95 bpm.

Other Meds: Venlafaxine, Bupropion ER

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm