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: 1070977
Sex: F
Age: 68
State: MI

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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None known

Symptom List: Dysphagia, Epiglottitis

Symptoms: Red rash, warm, itchy, firm beneath skin; appeared a week after vaccination and lasted about a week. No other issues then and none at this time. Notified primary physician.

Other Meds: Bupropion, sertraline, D3, Magnesium, Zinc

Current Illness: None

ID: 1070978
Sex: M
Age: 63
State: TX

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

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

Lab Data:

Allergies: unknown

Symptom List: Anxiety, Dyspnoea

Symptoms: report of patient being admitted for a stroke after about a week after first dose of moderna vaccine

Other Meds: unknown

Current Illness: unknown

ID: 1070979
Sex: F
Age: 81
State: CA

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: allergic to Penicillin & all derivatives pseudonephrine novocain additive (unknown name) ragweed, cedar, white oak, other high pollen plants crab (intolerance, perhaps not allergy) other medications including one kind of eye drops -- I don't have list handy poison ivy & oak sumac (skin rashes with blisters) tropical tree nuts ( Brazil, macadamia, cashew -- can't digest these oils) dust mites

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

Symptoms: slow onset of fever, aches, chills, stiffness and pain in lower extremities and back (entire), pain in center of chest, neck, head no trouble breathing, greast weakness, difficulty rising and standing -- best lying in bed under warm covers- Like the worst cases of flu or virus I've ever had.. Very thirsty

Other Meds: Losartan (Blood Pressure control) VitaCost A and D3 caps Country Life Coenzymate B complex CuraPro (turmeric preparation) B12 liquid CBD oil Source Natural Essential Enzymes caps Gut Restore caps Vit E

Current Illness: none -- beyond general fatigue (increasing), post-nasal drip and sore throat (minor), headache (no fever, at daily screening)

ID: 1070980
Sex: M
Age: 57
State: AZ

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: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Patient became hypotensive and bradycardic in the 40s. Patient passed out 4 times. EMS called over. Patient refused IV or further medical treatment. 30 min with EMS. Then observed for an additional 30 mins in the observation area of the POD.

Other Meds:

Current Illness:

ID: 1070981
Sex: F
Age: 46
State: OK

Vax Date: 02/22/2021
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: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: I could not go to sleep on Sunday night February 28th, after only a couple hours sleep I woke to watery eyes. Symptoms progressed throughout the day. I went to urgent care clinic on Tuesday, March 2nd and they sent me straight to ER and I was diagnosed with Bell's Palsy. I cannot shut one eye, tingling of face, mouth, and tongue. I was prescribed and antibiotic and steroid.

Other Meds: Novolog flex pen Tresiba flex pen Ortho tri low

Current Illness: None

ID: 1070983
Sex: F
Age: 59
State: FL

Vax Date: 02/25/2021
Onset Date: 02/26/2021
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: Iodine, levaquin, lyrica, acid, Effexor, sulfa, amoxicillin-pot Clavulanate, Lodine, erythromycin, articaine

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

Symptoms: Pain, swollen gland, flu, chills, tinnitus, fatigue

Other Meds: Propranolol, Singular, Fluticasone, Citacal, Vitamin D, Pantoprazole, Eletriptan, Ibuprofen, benedryl

Current Illness: Sinus allergies, ulcer

ID: 1070984
Sex: M
Age: 66
State: CA

Vax Date: 02/17/2021
Onset Date: 02/18/2021
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: Pyrexia, White blood cell count decreased

Symptoms: Extreme pain in the left shoulder and arm at the injection site. Unable to lift arm past height of shoulder or head without further pain. Pushing with the left hand on an object creates pain in the arm and shoulder. Resting on the elbow will also create the same pain. The pain is constant. At night I usually wake up between 1 and 3 am from the throbbing pain. According to the physician, the pain seems to mimic a rotator cuff injury, which I do not have, nor have I had. I have been taking Motrin 2 to 3x per day, and Extra Strength Tylenol during those 1 to 3 am morning wake-ups. Putting the left arm thru a shirt is a painful task. Outside of arm at injection to the touch creates pain.

Other Meds: Vitamin E, Vitamin D, Vitamin C, Zinc, Echinacea, Bromelain, Lutein,

Current Illness: None

ID: 1070985
Sex: F
Age: 40
State: PA

Vax Date: 02/25/2021
Onset Date: 02/25/2021
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: Augmentin, ceclor

Symptom List: Pharyngeal swelling

Symptoms: Arm soreness, fatigue, body aches, chills

Other Meds: Humira

Current Illness:

ID: 1070986
Sex: F
Age: 70
State: MA

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: Apple, balsam of peru, black dye, canola oil, cinnamon, coconut, cottonseed, grape, honey, mango, menthol, methyl salicylate, mold, peach, peas, peppermint, pineapple, Prevnar 13, pseudoephedrine, ragweed, soy, strawberry, sulfonamides, tetanus vaccine, red dye and latex.

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Patient developed the immediate onset within 1-2 hours of severe coughing, shortness of breath, wheezing, increased intestinal gas, sore joints, throat pain and low grade fever of 99.8. Coughing and shortness of breath continued to worsen over the day and evening and persisted for several days requiring treatment with prednisone. There were no other apparent causes for these symptoms except for the COVID-19 vaccination.

Other Meds: Flovent inhaler Singulair

Current Illness: Chronic persistent asthma well controlled

ID: 1070987
Sex: F
Age: 70
State: MN

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

Lab Data:

Allergies: None

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Headache with waviness in right eye peripheral vision. Resolved in an hour.

Other Meds: None

Current Illness: None

ID: 1070988
Sex: F
Age: 76
State: MS

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: SYR
Vax Site: LA

Lab Data:

Allergies: Iodine for CAT Scan

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

Symptoms: Chills. Low grade fever, severe headache, shooting joint pain. Took Tylenol. No treatment necessary. Symptoms gone in less than 24 hours.

Other Meds: Creator 20mg Omeprazol Vitamin D Vitamin C Probiotic Fish oil Quercertin Timolol eye drops Xalatin generic eye drop Alphagan eyedrops Rhopresso eye drops Vit B12 shot once a month

Current Illness: None

ID: 1070989
Sex: M
Age: 66
State: NE

Vax Date: 02/26/2021
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: SYR
Vax Site: RA

Lab Data:

Allergies: Morphine

Symptom List: Rash, Urticaria

Symptoms: He had first shot at their Covid immunization clinic. No reaction after first shot on 02/02/2021. No reaction after second shot 2/26/2021 until Tuesday March 2 when he lost his taste and smell, he had no temp and no other symptoms. He was tested on 3/3/2021 and it was negative. So only problem was the loss of taste and smell.

Other Meds:

Current Illness: none

ID: 1070990
Sex: F
Age: 71
State: WA

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: Morphine

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

Symptoms: Freezing , headache , nauseous, fever , dizzy

Other Meds:

Current Illness: None

ID: 1070991
Sex: F
Age: 57
State: CA

Vax Date: 02/06/2021
Onset Date: 02/07/2021
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: Latex

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

Symptoms: I had what I call ?hot spots?. There were bright red spots on my skin with a deep nerve itch. It would come and go. It appeared on my ankles, hands, elbows, stomach, thighs, button, forehead, head...all over. It then went into excema, which I haven?t had for years, on my elbows, behind my knees, back of hands, my ears...I am due for my second round and am still itchy despite Benadryl at night.

Other Meds: Minerals and vitamins with Omega 3s

Current Illness: None

ID: 1070993
Sex: F
Age: 58
State: GA

Vax Date: 02/09/2021
Onset Date: 02/10/2021
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: Suprax, an antibiotic

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

Symptoms: I woke up with chills at 3:30 a.m. added blankets and slept until about 5:30 and woke up sweating and feeling nauseous. Also had a fever of 100. Took Tylenol and slept a few more hours. Felt okay for a little while. Ate a plain English muffin and drank some water and went back to sleep. Painful muscle and joint aches throughout the day. Would sleep a while, wake up and feel better for a short time. Had fever of 99.8 during the day. Could only eat a few crackers for lunch. Slept most of the day. Took naproxen for joint and muscle pain after eating the crackers. Ate a little dinner and felt okay. Didn't feel "normal" until about 9 p.m.

Other Meds: Simvastatin, Acyclivir, Claritin, Zyrtec, Nasonex, Prilosec, calcium, magnesium, zinc, d3, turmeric curcumin, folic acid, essential oil supplements - Triease, Deep Blue capsules, Copaiba, Phytoestrogen, MicroPlex VMz, Alpha CRS, xEO Mega, M

Current Illness:

ID: 1070994
Sex: F
Age: 68
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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None known

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

Symptoms: About 24 hours after the injection I had a painful lump about 3" in diameter, with itching and redness. I iced it, took Tylenol and Benadryl at bedtime. Today it is less painful, but larger, redder and with itching. It is raised and looks like a small pancake on my arm. I did not have this reaction with my first dose.

Other Meds: Prozac 20 mg, Benicar 20 mg, Rouvastatin .05mg 1x daily for all

Current Illness: None

ID: 1070995
Sex: F
Age: 68
State: GA

Vax Date: 03/03/2021
Onset Date: 03/03/2021
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: aspirin, penicillin, apricots

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

Symptoms: About an hour after I received the vaccine my entire head was in pain including upper jaw and back of neck. My face was flushed and my throat began to tighten a little The headache and flush lasted about an hour. (I had taken Tylenol right after getting the vaccine.) The throat symptoms lasted longer ,lessening slightly after about an hour and a half. Never had trouble breathing, talking, eating or drinking. But the feeling has lasted into the late evening to a very mild degree; as if something is caught at the back of the throat, or the back of the tongue feels a little fuzzy.

Other Meds: Eliquis, Losartan Potassium, Fluoxetine

Current Illness: none

ID: 1070996
Sex: M
Age: 57
State: CA

Vax Date: 02/24/2021
Onset Date: 02/25/2021
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: None

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Shingles. 3 dermatomes. Sever case.

Other Meds:

Current Illness: None

ID: 1070997
Sex: F
Age: 41
State: SC

Vax Date: 01/20/2021
Onset Date: 01/27/2021
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: Azythromycin

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Developed herpes simplex around mouth after dose 1 and dose 2. Both incidents happened 1 week after each injection. Very painful. In addition, several canker sores in mouth after both injections as well.

Other Meds: Multivitamin

Current Illness: Had facial herpes after 1st and 2nd vaccines exactly 1week after administering

ID: 1070998
Sex: F
Age: 72
State: IL

Vax Date: 02/12/2021
Onset Date: 02/19/2021
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: Aleve and cipro

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

Symptoms: 1 week after - the shot site was really swollen .. red.. and hot to the touch .. the area swollen was apex 8? by 4? and a little itchy ... the week right after the shot I was fine!

Other Meds: Allergy, clopidogrel, torsemide,carvedilol,potassium, losartan, atorvastatin, Lorazepam (when needed) melatonin (when needed), Tylenol (when needed) multi vitamin, vitamin D,

Current Illness: None

ID: 1070999
Sex: F
Age: 74
State: GA

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: 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: queasy stomach hot flash rapid pulse metalic taste

Other Meds: propanolol hydrochloride hydrochlorothiazide lipitor fish oil lotrel cholecalciferol

Current Illness: none

ID: 1071000
Sex: F
Age: 64
State: TX

Vax Date: 02/09/2021
Onset Date: 02/10/2021
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: Swelling and redness day one, with increased swelling and redness until day 14. The redness encompassed 3/4 of my upper arm from the injection site to the elbow (day 14). On day 9 after injection the site was bumpy and the skin felt rough. The infection site was also bruised and there was still a bump at the site. It was itchy and warm to the touch from day one until day 17. From days 14-17 there was 2 inflamed bumps on the outside of my arm, on the back side, not at the injection site, which were very itchy and red. There were also itchy areas on the upper arm but no inflamed bumps. I went to care my primary care physician and she recommended Clariton daily for the allergic type reaction with cold compressing if needed and was prescribed an antibiotic with instructions to call her office the day before my second scheduled shot, on March 8th.

Other Meds: none

Current Illness: none

ID: 1071001
Sex: F
Age: 70
State: TX

Vax Date: 03/02/2021
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: CODEINE (NAUSEA), NAPROXEN (SWELLING OF LIPS)

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

Symptoms: Pt c/o burning in nose area and pt reports pain, itching & burning down her left arm, which then radiated across her shoulders. Pt has wheezing which she reports is normal for her. BP is elevated, pt reporting not taking her meds this a.m. MD ordered breathing treatment of albuterol and metoprolol 50mg po for BP of 175/101. HR 68 SR 100%SpO2/RA,RR=21, No Respiratory Distress Noted

Other Meds: ALBUTEROL, ATORVASTATIN, MELOXICAM, METOPROLOL Tartrate, TRAZODONE

Current Illness: NONE LISTED

ID: 1071002
Sex: F
Age: 39
State: NY

Vax Date: 02/04/2021
Onset Date: 02/09/2021
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: ?Covid arm? large itchy circular rash that occurred almost a week after the injection. VERY ITCHY for about a week

Other Meds: Loloestrin Fe, daily

Current Illness: None

ID: 1071003
Sex: F
Age: 17
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:
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Vaccination given to patient (age 17). No other adverse events besides headaches that began 3/3/21 (the day after the vaccination)

Other Meds:

Current Illness:

ID: 1071004
Sex: M
Age: 57
State: NY

Vax Date: 02/25/2021
Onset Date: 02/25/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: N/A

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

Symptoms: Patient endorsed chest pain one hour following administration of the vaccine.

Other Meds: N/A

Current Illness: N/A

ID: 1071005
Sex: F
Age: 78
State: CA

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:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Numbness and tingling in the left hand finger. Initial BP 172/63, pulse 71, 99% O2 sat. Patient went to the ED.

Other Meds:

Current Illness:

ID: 1071006
Sex: F
Age: 38
State: NY

Vax Date: 02/24/2021
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: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: 7 days after vaccination I developed very itchy rash on arm near injection site. Rash is approximately 3 inches long and 2 inches wide.

Other Meds: Metformin, Humalin insulin

Current Illness: None

ID: 1071007
Sex: F
Age: 73
State: CA

Vax Date: 02/24/2021
Onset Date: 02/24/2021
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: Clindamycin, lidocaine, penicillin, fish oil

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

Symptoms: Light headedness. Started 20-30 minutes after the vaccination and has persisted for 1 week without improvement.

Other Meds: ? Ascorbic Acid (VITAMIN C PO) Take by mouth. ? azelastine-fluticasone 137-50 mcg/act nasal spray 1 spray by Both Nares route two (2) times daily. ? B Complex Vitamins (VITAMIN B COMPLEX) capsule Take 1 capsule by mouth daily. ? cyclobenzap

Current Illness: None

ID: 1071008
Sex: M
Age: 82
State: IA

Vax Date: 02/24/2021
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: Meperidinem Latex, Vistan, Flagul, Demarel

Symptom List: Nausea

Symptoms: Skin rash-first Noticed 3 days after shot. Red spots front and back upper torso and down arms. Some redder with white pinpoint spot on surface. Called My Nurse. Advised using cold packs for itching and call Medical doctor after weekend. Called Dr Tuesday, Mar 2, and went in to office. Saw PA. She confirmed a reaction to Covid shot and prescribed Prednisone 20 mg two tablets by mouth for 10 days. Said to call and get another prescription for it 10 days before 2nd shot March 25. Wednesday, Mar 3, -still has rash.

Other Meds: Clopidogrel 75 mg, Amlodipine 10 mg, Metoprolol 25mg, Atrovastatin 80 mg, Donepezil 10 mg, Asprin 81mg, Fish Oil 1000mg, vits c 500mg, e 400 IU, d-3 1000 IU, Calcium 600 mg, Iron 325 mg, Nitroglycerin.

Current Illness: None

ID: 1071009
Sex: F
Age: 72
State: WA

Vax Date: 02/24/2021
Onset Date: 02/25/2021
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: Skin around injection site turned yellow and it spread to about 4 inch area on her Right Arm. Injection sight was slightly warm to touch. It was not tender though. Patient was advised to seek medical help. I did call and fax her PCP as well as spoke to on call MD to see if Cephalexin will be viable option with patient being diabetic. On call MD suggested to go to urgent care if it is severe and she will f/u with Dr next day . Followed up with patient and she declined to go to urgent care as she was seeing her PCP in next 48 hours. Next day (03/03) Patient did go to ER due to discomfort. ER MD advised to ice injection site and did not prescribe any antibiotics. Discoloration has decreased in last 24 hours and her arm is feeling much better per patient.

Other Meds: Warfarin, hydrochlorothiazide, oxybutynin, carvedilol, Metformin, Omperazole, Alendronate, Digoxin

Current Illness:

ID: 1071010
Sex: F
Age: 42
State: UT

Vax Date: 02/24/2021
Onset Date: 02/25/2021
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, Levaquin, welbutrin, buspar, clindamycin, pcn

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

Symptoms: Pain in legs and joints. A week later, left knee is painful, feels like it has locked up. Struggled to walk on it due to pain for about a week. Taken Tylenol, Ibuprofen, Naproxen but doesn't seem to be effective. Massage helps for a little while. Pain present for 24 hours after first dose. Have not sought care from PCP but will if pain does not resolve soon.

Other Meds: Zoloft, Metformin, Flecainide, Verapamil, Vitamin D3, Magnesium Oxide, Allegra, Omeprazole, Ibuprofen

Current Illness: None

ID: 1071011
Sex: F
Age: 83
State: OK

Vax Date: 02/23/2021
Onset Date: 02/28/2021
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: Amlodipine (Caused Swelling), Lisinopril caused cough, COMBIGAN

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

Symptoms: sourness, itchy, red, rash

Other Meds: Levothyroxin, Hydralazine, Flecainide , Olmesa Medox, Systane I-Caps Lutein & Zeaxanthin, Refresh Liquigel, Dorzolamide SOL, Timolol MAL Solo, Furosemide, Pot CL Micro , Metoprol SUC, Sertraline, Clopidogrel, Fiber Con, Complete Multivitami

Current Illness: n/a

ID: 1071012
Sex: M
Age: 51
State: CA

Vax Date: 02/25/2021
Onset Date: 02/25/2021
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:

Symptom List: Tremor

Symptoms: Patient received first dose of Pfizer vaccine, but the vaccine was erroneously entered into as the Moderna vaccine with the Pfizer lot number. The second vaccine dose was entered as the Moderna vaccine, but corrected to the Pfizer vaccine.

Other Meds:

Current Illness:

ID: 1071013
Sex: F
Age: 73
State: WA

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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Multiple Chemical Sensitivity; Glyphosate/Organophosphates: Anaphylaxis if Acute inhalation toxicity, breathing difficulty, urticaria & skin irritation, gastro-intestinal distress, vision degradation, hearing loss, loss of consciousness, Gluten, Corn Starch, Lactose: diarrhea, gastro-intestinal distress, cramping

Symptom List: Erythema, Pruritus

Symptoms: Swelling of arm from shoulder to elbow, skin hot to touch, soreness; Bad taste in mouth beginning approximately 5 minutes after shot administered and continued for two days; Vision changes: blurry vision and difficulty focusing; Fatigue and lack of appetite; Sharp pain in left arm pit;

Other Meds: B-complex, Bacopa, Boswellia, Bilberry, C-complex, CoQ10, D3, Fish oil, Folic Acid, Garlic 100:1, Gymnema, Horse Chestnut, K-Complex, Acetyl-L-Carnitine, L-Lysine, Lutein w/Zeaxanthin, Magnesium Chelate, Magnesium Malate, Marine Based Mag

Current Illness: None

ID: 1071014
Sex: F
Age: 36
State: AR

Vax Date: 02/19/2021
Onset Date: 02/19/2021
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: Sulfa drugs

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

Symptoms: Within the 50 hour period after vaccination: Sore arm, fatigue, fever, chills, mild body aches Within 8 days of vaccination: rash on left arm where injection was given. Rash started out small at at about 2 inches long, was light red, and was more hard/firm than the surrounding skin. It has continued to spread, and is now 5 inches long, bright red and blotchy, is mildly swollen, and is quite warm to the touch.

Other Meds: Pantoprazole, fexofenadine, Flonase

Current Illness:

ID: 1071015
Sex: F
Age: 25
State: NJ

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

Lab Data:

Allergies: N/A

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

Symptoms: Migraine, Fever, Chills, Aches

Other Meds: Citalopram, Zyrtec, Multivitamin, Miralax

Current Illness: N/A

ID: 1071016
Sex: M
Age: 71
State: CA

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:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: He was inadvertently given Pfizer as the second dose of his series. His first dose was Moderna and was given 26 days earlier on 2/4/21. There was an administration error. There was no adverse outcome. Patient was informed and understands.

Other Meds:

Current Illness:

ID: 1071017
Sex: F
Age: 61
State: WA

Vax Date: 02/28/2021
Onset Date: 02/28/2021
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: mild hayfever many food allergies (have microscopic lymphocytic colitis) possible development of allergy to bald face wasp stings

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

Symptoms: mild persistent headache all symptoms are mild flushed face tired lack of appetite/ food tastes different rash

Other Meds: levothyroxin losartin

Current Illness: n/a

ID: 1071018
Sex: F
Age: 44
State: NH

Vax Date: 02/23/2021
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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Penicillin

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

Symptoms: Itchy skin at injection site, swollen arm at injection site, warm to the touch

Other Meds: Trulicity Fluoxetine Rosuvastatin

Current Illness: None

ID: 1071020
Sex: F
Age: 37
State: NJ

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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Some fruits

Symptom List: Pain in extremity

Symptoms: Rash on chest and back

Other Meds: Dulera, nuvaring, metformin, tylenol

Current Illness: No

ID: 1071021
Sex: F
Age: 80
State: AL

Vax Date: 02/01/2021
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: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: Sulphur penicillin. Latex.

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

Symptoms: Tired. Aching. Left arm broken out from shoulder to elbow on top side of arm. Arm is hot to. Touch. Itches. Stings. Hurts.

Other Meds: Zinc. D 3. Ativan. Estrogen. Synthesis. Plavix

Current Illness: Psoriasis.

ID: 1071022
Sex: F
Age: 41
State: UT

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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: ERYTHROMYCIN

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

Symptoms: ? Ears ringing ? Dizziness ? Could not stand up ? Started 2 minutes after receiving vaccination ? Going on 4 minutes ? Will call 911 if does not resolve by 10 min total ? Ambulance offered to patient ? refused for now ? Pt reports never having had a reaction to a vaccine in the past ? Mother is shopping, will drive patient home ? At 10 min, patient reports that she is feeling better while remaining sitting, and that ringing in ears is still noticeable, but markedly decreased in volume ? Pt is able to stand up and reports that she is no longer dizzy and able to walk ? Driven home by Mother

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1071023
Sex: F
Age: 49
State: NV

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: N/A

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

Symptoms: I have a silver dollar size bruise at the base of my thumb. It was initially itchy, then just bruised. Appeared about 1 hour after vaccine was administered. It is not painful to touch.

Other Meds: N/A

Current Illness: N/A

ID: 1071024
Sex: M
Age: 49
State: NC

Vax Date: 02/01/2021
Onset Date: 02/04/2021
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: Nine

Symptom List: Vomiting

Symptoms: Swelling and pain in arm with headache and nausea. It has been a month since the shot and I still have a knot in arm and I am very sore. Swelling comes and goes still. Can?t hardly raise my arm after a month of getting shot

Other Meds: Tramadol. Sivisitan. Flexril

Current Illness: None

ID: 1071025
Sex: F
Age: 57
State: MT

Vax Date: 02/19/2021
Onset Date: 02/21/2021
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: Patient call the pharmacy on 3/3/21 and reported that a couple days after being vaccinated on 2/19/21 she experienced nausea, vomiting, diarrhea, and fainted. The paramedics were called by the patients husband when she fainted. The took her to the hospital for observation. The GI events lasted for a few days and resolved.

Other Meds:

Current Illness:

ID: 1071026
Sex: F
Age: 82
State: OR

Vax Date: 02/24/2021
Onset Date: 02/28/2021
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: penicillin sulfa drugs saids unless buffered narcotic drugs

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

Symptoms: headache 24hrs starting the 4th day after the injection Full body aches 12 hrs Temp 99.1 12hrs. took buffered aspirin diarrhea 1 time dizzy episodes. 6 & 7 days after vaccine. (no medical attention needed)

Other Meds: metoprolol. 25mg 2xday

Current Illness:

ID: 1071027
Sex: M
Age: 56
State: IN

Vax Date: 02/03/2021
Onset Date: 02/05/2021
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: Two days after receiving the second Moderna COVID-19 vaccination, I developed tinnitus that still persists after one month.

Other Meds: Fish Oil Pill x 2 daily Multi-Vitamin

Current Illness: None

ID: 1071028
Sex: F
Age: 56
State: VA

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: RA

Lab Data:

Allergies: Codeine.

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

Symptoms: Shortly after taking the vaccine, my left face and eye went numb. It returned to normal after around 24+ hours.

Other Meds: Vitamins: C, D, E. Flonase B Complex Spirulina

Current Illness: Asthma

ID: 1071029
Sex: F
Age: 76
State: LA

Vax Date: 01/25/2021
Onset Date: 01/25/2021
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: arm sore for 5 weeks -- felt like the needle hit the bone

Other Meds: multiple vitamin

Current Illness: none

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm