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: 1072921
Sex: F
Age: 54
State: IN

Vax Date: 03/04/2021
Onset Date: 03/04/2021
Rec V Date: 03/04/2021
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: unkown

Symptom List: Dysphagia, Epiglottitis

Symptoms: Patient received her vaccine at 1:12pm. She went to check out. The check out man reported that she didn't feel well. I noticed that she started to slump over in her chair. I went to her. I asked if she wanted to lay on the hospital bed. She said she couldn't get up. She wanted cold rags. She was visibly sweating. I motioned another health care worker over so I could go get the rags. When I got back less than 30 seconds later, she was on the floor. My coworker reported she slumped out of the chair and was unconscious for about 10 seconds. Security called 911 , and I called the emergency phone number to the hospital. She came back around and did not want to go to ER. Dr listened to her. Lungs were completely clear. She reports she has a history of dizziness with all vaccines. She has never gone totally unconscious before. She has no history of diabetes or hypertension. She did not eat lunch before coming. BP 123/80 at start of the event. 27 minutes after the event bp was 99/69 with pulse 66. 52 minutes later bp 109/86 with pulse of 71. We did not want her to drive home. We had her call someone to be picked up. She was able to walk out of the building without assistance.

Other Meds: unknown

Current Illness: unknown

ID: 1072922
Sex: F
Age: 68
State: IL

Vax Date: 03/03/2021
Onset Date: 03/04/2021
Rec V Date: 03/04/2021
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: Bactrim, Cipro

Symptom List: Anxiety, Dyspnoea

Symptoms: Beginning at 3 AM: Chills, 101.7 fever, headache, total body ache, feeling disoriented, elevated heart rate (108),loss of appetite. No treatment. I feel worse than when I had Covid! Considering not doing second dose.

Other Meds: multiple vitamin, MSM, digestive enzyme, vitamin C, ,magnesium, fish oil, curamin, strontium, D3K2, ostoprime forte (calcium blend), monolauren, Ligaplex

Current Illness: Was diagnosed with Covid-19 on December 28, 2020

ID: 1072923
Sex: M
Age: 29
State: AR

Vax Date: 03/02/2021
Onset Date: 03/02/2021
Rec V Date: 03/04/2021
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: None

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

Symptoms: During the first day after taking vaccine, started having a fever, headache, and sore throat. By the evening, fever was severe and 102+, with severe headache and sore throat. After sleeping on that nigh (had disruption of sleep from 2 - 4 in the morning), it was looking normal., just had usual fatigue after a fever. But on Thursday (Took vaccine on Tuesday morning, March 02, 2021), I suddenly started having a seizure, my whole body was shaking, legs were cramping. I thought it was going to go away, but after 10 minutes it was getting worse and I had to call the emergency services. The fire service members first came, they measured my blood oxygen level, it was 98%, but my blood pressure was high (140). I was still shaking and having the seizure. They tried to calm me down by talking, after some time, my blood pressure came to normal and I started getting normal (no seizure at that point). I declined the ambulance service as it is expensive and I was getting normal. I had a 101 fever just after that and went to visit the health care facilities .

Other Meds: Famotidine

Current Illness: None

ID: 1072924
Sex: F
Age: 44
State: WI

Vax Date: 02/03/2021
Onset Date: 02/04/2021
Rec V Date: 03/04/2021
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: FELT ILL

Other Meds:

Current Illness:

ID: 1072925
Sex: F
Age: 57
State:

Vax Date: 03/04/2021
Onset Date: 03/04/2021
Rec V Date: 03/04/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: tingling all over, tingling lips. Evaluated by EMS-Cleared

Other Meds:

Current Illness:

ID: 1072926
Sex: M
Age: 60
State: NY

Vax Date: 02/14/2021
Onset Date: 02/16/2021
Rec V Date: 03/04/2021
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: DOXYCYCLINE,CIPRO,KENALOG

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

Symptoms: Right elbow redness soreness burning , right kneecap burning Pimples on left shoulder and neck area very itchy right and left wrist area pimples and itchy FYI Elbow and wrist pimples had 2 small holes on each sore that almost looked like I was bitten by something but I wasnt. Dermatologist stated to apply Mometasone Furoate Ointment USP,0.1% which helped with the burning and itching.

Other Meds: Livalo 2mg, metoprolol 25mg, Aspirin 81mg, Fish oil 2400 mg, Ubiquinol 100mg, D3 250mcg, 1muti vitamin, B-12 1000mcg daily, Prostate SR by Theralogix

Current Illness: NONE

ID: 1072927
Sex: F
Age: 75
State: FL

Vax Date: 02/16/2021
Onset Date: 02/25/2021
Rec V Date: 03/04/2021
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: Lisinopril, Trazodone

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Maculopapular rash arms, legs, chest

Other Meds: Amlodipine 2.5mg once daily, Losartan 100mg once daily, fenofibrate 160mg once daily, Metoprolol succ 50mg 1.5 tabs daily, Levothyroxine 50mcg once daily, Prolia injections, multivitamin

Current Illness: Hypertension

ID: 1072928
Sex: F
Age: 37
State:

Vax Date: 03/04/2021
Onset Date: 03/04/2021
Rec V Date: 03/04/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: PT STATED SHE IS NORMALLY FATIGUED AND LETHARGIC AFTER VACCINES. NORMALLY TAKES BENADRYL AFTER VACCINES. PT WAS ADMINISTERED VACCINE AND WAS IN OUR OBSERVATION AREA AND STARTED COMPLAINING OF CHEST TIGHTNESS, CLAMMY HANDS AND LIGHTHEADEDNESS. PROVIDER APPROACHED PATIENT AND PT COMPLAINED OF SOME THROAT TICKLING BUT NO BREATHING ISSUES. EMS ASSIST WAS CALLED. WHEN EMS ARRIVED TO THE PT, SHE VOMITED. EMS TRANSPORTED PT TO ER.

Other Meds:

Current Illness:

ID: 1072930
Sex: F
Age: 43
State: CA

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 03/04/2021
Hospital:

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

Lab Data:

Allergies: KY Jelly

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Sweats, nausea, muscle spasms in the injected arm for 24 hours. Spasms went away and came back a couple of days later and have continued off and on. On 3/3/21 a mild fever and on 3/4/21 "covid arm" at the injection site. It is red, very itchy and hard and swollen.

Other Meds:

Current Illness:

ID: 1072932
Sex: F
Age: 41
State:

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

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Patient developed headaches and night sweats the day following the second vaccine administration and symptoms still persisting one month later.

Other Meds:

Current Illness:

ID: 1072933
Sex: F
Age: 63
State: OH

Vax Date: 03/04/2021
Onset Date: 03/04/2021
Rec V Date: 03/04/2021
Hospital:

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

Lab Data:

Allergies: DEMEROL, DARVOCET, BEE STINGS

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

Symptoms: SWEATING, INCREASED HEART RATE, INCREASED BLOOD PRESSURE, INCREASED BODY TEMPERATURE

Other Meds: NONE/UNKNOWN

Current Illness:

ID: 1072934
Sex: F
Age: 45
State: CO

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 03/04/2021
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: Ideopathic for dermado gravia

Symptom List: Rash, Urticaria

Symptoms: After my second vaccine, I experienced chills, sweats, headaches, body aches, join pain. I went to Occupational Health due to a large lymph node I also had to my vaccine, which was the size of a lemon. I took Ibuprofen for pain medication and relief of my headaches.

Other Meds:

Current Illness:

ID: 1072935
Sex: F
Age: 37
State: TX

Vax Date: 03/01/2021
Onset Date: 03/01/2021
Rec V Date: 03/04/2021
Hospital:

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

Lab Data:

Allergies: Skin irritation to green cosmetic dye

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

Symptoms: Bad muscle aches in upper left arm, limited use of left arm due to muscle pain, red spot at injection site that has gotten larger over the past 3 days, red spot is warm to the touch, fatigue, diarrhea, malaise, stomach cramps

Other Meds: Lisinopril, Omeprozole, Topiramate, Albuterol, Duloxetine, Cyclobenzaprine, Leflunomide

Current Illness: None

ID: 1072936
Sex: F
Age: 66
State: NY

Vax Date: 03/04/2021
Onset Date: 03/04/2021
Rec V Date: 03/04/2021
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: Patient has had a history of anxiety during vaccines in the past, and typically breaks out in hives. Because of this history with vaccines, it was determined by on-call nurses that patient should be given vaccine in private and held for 30 minutes with EMT assessment. After receiving vaccine, patient showed no symptoms of anxiety or hives, and was alert and oriented throughout entire encounter. Patient was calm and conversing with EMT during and after vaccine administration.

Other Meds: Unknown

Current Illness: Anxiety

ID: 1072937
Sex: M
Age: 70
State:

Vax Date: 03/02/2021
Onset Date: 03/02/2021
Rec V Date: 03/04/2021
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: muscle aches, shivering chills, fever, headache, one day+ in bed.at home. Out of bed today, but still weak and recovering. More thanthe "none to minimal" side effects as described in materials.

Other Meds: generic Zoloft and fenofibrate

Current Illness: None

ID: 1072938
Sex: F
Age: 70
State: AZ

Vax Date: 03/02/2021
Onset Date: 03/03/2021
Rec V Date: 03/04/2021
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: Bee sting

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

Symptoms: Pain in left arm within 30 minutes of administration. General tiredness/lethargy within10 hours (upon waking next morning). Sore/stiff neck within 14 hours. Body aches, chills within 16 hours. Stomach/abdominal discomfort within 20 hours. Diarrhea at 36 hours. At 36+ hours - arm pain considerably less. Body aches and chills gone by 36 hours. Continued stomach/abdominal discomfort seems to be improving after 40 hours.

Other Meds: Multivitamin, zinc, b-complex, elderberry, vitamin c

Current Illness: none

ID: 1072939
Sex: F
Age: 40
State: WI

Vax Date: 02/02/2021
Onset Date: 02/03/2021
Rec V Date: 03/04/2021
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: HEADACHE, BODY ACHES, CHILLS, FATIGUE

Other Meds:

Current Illness:

ID: 1072941
Sex: F
Age: 35
State: MI

Vax Date: 03/04/2021
Onset Date: 03/04/2021
Rec V Date: 03/04/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List: Ear pain, Hypoaesthesia

Symptoms: 1 1/2 hours after receiving vaccine had nausea, headache, vomiting and shaking . Symptoms lasted about 1/2 hour

Other Meds: No Known medication

Current Illness: None

ID: 1072942
Sex: F
Age: 48
State: MI

Vax Date: 03/04/2021
Onset Date: 03/04/2021
Rec V Date: 03/04/2021
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: Nausea, vomiting, headache. After pt vomited she felt better. At that time she was given crackers and apple juice. As time past she became better. The onset was immediate (within 10 mins) and lasted about 30 mins.

Other Meds:

Current Illness:

ID: 1072944
Sex: M
Age: 79
State: SD

Vax Date: 03/03/2021
Onset Date: 03/04/2021
Rec V Date: 03/04/2021
Hospital:

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

Lab Data:

Allergies: lactulose

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

Symptoms: Patient was given injection on 3/3/21, symptoms started in AM on 3/4/21 with dizziness and headache. Patient was given meclizine by one of our providers from our clinic to help with the dizziness since patient experienced this with the first vaccine. Patient will follow up with a clinic visit if symptoms do not improve.

Other Meds: prednisone, metoprolol, prevacid, synthroid, ambien, effexor, hydrocodone-acetaminophen, fentanyl, hyzaar, zinc sulfate, calcium, cranberry, ativan, miralax, flomax, secukinumab, vit d, excedrin migraine, multivitamin, senna

Current Illness: none

ID: 1072945
Sex: M
Age: 44
State: ND

Vax Date: 02/25/2021
Onset Date: 02/26/2021
Rec V Date: 03/04/2021
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: Amoxicillin, Nickel

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

Symptoms: Significant arm soreness for 4 days, fever of 102.2 for 24 hours, body aches/joint pain for 24 hours, severe headache for 24 hours, lingering headache for 5 days, nausea 12 hours, fatigue for three days. Have taken multiple doses of Tylenol 1000mg approximately every 8-10 hours for 5 days, ibuprofen 800mg every 8 hours for 1 day. All symptoms resolved after 5 days.

Other Meds: Tylenol PM, Melatonin, Vitamin D

Current Illness: None

ID: 1072946
Sex: M
Age: 73
State: MD

Vax Date: 03/03/2021
Onset Date: 03/04/2021
Rec V Date: 03/04/2021
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: Fever, chills, headache, light headed

Other Meds: Diebetic oral drugs

Current Illness: None

ID: 1072947
Sex: F
Age: 57
State: TX

Vax Date: 03/01/2021
Onset Date: 03/01/2021
Rec V Date: 03/04/2021
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: GLUTEN, DUST, HAY, AND POLLEN

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

Symptoms: numbness, tingling to both arms nausea and sore throat

Other Meds: magnesium, vit D,

Current Illness: NONE

ID: 1072949
Sex: F
Age: 67
State: TX

Vax Date: 02/21/2021
Onset Date: 02/22/2021
Rec V Date: 03/04/2021
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: tetracycline, sulfa, flagyl, epinephrine, lactose, niacin, zoledronic acid, ibandronic acid, keflex, sertraline, levofloxacin

Symptom List: Injection site pain, Pain

Symptoms: notes from patient: "I got my second Moderna shot on Sunday, Feb. 21. Had a one day fever and fatigue that was gone on Weds and fatigue was back on Thursday. Also had red blotches on my torso that faded on Tuesday."

Other Meds: adderall, pepcid, simvastatin, synthroid, pilocarpine, lidex cream, prozac, metoprolol, atrovent nasal spray

Current Illness: finger tip injury.

ID: 1072950
Sex: M
Age: 62
State: MA

Vax Date: 03/02/2021
Onset Date: 03/02/2021
Rec V Date: 03/04/2021
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: We were running 2 brands at the mas vaccination clinic (Pfizer and Moderna). Most patients were getting Pfizer #2 but we were also adding patients that were there for Moderna #1. We had one dedicated Moderna table and the nurse was drawing up and administering out of the same table (low volume use for that day). Nurse reports that instead of drawing up the whole vial before starting to vaccinate, she vaccinated 3 patients that were waiting. When the nurse finished drawing up the entire vial, realized that one of syringes that she administered may have been empty (no medication). We narrowed it down to 3 patients (the only 3 she had vaccinated). Contacted CDC for advise about how to address this error. This is their response: Note that CDC does not have specific guidance for managing a situation in which it is unknown if an empty syringe of vaccine was administered.

Other Meds:

Current Illness:

ID: 1072952
Sex: F
Age: 65
State: PA

Vax Date: 02/26/2021
Onset Date: 02/27/2021
Rec V Date: 03/04/2021
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: Atorvastatin, Cipro, Lisinopril, metoprolol, avocado

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

Symptoms: Patient received her 2nd Moderna COVID vaccine dose on 2/26 at 2:00PM. She started with urticaria at approximately 4:30PM. She took a dose of cetirizine that helped to alleviate the urticaria. She then started to develop tongue swelling around 10:00 PM, but noticed it to worsen around 1:00 AM today, which prompted her visit to the Emergency department. Tongue swelling/possible angioedema

Other Meds: aspirin 81 mg chewable tablet 1 po daily cyanocobalamin (vit B-12) 1,000 mcg tablet TK 1 T PO QD. cyclobenzaprine 10 mg tablet EpiPen 2-Pak 0.3 mg/0.3 mL injection, auto-injector 0.3 mg SC/IM x1 dose with tongue swelling/choking/short

Current Illness: None

ID: 1072953
Sex: F
Age: 69
State: MN

Vax Date: 02/18/2021
Onset Date: 02/25/2021
Rec V Date: 03/04/2021
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: bacitracin, tetanus toxoid

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Patient called primary care office on 3/1/21 stating she had a local reaction to the COVID vaccine that started a week after getting it. It started as a rash and reported it being very itchy. She took Benadryl and iced her arm and that was helping. She called on 3/4/21 stating the rash started to spread down her arm and her home treatments were no longer working so she was scheduled for an appointment in clinic with her provider. Provider did take a picture and prescribed a steroid cream and Zyrtec to take.

Other Meds: diclogenac topical gel, clonazepam, Zetia, metoprolol tartrate, trazodone, Co-Q 10, miralax, tylenol, aspirin, biotin, vitamin D3, fish oil, lysine

Current Illness: none

ID: 1072954
Sex: F
Age: 22
State: MO

Vax Date: 02/23/2021
Onset Date: 02/23/2021
Rec V Date: 03/04/2021
Hospital:

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

Lab Data:

Allergies: keflex

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: I had a headache just after my shot. Two hours later my lips turn red and swell up. Also, my face was burning. Then the next day ever since I felt lightheaded, nauseous, weak, and tired since 2/24. Lips are fine.

Other Meds: Tri-Lo-Sprintec, Prednisone, Monetlukast, Hydroxyzine, Phentermine, Tramodol, metformin, topiramte, verapamil, folic acid, sertraline, levothryroxine, iron, zyrtec, b complex,

Current Illness:

ID: 1072955
Sex: F
Age: 55
State: NY

Vax Date: 02/05/2021
Onset Date: 02/08/2021
Rec V Date: 03/04/2021
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, contrast dyes

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

Symptoms: pt stated that almost a week after she got the vax she could not move, her body was stiff and her pain level was at a 12. She was not able to work that day but the pain was still bad but she was able to go to work. Pt had a virtual appt w/ PCP where she was told it was a reaction to taking the vax. She was ordered blood work on 2/22/2021 and told if she does not here from them that means everything should be ok. She later had an appt w/ her Neurologist which confirmed the symptoms were related to taking the vax. Pt no longer has this pain.

Other Meds: Vitamin C, D, Zinc,

Current Illness: No

ID: 1072956
Sex: F
Age: 73
State: NH

Vax Date: 02/18/2021
Onset Date: 02/19/2021
Rec V Date: 03/04/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List: Nausea

Symptoms: Red circle rash on Left Deltoid, sore to the touch, hard, itchy, but not painful when it is not touched

Other Meds:

Current Illness:

ID: 1072957
Sex: F
Age: 47
State: CA

Vax Date: 03/04/2021
Onset Date: 03/04/2021
Rec V Date: 03/04/2021
Hospital:

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

Lab Data:

Allergies: Patient states she is allergic to the smells of marijuana and perfume and that she carries an epi-pen for this.

Symptom List: Injection site pain

Symptoms: Injection given at 0917 and at 0925 she was coughing and felt someone wrong with her breathing and had increasing mucous. Pt stated this is how she feels when she has an anaphylactic reaction. HR was 122 and B/P 155/93. Benadryl 50 mg given at 0930, and epi given at 1001. Solumedrol at 1032 O2 99% at 1034. ACLS transfer to ER.

Other Meds: Prozac, Valtrex, Flonase, neilmed sinus rinse, Sudafed, Advair, astelin, amoxicillin, albuterol, singulair, Robaxin, naproxen, voltaren, Atrovent,

Current Illness: na

ID: 1072958
Sex: M
Age: 72
State: MD

Vax Date: 02/19/2021
Onset Date: 02/25/2021
Rec V Date: 03/04/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: Patient was admitted for a scheduled vitrectomy surgery. Per the EUA, hospitalizations are to be reported irrespective of attribution to vaccine.

Other Meds:

Current Illness:

ID: 1072959
Sex: F
Age: 33
State: MT

Vax Date: 02/26/2021
Onset Date: 02/26/2021
Rec V Date: 03/04/2021
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: Left arm tingling and numb after injection

Other Meds:

Current Illness:

ID: 1072960
Sex: F
Age: 62
State: NJ

Vax Date: 02/28/2021
Onset Date: 03/03/2021
Rec V Date: 03/04/2021
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: ASPIRIN

Symptom List: Tremor

Symptoms: SWOLLEN TONGUE, WHEN TO EMERGENCY ROOM GIVEN MEDICATION DISCHARGE AFTER 3 HRS, SEND HOME WITH MEDICATION.

Other Meds: TELMISARTAN 10MG, CLOPIDOGREL 75MG, ALENDRONATE, PREMARIN ESTROGENS CREAM 6.25MG

Current Illness: NONE

ID: 1072962
Sex: F
Age: 66
State: GA

Vax Date: 03/03/2021
Onset Date: 03/03/2021
Rec V Date: 03/04/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: mild local site injection reaction

Other Meds:

Current Illness:

ID: 1072963
Sex: F
Age: 58
State: PA

Vax Date: 03/04/2021
Onset Date: 03/04/2021
Rec V Date: 03/04/2021
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: shellfish, nuts, eggs, latex, penicillin

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

Symptoms: Developed generalized pruritis, especially over arms. no visible rashes. spontaneously resolved without intervention. no SOB, GI distress. No lightheadedness, lungs clear to auscultation bilaterally. patient advised to follow-up with PCP.

Other Meds: omeprazole, lisinopril, insulin, dulaglitide, zofran

Current Illness:

ID: 1072964
Sex: F
Age: 50
State: WI

Vax Date: 02/03/2021
Onset Date: 02/04/2021
Rec V Date: 03/04/2021
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: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: DIZZINESS, FATIGUE, CHILLS, BODY ACHES, BRAIN FOG

Other Meds:

Current Illness:

ID: 1072965
Sex: F
Age: 70
State: FL

Vax Date: 02/16/2021
Onset Date: 02/18/2021
Rec V Date: 03/04/2021
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: Asthenia, Chills, Headache, Myalgia

Symptoms: 02/18/2021 developed Bells Palsey on left side of head and face Dr prescribed steroids and viral infection meds which I started 02/19/2021 and 02/20/2021 for 7 days Symptoms have receded

Other Meds: Blood pressure tramadol vitamin d Anxiety meds asthma meds

Current Illness: None

ID: 1072966
Sex: F
Age: 63
State: IN

Vax Date: 03/02/2021
Onset Date: 03/02/2021
Rec V Date: 03/04/2021
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: penicillin, sulfa, uncooked tomatoes, nabumetone(?)

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

Symptoms: Tiredness, headache, muscle pain, chills, fever

Other Meds: Lisinopril, baby aspirin, Pulmicort inhaler, Flonase.

Current Illness: none

ID: 1072967
Sex: F
Age: 40
State: NJ

Vax Date: 02/25/2021
Onset Date: 03/01/2021
Rec V Date: 03/04/2021
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: Nickel

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

Symptoms: Pruritus followed by a full body viral looking rash

Other Meds: Lexapro, Vyvanse, Rexulti, Vitamin D, Multivitamin

Current Illness: N/A

ID: 1072968
Sex: F
Age: 76
State: NM

Vax Date: 02/25/2021
Onset Date: 03/04/2021
Rec V Date: 03/04/2021
Hospital:

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

Lab Data:

Allergies: sulfer eggs pennicillin

Symptom List: Pain in extremity

Symptoms: hot sweats passing out dry mouth gasping for breath extreme energy loss (couldn't stand up)

Other Meds: levothyroxine meroproloolsulfer

Current Illness: nine

ID: 1072969
Sex: F
Age: 74
State: NY

Vax Date: 02/27/2021
Onset Date: 02/27/2021
Rec V Date: 03/04/2021
Hospital:

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

Lab Data:

Allergies: No

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

Symptoms: a few hours after I had it I was watching TV and I had 2 arrows off to my left one inside of the other and it seemed to have an image that was very liquid and it lasted 10-15 minutes and then floated away. 24 hours later my arm was extremely sore and I had a similar visual reaction and instead of arrows it was jagged circles that were fluid. it last 10-15 minutes and then left.

Other Meds: Synthroid B12 Vitamin D Omeprazole

Current Illness: No

ID: 1072971
Sex: M
Age: 64
State: UT

Vax Date: 02/23/2021
Onset Date: 03/02/2021
Rec V Date: 03/04/2021
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: redwod ashes, ragweed, bermuda grass, cedar

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

Symptoms: fatigue,headache, runny nose, dry nose, irtchy eyes, achy joints, anxiety

Other Meds:

Current Illness:

ID: 1072972
Sex: F
Age: 54
State: MT

Vax Date: 02/26/2021
Onset Date: 02/26/2021
Rec V Date: 03/04/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Injection site pain

Other Meds:

Current Illness:

ID: 1072974
Sex: F
Age: 68
State: AR

Vax Date: 03/02/2021
Onset Date: 03/02/2021
Rec V Date: 03/04/2021
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: Shellfish (muscles/oyster group). Lidocaine.

Symptom List: Vomiting

Symptoms: Within 45 minutes of getting the vaccine she started having a fast, racing heart beat. This reaction lasted for about 15 minutes. She has had no other reactions since the vaccine, no fever, headaches or anything. This episode only happened once, and has not returned. She laid down and it stopped. She spoke with her allergist today while getting her allergy shot who told her to report the reaction to us.

Other Meds: Probiotic, vitamin C, baby aspirin, Prevacid, calcium, Vitamin D, Elderberry, Vitamin C.

Current Illness: None.

ID: 1072975
Sex: F
Age: 66
State: TN

Vax Date: 03/04/2021
Onset Date: 03/04/2021
Rec V Date: 03/04/2021
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: Pt reported back to the clinic 35 minutes after receiving the vaccine reporting feeling dizzy with tingling of lips and tongue tingling along with chest tightness/shortness of breath

Other Meds:

Current Illness:

ID: 1072976
Sex: F
Age: 56
State: MA

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

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

Lab Data:

Allergies:

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

Symptoms: We were running 2 brands at the mas vaccination clinic (Pfizer and Moderna). Most patients were getting Pfizer #2 but we were also adding patients that were there for Moderna #1. We had one dedicated Moderna table and the nurse was drawing up and administering out of the same table (low volume use for that day). Nurse reports that instead of drawing up the whole vial before starting to vaccinate, she vaccinated 3 patients that were waiting. When the nurse finished drawing up the entire vial, realized that one of syringes that she administered may have been empty (no medication). We narrowed it down to 3 patients (the only 3 she had vaccinated). Contacted CDC for advise about how to address this error. This is their response: Note that CDC does not have specific guidance for managing a situation in which it is unknown if an empty syringe of vaccine was administered.

Other Meds:

Current Illness:

ID: 1072977
Sex: M
Age: 81
State: IN

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

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Have been very tired and lethargic since vaccination

Other Meds:

Current Illness:

ID: 1072978
Sex: F
Age: 62
State: CT

Vax Date: 03/01/2021
Onset Date: 03/02/2021
Rec V Date: 03/04/2021
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.

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

Symptoms: I experienced 6 hours of paroxsysmal sneezing and copious oronasal mucous.

Other Meds: Omeprazole, Lisinopril HCTZ, Atorvastatin

Current Illness: None.

ID: 1072979
Sex: F
Age: 73
State:

Vax Date: 03/03/2021
Onset Date: 03/03/2021
Rec V Date: 03/04/2021
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: NKA

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

Symptoms: I received my 2nd. Moderna vaccine @ 9:24 am at Publix pharmacy, at midnight I developed a fever and chills, headache and pain in every joint in my body I felt like I had the flu,

Other Meds: Tylenol; ASA CENTRUM SILVER

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm