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: 1073154
Sex: M
Age: 35
State: PA

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

Lab Data:

Allergies: None

Symptom List: Dysphagia, Epiglottitis

Symptoms: At around the 14 hour mark, I came down with severe chills, 102? fever, general pain all over, general weakness, no energy, vomited after I ate. This lasted until around midnight when I took nyquil and went to sleep. I slept for 12 hours without waking. I felt moderately better upon waking. I had a lingering headache and slight weakness.

Other Meds: Daily vitamins

Current Illness: None

ID: 1073155
Sex: F
Age: 87
State: WA

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

Lab Data:

Allergies: NONE

Symptom List: Anxiety, Dyspnoea

Symptoms: WITHIN AN HOUR MY WIFE STARTED THROWING UP AND HAD DIAREHEA

Other Meds: L-LYSINE (1 DAILY); SERTRALINE HCL TABS 100MG (1/2 TAB DAILY); LORATADINE TABS 10MG (1 TAB DAILY); SYNTHROID TAB 150MCG (1 TAB DAILY); HYDROXYZINE HCL 10MG (2 TABS IN PM); NIGHT TIME TYLYNOL (2 CAPSELS IN PM)

Current Illness: NONE

ID: 1073156
Sex: F
Age: 46
State: TX

Vax Date: 02/27/2021
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: Penicillin

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

Symptoms: Itchy head, face, ears followed by redness and inflammation

Other Meds: N/A

Current Illness: N/A

ID: 1073157
Sex: F
Age: 70
State: PR

Vax Date: 02/20/2021
Onset Date: 03/03/2021
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: No.

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Injection site redness, and swollen, with an extension of around 2 inches. Hypersensitivity in the area, and mild pain. On the second day was still swollen.

Other Meds: Lisinopril 40mg Simvastatin 40mg Omega 369 Flaxseed oil 2000 mg

Current Illness: No

ID: 1073158
Sex: F
Age: 63
State: NJ

Vax Date: 01/21/2021
Onset Date: 02/11/2021
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: Codeine,percocet

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

Symptoms: Patient received Pfizer dose#2 on 1/2/2021. Then approximately 3 weeks post vaccine, she began to experience acute upper arm/ clavicular joint pain and bilateral hands were "cupped". Received steroid treatment from PMD.

Other Meds:

Current Illness:

ID: 1073160
Sex: F
Age: 77
State: TX

Vax Date: 03/04/2021
Onset Date: 03/04/2021
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: Penicillin, Codeine, Vancomycin, Ace inhibitors, Ivanka, Iodine,

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

Symptoms: Patient reported lips swollen and tingling

Other Meds:

Current Illness:

ID: 1073161
Sex: F
Age: 65
State: NV

Vax Date: 02/25/2021
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: LA

Lab Data:

Allergies: no

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: At 10 pm after receiving the injection, pain developed and worsened as night continued to a severe level through to a.m. of next day. The pain radiated down the arm to hand. I was unable to move that arm independently both due to the lameness of the limb and severe pain level when moved by my other hand. 2 Tylenol extra strength were taken at 11pm when pain was developing; 2 more were taken at 4a.m.; 2 more at 9am of Feb 26th. The Tylenol helped alleviate some of the pain, but it was still at a level 8 out of 10 and unable to move it. Pain in the arm receded to about a level 4 Feb 27. Minor soreness was present Feb 28 but functional with 1 Tylenol. No pain March 1 March 2 some pain returned; manageble with 1 Tylenol. March 4 pain and soreness returned to about a level 5 and took 1 Tylenol.

Other Meds: none

Current Illness: no

ID: 1073162
Sex: F
Age: 78
State: SD

Vax Date: 12/22/2020
Onset Date: 01/01/2021
Rec V Date: 03/04/2021
Hospital: Y

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

Lab Data:

Allergies: Loevofloxacin, Sulfamethoxazole

Symptom List: Pharyngeal swelling

Symptoms: Pt had received dose 1 of COVID vaccine on 12/22/20. On 01/01/21 pt presented to the emergency department for intractable nausea, vomiting, cough, and non bloody diarrhea. Pt had tested positive for COVID 19 on 12/30/2020. Pt was spiking high fevers and was hypotensive. Pt was admitted to the hospital from 1/01-1/06 and treated with dexamethasone, remdesivir, and convalescent plasma.

Other Meds: Hhydrochlorothiazide, Synthroid, Potassium Chloride

Current Illness: None noted

ID: 1073163
Sex: F
Age: 55
State: NY

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

Lab Data:

Allergies: Antibiotics

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Severe muscle pain, arthritis pain, sensitivity to light, sinus pressure, pain around rib cage

Other Meds: Aleve, temazepam, lyrica, xanax, levocetirizine levothyroxine, Lisinopril protonix Seroquel multivitamin fish oil calcium

Current Illness:

ID: 1073164
Sex: F
Age: 96
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: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: The patient received a 3rd dose of the COVID vaccine due to improper record keeping/reporting from facility.

Other Meds:

Current Illness:

ID: 1073166
Sex: F
Age: 46
State: GA

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:

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

Symptoms: pt reports feeling dizzy which resolved before patient left facility- pt was assessed by EMS

Other Meds:

Current Illness:

Date Died: 02/24/2021

ID: 1073167
Sex: F
Age: 54
State: TX

Vax Date: 02/11/2021
Onset Date: 02/24/2021
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: No/Unknown

Symptom List: Rash, Urticaria

Symptoms: She passed away 2/24/2021

Other Meds: SOME OF THESE SHE WAS TAKING AND SOME SHE MAY NOT HAVE BEEN, List is from 2016. Metoprolol Omeprazole Duloxetine Valacyclovir Trazadone Tramadol HCL Cyclobenzaprine Augmentin

Current Illness: No

ID: 1073168
Sex: F
Age: 25
State: PA

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

Lab Data:

Allergies: None

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

Symptoms: My period started two weeks early, I am never off schedule.

Other Meds: 600 mg Tylenol

Current Illness: None

ID: 1073169
Sex: M
Age: 30
State: NJ

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: NKA

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

Symptoms: Patient stated that he was lightheaded. Patient presented with diaphoresis. Denies C/P, SOB, difficulty breathing. BP 142/92, P73, 02 98%RA. Patient stayed for approximately 20 mins post reaction. Upon reassessment, patient was no longer diaphoretic, or feeling lightheaded and states symptoms are resolved and at this time. Patient is breathing easy, respiration are unlabored, and color pink. Patient is refusing any further medical treatment and transportation. Patient ambulatory to car.

Other Meds: None reported

Current Illness: Denies history

ID: 1073170
Sex: F
Age: 79
State: NV

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

Lab Data:

Allergies: Penicillan, flu shot, eggs, pollen, dogs, cat

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

Symptoms: Itching all over body for the past 3 days

Other Meds: metformin, fenofibrate, meloxicam, losartan, aspirin, milk thistle, vitamin D

Current Illness: Diabetes 2

ID: 1073171
Sex: M
Age: 49
State: CO

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

Lab Data:

Allergies: None

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

Symptoms: Severe pain in shoulder and upper arm persisted for 48 hours, with arm almost immobile due to pain, gradually tapering off. On second night after receiving the vaccine, I had severe headaches and alternating chills/sweats. 72hrs after the vaccine, pain continues, although it has subsided to the point where almost full motion is possible. Periodic severe headaches continue, although these existed before receiving the vaccine and are linked to positive COVID in Nov 2020.

Other Meds: Montelukast 10mg Fluoxetine 40mg Lamotragine 200mg Lisonopril 20mh Daily fiber, allergy, vit D

Current Illness: None

ID: 1073172
Sex: F
Age: 76
State: IN

Vax Date: 02/07/2021
Onset Date: 02/11/2021
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: She developed nausea, vomiting that has persisted from 2/11/21 (first visit to see me) until today 3/4/2021 (second visit)

Other Meds:

Current Illness:

ID: 1073173
Sex: F
Age: 73
State: IA

Vax Date: 02/04/2021
Onset Date: 02/10/2021
Rec V Date: 03/04/2021
Hospital: Y

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

Lab Data:

Allergies: NKA

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Moderna COVID-19 Vaccine EUA 2/27/21: Pt received 1st Moderna vaccine 2/4/2021. She states that her symptoms 1st started out as a slight postnasal drip, which turned into a hoarse voice with a cough, which turned into a head cold, which has turned in due shortness of breath, diarrhea, and cough with associated chills. After 17 days of cold-like symptoms, pt was tested on 2/26 for COVID and tested positive. 2/27, pt worsened and presented to ED. Upon arrival to the emergency department, the patient's temperature is 100.2? F, heart rate 96, respiratory rate 24, saturating 84% on room air with blood pressure 164/84. The patient's laboratory studies were significant for BUN 17, CR 1.47, lactate 2.2, D-dimer 6.79, and phosphorus 2.2. The patient's chest x-ray showed no acute findings. CT chest showed extensive acute bilateral pulmonary emboli involving most of the lobar and segmental branches, right greater than left with no saddle embolus. Findings borderline for right heart strain, correlate with echocardiogram. Peripheral ground-glass airspace opacities consistent with atypical/viral pneumonitis. Reactive mediastinal and hilar lymphadenopathy. EKG showed normal sinus rhythm, heart rate 93 with inferior infarct-age undetermined. The patient was administered 1 L IV NS, ceftriaxone 1 g IV, azithromycin 500 mg IV, and heparin IV bolus and drip for PE indication. Remdesivir started. 2/28/21: Pt on 3 L oxygen. Azithromycin, ceftriaxone, remdesivir continued. Vancomycin started. 3/1/21: 1 L oxygen via nasal cannula. Small, nonproductive cough. Pt complains of SOB. 3/2/21: 1/2 blood cultures from 2/27 positive for CoNS. Vancomycin discontinued. Pt feeling much better. Still on 1 L oxygen via nasal cannula. More alert. 3/3: 5 day remdesivir course and azithromycin, ceftriaxone course completed. Patient weaned off oxygen. Pt discharged home with oxygen as a precaution. Pt also enrolled in COVID Safe At Home telehealth program.

Other Meds: Acetaminophen 650 mg PO Q8h PRN Amlodipine 10 mg PO QD Ascorbic acid 500 mg PO BID Cholecalciferol 1000 mg PO QD Dapagliflozin 5 mg PO QD Furosemide 20 mg PO QD Guaifenesin 1200 mg ER PO Q12h PRN Irbesartan 300 mg PO QD Metformin 500 mg PO

Current Illness:

ID: 1073174
Sex: M
Age: 71
State: PA

Vax Date: 03/03/2021
Onset Date: 03/03/2021
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: N/A

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Patient was given a 0.1 ml dose of the Moderna COVID vaccine rather that the 0.5 mL dose. this was caught by the clinical staff and the patient was revaccinated with a full o.5 mL dose in the opposite arm.

Other Meds: N/A

Current Illness: N/A

ID: 1073175
Sex: F
Age: 72
State: OH

Vax Date: 03/01/2021
Onset Date: 03/02/2021
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: pcn, sulfa

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

Symptoms: Patient reported having sore left arm after getting the vaccine. On march 3/4th patient reported sever pain in the left shoulder area. Pain did not go away after OTC medications. restricted hand movement as well

Other Meds:

Current Illness:

ID: 1073177
Sex: F
Age: 24
State: TN

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: 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: Pins/needles/tingling/numbness in entire left leg and down through foot. Calf muscle extremely tight/contracted; began 4 hours after second vaccine dose and has not resolved yet, 48 hours later.

Other Meds: None

Current Illness: None

ID: 1073178
Sex: F
Age: 73
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: Pt returned to health clinic 45 minutes after immunization reporting dizziness and blurry vision

Other Meds:

Current Illness:

ID: 1073179
Sex: F
Age: 29
State: NY

Vax Date: 02/08/2021
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: LA

Lab Data:

Allergies:

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

Symptoms: **Due date 5/8/21, Second pregnancy** I had a fever of 101 pretty consistent form 8:30am till mid day Wednesday . I had body aches and chills, When I got to work my heart rate was 160, I was checked out by my OB, the baby was fine. I was sent home to work, rested for the evening. I woke up Wednesday with Shingles. I called my Ob and she treated me with Valtrex for 5 days, then the rash cleared up. I still have some side effects for most went away. The baby has been perfectly fine through the whole thing, she is doing great.

Other Meds: Prenatal Generic Zyrtec-10mg daily Lexapro-5mg daily Tums-as needed

Current Illness:

ID: 1073180
Sex: F
Age: 62
State: VA

Vax Date: 02/04/2021
Onset Date: 02/09/2021
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: Epi, lidocaine intolerant

Symptom List: Injection site pain, Pain

Symptoms: Red blotchy itchy patch sever inches in circumference around vaccination site

Other Meds: Procardia, Coumadin, Ambriesentan, tadalafil, furosemide, sertraline, synthroid

Current Illness: None

ID: 1073181
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: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Throat swelling, tongue tingling, voice change

Other Meds:

Current Illness:

ID: 1073182
Sex: F
Age: 43
State: AZ

Vax Date: 02/19/2021
Onset Date: 02/22/2021
Rec V Date: 03/04/2021
Hospital:

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

Lab Data:

Allergies: Bees, iodine, betadine, shellfish, dairy, soy, hazelnuts, peanuts, grass

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

Symptoms: Reaction: swelling on upper left arm at injection site and redness; pain that radiated from the injection site up to the base of the skull and down to the fingertips Treatment: ice (made it worse); heat (helped for 30 minutes at a time); ibuprofen (helped for about an hour); Bactrim (after 3 days swelling decreased and redness cleared) doctor diagnosed me with an infection at the site Outcome: After 3 days on Bactrim the swelling and redness have cleared, but the pain remains

Other Meds: Daily multivitamin, birth control pill, 4X25mg. tablets per day, Claritin allergy tab (X1), Flonase

Current Illness: None

ID: 1073183
Sex: F
Age: 43
State: NC

Vax Date: 03/01/2021
Onset Date: 03/03/2021
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: none

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Patient with left hip pain starting approximately 48 hours after vaccine administration. Increase in pain and swelling over the following 24 hours. Location consistent with rectus femoris tenosynovitis. Treated with NSAIDs, ice.

Other Meds: none

Current Illness: none

ID: 1073184
Sex: F
Age: 16
State: AZ

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: RA

Lab Data:

Allergies: None

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Administration error: Patient incorrectly given Moderna as first dose on 2/5/21 despite being <18y/o. Error was detected when patient presented for second dose. Patient given Pfizer at that time due to age <18y/o which resulted in a mixed-dose series.

Other Meds: None

Current Illness: None

ID: 1073185
Sex: F
Age: 69
State: OH

Vax Date: 02/18/2021
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: Levothyroxine (Generic synthroid)

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

Symptoms: Extreme itching and swollen arm at injection site. Took a Benadryl tablet and used topical Benadryl itch cream. Itching is now occasional on third day but arm still swollen.

Other Meds: Synthroid, Valsartan HCTZ, Atorvastatin, Vitamin D3

Current Illness:

ID: 1073186
Sex: F
Age: 65
State: PA

Vax Date: 02/22/2021
Onset Date: 02/22/2021
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: Nausea

Symptoms: Headache, nausea, feeling weak for 24 hours

Other Meds: Synthroid Multivitamins Vitamin B-12 Vitamin D-3 Prilosec Biotin Weight loss suppl;ements Clonopin

Current Illness: None

ID: 1073187
Sex: M
Age: 62
State: AZ

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None known

Symptom List: Injection site pain

Symptoms: Fever and terrible chills about 12 hours after receiving the shot. Lasted about an hour. Woke up the next morning with mild fever, headache, aches, injection site very painful. Started taking Tylenol.

Other Meds: Simvastatin-5mg Lisinopril-5mg Famotidine-40mg Vitamin C-500mg AllerClear (Loratidine-10mg)

Current Illness: None

ID: 1073189
Sex: F
Age: 89
State: IA

Vax Date: 02/15/2021
Onset Date: 02/21/2021
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: Statins - unkown

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

Symptoms: Moderna COVID-19 Vaccine EUA Pt received Moderna COVID vaccine 2/15/21 (per pt, was 2/8/21 but shows 2/15/21). On 2/25/21 patient presented to ED with a complaint of generalized weekness for about 1 week, reporting it was worse that day. Pt reported diarrhea on Sunday 2/21 but none at visit. Denies fever, chills, chest pain, shortness of breath, nausea, vomiting, abdominal pain, vision changes, headache, sore throat, cough, diarrhea since Sunday, constipation, dysuria, hematuria, altered mental status. Low grade fever of 100 F, BP 155/65. Pt was tested for COVID, resulted in positive, and sent home with instructions for care. 2/26: Pt was contacted regarding starting monoclonal antibody bamlanivimab infusion.

Other Meds: Amlodipine 2.5 mg PO QD Aspirin 81 mg PO QD Betamethasone-clotrimazole topical BID Lovastatin 40 mg PO QHS

Current Illness:

ID: 1073190
Sex: F
Age: 66
State: IN

Vax Date: 02/06/2021
Onset Date: 02/10/2021
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: She had syncope, nausea, vomiting on 2/10/21, 4 days after vaccine. She went to ED that day. She saw me today (3/4/21) and has had recurrent nausea, vomiting and dizziness but no further syncope.

Other Meds:

Current Illness:

ID: 1073191
Sex: F
Age: 35
State:

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

Symptom List: Tremor

Symptoms: Patient felt ?wasted', foggy, exhausted, and hungover within 2 hours. Occipital headaches began that evening, then the next day fever, body aches, and head pain worsened. Blurred vision has been steadily worse since the day after the injection, and breathing is aggravated, requiring more gasping for air. Extreme fatigue has been present since the evening of the injection. GI symptoms including nausea, lack of appetite, and diarrhea, and gurgling ?upset' stomach have been present since the day after the injection. Severe trembling of the hands was observed on video, and body tremors were present in office. Patient reports feeling ?unwell', exhausted, nauseous, and in pain. It won't let me continue.

Other Meds:

Current Illness:

ID: 1073192
Sex: M
Age: 42
State: CA

Vax Date: 02/15/2021
Onset Date: 02/15/2021
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: Approximately 30 minutes after the administration of the dose I began feeling flush. I had intended to go back to work but instead my supervisor insisted on me being evaluated. It was determined that I was hypertensive. I felt a bit off and a bit strange. Even after lying on a bed in a dark room hypertension continued. I was transported by ambulance to the local emergency department where my BP continued to run high. The next day I was in bed the whole day feeling as if I had Covid all over again. I did previously had Covid but waited over 30 days to receive the vaccination.

Other Meds:

Current Illness:

ID: 1073193
Sex: F
Age: 39
State: VA

Vax Date: 02/24/2021
Onset Date: 03/03/2021
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: Oral allergy syndrome (stone fruits)

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

Symptoms: The injection site (about 2-3 inches in diameter) became red, firm, tender, itchy, and slightly swollen. This started a week after the injection, and is currently ongoing. The symptoms are all mild.

Other Meds: Multivitamin, Vitamins C & D, Zinc

Current Illness: None

ID: 1073194
Sex: M
Age: 71
State: OH

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

Lab Data:

Allergies: dogs cats pollen

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

Symptoms: Irregular heart beat - like afib - skipping 1 or 2 beats several times a minute. I noticed it the morning after the shot. It still continues but not as often Also extremely fatigued

Other Meds:

Current Illness: Sinus problem for about 5 months

ID: 1073195
Sex: F
Age: 70
State: PA

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

Lab Data:

Allergies: N/A

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Patient was given a 0.1 ml dose of the Moderna COVID vaccine rather that the 0.5 mL dose. this was caught by the clinical staff and the patient was revaccinated with a full o.5 mL dose in the opposite arm.

Other Meds: N/A

Current Illness: N/A

ID: 1073197
Sex: M
Age: 74
State: MN

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

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

Symptoms: Monday- 3 days later patient notice little red light small pink rashes on his chest area, down on his abdomen and on both ankles. Patient states it itches once in a while. Client will take Benadryl if rashes get worse or check with PCP.

Other Meds:

Current Illness:

ID: 1073198
Sex: M
Age: 61
State: MD

Vax Date: 03/03/2021
Onset Date: 03/04/2021
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: none

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

Symptoms: When I woke up this morning I was lethargic, on the way to work, I started getting tired. Mid way through the day I started getting chills

Other Meds: Adderall XR, Blood pressure medication

Current Illness: none

ID: 1073199
Sex: F
Age: 62
State: TX

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: IM
Vax Site: LA

Lab Data:

Allergies: ASA

Symptom List: Pain in extremity

Symptoms: C/O numbness around lips, able to stick tongue out and move, no discoloration around lips, able to talk without difficulty, pt states at 13:15BP 150/90 Hr 71 Spo2 100, 13:30 BP 154/105, HR 74 Spo2 100 13:35 that she feels anxious and will take her anti anxiety meds at home. instructed to F/U with PCP.

Other Meds: Synthroid ,3 Inhalers for Asthma, Clonazepam,

Current Illness: N/A

ID: 1073200
Sex: F
Age: 46
State: WI

Vax Date: 03/04/2021
Onset Date: 03/04/2021
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: amoxicillin, compazine, tylenol with codeine, adhesive

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

Symptoms: at 1355 client stated her tongue felt tingly. Pulse 96, BP 134/84. EMS fire fighter assisting with vaccine administration came over and then client stated tongue felt tingly and then she stated her lips started feeling tingly as well. EMS fire fighter administered epinephrine IM at 1413 and then benedryl IM at 1417. Client did not lose consciousness and was able to answer questions appropriately and move self from chair to gurnee without assist.

Other Meds:

Current Illness:

ID: 1073201
Sex: F
Age: 72
State: MD

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

Lab Data:

Allergies: Penicillin

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

Symptoms: Sweats, muscle aches, headache, exhaustion Symptoms gone in about 12 hours, except exhaustion, which lasted about 16 hours.

Other Meds: Doxycycline Multi vitamins Mucinex

Current Illness: None

ID: 1073202
Sex: M
Age: 70
State: AZ

Vax Date: 02/12/2021
Onset Date: 03/02/2021
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: None

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

Symptoms: ?Moderna COVID?19 Vaccine EUA? Severe skin rash, very itchy and sore

Other Meds: Crestor

Current Illness: None

ID: 1073204
Sex: M
Age: 42
State: OR

Vax Date: 02/24/2021
Onset Date: 02/24/2021
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: N/A

Symptom List: Vomiting

Symptoms: Pt. received their first dose of Moderna Covid 19 vaccine on 2/11/21 and was asked to come to the 2nd dose clinic on 3/8/21 as the two doses have to be given 28 days apart. Pt. came to clinic on earlier than asked date of 2/24/21 and was given 2nd dose by accident. Pt. was called to inform him that his 2nd dose was given too soon and next steps for resolution. Pt. was called on 2/24/21, 3/1/21 and 3/2/21 with no answer or call back. We will continue to call the patient and offer next steps.

Other Meds: N/A

Current Illness: N/A

ID: 1073205
Sex: F
Age: 59
State: MD

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: Paxil

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: During 15 minute window pt states her lip was tingling and both her hands were shaking. Denies any trouble breathing or other symptoms.

Other Meds: Amlodipine, Selexa, Rispirdol

Current Illness: HTN, Depression, Anxiety

ID: 1073206
Sex: F
Age: 67
State: CA

Vax Date: 03/01/2021
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: Donnatal, Mobic, possibly penicillin, ragweed

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

Symptoms: Large red, warm, tender skin rash at injection site appearing morning after injection. Today is 3rd day having rash.

Other Meds: Multi vitamin

Current Illness: None

ID: 1073207
Sex: M
Age: 0
State: RI

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: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Healthcare worker proceeded to inject the individual, only half of the dose was administered when the needle fell off of the syringe.

Other Meds:

Current Illness:

ID: 1073208
Sex: F
Age: 43
State: NC

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: RA

Lab Data:

Allergies: All opiates (morpheine, codeine, demerol, Dilladid), Aspirin, Naproxen sodium (alieve), poppy seeds, shellfish salmon

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

Symptoms: 10 minutes after shot sharp pain for about 10 minutes then it went away. Light itching also went away at same time. About an hour and a half after, stinging and burning eyes that has not gone away. started 11:30am and it is now 5pm at time of report. Been advised to call eye doctor tomorrow. Burning not so much it tears up but a constant burning feeling in both eyes.

Other Meds: Allegra and Nasacort taken in morning

Current Illness: none

ID: 1073210
Sex: F
Age: 41
State: CA

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

Lab Data:

Allergies: Not known

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

Symptoms: Nausea, chills, and joint ache

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm