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: 1075585
Sex: F
Age: 71
State: NY

Vax Date: 02/05/2021
Onset Date: 02/14/2021
Rec V Date: 03/05/2021
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: Hydrocodone

Symptom List: Dysphagia, Epiglottitis

Symptoms: 9 days after first dose.....bright red @ injection site; large hard lump below skin; skin was very warm; very sore; had a slight headache starting 4-5 days before any visible signs. A telemedicine call to my general physician was placed the day after noticing and was immediately placed on an antibiotic (Amoxicillin-CLAV 875-125MG TAB 2xday). After 72 hrs. a positive effect was beginning to be noticed. After 10 days, all but some soreness was gone.

Other Meds: Combigan, latanoprost, caltrate, ocuvite, multi-vitamin, baby aspirin

Current Illness: None

ID: 1075586
Sex: F
Age: 74
State:

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 03/05/2021
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:

Symptom List: Anxiety, Dyspnoea

Symptoms: Left at room temperature for >6hours

Other Meds:

Current Illness:

ID: 1075587
Sex: F
Age: 27
State: UT

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 03/05/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: I experienced fever, body chills, pain at the injection site. I also had a swollen lymph node under my armpit. I also experienced hot flashes, chills which lasted for one week. I had discharge from my breasts and a diagnostic mammogram and bilateral ultrasound of the breasts were performed, these exams were negative. My doctor thinks this symptom was from the vaccine.

Other Meds: Albuterol inhaler, Monklukast inhaler, gabapentin, Aixcila inhaler, Prestiq

Current Illness:

ID: 1075588
Sex: M
Age: 23
State: PA

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 03/05/2021
Hospital:

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

Lab Data:

Allergies: None known

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Student had gotten a flu vaccine on 11/03/20. He came to the campus flu clinic on 1/27/21 and received another flu vaccine, his first dose being unbeknownst to the flu clinic staff.

Other Meds: None

Current Illness: None known

ID: 1075590
Sex: F
Age: 47
State: CA

Vax Date: 03/04/2021
Onset Date: 03/04/2021
Rec V Date: 03/05/2021
Hospital:

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

Lab Data:

Allergies: Sulfa

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

Symptoms: The entire left side of my body immediately felt mildly heavy and affected, but it was so minimal I thought it could be in my head. Throughout the evening after my shot I felt a bit of contracting of leg muscles and neck/shoulder muscles on the left side of my body. The left side of my face felt noticeably warmer than the right. This was all very mild, but just noticeable. In the middle of the night, I woke up with extreme night sweats but only on the left side of my body. The next morning (today) the left side of my face is still warmer but it feels droopy and bloated and slightly "Numbish". My left eyelid feels heavy. My left cheeks feel swollen and puffy and my left gums and lips feel slightly numb. I also have a very mild headache only on the left side. This is disturbing, while it is not debilitating or painful, it is strange and makes me think I should not get the next shot. Even as I type this, my left hand feels very fatigued. I don't know who to call or talk to about this. I do not have a health care provider.

Other Meds: KPC herbs GuiZhi Fu Ling Wan

Current Illness: none

ID: 1075591
Sex: F
Age: 49
State: CA

Vax Date: 02/05/2021
Onset Date: 02/16/2021
Rec V Date: 03/05/2021
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: no

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

Symptoms: pt stated that she developed a rash on the left torso and back which turned into blisters. She had a virtual appt on 2/18/2021. Pt was diagnosed w/ Shingles. She was prescribed Valacyclovir. Pt is to take the 7 day RX along w/ Tylenol or Advil for pain.

Other Meds: levonorgestrel birth control

Current Illness: no

ID: 1075592
Sex: F
Age: 45
State: FL

Vax Date: 03/03/2021
Onset Date: 03/03/2021
Rec V Date: 03/05/2021
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: Client verbalized feeling lightheadedness. Evaluated by Fire Rescue. Patient was released to go home after symptoms were resolved at 10:58 am.

Other Meds: none

Current Illness: dylantin

ID: 1075593
Sex: M
Age: 90
State: AZ

Vax Date: 03/02/2021
Onset Date: 03/02/2021
Rec V Date: 03/05/2021
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: Pharyngeal swelling

Symptoms: HYPERTENSION PATIENT TAKING METOPROLO 100mg 12 HRS - MODERNA APPARENTLY RENDERED METOPROLO TOTALLY INEFFECTIVE BY BP READINGS FOR NOW 40 HRS AND CONTINUES.

Other Meds: Hidroclorotiazide 25mg, Metoprolol 100mg

Current Illness: NONE

ID: 1075594
Sex: F
Age: 73
State: NC

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 03/05/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: Vaccine administered had been at room temperature for > 6 hours.

Other Meds:

Current Illness:

ID: 1075595
Sex: F
Age: 38
State: PA

Vax Date: 03/01/2021
Onset Date: 03/01/2021
Rec V Date: 03/05/2021
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: Penicillin

Symptom List: Diarrhoea, Nasal congestion

Symptoms: developed a rash, that was hot to the touch and itchy and its covering the entire arm. I have fever of 100.9, body aches, chills, fatigue, vomiting, diarrhea. arm rash is horrible.

Other Meds: No

Current Illness: No

ID: 1075597
Sex: M
Age: 60
State: WI

Vax Date: 03/03/2021
Onset Date: 03/04/2021
Rec V Date: 03/05/2021
Hospital: Y

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

Lab Data:

Allergies: Sulfa

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

Symptoms: Patient had generalized weakness event, similar to MS exacerbation. It lasted approximately 24 hours, rapid recovery after overnight admission to the hospital.

Other Meds: Vitamin D3

Current Illness: no acute illness

ID: 1075598
Sex: M
Age: 76
State:

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 03/05/2021
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:

Symptom List: Rash, Urticaria

Symptoms: Vaccine left at room temperature for >6 hours.

Other Meds:

Current Illness:

ID: 1075599
Sex: F
Age: 74
State: CA

Vax Date: 02/11/2021
Onset Date: 02/13/2021
Rec V Date: 03/05/2021
Hospital:

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

Lab Data:

Allergies: sulfa

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

Symptoms: Rash on back of neck...entire scalp and torso became very itchy.

Other Meds: none

Current Illness:

ID: 1075600
Sex: F
Age: 60
State: MD

Vax Date: 02/23/2021
Onset Date: 03/02/2021
Rec V Date: 03/05/2021
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: Unknown

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

Symptoms: COVID rush on injected arm a circular red rush on skin itchy injection site

Other Meds: Thyroxin 112 @7:30 am

Current Illness: None

ID: 1075602
Sex: F
Age: 52
State:

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 03/05/2021
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: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: Vaccine left at room temperature for >6 hours

Other Meds:

Current Illness:

ID: 1075603
Sex: M
Age: 48
State: OH

Vax Date: 02/27/2021
Onset Date: 02/28/2021
Rec V Date: 03/05/2021
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: NO KNOWN

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

Symptoms: ON 2/28/2021- HEADACHE, NAUSEA , FEVER, FATIGUE AND CHILLS- LASTING UNTIL 3/2/2021. ON 3/2/2021AND 3/3/2021- SINUS HEADACHE , EYE AND EAR PRESSURE BEGAN. ON 3/4/2021 WOKE WITH SYMETRICAL RASH TO ARMS, HIPS, UPPER LEGS AND BUTTOCKS. NOT ITCHY UNTIL EVENING OF 3/4/2021. RASH BECAME BLOTCHY, RAISED "HIVE-LIKE" PROMPTING TO SEEK MEDICAL ATTENTION AT URGENT CARE. THEY PRESCRIBED- BENADRYL AND CALAMINE LOTION. STATES NO RELEIF AS OF TODAY.

Other Meds: TYLENOL

Current Illness: NONE KNOWN

ID: 1075604
Sex: M
Age: 82
State: MD

Vax Date: 03/02/2021
Onset Date: 03/04/2021
Rec V Date: 03/05/2021
Hospital: Y

Vax Type: DTAPHEPBIP
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: DTAP + HEPB + IPV (PEDIARIX)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies: cipro

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

Symptoms: Patient presented to ED for on/off SOB the past few days. Required O2 60% FiO2. Acute on chronic CHF exacerbation. Treated with Lasix. Patient is currently improved and planned discharge.

Other Meds:

Current Illness:

ID: 1075605
Sex: U
Age: 51
State: IL

Vax Date: 02/27/2021
Onset Date: 02/27/2021
Rec V Date: 03/05/2021
Hospital:

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

Lab Data:

Allergies: dust and ragweed

Symptom List: Ear pain, Hypoaesthesia

Symptoms: I got a severe headache, was seeing double, everything tasted like metal, couldn't stop throwing up, elevated blood pressure. I went to the ER on 2-28-21 and they gave me pain medicine, medicine to stop throwing up, and fluids through IV. On 3-5-21 I went to my primary care doctor because I still felt dizzy. Blood pressure 166 so she gave me blood pressure medicine.

Other Meds: Dulera, Singular, Claritan D, Flonase, Azelastine, Glucosmine, One A Day Multivitamin

Current Illness: none

ID: 1075606
Sex: F
Age: 48
State:

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 03/05/2021
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: Vaccine left at room temperature for >6 hours

Other Meds:

Current Illness:

Date Died: 03/04/2021

ID: 1075608
Sex: F
Age: 72
State: NJ

Vax Date: 03/03/2021
Onset Date: 03/04/2021
Rec V Date: 03/05/2021
Hospital:

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

Lab Data:

Allergies: Denies

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

Symptoms: Patient waited 15 mins after covid vaccination on Wednesday 3/3, cleared by EMT to leave. I was notified by nurse at the senior building where patient resides that she had expired Thursday evening at home. Paramedics were called. No other additional information.

Other Meds: unknown

Current Illness: Hx of Ca of the breast, last chemotherapy treatment 2/15/21

ID: 1075609
Sex: F
Age: 81
State:

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 03/05/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Vaccine left at room temperature for >6 hours.

Other Meds:

Current Illness:

ID: 1075610
Sex: F
Age: 73
State: FL

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

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

Lab Data:

Allergies: Penicillin

Symptom List: Unevaluable event

Symptoms: Have picture of approx. 4? diameter swelling, redness and Hot around injection site. In spite of cold compress swelling, redness, and heat remained unchanged throughout 3rd day. Now, 4th day, redness, swelling and heat are subsiding. No other physical symptoms. Is it safe to get 2nd vaccine shot?

Other Meds: L-thyroxine Bupropion Rosuvastatin Metoprolol Calcium Vitamin d Fish oil

Current Illness: None

ID: 1075611
Sex: M
Age: 79
State: FL

Vax Date: 03/03/2021
Onset Date: 03/04/2021
Rec V Date: 03/05/2021
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: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

Symptoms: Dizziness,sore vaccination site

Other Meds: Xarelto, hydroxyzine, tamsulosin, calcium, multivitamins,

Current Illness: None

ID: 1075612
Sex: M
Age: 48
State: CA

Vax Date: 03/05/2021
Onset Date: 03/05/2021
Rec V Date: 03/05/2021
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: NKA

Symptom List: Injection site pain, Pain

Symptoms: Pt. states that he feels "flushed" @0956. He denies any health Hx. Pt is visibly sweating. VS: BP 162/80, HR 65, SpO2 97%. Pt. stated that he started to feel better @ 10:01am. Pt. is D/C @ 10:10am.

Other Meds: none

Current Illness: N/A

ID: 1075613
Sex: F
Age: 30
State: MT

Vax Date: 03/02/2021
Onset Date: 03/02/2021
Rec V Date: 03/05/2021
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: Patient was given vaccine and then sent to observation area for 15 minute observation. Patient appeared pale and diaphoretic when she got to the observation area and then suffered a syncopal episode. She was unconscious for several seconds. She did not hit her head or have any trauma. Patient complained of nausea, and dizziness when she regained consciousness. Patient appeared pale and diaphoretic. Patient then developed hives over her abdomen, upper torso, and upper arms. Patient never complained of difficulty breathing but was constantly pulling at the neck of her sweater. Pt was a Type I diabetic and had a BG reading of 262. She was given 0.3 mL of epinephrine with an immediate positive response. Transported to local hospital emergency room.

Other Meds:

Current Illness: DM1

ID: 1075614
Sex: M
Age: 61
State: OH

Vax Date: 03/01/2021
Onset Date: 03/01/2021
Rec V Date: 03/05/2021
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: Latex

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

Symptoms: Numbness in face and lips. Some tingling. Rapid heartbeat. Normal breathing

Other Meds: Metformin. Estradiol. Pantoprozile.zoloft.wellbutrin xl. Montelukast.flomax.propranolol Simvastatin.levocetirizine

Current Illness:

ID: 1075616
Sex: M
Age: 22
State: PA

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 03/05/2021
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 Known

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Student had gotten a flu vaccine on 12/03/20. He came to the campus flu clinic on 1/27/21 and received another flu vaccine, his first dose being unbeknownst to the flu clinic staff.

Other Meds: None known

Current Illness: None Known

ID: 1075617
Sex: F
Age: 70
State: NC

Vax Date: 02/25/2021
Onset Date: 02/26/2021
Rec V Date: 03/05/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: chills, fever, sweats, tiredness

Other Meds: Fluoxetine, Calcitriol, Allopurinol, Levothyroxine, Bupropion SR, cinacalcet, Velphoro

Current Illness: End-Stage Renal Disease

ID: 1075618
Sex: F
Age: 46
State: GA

Vax Date: 02/26/2021
Onset Date: 02/26/2021
Rec V Date: 03/05/2021
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: None

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

Symptoms: 2.5 hours after injection I started feeling weird, clammy cold sweats, nauseous and it felt like my eyes were bulging or like an intense pressure behind my eyes, blurry eyesight, extreme headache. I have not ever had any issues with my blood pressure only my diabetes. It had recently been slightly elevated but controlled mostly. I knew it was high and it suddenly just came on even after not eating at that time. I proceeded to flush with alot of water and some walking to bring it down. I wasn't exactly sure of how high it got because I don't normally have to bring my tester to work with me. However as soon as I got home I tested it and even after heavy flushing and exercise my glucose level was down to 500. It has never been that high ever. I continued to flush and monitor and not eating due to nausea and headache I was taken to the hospital. At that time my glucose reading was at 400. I was given 10 units of novolog as well as 1 full bag of fluid thru an IV. And before I was discharged it had come down to 192. I have only had to have insulin 1 time since 2008-9. Since then my sugar is refusing to come down below 250. My vision is still not clear and I am now attempting to keep it down with 15 units of a fast acting insulin multiple times a day. I will also be starting metformin again as of tomorrow morning to also help bring it down to a more healthy level due to the possibility of another life altering stroke.

Other Meds: Phentermine

Current Illness: None

ID: 1075619
Sex: F
Age: 69
State: MD

Vax Date: 02/10/2021
Onset Date: 03/04/2021
Rec V Date: 03/05/2021
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: Patient presented to ED for nonintractable headache. was not admitted. Per EAU, hospitalizations are to be reported irrespective of attribution to the vaccine.

Other Meds:

Current Illness:

Date Died: 01/22/2021

ID: 1075620
Sex: M
Age: 91
State: NY

Vax Date: 01/05/2021
Onset Date: 01/22/2021
Rec V Date: 03/05/2021
Hospital:

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

Lab Data:

Allergies: Tylenol, Eliquis, Ketoconazole cream, Metoprolol, Lasix, senna, voltaren gel, I-vite

Symptom List: Injection site pain

Symptoms: Patient became acutely ill on 1/15/21 with recurrent pneumonia, treated with Augmentin. Pt became progressively worse on the next 48-72 hours, treatment goals changed to palliative-focused, and all treatments withdrawn. Patient died on 1/22/21.

Other Meds:

Current Illness: None

ID: 1075621
Sex: F
Age: 59
State: IN

Vax Date: 02/26/2021
Onset Date: 02/28/2021
Rec V Date: 03/05/2021
Hospital:

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

Lab Data:

Allergies: Penicillin, Sulfa, Levoquin

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

Symptoms: After my second vaccine on 2/26/2021 , Friday, on Feb 28th my lymph nodes under my left arm were extremely swollen and sore. My left underarm remained swollen quite noticeably for 3 days and sore for a total of 5 days.

Other Meds: Synthroid, Toviaz, Premarin, Miralax

Current Illness: Na

ID: 1075622
Sex: F
Age: 73
State: NC

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 03/05/2021
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: paragon forte, sulfa, hydrocodone,, penicillin

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

Symptoms: About 6 hrs after injection, I developed headache and then projectile vomiting. No appetite, still have a somewhat poor appetite.

Other Meds: Simvastatin, Alprazolam Citracal, One Daily Essential Multivitamin/Mineral Supplement, Vitamin D3, low dose Bayer aspirin (enteric coated), Niacin 500 mg, Selenium 200 mcg, Vitamin K 120 mcg, Vitamin E 180 mg

Current Illness: None

ID: 1075623
Sex: M
Age: 61
State: KY

Vax Date: 03/01/2021
Onset Date: 03/04/2021
Rec V Date: 03/05/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Tremor

Symptoms: Not sure if this was a reaction to vaccine or not? 3/4/2021 when I woke up to get out of bed, upon standing, I got a severe feeling of dizziness or vertigo that resulted in my legs giving out and me falling down. I didn't get hurt but it felt like I almost passed out. I fell backwards against a wall and slid down. I did not report this to my doctor previously listed.

Other Meds: Fish Oil 1000 mg 2/day Sertraline HCI 100 mg 1/day Alprazolam 0.25 mg 2/day Losartan Potassium 50 mg 1/day HydroChlorothiazide 12.5 mg 1/day Atorvastatin Calcium 10 mg 1/day

Current Illness:

ID: 1075624
Sex: M
Age: 70
State: NC

Vax Date: 02/26/2021
Onset Date: 03/01/2021
Rec V Date: 03/05/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Erythema, Pruritus

Symptoms: Significant swelling of eyelids and surrounding tissue around eyes, reddening of skin over most of body with raised skin and purities.

Other Meds: amlodipine, lisinopril, fish oil, probiotic

Current Illness: none

ID: 1075625
Sex: F
Age: 39
State:

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

Vax Type: UNK
Manufacturer: UNKNOWN MANUFACTURER
Vax Name: VACCINE NOT SPECIFIED (NO BRAND NAME)
Lot:
Dose Series: UNK
Vax Route: SYR
Vax Site: UN

Lab Data:

Allergies:

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

Symptoms: SOB, Elevated vitals. Evaluated by EMS-Transported to emergency room/department or urgent care.

Other Meds:

Current Illness:

ID: 1075626
Sex: M
Age: 31
State: KS

Vax Date: 03/04/2021
Onset Date: 03/05/2021
Rec V Date: 03/05/2021
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: Chills, Fever, Nausea, Vomiting, Body Aches, Fatigue

Other Meds:

Current Illness:

ID: 1075628
Sex: F
Age: 32
State: MA

Vax Date: 02/23/2021
Onset Date: 02/23/2021
Rec V Date: 03/05/2021
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: Local reaction of erythema at injection site on L arm. Denies pain at site. Denies fever. Erythema present x 2 weeks.

Other Meds:

Current Illness:

ID: 1075629
Sex: F
Age: 69
State: MI

Vax Date: 02/24/2021
Onset Date: 03/02/2021
Rec V Date: 03/05/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: none

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

Symptoms: Raised, warm, red bullseye ring around injection site, on your right upper arm.

Other Meds: Paxil 20mg, triamt-hydorcholrothiazide 37.5/25 mg. lofartan 100 mg, zyrtec allergy 10 mg, prilosec 25 mg, multivitamin, botin, B-12, zinc, vit D3, Vit C, motrin 800

Current Illness: none

ID: 1075630
Sex: F
Age: 21
State: WI

Vax Date: 02/10/2021
Onset Date: 02/14/2021
Rec V Date: 03/05/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: FEVER, HEADACHE

Other Meds:

Current Illness:

ID: 1075631
Sex: F
Age: 41
State: KS

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 03/05/2021
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: Pain in extremity

Symptoms: Progress Notes (Nurse Practitioner) Pt called to follow up s/p covid-19 vaccine done on 02/24/21. She reports she took a nap yesterday after getting home and felt better afterwards. Today she feels well. Denies any other questions or concerns. She is appreciative of the phone call. Progress Notes at 2/28/2021 7:34 AM Expand AllCollapse All VACCINE CLINIC 2/24/2021 Subjective Patient is a 41 y.o. female who was seen at SVH COVID Vaccine Clinic today for her first dose of the COVID 19 vaccination. She was given the Pfizer vaccination in the right deltoid muscle. During her 15 minute waiting period after the injection, the patient began to experience lightheadedness, headache, nausea, tingling lips and a metallic taste in her mouth. She denied rash, difficulty breathing, difficulty swallowing, throat tightness, facial swelling and lip swelling. She does mention having a history of anxiety and did take her duloxetine and Wellbutrin today. Denies use of her Ativan recently. This provider was notified of patient reaction and she was then assessed in the emergency bay area. Monitored patient for severe reaction symptoms, including but not limited to rapid progression of symptoms, respiratory distress, tongue swelling and vomiting. ALLERGY REVIEW OF SYSTEMS: Patient complains of dizziness and headaches Patient denies chills, facial swelling, chest tightness, shortness of breath and wheezing +nausea and metallic taste in mouth: Previous Reactions: Denies Objective Vitals Vitals: 02/24/21 1427 02/24/21 1434 BP: 126/70 112/68 Pulse: 81 80 SpO2: 99% 96% Physical Exam Constitutional: Appearance: Normal appearance. HENT: Head: Normocephalic and atraumatic. Mouth/Throat: Mouth: Mucous membranes are moist. Pharynx: Oropharynx is clear. No posterior oropharyngeal erythema. Comments: No swelling or lips or tongue. Cardiovascular: Rate and Rhythm: Normal rate and regular rhythm. Pulmonary: Effort: Pulmonary effort is normal. No respiratory distress. Breath sounds: Normal breath sounds. No wheezing or rales. Skin: General: Skin is warm and dry. Neurological: General: No focal deficit present. Mental Status: She is alert and oriented to person, place, and time. Assessment/Plan Treatment included: Tylenol and water Follow up response to treatment: good. She noted some lightheadedness prior to discharge but other symptoms were improved. I walked patient around the bay area and she was feeling okay. Her vitals were stable. Pt was escorted out of the facility. Patient discharge: Stable to go home and follow up with PCP. Electronically Signed 2/24/2021 2:43 PM

Other Meds:

Current Illness:

ID: 1075632
Sex: F
Age: 75
State: FL

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

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

Lab Data:

Allergies: none

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

Symptoms: Client verbalized feeling sudden headache after receiving the vaccine. Client was evaluated. Mrs./Ms. was released to go home at 10:51 am after symptoms subsided accompanied by niece.

Other Meds: none

Current Illness: none

ID: 1075633
Sex: F
Age: 36
State: TX

Vax Date: 03/03/2021
Onset Date: 03/03/2021
Rec V Date: 03/05/2021
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: NKDA

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

Symptoms: PT STATED SHE HAS A HEADACHE AND FEELS DIZZY. SHE HAS A METALLIC TASTE IN HER MOUTH. PT ALSO C/O LEG WEAKNESS. BP 108/66 HR 79 O2 98% REPEAT BP 112/68 HR 70 O2 97%

Other Meds: N/A

Current Illness: N/A

ID: 1075634
Sex: F
Age: 44
State: OH

Vax Date: 01/09/2021
Onset Date: 01/09/2021
Rec V Date: 03/05/2021
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: Within hours I had cold sores covering my lips. 72 hours later, I realized that I had developed tinnitus. The injection site took more than 35 days to heal.

Other Meds: None

Current Illness: None

ID: 1075635
Sex: F
Age: 44
State: MN

Vax Date: 02/10/2021
Onset Date: 02/14/2021
Rec V Date: 03/05/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: CODEINE

Symptom List: Vomiting

Symptoms: VISION DEFICITS IN RIGHT EYE, SUDDEN ONSET

Other Meds: ZOLOFT

Current Illness: NONE

Date Died: 02/18/2021

ID: 1075636
Sex: F
Age: 82
State: NH

Vax Date: 01/08/2021
Onset Date: 01/21/2021
Rec V Date: 03/05/2021
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: Sulfa Antibiotics Tegretol

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: 1/21/2021 During Covid 19 outbreak on the unit, resident contracted the virus. 1/21 MD updated on increased weakness, twitching, fatigue noted today. 2 rapid covid-19 tests done today, both negative. new orders cbc with diff, BMP, d. dimer stat and swab for covid and Influenza. 1/21-Covid and Influenza swab results received. PCR-Influenza negative, covid-19 positive. Palliative care updated. 1/21-Labs drawn cbc, BMP, d. dimer Results WNL. Temp 101.2 and Occ dry cough. 1/22 Palliative MD and APRN visited. Family preference for no hospitalizations, no IV's and do not intubate. DNR. Admitted to Hospice services on 1/25. 1/21-1/29. Symptomatic with lethergy, occ cough, off and on temp and began refusing meals and meds at times. 1/31 periods of apnea. 2/1 precautions ended for Covid 19. Continued with Hospice care and with ongoing refusal of meals, condition declining and comfort maintained. Meds slowly discontinued. Expired at facility on 2/18/2021.

Other Meds: cloZAPine Tablet 100 MG;Levothyroxine Sodium Tablet 100;Miralax Powder; Mirtazapine Tablet 15 MG Give 1 tablet by mouth at bedtime; Senokot Tablet;Vitamin D3 Tablet 5000 UNIT Q30D; Clozaril Tablet 50 MG

Current Illness: Resident on Palliative Care services. Off and on refusals of meds. On Clozaril with monthly CBC. 12/28 WBC low at 3.86, platelets 142. Followed by Mental Health.

ID: 1075637
Sex: F
Age: 46
State: MD

Vax Date: 03/04/2021
Onset Date: 03/04/2021
Rec V Date: 03/05/2021
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: none

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

Symptoms: Clammy hands, warm wave rushed over my body, felt very hot, racing heart, tightness in my chest-lasted approx 15-20 minutes

Other Meds: Lisinopril 20 mg, Escitalopram 10 mg, and Lo Loesterin Fe

Current Illness: none

Date Died: 03/04/2021

ID: 1075639
Sex: M
Age: 53
State: MD

Vax Date: 02/27/2021
Onset Date: 03/01/2021
Rec V Date: 03/05/2021
Hospital: Y

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: Citrus Peanuts

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Patient is a 53 year old man with a past medical history of follicular lymphoma diagnosed in 2008, more recently with DLBCL with CNS involvement (involving hypothalamus; dx 8/2018; s/p HD MTX, s/p BMT- followed by Dr.), autoimmune hepatitis, obesity, adipic DI, central hypothyroidism and type 2 DM who presented to Hospital via EMS after a fall at home with multisystem organ failure leading to intubation in the ED and subsequent transfer to Oncology ICU for further management. He was in his usual state if health until Sunday. On Saturday he got COVID vaccine at 4pm, that evening he had no issues. Sunday night around 10pm he didn't make complete sense and his wife was concerned because of his history of DM and treated CNS lymphoma. BG was 320-340 at that time. Monday he was good and Monday night he started to have shaking of his left hand. Tuesday he had one episode of diarrhea. Later he was more shaky in the shower and he started to fall and his wife was unable to grab him and he slid down the wall and could not get up. Family was called to help and he was not making sense so they called EMS. Wife reports that he was down approximately 3 hours before EMS was able to get him up. In EMS he was noted to have a large area of skin desquamation from the right posterior knee to the ankle. His GCS was 15. He had stable blood pressure and heart rate. He was hypoxia to the 50s and oxygen was applied. In the ED he was found to be in multisystem organ failure and was intubated and had rapid progression of shock requiring Epinephrine, Levophed and Vasopressin. Crash lines were placed and he was sent to hospital. Upon arrival he was noted to have a cold pulseless right lower extremity and surgery was called. He was evaluated by Trauma Surgery, Orthopedic surgery and Vascular surgery and eventually underwent above the knee amputation. Unfortunately they were not able to remove all nonviable tissue and he continued to deteriorate. He was taken level 1 back to the OR and an additional 10 cm of nonviable tissue was removed. Unfortunately upon arrive he suffered cardiac arrest in the setting of severe lactic acidosis and hyperkalemia.

Other Meds: Desmopressin levothyroxine Atorvastatin trulicity once a week

Current Illness: Hypothyroidism Diabetes Morbid obesity Hyperlipidemia Diabetes insipidus

ID: 1075640
Sex: F
Age: 53
State: FL

Vax Date: 03/04/2021
Onset Date: 03/04/2021
Rec V Date: 03/05/2021
Hospital:

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

Lab Data:

Allergies: Iodine- swelling

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

Symptoms: At the end of the 15 minute observation time, the patient stated she felt like her throat was closing and that she was having a difficult time swallowing. Her O2 sat was 98%, HR 61, lungs CTA, right side of neck and jawline had mild swelling. She was given 50 mg of liquid Benadryl and 911 called. She continued to complain of back of tongue tingling. O2 sats remained at 98%. She started to say she was feeling better just before EMS arrived and departed with the patient. Patient spoke Spanish and was interpreted by her car passenger, a medical interpreter was not used as this was an emergency. ED note indicates she had an anaphylactic reaction after 2nd Moderna vaccine. Epinephrine had been given approximately an hour after first complaining of symptoms. ED note says she initially had rash and throat swelling but now is feeling well and tolerating PO. She was counseled on Epi Pen and discharged same day.

Other Meds: Amlodipine 5 mg Vitamin C Flaxseed oil Flovent HFA 110 mcg Flonase Advair HFA Ginseng 100 mg capsule Duoneb Synthroid 125 mcg Magnesium 500 mg capsule Multivitamin ProAir HFA Vitamin D Zinc 50 mg

Current Illness:

ID: 1075641
Sex: M
Age: 68
State:

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 03/05/2021
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:

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

Symptoms: Vaccine left at room temperature for > 6 hours.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm