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: 1083136
Sex: F
Age: 41
State: KY

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 03/08/2021
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: Lavender, nicotine vaping oil

Symptom List: Dysphagia, Epiglottitis

Symptoms: Skin became hot, burning, difficulty swallowing, difficulty breathing, anxiety, dizziness, light headed. Took benadryl po 50 mg. Was seen at ER. Received albuterol neb, steroids IV, and prevacid PO. Sent home with po steroids and benadryl. S/S improved after treatment.

Other Meds: vit D, nexium, allegra

Current Illness: None

ID: 1083137
Sex: F
Age: 32
State: NE

Vax Date: 03/08/2021
Onset Date: 03/08/2021
Rec V Date: 03/08/2021
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: Sulfa drugs, lavender

Symptom List: Anxiety, Dyspnoea

Symptoms: Breathing feels slowed/ not enough, afraid to sleep in case I'm not breathing well enough, intense fatigue, intense sense of trembling like when your blood sugar is low, cold mouth, chills

Other Meds: Diazepam, fish oil, women's multivitamin, Turmeric supplement, Bit D3 supplement

Current Illness: N/a, none.

ID: 1083138
Sex: M
Age: 20
State: NY

Vax Date: 03/08/2021
Onset Date: 03/08/2021
Rec V Date: 03/08/2021
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: unknown

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

Symptoms: The patient took the first dose of the moderna vaccine around 10 minutes into the post observation time he become dizzy and fell to the floor. The patient was pale. 02 sat was between 78% -96 %. Oxygen 10/L per minute was administered. EMS services were called.

Other Meds: unknown

Current Illness: unknown

ID: 1083139
Sex: F
Age: 36
State: OH

Vax Date: 02/20/2021
Onset Date: 02/28/2021
Rec V Date: 03/08/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: On 2/28/20 I woke up with balance problems made worse with eyes closed or when moving my head. These balance issues are slowly improving but remain ever present. I am also experiencing some cognitive issues including word finding problems, difficulty processing verbal information, and general brain fog. I?ve had an increase in fatigue as well. The same weekend the balance issues began I had some visual disturbances as well.

Other Meds: Lexapro, prolastin c, weekly iv fluids, Mirena, multi vitamin, vitamin c, vitamin d, zinc, melatonin, CoQ10, quercetin, magnesium

Current Illness: None

ID: 1083140
Sex: M
Age: 48
State: CO

Vax Date: 03/06/2021
Onset Date: 03/06/2021
Rec V Date: 03/08/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Redness and itching at injection site Severe joint pain in neck, shoulder, hipd, knees, ankles for 36 hours

Other Meds: Metformin Verapmil Irbesartan Vitamin Niacin 84mg asparin Magnesium

Current Illness: Asthmatic Pre-diabetic

ID: 1083141
Sex: M
Age: 22
State: WA

Vax Date: 01/09/2021
Onset Date: 01/14/2021
Rec V Date: 03/08/2021
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:

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

Symptoms: I had upper body aches and heart palpitations. This lasted about a month. I went to a walk-in clinic and they told me that they have seen the same reactions in Covid shots in other individuals . My AST and ALT levels were elevated. The PVC lasted about a month and upper body aches lasted about a week.

Other Meds: Zyrtec

Current Illness:

ID: 1083142
Sex: F
Age: 43
State: TX

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 03/08/2021
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: Penicillin

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Chest pain & rapid palpitations, shortness of breath , headache , swollen at the left side of my armpit & pain in sore in the area of administration

Other Meds: None

Current Illness: None

ID: 1083143
Sex: F
Age: 37
State: WA

Vax Date: 03/05/2021
Onset Date: 03/05/2021
Rec V Date: 03/08/2021
Hospital:

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

Lab Data:

Allergies: Shellfish, Sulfa

Symptom List: Pharyngeal swelling

Symptoms: Janssen COVID-19 Vaccine EUA Chills, Bodyaches, Fever (102.6), Headache, Sweating, Dizzy, Nauseated, very tired. Fever started 4 hours after vaccine and broke the following day around 2pm. I continued to be nauseated, dizzy and have a headache through Sunday March 7th and Monday ( today) I am still tired and have dizzy spells and nauseated off and on. I do feel like it is improving though. The first night was really rough.

Other Meds: None

Current Illness: None

ID: 1083144
Sex: F
Age: 46
State: CO

Vax Date: 03/06/2021
Onset Date: 03/08/2021
Rec V Date: 03/08/2021
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, theopholin

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Rash, on the left side of my body, neck, both sides, and face. Looks similar to a heat rash on body and neck, looks like a sunburn on my face.

Other Meds: Buproprion, topiramate, Zolpidem

Current Illness:

ID: 1083145
Sex: F
Age: 65
State: IN

Vax Date: 03/04/2021
Onset Date: 03/04/2021
Rec V Date: 03/08/2021
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: Tablet form of Keflex

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Headache, chills, nausea, fatigue, soreness at injection site

Other Meds: Low-dose aspirin; magnesium; calcium supplement

Current Illness: None

ID: 1083146
Sex: F
Age: 47
State: NM

Vax Date: 03/06/2021
Onset Date: 03/06/2021
Rec V Date: 03/08/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Full body aches, 101? Fever, severe headache by 2am 3/6/21; all symptoms continuing through the end of 3/7/21 Resolving by 3/8/21

Other Meds: Cymbalta 60mg QD

Current Illness: None

ID: 1083147
Sex: F
Age: 61
State: NY

Vax Date: 03/04/2021
Onset Date: 03/04/2021
Rec V Date: 03/08/2021
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: latex, thimerasol, neomycin, gentamycin,

Symptom List: Rash, Urticaria

Symptoms: swelling and muscle pain in rt arm

Other Meds: maitake extract, multivitamin, probiotics, sam-e,

Current Illness:

ID: 1083148
Sex: F
Age: 58
State: TX

Vax Date: 03/06/2021
Onset Date: 03/06/2021
Rec V Date: 03/08/2021
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. Sulphur

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

Symptoms: Chills, severe headache, tired

Other Meds: levothyroxine

Current Illness:

ID: 1083149
Sex: F
Age: 70
State: NY

Vax Date: 02/24/2021
Onset Date: 03/01/2021
Rec V Date: 03/08/2021
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: Prednisone, all anti inflammatory meds, epinephrine, morphine, Cefdinir, epinephrine, Levaquin, Macrobid, Cymbalta

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

Symptoms: Since March 1, every day I have felt dizziness and some nausea throughout the day, when I get up out of bed in the morning, bend down and come up when doing laundry, cleaning, kitchen work, dressing, exercise and other normal daily activities. I must keep my upper body and head upright, and avoid bending, in order to prevent this dizziness. As a result, I feel weak and uncomfortable, and fear doing normal movement and activity.

Other Meds: Levothyroxin, Clonazepam, Azasite eyedrops, Metamucil Daily supplement, daily probiotic, Reflux Relief supplement for GERD, Multivitamin, Vitamin D3 supplement, TRF350/Cyplexinol supplement, EsterC Vitamin C, COQ10 Ubiquinol, Biotin, Mu

Current Illness: Dry eye, Meibomianitis,

ID: 1083150
Sex: F
Age: 41
State:

Vax Date: 02/17/2021
Onset Date: 02/17/2021
Rec V Date: 03/08/2021
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: not at the time

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

Symptoms: o Complaint The patient is a 41 year(s) old Female complaining of o Chief Complaint Quote Patient states she got her COVID vaccine today and rapidly started feeling SOB, dizzy and feeling tired. Per EMS, patient did receive one IM of Epi. o Time Seen 02-17-2021 11:49 o Historian patient o Objective Statement 41-year-old female brought to the emergency room by EMS for allergic reaction. Patient says just prior to arrival she received first dose of her Covid vaccination. She said she was waiting after she received her vaccination when she began to have difficulty breathing, lightheadedness and nausea. She was given a IM dose of epinephrine and sent to the emergency department for further evaluation. In the emergency department, she says difficulty breathing has improved. She said she is now having some chest pain. She says pain is across the anterior chest, pressure-like. She said she also feels nauseous. Headache, throat tightening, rash, pruritus, abdominal pain, vomiting, diarrhea, dysuria, paresthesias or focal weakness. She has never had an allergic reaction before. Review of Systems Constitutional: Negative for chills, diaphoresis and fever. HENT: Negative for congestion, facial swelling and rhinorrhea. Eyes: Negative for discharge and visual disturbance. Respiratory: Negative for cough. Positive for chest tightness and shortness of breath. Cardiovascular: Positive for chest pain. Negative for leg swelling. Gastrointestinal: Negative for abdominal pain, diarrhea, blood in stool and vomiting. Endocrine: Negative for cold intolerance and polydipsia. Genitourinary: Negative for difficulty urinating, dysuria and hematuria. Musculoskeletal: Negative for arthralgias, joint swelling and myalgias. Skin: Negative for rash. Neurological: Negative for speech difficulty, numbness and headaches. Physical Exam Nursing notes and vital signs reviewed. GENERAL: No distress HEAD: normocephalic, atraumatic EENT: PERRL, EOMI. Conjunctivae normal color, sclerae non-icteric; moist mucous membranes. There is no pharyngeal erythema or edema, uvula midline no stridor, patient handling secretions with no difficulty NECK: Supple, non-tender; no meningismus LUNGS: Patient in mild respiratory distress, tachypneic, lungs CTA. Normal air movement. HEART: Tachycardic with regular rhythm, no murmur CHEST: No deformity; non-tender ABDOMEN: The abdomen is soft, and non-tender, no masses or bruits. EXTREM: Normal ROM; no deformity, no calf tenderness. Normal pulses palpable in all extremities. There is no pedal edema. SKIN: No rash; no diaphoresis NEURO: Alert; normal speech and cognition; CN's grossly intact; strength grossly intact without focal deficit. BACK: No CVA TTP. o ED Course 1250: On reevaluation, patient resting comfortably in the room. She said she is feeling much better. She is no longer having any difficulty breathing. Chest pain has resolved. Her vital signs have normalized. She is no longer tachycardic. CBC shows a mild leukocytosis. CMP does show hypokalemia. On her EKG she does appear to have some U waves. EKG shows sinus tachycardia, no ischemic changes. Chest x-ray unremarkable. Potassium was repleted. On arrival, patient was given Benadryl, Solu-Medrol, Pepcid. She was given epinephrine at the vaccination site so no additional epinephrine was given here and at this point I do not feel she needs an additional dose. We will continue to monitor the patient in the ED. 1520: On reevaluation, patient is resting comfortably in the room. Her vital signs remained stable. She is not having any symptoms. No chest pain or shortness of breath. We will discharge the patient home. We will give her prescription for an EpiPen. Discussed warnings indications to return to ED. Told patient she should contact her primary care provider to discuss whether or not she should receive the second dose. Patient understands and agrees with the plan.

Other Meds: Prescribed (don't know what she was actually taking at the time of the event): amitriptylene 12.5mg QHS humulin R U-500 50units AM, 11 units PM ibuprofen 400mg 1 Q6H prn ferrous sulfate 325mg 1 QD albuterol HFA 90mcg inhaler 2 puffs Q6H p

Current Illness:

ID: 1083151
Sex: F
Age: 68
State: TX

Vax Date: 03/07/2021
Onset Date: 03/07/2021
Rec V Date: 03/08/2021
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: Lisinopril, oxycodone and duloxetine

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

Symptoms: Patient developed swelling and redness in the face, tightness in the chest, and nausea in the stomach.

Other Meds: Amlodipine

Current Illness: No

ID: 1083152
Sex: F
Age: 62
State:

Vax Date: 03/04/2021
Onset Date: 03/04/2021
Rec V Date: 03/08/2021
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: Pt. reported dizziness for less than 2 minutes while waiting in observation after vaccine. She ate right before coming. She was given a snack and water and waited another 15 minutes. After 30 minutes she felt better. Pt. instructed to go to the ED with any worsening or new concerning symptos. Pt. verbalized understanding.

Other Meds:

Current Illness:

ID: 1083153
Sex: F
Age: 71
State: NY

Vax Date: 02/20/2021
Onset Date: 02/21/2021
Rec V Date: 03/08/2021
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 & dust mites

Symptom List: Ear pain, Hypoaesthesia

Symptoms: I started getting hives the following evening. I took Benadryl and they went away. First the welts were on my shoulders and around my bra band. I have had recurring hives all except one night when I took Benadryl prophylactically. I have since gotten the rash on my neck,buttocks,leg,arm and inner thighs.

Other Meds: propanalol zetia zoloft tizanadine medrol probiotics rosuvastatin folic acid

Current Illness: none

ID: 1083154
Sex: M
Age: 75
State: WA

Vax Date: 03/02/2021
Onset Date: 03/04/2021
Rec V Date: 03/08/2021
Hospital:

Vax Type: PNC13
Manufacturer: PFIZER\WYETH
Vax Name: PNEUMO (PREVNAR13)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies: Penicillin

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Significant itching on most of body with NO rash Chills intermittently

Other Meds: Taken after vaccination - Prescriptions - Prednisone Warfarin Lipitor Atenolol Omeprazole OTCs - MultiVitamin - Vitamin C - D3

Current Illness: Prior surgery on 02/22/2021 for bladder stone removal and biopsy

ID: 1083155
Sex: F
Age: 58
State: IN

Vax Date: 03/04/2021
Onset Date: 03/05/2021
Rec V Date: 03/08/2021
Hospital:

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

Lab Data:

Allergies: See above

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

Symptoms: Large (egg size lump at the injection site with itching to hat has lasted until 3//8/2021

Other Meds: Once / Day - AM - Tamoxifen - 20 mg - Trulicity - 1.5 mg - Aspirin - 81mg - Metformin - 500 mg 2x/day -Pristiq - 100 mg per day -Diazepam - 5 mg every 6 hours as needed for anxiety -Amitiza- 24 mcg 2x/day -Pramipexole - 0.5 mg 3x/day as

Current Illness: None

ID: 1083156
Sex: F
Age: 48
State: UT

Vax Date: 03/02/2021
Onset Date: 03/07/2021
Rec V Date: 03/08/2021
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: NSAIDS

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

Symptoms: Left axillary pain Swollen lymph nodes left inner arm and armpit Fever Chills Fatigue

Other Meds: Humalog Estradiol cream

Current Illness: No

ID: 1083157
Sex: M
Age: 53
State: FL

Vax Date: 03/06/2021
Onset Date: 03/06/2021
Rec V Date: 03/08/2021
Hospital:

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

Lab Data:

Allergies: Amoxicillian

Symptom List: Unevaluable event

Symptoms: 3/6 arm pain starting about 3pm and continuing until 3/8 when it decreased to mild soreness 3/6 8:30 pm chills, aches, sweats until approx 8:00 am on 3/7 3/7 8:00 am bad headache across forehead for majority of day until approx 5:00pm. No appetite Extremely tired and lethargic until Slept approx 18 hours 3/8 took Tylenol and went to work felt better but ?like a wet noodle? still not much appetite

Other Meds: Vyvanse Lisinopril Lansoprazole Citalopram Hydrochlorothiazide Montelukast Niacin Potassium chloride Er Adderall Zyrtec Symbicort Pregnyl Clomiphene Airborne gummies

Current Illness: None

ID: 1083158
Sex: M
Age: 37
State: NY

Vax Date: 03/08/2021
Onset Date: 03/08/2021
Rec V Date: 03/08/2021
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: I received my vaccine this morning at 6:12AM and felt fine after. Around 7:45AM I started to feel slightly short of breathe, but figured it was just from the cold outside and my Asthma. The shortness of breathe feeling goes away. Later in the day sometime after 3 PM, I start to feel as if I am getting stuffy. I take a nap on the buss on my way home, and when I wake up I suddenly feel like I am freezing and have chills all throughout my body. I get home and jump in a hot shower to warm up, but it did not help. I then heat up some food to eat dinner, and I go to drink some soda, and I notice I have no taste. I figured the soda was flat, but even flat soda has some taste to it. I then drink a Cherry Gatorade, and still no taste. Now I check my temperature and it is at 101.4, and I have a slight cough.

Other Meds: I have Asthma, therefore I am on an oral steroid called Ellipta, which I must take once a day. I am also on an inhaler called Albuterol, and I take this when needed, which I have not needed to take.

Current Illness: None

ID: 1083159
Sex: M
Age: 73
State:

Vax Date: 02/15/2021
Onset Date: 02/17/2021
Rec V Date: 03/08/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None known

Symptom List: Injection site pain, Pain

Symptoms: Extreme fatigue for two weeks, change in gait and hand tremors over that time - culminated into - inability to walk, hand tremors, drooping face and slurred, garbled speech - I thought he was having a stroke and called 911

Other Meds: blood pressure meds

Current Illness:

ID: 1083161
Sex: M
Age: 1
State: TX

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 03/08/2021
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: none

Symptom List: Injection site pain, Menorrhagia

Symptoms: On 2/5/2021 mom called clinic with c/o high fever of 104, no other symptoms. Advised of home treatment. On 2/6/2021 mom called and stated that fever still at 103 and circulation looked to be problematic. Mom called back a short while later and stated that after putting a blanket on patient, he appeared to be okay. MD gave precautions if fever went beyond 4 days to come back in. On 3/5/2021 mom called and stated that for the past 3 days the patient was admitted to DCMC and was diagnosed with ITP. Mom read that MMR can cause ITP so she was concerned.

Other Meds: none

Current Illness: 1/2/21: fever 104.9, L ear infection 1/29/2021: fever 101.7

ID: 1083162
Sex: M
Age: 63
State: NH

Vax Date: 03/08/2021
Onset Date: 03/08/2021
Rec V Date: 03/08/2021
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: NKA

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

Symptoms: Pt presented for second vaccine and stated after his first vaccine he experienced severe chest tightness. He was watched by the EMS but the symptoms never progressed. Prior to receiving his second dose the patient was given 50 mg Benadryl, waiting 15 minutes and then given his vaccine. The patient felt well and did not experience any symptoms. The patients wife was the driver.

Other Meds: Lisinopril Atorvastatin

Current Illness: HTN HLD

ID: 1083163
Sex: F
Age: 39
State: CO

Vax Date: 03/06/2021
Onset Date: 03/06/2021
Rec V Date: 03/08/2021
Hospital:

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

Lab Data:

Allergies: Unknown

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Throat feeling inflamed and tingling, "my tonsils are closing on me" "throat is getting worse and so is my cough" Told through interpreter. Epi 0.3 mg (epi-pen) Mylan OFM407 expires 2/2022 given in left vastus lateralis at 515m

Other Meds: Unknown

Current Illness: Unknown

ID: 1083164
Sex: F
Age: 42
State: MD

Vax Date: 02/28/2021
Onset Date: 03/01/2021
Rec V Date: 03/08/2021
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: Redness around shot area within 4 hours. Swelling and itchiness started 24 hours later, and persisted for 2 days. The surrounding shot area has become redder and more raised 1 week later.

Other Meds: Melatonin, Benadryl

Current Illness:

ID: 1083165
Sex: F
Age: 71
State: NJ

Vax Date: 02/10/2021
Onset Date: 02/11/2021
Rec V Date: 03/08/2021
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 venom yellow jacket bees lake water (get skin rash) possibly papaya

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

Symptoms: Day 2 Covid adjacent to injection site with hardness under the red itchy site Day 5-6 subsided Day started all over with Covid arm minus the hardness Day 11 mild rash on face, itchy scalp persisted until around Day 30 Day 16 blood sugar seemed hard to control, some dizziness (perhaps related to larger swings in blood sugar?) Day 17 small pool of lymphatic fluid caused small bulge just below and front of Covid Arm site (which went from 2' in diameter to oval 2" wide and 4" long by then) Dizziness and itchiness continued until day around Day 25-26 ( always getting less with each day) Started taking Zyrtec under allergist recommendation, now itchiness is gone

Other Meds: Anastrozole Calcium Citrate Vitamin D Omega 3 fish oil capsule

Current Illness: Nine

ID: 1083166
Sex: F
Age: 65
State: IN

Vax Date: 03/04/2021
Onset Date: 03/04/2021
Rec V Date: 03/08/2021
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: Extreme muscular pain everywhere. Chills ? could not get warm. Severe pain at injection site which limited use of left arm. Symptoms lasted 15 hours

Other Meds: None

Current Illness: None

ID: 1083167
Sex: M
Age: 72
State: WA

Vax Date: 03/07/2021
Onset Date: 03/07/2021
Rec V Date: 03/08/2021
Hospital:

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

Lab Data:

Allergies: n/a

Symptom List: Injection site pain

Symptoms: pt was given a shot that was outside of the 6 hour puncture expiration date. No ADR's reported. Administering another 2nd dose since this dose is considered invalid per CDC guidance.

Other Meds: n/a

Current Illness: n/a

ID: 1083168
Sex: F
Age: 52
State: TN

Vax Date: 02/24/2021
Onset Date: 02/26/2021
Rec V Date: 03/08/2021
Hospital:

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

Lab Data:

Allergies: NKA

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

Symptoms: Lymph node in right armpit was swollen and very tender for 4 days. Swelling subsided by 4th day. Tenderness subsided by third day. 1st and 2nd day large and very painful.

Other Meds: Gabapentin; toprimate

Current Illness: None

ID: 1083169
Sex: F
Age: 28
State: CA

Vax Date: 03/05/2021
Onset Date: 03/05/2021
Rec V Date: 03/08/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None known

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

Symptoms: Recieved vaccine Friday afternoon with small rash on both arms approx. 6 hours after first dose. Continued to be itchy the next day (Saturday) with no obvious rash. Sunday still itchy and obvious small bumps on both arms. Monday (after taking allergy meds) rash gone but just a little itchy.

Other Meds: Zoloft 25 mg

Current Illness: None known

ID: 1083170
Sex: M
Age: 38
State: NY

Vax Date: 02/23/2021
Onset Date: 02/23/2021
Rec V Date: 03/08/2021
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: Tremor

Symptoms: Ringing in ears for two weeks

Other Meds: Vitamin D

Current Illness: N/A

ID: 1083171
Sex: M
Age: 86
State: MA

Vax Date: 03/08/2021
Onset Date: 03/08/2021
Rec V Date: 03/08/2021
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: Bloody nose, treated at home, bloody nose within 24 hrs of 1st dose also!

Other Meds: Lipitor, levothyroxine, carvedilol, lisinopril, hydrochlorothiazide, baby aspirin, ipratropium, vit b12, d3, b 6, folic acid

Current Illness: None Please note had bloody nose within 24 hours of receiving 1st dose and was reported . Has hx of bloody noses but this seems more than a coincidence.

ID: 1083172
Sex: F
Age: 69
State: CA

Vax Date: 01/31/2021
Onset Date: 02/21/2021
Rec V Date: 03/08/2021
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: NOT TO MY KNOWLEDGE

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

Symptoms: EXACTLY 3 WEEKS AFTER 1ST DOSE OF MODERNA, I WOKE UP WITH BELL'S PALSY. THE LEFT SIDE OF MY FACE WAS NUMB AND DROOPED DOWN. I WENT TO URGENT CARE THE NEXT DAY. THEY PRESCRIBED ME VALACYCLOVIR HCL 1 GRAM TABLET AND PREDNISONE 20 MG TABLET FOR 7 DAYS. IT IS SLOWLY RESOLVING BUT HAS NOT YET FULLY RESOLVED TO DATE.

Other Meds: ASPIRIN, METOPROLOL, LISINOPRIL, PRAVASTATIN SODIUM, EZETIMIBE, ALLOPURINOL, STOOL SOFTENER, METFORMIN, INVOKANA, VICTOZA

Current Illness: NONE

ID: 1083173
Sex: M
Age: 69
State: IN

Vax Date: 03/04/2021
Onset Date: 03/05/2021
Rec V Date: 03/08/2021
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: na

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

Symptoms: fever,aches,stiff neck

Other Meds: weekness, low grade fever - 99, arm hurt day two , stiff neck, body ache day three: all ok

Current Illness: na

ID: 1083174
Sex: F
Age: 74
State: OR

Vax Date: 02/26/2021
Onset Date: 03/05/2021
Rec V Date: 03/08/2021
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: 7 days after receiving moderna covid-19 vaccine, patient's arm started feeling itchy (Friday) and over the next 24 hours got red, hot, painful, with slight swelling near injection site . The symptoms started to subside on the following Monday. This was when patient reported adverse event to pharmacy.

Other Meds:

Current Illness:

ID: 1083175
Sex: M
Age: 64
State: IN

Vax Date: 03/03/2021
Onset Date: 03/04/2021
Rec V Date: 03/08/2021
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: Around 12 hours after my shot, I experienced chills and irregular heartbeat for around 30 minutes.

Other Meds: Atenolol 50 mg daily

Current Illness: none

ID: 1083176
Sex: F
Age: 17
State:

Vax Date: 02/17/2021
Onset Date: 02/17/2021
Rec V Date: 03/08/2021
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: unknown

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

Symptoms: The doctor was called STAT to evaluate this patient who was having feelings of weakness and feeling faint in the observation area after she received her first Pfizer COVID vaccine yesterday morning at the vaccination cite. She had already been given an IM Epi Pen injection of epi by the PA prior to my arrival. I had her lie supine with head down and legs elevated and she felt better. She declined EMS transport to ER. Further talk with her dad revealed she had been up since 2 am and had no breakfast. I don't think an allergy.

Other Meds: unknown

Current Illness: unknown

ID: 1083177
Sex: F
Age: 56
State: NC

Vax Date: 02/26/2021
Onset Date: 03/07/2021
Rec V Date: 03/08/2021
Hospital:

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

Lab Data:

Allergies: Ant bite.

Symptom List: Pain in extremity

Symptoms: Moderna COVID-19 Vaccine EUA 8 days after vaccine developed rash at injection site, rash under arms and lower back

Other Meds: B12, D3, Biotin, Zyrtec, Estroven

Current Illness:

ID: 1083178
Sex: F
Age: 37
State: NY

Vax Date: 02/25/2021
Onset Date: 03/04/2021
Rec V Date: 03/08/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: injection site started to itch 6 days after dose 1; 8 days after dose 1 a large rash appeared on arm; rash was warm to the touch. 11 days post vaccine rash is still present.

Other Meds:

Current Illness:

ID: 1083179
Sex: F
Age: 83
State: CA

Vax Date: 02/16/2021
Onset Date: 03/05/2021
Rec V Date: 03/08/2021
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: Shellfish

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

Symptoms: Approximately 15 days after the shot noticed large red patch where the shot had been administer. Was not there for at least 7 days after the shot. No itch, slight swelling.

Other Meds: Levathroid lovastatin, multivitamin

Current Illness:

ID: 1083180
Sex: F
Age: 62
State:

Vax Date: 02/18/2021
Onset Date: 02/25/2021
Rec V Date: 03/08/2021
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: 2/25/2021 OS became swollen to the point where she could not open her eye. It was swollen for two days. On 3/3/2021 OD became swollen. Pt seen at eye doctor 3/5/2021 who diagnosed eyelid edema of unknown cause and reccomended hot compresses bid. Full resolution today 3/8/2021.

Other Meds:

Current Illness:

ID: 1083181
Sex: F
Age: 17
State: IL

Vax Date: 01/18/2021
Onset Date: 01/18/2021
Rec V Date: 03/08/2021
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:

Symptom List: Vomiting

Symptoms: Patient was vaccinated at a non-approved age (Moderna is indicated for 18 years and older) on January 18, 2021.

Other Meds:

Current Illness:

ID: 1083182
Sex: F
Age: 28
State: GA

Vax Date: 03/08/2021
Onset Date: 03/08/2021
Rec V Date: 03/08/2021
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: NKA

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: patient stated she was fine after vaccine, then after a few minutes she stated she felt dizzy. before pharmacist could get back around counter to patient, she fainted and slid out of her chair. patient was alert moments after landing on the floor. patient was laid out on floor and vitals monitored. once vitals returned to normal and patient felt better, she was given water and a banana. EMT arrived and evaluated patient. patient was taken to hospital per EMT suggestion. time frame: 17:26-17:52

Other Meds: Patient did not state any medication history

Current Illness: none

ID: 1083183
Sex: F
Age: 43
State:

Vax Date: 03/01/2021
Onset Date: 03/02/2021
Rec V Date: 03/08/2021
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: Redness and heat around injection site 3 inches in diameter; Fever, chills about 16 hours after injection, lasted 12 hours

Other Meds: Orthotricyclen, Proplanolol, Gemfribrozil, singulair

Current Illness: None

ID: 1083184
Sex: F
Age: 53
State: CA

Vax Date: 03/01/2021
Onset Date: 03/05/2021
Rec V Date: 03/08/2021
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: Rash consistent with atopic dermatitis, rx clobetasol 0.5%. Seen today, 3/8 for symptoms x 3 days.

Other Meds: atorvastatin (Lipitor) 20 mg tablet carvediloL (Coreg) 3.125 mg tablet cholecalciferol (Vitamin D3) 1,000 unit tablet levETIRAcetam (Keppra) 250 mg tablet losartan (Cozaar) 50 mg tablet ferrous sulfate 325 mg (65 mg iron) delayed release ta

Current Illness: none

ID: 1083185
Sex: F
Age: 65
State: FL

Vax Date: 03/06/2021
Onset Date: 03/07/2021
Rec V Date: 03/08/2021
Hospital:

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

Lab Data:

Allergies: sulpha, celery, mangos, pistachhios

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

Symptoms: First vaccine was fine. With second, was fine til about 28 hours later, started to feel fatigued, then low grade fever, body aches, chills, headache. 32 hours later, rash on arms, inner legs, belly. Slept a lot. Rash bumps went away over night, 40 hrs later had just red arms and body, light fever, headache, body / skin aches AND lymph node in neck , on injection side, swelled up and visible bump. Took benedryl ... hope tomorrow is better.

Other Meds: .05 mg ambien

Current Illness: n/a

ID: 1083186
Sex: M
Age:
State: CA

Vax Date: 02/03/2021
Onset Date: 02/06/2021
Rec V Date: 03/08/2021
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: diarrhea/loose stool

Other Meds: ramapril, fenofexadine

Current Illness: none

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm