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: 1084246
Sex: F
Age: 67
State:

Vax Date: 02/26/2021
Onset Date: 02/26/2021
Rec V Date: 03/09/2021
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:

Symptom List: Dysphagia, Epiglottitis

Symptoms: During monitoring period post Pfizer COVID-19 vaccine, pt experienced throat constriction, ringing ears, palpations, dizziness & lightheadedness. Vital signs: 194/91-80-98% reporting throat constriction, & palpitations. Given benadryl 25mg IM x 1. Continued to monitor patient expressed throat "is closing but just a little bit" with lightheadedness & dizziness. Epinephrine 0.3mg IM given x 1. Pt reporting more dizziness and lightheadedness and that she is diabetic, coke given, pt does not have her glucometer on hand. EMS called for evaluation. EMS decides not to transport pt after pt states that she does not want to be transported. Patient monitored for 15-20 more minutes and went home with husband.

Other Meds:

Current Illness:

ID: 1084247
Sex: F
Age: 74
State: TX

Vax Date: 03/06/2021
Onset Date: 03/06/2021
Rec V Date: 03/09/2021
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: I had a very ,very bad back pain ,i couldn't move started 3/4 hours after vaccine

Other Meds:

Current Illness:

ID: 1084248
Sex: F
Age: 67
State: KS

Vax Date: 02/23/2021
Onset Date: 03/07/2021
Rec V Date: 03/09/2021
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: cipro sulfa meds and methylchoralonenonanone (preservative in shampoos, lotions & soaps

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

Symptoms: Rash with welt above and below the injection site with some swelling

Other Meds: pravastatin 20 mg daily, estradiol 1 mg daily, 1 methatraxate 2.5 mg weekly, vit c, vit d3, fish oil, calcium, baby aspirin 81 mg, multiple vitamin.

Current Illness: none

ID: 1084249
Sex: F
Age: 37
State: CO

Vax Date: 01/13/2021
Onset Date: 01/14/2021
Rec V Date: 03/09/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: It was administered really high in the arm, I started bleeding right away, no other pain at the time really. In the middle of the night I woke up in extreme pain, I couldn't lift my shoulder or move without being in so much pain. The first dose was a normal pain but this one I couldn't move my shoulder. This lasted days with extreme pain. I am still having issues with range of motion in my arm, certain ways I move my arm still causes pain but not extreme. I did a virtual visit on the next day after the 2nd dose and he prescribed a mild pain medication and recommended if it wasn't better in a week to come in and see someone. The pain didn't get better so I went in to see someone. The did an xray and nothing was wrong. and didn't know what exactly was going on and said it was varsities. He recommended doing cortisone injections but I opted out.

Other Meds:

Current Illness:

ID: 1084250
Sex: F
Age: 58
State: TX

Vax Date: 03/08/2021
Onset Date: 03/08/2021
Rec V Date: 03/09/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Patient reports tingling on face and lips, and headache. Felt better after a few minutes, no flushing or dizziness. Cleared by EMS.

Other Meds:

Current Illness:

ID: 1084251
Sex: F
Age: 71
State: NY

Vax Date: 02/28/2021
Onset Date: 03/01/2021
Rec V Date: 03/09/2021
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: Demoral

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

Symptoms: I got paralyzed .. could not stand on my legs ... I was wobbly

Other Meds: Synthroid Vitamin D

Current Illness:

ID: 1084252
Sex: M
Age: 19
State: CA

Vax Date: 03/08/2021
Onset Date: 03/09/2021
Rec V Date: 03/09/2021
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: Pyrexia, White blood cell count decreased

Symptoms: Starting 11 hours later, I got a bad headache, chills, my whole body aches, it hurts to move, I can?t sleep

Other Meds:

Current Illness:

ID: 1084253
Sex: F
Age: 61
State: WI

Vax Date: 01/11/2021
Onset Date: 01/12/2021
Rec V Date: 03/09/2021
Hospital:

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

Lab Data:

Allergies: IVP dye

Symptom List: Pharyngeal swelling

Symptoms: Day after 2nd vaccine had aching in all joints, chills with low fever, headache lasting 24-48 hours. Hip pain continues worsening with walking and standing over time. Hips started to ache after first vaccine but didn't realize it was attributed to vaccine. Started taking fish oil and Glucosamine tabs for joints. Hip pain after 2nd vaccine increased and continues today. Went to Internal Medicine clinic to be seen on 1/25/2021. Xrays, UA, ANA, CBC and CMP were done. Xrays show mild degenerative changes to hips bilaterally. ANA elevated at 2.1. Everything else within normal limits. Physician then added RA, C- Reactive Protein and Sedrate, all coming back WNL. Will be making appointment with Rheumatoidologist.

Other Meds: Vitamin D, Energy Plus Vitamin

Current Illness: None

ID: 1084254
Sex: F
Age: 74
State: WI

Vax Date: 02/28/2021
Onset Date: 03/04/2021
Rec V Date: 03/09/2021
Hospital:

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

Lab Data:

Allergies: tape, codeine, morphine, hydrocodone,

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: pt states that several days after getting the vax she started feeling extreme fatigue, SOB, and chills that lasted for 3 days. Pt states that she did not contact her PCP since the symptoms subsided.

Other Meds: gabapentin 300mg, carvedilol 6.5 mg, meloxicam 15mg, atorvastatin 20mg, lisinopril 40mg,amlodipine besylate 10mg, Multivitamin, stool softener, Vimentin B3, Glucosamine-Chondroitin-, calcium, Vitamin B12, anoro 6.25 -25 mg, butrans patch 2

Current Illness: no

ID: 1084255
Sex: F
Age: 69
State:

Vax Date: 02/28/2021
Onset Date: 02/28/2021
Rec V Date: 03/09/2021
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: Complain of feeling hot, flashed, scratchiness in the back of throat. No swelling, hives, itching, SOB. Patient had tingling in hands and face that patient stated is normal with her MS. T98.1, P80, R18, BP139/89, O2 sat 94%. Pt advised to take Benadryl when she gets home because it makes her very drowsy

Other Meds:

Current Illness:

ID: 1084256
Sex: F
Age: 47
State: TX

Vax Date: 03/08/2021
Onset Date: 03/08/2021
Rec V Date: 03/09/2021
Hospital:

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

Lab Data:

Allergies: Japanese soup

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

Symptoms: 1st dose of Moderna vaccine administered at 1608 in the right deltoid. At 1615 during the waiting period the patient reported mild itching and reports this has happened with the Flu vaccine. 1620 itching became progressively worse. 1624 Benadryl 50mg IM was administered into right gluteus. 1634 pt reports sx are relieved. Educated on follow up and CDC recommendation not to take the vaccine nor the 2nd dose again. Educated on emergency protocol and sx management. Pt was accompanied by a friend who says she will drive and take patient home.

Other Meds: Benadryl

Current Illness: None

ID: 1084257
Sex: M
Age: 52
State: TX

Vax Date: 03/02/2021
Onset Date: 03/03/2021
Rec V Date: 03/09/2021
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: NONE

Symptom List: Rash, Urticaria

Symptoms: I had itching and redness on my left arm where I received the shot on day 2. I also had some small bumps and itching on the back of my hands. As the days went on, I had more red bumps on my feet, ankles, forearms, and other areas of my body. It was really bad on 03/08/2021. I could not stop itching one my feet and ankles. The also in other places.

Other Meds: Mega Men multivitamin

Current Illness: NONE

ID: 1084267
Sex: M
Age: 48
State: NJ

Vax Date: 03/08/2021
Onset Date: 03/09/2021
Rec V Date: 03/09/2021
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: Dizziness (pretty bad). Nausea satisfying 430am and persists

Other Meds: None

Current Illness: None

ID: 1084268
Sex: F
Age: 72
State:

Vax Date: 03/05/2021
Onset Date: 03/06/2021
Rec V Date: 03/09/2021
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: Allergies: Allergies Allergen Reactions ? Penicillins CV - anaphylaxis Severe reaction in childhood ? Pneumovax 23 [Pneumococcal Vac Polyvalent] GENERAL - fever, SKIN - pruritis, CV - anaphylaxis and MUSC/SKEL - body aches DX: cellulitis ? Ceftriaxone SKIN - rash Whole body rash ? Erythromycin OTHER (explain in comments) Severe abdominal pain ? Cephalosporins SKIN - hives ? Codeine NEURO/PSYCH - headache ? Sulfa Drugs SKIN - hives, SKIN - rash and EENT - angioedema To gantrasin

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

Symptoms: Painful, itchy, red arm at injection site

Other Meds: Current Outpatient Medications Medication Sig ? acetaminophen (TYLENOL) 500 MG tablet Take 1 tablet (500 mg total) by mouth every 4 hours as needed. ? ALPRAZolam (XANAX) 0.25 MG tablet Take 1 tablet (0.25 mg total) by mouth 3 times daily as

Current Illness:

ID: 1084269
Sex: F
Age: 69
State: MI

Vax Date: 03/03/2021
Onset Date: 03/03/2021
Rec V Date: 03/09/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Chills, fever, headache, muscle aches, joint aches, nausea, diarreha, loss of appetite

Other Meds: Lisinipril Vitamin D

Current Illness: None

ID: 1084270
Sex: F
Age: 73
State: SC

Vax Date: 03/06/2021
Onset Date: 03/08/2021
Rec V Date: 03/09/2021
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: Farmed shellfish

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

Symptoms: Raised red rash on face, itchy red blotches

Other Meds: Trelegy inhaler, vitamin D3

Current Illness: None

ID: 1084271
Sex: F
Age: 52
State: AL

Vax Date: 03/08/2021
Onset Date: 03/08/2021
Rec V Date: 03/09/2021
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: Sulfa

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

Symptoms: Fever 100.7 with Tylenol, nausea, vomiting, chills and cold sweat, moderate to severe body pain. Better as time pass but still not gone but shot was yesterday.

Other Meds: Metformin, Lexapro, Ozempic, Pravastatin, Losartan, Trazadone, Sotolol, Xeralto

Current Illness: None

ID: 1084272
Sex: F
Age: 43
State: MI

Vax Date: 02/18/2021
Onset Date: 02/18/2021
Rec V Date: 03/09/2021
Hospital:

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

Lab Data:

Allergies: Iodine, Peanuts, Aspirin, Shellfish

Symptom List: Ear pain, Hypoaesthesia

Symptoms: 22 minutes after the shot 1:04PM tongue started to feel tingly and numb, followed by the lips. Felt flushed. 1:07 PM I started to feel a tingling in my throat. Took a benadryl given to me by EMS. 1;18PM Started to feel lightheaded. Had trouble speaking (slurring words) 2:30PM Felt like I had been drinking (I don't drink). Noticeable by my peers and my husband. Acting loopy. Altered taste of food. Everything tasted like blood. Issues with my tongue/lips subsided after about 4 hours. Taste Issues resolved by the next morning. Light soreness on the left arm on the day of the shot, better the next day. One week later, 3/24/21, Vaccine area felt warm, hard, swollen to the touch. Arm felt like someone had hit me with a bat. Pain went from Vaccine area to fingers. Finger joints felt swollen. Lasted for about a week Armpit felt swollen, bumpy (grape sized bumps), and painful. Lasted for more than 1 week.

Other Meds: None

Current Illness: Allergies

ID: 1084273
Sex: F
Age: 61
State: VA

Vax Date: 03/05/2021
Onset Date: 03/05/2021
Rec V Date: 03/09/2021
Hospital:

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

Lab Data:

Allergies: no known drug or food allergies

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Within in 30 minutes of administration she felt nasal stuffiness that lasted 1-2 hours. 10 hours after administration she developed fatigue but could not sleep. 12 hours after administration she developed severe chills that made her teeth chatter beyond control x 2 hours. She also reported severe joint and muscle pain. Saturday she felt nausea, aching and fatigue. Sunday (40 hours after vaccine was given) she developed syncope and fell hitting her head. Her B/P at that time was 89/49. Her b/p was checked numerous times after that and stayed low for about 24 hours. She missed work d/t this on Monday 3/8/21.

Other Meds: Singular 10 mg Calcium supplement Vitamin D3 Preservision

Current Illness: none

ID: 1084275
Sex: F
Age: 65
State: IN

Vax Date: 03/03/2021
Onset Date: 03/03/2021
Rec V Date: 03/09/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Sore arm evening of injection Joint pain starting 2nd day and continuing for 3 days Not severe enough to call Dr.

Other Meds:

Current Illness:

ID: 1084276
Sex: M
Age: 62
State: WV

Vax Date: 02/26/2021
Onset Date: 02/28/2021
Rec V Date: 03/09/2021
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: Keflex

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

Symptoms: fatigue, sinus migraine headache, muscle pain, chills, nausea, low grade fever

Other Meds:

Current Illness:

ID: 1084277
Sex: M
Age: 66
State: WV

Vax Date: 03/05/2021
Onset Date: 03/06/2021
Rec V Date: 03/09/2021
Hospital: Y

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

Lab Data:

Allergies: demerol sulfa

Symptom List: Unevaluable event

Symptoms: Chocking sensation, tightness in throat and chest severe enough to make me go to the emergency room of Hospital. I spent the entire weekend in Hospital. I had gotten the vaccine in that same hospital earlier that afternoon. I had a similar reaction with the first dose also given at hospital one month before on Feb 5 ,2021. It was not severe enough to make me go the emergency room. It happened approximately the same amount of time after the vaccination. approximately 12 hours after the shot.

Other Meds: bupropion metropronol omeprazole

Current Illness:

ID: 1084278
Sex: F
Age: 50
State: IN

Vax Date: 02/24/2021
Onset Date: 02/25/2021
Rec V Date: 03/09/2021
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: Penicillin, Biaxin

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

Symptoms: Dizziness with Vertigo. Eye spasms have been happening since second dose. They are weaning more each day, however the dizziness has not.

Other Meds: Singulair, Flovent, Ventolin

Current Illness: None

ID: 1084279
Sex: F
Age: 70
State: FL

Vax Date: 03/08/2021
Onset Date: 03/08/2021
Rec V Date: 03/09/2021
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: Contrast dyes

Symptom List: Injection site pain, Pain

Symptoms: Headache, fever, joint pain, muscle pain, from 7 PM through 7 AM, now feeling tired, achy and light headed.

Other Meds: Simvastatin 20mg; Triampterene 37.5mg HCTZ 25mg; Preservision with Areds2 ; Biotin 10,000

Current Illness: none

ID: 1084280
Sex: M
Age: 74
State: FL

Vax Date: 02/21/2021
Onset Date: 02/23/2021
Rec V Date: 03/09/2021
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: symptoms are " like its something inside his legs and its eating away at it" , no fever no overall body aches. Symptoms started 2 days after vaccine. Has appt. on 3/8 with PCP. He has not taken any medication, states it upsets his stomach.

Other Meds:

Current Illness:

ID: 1084281
Sex: M
Age: 37
State: OH

Vax Date: 03/03/2021
Onset Date: 03/05/2021
Rec V Date: 03/09/2021
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: None.

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

Symptoms: He began to have some severe pain in his ears to the point of 8/10. He went to the hospital, saw a doctor and they gave him some medication Amox/clav that he took. He did not help the pain. After 2 days he went back to the ER on 3/7/21, they gave him another antibiotic called Ofloxacin ear drops. He found out that he had a hole in his ear drum. He has never had an issue like this before, and he was fine when he got the vaccine and feels it's related to that. He has had no problems other than the regular side effects which only lasted for 1 day and then went away. Yesterday, 3/8/21 the problem shifted to the other ear. He is beginning to feel pain on his left ear as well now. He has terrible hearing loss due to this issue.

Other Meds: Novo-Log, Basaglar insulin, Atorvastatin, Vitamin B.

Current Illness: None.

ID: 1084282
Sex: F
Age: 64
State: MO

Vax Date: 03/05/2021
Onset Date: 03/05/2021
Rec V Date: 03/09/2021
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: Allergic to shell fish and sulpha medication and poison ivy

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Pressure moving across chest from left to right, rapid heartbeat, swollen throat and out of breath. I also had arm pain and confusion

Other Meds: Took nothing that day. The day before I took naproxen, vitamin D, zinc and a multi vitamin

Current Illness: None

ID: 1084283
Sex: M
Age: 79
State: IN

Vax Date: 03/01/2021
Onset Date: 03/02/2021
Rec V Date: 03/09/2021
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: Severe Fatigue, Sore Joints and Muscles, Nausea, Dizziness and head aches

Other Meds: Amlodipien Besylate 5 mg 1 X Daily Metoprolol Succinate ER 100 mg 2 X Daily Benazepril 40 mg 1 X Daily Lipitor(Atorvastatin) 40 mg Diltiazem 180 mg Daily Primidone 100 mg 2 X Daily Eliquis 5 mg 2 X Daily OTC: Osteo Bi-Flex which c

Current Illness: None

ID: 1084284
Sex: F
Age: 50
State:

Vax Date: 02/26/2021
Onset Date: 02/27/2021
Rec V Date: 03/09/2021
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: tree nuts & Norvasc

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

Symptoms: large red hot rash at site of injection, waxing & waning

Other Meds: Fluconazole 150 MG Tablet Start Metformin HCl 500 MG Tablet Taking Loratadine 10 MG Tablet Taking Aspirin 81 MG Tablet Delayed Release Taking Pravastatin Sodium 20 MG Tablet Taking Losartan Potassium 100 MG Tablet

Current Illness: Active psoriasis

ID: 1084285
Sex: F
Age: 18
State: MD

Vax Date: 03/06/2021
Onset Date: 03/06/2021
Rec V Date: 03/09/2021
Hospital:

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

Lab Data:

Allergies: Penicillins, Cephalosporins

Symptom List: Nausea

Symptoms: Began with heavy feeling in limbs, progressed to painful joints and muscle weakness. Extreme fatigue, headache, and fever and chills throughout the day 3/7. Woke up feeling better on 3/8.

Other Meds: JunelFe

Current Illness: N/A

ID: 1084286
Sex: F
Age: 28
State: IN

Vax Date: 03/05/2021
Onset Date: 03/06/2021
Rec V Date: 03/09/2021
Hospital:

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

Lab Data:

Allergies: penicillin, ceclor lomotil and laughing gas

Symptom List: Injection site pain

Symptoms: Red bump appeared and where itching at injection beginning 3/6/21 At 7am And ending 3/8/21 around 430pm. I took benadryl to relieve temporarily until it went away on its own.

Other Meds: None

Current Illness: none

Date Died: 02/04/2021

ID: 1084287
Sex: M
Age: 80
State: MN

Vax Date: 02/02/2021
Onset Date: 02/04/2021
Rec V Date: 03/09/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Death

Other Meds:

Current Illness:

ID: 1084288
Sex: F
Age: 58
State: NJ

Vax Date: 02/16/2021
Onset Date: 02/26/2021
Rec V Date: 03/09/2021
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: nuts, raglan, shellfish

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

Symptoms: a week after vaccination I have been itching like crazy taking allegra, zyrtec and beneadryl its like im itching in the inside, no outward rash had to go to ER itching so bad have an appointment with allergist(0even private itching

Other Meds: yes vitamins. losartan

Current Illness: no

ID: 1084289
Sex: F
Age: 82
State: CT

Vax Date: 01/07/2021
Onset Date: 01/13/2021
Rec V Date: 03/09/2021
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: nka

Symptom List: Tremor

Symptoms: Patient's family concerned regarding increased confusion and arm pain post covid vaccination. Insistent that an adverse event form completed. Resident had covid-19 in November 2020, then a uti, and CHOLELITHIASIS WITHOUT OBSTRUCTION right before the vaccine series started.

Other Meds: Biscolax Suppository 10 MG (Bisacodyl) **DAW** Insert 10 mg rectally every 24 hours as needed for Constipation Give once daily as needed for constipation if MOM is ineffective (use second) BusPIRone HCl Tablet 5 MG Give 5 mg by mouth two t

Current Illness: Had covid 11/3/2020

ID: 1084290
Sex: F
Age: 63
State: AR

Vax Date: 02/26/2021
Onset Date: 02/27/2021
Rec V Date: 03/09/2021
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: redness at site of injection and down the arm for several days

Other Meds:

Current Illness:

ID: 1084291
Sex: F
Age: 68
State: IN

Vax Date: 03/05/2021
Onset Date: 03/06/2021
Rec V Date: 03/09/2021
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: Headache treated with Tylenol, 2 hours Lethargy, 24 hours Unusual taste of all food, 48 hours

Other Meds: Losartan, Citalopram, Vitamin D, Cephalexin

Current Illness: Tooth Infection

ID: 1084292
Sex: F
Age: 38
State: IA

Vax Date: 02/06/2021
Onset Date: 02/06/2021
Rec V Date: 03/09/2021
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: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: 2 hours after injection patient states she spiked 102 fever, had chills/body aches, a migraine, pain and bruising at injection site, and a rash on her upper back. Called her MD and was told not to get the second shot.

Other Meds: NONE

Current Illness: NONE

ID: 1084293
Sex: F
Age: 71
State: MA

Vax Date: 03/08/2021
Onset Date: 03/08/2021
Rec V Date: 03/09/2021
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: Topical bacitracin

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: About 8 hours after getting the shot, I felt tired, then got chills. A couple of hours later, I had diarrhea and nausea with vomiting. This lasted for about 1 hour or so. I became dehydrated and also had a headache. This morning, I seem to be fine - just exhaustion and some headache.

Other Meds: Levoxyl; vitamin b, d, k, fish oil; magnesium; probiotic; topical estrogen

Current Illness: Upper chest cough

ID: 1084294
Sex: F
Age: 60
State: IN

Vax Date: 03/04/2021
Onset Date: 03/06/2021
Rec V Date: 03/09/2021
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: Z-pack. I have seasonal allergies

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

Symptoms: Vaccination site became large red circle and has itched since day one. Approximately 48 hours later I began to have a headache and ran a fever of 101.4 with body aches and slept almost the entire day. The next day my temperature was 100.6 with headache but no body aches but I had nausea for the next for the next 48 hours. I had really bad night sweats for 3 nights. On 3/8 I developed a red bump the size of a dime in the center of my rash on my arm. The arm has itched the entire time. On 3/9 I woke up feeling better finally but itching still persists but compared along with the other side effects it?s nothing.

Other Meds: Trulicity, Metformin, Glimeperide, Atavastorin,Lisinporil, Aspirin, Singulair, Paroxetine, Multibetic Vitamin. I get allergy shots every two weeks.

Current Illness: None

ID: 1084295
Sex: F
Age: 41
State: MN

Vax Date: 03/07/2021
Onset Date: 03/08/2021
Rec V Date: 03/09/2021
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: No

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

Symptoms: I have a mosquito bite looking mark on my arm from the injection. around 2 pm I had 102.5 fever and I had a headache and felt really tired. I asked the nurse when I went in to get the vaccine if I could get the vaccine if I have already had covid, she said that I could still have the vaccine. The nurse proceeded to vaccine. My boss then told me that she was wrong and that I should not have been given the vaccine if I have already had covid. Is the nurse wrong?

Other Meds: vitamin C Vitamin D3

Current Illness: I had Covid; diagnosed 02/15/2021

ID: 1084296
Sex: F
Age: 51
State: TX

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 03/09/2021
Hospital:

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

Lab Data:

Allergies: PCN

Symptom List: Pain in extremity

Symptoms: Reports Facial numbness/tingling Refused to go to ER, states symptom is getting better Seen and cleared by EMS

Other Meds:

Current Illness:

ID: 1084297
Sex: M
Age: 67
State: FL

Vax Date: 02/01/2021
Onset Date: 02/04/2021
Rec V Date: 03/09/2021
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: Muscle and joint pain

Other Meds: Metoprolol norvask lisinapril

Current Illness: None

ID: 1084298
Sex: F
Age: 43
State: IN

Vax Date: 03/06/2021
Onset Date: 03/06/2021
Rec V Date: 03/09/2021
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: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: Chills real bad still cold 3 days later face broke out real bad.

Other Meds: None

Current Illness: None

ID: 1084299
Sex: M
Age: 37
State: IA

Vax Date: 03/05/2021
Onset Date: 03/05/2021
Rec V Date: 03/09/2021
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: Reported no known previous allergic reactions at time of injection.

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

Symptoms: 1515-Vaccine administered-Employee was monitored for 15 min and returned to work. 1600- Employee developed hives, reported to occupational health and benadryl administered. APRN present in Occupational Health. Patient stated he felt that his throat was swelling. Epi-Pen was administered while an ambulance was called, employee was transported to ER.

Other Meds:

Current Illness:

ID: 1084300
Sex: F
Age: 58
State: FL

Vax Date: 03/05/2021
Onset Date: 03/07/2021
Rec V Date: 03/09/2021
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: Swollen lymph nodes

Other Meds: Fish Oil, Zyrtec, Vitamin D, CoQ10

Current Illness:

ID: 1084301
Sex: F
Age: 23
State: CA

Vax Date: 03/05/2021
Onset Date: 03/05/2021
Rec V Date: 03/09/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Headache right after vaccination Very sore arm for 2 days Mild fever night of 3/5

Other Meds: Albuterol

Current Illness: Asthma

ID: 1084302
Sex: F
Age: 39
State: SD

Vax Date: 03/05/2021
Onset Date: 03/05/2021
Rec V Date: 03/09/2021
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: Adhesives, cats, chicken, cipro, cotton seed oil, walnuts, hazelnuts, seafood, soybean, bactrium, hornets, insect bites, latex, palm oil

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

Symptoms: Patient experienced rash and tachycardia after receiving vaccine. Patient was given Benadryl 50 mg and Epinephrine 0.3mg. Patient responded well to medications and sent home with Prednisone Rx.

Other Meds: Bactroban 2% ointment, Vyvanse 60 mg Daily, Ashwagandha 125 mg , magnesium 100mg , L-Theanine 100mg, Singulair 10mg daily, Albuterol Inhaler PRN, Lotrisone cream PRN, Zyrtec 10 mg daily, Melatonin 1 mg tablet at bedtime, Calcium Carbonate

Current Illness:

ID: 1084303
Sex: M
Age: 50
State: TX

Vax Date: 03/08/2021
Onset Date: 03/08/2021
Rec V Date: 03/09/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Dizziness, mild tachycardia, and moderate to severe headache.

Other Meds: Losartan

Current Illness: None

ID: 1084304
Sex: F
Age: 36
State: CT

Vax Date: 03/06/2021
Onset Date: 03/06/2021
Rec V Date: 03/09/2021
Hospital:

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

Lab Data:

Allergies: N/A

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

Symptoms: Fever, Chills, Extreme Fatigue, Sweats, Severe headache, Joint and muscle pain/aches for 24hrs

Other Meds: Zyrtec

Current Illness: N/A

ID: 1084305
Sex: F
Age: 73
State: IN

Vax Date: 03/01/2021
Onset Date: 03/01/2021
Rec V Date: 03/09/2021
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: Erythromycin, Lanacane, Macrodantin, Thimerosol, Tramadol

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

Symptoms: Severe headache lasting 36 hours, fatigue and malaise for at least a week. No treatment except for rest.

Other Meds: Caltrate, Centrum Silver, Coumadin, Cymbalta, DHEA, Ester-C, Fortify, Levothyroxine, Metformin, Montelukast, Myrbetriq, Pentoxifylline, Prolia, Vitamin E

Current Illness: Post nasal drip

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm