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: 1084306
Sex: M
Age: 69
State: ME

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

Lab Data:

Allergies: None

Symptom List: Dysphagia, Epiglottitis

Symptoms: My body started shaking uncontrollably - lasted for about 30 to 45 minutes. Also developed a mild headache with the shaking.

Other Meds: Tamsulosin

Current Illness: None

ID: 1084307
Sex: F
Age: 58
State: LA

Vax Date: 03/01/2021
Onset Date: 03/08/2021
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: not that I know of

Symptom List: Anxiety, Dyspnoea

Symptoms: 7 days post I developed a large red circle on my left arm. It is hard, warm and tender. This did not happen right away. It took a week. I just had normal soreness at the vaccination site initially. I am just watching for now and applying a cold compress as directed by cdc.

Other Meds: none

Current Illness: none

ID: 1084308
Sex: F
Age: 72
State: FL

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

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

Symptoms: about 12 hrs after, she felt equilibrium problems and nausea but resolved 24 hrs later, today she complains of dizziness and tiredness. Spoke with patient, states that feeling better but will f/u with her ENT for her known equilibrium issues. No longer has nausea. Advised to call us if needed.

Other Meds: vitamins supplements no rx meds

Current Illness:

ID: 1084309
Sex: F
Age: 53
State: PA

Vax Date: 03/03/2021
Onset Date: 03/04/2021
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: no known allergies.

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Patient is unable to move her right arm without considerable pain. She states that at onset she was unable to move the arm at all. By friday approximately 36 hours post vaccination she has gained a few inches of mobility, but still has considerable pain from the vaccine and from movement. She is able to bend at the elbow and move her wrist and fingers.

Other Meds: none known.

Current Illness: none stated.

ID: 1084310
Sex: F
Age: 30
State: GA

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

Symptoms: Dizziness, vomiting, Headache.

Other Meds: Phendimetrazine ER 105 MG cap, Paused 48 hour before the vaccine.

Current Illness: None

ID: 1084311
Sex: F
Age: 33
State: TX

Vax Date: 03/02/2021
Onset Date: 03/04/2021
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: Ibuprofen and percocet - rash/hives Food allergies - oats, catfish, peas, pecans, walnuts, cashews Other allergies - animal dander, fur, pollen (most kinds), molds/mildews, trees, grass, sweat (my own and others), hair (my own and others), protein reaction upon skin contact but not consumption

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

Symptoms: 3/2 - Felt nausated a few hours after, but it passed 3/3 - Right arm (injection arm) itched, but hydrocortizone application relieved it 3/4 - Began feeling hot and flushed towards the early afternoon, no fever. That evening I slept under multiple blankets because I could not seem to get warm but I was sweating 3/5 - The skin on both arms was red and hot all day. I felt like I was sun burnt; no itching and no fever. By the end of the day, I was red and hot all over. No other symptoms except feeling like I was sunburnt all over. I began, at the suggestion of an urgent care doctor, taking a regime of Benadryl and Tylonel. I stopped taking the multivitamin that contained niacin. 3/6 - The same and the day before; no fever, no itching, no respiratory complicatons. 3/7 - Some redness, but I stopped taking Benadryl 3/8 - Some redness, resumed multi vitamin 3/9 - No change, still some redness.

Other Meds: Vitamin/Medicine Prednisone 10 MG D3 5000 IU Tumeric Curcumin 1200 MG CoQ10 100 MG Garlic 1000 MG Cinnamon 1000 MG Selenium 200 MCG Potassium 99 MG Zinc 50 MG Echinacea & Goldenseal 450 MG Calcium 1200 MG MSM 1000 MG Acidophilus 100 MIL

Current Illness: N/A

ID: 1084312
Sex: F
Age: 29
State: ID

Vax Date: 02/24/2021
Onset Date: 02/24/2021
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: Pyrexia, White blood cell count decreased

Symptoms: Fever of 102.4, chills, hard time breathing, body aches lasted about 5 hours until I fell asleep, woke up the next morning at 8:00 AM with body aches

Other Meds: Prenatal vitamin

Current Illness: None

ID: 1084313
Sex: F
Age: 74
State:

Vax Date: 02/27/2021
Onset Date: 02/27/2021
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:

Symptom List: Pharyngeal swelling

Symptoms: Moderna COVID -19 Vaccine EUA 2-3 days after vaccine injection site on left arm felt pain and hardness. 11 days passed hardness is gone but having mild red and itch around the injection area. The second dose had been scheduled on 3/27 which is 20 days away from now. Should I take the second dose?

Other Meds:

Current Illness:

ID: 1084314
Sex: F
Age: 62
State: CO

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

Lab Data:

Allergies: None

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Shakes & Chills,Muscle Aches in legs, 101 Fever Fatigue

Other Meds: Restasis-eye drops Areds-eye vitamins

Current Illness: None

ID: 1084315
Sex: F
Age: 70
State: AZ

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: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Penicillin

Symptom List: Diarrhoea, Nasal congestion

Symptoms: 3/5/21 Restlessness, fatigue & arm soreness. 3/6/21 Arm fevered, inflamed and bruising at and around injection area 3/7/21 Arm worsen with the bruising and redness 3/8/21 & 3/9/21 No improvement in arm Took Benadryl- no change

Other Meds: None

Current Illness: None

ID: 1084316
Sex: F
Age: 32
State: NY

Vax Date: 03/07/2021
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:

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

Symptoms: "Janseen COVID-19 Vaccine EUA" - experienced following symptoms for 1 day: diarrhea, stomach pain, chills, brain fog/headache, aches throughout my entire body, could barely walk

Other Meds: antihistamine, flonase, biotin, vitamin d

Current Illness:

ID: 1084317
Sex: F
Age: 31
State: PA

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: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies: papaya, raw carrots, raw apples

Symptom List: Rash, Urticaria

Symptoms: Received vaccination 3/4 in the afternoon. Noticed left eye irritation/redness/swelling on 3/6 in the evening. Progressed through the evening to have lots of discharge and watery. Eye crusted shut morning of 3/7 and 3/8. Symptoms of redness/irritation/swelling continued. Diagnosed with pink eye morning of 3/9/21.

Other Meds: One-a-day prenatal vitamin, cholecalciferol 1000 units/day, biotin 5000 units/day, vitamin C 500 units/day

Current Illness: N/A

ID: 1084318
Sex: F
Age: 51
State: AL

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

Symptoms: The patient reports nausea and vomiting with a jittery feeling. Patients B/P was 132/73, HR was 83, RR WAS 18. Patient denies any difficulty breathing. The patient is awake and alert with no apparent distress.

Other Meds: ?

Current Illness: ?

ID: 1084319
Sex: F
Age: 50
State: ID

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: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Penicillin, Tetracycline

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

Symptoms: Headache ongoing since day of injection. Pulsatile Tinnitus, right ear. Arm pain first 3 days after vaccine. Rash at injection site appearing 1 week after injection.

Other Meds: Spirinolactone, Bupropion, Citalopram

Current Illness: None

ID: 1084320
Sex: M
Age: 68
State: AL

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

Lab Data:

Allergies: nono

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

Symptoms: aching all over, had the chills, sweating, fever,

Other Meds: Lisinipril, prostatin, metformin, micro er, Protropazole, meloxicam

Current Illness: no

ID: 1084321
Sex: F
Age: 40
State:

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:

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

Symptoms: Patient called health department 3 days after receiving second dose of Moderna vaccine. Patient reported that she believed her injection was given too high in the arm and her arm was in increasingly worse pain as the days were going on. She could not do normal daily activities such as driving as it caused her too much pain.

Other Meds:

Current Illness:

ID: 1084322
Sex: F
Age: 67
State: IN

Vax Date: 03/05/2021
Onset Date: 03/05/2021
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: Anaprox, sulfa, Loratab

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

Symptoms: I had the following symptoms fir approx 2 days: a very sore and swollen arm, temp of 102, bad headache, body aches, fatigue, and bad nausea.

Other Meds: Dexcilant 60 mg, Emgality 120mg, Fentanyl 75 mg, Midrodine HCL 5 mg, oxycodon 7.5 mg, Tizanadine HCL 2 mg, Fluticasone Proponate 50 mg, miralax 3350 Powder, CBD Oul, Centrum Silver, Calcium 600mg with Vitamin D 800 mg, Melatonin

Current Illness: None

ID: 1084323
Sex: F
Age: 76
State: FL

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

Symptom List: Ear pain, Hypoaesthesia

Symptoms: feeling dizziness contacted the patient , patient states that she is not having any more dizziness , but some HA , took some tylenol .

Other Meds: metformin amlodipine diastolic

Current Illness:

ID: 1084324
Sex: F
Age: 42
State: CA

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

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Chills and aches all over body for 5 hours

Other Meds: None

Current Illness: None

ID: 1084325
Sex: F
Age: 80
State: FL

Vax Date: 01/12/2021
Onset Date: 01/18/2021
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: Penicillin

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

Symptoms: Huge hives mainly on my lower extremities.

Other Meds: Metformin Metropolol Crestor Lisinopril Co q 10

Current Illness: None

ID: 1084327
Sex: M
Age: 69
State: IN

Vax Date: 03/05/2021
Onset Date: 03/06/2021
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:

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

Symptoms: Chills, Body Aches, Headache, Malaise

Other Meds: Omeprazole 40MG Valsartan 80MG twice daily Carvedilol 3.125MG twice daily Spironolacton 12.5 MG

Current Illness:

ID: 1084328
Sex: F
Age: 40
State: MD

Vax Date: 02/27/2021
Onset Date: 02/27/2021
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: Unevaluable event

Symptoms: Vaccine ran down arm. Unknown whether partial or none e tested patient?s arm.

Other Meds: None. The problem was possible error with vaccine administration. Patient felt liquid running down her arm as needle was withdrawn. Asked if it was blood, vaccinator replied No, was it vaccine? Yes, but no problem as she took tissue t

Current Illness: None

ID: 1084329
Sex: F
Age: 61
State: PA

Vax Date: 03/09/2021
Onset Date: 03/09/2021
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:

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

Symptoms: Dizziness immediately after vaccine, Resolved after rest.

Other Meds: Blood pressure medicine

Current Illness: none known

ID: 1084330
Sex: M
Age: 72
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: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Injection site pain, Pain

Symptoms: Woke up around 2 AM on Saturday morning after the Friday morning shot --- fever/sweating, headache, felt like every bone and muscle in my body hurt. Felt like I had been hit by that truck everybody gets hit by. Fever broke some time during the night. Pain subsided. Was able to eat breakfast about 9AM. Very weak. Dozed on and off the rest of the morning. Low grade fever most of the rest of the day. By Sunday morning felt pretty much normal, but still weak. By Monday morning pretty much back to normal.

Other Meds: Fish Oil 1200mg Men 50+ Multivitimineral Supplement Low Dose Aspirin 81mg Meloxicam 15mg Hydrochlorothiazide 25mg Amlodipine besylate 10mg

Current Illness: none

ID: 1084331
Sex: F
Age: 68
State: LA

Vax Date: 02/26/2021
Onset Date: 03/05/2021
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: dust, pollen, codein, sulfa

Symptom List: Injection site pain, Menorrhagia

Symptoms: redness itching swelling at injection site

Other Meds: Amlodopine, atorvestatin, omeprozole, levothyroxine, baby aspirin, allegra, hctz, potassium, multivitamin,

Current Illness: none

ID: 1084332
Sex: F
Age: 53
State: NM

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

Lab Data:

Allergies: no

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

Symptoms: aside from chills, fever, aches I also had an anaphylactic reaction to the shot. In the evening I was exhausted and could barely move, around 10pm, I think, I started to labor with my breathing. It felt like I would stop breathing and then take 4 gasps for air, and this repeated all night and into the morning. Eventually it stopped the following day, every now and then on the following day I would repeat it but not as often.

Other Meds: vit C, magnesium, Vit B, multi-vitamin

Current Illness: no

ID: 1084333
Sex: F
Age: 47
State: VT

Vax Date: 03/08/2021
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Lip and tongue tingling, throat tightness, nausea. Took benadryl before arrival. Treated with dexamethasone with improvement.

Other Meds: None

Current Illness: None

ID: 1084334
Sex: M
Age: 76
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:
Dose Series: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: No known allergies

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Patient called the morning after her second dose of the Moderna vaccine. She states that she started with a rash (no at the injection site) last night. The rash was down her arms, on her neck and scalp. Rash was red and itchy per patient. She took a Claritin and the rash resolved. Today she is feeling fine but states her skin almost feels "tingly" like the rash may come back. Advised to continue on her normal regimen of 1 Claritin a day (normally taken for treatment of her seasonal allergies) If any of her symptoms come back, worsen or new symptoms are to arise she is to call out office.

Other Meds: No medications taken day of vaccination (before vaccination) Claritin taken after reaction to the vaccination

Current Illness: none per patient

ID: 1084336
Sex: F
Age: 84
State: CO

Vax Date: 02/12/2021
Onset Date: 02/19/2021
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: Scallops - anaphylaxis Adhesive - reaction unknown Levaquin - dizziness

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

Symptoms: 84 yo woman here to follow up from recent episode of vasculitis. She started getting a rash - started 7 days after 2nd dose of vaccine At last visit, we did testing for vasculitis after the rash looked more vasculitic to me; ANCA testing was positive, as was ANA. - 17 days after 2nd vaccine She was given prednisone 20 mg taper over the last 8 days. She is feeling much better in terms of her rash and swelling. She is having surgery on the 29th for her BCC on the left eyelid. She is noticing blurred vision in both eyes since this all started and she is mentioning this to the eye doctor when she sees them. She says her head was fuzzy when this started and this is better but is still "fuzzy sometimes" Her renal function was normal. Her CBC was mildly elevated WBC but otherwise normal. She denies any breathing problems, blood in stools or blood in urine, or neurologic symptoms other than the fuzzy head.

Other Meds: Symbicort, Estrace cream, Flonase nasal spray, gabapentin, Duoneb, ketoconazole cream, omeprazole, pravastatin, Proair

Current Illness: Acute cystitis

ID: 1084337
Sex: F
Age: 69
State: IN

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

Lab Data:

Allergies: NSAIDs, Tetanus Toxoid

Symptom List: Nausea

Symptoms: Soreness in arm (severe); spiked fever of 100.7 F. Fever subsided 1.5 hours later without medication after sleeping.

Other Meds: None

Current Illness: None

ID: 1084338
Sex: M
Age: 55
State: NY

Vax Date: 03/07/2021
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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Injection site pain

Symptoms: Fever/chills and slight nausea overnight (24 hours post-shot). Temperature check is normal, but sweated through night and general malaise 36 hours after shot still. Hot and cold flashes persist 36 hours after.

Other Meds: Lamotrigine 200mg and Propanolol 10mg

Current Illness: none

ID: 1084339
Sex: F
Age: 48
State: MN

Vax Date: 03/03/2021
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: Latex, penicillin

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

Symptoms: presented for regular preventative visit 5 days after injection with large area of erythema surrounding the injection site and spanning the width of the arm (8 inches in diameter). There is also yellow bruising. It has been getting worse but is not warm nor associated with any systemic signs of infection, including fever or chills. She was advised to apply cool compresses to the area as desired and to return if worse.

Other Meds: divalproex sodium, metformin, duloxetine, montelukast, naproxen, lisinopril, cetirizine, metoprolol, fluticasone nasal, amlodipine, rosuvastatin, fluconzaole, asenapine, hydroxyzine

Current Illness:

ID: 1084340
Sex: F
Age: 74
State: CA

Vax Date: 02/26/2021
Onset Date: 03/07/2021
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: MSG, Sulphates

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

Symptoms: Chills, Nausea, Diarrhea, Low Temperature (96) Symptoms lasted for 8 hours

Other Meds: Synthroid, Toprol, Altace, Aspirin, Lipitor

Current Illness: None

ID: 1084341
Sex: F
Age: 35
State: NC

Vax Date: 02/26/2021
Onset Date: 03/04/2021
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: Tremor

Symptoms: About 4-5 days later I began feeling a little nauseous. By day 6-7 I had excessive diarrhea. By day 9-10 I have had to leave work because I can?t go more than an hour without having to run to the restroom, and now there is also sharp bowel pain which radiates to my back. My nausea is extreme and I?m barely eating. My fatigue is such that I can barely keep my eyes open- not sure if it is related to the diarrhea and lack of eating out the vaccine, and my migraine which I usually get once a week have been more like every other day for the past week.

Other Meds: Lisinopril, escitalopram, Xanax, Sumatriptan, B12 injections, will take aleve for headaches

Current Illness: None

ID: 1084342
Sex: F
Age: 34
State: PA

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

Lab Data:

Allergies: None

Symptom List: Erythema, Pruritus

Symptoms: Pain at injection site. Slight chills. Night sweats with sleep terrors. Slight lymphadenopathy. Slight dizziness.

Other Meds: None

Current Illness: None

ID: 1084343
Sex: F
Age: 83
State: ID

Vax Date: 03/04/2021
Onset Date: 03/06/2021
Rec V Date: 03/09/2021
Hospital: Y

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: None

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

Symptoms: Rigors and pre-syncope with fall and right hip fracture

Other Meds: atorvastatin 40mgpoqd

Current Illness: None

ID: 1084344
Sex: F
Age: 57
State: IN

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: 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: Days 1-2: fast heart rate, difficulty breathing, asthma attack requiring inhaler, muscle weakness. Days 4+: rash at injection site - size of a dime

Other Meds:

Current Illness: none

ID: 1084345
Sex: F
Age: 59
State: MN

Vax Date: 02/27/2021
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: Asthenia, Chills, Headache, Myalgia

Symptoms: My arm is still sore. It is swollen around the injection site. It has spread out about 2 inches from center. It is warm to the touch. Today, 3/9/2021, I marked the parameter with a sharpie pen.

Other Meds: 5,00 mg Vit. D, Lisiopril 10mg HTC,

Current Illness: none

ID: 1084346
Sex: F
Age: 54
State: NJ

Vax Date: 03/07/2021
Onset Date: 03/07/2021
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: Sulfa: a rash

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

Symptoms: Very Bad Headache, body aches, chills, vomiting, very weak

Other Meds: Toujeo: 14 units at Bedtime Victoza: 1.8 units once a day Gabapentin: 400 MG 1 tab twice a day Naproxen: 500 MG 1 tab twice a day Metformin HCL: 500 MG 2 tabs twice a day Simvastatin: 20 MG 1 tab once a day at night Levothyroxine: 88 MCG 1

Current Illness: n/a

ID: 1084347
Sex: F
Age: 31
State: VI

Vax Date: 03/03/2021
Onset Date: 03/03/2021
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: None Known

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

Symptoms: Within 4-5 minutes after receiving the vaccine the recipient became Hypotension and Diaphoretic . blood Pressure 78/59 and HR 89. She was given oxygen, and bolus of IV fluids in ambulance. BP inproved to 112/76. She was taken to the ER and after additional tests, she was discharged around 9pm with diagnosis of Vasovagal Syncope.

Other Meds: Birth Control Pills

Current Illness: No

ID: 1084348
Sex: F
Age: 50
State: NY

Vax Date: 03/07/2021
Onset Date: 03/07/2021
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: Shrimp, Rye and Medical tape

Symptom List: Pain in extremity

Symptoms: after leaving facility, while driving home, my left facial cheek began to tingle, then burn. By the time I got home, both my hands and feet also were tingly, like pins and needles falling asleep. The following day, at about 4 PM the tingling, returned to the entire left side of my face, so Monday 03-08-2021 @ 4 PM, from hairline to jaw, tightness, burning and tingling including around my left eye. lasting until roughly 7 PM

Other Meds: Phentermine, Losartan 25 MG, Vitamin B12, D 50K, Multivitamin, Biotin + Keratin, Fiber gummies, Lactulose, Meloxicam

Current Illness: none

ID: 1084349
Sex: M
Age: 26
State: WY

Vax Date: 03/04/2021
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: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: PCN

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

Symptoms: During sleep, pt's arm was hurting. He got up to use the bathroom. His spouse said he collapsed next to the bed and started convulsing. Spouse said she called 911. Convulsing lasted until EMT's arrived. When pt awoke, he was in the ambulance and was vomiting. Taken to ER at Hospital. Given muscle relaxors and zofran for emesis. Was also given fluids. When fluids were complete, he was released to home.

Other Meds: None

Current Illness: None

ID: 1084350
Sex: M
Age: 72
State: FL

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

Lab Data:

Allergies: None, sulfates in wine

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

Symptoms: I had a ?COVID arm? appear with a red circle about the size of a half dollar at the sight of the injection. It also itches and is warm to the touch.

Other Meds: Tylenol, antihistamines

Current Illness: Diabetic

ID: 1084351
Sex: F
Age: 61
State: TX

Vax Date: 01/15/2021
Onset Date: 01/29/2021
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: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: Blood pressure spiked for 6 weeks post first dose...jumped 50 points

Other Meds: Diovan 80 mg

Current Illness:

ID: 1084352
Sex: F
Age: 51
State: IN

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: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Soy, nickel, gold, ammonium persulfate, Benzoic Acid, Benzoates, Benzephenone-4, Cobalt Dichloride, Gold Sodium Thiosulfate, Linalool, Propyl Gallate.

Symptom List: Vomiting

Symptoms: Symptoms: Onset approximately 6 hours after injection of fever of 102 , severe body aches with joint pain, chills, loss of appetite, decline in cognitive abilities - brain fog. These symptoms lasted for 72 hours. Treatment: I used Tylenol every 4 hours to try and alleviate the symptoms. With treatment, the only improvement was a slight decrease in fever, but fever continued to be over 100. The adverse events caused me to lose 2 days of work.

Other Meds: Multi-vitamin

Current Illness: none

ID: 1084353
Sex: F
Age: 54
State: MO

Vax Date: 02/27/2021
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: Shell Fish, Iodine

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: swollen lymph nodes under left arm. Pain and tenderness in lymph nodes under arm and underside of arm about mid way to elbow. Headache and just over all feeling tired. Started on day 6 after the vaccine. Up to that day i felt fine. I called my provider and spoke with him. The reaction is improving daily.

Other Meds: vitamin, c, d, b12, folic acid, calcium, Collagen supplements

Current Illness: none

ID: 1084354
Sex: M
Age: 38
State: MO

Vax Date: 03/08/2021
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:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

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

Symptoms: Elevated heart rate, chills, fever, headache, body ache,

Other Meds: None

Current Illness: None

ID: 1084355
Sex: F
Age: 57
State: IN

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: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Insurance Lysinoprel

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Body aches. Joint pain. Fever. Chills. headache. Skin sensitivity. Thirst. Started about 7:00 pm and pain and symptoms lasted about 24 hrs

Other Meds: Creator Elavil Entocort Bystolic Prozac Hydrodiurol

Current Illness:

ID: 1084356
Sex: F
Age: 55
State: TX

Vax Date: 02/27/2021
Onset Date: 02/27/2021
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: Shellfish

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

Symptoms: Received vaccine Saturday Feb 27th 3 hours after shot starting having chill and body aches 5 hours after shot high fever up 103, Sunday Feb 28th evening started taking Tylenol every 6 hours to reduce fever. Monday March 1st a severe rash began on the arm where the vaccine was given. Rash covered the whole area on front of the arm and area where the shot was given. It was patchy red, extremely itching and painful to the touch started using Hydrocortisone Cream to relieve the itching. Rash slowly subsided by March the 5th rash disappeared.

Other Meds: None

Current Illness: Autoimmune Disease Asthma

ID: 1084357
Sex: F
Age: 71
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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Sulfa Drugs, Cipro

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

Symptoms: Extreme dizziness and nausea on 3/6/21, is getting progressively better little by little.

Other Meds: Metoprolol Succ ER, Simvastatin, Hyrochlorothiazide, Latanoprost, Calcium, Vit D3, Preservision

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm