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: 1085297
Sex: M
Age: 74
State: WI

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

Lab Data:

Allergies: shell fish

Symptom List: Dysphagia, Epiglottitis

Symptoms: fever, chills, body aches

Other Meds: Omeprazole, Tylenol, a probiotic for gut problems

Current Illness: none

ID: 1085298
Sex: F
Age: 59
State: PA

Vax Date: 02/27/2021
Onset Date: 03/03/2021
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: Bleach, aspirin, Penicillin, Compazine.

Symptom List: Anxiety, Dyspnoea

Symptoms: She got the vaccine, started feeling like she thought was muscle pain and now that she thinks about it was menstrual cramps. Then some dark menstrual discharge. She thought it had stopped, but this afternoon had dark bloody clots/discharge when wiping. She is not having as bad of cramps. Sunday and morning were definitely worse days than today. She has not had a menstrual cycle in over 15 years, she is 60. She did not take anything for the pain. She is still having the symptoms, and actually worse than it was earlier.

Other Meds: Zolpidem, Nifedipine, Lamotrigine, progesterone, Estrogel.

Current Illness: None.

ID: 1085299
Sex: F
Age: 36
State: CA

Vax Date: 03/02/2021
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: Reaction: tingling in fingers of vaccine arm and small local rash on forearm Outcomes: Benadryl 25 mg given at 17:10. Rash resolved and tingling subsided.

Other Meds: baclofen 10 mg bupropion 300 mg clonazepam 0.5 mg cyanocobalamin Vitamin B 12 fluoxetine hcl 30 mg lemborexant 10 mg methylphenidate hcl 20 mg naproxen 500 mg omega 3 ondansetron 4 mg riboflavin, vitamin B2 400 mg sumatriptan 50

Current Illness:

ID: 1085300
Sex: F
Age: 62
State: MA

Vax Date: 02/11/2021
Onset Date: 02/18/2021
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: NSAID's, Percocet, Lisinopril

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Diffuse maculo-papular rash all of left upper arm and associated swelling and burning.

Other Meds: Albuterol HFA inhaler, Metoprolol Succinate. Anoro Ellipta inhaler, Multivit, Omeprazole, Losartan, Lasix, Magnessium

Current Illness: N/A

ID: 1085301
Sex: F
Age: 80
State: MI

Vax Date: 03/04/2021
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: BETA BLOCKERS, CODEINE, METRONIDAZOLE, VALACYCLOVIR, INHALED ANTICHOLINERGIC AGENTS

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

Symptoms: PATIENT REPORTS T-SHAPED, HARD, BLUE, SORE SPOT ON LEFT HAND NEAR THUMB BEGINNING 3 DAYS AFTER VACCINATION AND STILL CONTINUING TO PRESENT (5 DAYS POST-VACCINATION). SHE ALSO REPORTS THAT HER LEFT THUMB ACHES. SHE ALSO REPORTS A BLACK AND BLUE, SORE SPOT AT INJECTION SITE AND INTERMITTENT NAUSEA STILL CONTINUING 5 DAYS POST VACCINATION.

Other Meds:

Current Illness:

Date Died: 03/02/2021

ID: 1085302
Sex: M
Age: 79
State: WI

Vax Date: 02/26/2021
Onset Date: 03/01/2021
Rec V Date: 03/09/2021
Hospital: Y

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: Lisinopril

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

Symptoms: Patient was admitted to Hospital on 3/1/21. Blood Sugar of 758. Patient diagnosis with Acute respiratory failure with hypoxia and acute heart failure and Metabolic encephalopathy. Patient put on ventilator and passed away on 3/2/21 at 17:04.

Other Meds: Aspirin 81 mg oral tablet Atorvastatin Calcium 80 MG Oral Tablet Empagliflozin (Jardiance) 10 MG Oral Tablet Fiber FluoGlimepiride 4 MG Oral Tablet Propranolol HCl (Propranolol HCl ER) 60 MG Oral Capsule Extended Release 24 Hour Sitagliptin

Current Illness:

ID: 1085304
Sex: F
Age:
State: FL

Vax Date: 03/02/2021
Onset Date: 03/02/2021
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: HA, and site pain , arm nodule close to site

Other Meds: synthroid simvistatin

Current Illness:

ID: 1085305
Sex: F
Age: 54
State: IN

Vax Date: 03/04/2021
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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Penicillin, sulfa, acetaminophen, shellfish, latex

Symptom List: Pharyngeal swelling

Symptoms: Fever of 100.6, painful body aches, chills, mild headache for 24 hours Felt fatigue and sore muscles for the following 24 hours

Other Meds: None

Current Illness: None

ID: 1085306
Sex: F
Age: 25
State: UT

Vax Date: 03/04/2021
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: Estrogen

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Hives on back, hands, elbow - night after vaccine and up to 4 days after Lots of itchiness all over body a few hours after vaccine Intense joint pain and swelling keeps progressing - especially in wrists, fingers, and knees

Other Meds: Xarelto Minocycline Spironolactone

Current Illness:

ID: 1085307
Sex: M
Age: 35
State:

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

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: cold throughout body, increased HR, Numbness in hands and feet, dry throat. Evaluated by EMS-Cleared

Other Meds:

Current Illness:

ID: 1085308
Sex: F
Age: 33
State: AZ

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: None

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

Symptoms: Sore arm, nausea (throwing up), headache. Self treated at home with over the counter medications (tylenol & advil)

Other Meds: Multivitamin, methyl folate, Fish oil, probiotic, fluoxetine (10mg)

Current Illness: None

ID: 1085309
Sex: M
Age: 74
State: CO

Vax Date: 02/05/2021
Onset Date: 02/05/2021
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:

Symptom List: Rash, Urticaria

Symptoms: They made me wait 20 mins to make sure I didn't have a reaction, went home and was fine. A couple days later I started itching and the next Monday it was worse. I woke up the next morning with a rash on my face, right arm, head, all over my chest moving to my legs. It just got worse and hurt so bad, so i went to the ER right away. They put me on IV pecid and Benadryl, that didn't help. They put me on a steroid IV, tat really calmed the itching down. I was in the ER about 2 hours and then they sent me home. They sent me home with steroid and hydroxyzine HCL -10mg 1/3x days. It took about a week and a half for the rash to go away. I still have some itching but not a problem.

Other Meds: Semistatin Metphormin Simvastatin Allpurinol -100mg/2x daily Sanotitine- 40mg /2x daily Lostartin- 1/2 pill

Current Illness:

ID: 1085310
Sex: F
Age: 50
State: WV

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:
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: Moderna COVID-19 Vaccine EUA Woke up in the middle of the night Saturday morning with a horrible headache and intense body aches and joint aches. It hurt to have heavy bed covers on me so I slept in the other room in just my down sleeping bag because it was so light and I could barely feel it. Slept most of the day. Sunday I was insanely tired and fatigued and laid around and watched movies. Felt trashed most of the day. Monday morning I was fine.

Other Meds: Dong Quai Black Cohosh Vitamin E Multivitamin Probiotic Cranberry capsules

Current Illness: none

ID: 1085311
Sex: F
Age: 72
State: NY

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

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

Symptoms: 3/4, 10PM -- MUSCLE PAIN AROUND NECK AND SHOULDERS -- WENT TO BED AT MIDNIGHT 3/5, 5AM -- WOKE UP WITH CHILLS FOR ABOUT 2HRS. -- WENT BACK TO SLEEP 3/5, 9AM -- BOTH CHILLS AND MUSCLE PAIN WERE GONE -- INJECTION SITE WAS TENDER 3/7, 7PM -- LYMPH NODES UNDER MY LEFT ARM WERE SWOLLEN AND TENDER, BUT NOT PAINFUL 3/8, 4PM -- ITCHY, SWOLLEN SKIN ON LEFT ARM, BETWEEN INJECTION SITE AND ELBOW TODAY: 3/9, 2PM -- INJECTION SITE STILL TENDER, LYMPH NODES AND LEFT ARM STILL SWOLLEN AND TENDER

Other Meds: METOPROLOL, LOSARTAN, HYDROCHLOROTHIAZIDE, TACROLIMUS...

Current Illness: SKIN RASH

ID: 1085312
Sex: F
Age: 50
State: CA

Vax Date: 02/11/2021
Onset Date: 02/15/2021
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: Latex

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

Symptoms: Rash developed around and below injection site. Swelling and red bumps that lasted approximately 10 days.

Other Meds:

Current Illness: n/a

ID: 1085313
Sex: F
Age: 61
State: VT

Vax Date: 01/28/2021
Onset Date: 01/28/2021
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: Malaise, fever, missed work

Other Meds:

Current Illness:

ID: 1085314
Sex: F
Age: 46
State: TX

Vax Date: 02/23/2021
Onset Date: 03/02/2021
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: None

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

Symptoms: Exactly a week after the vaccine shot, I started a very heavy menstural period. It was not time yet. I am on birth control pills and I am very regular. It's been a week and I am still on a heavy period. It was so bad that I purchased a pregnancy test because I was having a miscarriage. Test was negative.

Other Meds: Over the Counter Probiotics, prescribed Vitamin D, Iron (not taken daily), Yaz (generic) Birth Control Pills and I get allergy shots every 7-14 days

Current Illness: None

ID: 1085315
Sex: F
Age: 73
State:

Vax Date: 03/09/2021
Onset Date: 03/09/2021
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: nausea, throat feels tight. Evaluated by EMS- Cleared

Other Meds:

Current Illness:

ID: 1085316
Sex: M
Age: 55
State: PA

Vax Date: 02/04/2021
Onset Date: 02/26/2021
Rec V Date: 03/09/2021
Hospital: Y

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

Lab Data:

Allergies: Penicillins (hives/urticaria)

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Patient received first COVID vaccine (Moderna) on 2/4. On 2/9, patient states he had fevers, chills, headaches, and loss of taste and smell. He was tested through his workplace via Saliva PCR on 2/11, which resulted positive on 2/14. Symptoms began to resolve around the date of 2/21 for about 2 days. On 2/23, he started experiencing numbness in his fingers and toes along with severe nausea, vomiting, and diarrhea. He became so weak and ill, he presented to the hospital and was admitted on 2/26. During his hospitalization, he was seen by neurology, completed several tests including a lumbar puncture, nerve conduction study/EMG who diagnosed him with "likely some variation of AIDP, very possible mixed demyelinating/axonal variant".

Other Meds: Aspirin 81 mg PO daily, esomeprazole PO daily, vitamin C 1000 mg PO daily, vitamin D3 PO daily, zinc PO daily

Current Illness:

ID: 1085317
Sex: F
Age: 66
State:

Vax Date: 03/08/2021
Onset Date: 03/08/2021
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: Pt. stated "her "Throat felt as if it was closing." "Starting to feel like I cant breathe." Emergency team evaluated VS. Final VS are BP: 177/88 O2 Sat:99% HR:96 .

Other Meds: Metroprolol, Asprin, Lyrica

Current Illness:

ID: 1085318
Sex: F
Age: 16
State: AR

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: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Patient developed hives around 2-3 hours post-vaccination and proceeded to have lip swelling, throat tightness, shortness of breath, nausea and abdominal pain. She was given 50mg of Benadryl po by her mother on the evening of vaccination, but mother noted that it didn't seem to help, so did not give any additional medication. She presented to clinic the following morning at 0900 with continued symptoms and was directed to go directly to the ED for management of anaphylaxis.

Other Meds: None

Current Illness: Migraines, depression/anxiety, eating disorder

ID: 1085319
Sex: F
Age: 81
State: SC

Vax Date: 03/04/2021
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: STATIN DRUGS, FELDIN, SOME INFLAMITOR DRUGS

Symptom List: Unevaluable event

Symptoms: Weakness in both arms started around 2:40 Thursday afternoon. The weakness in right arm subsided but continued in left arm until Monday evening. There has been swelling and redness in the upper left arm since Sunday still persists until now. There is also itching and redness around the upper left arm, injection sight.

Other Meds: GEMFIBROZIL 600MG 2 DAILY, TOPIRAMATE 200MG, 1 DAILY, METFORMAN HYDROCHLORIDE 500M 2 DAILY, TRIMTERENE/HYDROCHLOROTHIAZIDE 37.5-24MG 1 DAILY, FAMOTIDINE 40 MG 1 DAILY, ACYCLOVID 400 MG 2 DAILY, GABAPENTIN 600 MG 1 DAILY, GLEMEPRIDE 4 MG 2 D

Current Illness: NONE

ID: 1085321
Sex: M
Age: 53
State: FL

Vax Date: 02/03/2021
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: UNKNOWN

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

Symptoms: PRESENTED WITH SIGNS/SYMPTOMS CORRELATED WITH VESTIBULAR HYPOFUNCTION ON THE LEFT MOST POSSIBLY CORELATED WITH L VESTIBULAR NEURITIS.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1085322
Sex: M
Age: 78
State: ID

Vax Date: 02/09/2021
Onset Date: 02/17/2021
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: LITTLE, ITCHY PIMPLE TYPE BUMPS ON ARMS AND LEGS. RECEIVED A CORTISOL SHOT THE NEXT DAY. TOOK ANOTHER 10 DAYS OR SO AFTER THAT FOR IT TO CLEAR UP.

Other Meds: levothyroxine, lyrica, dexilant

Current Illness: none

ID: 1085323
Sex: M
Age: 69
State: UT

Vax Date: 02/26/2021
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: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Injection site pain, Menorrhagia

Symptoms: Patient started to feel right leg pain the evening of 3/2/2021, four days after receiving the COVID-19 vaccination. Patient came to the ER where a DVT was discovered in the right popliteal, peroneal, and posterior tibial veins. Patient was given apixaban 10 mg x1 and a prescription to continue apixaban outpatient. Patient was discharged from ER to home.

Other Meds:

Current Illness:

ID: 1085324
Sex: M
Age: 35
State: NJ

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

Lab Data:

Allergies: Shellfish

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

Symptoms: Severe onset of rash on chest, stomach, complete back, both left/right arms and neck shortly after 24 hours from the second dose shot, of the Pfizer COVID-19 vaccine. Initial onset involved bumps/hives and severe redness, leading to severe itching. OTC antihistamine obtained from local pharmacy to address hives. While the hives subsided, bumps/redness and severe itching remains present at time of this report, in addition to drying/peeling of skin in aforesaid areas remain. Heavy regiment of multiple moisturizers used to attempt to treat aforesaid conditions, however symptoms/effects remain.

Other Meds: N/A

Current Illness: N/A

ID: 1085325
Sex: F
Age: 61
State: MO

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

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: I lost my sense of taste three days after the shot. So far it has not come back yet a week later. I am noticing that I can taste salt now, but that is about it.

Other Meds: euthyrox, ciprofloxacn

Current Illness: kidney infection

ID: 1085326
Sex: M
Age: 73
State: NY

Vax Date: 03/02/2021
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: RA

Lab Data:

Allergies: None

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Dizziness, occasionally severe, and chronic fatigue beginning Saturday morning, 3/6/2021, and continuing unabated thru Tuesday, 3/9/2021. Currently on bedrest. This condition is ongoing.

Other Meds: Furosemide, Esomeprazole, Spironolactone, Losartan, Metoprolol ER, Buprion SR, Carevedilol, CoQ-10, aspirin, multivitamins.

Current Illness: None

ID: 1085327
Sex: F
Age: 49
State: TX

Vax Date: 03/06/2021
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:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

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

Symptoms: Extreme fatigue, body aches in joints comparable to the flu, nauseous, insomnia

Other Meds: B12, Black Cohosh, Ashwahganda

Current Illness: None

ID: 1085328
Sex: F
Age: 63
State:

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: RA

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: lips tingling, tongue swelling/numbness. Evaluated by EMS-Cleared

Other Meds:

Current Illness:

ID: 1085329
Sex: F
Age: 29
State: VT

Vax Date: 01/29/2021
Onset Date: 01/29/2021
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: Injection site pain

Symptoms: Swollen lymph nodes, malaise

Other Meds:

Current Illness:

ID: 1085330
Sex: F
Age: 39
State: VA

Vax Date: 03/04/2021
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: NKA

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

Symptoms: Tightness and pain in center of chest. At times waxed and waned, but lasted approximately three hours in duration and started waning through the night.

Other Meds: Daily multivitamin, hair and nails multivitamin, zytrec

Current Illness: None

ID: 1085331
Sex: F
Age: 55
State: MI

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: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Statins, PCN, toradol, tylenol, Cipro, Dioxyvenzolne, methadone, clindamycin,

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

Symptoms: Facial/neck swelling. Face and neck reddened. Sensation of something caught in throat. Itching to back and chest.

Other Meds: Multivitamin daily., Omega 3, Methocarbamol, fenofibrate, metformin, lopressor, norvasc, topamax, vitamin D, hydrochlorothiazide, ropinirole,

Current Illness: Diabetic, heart patient, COPD

ID: 1085332
Sex: F
Age: 84
State: FL

Vax Date: 02/19/2021
Onset Date: 03/01/2021
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: Codeine and Meperidine (Demerol).

Symptom List: Tremor

Symptoms: Early during the week of 03/01/2021 a rash developed on pt's arms (forearm to elbow, scattered on the upper arm, and only present on the anterior side of the arm), a couple of days later a rash began on the pt's lower legs (only present on the anterior side of the legs), on 03/04/2021 rash appeared on the pt's neck (scattered throughout anterior side of the neck). Pt described the rash as red and itchy. Pt started Benadryl 03/04/2021, stated relief was very mild. Pt saw Dermatologist on 03/05/2021. Doctor recommended to continue Benadryl, performed biopsy on rash, and called in a prescription. Pt did not remember the name of the medication ordered and has not picked up the medication from the pharmacy at the time of the call.Pt was advised to follow medication treatment the dermatologist recommended, get the second dose, advise the facility of the rash after the 1st dose, and stay in observation at the facility for twice as long as a precaution. Pt was also told to contact dermatologist if rash worsens. Doctor was notified.

Other Meds: Levothyroxine 0.75 mg qd, lovastatin 40 mg qd, aspirin 81 mg three times a week, calcium supplement, and Vitamin D3

Current Illness:

ID: 1085334
Sex: M
Age: 63
State: LA

Vax Date: 02/19/2021
Onset Date: 03/01/2021
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: shortness of breath on excertion

Other Meds: asprin 81mg, 2000mg fish oil

Current Illness: none

ID: 1085335
Sex: F
Age: 52
State: IN

Vax Date: 03/01/2021
Onset Date: 03/09/2021
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: red bump at injection site, developed 8 days later.

Other Meds:

Current Illness:

ID: 1085336
Sex: F
Age: 65
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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: cipro, penicillin

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

Symptoms: Extreme pain in joints, legs, arms. Could barely move my left arm for over 24 hours. Low grade fever, chills and body ache

Other Meds: baclofen, sertraline

Current Illness: none

ID: 1085337
Sex: F
Age: 65
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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Milk, wheat, strawberries, venom many more

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Light headed within minutes, coughing then wheezing, heart rate increased , around lips became itchy and bumpy. Took my inhaler within 20 minutes better ..6 hours later went into bad bronchitis white frothy thickish sputum lots brought up and cleared airways neededd nebulizer treatments past four days, fatigue, fever highest 100.6, extreme chills next morning and slept a lot of 3/6/2021 and fever. Huge tissue pain, and joint pain worse second day

Other Meds: Elipta, levalbuterol, vitamins, woman's health, vitamin D

Current Illness: Bronchitis from first dose Feb. 4, 2021 Just got better

ID: 1085338
Sex: F
Age: 43
State: IL

Vax Date: 02/26/2021
Onset Date: 03/08/2021
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: Penicillin Squash Trees Grass Tree Nuts watermellon Cantaloupe Beans Wheat Barley

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

Symptoms: I had warmth, redness, hard area in the spot where the vaccine was administered that appeared approximately 10 days after the vaccine was administered. I had itching immediately after the vaccine was administered but that wore off about 1 hour later. However, the warmth, redness and hard area on the arm appeared days later.

Other Meds: Metformin Calcium Vitamin D Propanolol Simvastatin Flonase Epipen Multivitamin Singulair Norlyda Ubrelvy Iron Supplements Topriamate Zyrtec Omeprazole Potassium Chloride

Current Illness:

ID: 1085339
Sex: F
Age: 68
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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Pt began feeling warm from head to toe, and dizzy. All vitals were stable and within 20min client stated that she was feeling normal again.

Other Meds:

Current Illness:

ID: 1085340
Sex: F
Age: 43
State: MO

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: no

Symptom List: Pain in extremity

Symptoms: pt stated that after she got the vax she started feeling really bad. She can hardly mover her left arm. Her arm is swollen and had a red mark around the injection. She has fever, headache and is fatigued. Next day she has all the same symptoms plus chills and has a funny taste in mouth. She is alternately ibuprofen and Tylenol for her head ache and fever (temp 101.5) but neither has helped. Pt states she will go to the ER if she doesnt feel better within the next 3 hours.

Other Meds: no

Current Illness: no

ID: 1085341
Sex: F
Age: 56
State: IN

Vax Date: 03/05/2021
Onset Date: 03/01/2021
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: Crtical: contrast dye, seratonin, codeine, bee/insect venom. Other non-critical: aspirin, erythromycin, sulfa, talc, gluten, silver salve

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

Symptoms: Covid-type headache, severe neck muscle pain, fatigue, injection site pain, injection site fever, chills

Other Meds: Gabapentin, low dose naltrexone, multivitamin w/iron, D3, K2, metoprol, magnesium glycinate, NuAdapt, melatonin, Unithroid, liothyronine, cholestyramine, glycosamine chondroitin, turmeric, temazepam, collagen peptides

Current Illness: Celiac Disease, Hashimoto's Thyroiditis, hypothyroidism, cardio pulmonary hypertension, leaky mitral valve, heart palpitations, migraine

ID: 1085342
Sex: F
Age: 68
State: CO

Vax Date: 02/27/2021
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: penicillin

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

Symptoms: Rash by the injection site with some swelling and irritation. Used cortisone and that helped.

Other Meds: Euthyrox, calcium, collagen, multivitamin, vision multivitamin, and vitamin D3.

Current Illness: none

ID: 1085343
Sex: M
Age: 52
State: IN

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

Lab Data:

Allergies: penicillin

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

Symptoms: flu-like symptoms (i.e., chills, body ache, fatigue, severe headache and slight temperature) for approximately 24 hours

Other Meds: none

Current Illness: none

ID: 1085344
Sex: F
Age: 28
State:

Vax Date: 02/17/2021
Onset Date: 02/18/2021
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: muscle aches, cold sweats, migraine.

Other Meds:

Current Illness:

ID: 1085345
Sex: F
Age: 39
State: TX

Vax Date: 03/04/2021
Onset Date: 03/04/2021
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: Once vaccine was administered I felt short of breath but didn?t pay any mind. I thought it was my anxiety. About 6 I started to feel tired with a headache. About 8 pm my throat started to feel itchy. Next day I woke up with my chest feeling tight with a cough and phlegm. I thought it was just a side affect of vaccine and took my inhaler. On Saturday I woke up with a bad migraine and my chest still hurting. I knew something was wrong. I went to urgent care. I had ekg and X-ray and Covid test done. The ekg numbers came back low so dr requested a CT. My results came back as me having Covid in my left lung. Covid testing came back positive the next day. Prior to vaccine I did not feel sick or have any symptoms of being sick.

Other Meds: Zyrtec One a day woman?s vitamins

Current Illness: None

ID: 1085346
Sex: F
Age: 22
State: OH

Vax Date: 03/06/2021
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:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: none

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

Symptoms: walk in clinic nurse practitioner saw her Sunday 3/7 and reported rash on patient over entire body including palms. reported to health dept as well.

Other Meds: unknown

Current Illness: unknown

ID: 1085347
Sex: F
Age: 42
State: NC

Vax Date: 03/04/2021
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: Pitted tree fruits, some melons, strawberries, raw tree nuts, milk

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Sore arm after injection on Friday AM- by Friday afternoon, she had basic fever, chills- and her arm had swollen up, turned beet red, size of a lime- pt reported. Pt unable to move the arm. By Saturday evening, no more fever or chills but arm was still swollen. Still could not move her arm and it was itching.

Other Meds: Calcium chews only

Current Illness: None

ID: 1085348
Sex: F
Age: 28
State:

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: RA

Lab Data:

Allergies:

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

Symptoms: Pt mother states that Pt is having a panic attack, pt verbal, but kept repeating that her hands were numb, seated and agitated. Evaluated by EMS-Cleared

Other Meds:

Current Illness:

ID: 1085349
Sex: M
Age: 75
State: SC

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: RA

Lab Data:

Allergies: No.

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

Symptoms: Moderna COVID?19 Vaccine Severe confustion, can not communicate, can not walk without help. Same symptoms as with first shot.

Other Meds: atenolol 25mg simvastatin 40mg asprinin 81mg privigen monthly

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm