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: 1086081
Sex: M
Age: 33
State: NJ

Vax Date: 01/14/2021
Onset Date: 01/14/2021
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: Periodic ringing in my ears starting approximately 30 to 45 minutes after receiving the first dose and continuing to this day.

Other Meds: Multivitamin

Current Illness: None

ID: 1086082
Sex: M
Age: 24
State: FL

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: None

Symptom List: Anxiety, Dyspnoea

Symptoms: Extremely Red Eyes since day on injection.

Other Meds: Abilify Zoloft Ezetimibe Multivitamin Calcium Miralax

Current Illness: None

ID: 1086083
Sex: F
Age: 78
State: CA

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: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Myabetric,

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

Symptoms: Day after vaccine, I was very sick as though I had the flu. Had a severe headache above both eyes, was nauseous and vomited, slightly off-balance, and tired.

Other Meds: Simvastatin, Estradiol/Noreth, Wellbutrin, Cymbalta, Fish Oil, D3, Cranberry, Magnesium, Cinnamon,Ginger CoQ10, B-100 Complex, Biotin, Move Free, Probiotic 10, Moringa, Optimized Folate, Collagen w/Turmeric, Vitamin C

Current Illness: 3 Fractured Ribs

ID: 1086084
Sex: F
Age: 58
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: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data:

Allergies: Keflex, Septra, Penicillin, Ampicillin, Codeine, Lactose Intolorent

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: sensation of cold, circulation issues in extremities, Severe shakes, Chills, fever: 100.4 at highest, fatigue, muscle aches, abdominal pain. as of now, 15 hours later after incident started at 3:15 am, still low fever of 99.4 ad feel like crud, like have a flu.

Other Meds: Amlodipine 5 mg, 1x bedtime Tresiba, 18 units bedtime Omeprozole 20 mg, 1x day, pm Seroquel 50 mg, 1xday Ropinirole (for RLS) Up to 4mg Lithium 300 mg am 450 mg pm 750 a day total Levothyroixine 112mg, 1x day Atorvastatin 20 mg, 1

Current Illness: none

ID: 1086086
Sex: F
Age: 70
State: IN

Vax Date: 02/24/2021
Onset Date: 02/25/2021
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: Sulfa, latex

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

Symptoms: Muscle aches, headache, chills, injection site hot, red and hard for one week, rash on upper body, blisters on face

Other Meds: Multi-vitamin

Current Illness: Covid in January

ID: 1086087
Sex: M
Age: 78
State: TX

Vax Date: 02/23/2021
Onset Date: 03/06/2021
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: none

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

Symptoms: chills.fever very soar and very achy it all lasted a littlr over 24 hours

Other Meds: metformin, lisinopril, meloxicam

Current Illness: none

ID: 1086088
Sex: M
Age: 34
State: AZ

Vax Date: 01/26/2021
Onset Date: 01/28/2021
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: Tree nuts

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: severe pain from left wrist to left mandible and down to left hip most heavily concentrated in the left shoulder and chest region, with accompanying stiff neck and reduced mobility of the neck rapid onset after post vaccination fever broke. pain and neck rigidity lasted ~72 hours. Reduced neck mobility still present 1 and a half months later.

Other Meds: Loratidine

Current Illness: None

ID: 1086089
Sex: F
Age: 48
State: NJ

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Pharyngeal swelling

Symptoms: Extreme nausea that resulted in vomiting. Also headache and dizziness. Lasted a minimum of 12 hours.

Other Meds: Birth control pills

Current Illness: None

ID: 1086090
Sex: M
Age: 62
State: AL

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

Lab Data:

Allergies: none

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: 100.9 fever, chills, body aches, more than 6 days

Other Meds: 40mg flomax Pravastatin Saw palmetto Maga men 50 plus Azelastine .1%

Current Illness: Sinus drainage

ID: 1086092
Sex: F
Age: 58
State: OK

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

Lab Data:

Allergies: NKDA

Symptom List: Diarrhoea, Nasal congestion

Symptoms: She noted at 1515 sweating, feeling like heart racing and felt like throat closing . Required 2 doses of 25 Mg liquid benadryl and 60 Mg Dexamethasone which then she noticed her throat not feeling so tight. Walked out and was given a prednasone burst for home 40 mg, 40 mg, 20 mg, 20 mg, 10 mg 10 mg.

Other Meds: hydrochlorothiazide 25 mg qd, Pravastatin 40 mg Qd, Amitriptyline 25 mg QHS, Multivitamin.

Current Illness: none

ID: 1086093
Sex: M
Age: 56
State: TN

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: SYR
Vax Site: LA

Lab Data:

Allergies: no

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

Symptoms: His arm was swollen and sore, felt like fever in it, coughing until he would strangle. He also had really bad headaches, extreme tiredness and not feeling well. Last night he was given Tylenol, which helped him.

Other Meds: Omega 3 Fish Oil, Januvia, Metformin, Fluoxetine, Gabapentin, Pantoprazole, Famotidine, Lisinopril, Metoprolol, Vitamins C, D3 and Zinc

Current Illness: no

ID: 1086094
Sex: F
Age: 63
State: AZ

Vax Date: 02/22/2021
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: SYR
Vax Site: RA

Lab Data:

Allergies: Pcn

Symptom List: Rash, Urticaria

Symptoms: Fever to 101.8, body aches, fatigue. Mild cough

Other Meds: Vitamin d

Current Illness: Low grade fevers x 8 months

ID: 1086095
Sex: F
Age: 57
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:
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: Chills:started on day 1 lasted for 2 days low grade fever, started on day 2, last for 2 days 99.8-100.4 dull headache, 3 days, still a sympton breast/underarm tenderness, started on day 2 sour stomachs started on day 2, still a sympton

Other Meds: Levothyroxine, Calcium, Vit. C, Vit. D3

Current Illness: None

ID: 1086096
Sex: F
Age: 54
State: OK

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

Lab Data:

Allergies: amoxicillin, peanut oil

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

Symptoms: Generalized muscle pain, stomach pain, red face on the 3rd day after vaccination. Spoke with patient via phone on 03/09/2021 and all side effects currently resolved.

Other Meds: bupropion, cetirizine, amitriptyline, albuterol, albuterol, asmanex,

Current Illness: none

ID: 1086097
Sex: F
Age: 71
State: IN

Vax Date: 02/24/2021
Onset Date: 02/25/2021
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: Erythromycin, Biaxin, Zithromax, Penicillin, Sulfa drugs, topical Benzocaine

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

Symptoms: With my first vaccine shot on 2/1/21 I developed a small itchy spot on my neck immediately following injection. The doctor on site recommended waiting there at the hospital to monitor it for a few minutes, and I did, and the spot went away. My second vaccination was 2/24/21 and the next day, around noon, I started to have a back ache. Late afternoon I became a little light headed and slightly queasy. That night the pain started in my joints - neck, shoulders, all down my back. They became rather intense, and at one point during the night, after I had managed to fall asleep, I was awoken with burning pain in both elbows, and random sharp pains in toes and fingers. I took Tylenol through the afternoon and night. The following day I was still sore, but not in pain. Then all symptoms disappeared. Not severe enough to seek medical attention but thought I ought to report symptoms for medical research reasons.

Other Meds: Fenofibrate; Zafirlukast; Olmesartan Medoxomil

Current Illness:

ID: 1086098
Sex: M
Age: 23
State: NJ

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: IM
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: 10 min. after vaccine - small pang of soreness through left arm, went away after a couple of seconds 7:30 PM the same day - Grade 3 fever (102.9 degrees), intense chills, joint pain, minor headache, loss of taste and smell, coughing fits. Threw on lots of blankets, drank some water, and took two Tylenol pills. 10:30 PM the same day - while on Tylenol, fever dropped to 101.9. Kept taking Tylenol until I went to bed at around 1 AM. 9 AM on Sunday 3/7 - 101.2 w/out Tylenol, no chills or coughing, minor headache. Symptoms faded away over the course of the rest of the day. Back at 100% on Monday 3/8.

Other Meds: None

Current Illness: None

ID: 1086099
Sex: F
Age: 75
State: OH

Vax Date: 02/07/2021
Onset Date: 02/21/2021
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: On the 2/22/ 21 I discovered itchy red bump like a bite on left side under arm. It really itched and I put some bug bite non itch cream on it. Next day more red 'bites' going up and across top of breast. also many little red bumps appeared aroud initial 'bite'. Was able to see Dr. that Friday 2/26/21 where it was diagnosed as shingles. Given medrol dose pack for 6 days and famciclovir 500 mg tablets tid for 7 days. Rash started to improve immediately and finished all medications in time for my 2nd covid-19 vaccine.

Other Meds: none

Current Illness: none

ID: 1086100
Sex: F
Age: 33
State: RI

Vax Date: 02/10/2021
Onset Date: 02/10/2021
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: Escitalopram

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Arm pain, nausea, chills, fevers, vomiting, headache. Resolved within 36 hours

Other Meds: Atenolol

Current Illness:

ID: 1086101
Sex: F
Age: 46
State: MT

Vax Date: 03/04/2021
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: Opana, Tylenol, Strawberries, Bandages, Celebrex, NSAIDs, Tape, Tylox, Ultracet, Ultram, cloNIDine, morphine, penicillin

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: 20" after injection patient self-reported feeling lightheaded, dizziness, "foggy", generalized tingling in her hands and feet and felt like her tongue was a bit swollen. Stated she felt "funny". Also stated that she had a similar reaction after her first dose but states this reaction was more severe.

Other Meds:

Current Illness:

ID: 1086102
Sex: F
Age: 79
State: IN

Vax Date: 03/05/2021
Onset Date: 03/06/2021
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: none

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

Symptoms: heavy fatigue, mild nausea, loss of appetite, soreness in upper arm. was at worst from about 18-32 hours after getting the vaccine. took some aspirin for the soreness, slept much of the day.

Other Meds: none

Current Illness: none

ID: 1086103
Sex: F
Age: 67
State: PA

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

Lab Data:

Allergies: Intolerant to Demerol

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

Symptoms: Extreme tiredness 8 hours after the vaccine. Fever over 100 that evening continuing intermittently for four days after vaccine. On the fourth day, I woke up with a reddish purple rash over most of my body. My doctor advised me not to take the second dose.

Other Meds: Levothyroxine, Valsartan, Anastrozole, Calcium + D, PreServision

Current Illness: None

ID: 1086104
Sex: M
Age: 20
State: CA

Vax Date: 02/18/2021
Onset Date: 02/20/2021
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: Unevaluable event

Symptoms: Allergic Contact dermatitis, Treated with Triamcinolone today.

Other Meds: no

Current Illness: no

ID: 1086105
Sex: F
Age: 31
State: CA

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: None

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

Symptoms: Tingly tongue, sensation level 5/10 or so. Took Benadryl and Claritin. Felt better after 2-3 hours.

Other Meds: Inderol, Cymbalta, Klonopin, Vitamins B2, B12, D3, K, Saw Palmetto, CBD, Inflammatone, Petadolex, Omega 3, Magnesium

Current Illness: Chronic migraine

ID: 1086106
Sex: M
Age: 70
State: ID

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: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Penicillin

Symptom List: Injection site pain, Pain

Symptoms: 2 days of extreme fatigue (in bed for 36 Hours) and extreme nausea, starting the morning of the day after receiving the injection. Totally back to normal after 4 days.

Other Meds: Valsartan-Hydrochlorothiazide 160-12.5 daily Atorvastatin Calcium 40 mg daily Aspirin 81 mg daily Multi-Vitamin/Mineral (Centrum Performance daily

Current Illness: none

ID: 1086107
Sex: F
Age: 51
State: NM

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

Lab Data:

Allergies: Penicillin

Symptom List: Injection site pain, Menorrhagia

Symptoms: Patient felt hot once sat down at bleachers, became sweaty and queasy. 15 minutes passed. Patient felt better then stood up and became hot and queasy again.

Other Meds: Unknown

Current Illness: Uknown

ID: 1086108
Sex: M
Age: 20
State: CA

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

Lab Data:

Allergies: None

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

Symptoms: After vaccine was administered patient stated feeling a little dizzy and then patient fainted out of chair and came back to for a few seconds, hten passed out again and came back seconds after. Patient was then transported to the Emergency Room where EKG was done. Diagnosed with Syncope, Vasovagal.

Other Meds: None

Current Illness: None

ID: 1086109
Sex: M
Age: 61
State: AZ

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

Lab Data:

Allergies: no

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Loss of hearing in right ear with a buzzing noise same side of the injection

Other Meds: Alprazolam 0.5mg, Amlodipine-Valsartan 10mg-320mg, Hydrochlorothiazide 25mg; Atorvastatin 20mg; Valacyclovir 500mg

Current Illness: none

ID: 1086111
Sex: M
Age: 59
State: IN

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

Lab Data:

Allergies: None that I'm aware of.

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Body ache, chills and headache and feeling hot

Other Meds: Metformin, Tamsulosin, Amlodipine, Pravastatin Sodium, Quinapril-Hctz, Men's One A Day vitamin and B12

Current Illness: None

ID: 1086112
Sex: F
Age: 36
State: IA

Vax Date: 03/03/2021
Onset Date: 03/04/2021
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:

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

Symptoms: Woke up with body aches and migraine. Migraine took me out all day. Serve lightheadedness, pass out (full on collapse, woke up laying on ground with hand twitching). Serve lightheadedness continued for next 5 days, where would become dizzy just sitting and if moved would need to stop and let body catch up.

Other Meds: colchicine 0.6 MG tablet enalapril 2.5 MG tablet sertraline 100 MG tablet cetirizine 10 MG tablet acyclovir 800 MG tablet

Current Illness: Recovering from Pericardial effusion which was caused from having covid

ID: 1086113
Sex: F
Age: 84
State: CO

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: RA

Lab Data:

Allergies: Penicillin

Symptom List: Nausea

Symptoms: Chills, Feverish and fatigued for 2 days only. Arm hurt from shoulder to wrist, large red spot size of a tennis ball at injection site . Slightly swollen and warm to the touch.

Other Meds: HCTZ 25mg Lisinopril 40mg Potassium CL 10mg Aspirin 81mg Vitamin C Calcium Multiple Vitamins Probiotics

Current Illness: None

ID: 1086114
Sex: F
Age: 31
State: CA

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: Very tender arm and headache for first 24 hours, 36 hours post injection, pain and headache were accompanied by nausea, chills and extreme tiredness

Other Meds: Acyclovir, ortho tri cyclin lo

Current Illness:

ID: 1086115
Sex: F
Age: 37
State: CA

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: None

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

Symptoms: Patient stated to Lead RN that she was feeling "itchy" on her arms and legs and that scratching did not relieve the itchiness after receiving her second dose of Pfizer vaccine. She stated it was the same reaction she felt as the first dose. EMT & Lead RN did not obverse any signs of distress or indication including hives or redness on skin. Patient stated she was not experiencing any SOB and upon observation by EMT Lead RN her breathing appeared unlabored and within normal limits. Lead RN authorized EMT to give 50mL Diphenhydramine HCl oral solution per protocol and a water bottle at approximately 2:15pm. Patient stated at approximately 2:30pm she was no longer feeling itchy. Lead RN &EMT educated patient regarding s/sxs of adverse reaction and when to go to the ED/call MD.

Other Meds:

Current Illness: None

ID: 1086116
Sex: F
Age: 52
State: MI

Vax Date: 02/09/2021
Onset Date: 02/09/2021
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: Augumentin

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

Symptoms: Arm burns and is still sore to touch

Other Meds: Blood pressure meds Toporol Dyazide Enalpril Supplement Tru vision Tru control and Tru fix Multi vitamin Weekly vitamin D Hair skin and nails supplement

Current Illness: None

ID: 1086117
Sex: F
Age: 76
State: FL

Vax Date: 02/15/2021
Onset Date: 02/23/2021
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: clonidine, ace inhibitors,

Symptom List: Tremor

Symptoms: Patient has sores and rash covering legs and left wrist, was just prescribed prednisone on 3/9, waiting to see if it helps

Other Meds: calcitriol, sodium bicarbonate, nifedipine er osmotic, levothyroxine, latanoprost, atarax, brimonidine, basaglar, novolog, montelukast, percocet, omeprozole,

Current Illness: none listed

ID: 1086118
Sex: F
Age: 80
State: DC

Vax Date: 02/21/2021
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: IM
Vax Site: LA

Lab Data:

Allergies: NONE

Symptom List: Erythema, Pruritus

Symptoms: Sudden redness on right arm from point of vax injection down to area just above elbow bend. Began on Sat. Mar 13, still some appearance on Mar 9, although seems to be disappearing. Used ice, Benadryl to relieve redness, and OTC medication for slight itch.

Other Meds: Centrum Silver vitamins , Nature Made fish oil, Caltrate Bone with D-3, Garllique

Current Illness: NONE

ID: 1086119
Sex: F
Age: 44
State: GA

Vax Date: 03/09/2021
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: Codeine

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

Symptoms: Left preauricular swelling and tenderness. States symptoms began 2-3 hours post injection. No difficulty swallowing, opening mouth, breathing. No specific treatment required.

Other Meds: Lisinopril, cetirizine, duloxetine, Singulair, vitamin D, Topamax

Current Illness:

ID: 1086120
Sex: F
Age: 60
State: TN

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: Sulfur

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

Symptoms: She had a really bad and deep cough, bad headaches and extremely tired

Other Meds: BC Arthritis Powders, Vitamins C, D3 and Zinc

Current Illness: no

ID: 1086121
Sex: M
Age: 75
State: CA

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

Lab Data:

Allergies: a form of penicillin (rash in high school); codeine (nausea)

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Moderna COVID-19 Vaccine EUA I had nothing more than a sore arm after the vaccine and felt fine the next morning so I went to play golf. On the 4th hole I started feeling light headed and after an hour or so went home and rested. My resting heart rate after 20 minutes was 88 according to my watch. It is normally 60-65. My watch also indicated that my heart rate was 122 while playing golf. My temperature was 100.5. After a couple of hours resting my heart rate went down to 75 and temperature lowered to 99. I felt fine the following morning but my vaccination site turned bright pink and started itching. This continued for 2 days. I have had no issues since Friday, March 5th.

Other Meds: Atorvastatin 10 mg; diclofeman sodium/misoprostol; milk thistle; lutein; krill oil; vitamin d; vitamin b12; loratadine 10mg

Current Illness: None

ID: 1086122
Sex: M
Age: 40
State: IL

Vax Date: 01/21/2021
Onset Date: 02/01/2021
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: None known

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

Symptoms: Pt started with rash on L arm just inferior to vaccination site about 10 days after first vaccine Got a bit better, but then got more red and itchy about 2 wks after 2nd vaccine was administered at the same site on 2/18 hydrocortisone 1% and benadryl 25 mg helping a little, have modified to using triamcinolone 0.1% and claritin 10 mg as well

Other Meds: none

Current Illness: none

ID: 1086123
Sex: F
Age: 40
State: OR

Vax Date: 03/06/2021
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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Citalopram Hydrobromide Clindamycin Hydrochloride Sulfa

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

Symptoms: Fast onset of Tiredness occurred at 11:00pm until 11:00am.. Sore arm at injection site lasted for 4 days. Trouble breathing, felt like a weight on my chest and it was difficult to speak lasted for 90 minutes.

Other Meds: Mesalamine DR 1.2GM Tablet Acyclovir 400mg Tablet Escitalopram 10mg Tablet Cetirizine HCL 10mg Tablet

Current Illness: None

ID: 1086124
Sex: F
Age: 37
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: N/A

Symptom List: Pain in extremity

Symptoms: Vaccine event: higher volume given. Approx 0.6 to 0.65 ml given to patient for Janssen vaccine instead of 0.5 ml. Currently no adverse consequences reported.

Other Meds: N/A

Current Illness: N/A

ID: 1086125
Sex: F
Age: 62
State: VA

Vax Date: 12/27/2020
Onset Date: 12/28/2020
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: Gluten - Celiac - autoimmune

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

Symptoms: Significant joint pain; fatigue; left arm pain. - Joint pain lasted 3 weeks from 12/27/2021 - 1/19/2021; Called Dr. - telemed visit - 1/18/2021. I had not recovered from the adverse symptoms of first dose before getting second dose. I had the second dose on January 19, 2021 - had joint pain but I did so much easier than this first dose.

Other Meds: Sinvia; Pentasa; Lialda - 3 meds I am taking for Chrohn's; Multivitamin; Biotin; Pre and Probiotic - in one capsule; vit D3

Current Illness: No

ID: 1086126
Sex: F
Age: 27
State: IL

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:

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

Symptoms: 11-12 hours after vaccine I began to have a metallic taste in my mouth and nose. 24 hours later and there is still a weird smell in my nose and taste in my mouth.

Other Meds:

Current Illness:

ID: 1086127
Sex: F
Age: 59
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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Sulpha

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

Symptoms: Around 1:30 am 3/6/21 I woke up nauseous. Did not vomit. When I got up around 8:30 am the nausea had eased up a lot. Later in the morning I started experiencing muscle aches in my neck, shoulders, back and arms along with a headache. Late afternoon I took my temperature and it was 100.6. I felt like crap! Went to bed around 9:00 pm still feeling bad Saturday night. I was much better when I woke up 9 hrs later.

Other Meds: Duloxetine, Atorvastatin, Metoprolol, Meloxicam, Metformin, vitamin C, calcium, vitamin D

Current Illness: None

ID: 1086128
Sex: F
Age: 64
State: OH

Vax Date: 03/02/2021
Onset Date: 03/04/2021
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: ONLY GET VERY SWOLLEN FROM MOSQUITO BITES...THEY TURN BLACK AND GET VERY HARD

Symptom List: Vomiting

Symptoms: RASH STARTED @ 1.5 DAYS LATER...STARTED ON CHART ALL ACROSS/GOT WORSE AS DAY PROGRESSED ALL OVER BODY.. NOT ON LEGS PAST KNEE AND ONLY ON INSIDE OF BOTH ARMS...OTHERWISE ALL OVER BODY NOT FACE EITHER HOT AND ITCHY.. FRIDAY WENT TO URGENT CARE THEY GAVE ME STEROID METH PAK 4 MG GOT WORSE OVER WEEKEND AND WENT TO EMERGENCY ROOM MONDAY MORNING 3/8 AT @ 6 AM I WAS GETTING CHEST SPASMS IN FRONT CHEST AND BACK/MY RASH WAS THE WORST ON CHEST. HOSPITAL CHECKED OUT HEART...ALL GOOD/PLATELETS ALL GOOD I FORGOT TO MENTION EARLIER THAT I WAS ALSO ON AMOXICILLIN DUE TO A ROOT CANAL DONE DAY BEFORE VACCINE HOSPITAL GAVE ME STRONGER PREDNOZONE PILLS TO TAKE 6 FOR 2 DAYS THEN 5 FOR 2 DAYS...ETC. SOMEWHAT LIGHTER ON DAY 2 TODAY IN RASH..STILL ALL OVER...BUT GETTING DARKER IN COLOR.

Other Meds: PRESCRIPTIONS; TRAMADOL; METOPROLOL; TORSEMIDE; POTASSIUM; ALAVERT; FLONASE; VITAMINS/MULTI/TUMERIC/B12/BIOTIN WITH COLLAGEN/JOHNS WORT/VITAMIN D/BABY ASPIRIN/EVENING PRIMROSE/FORSKOLIN

Current Illness: CLL; TYPE 2 DIABETES; NEUROPATHY; HIGH BLOOD PRESSURE; RETAIN FLUID

ID: 1086129
Sex: F
Age: 49
State: CA

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

Lab Data:

Allergies: none

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Within one minute of receiving injection, my heart started racing and I felt dizzy and light headed. After waiting at the vaccination site for 30 minutes, my heart rate slowed and the dizziness lifted enough to drive myself home. It's now been almost 3 hours and I still feel a little off but mostly just have a headache.

Other Meds: 100 mgs daily: zoloft Methimazole: 1/2 tab, twice a week

Current Illness: none

ID: 1086130
Sex: F
Age: 54
State: LA

Vax Date: 02/09/2021
Onset Date: 02/10/2021
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:

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

Symptoms: Patient reported burning pain, numbness of the arm, tingling, shaking, weakness, chest pain., and back pain. She said she could not move her arm for 4 days. She also said she had swelling in the chest and arm.

Other Meds:

Current Illness:

ID: 1086131
Sex: F
Age: 89
State: SC

Vax Date: 02/25/2021
Onset Date: 02/25/2021
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:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Pt states that injection site looked like an insect bite for 5 days after administration. On the 5th day, the site became red and warm. Pt is not concerned. Counseled to seek medical attention if symptoms worsen.

Other Meds:

Current Illness:

ID: 1086132
Sex: F
Age: 45
State: IL

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: RA

Lab Data:

Allergies: Zpac

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

Symptoms: Brain fog, body aches, light headed, dizzy, metal taste in mouth, slight sore throat, headache, eye pain, flushed

Other Meds: Diclofenac Cymbalta Estrogen Flexeril

Current Illness: Pinched nerve in neck

ID: 1086133
Sex: M
Age: 69
State: MT

Vax Date: 02/16/2021
Onset Date: 02/16/2021
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: None

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

Symptoms: SIRVA

Other Meds: Eliquis and Lipitor

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm