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: 1086186
Sex: F
Age: 60
State: AK

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

Lab Data:

Allergies: Penicillin Naproxen

Symptom List: Dysphagia, Epiglottitis

Symptoms: Sore nipples and armpits for several days then today light vaginal bleeding I am in or done with menopause and have not had a period for several years

Other Meds: Fluoxetine Robaxin Celebrex Vitamins C and D Lutein

Current Illness: None

ID: 1086187
Sex: F
Age: 47
State: NY

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: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Sore arm, fatigue, body aches (like recovering from flu), slight chills

Other Meds: Losartan

Current Illness:

ID: 1086188
Sex: F
Age: 60
State: IN

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

Lab Data:

Allergies: None that I'm aware of

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

Symptoms: Body was itchy all over. No apparent rash or hives.

Other Meds: None

Current Illness: None

ID: 1086189
Sex: M
Age: 51
State: VA

Vax Date: 12/29/2020
Onset Date: 01/10/2021
Rec V Date: 03/09/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: A few days of heart palpitations - consistent through the day. And then blood pressure spiked. I was taking Blood pressure and the cuff detected an arrhythmia and so I went to ER on the 12th. Cardiologist dr visit was on 14th of January. I was put on blood pressure medicine - a second one (I was already on one) - Metoprolol ER Succinate. I had my second dose on January 15, 2021. After my second dose, I had pain in my upper part of my chest - left side - and it went away.

Other Meds: I was Blood Pressure med - Amlodipine Besylate

Current Illness: no

ID: 1086190
Sex: M
Age: 67
State: OH

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: LA

Lab Data:

Allergies: pencillan

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

Symptoms: continued severe pain in hips, back, below shoulder blade right side, legs. NO RELIEF FROM PAIN CONSTANT

Other Meds: CARVEDILOL 6.25 MG TWICE A DAY PRO FE 180 MG ONE A DAY (HAS NOT TAKEN FOR 7 DAYS) PANTOPRAZOLE SOD EC TB40 MG ONE A DAY FUROSEMIDE 20 MG TWICE A DAY SPIRONOLACTONE 50 MG ONE A DAY JARDIANCE ONE A DAY GE

Current Illness: diabetic

ID: 1086191
Sex: M
Age: 25
State: NM

Vax Date: 01/13/2021
Onset Date: 01/15/2021
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: Pen

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

Symptoms: Numbness in entire body. Vision loss in eyes. Severe headache

Other Meds: No

Current Illness: No

ID: 1086192
Sex: F
Age: 59
State:

Vax Date: 02/22/2021
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: LA

Lab Data:

Allergies: AMOXICILLIN

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: SEVERE INDIGESTION/ESPHAGEAL SPAPMS,LOW GRADE FEVER,SWEATING,FATIQUE,MILD HEADACHE,NAUSEA. RESOLVING AFTER TWO DAYS. NO TREATMENT

Other Meds: LOVASTATIN,SIMVASTATIN.SERTRALINE,SYMBICORT,COREG,OMEPRAZOLE,DICYCLOMINE,FISH OIL,CALCIUM.CRANBERRY

Current Illness: NONE

ID: 1086193
Sex: F
Age: 71
State: PA

Vax Date: 02/24/2021
Onset Date: 03/06/2021
Rec V Date: 03/09/2021
Hospital:

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

Lab Data:

Allergies: penicillin

Symptom List: Pharyngeal swelling

Symptoms: rash on left upper arm, increasing in size over next days. Saturday morning 1 1/2 " x 1 1/2", by Monday morning 3 1/2" x 4". As of today about 4" x 6". Rash was warm to the touch and itchy. Told to take Benadryl and use cold compresses.

Other Meds: simvastatin, xaralto ,metoprolol, vit D, multi-vitamin

Current Illness: n/a

ID: 1086194
Sex: F
Age: 65
State: IN

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: None

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Headache, dizziness and red knot under right knee

Other Meds: Duloxetin HCL 60 mg

Current Illness: I?ve had an intense headache for 2 days after taking the vaccine. I?ve been dizzy since the day of the vaccine. Today I found a red knot on my right leg below my knee that?s very itchy.

ID: 1086195
Sex: F
Age: 82
State: CA

Vax Date: 02/11/2021
Onset Date: 02/24/2021
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 latex Losarten Lisinopril Morphine

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Swollen raised area about the size of a Nickle and redness at injection site 2 weeks post injection. Dr. consulted on 3/4, told to just observe. Grew larger and more inflamed. Obvious sign of infection and Dr. consulted again on 3/9. Patient given antibiotic injection that day and prescribed Doxycycline Hyclate 100mg tab - one tablet twice daily for 10 days. (pictures taken often for comparison)

Other Meds: 1. Aspirin 81 mg ? 1 tablet daily ? BLOOD THINNER 2. Atrovastatin 20mg (Lipitor) ? 1 tablet @ bedtime ? HYPERLIPIDEMIA 3. Bevespi Aeorspehre 9mcg/4.8mcg ? 1 Puff twice time per day - COPD 4. Docusate Sodium 100 mg softgel (Colace) ? 1 soft

Current Illness:

ID: 1086196
Sex: M
Age: 29
State: WI

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: SYR
Vax Site: LA

Lab Data:

Allergies: no

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

Symptoms: Patient was sweating. Blood Pressure taken = 102/62. Monitored additionally after 15min observation period while getting fresh air outside before determining it was safe to leave.

Other Meds: no

Current Illness: no

ID: 1086197
Sex: F
Age: 23
State: TX

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: At 10:44am, Fainting, drastic drop in blood pressure, blurred vision, numb hands. That evening, chills and vomiting.

Other Meds:

Current Illness:

ID: 1086198
Sex: U
Age:
State:

Vax Date:
Onset Date:
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: Fever up to 101.5, chills, fatigue, body aches and joint pain

Other Meds:

Current Illness:

ID: 1086199
Sex: M
Age: 58
State: NV

Vax Date: 02/12/2021
Onset Date: 02/14/2021
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: CDN

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

Symptoms: Bilateral knee pain. Right hip pain. Lower back pain. Neck pain. Right elbow pain left thumb pain. Right wrist pain. Right ankle pain (All previous injuries at these sites in the past) Tested, rest, stretching, Advil, Tylenol, colchicine, prednisone. Improved up to 4 hours then returned up until filling vaers today

Other Meds: D3, zinc, Pepcid, melatonin, Advil, aspirin

Current Illness: No

ID: 1086200
Sex: F
Age: 32
State: KY

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

Lab Data:

Allergies: Gluten

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

Symptoms: Headache, dizziness, nausea, fatigue, arm soreness, injection site redness.

Other Meds: Mirena IUD, lexapro, multivitamin, vitamin D, Calcium, montelukast, xyzal, Maxalt if needed for migraine.

Current Illness:

ID: 1086201
Sex: F
Age: 23
State: GA

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: IM
Vax Site: LA

Lab Data:

Allergies: no known allergies

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

Symptoms: patient became lethargic and briefly passed out 1 minute after receiving vaccine. Patient did not have swelling or breathing problems so an epinephrine pen was not needed. Patient became sweaty and had muscle rigidity of her hands and arms. Patient had rapid heart rate and extreme exhaustion. Ambulance was called and patient care was passed off to the EMTs and the hospital.

Other Meds: citalopram

Current Illness: panic attacks

ID: 1086202
Sex: M
Age: 56
State: IN

Vax Date: 03/04/2021
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: None

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

Symptoms: Couldn?t get warn, low grade fever, tiredness

Other Meds:

Current Illness:

ID: 1086203
Sex: F
Age: 26
State: NJ

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: NKA reported/ denies

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Post vaccination reports "feels faint and dizzy"; informs previous hx of these symptoms w/other injections (non-specific) Medical monitor x 40 min w/ improvement and symptom resolve; released from facility to home

Other Meds: Reports medication list: Zoloft

Current Illness:

ID: 1086205
Sex: F
Age: 38
State: NY

Vax Date: 03/08/2021
Onset Date: 03/08/2021
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: Pfizer-BioNTech Covid-19 Vacine EUA Left side of my face feels tingly. It?s not swollen and still functional. Just tingly. Same feeling as if your foot falls asleep. No treatment yet. Waiting to see if it goes away in a few days.

Other Meds: None

Current Illness: None

Date Died: 02/25/2021

ID: 1086206
Sex: M
Age: 87
State: AZ

Vax Date: 02/18/2021
Onset Date: 02/19/2021
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: no

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

Symptoms: Four days of feeling sick with aches, pains, upset stomach. On day 2 he was so sick he thought he would die. Sudden death on day 7.

Other Meds: unknown

Current Illness: no

ID: 1086207
Sex: F
Age: 64
State: NJ

Vax Date: 02/27/2021
Onset Date: 02/28/2021
Rec V Date: 03/09/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Chills and all over body aches

Other Meds: Allegra

Current Illness: None

ID: 1086208
Sex: F
Age: 74
State:

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: Unevaluable event

Symptoms: Diarrhea later that night

Other Meds:

Current Illness:

ID: 1086209
Sex: F
Age: 67
State: NY

Vax Date: 03/08/2021
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: lt foot is vibrating under skin, like a surge

Other Meds: vitamin c,d

Current Illness:

ID: 1086210
Sex: F
Age: 43
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: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Patient reports adverse effect with flu vaccine, scallops

Symptom List: Injection site pain, Pain

Symptoms: Patient reported numbness at the vaccination site as well as the left cheek within 30 minutes of vaccine administration. Also noted that numbness spread to right cheek. Patient stated her face felt tight all day on 3/7 and when she went to bed and woke the next morning, she noticed that her right cheek was swollen compared to the right.

Other Meds: Albuterol q6hr, fluticasone daily, Irbesartan 150 mg daily

Current Illness: None

ID: 1086211
Sex: M
Age: 75
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: SYR
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Injection site pain, Menorrhagia

Symptoms: Low grade fever, fatigue, chills, mild headache, No treatment seeked. Only lasted 24 hours

Other Meds: Metforman Tansulosin Insulin Low dose asprin Farxgia Simvasttin Lisinopril

Current Illness: None

ID: 1086212
Sex: F
Age: 68
State: MI

Vax Date: 02/28/2021
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: Penicillin, erythromycin, clyndamycin, morphine

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

Symptoms: Large har lump at injection site, soreness and itching

Other Meds: Metformin, lisinopril, gabapentin , carvedilol, lisinopril, doxepin, oxybutynin, astorvasatin

Current Illness:

ID: 1086213
Sex: M
Age: 51
State: VA

Vax Date: 01/15/2021
Onset Date: 01/17/2021
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: 20 hours after the vaccine, at 3:00 PM on 16th I had small a fever and chills. Those symptoms lasted until 05:00 PM on 17th. I had a sharp pains in my chest that would come and go. That lasted for three to four days. Then they just went away. I just kept taking my meds. It wasn't clear if it was a muscle pain or inside my chest - it wasn't bad enough to hinder me or for me to see a doctor.

Other Meds: I was Blood Pressure med - Amlodipine Besylate; Metoprolol ER Succinate

Current Illness: no acute illnesses; adverse symptoms from 1st dose of vaccine

ID: 1086214
Sex: F
Age: 29
State: TX

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

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

Lab Data:

Allergies: None

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Vomited from 11:00 PM to around 3:15 AM about every 10 to 15 minutes.

Other Meds: None

Current Illness: None

ID: 1086215
Sex: F
Age: 55
State: FL

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: RA

Lab Data:

Allergies: IV Contrast

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

Symptoms: 4:36- patient noticed itching on back and over her body. Taken to separate observation area. Flat, diffuse rash noted on back and abdomen. 4:40 pm. Benadryl 25mg po administered by HCP; continuous monitoring by EMS last BP 143/77- hr 78- SATS 98% on RA. Discharged home at 5:33 pm

Other Meds: Synthroid 125 mg; NutraDHEA 10 mg qd; Vitamin C 1000mg qd; Vitamin D 12 gtts/wk/ solution- unknown strength; Vitamin B12-? dose; Fish Oil 2 caps/day/ Various "nutritional supplements"

Current Illness: Noe

ID: 1086216
Sex: F
Age: 62
State: AZ

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: None, only environmental allergies, and sensitivity to fragrances/fragranced products

Symptom List: Nausea

Symptoms: I experienced mild tingling and numbness in my lips, which lasted for several hours. I had taken an Allegra 24 the evening of 3/8/2021, no treatment was necessary.

Other Meds: Advair inhaler, Levabuterol tartrate HFA inhaler PRN, Allegra, Flonase Sensi-Mist nasal spray, Allergy desensitization shots Unithroid, NP Thyroid Sumatriptan PRN Low dose aspirin Biotin, Vitamin B12, Vitamin D3

Current Illness: No acute illnesses within the past month

ID: 1086217
Sex: F
Age: 62
State: CA

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

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

Lab Data:

Allergies: According to the enrollment questions, she had no allergies to medication, food, or other products

Symptom List: Injection site pain

Symptoms: C/O feeling like her BP was high, had patient first drink water and lay down, then sent her to ED, they transferred her to hospital for admission.

Other Meds: Patient has h/o HTN and takes an anithypertensive medication, did not state what it was at the time of the vaccination.

Current Illness: None noted except for her HTN

ID: 1086219
Sex: F
Age: 28
State: TX

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

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

Lab Data:

Allergies:

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

Symptoms: Patient fainted about 2 minutes after receiving vaccine. She experience nausea, dizziness , and a moment of confusion. Patient stated at pharmacy for 1 hour after episode. She was given water and crackers but refused other medical attention. Patient denied shortness of breath: difficulty breathing. Checked patients blood pressure. It was 144/74. Patient left pharmacy after 1 hour. She called when she make it home. She said she was still a little dizzy and nauseous. She had vomited. I asked patient if she was alone or if someone was there with her. She stated her sister is a nurse and was with her. Will follow up with patient on 3/10/21

Other Meds:

Current Illness:

ID: 1086220
Sex: F
Age: 26
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: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: PCN

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

Symptoms: Patient is a 26 y.o. female who received the Moderna Covid-19 Vaccine, mRNA-1273 (PF) 100 mcg/0.5 mL IM Susp, Lot 001B21A on 3/9/2021. The patient experienced the following reaction(s) during the immediate of observation: Pt reports feeling a bit of numbness and tingling in her fingers in her left arm. Patient was treated/managed as follows: Pt observed and vitals taken. 1611: BP 138/82 HR: 92 O2: 97% RA 1621: BP 144/80 HR: 88 O2: 98% Pt reports tingling has subsided. Patient given educational material regarding vaccine and advised to continue to self-monitor per the CDC guidance. Pt escorted to car at 1627 by RN.

Other Meds: Multi vitamins

Current Illness: Common Cold

ID: 1086221
Sex: F
Age: 58
State: CA

Vax Date: 01/19/2021
Onset Date: 01/22/2021
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: Statins, Tramadol, Imitrex, Indomethacin, Cilantro

Symptom List: Tremor

Symptoms: 2nd dose given on 2/23/21. Both times I got "Covid arm". It started quicker after the second dose, but the first was more severe. A red welt like rash began a few days after the first. It grew into a large red circle and lasted about 3 weeks. Towards the end it was itchy. After the second dose, it started appearing the next day, along with a low grade fever (under 100). It was not a red and resolved in about 2 weeks, but it was itchier than the first one.

Other Meds: Metformin, Victoza, CoQ-10, Magnesium, 21 mg aspirin, Vit. C, Zinc, L Methyl Folate, Vit. B-2, Vit. B-12, Vit. D, Tylenol, Trazadone, Praluent

Current Illness: none

ID: 1086222
Sex: M
Age: 70
State:

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Morphine, atorvastatin

Symptom List: Erythema, Pruritus

Symptoms: Vaccine was not administered at our hospital, but reporting since patient presented to the ED. Presented to ED on 3/6/21 with right sided weakness. Admitted for acute right sided weakness. Unable to get MRI due to pacemaker. Discharged the next day in stable condition with clopidogrel and aspirin.

Other Meds: cetirizine (ZYRTEC) 10 mg tablet TAKE 1 TABLET(10 MG) BY MOUTH EVERY DAY ? cholecalciferol, vitamin D3, 2,000 unit Tab Take 2,000 Units by mouth every morning. ? lansoprazole (PREVACID) 30 mg capsule TAKE 1 CAPSULE BY MOUTH EVERY DAY ? mo

Current Illness:

ID: 1086223
Sex: F
Age: 50
State: FL

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

Vax Type: UNK
Manufacturer: UNKNOWN MANUFACTURER
Vax Name: VACCINE NOT SPECIFIED (NO BRAND NAME)
Lot:
Dose Series: UNK
Vax Route: SYR
Vax Site: UN

Lab Data:

Allergies: NKA

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

Symptoms: I received my shot and we drove to the parking waiting area. By the time we got to the person to tell us where to park I was feeling very light headed. My heart felt like it was racing and I felt like I was going to faint. This was about 2-3 minutes after receiving the shot. The woman told us to park near the EMS tent. We parked and about a minute later I started feeling better. It took about 10 minutes in all to feel completely fine again. I did have a bowl of cereal for breakfast that morning before we left for the appointment, so it wasn't low blood sugar due to an empty stomach. I did call my doctor, but I have not seen him as of yet.

Other Meds: Levothyroxine 0.05mg, (1) Losartan 50mg (1) see below also

Current Illness: None

ID: 1086224
Sex: F
Age: 59
State: CO

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: LA

Lab Data:

Allergies: morphine

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

Symptoms: I did not have an adverse reaction to my vaccine but I have been advised to report that the first dose was given in the incorrect location on my right arm. It was given in the fatty part of the far back of my right arm by a pharmacy student who was helping out that day. I experienced no pain or any other side effects from this dose and there was concern immediately that it was even effective considering it was given far away from the deltoid muscle. The pharmacist recommended after two weeks that I have a rapid covid antibody test to determine if my body had produced antibodies. The test determined that I did have them, but the level was not able to be measured in this test. Today, 3/09/2021 I had my second dose

Other Meds: anastrozole, lisionopril HCTZ, atorvistatin, Klor Kon

Current Illness: n/a

ID: 1086225
Sex: F
Age: 69
State: CA

Vax Date: 02/05/2021
Onset Date: 02/06/2021
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: sulfa allergy

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: 72 hours of 101 degree fever; intense chills and muscle ache; overall "fluishness"; fatigue for a few days thereafter. 30 days after 1st injection and one day before the 2nd shot: generalized upper torso rash, may or may not be related . Still present 4 days after 2nd shot.

Other Meds: Hydroxyurea; Synthroid; Cytomel; Amlopidine; aspirin

Current Illness: none

ID: 1086226
Sex: F
Age: 26
State: CA

Vax Date: 01/13/2021
Onset Date: 01/13/2021
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

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

Symptoms: Fatigue - same evening, lasted for 4 days Fever - middle of the night Headache - all throughout the next day

Other Meds: Vitamin C Calcium-Magnesium-Zinc Imitrex (as needed)

Current Illness: Allergies

ID: 1086227
Sex: F
Age: 42
State:

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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Taxol

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

Symptoms: Tachycardia, Urticaria

Other Meds:

Current Illness:

ID: 1086228
Sex: F
Age: 47
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: Pain in extremity

Symptoms: 5 min after shot became starting feeling unwell became faint had to lay down , was very hot, hearing was impaired , could not sit up for a few minutes.

Other Meds: None

Current Illness: None

ID: 1086229
Sex: M
Age: 61
State: NY

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: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: no known allergies

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

Symptoms: Johnson and Johnson vaccination fever, body aches, rash

Other Meds: BP medication

Current Illness: N/A

ID: 1086230
Sex: F
Age: 44
State: TX

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: Penicillin

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

Symptoms: Vomiting, fatigue, headache, dizziness, chills, low grade temp, loss of taste, difficulty breathing, rapid heart beat. The vomiting stopped yesterday. Rapid heartbeat and dizziness started within 10 mins of having the vaccine.

Other Meds: Armour Thyroid

Current Illness: no

ID: 1086231
Sex: F
Age: 71
State: NY

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: all petroleum derivatives, contrast dyes in medical procedures, volatile organic solvents, chlorine, scallops, some preservatives, formaldehyde, plastics and plastic outgassing, many insecticides, mildew and other molds

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

Symptoms: about two hours after injection, I experienced headache, then mild dizziness, then extreme dizziness, then sudden overwhelming fatigue, then swollen eyes and eyelids, then chills and elevated heart rate, with pounding. I had to cancel the class I was supposed to teach, because I would not have been safe to drive to campus. I slept from approximately 2:30 pm on March 8 until 8:30 am today, March 9, all symptoms continuing, with bathroom breaks, a couple of short reports to family members who were watching out for me, and one 2-hour window during which I ate a small meal, went back to bed, and read part of a book. During bathroom breaks I took more antronex, some milk thistle, and some glutathione, which seemed to at least temporarily reduce dizziness and eye/eyelid swelling. At one point I took some hawthorne tincture because I was concerned about the heart pounding. Today I woke up feeling symptom-free, but by 2 pm I was compelled by sudden fatigue to take a two-hour nap. After that I felt better, and I think I am now fine, at 7:45 pm on 3/9/21. I am happy to have gotten the Janssen vaccine, because it is one and done!

Other Meds: antronex, L-glutathione

Current Illness: none

ID: 1086232
Sex: F
Age: 68
State: IN

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

Lab Data:

Allergies: iv dye: ct, ivp, karotine. tb test. demerol. pcn. keflex. biaxin. food: all raw fruits and vegetable. nuts, shellfish. chocolate. artificial sweetnes except sacchrin eg: sucrose. trees, grass, mold, dust, certain flowers.

Symptom List: Vomiting

Symptoms: throat closing, redness, itching generally

Other Meds: flovent inhalor, proventil inhalor, metformin, januvia, verapamil, hyzaar, humalog, levemir, protonix, macrobid, b12, feosol, asa, protonix, pepcid, demannose, singular

Current Illness: anemia,

ID: 1086233
Sex: M
Age: 65
State: GA

Vax Date: 01/05/2021
Onset Date: 01/08/2021
Rec V Date: 03/09/2021
Hospital:

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

Lab Data:

Allergies: n/a

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: 1/5 vaccination 1/8 started with pain lower R back, near waist. I could not turn. extreme sharp pain. I could hardly stand. Went to physiotherapist for 2-3 weeks. Cardiologist for ultra sound. Blood panel. Urine. on and off with symptoms. frequency has subsided.

Other Meds: BP medications, losartan, cholesterol, baby aspirin, multi vitamins

Current Illness: n/a

ID: 1086234
Sex: M
Age: 36
State: PA

Vax Date: 03/08/2021
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: RA

Lab Data:

Allergies: None

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

Symptoms: Extreme joint pain, headache, muscle pain, fatigue x 18 hours

Other Meds: Decline

Current Illness: None

ID: 1086235
Sex: F
Age:
State: MI

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

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

Lab Data:

Allergies: Shellfish

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Reported

Other Meds: One a day women's vitamins

Current Illness: I consumed two bottles of wine 26 hours after my second vaccination of Moderna and usually it would have me inebriated. However, this time it was like I never had a drink. But after 72 hours I had just one glass of wine and became inebriated. I did not read or hear anything about the vaccination and alcohol consumption so decided to report my experience.

ID: 1086236
Sex: F
Age: 64
State: MO

Vax Date: 02/25/2021
Onset Date: 03/06/2021
Rec V Date: 03/09/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: Moderna COVID-19 Vaccine EUA after 10 days, a raised red patch at the injection site. Itchy and achy. Still there 4 days. approx 2" diameter.

Other Meds: lisinopril, celecoxib, venlafaxine, vitamins C, D, calcium, magnesium, multi vitamin

Current Illness: none

ID: 1086237
Sex: F
Age: 40
State: MA

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

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

Lab Data:

Allergies:

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

Symptoms: Day of vaccine- has increased HR within 3 mins but resolved within an hour; severe headache, lip tingling, "loopy feeling" Day after vaccine: facial swelling, daily headache, fatigue 3/7: Itchy between her breasts and bilat arm, arm pit itching, lip burning, described "spiderweb like rash with visible capillaries"; throat itchy/swelling intermittently Taken benadryl without improvement H/O asthma, allergies:

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm