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: 1087376
Sex: F
Age: 30
State: MI

Vax Date: 03/09/2021
Onset Date: 03/10/2021
Rec V Date: 03/10/2021
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: Bactrim

Symptom List: Dysphagia, Epiglottitis

Symptoms: Janssen COVID-19 Vaccine EUA headache, fever, chills, nausea

Other Meds: Apri birth control

Current Illness:

ID: 1087377
Sex: M
Age: 74
State: IN

Vax Date: 03/01/2021
Onset Date: 03/09/2021
Rec V Date: 03/10/2021
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: Flaxseed

Symptom List: Anxiety, Dyspnoea

Symptoms: Low grade fever, Tylenol. Very bad lower intestinal distress (gas). No treatment

Other Meds: Xarelto 20mg, atorvastatin 10mg, glipizide 5mg, levothyroxine 50mcg, omeprazole 20mg, Ubiqunol 20g, eye promise restore, Vit C 1000 mg, Vit D 50mcg, Magnesium 250mg. All daily

Current Illness: None

ID: 1087378
Sex: F
Age: 51
State: FL

Vax Date: 02/18/2021
Onset Date: 02/18/2021
Rec V Date: 03/10/2021
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: no known allergies at this time

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

Symptoms: left arm soreness - like inside, like the bones are dying or festering - very hard to describe (at least 21 days as it's never changed nor gone away since starting the day of the injection); whole body joint pain for at least 3 full days (couldn't walk at normal pace or grip chopsticks etc), fatigue for maybe 6/7 days (in bed 10-14 hours barely able to move, but awake and alert so not sleepy per se), muscle numbness in left arm for 2 days.

Other Meds: none

Current Illness: Auto-Immune Hepatitis, Cirrhosis of the Liver, Ulcerative Colitis

ID: 1087379
Sex: F
Age: 46
State: PA

Vax Date: 03/07/2021
Onset Date: 03/08/2021
Rec V Date: 03/10/2021
Hospital:

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

Lab Data:

Allergies: none known

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Approximately 24 hours after receiving the shot I had serious adverse side effects. On my upper lip I had 20+ enormous cold sores break out on my top lip. My lips had been chapped on Sat/Sun, so it would not have been unusual to get ONE cold sore, but my top lip is absolutely covered in cold sores. I've never had more than 1 at a time, and I might have 30 by now.

Other Meds: none

Current Illness: none

ID: 1087380
Sex: F
Age: 68
State: IN

Vax Date: 03/04/2021
Onset Date: 03/04/2021
Rec V Date: 03/10/2021
Hospital:

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

Lab Data:

Allergies: Patient stated that she is allergic to several medications and products.

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

Symptoms: Patient reported at 0820, 10 minutes after receiving her second dose of Moderna, that she was feeling hot. She stated it felt like a "hot flash". At this time patient was asked to lay down and was given a wash cloth and water. Patient denied shortness of breath, chest pain, or rapid heart rate. At this time this nurse asked patient to stay for 30 minutes to assure that her symptoms didn't worsen. At 0835 nurse gave patient crackers, more water, and a new wash cloth but denied any new symptoms. At 0908 patient left, prior to leaving she denied any "hot flash" symptoms or tingling. Patient stated she was starting to get a head ache but she would take a tylenol when she got home.

Other Meds:

Current Illness:

ID: 1087381
Sex: M
Age: 85
State: IN

Vax Date: 03/04/2021
Onset Date: 03/05/2021
Rec V Date: 03/10/2021
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:

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

Symptoms: Chills, Temp of 104, weakness

Other Meds:

Current Illness:

ID: 1087382
Sex: F
Age: 54
State: FL

Vax Date: 03/02/2021
Onset Date: 03/03/2021
Rec V Date: 03/10/2021
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: n/a

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Sick the day after the 2nd shot with 101 fever, chills, aches, etc . Felt fine for 4-5 days after that. Then, nausea, fatigue and fever set in. Have experienced low-grade temperature, nausea and some fatique for several days now.

Other Meds: rosuvastatin

Current Illness: n/a

ID: 1087383
Sex: M
Age: 73
State: IN

Vax Date: 02/25/2021
Onset Date: 03/01/2021
Rec V Date: 03/10/2021
Hospital:

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

Lab Data:

Allergies: Penicellin

Symptom List: Pharyngeal swelling

Symptoms: Limited ability to move right arm and pain when I tried.

Other Meds: Celebrex,lisinopril,atorivastan

Current Illness: None

ID: 1087384
Sex: F
Age: 62
State: MI

Vax Date: 02/23/2021
Onset Date: 03/09/2021
Rec V Date: 03/10/2021
Hospital:

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

Lab Data:

Allergies: Gluten (Have Celiac), Cafergot Erythromycin

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Moderna COVID-19 Vaccine EUA Skin reaction at site of injection. Large red circle, slightly raised about 2" x 2.5" . Does not itch.

Other Meds: Prozac, xanax, ambien, miralax, lisinopril, topamax,

Current Illness: None

ID: 1087385
Sex: F
Age: 39
State: MD

Vax Date: 03/07/2021
Onset Date: 03/07/2021
Rec V Date: 03/10/2021
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: None

Symptom List: Diarrhoea, Nasal congestion

Symptoms: When the injection was placed I experienced deep pain inside my shoulder. Within 3 hours my shoulder was frozen in pain and unable to move. I used ice and anti-inflammatory medication with no relief. I was unable to move my shoulder and could not complete daily self care tasks like brushing hair, changing clothes, cooking or driving. I could not drive to work the next day and had to use sick leave. I was in a high level of pain. I woke up crying throughout the night for three nights due to pain. I sought care at unspecified Urgent Care and was told that it was just sore and I need to keep moving the shoulder and apply heat. I was given an RX for Cephalexin, an antibiotic. Dr. indicated the injection site was warm to the touch. By Wednesday morning, there has been a slight improvement in pain and mobility. I am able to hold my arm straight down as opposed to keeping the elbow bent and tucked in. Still cannot raise my arm at all from the shoulder joint.

Other Meds: None

Current Illness: None

ID: 1087386
Sex: F
Age: 37
State:

Vax Date: 01/29/2021
Onset Date: 02/01/2021
Rec V Date: 03/10/2021
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: Patient received the Moderna COVID Vaccine on 29 January, at which time she was 7 weeks pregnant. No other comorbities noted. On 01 February she had a miscarriage. She also received the first dose while pregnant, first dose was given on 30 December 2020 and she was 3 weeks pregnant

Other Meds: Pre natal

Current Illness: None noted

ID: 1087387
Sex: F
Age: 68
State: OH

Vax Date: 03/08/2021
Onset Date: 03/08/2021
Rec V Date: 03/10/2021
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: Fish/Seafood, Erythromycin, Amox TR-K CLV 875, Tumeric

Symptom List: Rash, Urticaria

Symptoms: 12 hours later I was freezing enough to have teeth chatter. Next day my whole body ached. Everything hurt.

Other Meds: IC Estradiol, Valacyclovir, Tolterodine Tart, Amlodipine Besylate, Lisinopril, Pantoprazole Sod, IC Atorvastatin, Hydrolyzed Collagen, Metanx, B Complex, Calcium Magnesium D3, Multi Vita-Min, Tonic Water, Rogain,

Current Illness: None

ID: 1087388
Sex: M
Age: 33
State: OH

Vax Date: 03/05/2021
Onset Date: 03/07/2021
Rec V Date: 03/10/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: Red rashy/swollen area in the pit of my left arm, which is the same side as the injection. It started on Sunday, 3.7.2021 and is getting worse.

Other Meds: Vitamin C, Zinc, Vitamin B3, Vitamin D

Current Illness: n/a

ID: 1087389
Sex: F
Age: 63
State: OH

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 03/10/2021
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: In the evening I started to feel aches in my eyes and joints. I was having trouble falling asleep. I woke up every 2 hours. My heart bpm went up to 102 in the middle of the night. I know this because my fit bit was vibrating and encouraging me to keep exercising and I was just laying in bed trying to sleep. I finally got up around 2:30 in the morning and took 1 Aleve. I also took my temperature with a forehead type and it was 98.5, so no high fever. I took another Aleve around 7:00 in the morning. Now I am feeling fine. It's now 8:22 a.m. and I am working from home. I just wanted to report that the aches in joints and 102 bpm and unable to fall asleep were my side effects. I feel fine now. I will continue to take Aleve as needed. I have never been tested for Covid. I have never had any symptoms to warrant testing for covid. Since March 13, 2020 I have been fortunate to work for a company that has us all working from home. We are still working from home. i am 63 years old. I shop around 6 a.m. in the morning for groceries to avoid people. I do not go out. I have been very careful.

Other Meds: Metformin er 500mg simvastatin 20mg hydrochlorothiazide 12.5mg low dose aspirin, b complex, d3, zinc

Current Illness: none

ID: 1087390
Sex: F
Age: 28
State: CT

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 03/10/2021
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: Cefcil

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

Symptoms: Fever, shakes, severe body aches and sharp pains throughout my body. Nausea and vomiting and constant use of the bathroom. Dizziness, and severe migraine, fatigue and trouble breathing that lasted 2+ hours.

Other Meds: None

Current Illness: None

ID: 1087391
Sex: F
Age: 35
State: MA

Vax Date: 01/08/2021
Onset Date: 01/29/2021
Rec V Date: 03/10/2021
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: Positive PCR test after receiving 2nd vaccination

Other Meds:

Current Illness:

ID: 1087392
Sex: F
Age: 69
State: OH

Vax Date: 03/02/2021
Onset Date: 03/03/2021
Rec V Date: 03/10/2021
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: Penicillin/Sulfa/ChloroaPrep

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

Symptoms: Wednesday, the morning after the shot: 101.7 fever and in bed all day; chills/cold; can "feel my skin;" stomach and diet off; bowels off; chest and upper back pressure; deliberate taking of a deep breath; tinny taste in my mouth; slightly headache; low energy; Thursday, the second day after the shot: 99.7 temp; stomach and diet off; chest and upper back pressure; deliberate taking of a deep breath; tinny taste in my mouth; thirsty Friday, day three: stomach and die off; chest and upper back pressure; deliberate taking of a deep breath; tinny taste in my mouth; thirsty Saturday, day four: chest and upper back pressure; deliberate taking of a deep breath; tinny taste in my mouth Sunday, day five: chest and upper back pressure; deliberate taking of a deep breath Monday, day six: chest and upper back pressure; deliberate taking of a deep breath Tuesday, day seven: chest and upper back pressure; deliberate taking of a deep breath Wednesday, day eight: chest and upper back pressure; deliberate taking of a deep breath

Other Meds: Synthroid/Tamoxifen/Vitamin D-3

Current Illness:

ID: 1087393
Sex: M
Age: 42
State:

Vax Date: 02/13/2021
Onset Date: 03/05/2021
Rec V Date: 03/10/2021
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: Unilateral sudden hearing loss, left ear. Normal tympanogram, normal temporal CT. No headache, visual change, dizziness, otalgia, tinnitus. Symmetrical facial movements. Exam was consistent with conductive hearing loss. Was referred to ENT, started on corticosteroids. Outcome undetermined.

Other Meds: Losartan 50mg once daily Atorvastatin 20mg

Current Illness: No illnesses prior

ID: 1087394
Sex: F
Age: 43
State: FL

Vax Date: 02/17/2021
Onset Date: 02/24/2021
Rec V Date: 03/10/2021
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: Covid arm 3-4 inch itch welt

Other Meds: None

Current Illness: None

ID: 1087395
Sex: F
Age: 44
State: FL

Vax Date: 03/01/2021
Onset Date: 03/01/2021
Rec V Date: 03/10/2021
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: Migraine headaches, dizziness, nausea, weakness, numbness, pins and needles, palpitations, ringing in ears, clamminess, hot flashes

Other Meds: Vitamin C, multivitamin , vitamin D

Current Illness:

ID: 1087396
Sex: F
Age: 61
State: NY

Vax Date: 03/08/2021
Onset Date: 03/09/2021
Rec V Date: 03/10/2021
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: Severe headache pain in the eyes a lot of pain in the body breast pain the arm swollen and red nausea

Other Meds: Janumet ,rubostatin 40 lisinopril , e omoprazol

Current Illness: Bladder infection

ID: 1087397
Sex: M
Age: 71
State: IN

Vax Date: 02/26/2021
Onset Date: 03/01/2021
Rec V Date: 03/10/2021
Hospital:

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

Lab Data:

Allergies: lipitor (sinus issues)

Symptom List: Unevaluable event

Symptoms: After a few days, a rash appeared on both legs from foot to buttock. Very itchy, worse at night. It lasted about 10 days.

Other Meds: rosuvastatin and ecotrin

Current Illness: none

ID: 1087398
Sex: F
Age: 41
State: TX

Vax Date: 03/06/2021
Onset Date: 03/07/2021
Rec V Date: 03/10/2021
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: Woke up with a severe headache, threw up, had chil. A rash on my neck developed that was red, itchy, and scaly and has persisted for 4 days.

Other Meds: Adderall XR

Current Illness: none

ID: 1087399
Sex: F
Age: 27
State:

Vax Date: 03/05/2021
Onset Date: 03/05/2021
Rec V Date: 03/10/2021
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:

Symptom List: Injection site pain, Pain

Symptoms: Extreme fatigue, weakness, myalgias, drowsiness, night sweats, abd pain, bloating, GERD, joint pain,

Other Meds: Loe loestrin fe, omeprazole

Current Illness: Chronic migraines

ID: 1087400
Sex: F
Age: 40
State: NY

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 03/10/2021
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, omeprazole

Symptom List: Injection site pain, Menorrhagia

Symptoms: blurred vision, diaphoresis, hypotension, placed in trendelburg position

Other Meds:

Current Illness:

ID: 1087401
Sex: M
Age: 32
State: TN

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 03/10/2021
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: NKA

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

Symptoms: Pt was riding with parents through drive through clinic. Received vaccine and proceeded to observation area, after approximately 13 minutes, pt's parent honked the horn and flagged down paramedic. Upon arrival, paramedic stated pt had a blank stare and was unresponsive. Supervisor notified and EMS was called. Pts hand began to tremor at 0940. VS were: BP 120/74, HR 100. Pt broke his blank stare, and stopped tremoring at 0949. EMS arrive at 0950. blood sugar taken- 123. Pt able to confirm orientation to self and location.

Other Meds: Kepra, Topamax, Singulair, Albuterol PRN, Fish Oil, Fluoxetine, Straterra, Benadryl

Current Illness:

ID: 1087402
Sex: F
Age: 46
State: TN

Vax Date: 02/22/2021
Onset Date: 03/04/2021
Rec V Date: 03/10/2021
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: reddening of the area around the injection approx 3"x5" in size, warm& tender to touch, lasted about 5 days

Other Meds: NADOLOL, NORTRIPTYLINE, ASHLYNA BIRTH CONTROL, RELPAX

Current Illness: NO

ID: 1087403
Sex: F
Age: 46
State: NJ

Vax Date: 02/28/2021
Onset Date: 03/08/2021
Rec V Date: 03/10/2021
Hospital:

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

Lab Data:

Allergies: n/a

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Rash at injection site, bruising, dull pain in the area that reaches up to collar bone, itchiness

Other Meds: Co q 10, Vitamin B, D3, Multi, Omega 3, Ester C

Current Illness:

ID: 1087404
Sex: F
Age: 70
State: GA

Vax Date: 03/04/2021
Onset Date: 03/04/2021
Rec V Date: 03/10/2021
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: Penicillin

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

Symptoms: Pt reports that after receiving her vaccine at 11:15AM, she waited until 11:35AM to leave. No adverse reactions at that time. Within 5-10 minutes of leaving, she reports dizziness and lightheadedness that started and continued all night. Upon waking 03/05/2021, the dizziness/lightheadedness continued. After getting up out of bed, she reports LOC for unknown length of time around 8:15AM. Head injury occurred at the time of the fall. Another incident of LOC for < 5 minutes occurred at 12:00PM. Husband took to the ER, 4 staples to the back of her head. CT of head was negative.

Other Meds: None reported

Current Illness: None reported

ID: 1087405
Sex: F
Age: 76
State: IN

Vax Date: 03/05/2021
Onset Date: 03/07/2021
Rec V Date: 03/10/2021
Hospital:

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

Lab Data:

Allergies: n/a

Symptom List: Nausea

Symptoms: Had chills for 3 hours in middle of night..

Other Meds: Evista, latanoprost, timolo maleate, raloxifene, allegra, vitamin D, lutein,

Current Illness: n/a

ID: 1087406
Sex: F
Age: 32
State: NY

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 03/10/2021
Hospital:

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

Lab Data:

Allergies: Contrast Medium (unknown type) and Morphine

Symptom List: Injection site pain

Symptoms: 13:49: Pfzier Vaccine administered to Left Deltoid 13:55: patient complained of tongue "thickening" 13:56: patient complained of shortness of breath and concerned with taking Benadryl 13:58: patient complained of drowsiness. 911 called 14:00: patient complained of chest pain BP 135/98, P104, PO2 96 14:03: BP 125/100 P 94 PO2 92 14:05: PT states I cant lift my legs 14:06: PT tolerated sips of water. Benadryl 25 mg PO given BP 122/86 P98 PO2 94

Other Meds:

Current Illness:

ID: 1087407
Sex: M
Age: 18
State: NY

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 03/10/2021
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: Fever, chills, numbness and tingling of face, weakness, headache, sore throat, rapid heart rate.

Other Meds:

Current Illness:

ID: 1087408
Sex: F
Age: 69
State: MO

Vax Date: 02/15/2021
Onset Date: 02/15/2021
Rec V Date: 03/10/2021
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: No

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

Symptoms: Fever started about 5:00pm and lasted 24 hours. Started feeling drowsy about 4 hours after the vaccine. I slept for about 2 days and couldn't stay awake. Headache started that evening. I still have the headache 3 weeks later with no relief. My right cheek and gums hurt so bad too.

Other Meds: Preservision, multivitamin, baby aspirin

Current Illness: No

ID: 1087409
Sex: M
Age: 34
State: CT

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 03/10/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None known

Symptom List: Tremor

Symptoms: Fever (101 degree), headache, muscle aches, chills. Treated with tylenol and rest. So far it seems to be helping.

Other Meds: 300mg Allopurinol, 2.5mg lisinopril, 300mg gabapentin, 100mg sertraline, 100mg minocycline, 50,000 units vitamin d

Current Illness: N/A

ID: 1087410
Sex: M
Age: 76
State: IN

Vax Date: 03/01/2021
Onset Date: 03/01/2021
Rec V Date: 03/10/2021
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: Penicilin

Symptom List: Erythema, Pruritus

Symptoms: The morning after the second Covid 19 shot I woke up with soar joints, fatique,. dizzy. Throughout the day chills, then hot, no energy.

Other Meds: Losartan Metoprolol Rosuvastatin

Current Illness:

ID: 1087411
Sex: F
Age: 40
State: FL

Vax Date: 03/08/2021
Onset Date: 03/08/2021
Rec V Date: 03/10/2021
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: Janssen COVID-19 Vaccine EUA About 6 hours after receiving vaccine, sudden onset of fever to 101 degrees with chills. About two hours after the fever began, extreme fatigue and muscle and joint pain, and left breast pain began (had the injection in my left arm). The extreme fatigue lasted for about 9 hours, during which time I felt like I could barely walk or move in bed. After the extreme fatigue passed, and for about 24 hours, I continued to experience moderate fatigue, joint and muscle pain, and headaches. A bad headache has bothered me for about 36 hours since the extreme fatigue passed. All symptoms are now clearing up (it is now about 42 hours post vaccination).

Other Meds: Allegra 24 hr (180 mg)

Current Illness:

ID: 1087412
Sex: F
Age: 31
State: MA

Vax Date: 01/08/2021
Onset Date: 01/30/2021
Rec V Date: 03/10/2021
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: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: Positive PCR test after second COVID vax

Other Meds:

Current Illness:

ID: 1087413
Sex: F
Age: 16
State: CA

Vax Date: 03/07/2021
Onset Date: 03/07/2021
Rec V Date: 03/10/2021
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: Rocephin

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Patient was given Moderna and is under the age of 18

Other Meds: Concerta

Current Illness: Unknown

ID: 1087414
Sex: F
Age: 46
State: MA

Vax Date: 01/25/2021
Onset Date: 02/28/2021
Rec V Date: 03/10/2021
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: fever, sore throat, cough, nasal congestion, headache

Other Meds:

Current Illness:

ID: 1087415
Sex: F
Age: 70
State: MI

Vax Date: 03/04/2021
Onset Date: 03/06/2021
Rec V Date: 03/10/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: no

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

Symptoms: pt states she had headache, chills, muscle pain. she developed red rash all over her body with some spots that are swollen. She went to her PCP on 3/8/2021. He told her she was allergic to the vaccine and told her take Benadryl. She has FU appt on 3/12/2021. Pt states the rash is still present, still spreading, itchy and swollen. The rash has been from head to toe.

Other Meds: Eliquis, metoprolol, Montelukast, Multivitamin, Magnesium, Probiotic, Calcium

Current Illness: no

ID: 1087416
Sex: F
Age: 22
State: VA

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 03/10/2021
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: Janssen COVID-19 Vaccine EUA Nausea, headache, fever, muscle soreness

Other Meds: None, but i took some ibuprofen around 9pm that night

Current Illness: None

ID: 1087417
Sex: F
Age: 75
State: MD

Vax Date: 03/01/2021
Onset Date: 03/01/2021
Rec V Date: 03/10/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: Sulfa

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

Symptoms: Headache, muscle/body ache, chills No fever, no nausea

Other Meds: Vitamin D3, cholestyramine powder, acetaminophen as needed

Current Illness: None

ID: 1087418
Sex: F
Age: 50
State: OH

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 03/10/2021
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: NKDA

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

Symptoms: WITHIN 5 MINUTES OF RECEIVING VACCINE PATIENT BEGAN FEELING VERY LIGHTHEADED, SWEATING, AND SPINNING. PATIENT SAID SHE NEEDED TO LAY DOWN. AS WE BEGAN LAYING HER DOWN SHE DID PASS OUT. AFTER LAYING ON THE GROUND WITH ELEVATED LEGS SHE REGAINED CONCIOUSNESS WITHIN ABOUT 30 SECONDS OR SO. PATIENT CONTINUED TO LAY AND THEN SLOWLY SIT UP. AFTER APROX 20 TO 30 MINUTES SHE WAS FEELING OK AND WAS ABLE TO GO HOME

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1087419
Sex: M
Age: 65
State: IL

Vax Date: 03/01/2021
Onset Date: 03/02/2021
Rec V Date: 03/10/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Pt received 2nd Moderna COVID vaccine on 3/1/21. He experienced some aches, pains, and a stuffy nose for about 5 days. Pt used Tylenol as needed.

Other Meds: Cosentyx, folic acid, Cymbalta, Niacin ER, carvedilol, methotrexate, valsartan, pravastatin, glucophage, fenofibrate

Current Illness:

ID: 1087420
Sex: F
Age: 70
State: MI

Vax Date: 03/06/2021
Onset Date: 03/06/2021
Rec V Date: 03/10/2021
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: codeine - shortness of breath penicillin - shortness of breath

Symptom List: Vomiting

Symptoms: Patient received vaccine in the morning 3/6/2021. In the evening, patient developed multiple episodes of profuse diarrhea. She did become lightheaded, fell, and 'broke my tailbone.' She did see a family medicine physician 3/8/2021 - patient did pass out per the note but did not hit her head. +camps -nausea -emesis No known contacts to anyone with illness or diarrhea

Other Meds: none

Current Illness: felt well at time of vaccination

ID: 1087421
Sex: M
Age: 62
State:

Vax Date: 03/01/2021
Onset Date: 03/07/2021
Rec V Date: 03/10/2021
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: Itching and swelling at injection sight. Turned red and is about 3" in diameter.

Other Meds:

Current Illness: none

ID: 1087422
Sex: F
Age: 29
State: MN

Vax Date: 03/08/2021
Onset Date: 03/09/2021
Rec V Date: 03/10/2021
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: Chills, tiredness, muscle aches, fever

Other Meds: None

Current Illness: None

ID: 1087423
Sex: M
Age: 55
State: AZ

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 03/10/2021
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: Penicillin

Symptom List: Injection site swelling, Limb discomfort

Symptoms: About 9:00 PM got chills. Finally broke around midnight and after that was hot and achy. Today body aches, head ache, and eyes hurt. This is a similar reaction to what I have with the flu vaccine. I no longer get the flu vaccine because of this.

Other Meds: Vitamins C, D, and B Complex

Current Illness: None

ID: 1087424
Sex: F
Age: 74
State: MA

Vax Date: 03/08/2021
Onset Date: 03/08/2021
Rec V Date: 03/10/2021
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: On the day of the vaccine I got nauseous about 12:00. This lasted until bedtime. Throughout the night I experienced chills, an earache and my skin was very sensitive to the touch. Upon rising about 9:00 those symptoms went away and I became nauseous again and my bones aches like I had the flu. Woke up the second day after the vaccine and I am completely well. It is like a switch gets turned off and your well again!!

Other Meds: Leithiroxine

Current Illness:

ID: 1087425
Sex: F
Age: 65
State: IN

Vax Date: 03/05/2021
Onset Date: 03/06/2021
Rec V Date: 03/10/2021
Hospital:

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

Lab Data:

Allergies: Sulfa drugs

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

Symptoms: Chills, headache, lethargic. Following day red hot spot the size of a softball 2 inches below injection site. This lasted for 3 days before fading to just a red spot.

Other Meds: Crestor, levithoroxine, lisinopril, metoprolol, Vitamins C and D, zinc

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm