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: 1087541
Sex: F
Age: 20
State: KY

Vax Date: 03/10/2021
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: unknown

Symptom List: Dysphagia, Epiglottitis

Symptoms: patient received moderna covid vaccine via im route started experiencing shortness of breath pharmacist administered benedryl and epi pen

Other Meds: unknown

Current Illness: unknown

ID: 1087542
Sex: F
Age: 17
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: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: patient is 17 not 18

Other Meds: n/a

Current Illness:

ID: 1087543
Sex: F
Age: 40
State: XL

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

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: OFLOXACINO

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

Symptoms: High blood pressure, tachycardia, difficulty breathing air, mental confusion, dizziness, nausea, asthenia, numbness arms hands and legs, couldn't move arms, flushing facial on neck and arms, hyporexia.. applied hydrocortisone and medication to reduce blood pressure.. I was hospitalized for 3 hours and they sent me home.. reoccurance 12 hours later but with greater intensity and I was hospitalized again.. I am the patient and I am a medical doctor..

Other Meds: NONE.

Current Illness: NO

ID: 1087544
Sex: F
Age: 43
State: SD

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: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Patient returns to vaccine location two hours after vaccine, stating within minutes she had sensation of tingling on the left side of her face and tongue. No other symptoms. Vaccine clinic was closed for the day, encouraged to seek care at an acute care. Confirms understanding.

Other Meds:

Current Illness:

ID: 1087546
Sex: M
Age: 65
State: FL

Vax Date: 02/28/2021
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: none

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

Symptoms: Pain runs from pelvis to clavicle, dry cough, fatigued, aching(most noticeable), happens in 2-3 hour spurts, headache on front left lobe, happened once Thursday twice yesterday, through the night, and this morning. Not as strong as before but still going. Has tried to self medicate with extra Norco, and tylenol but did not help For many people the headache, fatigue, and aches tend to happen after receiving the vaccine. The pain radiating from your pelvis to your clavicle is not a symptom I have seen and can be something unrelated to the vaccine or COVID, if symptoms persist check with PCP or go to ED.

Other Meds: Nifedipine 90mg qd Olmesartan 40mg Meclezine Zofran 4mg Norco 10/325 1/2 tab qd Metoprolol Succinate 200mg Sertraline 100mg qd Gabapenten 600mg qd

Current Illness:

ID: 1087547
Sex: F
Age: 68
State: IN

Vax Date: 02/24/2021
Onset Date: 02/24/2021
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: Azulfadine

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

Symptoms: Continuing pain in left arm from date of vaccination on 2/24/2021. No other side effects like fever. Took ibuprofen and used a heating pad. Went to PCP today and have prescription for MOBIC to help with discomfort and suggested icing and movement of affected arm. Will get next vaccine shot 03/20/2021 at 8:20 am in right arm and hope that I don't the same side effect in that arm. Is it possible to get the injection in a different muscle site?

Other Meds: Carvedilol, Losartan, Amlodipine, Sertraline, and Pravastatin. Low dose aspirin, calcium, fish oil.

Current Illness: NA

ID: 1087548
Sex: F
Age: 61
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: none known

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: I felt no immediate side effects of the shot, but 2 hours later, while sitting calmly, my heart rate suddenly elevated and I began to feel light headed. My home blood pressure monitoring kit provided a reading of 149/99 and a resting heart rate of 108. Normally, my blood pressure is very well maintained with my meds and hovers in the 118/75 range. My resting heart rate is usually below 70. I was going to dial 911 but within 5 minutes, my heart rate began to slow down and I felt better. When I rechecked my numbers at 8 pm, BP was down to 118/80 and resting heart rate was 70.

Other Meds: 160 mg Diovan once/day 5 mg Amlodipine Bestylate once/day

Current Illness: none

ID: 1087549
Sex: F
Age: 37
State: NJ

Vax Date: 02/16/2021
Onset Date: 03/10/2021
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:

Symptom List: Pharyngeal swelling

Symptoms: Triggered periodic Fever sydrome, chronic fatigue headaches body aches joint pain hives - took steroids

Other Meds: Arcalyst, Dupixent, Colcrys, Botox every 10 weeks, metformin, durezal eye drop, Wellbutrin, Xanax as needed, proair, low dose naltrexone, topical steroids, vit d, vit c, melatonin, Benadryl, biotin

Current Illness: Ehlers Danlos Syndrome, POTS, migraines

ID: 1087550
Sex: F
Age: 76
State: NY

Vax Date: 02/01/2021
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: IM
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Heavy, aching legs from the knee down. Knees throb. Right shoulder intermittent aching. Walking affected in that the aching reduced distance I could comfortably cover. Dragging body after a walk beyond a quarter of a mile. worst symptoms in the evening and night. Sleep disturbed on many nights. tylenol helped but did not always allow for a good sleep.

Other Meds: none

Current Illness: none

ID: 1087551
Sex: F
Age: 46
State: CA

Vax Date: 03/02/2021
Onset Date: 03/09/2021
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: Pain, but not as bad as day 1. Warm, red patch with one bump in the center, about 5 in long and 3 in across. The bump is sometimes itchy.

Other Meds: Lipitor, 1aday vitamins, restasis

Current Illness: None

ID: 1087552
Sex: F
Age: 69
State: NY

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

Lab Data:

Allergies: Seasonal allergies to pollens, dust mites, cat dander

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

Symptoms: About 9 hours after the injection, I experienced chills, increased heart rate, and headache. I began taking alternate doses of aspirin and acetaminophen. By 5 a.m., chills were gone.

Other Meds: Metrogel for rosacea

Current Illness: None

ID: 1087553
Sex: F
Age: 79
State: MI

Vax Date: 02/16/2021
Onset Date: 02/16/2021
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: Unknown medication that causes coughing.

Symptom List: Rash, Urticaria

Symptoms: Following the vaccine she was at the grocery store around 5:00 PM, her granddaughter asked her why her mask was red, and she noticed that she had a dripping nose bleed, and left and by the time she got home it was done. Then, 2/21/21, she had another nose bleed, was at a pizza place in the car, and felt like she had to spit and it was blood and had a smaller nose bleed that did not last night. The next one 2/26/21, was in the store and had a dripping nose bleed again, took a while to get it stopped, but by the time she left the store she was fine. Then Saturday 2/27/21, she kept getting up in the night and had nose bleeds off and on, and managed through the night and the morning. She went to the ER in the morning on 2/28/21, and her nose was packed with dissolving packing and gave her a prescription for 3 pills to take to prevent her from getting an infection. During the night Sunday night she had a very bad night and went to the ER again on 3/1/21 at around 5:00 AM. They then packed her nose with a balloon and then got the first prescription filled that she took. On Wednesday she went back to the ER and they removed the balloon and now has been fine. Her Coumadin has been up and down during this period of time. Her INR reading was 4.5 on 2/28/21, and subsequently has gone down to where it is quite low. No issues with the injection site. She has never had nosebleeds prior to the vaccine. In October/November she had a procedure she had a hernia repair and had a COVID test and since then she has had a tinge on tissue, but not a nose bleed. These were mainly on the right until she had the profuse one, and then it was both nostrils as well as coming out of her mouth. Has an appointment with the ENT on 3/18/21.

Other Meds: Vitamin D, Cozaar, Aldactone, Amiodarone, Coumadin. Glucosamine chondroitin, mega Q-plus, C0Q10.

Current Illness: None.

ID: 1087554
Sex: F
Age: 42
State:

Vax Date: 02/25/2021
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:

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

Symptoms: One week after my vaccination my left arm felt sore down to my hand and my hand felt a little numb. The day after on March 5 in the afternoon my arm felt hot and there was a sort or lump just below the injection area and it was swollen and red about a 3 inch circle. This lasted Friday, then the swelling began to go down and was hardly noticeable the next evening except for a some redness that lasted for a few more days.

Other Meds: propranolol

Current Illness:

ID: 1087555
Sex: M
Age: 41
State: IL

Vax Date: 02/09/2021
Onset Date: 02/09/2021
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: PCN - Anaphylaxis

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

Symptoms: Pt received dose 1 of PfizerBiontech COVID Vaccine AT 1318. He was observed 30min without complaint and left without incident. He returned at 1356 c/o" throat and chest tightness." Upon assessment, wheezing is noted bilaterally. Resp Rate and Work of Breathing Within Normal Limits. Denies any other complaints and exhibits no further signs or symptoms. Albuterol/Atrovent Neb as well as IV Benaryl 50mg administered on scene and patient states his tightness is improving/resolving. Continues to denye further Complaints. Responding units Fire Department and Ambulance arrive on scene and care handed over to crew. Assessments, care, and treatment continued enroute and patient transported to ED

Other Meds:

Current Illness:

ID: 1087557
Sex: F
Age: 30
State: TN

Vax Date: 01/02/2021
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: None

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

Symptoms: Miscarriage following COVID vaccine.

Other Meds: Prenatal

Current Illness: None

ID: 1087558
Sex: M
Age: 32
State: TX

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: IM
Vax Site: LA

Lab Data:

Allergies: Allergy to pollen only

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

Symptoms: 32 y/o male with history of allergic rhinitis here for first COVID vaccine (Pfizer). Within 20 minutes or so of being vaccinated (the patient was observed for 15 minutes and then left as per normal procedure, went upstairs to get medications at the pharmacy when started to have symptoms) - throat tightness/fullness/feeling of constriction but no inability to swallow or breathe. Walked back to the vaccination area for evaluation. No prior reactions to medications or vaccines. No rash, itching, dyspnea, lightheadedness. Symptoms coincident to vaccination with COVID-19 Pfizer vaccine - throat tightness, sinus fullness and chest heaviness. No abnormalities on physical exam or vitals other than slight elevation in BP. Due to progression of symptoms, lack of resolution treated with antihistamine and epinephrine 0.3mg IM left thigh. Called 911 to transport patient for observation in the ED.

Other Meds: Flonase Allegra Motrin Pentanol

Current Illness: None

ID: 1087560
Sex: M
Age: 82
State: IA

Vax Date: 03/04/2021
Onset Date: 03/04/2021
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: prednisone and penicillin

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

Symptoms: - covid shot Thursday at 1445 - upper lip swelling at 1730 Thursday - Friday fine til evening and was complaining of itching - Saturday morning red raised areas that were itchy on back, buttocks, and back of thighs. Denies discharge. - today better, areas still there, but lighter in color and has not complained of itching so far.

Other Meds: amiodarone, amlodipine, asa, atorvastatin, bisoprolol, sinemet, catapres, furosemide, amaryl, losartan, metformin,

Current Illness: anemia that is worsening

ID: 1087561
Sex: F
Age: 41
State: TX

Vax Date: 03/05/2021
Onset Date: 03/06/2021
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: codeine, imitrex, sulfa drugs

Symptom List: Ear pain, Hypoaesthesia

Symptoms: 4 days fever over 102, vomiting, day 2 unable to stand or walk, shortness of breath for 3 days to the point it was hard to talk. day 3, delayed skin reaction hive at injection site, along with hives on chest, back, thighs. both feet and both hands fully numb for 3 days. severe headache.

Other Meds:

Current Illness:

ID: 1087562
Sex: F
Age: 47
State: NC

Vax Date: 03/05/2021
Onset Date: 03/06/2021
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: Biaxin, Pneumonia vaccine

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Received vaccine at 825 am, low grade temp, chills, body aches, temp never over 100.4, at approximately 1:00am woke up to use restroom, felt lightheaded, nauseated. Passed out, hit head and had tonic-clonic seizure. No history of syncope or seizures. Transported to ER by EMS. given fluids, completed labwork and CT head, given concussion protocol. Discharged and arrived home by 5:00am.

Other Meds: Eliquis 2.5mg, Prilosec 20mg, Celexa 20mg, Dicyclomine

Current Illness: None

ID: 1087563
Sex: M
Age: 72
State: FL

Vax Date: 03/01/2021
Onset Date: 03/03/2021
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: Onset of pain in mid/lower right quadrant of abdomen, fever, nausea, fatigue roughly 60 hours after injection. Vomiting began 75 hours after injection. Symptoms lasted 96 hours.

Other Meds: Ramipril, AmLODIPine, Carvedilol, Rosuvastatin, Zetia, Nexium, Aspirin,co-Q-10, D3, Magnesium, Fish Oil, Multivitamin

Current Illness:

ID: 1087564
Sex: F
Age: 51
State: LA

Vax Date: 01/08/2021
Onset Date: 01/09/2021
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: Dairy

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

Symptoms: I exp low grade fever 100.5 on Saturday, diarrhea and severe joint pain.On Wed/Thurs I had to miss work due symptoms.

Other Meds: Metoprolol, Multaq, Eliquis, Prozac, Gabapentin

Current Illness: No

ID: 1087565
Sex: M
Age: 55
State: VA

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: LA

Lab Data:

Allergies: Unverified childhood adverse response to penicillin

Symptom List: Unevaluable event

Symptoms: General malaise within 1 hour of injection. Worsening to fever, chills, severe headache, and nausea within 6 hours of injection. No medication taken. Symptoms returned to general malaise 30 hours after injection.

Other Meds: Berkley & Jensen, Cetirizine Hydrochloride, 10mg, 03/08/2021, 8:00 AM

Current Illness: None

ID: 1087566
Sex: F
Age: 17
State: LA

Vax Date: 02/23/2021
Onset Date: 03/05/2021
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: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

Symptoms: Patient is younger than 18. No other side effects from shot. She works at the pharmacy on register and the patient and her parents wanted her to get the vaccine

Other Meds: Fluoxetine 40mg

Current Illness: No

ID: 1087567
Sex: F
Age: 55
State: IN

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

Lab Data:

Allergies: Night shades

Symptom List: Injection site pain, Pain

Symptoms: Fever up to 102 Severe headache for 24 hours Nausea Chills Severe joint pain - felt like I was in fire

Other Meds: Multi vitamin Supreme B vitamins Zyrtec

Current Illness: None

ID: 1087568
Sex: M
Age: 66
State: WI

Vax Date: 02/17/2021
Onset Date: 02/18/2021
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: Injection site pain, Menorrhagia

Symptoms: Vomit 2/18/21 12 hours Diarrhea 2/18/21 8 hours Sore muscles 2/18/21 - 2/19/21 48 hours, Advil Fatigue 2/18/21 - Current date Ache in the back of my head, lower right side 2/18/21 - Current date, Aleve helps it for short periods Bell's Palsy 2/25/21 - Current date, no medication

Other Meds: Medicine 09/28/20 1 Hydrochlorothiazide 25mg 1 Atenolol 50mg 1 Amlodipine 10mg 1 Atorvastatin 40mg 2+2 Glyburide 5mg 2+2 M

Current Illness: Covid

ID: 1087569
Sex: F
Age: 73
State: PA

Vax Date: 02/22/2021
Onset Date: 02/23/2021
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: None

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

Symptoms: Pt felt dizzy and started shaking, and then fainted. awoke on the floor had been passed out for greater than 30 minutes per patient.

Other Meds: centrum silver, vitamin B 12, Caltrate, glucosamine chondroitin, tamoxifen, singular.

Current Illness: none

ID: 1087570
Sex: M
Age: 24
State: TX

Vax Date: 03/09/2021
Onset Date: 03/10/2021
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: n/a

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: chills (woke up cold in middle of the night and couldn't stop shivering)

Other Meds: n/a

Current Illness: n/a

ID: 1087571
Sex: M
Age: 59
State: IN

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: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Low grade fever Muscle aches Loss of sleep General malaise

Other Meds: 20 mg. Simvastatin daily 0.5 mg. Cabergoline weekly

Current Illness: None

ID: 1087572
Sex: F
Age: 51
State: PA

Vax Date: 02/23/2021
Onset Date: 02/23/2021
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:

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

Symptoms: Patient was given her first COVID vaccine on 2/1/21 and received Pfizer (EL3302). Upon returning for her second dose on 2/23/21 she did not bring her vaccine card and mistakenly told the vaccination site that her first dose was Moderna. The vaccine site did not confirm this and gave her a Moderna vaccination for her second shot. She had mild headache and neck pain after vaccination which resolved within 1 day. She does complain of intermittent nausea and neck stiffness since vaccination but states it is unknown if this is related to vaccination.

Other Meds:

Current Illness:

ID: 1087573
Sex: F
Age: 69
State: FL

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: RA

Lab Data:

Allergies: nka

Symptom List: Nausea

Symptoms: Client c/o swelling to the site of vaccination. Client seen and assessed by EMT and vital signs are: BP 210/90, O2 98, HR 78. Vital signs were reassessed and client was advised to go to the ER but refused to be transported by EMT. Pt. stated that she would drive herself but advised to call someone to take her and she called her son to come meet with her and accompany her to the ER. Client cleared but strongly advised to go to the ER.

Other Meds: Amlodipine, Humalog

Current Illness: none

ID: 1087574
Sex: F
Age: 59
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: no

Symptom List: Injection site pain

Symptoms: pt stated that she started getting a sore left shoulder the night of getting the vax. Pt woke up w/ headache, body aches, and fever (100.4), loss of appetite. Pt will contact her PCP is her fever doesnt subside.

Other Meds: amlodipine 2.5mg, metoprolol 25mg, multivitamin, calcium, fiber, vitamin D, Ocusight, probiotic

Current Illness: Covid positive in February 2021

ID: 1087575
Sex: F
Age: 71
State: MD

Vax Date: 02/24/2021
Onset Date: 02/25/2021
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: Strawberries, tetanus toxin

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

Symptoms: Although it was fine on 2/24/2021 it became sore on 2/25 and stayed sore. I would see a yellow mark and that was all, but today, I looked in the mirror and there was a rash surrounding the yellow mark. I don't know how long the rash has been there.

Other Meds: Amlodopine besylate, pravastatin, Calcium with D3, D3 capsules

Current Illness: No

ID: 1087576
Sex: F
Age: 67
State: MN

Vax Date: 03/08/2021
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: RA

Lab Data:

Allergies: None

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

Symptoms: Fever up 100.6 for 12 hours, headache, body ache, joint ache, lethargic, vomiting. Started 12 hours after the vaccine was received and lasted for the next 24 hours.

Other Meds: None

Current Illness: None

ID: 1087577
Sex: F
Age: 22
State: NY

Vax Date: 03/02/2021
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: N/a

Symptom List: Tremor

Symptoms: Site of vaccine is swollen, warm, itchy, skin has a red circle around the site

Other Meds: Venlafaxine HC L ER 37.5 mg

Current Illness: N/a

ID: 1087578
Sex: M
Age: 58
State: IN

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

Lab Data:

Allergies: None that I knew of

Symptom List: Erythema, Pruritus

Symptoms: Shaking, Confusion, Head Ache

Other Meds: Metformin Lisinpril Glipizide Norvasc

Current Illness: N/A

ID: 1087579
Sex: F
Age: 57
State: FL

Vax Date: 03/05/2021
Onset Date: 03/05/2021
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: Headache, muscle ache near the chest, no cough, general malaise

Other Meds: rosuvastatin

Current Illness:

ID: 1087580
Sex: F
Age: 70
State: TX

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: Penicillin

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

Symptoms: High fever, headache, muscle pain, neck pain, dizziness, tremors starting with in 7 hours of injection lasting all night and next day

Other Meds: CARVEDILOL 25MG TAB TEV TWICE A DAY (morning & evening) (BP) LISINOPRIL/HCTZ 20-12.5MG TAB LEG DR K TWICE A DAY (morning & evening) (BP) GLIPIZIDE XL 5MG TAB GRE ONCE A DAY (morning) (BLOOD SUGAR) LEVOTHYROXIN 100MCG TAB

Current Illness: none

ID: 1087581
Sex: F
Age: 32
State: OH

Vax Date: 03/07/2021
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: No known

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Red swollen spots on arm of injection site

Other Meds: Prenatal vitamin Claritin Colace

Current Illness: None

ID: 1087582
Sex: M
Age: 60
State: CA

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

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

Symptoms: Itchy rash came 7 days after shot

Other Meds:

Current Illness:

ID: 1087583
Sex: F
Age: 50
State: MO

Vax Date: 02/27/2021
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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Developed full blown rash on my lower back probably the size of a fist now. I now have a rash across the back of my neck and scattered bumps on my arms and thighs. Extremely itchy...

Other Meds: Hydrochlorothiazide 12.5 mg, Pravastatin 20mg

Current Illness: None

ID: 1087584
Sex: F
Age: 40
State: CA

Vax Date: 02/06/2021
Onset Date: 02/13/2021
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: Sulfa

Symptom List: Pain in extremity

Symptoms: hives all over my body including my eyelids

Other Meds: Humira 40 mg, diclofenac, trazadone 100mg, Xanax .5 mg as needed, Zoloft, Botox injections

Current Illness:

ID: 1087585
Sex: F
Age:
State: FL

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

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

Symptoms: Caller is a M of unknown age reporting he has just called PC. He took the first dose of the Johnson and Johnson COVID-19 vaccine at 1000 on 3/5 and wants to know if he can take ibuprofen or acetaminophen for a headache. Advised caller would need to contact MD or pharmacist for advice.

Other Meds:

Current Illness:

ID: 1087586
Sex: F
Age: 78
State: MD

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

Lab Data:

Allergies: Penicillin

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

Symptoms: :Took vaccine at 1:15pm March 9 then 12 hours later at 1:15 am March she started shivering and threw up once. Felt lousy. Headache No rashes, injection site clear. No fever Took Tylenol 9:30 am for headache

Other Meds: None

Current Illness: NA

ID: 1087587
Sex: F
Age: 27
State: TX

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

Lab Data:

Allergies: None

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

Symptoms: Janssen COVID-19 Vaccine EUA Sore arm, woke up at 1:00am with chills but no fever. I went back to sleep. When I got up at 5:40am, I had a headache and my body was aching. I took ibuprofen. After a few hours, those symptoms are much milder.

Other Meds: Vyvanse, Tylenol

Current Illness: None

ID: 1087588
Sex: M
Age: 35
State: TN

Vax Date: 03/06/2021
Onset Date: 03/07/2021
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: n/a

Symptom List: Vomiting

Symptoms: fatigue and headache starting 1 day after injection. Mild rash on torso 4 days post infection.

Other Meds: Zyrtec - 10 mg/day Lipitor - 40 mg/day

Current Illness: n/a

ID: 1087589
Sex: F
Age: 95
State: NC

Vax Date: 02/13/2021
Onset Date: 03/08/2021
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:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Resident recieved 2nd dose of Moderna vaccine 2/13/2021. During routine testing, resident tested positive for COVID-19 on 3/8/2021 -- 24 days out from last dose of vaccine. Resident is asymptomatic. Resident previously tested positive for COVID-19 on 11/30/2020.

Other Meds:

Current Illness:

ID: 1087590
Sex: F
Age: 52
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: RA

Lab Data:

Allergies: None

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

Symptoms: Pfizer-BioNTech COVID-19 Vaccine EUA Injection site pain, swelling and redness x 3 days Tiredness x 2 days Headache x 2 days Muscle pain x 2 days Chills x 2 days Joint Pain x 2 days Fever up to 104.0 degrees x 2 days Nausea x 2 days Feeling Unwell x 2 days Swollen Lymph node left collarbone x 4 days

Other Meds: Octagam IV monthly 60gm of 5% Levothyroxine Sodium 0.2mg am ac Cytomel 5mcg QD Singulair 10mg HS Viberzi 100mg BID Nadolol 40mg QD Fluoxetine 40mg QD Omeprazole 40mg QD Ambien 10mg HS Citrus Bergamot 500mg bid Align probiotic qd B-Complex w

Current Illness: None

ID: 1087591
Sex: M
Age: 53
State: IN

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

Lab Data:

Allergies: None

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Strong Headache for about 18 hours, and full body muscle ache for about 24-36 hours.

Other Meds: QVAR RediHaler (beclomethasone dipropionate HFA) and Omeprazole 20MG.

Current Illness: None

ID: 1087592
Sex: M
Age: 63
State: IN

Vax Date: 03/08/2021
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: RA

Lab Data:

Allergies: n/a

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

Symptoms: sudden fever spike followed by intense vomiting/dry heaves which lasted most of the day but has eased in the day following...

Other Meds: lisinipril, atenolol,

Current Illness: covid19 but was tested to be negative.

ID: 1087593
Sex: F
Age: 42
State: PA

Vax Date: 01/29/2021
Onset Date: 02/12/2021
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: Z-pak - Zithromax/ Azithromycin

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

Symptoms: 2 weeks after receiving the Moderna vaccine I started to have rheumatoid arthritis (RA) joint pain in my hands, shoulders, feet, knees, elbows. My RA has been stable for over a year. The only change was getting the vaccine. I started taking prednisone to help with the flare ups at the instruction of my doctor - . I am currently taking 10mg a day. I started taking prednisone on 2/18/21.

Other Meds: Remicade infusion (every 4 weeks), Daily: Leflunomide 2 - 10mg, Hydroxychloroquine 2- 200mg, Calcium 600mg, D3 50mcg, One a Day Women's vitamin, Allegra 180mg 24hr, Dymista nasal spray 137-50mcg 2 sprays.

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm