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: 1089050
Sex: F
Age: 37
State: IA

Vax Date: 03/05/2021
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:

Symptom List: Dysphagia, Epiglottitis

Symptoms: woke up with eye swelling. Now with jaw and chin numbness

Other Meds: Multivitamin

Current Illness:

ID: 1089051
Sex: M
Age: 24
State: CA

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

Lab Data:

Allergies: Pork

Symptom List: Anxiety, Dyspnoea

Symptoms: Patient was given dose one of Moderna vaccine this morning. Patient returned to our site around 1230 pm with ?facial swelling.? He also reported throat itching and tightness.

Other Meds: Unknown

Current Illness: No

ID: 1089052
Sex: M
Age: 87
State: NC

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

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

Symptoms: Vaccine was at room temperature for>6 hours at time of administration.

Other Meds:

Current Illness:

ID: 1089053
Sex: F
Age: 67
State: MS

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

Lab Data:

Allergies: anaprox

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Approx 2 min after receiving vaccination pt complained of throat swelling, toes tingling, and headache. VS: 158/64, P 66, 02 98% RA, R 18. Benadryl 50 mg IM R deltoid administered. Transferred by EMS to hospital.

Other Meds: unknown

Current Illness: unknown

ID: 1089054
Sex: F
Age: 64
State: CA

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:

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

Symptoms: patient feels a slight tingling sensation on L hand. Vitals 97% RA 85 bpm 141/87 Bp 19 cpm #21 pt stable and sent home

Other Meds:

Current Illness:

ID: 1089055
Sex: F
Age: 53
State: OH

Vax Date: 03/10/2021
Onset Date: 03/10/2021
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: Questionable Bees, contrast IV dye, shellfish, spiders

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

Symptoms: Speech garbled, client complained of tongue swelling. Client was given EPi Avi Q injection. Following injection client self amdministered PO Benadryl. Then taken by EMS to ER.

Other Meds: Unknown

Current Illness:

ID: 1089056
Sex: F
Age: 80
State: CA

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

Lab Data:

Allergies: NKA

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Pt denied any complaints upon arrival to vaccine site at 1205. After vaccine, pt states to observation team that she has been dizzy for a few days and is now feeling dizzy at 1225. ALS assesment at the vaccine site revealed HTN and pt remained dizzy. ALS transport was arranged at 1227 and transported pt to Emergency dept. Medics from vaccine site completed EPCR reporting system. PFIZER Covid 19 EUA

Other Meds: Unknown

Current Illness: HTN, DIZZY, LIGHT HEADED

ID: 1089057
Sex: M
Age: 90
State: CA

Vax Date: 03/03/2021
Onset Date: 03/05/2021
Rec V Date: 03/10/2021
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: amoxicillin, cephalexin, ciprofloxacin, clindamycin, sulfa

Symptom List: Pharyngeal swelling

Symptoms: Acute Pulmonary Embolism, and Acute Deep Vein Thrombosis. He is active every day doing arm exercises and walking in place for exercise, and moving about his house with his walker, and this day was no different. He finished making breakfast and went to sit down on the couch, and had sudden-onset pleuritic chest pain. No other recent risks such as long car ride, illness, plane ride, or other immobility. Patient says the vaccine was Moderna second dose, given at pharmacy.

Other Meds: simvastatin, clopidogrel

Current Illness:

ID: 1089058
Sex: F
Age: 31
State: TN

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

Lab Data:

Allergies: None

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Hives on right side of face. Tightness in chest.

Other Meds: Prozac and adderall

Current Illness: Sinuses/runny nose

ID: 1089059
Sex: F
Age: 61
State: IN

Vax Date: 03/06/2021
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: Phenobarbital, Prisolec

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Sore dark red patch will pealing dry skin on top. About the size of a quarter. Red sore patch on the roof of my mouth, also the size of quarter.

Other Meds: Losartan, Hydrochlorothiazide, Metformin, Ezetimibe, Bupropion HCL

Current Illness: no

ID: 1089060
Sex: M
Age: 68
State: MA

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: unknown

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

Symptoms: Mental status changes. Did not know how to turn TV off. Seemed confused to wife

Other Meds: unknown

Current Illness: unknown

ID: 1089061
Sex: F
Age: 81
State: NC

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

Symptom List: Rash, Urticaria

Symptoms: Vaccine was at room temperature for>6 hours at time of administration.

Other Meds:

Current Illness:

ID: 1089062
Sex: F
Age: 57
State: PA

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: LA

Lab Data:

Allergies: Biaxin, Valium, Penicillin, Succinylcholine

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

Symptoms: at 11 hours past the vaccination time (COVID #2) I developed a rapid heartbeat > 90 and body aches. They intensified 18 hours later and lasted another 24 hours. I also had dry heaves(once only) and loose bowels. I am diabetic and my sugars also went crazy. I had to visit my cardiologist for an EKG to make sure there wasn't a problem with my heart. I had to call my diabetes doctor several times for help with how to handle my numbers.

Other Meds: Levothyroxine, Bystolic, Vitamin D3, Nexium, Simvastatin, Xyzal, Mucinex, Pepcid, Wellbutrin, Metformin

Current Illness: none

ID: 1089063
Sex: F
Age: 62
State: MO

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

Lab Data:

Allergies: PATIENT REPORTED PREVIOUS ALLERGIES TO PRESERVATIVES BUT COULDN'T STATE WHICH PRESERVATIVES

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

Symptoms: PATIENT STATED SHE FELT LIGHT HEADED ALMOST IMMEDIATELY AFTER THE IMMUNIZATION. SHE DIDN'T REPORT THAT TO ANYONE AT THE TIME AND SHE SAID IT GOT BETTER BEFORE SHE LEFT THE IMMUNZATION AREA. SHE SAID THE NEXT EVENING (3/3/21) AROUND 6PM SHE STARTED TO EXPERIENCE SHORTNESS OF BREATH AND LOOKED AT HER THROAT AND SAID IT SEEMED SWOLLEN, SHE TOOK BENADRYL AND STATED THE SHORTNESS OF BREATH DIDN'T GET WORSE AND RESOLVED WITHIN ABOUT 2 HOURS. SHE ALSO STATED SHE FELT ACHY AND FLULIKE WITH CHILLS AND FEELING FEVERISH BUT WITH NO FEVER. SHE FELT PRETTY ACHY AND TIRED FOR A COUPLE OF DAYS AND THEN EVERY THING RESOLVED.

Other Meds:

Current Illness:

ID: 1089064
Sex: F
Age: 48
State: PA

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

Lab Data:

Allergies: N/A

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

Symptoms: Exhaustion, sore hips, skin felt like it hurt to touch, sleeplessness during evening because of being uncomfortable, slept all day following day and felt out of it. Could not sleep comfortably following night either. Very strong arm pain. Two days later itchy injection site and very red. Felt better by 10 AM on the second day after shot.

Other Meds: Sudafed D, Omeprazole, Vitamin D, Allegra 24 hour, Biosil Collagen Supplement

Current Illness: N/A

ID: 1089065
Sex: F
Age: 74
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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: went to bed

Other Meds:

Current Illness:

ID: 1089066
Sex: F
Age: 39
State: CA

Vax Date: 02/03/2021
Onset Date: 02/14/2021
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: NA

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

Symptoms: I started experiencing twitching on my right leg and arm at random hours of the day and night

Other Meds: Estradiol 0.0325mg patch Medroxyprogesterone 2.5mg

Current Illness: NA

ID: 1089067
Sex: M
Age: 78
State: LA

Vax Date: 03/02/2021
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: Pt had facial paralysis on one side of face. Pt reporting right side of face was drooping.

Other Meds:

Current Illness:

ID: 1089068
Sex: F
Age: 54
State: CA

Vax Date: 03/09/2021
Onset Date: 03/09/2021
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:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Lightheaded, facial tingling, weird sensation in left hand. BPs 166/102 (pulse 84), 160/97 (pulse 77), O2 sats 100%.

Other Meds:

Current Illness:

ID: 1089069
Sex: F
Age: 19
State: TX

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

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

Symptoms: Patient began experiencing difficulty breathing a few hours after getting her covid 19 vaccine. She took benadryl and zyrtec to relieve the symptoms. About 3 days later the symptoms started back and again she took the benadryl and zytrec. She is currently symptom free.

Other Meds: none

Current Illness: none

ID: 1089070
Sex: F
Age: 32
State: OH

Vax Date: 03/10/2021
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: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Sulfa

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

Symptoms: Tachycardia-heart rate up to 140's. Resolved with deep breathing and rest. Physician notified-observe. Client denies "anxiety reaction". Left after 30 minutes of observation with heart rate in the 90's.

Other Meds: Birth Control

Current Illness: N/A

ID: 1089071
Sex: F
Age: 25
State: TN

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: Morphine, grass/pollen, certain adhesives

Symptom List: Unevaluable event

Symptoms: Painful, hard, red swollen lump at injection site. Began hours after vaccination and continues to grow, now at 1.5" in diameter.

Other Meds: Natazia (birth control)

Current Illness: none

ID: 1089072
Sex: F
Age: 49
State: CO

Vax Date: 01/16/2021
Onset Date: 01/23/2021
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: LA

Lab Data:

Allergies: None known

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

Symptoms: 1/23/2021: Seven days after receiving Moderna vaccine, arm was bright red, hot to the touch and swollen in area approx 6" in diameter. Went to ER and was prescribed 5-day Keflex regimen for Cellulitis. Area cleared up after four days of antibiotics. 1/28/2021: Itchy red rash appears from injection site down to elbow. Doctor visit. Was prescribed Aristocort cream and Claritin. Rash cleared up after several days of treatment. 2/13/2021: Received second vaccine and developed same symptoms one day later. Used Aristocort cream and Claritin. Rash cleared up five days later.

Other Meds: Metformin 500mg (2x daily) Simvastatin 40mg Lisinopril 20mg Omeprazole 20mg Portia Tab 0.15mg levonorgestrel/0.03mg ethinyl estradiol Aspirin 80mg

Current Illness: None

ID: 1089074
Sex: M
Age: 68
State: NY

Vax Date: 02/24/2021
Onset Date: 03/07/2021
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: None known

Symptom List: Injection site pain, Pain

Symptoms: Patient was admitted to facility May 7 2021 with hemolytic anemia. Recent surgery for lung cancer but had not started adjuvant chemotherapy. No antecedent hematologist or autoimmune problems. Had Moderna Covid vaccine at facility 02/24/2021. I am inclined to think we need to report to FDA. Please advise.

Other Meds: Gabapentin, albuterol, aspirin 81, multivit, rosuvastatin, Trulicity, Wixela

Current Illness: Adenocarcinoma of lung with right upper lobectomy 2/1/2021. Has not started adjuvant chemotherapy

ID: 1089076
Sex: F
Age: 52
State:

Vax Date: 02/09/2021
Onset Date: 02/15/2021
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: Sulfa

Symptom List: Injection site pain, Menorrhagia

Symptoms: Large warm welt at injection site, tightness, swelling of left arm. Swollen tongue. Lasted 2 days. Did not take any medication for symptoms.

Other Meds: Vitamin D, Omega 3

Current Illness: None

ID: 1089077
Sex: F
Age: 58
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: SYR
Vax Site: LA

Lab Data:

Allergies: N/A

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

Symptoms: patient developed a rash and hives on head neck and face. Patient went to work and was identified to have an adverse reaction to the Janssen immunization. Patient was sent to the clinic for treatment and was told to use Benadryl for the rash. patient did take two capsules for a 50 mg dose. Patient worked about two to three hours and was then sent home for high blood pressure which patient claims lasted three hours. Patient is feeling fine on 03/10/2021 and says they do not have a rash today.

Other Meds: Vitamin D

Current Illness: N/A

ID: 1089079
Sex: F
Age: 73
State: AZ

Vax Date: 02/20/2021
Onset Date: 02/24/2021
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: Nitrofurantoin, metronidazole, ciprofloxacin

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: I had aching in my armpit off and on when reaching up for about a week.

Other Meds: Lisinopril, amytriptyline, rosuvastatin, vitamin D-3, Estroven, CO Q 10

Current Illness: None

ID: 1089080
Sex: F
Age: 65
State: AZ

Vax Date: 02/26/2021
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: RA

Lab Data:

Allergies: Iodine, latex, eggs, cranberries, blueberries

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: On March 9, 2021, 11 days after receiving the Moderna COVID-19 vaccine, I woke with a left sore arm that felt similar to the sore arm I experienced after receiving the vaccine. As the day progressed I developed a rash beginning near the injection site that eventually spread from my shoulder to just above my elbow. The rash is not raised, warm to the touch with mild itching. Left arm is slightly swollen.

Other Meds: 1) Zyrtec: on the day I received the Moderna COVID-19 vaccine I premedicated with a one time dose of 1.25mg (cut 10mg tablet into 8ths) one hour before vaccine, per the recommendation. 2) Vitamin C.

Current Illness: none

ID: 1089081
Sex: M
Age: 81
State: GA

Vax Date: 02/15/2021
Onset Date: 02/15/2021
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: My ears felt "slightly stuffed" similar to the change in elevation after my first shot. First the left side then the right side but it cleared up in about three hours. This was no big deal but a friend of mine that is retired from the CDC said I should report it. I get my second shot on March 15th,

Other Meds: Zyrtec, Glucosamine, Mucinex, Losartan, Multi Vitamin, Omeprazole, Simvastatin, Synthroid, Flovent, Proair

Current Illness: High Blood Pressure, Asthma

ID: 1089082
Sex: M
Age: 69
State: NC

Vax Date: 02/12/2021
Onset Date: 03/06/2021
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: NONE

Symptom List: Nausea

Symptoms: HAD BELLS PALSY 8 YEARS AGO MODERNA VACCINE 1ST DOSE 2/12/2021 3/6/2021 HAD TINGLING LIP THAT PROGRESSED TO DROOPING FACE AND EYE TO CENTER ON 3/8/2021 AND RECIEVED PRED PACK AND ACYCLOVAIR

Other Meds: benazepril hcl 20 mg bid hctz 25 mg bid protonix 40 mg qd acyclovair for 7 days ,started 3/8/2021 prednisone decreasing doses to end 3/18/2021 aleve and Tylenol prn

Current Illness: NONE

ID: 1089083
Sex: M
Age: 43
State: CA

Vax Date: 01/06/2021
Onset Date: 01/07/2021
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: Injection site pain

Symptoms: Patient reported symptoms of fatigue, headache, muscle/body aches, and runny nose that lasted longer than 72 hours.

Other Meds:

Current Illness:

ID: 1089084
Sex: F
Age: 54
State: VA

Vax Date: 03/06/2021
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: Lactose; Allergies (grass, trees, weeds, pollen)

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

Symptoms: I experienced severe vertigo. I visually saw the room spinning. I had to close my eyes but I still felt the spinning in my head. I used the wall to lean on to get down on the floor. Lasted about 1 1/2 - 2 minutes with nausea. I never had vertigo. When I went to bed I had an ache under my left breast. It eventually subsided.

Other Meds: Fluoxetine 10mg, Triamterene/HCTZ 37.5/25 mg - half tab, Rhinocort allergy spray, Olopatadine HCL nasal spray, Zyrtec

Current Illness: None

ID: 1089085
Sex: F
Age: 52
State: NC

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

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

Symptoms: Pain in arm was minimal but became very sleepy and developed headache Thursday evening following covid vaccine. Slept 10 hours. 03/05 sinus pain, headache worse. 03/06 slept most of the day. achy, lack of appetite, 03/07 no pain in arm but body aches and continued strong headache & fatigue. Contacted Teledoc on 03/08, Dr. suggestion Acute upper respiratory infection with secondary diagnosis serum reaction due to vaccination. 03/09 continued headache, chills, body aches, fatigue, ringing in ears fever (no working thermometer). Took Covid test, results due by Friday. 03/10 continued headache, fatigue, occasional chills, not able to smell, ears ringing. Ibuprofen, Extra strength tylenol and Excedrin migraine not helping headache.

Other Meds: norgestimate-ethinyl estradioL 0.25-35 mg-mcg per tablet

Current Illness: None

ID: 1089086
Sex: F
Age: 57
State: OH

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

Lab Data:

Allergies: Sulfa drugs, seasonal allergies

Symptom List: Tremor

Symptoms: Approx 5 minutes after I received the IM injection I developed SOB, Heart rate was in the 160's, b/p-158/90. I was lightheaded and thought I was going to pass out. My blood pressure has never been that high. Nor have I ever had a HR like that. My body was shaking so much that I couldn't hold on to the water bottle they gave me( d/t developing a very dry mouth.) This lasted about 8 min and then my HR started to go back down.

Other Meds: zoloft, wellbutrin

Current Illness: None

ID: 1089087
Sex: F
Age: 36
State: LA

Vax Date: 03/03/2021
Onset Date: 03/04/2021
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: Erythema, Pruritus

Symptoms: Patient described numbness on one side of the face. No drooping or paralysis. Which Side of face unknown.

Other Meds:

Current Illness:

ID: 1089088
Sex: F
Age: 24
State: CA

Vax Date: 03/09/2021
Onset Date: 03/09/2021
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: Peanuts, latex, MSG, sulfa

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

Symptoms: 5:20pm Pt c/o scratchy throat , itchy arm, hard to breath, and light headedness. 5:35pm BP 102/58 O2 sat 97% pulse 93 5:35pm gave pt 50mg of Benadryl PO 5:40pm pt states scratchy throat improving, breathing improving BP 102/68 O2 sat 99% pulse 93 6:00pm BP 112/70 O2 sat 99% pulse 83 6:10pm BP 108/72 O2 sat 99% pulse 87

Other Meds: Lexapro, Lamotrigine, omeprazole, Prazosin, multi-vit, Allegra D, Buspar

Current Illness:

ID: 1089089
Sex: F
Age: 69
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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Opiates Hymenoptera

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

Symptoms: About 5 hours after vaccination, unusual ?stingy? headache and tiredness, some malaise after nap. Symptoms lessened, then disappeared during morning of next day. About 30 hours after vaccination, hot flashes (no fever), chills, tired, but jittery with difficulty sleeping, dizzy, head felt ?weird?, - mostly diminished in morning. About 48 hours after vaccination, headache and tiredness returned -still no fever. Very little soreness in arm over the past two days since injection.

Other Meds: Hydroclorothizide, ZetIa,Crestor Centrum Silver for Women, CaCO3, CoQ10, Omega-3, Vit.D, cinnamon,

Current Illness: None

ID: 1089090
Sex: F
Age: 52
State: TX

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

Lab Data:

Allergies: Bactrim-hives

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Brief episode of lightheadedness 5 mins. post vaccination. O2 sat 100%, HR 86

Other Meds: Allegra

Current Illness: None

ID: 1089091
Sex: M
Age: 64
State:

Vax Date: 02/12/2021
Onset Date: 02/22/2021
Rec V Date: 03/10/2021
Hospital: Y

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: Patient received 1st COVID vaccine on 2.12.21. Reported to local ER with chest pain and increased ShOB on 2.22.21. Found to be positive for COVID, elevated troponin. Transferred to medical center. Patient was mildly hypoxic on the floor but never required more than 2L nasal prongs. Patient is currently on dialysis. Patient received dexamethasone therapy only while on the floor. Discharged home on 3.4.2021.

Other Meds:

Current Illness:

ID: 1089092
Sex: M
Age: 66
State: VA

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

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

Symptoms: Throat tightness- Given Benadryl oral to resolve symptoms

Other Meds: Allopurinol/ Atorvastatin/ Janumet/Jardiance/ Losartan

Current Illness:

ID: 1089093
Sex: F
Age: 67
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: LA

Lab Data:

Allergies: None

Symptom List: Pain in extremity

Symptoms: Tired, chills, headache, fever, diarrhea, cramps

Other Meds: Lexapro Biotin Cholesterol med

Current Illness: None

ID: 1089095
Sex: F
Age: 49
State: NY

Vax Date: 03/02/2021
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: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: Sulfa and laratabs

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

Symptoms: I started with a rash on my chest which spread to my abdominal area and very top part of my thighs

Other Meds: Hydroxychloroquain 200 mg 2x daily

Current Illness:

ID: 1089096
Sex: F
Age: 35
State: TX

Vax Date: 02/08/2021
Onset Date: 02/10/2021
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: None

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

Symptoms: Very ill for 5 days, entire illness lasted 8 days. Fatigue, muscle aches, headache, and sore throat. I took Tylenol and rested.

Other Meds: Zoloft 100mg, Prenatal Vitamin

Current Illness: None

ID: 1089097
Sex: M
Age: 64
State: SC

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:

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

Symptoms: Flu like symptoms, muscle aches, fever, headache, pain at injection site

Other Meds: Tylenol, prior to getting vaccine

Current Illness:

ID: 1089098
Sex: F
Age: 84
State: CA

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

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: Patient fell and hit back of head (remained conscious). Silver dollar-sized swelling. No bleeding. BPs 233/85, final BP 202/90. O2 sat 97%. Sent to ED.

Other Meds:

Current Illness:

ID: 1089099
Sex: F
Age: 17
State: MN

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

Lab Data:

Allergies: Unknown

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Post clinic it was discovered that client was inadvertently vaccinated with Moderna and client was only 17. Client registered thru new electronic registration system. System has since been updated to prevent underage clients from registering. Nurse recalled that this client verbally told him she was 18 but he stated he did not compare it to the birthdate. Going forward he will confirm age and date of birth. Per CDC guideline, client will be scheduled for second dose.

Other Meds: Unknown

Current Illness: Unknonw

ID: 1089100
Sex: M
Age: 36
State: NC

Vax Date: 03/02/2021
Onset Date: 03/05/2021
Rec V Date: 03/10/2021
Hospital: Y

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: Woke up on Friday morning (3/5) with severe neck pain and vertigo. Tried to walk to bathroom and was falling over to the right side and felt very nauseous. Starting throwing up. Arrived at ER around9:30AM and was diagnosed with vertigo and discharged a few hours later. He slept most of the day but woke up for a few minutes to take medicine on Friday evening and told me his vision was blurry. He went back to sleep and slept until Saturday (3/6) morning around 9:30. He told me his vision was still really blurry so we went back to the ER. They did an MRI and MRA and saw that he had two strokes. The strokes have affected his vision and he still has blurry vision and is not able to see well peripherally.

Other Meds: None.

Current Illness: None.

ID: 1089101
Sex: M
Age: 46
State: CT

Vax Date: 01/29/2021
Onset Date: 01/31/2021
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: Nothing

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Rapid heart rate = hospitalization.

Other Meds: Nothing

Current Illness: Nothing

ID: 1089102
Sex: F
Age: 50
State: FL

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

Lab Data:

Allergies: citrus, antibiotics

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

Symptoms: The first day, fatigue and diarrhea. Day 7 started as a lump now day 8 today, its the size of a grapefruit, redness, and warm to the touch

Other Meds: Paramin, B12, Garlic Pill

Current Illness: no

ID: 1089103
Sex: F
Age: 78
State: CA

Vax Date: 02/15/2021
Onset Date: 02/23/2021
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: No

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

Symptoms: Red rash that lasted two weeks and is still slightly red and irritated. Used cortizone cream, which helped somewhat.

Other Meds: Simvastatin, Losartan, Potassium Chloride, Hydrochlorothiazide, Vitamin D, Biotin, Vitamin B12

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm