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: 1091243
Sex: F
Age: 42
State: KS

Vax Date: 03/10/2021
Onset Date: 03/10/2021
Rec V Date: 03/11/2021
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: YEAST

Symptom List: Dysphagia, Epiglottitis

Symptoms: Pharmacy knew that patient was experiencing symptoms (chest tightening) at 3:50pm. Unknown the exact time of outset of symptoms. Patient progressed to coughing and shortness of breath. Patient remained responsive. Pharmacist asked patient if she could administered epi-pen. Patient said yes. Pharmacist administered epi pen and call 911 at 3:58pm, pharmacist stayed with patient till paramedics arrived. Symptoms somewhat improved and patient left with paramedics.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1091244
Sex: M
Age: 49
State: FL

Vax Date: 03/10/2021
Onset Date: 03/11/2021
Rec V Date: 03/11/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None known

Symptom List: Anxiety, Dyspnoea

Symptoms: Pain in arm at injection site, hives up side of neck and face

Other Meds: Losartan 12.5 mg, Vitamin C, Vitamin B Complex, Baby Aspirin, Claritin, Gabapentin 600mg

Current Illness: High blood pressure, herniated disc lower back

ID: 1091245
Sex: F
Age: 19
State: NC

Vax Date: 03/04/2021
Onset Date: 03/04/2021
Rec V Date: 03/11/2021
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: nut, soy

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

Symptoms: Itchy feet, hands, arms, mouth. Throat began to feel tight. Eyelids began to itch.

Other Meds:

Current Illness:

ID: 1091246
Sex: F
Age: 55
State: OK

Vax Date: 03/01/2021
Onset Date: 03/02/2021
Rec V Date: 03/11/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Having tingling on the left side of my face and left leg. Feels like my leg is asleep. My face feels like after you go to the dentist and the numbing is going away. It has gotten better but still having some numbness under my left eye and inside my left nostril.

Other Meds: Meloxicam Simvastatin Vitamin d Multivitamin Salmon oil Turmeric Estrogen Vesicare

Current Illness:

ID: 1091247
Sex: F
Age: 28
State: FL

Vax Date: 03/02/2021
Onset Date: 03/05/2021
Rec V Date: 03/11/2021
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: Underarm lymph node swelling and tenderness began 3 days after injection and has continued trough today ( 10 days after vaccination) and redness, inflammation, itching sensation has started at vaccine site today on left arm.

Other Meds: Birth control: Enskyce

Current Illness:

ID: 1091249
Sex: M
Age: 52
State: VT

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 03/11/2021
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: Body aches, HA, Fever, unable to come in for next shift

Other Meds:

Current Illness:

ID: 1091250
Sex: F
Age: 53
State: NJ

Vax Date: 03/05/2021
Onset Date: 03/06/2021
Rec V Date: 03/11/2021
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: Pyrexia, White blood cell count decreased

Symptoms: injection pain, nausea, dizziness, headache immediately following injection pain, swelling in underarm 2 days following injection Continues to be problematic

Other Meds: Taking tylenol for injection pain. Developed severe pain under left arm / armpit accompanied by rash and redness. Sought medical attention on Monday, March 8, 2021 when symptoms did not subside. Was diagnosed with infection in lymph note

Current Illness: Pain in left calf after having Covid infection and prior to vaccine

ID: 1091251
Sex: M
Age: 55
State: MI

Vax Date: 02/03/2021
Onset Date: 02/17/2021
Rec V Date: 03/11/2021
Hospital:

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

Lab Data:

Allergies: none known

Symptom List: Pharyngeal swelling

Symptoms: On 2/17/2021 patient complained of not feeling well, noted to be hypotensive, was sent to Medical Center Emergency Department for further evaluation. Diagnosed with COVID-19 infection.

Other Meds: coumadin, midodrine

Current Illness: obesity, end stage renal disease, a-fib

ID: 1091252
Sex: M
Age: 68
State: TX

Vax Date: 03/11/2021
Onset Date: 03/11/2021
Rec V Date: 03/11/2021
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: nausea, headache on left , right and fronntal face

Other Meds: none

Current Illness: per patient, borderline diabetes and hypertension

ID: 1091253
Sex: F
Age: 38
State: AK

Vax Date: 03/08/2021
Onset Date: 03/09/2021
Rec V Date: 03/11/2021
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: peanuts, tomatoes, latex, flu

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Symptoms days 1-3 following vaccination: body aches, sore/tender arm, muscle aches, fever, headache, body aches, Fever no longer present on day 3 (today), arm soreness improved; all other symptoms still present on day 3 following vaccination.

Other Meds: Synthroid 150mcg, chlorthalidone, calciferol 25mcg OTC: calcium and vitamin D

Current Illness: none

ID: 1091254
Sex: M
Age: 81
State: IL

Vax Date: 03/11/2021
Onset Date: 03/11/2021
Rec V Date: 03/11/2021
Hospital:

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

Lab Data:

Allergies: NKA

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

Symptoms: Partial dose - vaccine leaked at needle hub.

Other Meds: Unknown

Current Illness: None

ID: 1091255
Sex: F
Age: 58
State: TX

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 03/11/2021
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: Developed shingles 10 days after 2nd dose was received. Diagnosed 3/11/2021 and prescribed Famciclovir @ Dr. office.

Other Meds: losartan amlodipine carvedilol diuretic vitamin d3 alive 55 vitamin calcium

Current Illness:

ID: 1091256
Sex: M
Age: 16
State: CA

Vax Date: 03/10/2021
Onset Date: 03/11/2021
Rec V Date: 03/11/2021
Hospital:

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

Lab Data:

Allergies: Amoxicilin

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

Symptoms: Patient was age 16 at time vaccine was given. No side effects observed at time of vaccination or during 15 minute observation period. Follow up phone call 24 hours after vaccination the patient related only arm soreness.

Other Meds: Concerta, Fluoxetine, Cyproheptadine

Current Illness:

ID: 1091257
Sex: F
Age: 49
State: WV

Vax Date: 03/11/2021
Onset Date: 03/11/2021
Rec V Date: 03/11/2021
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: Nausea, Vomiting and cold sweats

Other Meds: Linsinopril Tabs 10mg 1 daily Metformin Hcl Tabs 500 mb 2 daily Estradiol Tabs 1 mb 1 daily Low Dose Asprin 81 mg 1 daily Lansorpazole 15 mg 1 daily B-12 1 daily Calcium 600 mg 1 daily Multivitamin 1 daily

Current Illness: None

ID: 1091258
Sex: M
Age: 66
State: WI

Vax Date: 01/14/2021
Onset Date: 01/15/2021
Rec V Date: 03/11/2021
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: Sulfa,Nsaids

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

Symptoms: On 1/15 when I woke exp throbbing pain in right hand thumb,index, long finger.) The next day less pain dint have to take any Tylenol.

Other Meds: Tylenol

Current Illness: No

ID: 1091259
Sex: F
Age: 58
State: VT

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 03/11/2021
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: Body aches, HA, Fever, unable to come in for next shift

Other Meds:

Current Illness:

ID: 1091260
Sex: F
Age: 58
State: CA

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 03/11/2021
Hospital:

Vax Type: DTAPHEPBIP
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: DTAP + HEPB + IPV (PEDIARIX)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies: None

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

Symptoms: 11:00 pm - woke up sore - took benadryl 1 pill 2:00 am - woke up with total body aches - took motrin 800 mil tired the next day

Other Meds: Vit C Vit D Womens Multi Fish Oil Hormone Replacements - Medroxprojesteone 2.5mg, Estradrol 1 mg

Current Illness: None

ID: 1091261
Sex: F
Age: 47
State: FL

Vax Date: 03/10/2021
Onset Date: 03/10/2021
Rec V Date: 03/11/2021
Hospital:

Vax Type: HIBV
Manufacturer: MERCK & CO. INC.
Vax Name: HIB (PEDVAXHIB)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies: n/a

Symptom List: Ear pain, Hypoaesthesia

Symptoms: sever flu like symptoms. Then chest tightening and inability to breathe. Spouse called 911.

Other Meds: n/a

Current Illness: n/a

ID: 1091262
Sex: F
Age: 16
State: KY

Vax Date: 03/10/2021
Onset Date: 03/11/2021
Rec V Date: 03/11/2021
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: Sore arm

Other Meds: None

Current Illness: None

ID: 1091263
Sex: M
Age: 41
State: NY

Vax Date: 02/25/2021
Onset Date: 03/04/2021
Rec V Date: 03/11/2021
Hospital:

Vax Type: RV1
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: ROTAVIRUS (ROTARIX)
Lot:
Dose Series: 1
Vax Route: PO
Vax Site: MO

Lab Data:

Allergies: none

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

Symptoms: Starting one week after first Moderna dose, experiencing low grade fever, chills, sweating, and myalgia. Still has not resolved after 7 days.

Other Meds: Lisinopril

Current Illness: none

ID: 1091264
Sex: F
Age: 33
State: CT

Vax Date: 03/11/2021
Onset Date: 03/11/2021
Rec V Date: 03/11/2021
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: Penicillin

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

Symptoms: Patient is 4 mos postpartum and is breast feeding Became lightheaded, dizziness and reported visual changes, Supine blood pressure 77/52 HR 100 / min Administered juice . After 5 min supine BP rose to 96/67 Patient continued to feel dizzy and EMS called Extremities were cool to touch Standing BP 60/42 following arrival of EMS (Patient felt weak and unable to stand Placed on stretcher and transported to Hospital Chest clear Airway Clear No wheezing .

Other Meds: None

Current Illness: None

ID: 1091265
Sex: F
Age: 72
State: WA

Vax Date: 02/28/2021
Onset Date: 02/28/2021
Rec V Date: 03/11/2021
Hospital:

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

Lab Data:

Allergies: Soy causes me IBS.

Symptom List: Unevaluable event

Symptoms: Within seconds of receiving the vaccine shot in my arm, I felt a feeling of a nerve sensation shooting across my lower face. My lower face, both sides, turned numb. I also instantly got a headache, not severe, the pain was about a 4 on a scale of 1 to 10 with 10 being the worst. After waiting 15 minutes, I asked to talk to a medical person and was directed to an EMT. I explained my facial numbness and he knew nothing about it and just said to see a doctor if it moved to any other part of my body. Over the following days, my jaw, lips and gums have been feeling a numb tingling feeling, exactly as if I have had Novocain at the dentist and it is wearing off. After one week, the symptoms were continuing and I was worried, so I called the advice nurse. After explaining my symptoms to her she advised me to immediately have someone drive me to the nearest emergency room. I went to the ER where I was seen by the dr. He did some research and said there have been a couple of other reports of people having these symptoms. He thought they would go away and wasn?t concerned. It has been 11 days now and my jaw, gums and lips still feel numb and tingly. The feeling comes and goes.

Other Meds: Biest, Albuterol inhaler, progesterone cream.

Current Illness: None

ID: 1091267
Sex: M
Age: 87
State: CT

Vax Date: 02/26/2021
Onset Date: 03/05/2021
Rec V Date: 03/11/2021
Hospital: Y

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: NKA

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

Symptoms: In one week fell and was in Icu. now in rehabilitation. can't walk. very weak, even voice sounded different. All test were negative. Don't really know what happened.

Other Meds: finasteride low dose aspirin

Current Illness: none

ID: 1091268
Sex: F
Age: 50
State: OH

Vax Date: 03/10/2021
Onset Date: 03/11/2021
Rec V Date: 03/11/2021
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: Fever of 100.9 Chills Body aches

Other Meds:

Current Illness:

Date Died: 02/26/2021

ID: 1091269
Sex: M
Age: 83
State: MI

Vax Date: 02/04/2021
Onset Date: 02/12/2021
Rec V Date: 03/11/2021
Hospital: Y

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

Lab Data:

Allergies: Sulfa, Vancomycin

Symptom List: Injection site pain, Menorrhagia

Symptoms: A home dialysis patient who received his first COVID-19 (Moderna) vaccine on 2/4/2021. He was screened prior to admission into the clinic and reported no signs of symptom of COVID-19. This patient was diagnosed with COVID-19 on 2/12/2021 and hospitalized on 2/16/2021 with COVID pneumonia. The patient's spouse and son (who lives with them) also tested positive for COVID-19. This patient developed COVID-19 complications while inpatient including stroke and mechanical ventilation was required. The patient was made a DNR by family and removed from mechanical ventilation and expired on 2/26/2021.

Other Meds: Aranesp, Amlodipine, Aspirin, Eliquis, Furosemide, Nephrocaps, Tamsulosin, Vitamin D, Renvela, Senna, Tessalon Perles

Current Illness:

ID: 1091270
Sex: F
Age: 54
State: UT

Vax Date: 03/10/2021
Onset Date: 03/10/2021
Rec V Date: 03/11/2021
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: headache, back ache & chills

Other Meds: Bariatric multi vitamin 1 a day Calcium supplements 1500 MG Biotin 10,000 mcg

Current Illness: none

ID: 1091271
Sex: F
Age: 49
State: CA

Vax Date: 02/28/2021
Onset Date: 03/02/2021
Rec V Date: 03/11/2021
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: Nausea, Pain in extremity, Pyrexia

Symptoms: Swollen Lymph nodes at neck Red rash on arm at site of vaccination and up to the neck Painful arm

Other Meds: probiotic, vit D

Current Illness: none

ID: 1091272
Sex: F
Age: 55
State: PA

Vax Date: 01/09/2021
Onset Date: 01/09/2021
Rec V Date: 03/11/2021
Hospital:

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

Lab Data:

Allergies: Latex , shellfish, seasonal allergies , prior reactions to flu shots

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Had swelling at site and lips swelled up from first dose symmetrically but did not affect airway, had chills , and malaise , 2nd dose had more chills fatigue , GI upset , nausea , swelling at site of injection , arm pain couple of small hives on arm no lip swelling with second dose and migranous headache . Was not as bad as prior reactions to flu vaccine but enough to not feel well enough to go in to work Monday . Was able to go to work Tues though after Sat appt .

Other Meds: none , took 1/2 tablet of benydryl approx 1 hour prior to appt because of prior reactions to flu shots

Current Illness: none

ID: 1091273
Sex: F
Age: 43
State:

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 03/11/2021
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 allergy

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

Symptoms: headache, fatigue, body aches, left arm pain, really tired, nausea. All lasted for 2 days after second shot.

Other Meds: zoloft, zyrtec, vitamin multi, nasocort, atorvastatin

Current Illness:

ID: 1091274
Sex: M
Age: 66
State: MD

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 03/11/2021
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 listed

Symptom List: Nausea

Symptoms: Patient may have inadvertently been given 1cc of Moderna COVID vaccine instead of 0.5cc. Patient was notified. State was notified

Other Meds: none listed

Current Illness: not at time of vaccination

ID: 1091275
Sex: F
Age: 17
State: IL

Vax Date: 03/02/2021
Onset Date: 03/02/2021
Rec V Date: 03/11/2021
Hospital:

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

Lab Data:

Allergies: unk

Symptom List: Injection site pain

Symptoms: was a previous VAERS because on 2/2/2021 Health Department had a administration error and gave this 17 year old a Moderna vaccine. Family (Father) was notified and told that error had been made. On 3/9/2021 Health Department saw update on website dated 3/5/2021 with recommendations on what to do for a person who was too young to receive Moderna. Upon looking in our State Immunization Registry , , found that client had received a Pfizer Vaccine in another town in at a . Called and spoke with Pharmacist. Pharmacist on duty was unaware of updates on 3/5/2021 on website for Interim Clinical Considerations for COVID Vaccine. Pharmacist on duty states she does not have access to , State Immunization Registry to see what vaccines have previously been given. Informed Pharmacist that Health Department would submit a 2nd VARES on . She will speak to the lead pharmacist when he works next.

Other Meds: unk

Current Illness: unk

ID: 1091276
Sex: F
Age: 37
State: TX

Vax Date: 03/11/2021
Onset Date: 03/11/2021
Rec V Date: 03/11/2021
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: Passed out, confused, loopy like they Drunk.

Other Meds:

Current Illness:

ID: 1091277
Sex: F
Age: 75
State:

Vax Date: 02/20/2021
Onset Date: 02/20/2021
Rec V Date: 03/11/2021
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:

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

Symptoms: Patient administered 2nd dose Pfizer after receiving 1st dose Moderna by another provider. Patient did not present vaccine card and stated this was first dose.

Other Meds:

Current Illness:

ID: 1091278
Sex: F
Age: 38
State: KY

Vax Date: 03/10/2021
Onset Date: 03/10/2021
Rec V Date: 03/11/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: Post Vaccine 5 to 7 minutes, swelling, red arm, temperature on site, applied ice pack, arm was better after ice pack

Other Meds:

Current Illness:

ID: 1091279
Sex: F
Age: 65
State: CA

Vax Date: 03/02/2021
Onset Date: 03/10/2021
Rec V Date: 03/11/2021
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: Redness, pain, swelling at injection site

Other Meds: Carvedilol, Thorsemide, Atorvostatin

Current Illness:

ID: 1091280
Sex: M
Age: 57
State: MS

Vax Date: 03/05/2021
Onset Date: 03/06/2021
Rec V Date: 03/11/2021
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: Contrast Dye media, grass,tree and weed pollen

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

Symptoms: Moderna Covid-19 Vaccine EUA - 3/6/2021 Went to hospital at 4pm because I was coughing up blood and having a hard time breathing. Air lifted to another Hospital. admitted 19:00 hrs. Chest X-rays 2 sets, CT Scan, Ultrasound, Bloodwork and 2 Covid-19 test. I was told i had pnuemonia followin first chest x-ray on 03/06/2021. on 03/07/2021 after CT Scan and 2nd chest x-ray I was told I did not have pnuemonia or Bronchitus. I was dischrged on 03/08/2021. I have shortness of breath with little to no energy. I am not retired. I own a business and have not been sick until 03/06/2021

Other Meds: Pravastatin, Lisinopril,Amplodipine Besylate, Omega 3 Krill oi

Current Illness: none

ID: 1091281
Sex: F
Age: 33
State: HI

Vax Date: 01/08/2021
Onset Date: 02/08/2021
Rec V Date: 03/11/2021
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: Patient caught COVID, tested positive 02/08/2021. 1st shot: 12/18/2020 Pfizer, Left Arm IM, Lot: EJ1685 2nd shot: 01/08/2021 Pfizer, Left Arm IM, Lot: EL0142

Other Meds:

Current Illness:

ID: 1091282
Sex: F
Age: 52
State: VT

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 03/11/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Chills

Other Meds:

Current Illness:

ID: 1091283
Sex: M
Age: 42
State: CA

Vax Date: 03/04/2021
Onset Date: 03/04/2021
Rec V Date: 03/11/2021
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: Patient was transferred from facility on 2/6/21. Prior to his transfer he had received the first dose of Moderna vaccine n 2/4/21. He received a dose of Pfizer BioNTech vaccine on 2/17/21 at facility where he is now.

Other Meds: Orphenadrine Citrate ER, Oral 100 mg Renu Multipluc, BID Duloxetine HCL, 30 mg BID, Oral

Current Illness: None noted

ID: 1091284
Sex: F
Age: 33
State: NY

Vax Date: 03/07/2021
Onset Date: 03/09/2021
Rec V Date: 03/11/2021
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: Shellfiish, flagyl, diflucan

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

Symptoms: Received injection on the R arm. However, injection was administered very close to the shoulder instead of the deltoid muscle. Area is very swollen and it has not decreased in swelling in several days despite applying ice, taking ibuprorfen, and also applying heat. There is also a knot. I massaged the area to try to loosen the knot. However, I noticed it gets more swollen instead of getting better. The pain subsides momentarily. However, it returns. It is affecting my range of motion, I cannot lift my arm above my head as it causes extreme pain.

Other Meds: Zyrtec

Current Illness: Pre-Diabetes

ID: 1091285
Sex: M
Age: 33
State: NJ

Vax Date: 03/10/2021
Onset Date: 03/10/2021
Rec V Date: 03/11/2021
Hospital:

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

Lab Data:

Allergies: Unknown

Symptom List: Pain in extremity

Symptoms: Client contacted NJCRI on 3/11/21 complaining that on 3/10/21 at 10 pm he began feeling tire, achy throat and this morning 3/11/21 at 8 am began with profuse diarrhea, shortness of breath and heart palpitations. BP taken by patient at home 164/90 and pulse of 140 bpm while nurse triaged on the phone.

Other Meds: Multiple vitamins and other are unknown

Current Illness: Tachycardia hospitalization 3/3 to 3/4/21

ID: 1091286
Sex: M
Age: 25
State: TX

Vax Date: 03/11/2021
Onset Date: 03/11/2021
Rec V Date: 03/11/2021
Hospital:

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

Lab Data:

Allergies: MANGO FRUIT INSECT BITES

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

Symptoms: PT C/O FACIAL FLUSHING, FATIGUE, PAIN IN JOINTS AND A HEADACHE. VS @ 10:46 AM BP 124/93 HR 78 SpO2 98% PT REACTION RESOLVED WITH TIME AND HYDRATION WITH GATORADE.

Other Meds: NONE REPORTED

Current Illness: NONE REPORTED

ID: 1091287
Sex: F
Age: 66
State: MO

Vax Date: 02/18/2021
Onset Date: 02/19/2021
Rec V Date: 03/11/2021
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: Fever 101.5 for 3 days chest pain SOB heaviness in chest upon exertion since 02/19/2021 to present

Other Meds: Meloxicam 7.5mg. Sentry multivitamin & multimineral supplement. Aspirin 81mg once daily for each

Current Illness: None

ID: 1091288
Sex: F
Age: 52
State: IN

Vax Date: 03/07/2021
Onset Date: 03/07/2021
Rec V Date: 03/11/2021
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: Headache, body aches, chills started approximately 6 hours post vaccine. Treated only with Advil and Tylenol . Symptoms, including tiredness, were prominent for first 24 hours; less but still apparent for next 24 hours ( same treatment used). Symptoms resolved by 3 days post vaccine.

Other Meds: Centrum multivitamin for women 50+, 1 daily Fluoxetine, 60mg daily

Current Illness: None

ID: 1091289
Sex: F
Age: 65
State: IN

Vax Date: 03/09/2021
Onset Date: 03/10/2021
Rec V Date: 03/11/2021
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: Tylenol (aceteminophen severe reactions) Tetnus vaccination (1985) Premarin (any medications made from horse serum) Decongestants

Symptom List: Vomiting

Symptoms: Symptoms started around noon the next day and consisted of beginning with chills and then led to a fever of 101.6 for the rest of the afternoon. Ached all over felt like been hit by a truck. Around 9pm the fever broke and then just had slight headache. I was fine the next day.

Other Meds: Synthroid 75mcg once a day Calcium, Magnesium and Zinc once a day D3 (5000 iu) Once a day 81mg aspirin

Current Illness: None

ID: 1091290
Sex: F
Age: 43
State: TN

Vax Date: 03/10/2021
Onset Date: 03/10/2021
Rec V Date: 03/11/2021
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: NKDA

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Patient received Moderna Covid 19 vaccine lot# 031A21A expiration 08/28/2021 0.5ml to right deltoid at 09:45 a.m. on 03/10/2021. Patient verbalized No known drug allergies. Patient was asked to wait in parking lot area for monitoring of adverse reaction. At approximately 09:49 a.m monitoring officer called to RN that patient needed assistance. RN, LPN, EMT-P, LPN and , LPN went to assess patient at her vehicle. Patient reports "she feels like her throat is tingling, itching, and closing up and just weird." Patient also reported that "she could feel her throat swelling." RN assessed for any rash or swelling and patient only with chest redness but no rash. RN assessed vitals. BP 138/90, HR 92, Respirations 14. Patient educated on epi injection and possible side effects and patient verbalized understanding. EMS contacted to come assess. At 09:51 a.m. Epinephrine Injection (Auto Injector) 0.3mg given to right thigh w/o difficulty. Lot# 0FM534, Exp 09/2022. Patient monitored. Patient stated at 09:55 "I can already feel my throat getting better and it doesn't seem to be swelling anymore." EMS arrived at approximately 09:57 to assess patient. Vitals taken by EMT at 10a.m. BP 184/129, HR 88, O2 sat 100%, Respirations 16. EKG performed by EMT . Results were normal. EMT assessed patients throat and patient continues to report "the swelling and tingling is getting better and I do not feel short of breath." EMT recommended ER visit since epi was administered for eval. Patient declined and states "she feels better and knows what to do if reaction starts again." EMT recommended patient to take Benadryl when she gets home and to go to ER with any additional problems. RN checked vitals again at 1012 a.m. BP 172/120, HR 80, Respirations 16. and asked patient to continue to wait for 20 more minutes for additional monitoring. Vitals at 1031 a.m BP 168/110, HR 78, Respirations 16. Patient continues to report "she is feeling much better and ready to go home. Patient left at 10:33 a.m.. Spouse driving. RN contacted patient same day at home at 1353. Patient stated she took 50mg of Benadryl at home and is resting and feeling much better and questioned if she could still get her second dose of moderna vaccine. RN educated she should talk with her Primary Care physician regarding any additional vaccines. Patient verbalized understanding.

Other Meds: Vivance 60mg 1 po daily Ziac 5-6.25mg 1 po daily Xyrem 4.5 g 2 tabs po qhs

Current Illness: None

ID: 1091291
Sex: F
Age: 20
State: MD

Vax Date: 03/10/2021
Onset Date: 03/10/2021
Rec V Date: 03/11/2021
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: N/A

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

Symptoms: Severe muscle pain all over body

Other Meds: Singular

Current Illness: N/A

ID: 1091292
Sex: M
Age: 81
State: MN

Vax Date: 02/13/2021
Onset Date: 02/22/2021
Rec V Date: 03/11/2021
Hospital: Y

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: Sulfa Drugs

Symptom List: Injection site swelling, Limb discomfort

Symptoms: went to the hospital for 5 days and had 5 infusions, one each day. He was diagnosed with Guillain Barre Syndrome. currently in rehab going on 3 weeks now.

Other Meds: Eliquis amiodarone b-12 baby aspirin Flonase loratadine mexiletine Montelukast metoprolol omeprazole Crestor Vyndamax

Current Illness: No

ID: 1091293
Sex: M
Age: 24
State: NC

Vax Date: 03/06/2021
Onset Date: 03/06/2021
Rec V Date: 03/11/2021
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: Janssen COVID-19 Vaccine EUA At 11 PM the night of the vaccine (Saturday), extremely bad chills, fever and weakness set in almost immediately. I could not get my body to warm up and was borderline too weak to walk. Very bad headache and nausea set in as well. After several hours the chills turned to intermittent sweating/cold and I could not keep a consistent body temp, nor sleep that night. The next morning (Sunday) I had very bad aches and soreness, along with chills/fever and headaches that could be managed fine with around the clock acetaminophen. Around 8 PM that night, most of these flu like symptoms subsided. The following morning (Monday), still very exhausted despite a full 10 hours sleep. Tiredness and weakness lasted through the day. Tuesday morning until around 3 PM i still experienced drowsiness and was unable to gain strength for anything more than typical day to day tasks (could not workout). Wednesday morning, felt normal but while exercising experienced shortness of breath almost immediately as well as chest/lung pain easily. Come Thursday I feel 90% normal.

Other Meds:

Current Illness:

ID: 1091294
Sex: F
Age: 51
State: KS

Vax Date: 02/24/2021
Onset Date: 03/10/2021
Rec V Date: 03/11/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Developed a red, hot, slightly elevated spot on the back of arm that received injection on day 14 post vaccination (yesterday). Patient marked area with a pen, to see if it spread overnight. Area did spread and was approx. 9cm x 9cm today when reported to pharmacy.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm