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: 1092627
Sex: F
Age: 62
State: NY

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

Lab Data:

Allergies: Penicllin Sulfar medication

Symptom List: Dysphagia, Epiglottitis

Symptoms: Fever (101) Swelling, pain under arm that was vaccinated, lymph nodes Body chills Headache

Other Meds: Amitriptyline Amlodipine Citalopram Clonidine

Current Illness: none

ID: 1092628
Sex: F
Age: 26
State: NC

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

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

Lab Data:

Allergies: tree nuts, zantac

Symptom List: Anxiety, Dyspnoea

Symptoms: Pt. has a history of dizziness/nausea after vaccination. 15 minutes after this vaccination, she had a short 'seizure-like' episode accompanied with slight shortness of breath. Pt. was also very dizzy and nauseous. Sweating came shortly after. EMS was called immediately when first symptoms began. She was responsive the entire time and reported gradually feeling better after about 5-10 minutes. EMS did a prompt check-up and revealed no unusual findings.

Other Meds:

Current Illness:

ID: 1092629
Sex: F
Age: 61
State: AZ

Vax Date: 03/09/2021
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: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Steroids (all) causes extreme tremors Morphine Demerol Prolia Reclast Zofran Meloxican Fentanyl

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

Symptoms: 4 pm injection 10 pm mind racing unable to sleep 10 pm body ache 2 (scale 0=none 10=worst pain) 11 pm body ache shine bone pain 4 2 am body pain 7 2 am chills 7 3 am uncontrollable leg twitching 10 4 am body pain, fever now twitching 10 7 am body pain, fever, twitching 10 (Still no sleep) 10 am body pain, fever 10 10 am leg twitching 7 12 (Noon) body pain, fever 8 12 leg twitching 4 3 pm body pain, fever 5 3 pm leg twitching 0 6 pm body pain, fever 2 10 pm body pain 1, fever 0

Other Meds: Nexium 40 mg Crestor 5mg Topiramate 25mg Vitamin D 1000mg Zyrtec 25mg

Current Illness: None-Feeling great!

ID: 1092630
Sex: M
Age: 52
State: LA

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

Lab Data:

Allergies: nka

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: 5min following administration of vaccine pt passed out. Within moments pt became responsive. Pt was pale and diaphoretic. Bp 76/54. HR 84. Pt was taken to hospital by ambulance. Pt was d/c from hospital 2hrs later. Pt states he received iv fluids and ekg wnl. Pt states he feels much better.

Other Meds: none

Current Illness: none

ID: 1092631
Sex: F
Age: 62
State: NY

Vax Date: 02/10/2021
Onset Date: 02/18/2021
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: Shellfish, berries, avocado

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

Symptoms: Headache increasing in severity to worse ever felt from Day 8th, February 17th through February 19th. Some relief with Aleve and Tylenol, Having minor to moderate headaches on and off since, relieved by OTC, combination of OTC anti inflammatory or Tylenol.

Other Meds: Norvasc 5 mg po od

Current Illness: None

ID: 1092632
Sex: F
Age: 82
State: IN

Vax Date: 02/19/2021
Onset Date: 02/20/2021
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: NKDA

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

Symptoms: I received vaccine on Friday 02/19/2021 , Saturday woke up with rash on back and pain under left breast went to doctor 02/23/2021, they prescribed cream Triamcinolone Acetonide Cream 0.5%. then went back Monday 03/08/2021 they prescribed Valacyclovir gram every hours for 21 pills and Gabapentin for the pain for what they called shingles .

Other Meds:

Current Illness: none

ID: 1092633
Sex: M
Age: 63
State: CT

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

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: At 9:15 pm. he took three steps and he started shaking. Got home and went to sleep, woke up every couple hours with a stabbing chest pain, chills and sweating. About 10:30 a.m. the next day, he took 800mg of Ibuprofen and slept for a while and feels better.

Other Meds: no

Current Illness: no

ID: 1092634
Sex: F
Age: 79
State: HI

Vax Date: 03/04/2021
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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: n/an/a

Symptom List: Pharyngeal swelling

Symptoms: Moderna C19 Vaccine EUA Mar 5: 3:15 AM arm started hurting. 8:30AM chills, body ache. 11:40 temp 98.6. arm stopped hurting. 12:05 temp 99.5. slight headache. 12:25 temp 99.9. 1PM temp 101. 5PM temp 99.8. Mar 6: 12:30 PM feeling better. no fever, chills, body ache Mar 9 very difficult bowl movement. Mar 10/11 stomach problems diarrhea

Other Meds: n/an/a

Current Illness: n/an/a

ID: 1092635
Sex: F
Age: 36
State: CA

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: None

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: 3? welt at injection site. It?s red, painful and warm. Antihistamine on 3/10 with no change

Other Meds: Armour thyroid, metformin

Current Illness: None

ID: 1092636
Sex: M
Age: 55
State: IN

Vax Date: 03/09/2021
Onset Date: 03/11/2021
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: none

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Swelling around both ankles, itchy skin rash around ankles, which after 4hrs advanced to both calves and after 6hrs to both knees. Rash was more severe on left leg. Took 1 single dose of diphenhyrdramine at 12 pm with little to no effect, took another single dose at 5pm and the rash seemed to stop advancing with less itchiness.

Other Meds: Multi-vitamin, glucosamine with MSM

Current Illness: none

ID: 1092637
Sex: F
Age: 44
State: NC

Vax Date: 02/27/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: On 3/4. I developed a 1 inch fevered hot oval at injection site. It was sore and itchy. It began getting bigger and bigger with fever into the newly expanding area. Went to the doctor on 3/8/21, and Dr. thought that it was cellulitis. He put me on Cephalexin 250 mg 3 times per day for 7 days. It is still there, but lighter in color on 3/11/21. I return to have it rechecked at doctors office tomorrow.

Other Meds: Atenolol, Metformin,

Current Illness: None

ID: 1092638
Sex: F
Age: 47
State: AZ

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: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies: Peanuts, grass

Symptom List: Rash, Urticaria

Symptoms: None

Other Meds: Alegra

Current Illness: Allergies

ID: 1092639
Sex: F
Age: 63
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Septra, Erthomycin, Bentyl, Levaqin

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

Symptoms: Had Bamlanivimab IV on December 9, 2020 at The County Hospital. On 3/9/2021 had first Covid injection. I had slight headache, sore throat, gland in neck swollen, chills and bad hip pain that started about11:00 am on 3/10/202. Today, feeling some better but very tired.

Other Meds: Atenolol, Doxazosin, Novalog, Jardiance, Lasix, Levemir,Lipito

Current Illness:

ID: 1092640
Sex: F
Age: 38
State: CT

Vax Date: 01/21/2021
Onset Date: 01/25/2021
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: adverse reactions - don't do well with medications: Ambien - amnesia; prednisone - manic events

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

Symptoms: atrial flutter pain in right arm , pain kept going up arm but only if you touched it, got on xartorl ( blood thinner) . right forearm was really swollen , tingling and turned blue, went to hospital they did a ultrasound to check pressure in veins. if she had hand at 90 degree angel it wouldnt turn blue but if I drop it it would turn blue. next day ran more test. MRI on arm. taped vitamin c to spot where pain was in arm. developed blood clot. told her to put heat on arm and take pain meds. felt better until she stopped blood thinner feb22, 2021. two days later had more blood clots on arms, veins were showing huge in breast and foot, pants got tighter. feb 27veins in lower leg and neck started appearing more. feb28 my left hand was cold and the veins were showing more and u could see veins. right back veins started appearing , got period but after 12 hours it stopped. march 3 veins started appearing again. march 4 right arm swelled and tingling in fingers and right right arm was so painful. Nerve pain. put back on blood thinner. march 4 in evening was put on new meds. I'm still dealing with pain and different issues. march 9 had a Val moment but had tingling from butt to brain . next morning felt miserable, nauseous , throwing up and couldnt control it. 3/11 neck is swollen. referring her to university because no doctor can figure out what it is.

Other Meds: Parnate 20 mg twice a day; Lexical - 200 mg twice day; Seroquel 50 mg at bedtime; corlinor - 5 mg twice a day; Opral xl - 50 mg once a day in am; Cartazan LA 120 mg once a day; Sleainde - 100 mg twice day; Protonics - 40 mg daily; Albuterol

Current Illness:

ID: 1092641
Sex: M
Age: 38
State: LA

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: 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: Fatigue suddenly and chills

Other Meds: Blood Pressure Iron DHEA Vitamin D Multivitamin

Current Illness: N/A

ID: 1092642
Sex: F
Age: 20
State: CA

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

Lab Data:

Allergies: NA

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

Symptoms: Symptoms for 10 days (March 2 - March 11, 2021): nausea, fatigue, headache, chills Symptoms for March 2: nausea, fatigue, headache, chills, vomiting, and diarrhea (vomiting for one day, diarrhea for 2) Symptoms for March 3: nausea, fatigue, headache, chills, diarrhea

Other Meds: Fluoxetine Hcl 20 Mg capsule (take 2 daily)

Current Illness: NA

ID: 1092643
Sex: U
Age: 62
State: CA

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

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

Symptoms: IM injection given in left thigh due to patient having bilateral Eversense glucose monitors embedded in upper arms

Other Meds:

Current Illness:

ID: 1092644
Sex: F
Age: 72
State: IN

Vax Date: 03/08/2021
Onset Date: 03/08/2021
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: penicillin, sulfer drug

Symptom List: Ear pain, Hypoaesthesia

Symptoms: slept for most of 2 days, no energy, achy all day, balance was off, shot site was sore, was not able to lay on it or rub it

Other Meds:

Current Illness:

ID: 1092645
Sex: F
Age: 50
State: AL

Vax Date: 03/03/2021
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: No

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Rash appeared on arm at the injection site one week after first Moderna dose

Other Meds: Lexapro

Current Illness: No

ID: 1092646
Sex: U
Age: 56
State: CA

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

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

Symptoms: IM injection given in right thigh due to bilateral mastectomy, and prior significant swelling of right arm with flu vaccine in 10/2019, with small mass remaining.

Other Meds:

Current Illness:

ID: 1092647
Sex: F
Age: 57
State: IN

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: NKA

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

Symptoms: Patient developed rash on arm and chest, called pharmacy to report, within two hours of vaccination. No respiratory involvement. We recommended benadryl and a trip to emergency room if the allergic reaction became severe. She is not alone.

Other Meds: Buspar, Singulair, Phentermine, Protonix

Current Illness: none known of

ID: 1092648
Sex: F
Age: 36
State: IN

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

Lab Data:

Allergies: None

Symptom List: Unevaluable event

Symptoms: At 2:50 am on 3/9/21 (about 7.5 hours after receiving the vaccine), I awoke to my body shaking intensely. It felt like a muscle spasm or like electricity was being pulsed through my body. First it would happen in one leg, and then the leg would curl up under my body. Then it would spasm in my chest and my arms would be drawn inward. Then the other leg, or sometime multiple locations at once. I didn't feel cold at the time. This lasted for 40 minutes total. I took 1000 mg Acetaminophen at 3:00 am. Then, as the shaking lessened, I became very cold. I put on lots of clothes and laid on a heating pad under my comforter. Sometime later, I became very hot. Throughout the night into the morning, I felt feverish and chilled back and forth. At 6:00 am I took 200 mg Ibuprofen. I then spent the rest of the day with fever, chills, and body aches. Everything was achy and I was very tired. I slept well that night. The next day I was fatigued.

Other Meds: Acidophilus, Bifidus, Vitamin D3, Vitamin B-6, Zinc, Magnesium, AlliBiotic CF

Current Illness: None

ID: 1092649
Sex: F
Age: 94
State: WI

Vax Date: 02/23/2021
Onset Date: 02/25/2021
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: None

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

Symptoms: Red pruritic rash at the injection site Two days following vaccination, she had an episode of syncope with fall, head trauma, rhabdomyolysis that resulted in hospitalization

Other Meds:

Current Illness:

ID: 1092650
Sex: M
Age: 35
State: AK

Vax Date: 01/06/2021
Onset Date: 03/10/2021
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: amoxicillin- hives

Symptom List: Injection site pain, Pain

Symptoms: tested positive for COVID-19 on 3/10/2021- asymptomatic

Other Meds:

Current Illness:

Date Died: 02/27/2021

ID: 1092651
Sex: M
Age: 77
State: CA

Vax Date: 02/26/2021
Onset Date: 02/27/2021
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: None

Symptom List: Injection site pain, Menorrhagia

Symptoms: DEATH

Other Meds: HTN, DM, Cholesterol and blood thinners

Current Illness: +Covid in January 2021

ID: 1092652
Sex: F
Age: 26
State: CA

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 known

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

Symptoms: 1120 injection. 1125extreme itching at injection site, 1127 itching down arm of injection site , 1136throat tightness, 'sticky tongue' , 1137difficulty speaking and mentally altered, difficulty breathing 1138 Benadry 50 mg IM 1139 Dexamethasone 10 mg IM 1140 EPI Pen 0.3 mg IM 1141 Oxygen 6 L via face mask added responding to commands , assessed by PA 1145 Patient able to speak but speech slurred . Paramedics arrived transported patient to nearby Medical Center

Other Meds: Thyroid

Current Illness: none

Date Died: 03/10/2021

ID: 1092653
Sex: F
Age: 88
State: CA

Vax Date: 03/09/2021
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: LA

Lab Data:

Allergies: robitussin

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Patient received the vaccine on the evening of 03-09-2021. R.N. states she was "fine " at 440 AM bed check. At 0830 03-10-2021 patient was found slumped over on her bathroom toilet having expired sometime between 440AM and 830 AM

Other Meds: Vitamin B12,C,D3. Eyedrops, probiotics

Current Illness: Bladder cancer, Malignant melanoma, both in remission

ID: 1092654
Sex: M
Age: 17
State: MD

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: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Nuts

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Vaccine age contraindication; 17 year old patient was injected Moderna brand COVID 19 vaccine which is approved for patients 18 years and older. Vaccination occurred on 03/10/21. Patient's mother was contacted on 03/11/21 for follow up. Patient's mother stated that the only side effect patient has experienced is pain on the injection site.

Other Meds:

Current Illness:

ID: 1092655
Sex: F
Age: 59
State: CA

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: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: NKDA

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

Symptoms: Patient received 1st dose of Moderna vaccine. She had facial swelling on her lips and tongue. She had the sensation of her throat swelling and closing. Patient was brought to the observation area, VSS, Epi was given, and patient was transported to the ED via gurney. The doctor was notified and she ordered Tryptase to be drawn in the ED.

Other Meds:

Current Illness:

ID: 1092656
Sex: M
Age: 59
State: GA

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

Lab Data:

Allergies: NONE

Symptom List: Nausea

Symptoms: patient woke up filling faint and dizzy. temperature went to 102 and his blood glucose level was 160.

Other Meds: LISINOPRIL 10 MG PRAVESTATIN 20MG METFORMIN ER 500MG

Current Illness: NONE

ID: 1092657
Sex: F
Age: 80
State: MD

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Injection site pain

Symptoms: While in the observation room after receiving Moderna vaccination, member complained of chest tightness; she denied difficulty breathing/shortness of breath, was alert and oriented and did not appear to be in respiratory distress (also no itching, hives, rashes, or other complaints at the time); manager on duty was also present. Blood pressure, heart rate, and oxygen saturation were 250/87, 76, and 100% (room air), respectively (4:55 pm). 911 was called (4:55 pm). Blood pressure was repeated at 5:00 pm (230/77) and 5:03 pm (221/159); oxygen saturation remained at 100%. At 5:04 pm, member started to complain of lightheadedness and EMS arrived at that time. Member was placed on the stretcher and transferred member to the Hospital. Note: Member has hypertension and stated she did not take her medication today.

Other Meds: None

Current Illness: None

ID: 1092658
Sex: F
Age: 93
State: IL

Vax Date: 02/21/2021
Onset Date: 02/01/2021
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: No Known Allergies

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

Symptoms: Patient developed a heavy rash over the entire upper body Dermatologist identified as a Hypersensitivity Reaction Prescribed topical lotion and mosturizer

Other Meds: Vitamin D, Chlorella

Current Illness: None

ID: 1092659
Sex: M
Age: 67
State: MN

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: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: 2nd dose was given 1 day early. The first dose was given on 02/11/21, and the second dose was due on 03/11/21. Patient could not make it to designated appointment on 03/11/21; however, a dose was available one day early on 03/10/21. Per Moderna provider sheets, dose can be given 4 days early if needed and should be reported to VAERS.

Other Meds:

Current Illness:

ID: 1092660
Sex: F
Age: 67
State: FL

Vax Date: 01/20/2021
Onset Date: 02/01/2021
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: Environmental

Symptom List: Tremor

Symptoms: First effects looked like psoriasis after the first dose. More skin lesions appeared and after the second dose my arms and legs were affected with various skin disorders. Dermatologist seen 3/2/21 indicated herpes and another bacteria. Was given Valacyclovir 1gm 2 x day, Cephalexin 500mg 2 x day, Prednisone packet and Mupirocin ointment. Festering lesions have continued to grow and now are painful. More lesions are appearing on extremities.

Other Meds: Janumet, Jardiance, Rosuvastatin, Montelukast, Losartan, B12, Magnesium, Cinnamon, Alpha Lipoic Acid, Otezla

Current Illness: Psoriasis

ID: 1092661
Sex: F
Age: 63
State: CT

Vax Date: 03/09/2021
Onset Date: 03/09/2021
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: Erythema, Pruritus

Symptoms: Had an immediate headache. Five to ten minutes later left hand was numb and tingle. Blood pressure went up to 147/85 and pulse was 53. I was observed by an EMT. Last vitals were taken at 11:00. 135/82 and pulse was 53. I am not on any blood pressure meds. I called my dr. and when I was seen in December of 2020, my pressure was 116/68 and my pulse was 74. I refused to go to the hospital. on the day of the vaccine but I did go to my drs. the same day at 4:30 and my pressure was 122/80 and pulse was 54. I did not go to work the next day. I felt heaviness in my chest and my arm was sore. I was also tired. I feel better today, but still do not feel myself. My dr. recommended I get my second shot at the hospital if I possible.

Other Meds: omeprazole dr 40mg cap 1x daily simvastatin 20mg tab 1x daily

Current Illness: None

ID: 1092663
Sex: F
Age: 59
State: IN

Vax Date: 03/09/2021
Onset Date: 03/10/2021
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: Very allergic to nightshade, a plant

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

Symptoms: Head ache and body aches as expected. But also a hard red patch about 5 inches below injection site; my lips got swollen as if I had worn a 'bad' cosmetic; eyes were slightly swollen and watery; had some colitis reaction too. Also joint pain and tender abdomen. Just seems like a lot of inflammation.

Other Meds: Claratin

Current Illness: None

ID: 1092664
Sex: M
Age: 67
State: CA

Vax Date: 03/07/2021
Onset Date: 03/07/2021
Rec V Date: 03/11/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: keflex, penicillin

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

Symptoms: Patient reports that he noticed chest pain after getting his COVID19 shot on 3/7/2021. While patient admits that his arm felt sore, he reports that he was surprised to find mid chest pressure developing and persisting long after the shoulder pain resolved. Patient describes the pain as a pressure-like sensation mid chest with some radiation to the shoulder, overall fairly mild in intensity (3/10). Patient states that the pain seems to be brought on by "every day activities" Patient reports that he walks but does not engage in strenuous activity typically. Patient denies experiencing acid reflux. Patient reports that the pain was resolved by nitroglycerin.

Other Meds: Atenolol 25mg, ASA 81mg, Atorvastatin 40mg, Tamsulosin 0.4mg, Sildenafil as needed

Current Illness:

ID: 1092665
Sex: F
Age: 56
State: IN

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

Lab Data:

Allergies: Contrast dye, Penicillin, Biaxin, Cephalaxen

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: I broke out in red, hot, itchy patches, headache , chills and sweats 8 hours later. I called my doctors office and took two benedryl ultratabs each. The next day, the red skin was gone, bno more itching. The next day injection site pain, muscle aches and headache. Still had headache and backache Monday, which was two days later.

Other Meds: Humalog Insulin, Vitamin D, Enalipril, Levothyroxine, Pantoprazole, Combigan Eye Drops, Travatan eye drops.

Current Illness: Type I Diabetes, High Blood pressire, High cholestrol

ID: 1092666
Sex: F
Age: 24
State: MD

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

Lab Data:

Allergies: Sulfa allergy

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

Symptoms: Low-grade fever, but aches, chills, and weakness making it feel higher, starting a few hours after vaccine. Not helped much by Tylenol or Advil. Insomnia the night following vaccine.

Other Meds:

Current Illness:

ID: 1092667
Sex: F
Age: 65
State: IN

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

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

Symptoms: Slight headache, chills, fatigue, sore arm

Other Meds:

Current Illness:

ID: 1092668
Sex: F
Age: 64
State: CT

Vax Date: 03/04/2021
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: pollen, mold

Symptom List: Pain in extremity

Symptoms: Swelling and itchiness at injection site 7 days after injection. Have only had 1 shot.

Other Meds: symvistatin synthroid vitamin b12, D/K

Current Illness:

ID: 1092669
Sex: F
Age: 23
State: CA

Vax Date: 03/04/2021
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:
Dose Series: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: Peanuts, hazelnuts, legumes, lactose intolerant

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

Symptoms: 5 days post vaccine 3/9/2021 - small (rash-like) bumbs on arms, and minimal on legs, attempted to treat with Benadryl, bumps persisted to todays date 3/11/2021. Do see a dermatologist for other skin issues (acne), saw dermatologist today (two days after symptoms appeared) said it could be related to the vaccine and did not think it was anything of concern but more of an immune response.

Other Meds: Isotretinoin 30mg twice daily, othrotryclcine (birth control pill)

Current Illness: N/a

ID: 1092670
Sex: M
Age: 73
State: OH

Vax Date: 03/02/2021
Onset Date: 03/09/2021
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: opioids, penicillin, wheat

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

Symptoms: 1 week later swelling, heat, redness, and itch at injection site

Other Meds: symbicort, combivent, hydrochlorothiazide, cymbalta, coreg, singulair, lisinopril, flomax

Current Illness: none

ID: 1092672
Sex: F
Age: 86
State: MO

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

Lab Data:

Allergies:

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

Symptoms: DUE TO ERROR AT INTAKE PATIENT RECEIEVED 3RD DOSE OF COVID VACCINE (MODERNA)

Other Meds:

Current Illness:

ID: 1092673
Sex: M
Age: 43
State: TN

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

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: Fatigue, headache, fever of 100 degrees. Treated with ibuprofen to relieve symptoms.

Other Meds: Men?s multivitamin, glucosamine, QVAR inhaler

Current Illness: Mild cold days prior (tested negative for COVID 3/10/2021)

ID: 1092674
Sex: M
Age: 42
State: NV

Vax Date: 02/12/2021
Onset Date: 02/12/2021
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: None

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: First night after 2nd dose was the common chills, fever, fatigue. I have been fatigued ever since, almost 4 weeks later. In the past 2 weeks, so 2 weeks after 2nd dose I have had abdominal pain possibly in liver, constant hunger pains and constant nausea and continuing fatigue.

Other Meds: None

Current Illness: None

ID: 1092675
Sex: F
Age: 31
State: AK

Vax Date: 02/01/2021
Onset Date: 02/21/2021
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:

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

Symptoms: fully vaccinated- received 2nd dose of vaccine on 2/1/2021 tested positive for COVID-19 on 2/21/2021

Other Meds:

Current Illness:

ID: 1092676
Sex: M
Age: 55
State: MA

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

Lab Data:

Allergies: no

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Soreness in shoulder yesterday. The next day had headache and tiredness and fever with chills. Last night had sweats the whole night. Felt fine this morning, all symptoms had gone. Feels pretty good today.

Other Meds: no

Current Illness: no

ID: 1092677
Sex: F
Age: 57
State: CA

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: RA

Lab Data:

Allergies: NKDA No other allergies

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

Symptoms: 5 minutes after receiving vaccine, patient became syncopal, per EMT she was slumped over in her chair. EMT able to wake her and get her to antigravity chair. BP 166/110, R 22. Patient dizzy and in and out of consciousness. 911 called at 2:15pm. Assessment by Paramedics showed BP 178/107, HR 204, BS 105. Patient reported no respiratory distress but having feelings of nausea. Alert and Oriented x3. Patient refused ambulance transport and wanted her "caregiver" to pick her up. 2:55pm Ambulance left. 3:10pm client stated she took her inhaler from her purse because she was having "chest tightness", reported immediate relief. Patient also reported she took her own Klonopin to "decrease her heart rate". 3:15pm HR 92, BP 170/90. Patient's caregiver arrived helped her up with a use of her own cane, and helped her to caregiver's car to be taken home with caregiver.

Other Meds: Klonipin Albuterol BP meds - unknown prescription

Current Illness: None

ID: 1092679
Sex: F
Age: 24
State: OK

Vax Date: 03/05/2021
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: Swollen limp node/ lump under armpit of the left arm, the vaccine site

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm