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: 1092680
Sex: F
Age: 49
State: SC

Vax Date: 01/26/2021
Onset Date: 01/26/2021
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:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Lower-than-authorized dose volume administered (e.g., leaked out). Patient requested administration of additional dose. Per CDC recommendations "If less than half of the dose was administered or the proportion of the dose cannot be estimated, administer the authorized dose immediately (no minimum interval) in the opposite arm." Additional dose administered 3/11/2021.

Other Meds:

Current Illness:

ID: 1092681
Sex: F
Age: 63
State: CA

Vax Date: 03/11/2021
Onset Date:
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

Symptom List: Anxiety, Dyspnoea

Symptoms: None

Other Meds: A Lodi pine Besylate 5mg

Current Illness: High blood pressure

ID: 1092682
Sex: F
Age: 37
State: NC

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: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Highly allergic to bees, lactose intolerance

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

Symptoms: Aprox 3 min after injection, broke out in rash and hives, severe itching in neck, face, chest, tingling lips and shaking. EMS was on scene at clinic immediately removed me from car and checked vitals, BP was high 176/94, took by ambulance to ER at Medical Center. Treated in ER for 4.5 hours. Developed migraine, received benadryl, steriods,and medicine for the migraine. Sent home told take benadryl for 2 days and do

Other Meds: Prozac, oxycodone, vistaril, doxepin

Current Illness: Torticollis

ID: 1092683
Sex: F
Age: 49
State: MO

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:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Patient started to feel unwell approx 5 minutes after injection, light headed and dizzy, felt like heart was racing. Used our manual BP cuff and check pulse at approx 1:20 was 114/110 P between 98-108. Omrom automated BP cuff to check her at 1:25 BP 138/105 P 103 at 1:28 BP 135/100 P 103. At 1:43 BP 147/99 and P 99 using quick clinic's automated BP machine. Spoke with customer about her normal BP and pulse she states is normally 130/80 and pulse in 80s. She takes metoprolol 50 Er 50 mg bid and said she had not missed any doses recenrly. I asked that she report her bp and pulse to medical provider as they seem elevated.

Other Meds:

Current Illness:

ID: 1092684
Sex: F
Age: 41
State: CO

Vax Date: 03/06/2021
Onset Date: 03/07/2021
Rec V Date: 03/11/2021
Hospital: Y

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

Lab Data:

Allergies: None.

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

Symptoms: Fever reaching 102.5, chills, muscle aches 9 hours following vaccination Acute appendicitis - approximately 20 hours following vaccination

Other Meds: None.

Current Illness: None.

ID: 1092685
Sex: F
Age: 68
State: NY

Vax Date: 03/09/2021
Onset Date: 03/10/2021
Rec V Date: 03/11/2021
Hospital: Y

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: None

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

Symptoms: Symptoms started at 5:15 PM the next day, about 20 hours after vaccination - Vomiting - High heart rate - Suspected seizure (symptoms differed from the past instances) - Loss of coherence (intermittent for 2 hours) Ambulance brought her to hospital, where she was in ER and later admitted. She is still at hospital under observation at this time, with no discharge date set.

Other Meds: Keppra (leviteracetam) Divalproex Co-Q 10 Low-dose (81 mg) aspirin

Current Illness: No short-term illness

ID: 1092686
Sex: F
Age: 49
State: MO

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: LA

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Patient started to feel unwell approx 5 minutes after injection, light headed and dizzy, felt like heart was racing. Used our manual BP cuff and check pulse at approx 1:20 was 114/110 P between 98-108. Omrom automated BP cuff to check her at 1:25 BP 138/105 P 103 at 1:28 BP 135/100 P 103. At 1:43 BP 147/99 and P 99 using quick clinic's automated BP machine. Spoke with customer about her normal BP and pulse she states is normally 130/80 and pulse in 80s. She takes metoprolol 50 Er 50 mg bid and said she had not missed any doses recenrly. I asked that she report her bp and pulse to medical provider as they seem elevated.

Other Meds:

Current Illness:

ID: 1092687
Sex: F
Age: 64
State: IN

Vax Date: 03/05/2021
Onset Date: 03/07/2021
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: Sulfa(Sulfonamide Antibiotics), Doxycycline, Amoxicillin, Augmentin, Levaquin, Norvasc, Phenergan, Procardia, Zithromax, tomato

Symptom List: Pharyngeal swelling

Symptoms: My right arm has a large hard knot that is warm to the touch at the injection site.

Other Meds: Latanoprost Ophthalmic Solution 0.005%, Lisinopril, Hemagenics, Klor-Con M20, Omeprazole, B12, D3, Triple Omega 3, 6, & 9, C, Multivitamin

Current Illness: None

ID: 1092688
Sex: F
Age: 51
State: NY

Vax Date: 02/11/2021
Onset Date: 02/14/2021
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: NKDA

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Moderate ?> Severe pain & discomfort to Muscles , Joints & Back (worst) also swelling of left knee. Lymph node under left arm which resolved within 1 week. Continued joint & muscle pain currently. Spoke with PCP who recommended to speak with Asthma & Allergy provider doctor who advised NOT to take 2nd dose. Seen by Ortho-spine doctor who ordered labs & also PT prescription. Pain control by OTC medication ( Tylenol previous & Aleve (back & muscle pain) type.

Other Meds: Tylenol Arthritis 650mg 1 every 8 hours

Current Illness: None

ID: 1092689
Sex: F
Age: 64
State: CA

Vax Date: 02/22/2021
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: none

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Symptoms began a full 15 days after my second shot and included: -- Intense body aches -- Completion depletion of energy -- Severe chills All the symptoms that were expected a few days after the vaccine, but I couldn't find anything anywhere about them showing up so long after the vaccine. The immediate effect of the vaccine was only a very sore arm.

Other Meds: Tamoxifen - 20 mg per day

Current Illness: none

ID: 1092690
Sex: F
Age: 72
State: MN

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 03/11/2021
Hospital:

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

Lab Data:

Allergies: oxycodone erythromycin

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

Symptoms: After first Shot: First day: headache, slightly sore arm , achy, fatigue Next few days: elevated heart rate 1 week after shot: even higher heart rate, pain when breathing, pain in chest and right shoulder, extreme fatigue After second shot: Shortness of breath, pain with breathing,fast heart rate, extreme fatigue, achy

Other Meds: lisinopril

Current Illness: none

ID: 1092691
Sex: F
Age: 0
State: FL

Vax Date: 02/11/1977
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: Latex allergy

Symptom List: Rash, Urticaria

Symptoms: stated she felt dizzy within the 15 minute wait time after being immunized. I broke an ammonia inhalant and use a cool compress on her face because she had started to sweat. Her boyfriend who was with her stated had not eaten anything before she came in to be vaccinated. Patien t stated she felt better after inhaling the ammonia and using the cool ompress. Patient stated she felt a little burning in her arm, but that went away.

Other Meds: I do not know.

Current Illness: I do not know.

ID: 1092692
Sex: F
Age: 24
State: ND

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

Lab Data:

Allergies: Juniper, pollen, mold, pet dander

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

Symptoms: Came down with a 100.2 degree F fever the night I got it, which went away after one dose of tylenol. The following night I did have a low grade fever of 99.3, which also went away after one dose of tylenol. I have had muscular soreness, and am now developing a small, itchy, red patch at the injection site. I will fill out another adverse form if it gets worse.

Other Meds: Albuterol, symbicort, mili birth control

Current Illness:

ID: 1092693
Sex: M
Age: 22
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: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: unknown

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

Symptoms: Right away after receiving the vaccination patient felt dizzy, overheated and light headed. Patient sat down, had some water, and received ice packs placed on the neck. After about 10 minutes patient felt okay, he then sat in an airway with a breeze and felt back to normal after another 10 minutes. Called patient to check in about 3 hours after event with no response.

Other Meds: unknown

Current Illness: unknown

ID: 1092694
Sex: F
Age: 30
State: FL

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: nkda

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

Symptoms: patient reported a metallic taste in her mouth and nausea immediately following administration of the vaccine

Other Meds: not known

Current Illness: none known

ID: 1092695
Sex: F
Age: 57
State: GA

Vax Date: 01/22/2021
Onset Date: 01/26/2021
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: Shellfish, pineapple, penicillin, erythromycin, percocet, morphine, and codeine and any derivatives

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

Symptoms: SEVERE RASH FROM NASAL AREAS, UNDER NOSE, AROUND MOUTH AND CHIN. IT WAS RED, WEEPING, SORE AND ITCHED. I WENT TO DERMATOLOGIST AND WAS PRESCRIBED METRONIDAZOLE, IVERMECTIN, AND FLUOCINOIDE.

Other Meds: Advair, Singular, Xolair subcutaneously, Valsartan HCT, Spironlactone, and Lantanaprost

Current Illness:

ID: 1092696
Sex: F
Age: 73
State: TX

Vax Date: 03/08/2021
Onset Date: 03/08/2021
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 listed

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

Symptoms: PATIENT'S HUSBAND REPORTED CHILLS AND MUSCLE ACHES

Other Meds: none listed

Current Illness: none listed

ID: 1092697
Sex: F
Age: 60
State: WA

Vax Date: 01/08/2021
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: Unknown

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Pt tested positive for COVID 2 months after 2nd dose in series

Other Meds: Unknown

Current Illness: unknown

ID: 1092698
Sex: F
Age: 66
State: IN

Vax Date: 03/05/2021
Onset Date: 03/06/2021
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: Nausea vomiting aches everywhere extreme headache dehydrated chills sweats

Other Meds: Fluoxitin Losarden Abtorastan Advil

Current Illness: None

ID: 1092699
Sex: F
Age: 69
State: OH

Vax Date: 03/03/2021
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: sulpha drugs

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

Symptoms: One week post receiving Moderna vaccine, the left upper arm developed a large 3cm hive..itchy, warm, hard, red...about 1/2" below the injection site in that arm Went to Clinic...recommended hydrocortisone cream and benedryl

Other Meds: levothyroxine, simvastatin, amlodipine, spirnolactone, calcium, glucosamine

Current Illness: none

ID: 1092700
Sex: M
Age: 70
State: CA

Vax Date: 02/12/2021
Onset Date: 02/24/2021
Rec V Date: 03/11/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

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

Symptoms: Received COVID vaccine 1/26/21 and 2/12/21, and didn't have symptoms right after vaccine. Symptoms started Wednesday February 2/24/21 - started at 9PM that night preventing him from sleeping. Stated the chest pressure was like something "sitting on his chest". Also had body aches, chills, fever, fatigue, cough, and mild shortness of breath. Found to have heart failure, EF 25%

Other Meds: Crestor 20mg, Protonix 40mg prn

Current Illness:

ID: 1092701
Sex: F
Age: 36
State: NC

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: Bananas

Symptom List: Unevaluable event

Symptoms: I was fine after my shot, but at 3:00pm I started having chills muscle aches and severe nausea. I also have a headache and fever. While driving home my muscles seem to shut down. My face was numb I couldn?t move my hands or my legs to drive. I had to pull over on the highway for 20min until my hands legs and face regained mobility.

Other Meds: Serelitine

Current Illness: None

ID: 1092702
Sex: M
Age: 82
State: MO

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: LA

Lab Data:

Allergies:

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

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

Other Meds:

Current Illness:

ID: 1092703
Sex: F
Age: 58
State: NC

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

Lab Data:

Allergies: None

Symptom List: Injection site pain, Pain

Symptoms: 15 minute waiting period I had no events, but 20 minutes after receiving vaccine I had metal taste in mouth on right side along with numbness on right side of face, right jawline, ear area, and small portion of tongue. No pain. No swelling. The metal taste dissipated in approximately 1/2 hour but numbness lasted until evening. By next morning, all symptoms were gone.

Other Meds: Levothyroxin Wellbutrin

Current Illness: None

ID: 1092704
Sex: F
Age: 25
State: NE

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: SYR
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Injection site pain, Menorrhagia

Symptoms: Janssen COVID-19 Vaccine EUA Chills- morning of 3/10 Aches- all day Fever- afternoon of 3/10 High Heart Rate- 130-150 resting Headache- all day Fatigue- all day

Other Meds: None

Current Illness: None

ID: 1092705
Sex: F
Age: 66
State: OH

Vax Date: 03/05/2021
Onset Date: 03/05/2021
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: Ciprofloxacin Flagella Percocet

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

Symptoms: Fever for 3 days. 101.2-101.6, chills, body aches, sore arm at injection Severe migraine type headache lasted for 4 days Severe exhaustion 4 days No appetite 4 days Day 5 just wiped out!

Other Meds: Rosuvastatin

Current Illness: None

ID: 1092706
Sex: F
Age: 72
State: IN

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

Lab Data:

Allergies: sulfa

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Body ache slight fever very tired arm quite sore

Other Meds: Lousartan minocyline fish oil vit D

Current Illness: no

ID: 1092707
Sex: M
Age: 28
State: NJ

Vax Date: 12/30/2020
Onset Date: 01/01/2021
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: None

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Approximately 2 weeks after getting the 1st dose of vaccination I noticed bilateral lower leg rash which eventually turned out be leukocytoclastic vasculitis after medical work-up

Other Meds: None

Current Illness: None

ID: 1092709
Sex: F
Age: 53
State: OH

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:

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

Symptoms: Patient c/o light headedness, diaphoresis, and sweating shortly after receiving vaccine. Symptom onset ~1145a, vaccine time ~1140am. She was incontinent of urine. No loss of consciousness. Neuro intact entire time - no seizure activity. No facial swelling, difficulty breathing, rash. No chest pain. She did complain of left trapezius pain. All extremities with normal movement. Patient was laid flat on cot - no injury sustained. 15L O2 NRB placed.Vitals: 1150: 116/50, HR: 51, Spo2 99%, 1155: 115/65, HR 62, 97%. Blood glucsoe: 110 mg/dl. ECG SR. Patient did feel better once laying flat. 911 was called at symptom onset. EMS arrived at 12:05p. Reports provided. Patient transported to Hospital ER.

Other Meds:

Current Illness:

ID: 1092710
Sex: M
Age: 38
State: WA

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: none

Symptom List: Nausea

Symptoms: Within a few hours I felt cold chills, then felt hot, then itchiness around my eyes, then finally a bad headache. Went back to the and was observed for about an hour. Was directed by the doctor to go to ER to get further diagnose. The PA from said should be back at normal state and decided to put me on quarters for 2 days and prescribed me ibuprofen and Tylenol.

Other Meds: none

Current Illness: none

ID: 1092711
Sex: F
Age: 62
State: CA

Vax Date: 01/12/2021
Onset Date: 01/12/2021
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: Sulphadimide Red wine-hives Niacin-hot flashes and tingling

Symptom List: Injection site pain

Symptoms: I started to feel bad in the afternoon. I had fever and chills for 48 hours. Severe muscle and body aches and joint pain for three days. I very tired and had to lay down. I took Tylenol and Omeprazole for gastric pain. This lasted for a week. Some gastric pain and no appetite and a bitter taste in my mouth. I had no nausea. The second dose was less severe but it lasted 24 hours. I had hip pain which was different. Second dose

Other Meds: Aspirin Metoprolol-Beta Blocker Losartan Atorvastatin

Current Illness:

ID: 1092712
Sex: F
Age: 62
State: WI

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:

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

Symptoms: Had my second COVID Vaccine and not sure if the nurse hit a small vessel, but blood ran down my arm. Band aid had blood on it. That night I had lump, which I just thought was a hematoma. But today, I am noticing some redness around the site. I have been icing it. My provider is giving me an antibiotic because I will be traveling. I have had Cellulitis before and should have told the nurse to clean my arm with something more than alcohol. Please report to VAERs per my manager. I received the Moderna.

Other Meds:

Current Illness:

ID: 1092713
Sex: F
Age: 35
State: CA

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

Lab Data:

Allergies: Penicillin

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

Symptoms: 1 dose ERYTHEMA at injection site location. Skin was red and hot to touch and itchy for four days.

Other Meds: No

Current Illness:

ID: 1092714
Sex: F
Age: 66
State: MI

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

Lab Data:

Allergies: none

Symptom List: Tremor

Symptoms: About 9pm same day as shot, all of my finger tips on the right hand became sore and the hand felt like it was going to seize up. The next day I was very tired and couldn't stay woke slept all day. Woke up with a headache, which remained all day. Later that night or the next morning I realized I have a knot on the base of my next where the chest and neck meet on the right side. It was and still is sore. I think it is a lymph node? because it kind of moves...

Other Meds: none

Current Illness: Acid reflux

ID: 1092715
Sex: F
Age: 42
State: NC

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: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Erythema, Pruritus

Symptoms: Side effects started with in 7 hours starting with tiredness. Headache within 8 hours. Muscle aches, fever and small bouts of nausea within 11 hours. All side effects lasted about 24 hours after injection of the vaccine.

Other Meds: None

Current Illness: None

ID: 1092716
Sex: F
Age: 64
State: MD

Vax Date: 03/10/2021
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: no

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

Symptoms: Last night eye felt itchy. Had some puffiness on both eyelids. Today, right side face swelling. No SOB, no swelling of the tongue or lips.

Other Meds: High blood pressure meds and Diabetes medication

Current Illness: no

ID: 1092717
Sex: F
Age: 47
State: PA

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:

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

Symptoms: Needle became detached from syringe during injection. Participant stated she she felt some vaccine leak down her arm, and a couple of drops of vaccine were visible on the table. Participant was worried that she did not receive full dose. Participant was informed that the amount she received was more than plenty to elicit the appropriate immune response, and that protocol was to not administer additional vaccine in this instance. Participant stated understanding, although still uneasy. Participant information was collected for VAERS report.

Other Meds:

Current Illness:

ID: 1092718
Sex: F
Age: 50
State: AK

Vax Date: 12/19/2020
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: Asthenia, Chills, Headache, Myalgia

Symptoms: Not adverse event but reportable event. Patient has received both COVID-19 vaccinations due in series and is more than 2 weeks out from vaccination and developed COVID-19, patient tested positive for COVID-19 3/10/2021 form for breakthrough case sent to Epidemiology Dose 1: 12/19/2020 Pfizer EK5730 in left deltoid Dose 2: 1/8/2021 Pfizer EL3246 in left deltoid Tested positive for COVID-19 3/10/2021

Other Meds:

Current Illness:

ID: 1092719
Sex: F
Age: 32
State: AK

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

Lab Data:

Allergies: Amoxicillin

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

Symptoms: Patient experienced cramping immediately after administration and then "tingly throat" approximately 10 minutes after administration. I administered 50 mg diphenhydramine and continued to observe patient. Patient reported that tingling had stopped and she was feeling better prior to departure from observation area at 7:49 am. Counseled patient on potential for allergic reaction days to weeks after administration.

Other Meds:

Current Illness:

ID: 1092721
Sex: F
Age: 71
State: OR

Vax Date: 02/27/2021
Onset Date: 03/06/2021
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: epinephrine sensitivity, azithromycin

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

Symptoms: Moderna COVID-19 Vaccine EUA 7 days after the shot: itching, swelling, redness at the injection site. The pharmacist at the vaccine provider recommended using an anti-histamine and ice, which lessened the reaction. There is still redness at 12 days after the injection.

Other Meds: multi-vitamin, vitamin D, vitamin B12, magnesium citrate, atorvastatin, Miralax (polyethylene glycol)

Current Illness: none

ID: 1092722
Sex: F
Age:
State: OH

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

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: STROKE SYMPTOMS, DIFFICULTY AMBULATING, IMPAIRED SPEECH

Other Meds: NORVASC, HYDROCHLOROTHIAZIDE

Current Illness: HYPERTENSION

ID: 1092723
Sex: F
Age: 31
State: TX

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

Lab Data:

Allergies: None

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

Symptoms: No adverse. Affect 19 weeks pregnant

Other Meds: Baby asprin and prenatal

Current Illness: None

ID: 1092724
Sex: F
Age: 73
State: TN

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

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

Symptoms: patient called in and spoke with writer. She reports that the evening of her second dose she could not pick her left arm up over her head. Unable to bear weight or grip. States that she attempted to contact her PCP and MD on 3/5/21. She received a call back on Monday 3/8/21 and was sent in for an MRI of Lt Arm. Per patient, her PCP followed up with her about MRI results stating she could go for a walk -in appointment at the Clinic. Patient states she has not gone to the clinic as of yet and has not followed up with PCP at this time but plans to do so.

Other Meds: Keppra 500 mg Simvastatin 20 mg Multivitamin

Current Illness: None

ID: 1092725
Sex: F
Age: 35
State: AK

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

Lab Data:

Allergies:

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

Symptoms: Diarrhea

Other Meds: Citalopram 40mg Seroquel 150mg

Current Illness:

ID: 1092726
Sex: F
Age: 32
State: OH

Vax Date: 03/01/2021
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: Composine

Symptom List: Vomiting

Symptoms: Fever and spotting (very early in pregnancy. About 4 weeks) spotting happened with fever. No damage to the pregnancy know so far. Spotting stopped

Other Meds: N/a

Current Illness: N/a

ID: 1092727
Sex: F
Age: 34
State: PA

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

Lab Data:

Allergies: Codeine

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Feeling hunger after getting the injection.

Other Meds: Valtrax 500 mg per day. Pre-natal supplement 1 dose per day. Levothyroxine 50ug per day.

Current Illness: None

ID: 1092728
Sex: M
Age: 42
State: TN

Vax Date: 03/08/2021
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: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: Severe muscle/joint pain/swelling in the middle of my left foot. Unable to walk in the morning. Slowly relieved over the next 36 hours. Soreness at injection site. Relieved within 24 hrs of injection.

Other Meds:

Current Illness:

ID: 1092729
Sex: F
Age: 63
State: CA

Vax Date: 03/11/2021
Onset Date: 03/01/2021
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: None

Symptom List: Injection site swelling, Limb discomfort

Symptoms: None

Other Meds: Amlodipine Besylate 5mg

Current Illness: High blood pressure

ID: 1092730
Sex: F
Age: 53
State: IN

Vax Date: 03/08/2021
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: Sulfa - causes body rash

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

Symptoms: 3/10/2021 at approximately 7 p.m. I noticed my gums, roof of mouth and inside bottom lip hurting when I was eating. I discovered I had approximately 10 sores, similar feeling to a small blister or canker sore.

Other Meds: Aptiom, 200mg daily Vitamin C, 500mg daily Fiber Well Sugar Free Gummies, 5mg 2X/day Centrum Silver Multivitamin, Women50+ daily Fish Oil, 1200mg daily Aspirin, 81mg daily

Current Illness: NA

ID: 1092731
Sex: F
Age: 77
State: AZ

Vax Date: 03/08/2021
Onset Date: 03/11/2021
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: Ambien and iodine contrast

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

Symptoms: Swelling, redness tenderness and itching at injection site

Other Meds: Many

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm