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: 1095421
Sex: M
Age: 43
State: CA

Vax Date: 03/12/2021
Onset Date: 03/12/2021
Rec V Date: 03/12/2021
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: MDM-43-year-old man presents wit syncope versus near-syncope. Differential diagnosis includes vasovagal reaction versus dehydration versus anxiety versus arrhythmia.

Other Meds:

Current Illness:

ID: 1095422
Sex: F
Age: 78
State: NY

Vax Date: 03/03/2021
Onset Date: 03/12/2021
Rec V Date: 03/12/2021
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: Dust, molds, penicillin, HTCZ,

Symptom List: Anxiety, Dyspnoea

Symptoms: covid arm - red itchy swollen 3" circle just under injection site on left arm, began 6 hours ago

Other Meds: Synthroid, Atenolol, Diovan, Allopurinol,Klor-con M20, Vitamin D1000iu, Proventil HFA, TUMS

Current Illness: none

ID: 1095423
Sex: F
Age: 55
State: VA

Vax Date: 02/09/2021
Onset Date: 02/11/2021
Rec V Date: 03/12/2021
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: N/A

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

Symptoms: Rash developed on upper body, on arms ,neck, and, around the injection site. I had a tele-heath appointment with my doctor unfortunately, the medication did not help the rash it spread so I visited the Urgent Care to receive medical help.

Other Meds:

Current Illness: N/A

Date Died: 02/21/2021

ID: 1095424
Sex: F
Age: 92
State:

Vax Date: 01/09/2021
Onset Date: 02/21/2021
Rec V Date: 03/12/2021
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: death

Other Meds:

Current Illness:

ID: 1095425
Sex: F
Age: 28
State: TN

Vax Date: 03/04/2021
Onset Date: 03/05/2021
Rec V Date: 03/12/2021
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: Low grade temp, body aches, chills, headache.

Other Meds:

Current Illness:

ID: 1095426
Sex: F
Age: 59
State: TX

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 03/12/2021
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: Patient was administered a prefilled Covid-19 vaccine injection in L deltoid. Patient was monitored for 15 minutes following vaccine administration. Post injection the clinic soon realized the injection was empty without the vaccine present. The "prefilled' Johnson and Johnson vaccine was pulled back to 0.5 ml and individually packed and appeared to be a single use vaccine. The patient was called and notified via phone call of the situation and that the patient unintentionally did not receive COVID-19 immunization. Advised patient to FU for any questions or concerns. The Health Department was notified. Patient was understanding and denies acute concerns.

Other Meds:

Current Illness:

ID: 1095427
Sex: F
Age: 44
State: FL

Vax Date: 03/12/2021
Onset Date: 03/12/2021
Rec V Date: 03/12/2021
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: Cipro, Sulfa, Flagyl, Percocet

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Fatigue, tingling in lips, face, neck, hands. Dryness in lips and hands. Soreness at injection site. Temperature 99.8

Other Meds: Multivitamin

Current Illness: None

ID: 1095428
Sex: F
Age: 46
State:

Vax Date: 03/12/2021
Onset Date: 03/12/2021
Rec V Date: 03/12/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: difficulty swallowing. Evaluated by EMS-Cleared

Other Meds:

Current Illness:

ID: 1095429
Sex: M
Age: 58
State: CA

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

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

Lab Data:

Allergies: sulfides

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Pain at injection site. It has progressed to severe shoulder and arm pain starting 03/08/2021 that is still increasing

Other Meds: pradaxa, protonix, norvasc, lipitor, flomax, aspirin 81 mg,lopressor, lisinopril 20mg-hydrochorothiazide 25mg

Current Illness: none

ID: 1095430
Sex: M
Age: 70
State: TX

Vax Date: 02/27/2021
Onset Date: 02/28/2021
Rec V Date: 03/12/2021
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: Nka

Symptom List: Diarrhoea, Nasal congestion

Symptoms: High blood sugars, unable to control when my sugars are normally under control. I usually run in low 100s, sugars up into 300s unexplained. At this point, two weeks later they are starting to come down some. I have talked with others and 4 others I know have had similar issues.

Other Meds:

Current Illness:

ID: 1095432
Sex: M
Age: 79
State:

Vax Date: 02/19/2021
Onset Date: 02/24/2021
Rec V Date: 03/12/2021
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 the fifth day after vaccination I found myself disorganized in routine, everyday activities, such as washing & dressing, preparing meals, etc.; for example, I omitted washing my ears and forgot to put the kettle on. In the afternoon I was troubled by a headache of a novel sort, not with indefinite perimeter, but more specifically delimited, with ragged edges. Then that evening after ascending a flight of stairs, I heard a loud thumping, then suddenly realized that it was my own heartbeat that I could hear in my head. These bizarre effects disappeared by the next day. On the seventh through fourteenth days after the vaccination, I experienced a soreness in my trunk below the rib-cage, at first toward the sides, but then becoming more insistent and less localized; this was accompanied by headache (normal dull sort), along with irritation at the back of my nasal passages, and a feeling of being tired already upon waking.

Other Meds:

Current Illness:

ID: 1095433
Sex: M
Age: 43
State: TX

Vax Date: 03/08/2021
Onset Date: 03/08/2021
Rec V Date: 03/12/2021
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: Patient was administered a prefilled Covid-19 vaccine injection in L deltoid. Patient was monitored for 15 minutes following vaccine administration. Post injection the clinic soon realized the injection was empty without the vaccine present. The "prefilled' Johnson and Johnson vaccine was pulled back to 0.5 ml and individually packed and appeared to be a single use vaccine. The patient was called and notified via phone call of the situation and that the patient unintentionally did not receive COVID-19 immunization. Advised patient to FU for any questions or concerns. The Health Department was notified. Patient was understanding and denies acute concerns.

Other Meds:

Current Illness:

ID: 1095434
Sex: F
Age: 56
State:

Vax Date: 03/12/2021
Onset Date: 03/12/2021
Rec V Date: 03/12/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: anxious, SOB, dizzy. Evaluated by EMS-Cleared

Other Meds:

Current Illness:

Date Died: 01/27/2021

ID: 1095435
Sex: F
Age: 51
State: TX

Vax Date: 01/11/2021
Onset Date: 01/25/2021
Rec V Date: 03/12/2021
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:

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

Symptoms: Headache, nausea on 1/25 progressed to SOB 1/26 and death 1/27

Other Meds: Atenolol

Current Illness: Feeling nauseated vomiting with headache

ID: 1095436
Sex: M
Age: 61
State: CA

Vax Date: 03/11/2021
Onset Date: 03/11/2021
Rec V Date: 03/12/2021
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: No known allergies

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

Symptoms: Patient complained of tightening of throat and tingling of the lips, stated it feels "similar to a reaction to a bee sting". A doctor was notified, and ordered sublingual Zyrtec be given, 10mg of Zyrtec given sublingually. Symptoms resolved and patient was discharged from clinic.

Other Meds: Unknown

Current Illness: None reported by patient

Date Died: 02/24/2021

ID: 1095437
Sex: M
Age: 91
State:

Vax Date: 01/23/2021
Onset Date: 02/24/2021
Rec V Date: 03/12/2021
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: 2nd dose injected on 02/19/2021 death on 2/24/2021

Other Meds:

Current Illness:

ID: 1095438
Sex: F
Age: 44
State: TX

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 03/12/2021
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: Pfizer-BioNTech COVID- 19 Vaccine EUA Moderna COVID- 19 Vaccine EUA Patient received COVID vaccine dose #1 as Pfizer at one location. Presented to a different location for COVID vaccine #2 and was provided Moderna.

Other Meds:

Current Illness:

ID: 1095439
Sex: F
Age: 38
State: CA

Vax Date: 03/08/2021
Onset Date: 03/11/2021
Rec V Date: 03/12/2021
Hospital:

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

Lab Data:

Allergies: aspirin - Reyes syndrome age 12 (taken when had the the flu)

Symptom List: Ear pain, Hypoaesthesia

Symptoms: I am not sure if this is typical, but it's been really scary and I'm not sure if I should get the 2nd dose now... about 7p on 3/11/21 I started noticing my Right hand was feeling cold/tingly/numb. By the time I went to bed it was feeling strange up to my right elbow. I woke up (3/12/21 about 6a) with both hands (mostly all my fingers) looking very white (like Raynaud phenomenon). My right hand to elbow still feels strange and seems most affected (shot was administered on Left deltoid). My right hand almost feels like I have a glove on (wetsuit material).. I've been trying to keep circulation to them by taking hot showers and rubbing them. They now seem more reddish and almost like chilblains might occur. They feel tingling. I have previously had chilblains in my feet when they were cold, but I've been good at managing and don't get that anymore. Never had it in my hands previously..

Other Meds: Vitamin C, D, and BCAA

Current Illness: n/a

ID: 1095440
Sex: M
Age: 30
State: NY

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

Vax Type: PNC13
Manufacturer: PFIZER\WYETH
Vax Name: PNEUMO (PREVNAR13)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies: unknown

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: numb and cold bilateral toes started a couple of hours after the vaccine was administered.

Other Meds: unknown

Current Illness: none

ID: 1095441
Sex: M
Age: 63
State: TX

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 03/12/2021
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: Patient was administered a prefilled Covid-19 vaccine injection in L deltoid. Patient was monitored for 15 minutes following vaccine administration. Post injection the clinic soon realized the injection was empty without the vaccine present. The "prefilled' Johnson and Johnson vaccine was pulled back to 0.5 ml and individually packed and appeared to be a single use vaccine. The patient was called and notified via phone call of the situation and that the patient unintentionally did not receive COVID-19 immunization. Advised patient to FU for any questions or concerns. The Health Department was notified. Patient was understanding and denies acute concerns.

Other Meds:

Current Illness:

ID: 1095442
Sex: F
Age: 37
State: SC

Vax Date: 03/12/2021
Onset Date: 03/12/2021
Rec V Date: 03/12/2021
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: Iodine, milk, eggs, peanuts, tree nuts, (all listed as sensitivity). Azithromycin. States she's had "throat swelling" with other medications and rashes of unknown etiology.

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

Symptoms: Complained of throat swelling with no acute cardiopulmonary distress. Given: Diphenhydramine 25mg IM, Epinephrine 0.3 mg IM, Dexamethasone 10mg IM and transported to the ED for evaluation. Vitals stable with O2 sat 99-100% on room air.

Other Meds: Reports multiple medications but no list given.

Current Illness: No acute illness.

ID: 1095444
Sex: F
Age: 75
State: NY

Vax Date: 03/04/2021
Onset Date: 03/10/2021
Rec V Date: 03/12/2021
Hospital:

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

Lab Data:

Allergies: Contrast dye

Symptom List: Unevaluable event

Symptoms: Runny nose, congested nose, scratchy throat. cough up phlegm

Other Meds: Quinapril, Metformin, Pravastatin, Vitamin B complex. Vitamin D, oxybutynin, hydrochlorothiazide, Meloxicam, Aspirin low dose

Current Illness: None

ID: 1095445
Sex: F
Age: 72
State: CA

Vax Date: 03/12/2021
Onset Date: 03/12/2021
Rec V Date: 03/12/2021
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: PCN

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

Symptoms: Patient is a 72 y.o. female who received the Janssen Covid vaccine Lot# 1805020 on 3/12/2021. The patient experienced the following reaction(s) during the immediate of observation: Dizziness Patient was treated/managed as follows: Pt given gatorade and VS taken 0948: BP: 106/82 HR 76 O2: 96% 0958: BP: 122/82 HR: 78 O2: 97% Pt reports feeling better Patient given educational material regarding vaccine and advised to continue to self-monitor per the CDC guidance. Pt escorted to car by RN.

Other Meds: Synthroid

Current Illness: none

ID: 1095446
Sex: M
Age: 48
State: NJ

Vax Date: 03/12/2021
Onset Date: 03/12/2021
Rec V Date: 03/12/2021
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: Unknown

Symptom List: Injection site pain, Pain

Symptoms: Patient received a dose from an undiluted vial. so staff drew 0.3ml of undiluted/concentrated product

Other Meds: Unknown

Current Illness: Unknown

ID: 1095447
Sex: F
Age: 49
State: NC

Vax Date: 03/03/2021
Onset Date: 03/03/2021
Rec V Date: 03/12/2021
Hospital:

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

Lab Data:

Allergies: Aspirin

Symptom List: Injection site pain, Menorrhagia

Symptoms: Swollen knot at injection site, red, warm, itchy, painful to the touch

Other Meds: Abilify Adderall Equatro Xarelto Omeprazole Saphris Gabapentin Cetirizine

Current Illness: none

ID: 1095448
Sex: F
Age: 74
State: CA

Vax Date: 02/05/2021
Onset Date: 02/15/2021
Rec V Date: 03/12/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: LEVAQUIN BACTRIM

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

Symptoms: weakness, cannot walk, swelling of extremities, could not swallow, gallbladder enlarged and removed, hospitalized for 14 days. Gullian barre syndrome.

Other Meds: Pantoprazole SOD DR 40MG 1 TAB BID SUCRALFATE 1 GM 1 TAB QID LEVOTHYROXINE 150 MCG 1TAB ASPRIN 81 MG 1 TAB OXYBUTYNIN CH ER 10MG 1 TAB MYBETRIQ 25 MD 1 TAB LORAZEPAM 0.5 1 TAB BID VIT C 500 MG 1 Tab BID VIT B12 1000 MG 1 TAB ESTRADRIOL CREA

Current Illness: NA

ID: 1095449
Sex: F
Age: 55
State: OH

Vax Date: 03/10/2021
Onset Date: 03/11/2021
Rec V Date: 03/12/2021
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: Fever highest 101.6 Chills Body aches Exhaustion Treated with extra strength Tylenol And sleep Woke up today with the ?day after the flu? residual malaise

Other Meds: Albuterol Symbicort

Current Illness:

ID: 1095450
Sex: F
Age: 63
State: IL

Vax Date: 03/09/2021
Onset Date: 03/10/2021
Rec V Date: 03/12/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Patient has redness on her stomach and arms. She reports that the redness has improved some. She will continue to monitor and will follow-up with her primary care doctor on Monday 3/15/21.

Other Meds:

Current Illness:

ID: 1095451
Sex: F
Age: 65
State: CT

Vax Date: 03/02/2021
Onset Date: 03/02/2021
Rec V Date: 03/12/2021
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: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: Weak legs, shakes, night sweats, extreme fatigue, headache

Other Meds: Elderberry and turmeric

Current Illness: None

ID: 1095452
Sex: M
Age: 56
State: LA

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 03/12/2021
Hospital: Y

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

Lab Data:

Allergies: None known

Symptom List: Nausea

Symptoms: Patient presented to the Emergency Department of our hospital with report of nausea, vomiting, fever and chills after receiving a COVID-19 vaccination at the local Health Center. Specific information regarding the vaccine (lot number, vaccination site, etc.) is not available to me at the time of this report as the vaccination was not administered by our organization.

Other Meds: Aspirin, Atorvastatin calcium, Carvedilol, CoQ10, Coreg, Entresto, Furosemide, Spironolactone

Current Illness:

ID: 1095453
Sex: F
Age: 65
State: CA

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

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

Lab Data:

Allergies: Niaspan

Symptom List: Injection site pain

Symptoms: 4 hrs after injection experienced joint pain in wrists and hands, treated with Extra Strength Acetaminophen 10 hrs after injection experienced fever & chills, body aches, headache and continued joint pain in wrists and hands; treated with Extra Strength Acetaminophen throughout night 21 - 28 hrs after injection continued to have headache; treated with Extra Strength Acetaminophen

Other Meds: Levothyroxine; Amlodipine; Atorvastatin; Losartan

Current Illness: none

ID: 1095454
Sex: M
Age: 24
State: AL

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

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

Lab Data:

Allergies: None

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

Symptoms: Intense itching around chest, head, and neck. Symptoms subsided after taking benadryl.

Other Meds: Modafinil 100 mg Sertraline 100 mg Vitamin D3 25 mcg

Current Illness: None

ID: 1095455
Sex: F
Age: 38
State: GA

Vax Date: 02/28/2021
Onset Date: 03/01/2021
Rec V Date: 03/12/2021
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: Celiac disease

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

Symptoms: Vomiting (and chills and headache)

Other Meds: Synthroid, citalopram, stratera

Current Illness: None

Date Died: 01/30/2021

ID: 1095456
Sex: F
Age: 91
State:

Vax Date: 01/20/2021
Onset Date: 02/15/2021
Rec V Date: 03/12/2021
Hospital: Y

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: date of injection 01/30/2021 CARDIAC ARREST 1/30/2021 Death 1/30/2021

Other Meds:

Current Illness:

ID: 1095457
Sex: F
Age: 57
State: NM

Vax Date: 03/11/2021
Onset Date: 03/11/2021
Rec V Date: 03/12/2021
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: During observation felt hot and sweating No LOC vision blurred Responded to lying down and fluids discharged home with daughter

Other Meds:

Current Illness:

ID: 1095458
Sex: M
Age: 71
State: HI

Vax Date: 01/21/2021
Onset Date: 02/26/2021
Rec V Date: 03/12/2021
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 ibuprofen

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

Symptoms: following day: calf pain so severe he couldnt walk for 3 days, increasing coughing and wheezing, scalp felt like it was on fire, ongoing brain fog.

Other Meds: none

Current Illness: none

ID: 1095459
Sex: M
Age: 32
State: OH

Vax Date: 03/11/2021
Onset Date: 03/12/2021
Rec V Date: 03/12/2021
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: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: Headache, lethargy

Other Meds: Losartan, multivitamins

Current Illness: None

ID: 1095460
Sex: F
Age: 72
State: CA

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 03/12/2021
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: penecillin

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: At 11;00 pm I had my injection site sore, muscle pain, violent chills, fever, vomiting, diarrhea, headache. This lasted over night and into the next day. I was unable to perform daily functions and was limited to bed rest all day.

Other Meds: Eliquis, alendronate,

Current Illness:

ID: 1095461
Sex: M
Age: 16
State: KY

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

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

Lab Data:

Allergies:

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

Symptoms: No adverse event but patient underage

Other Meds:

Current Illness:

ID: 1095462
Sex: M
Age: 60
State: NM

Vax Date: 03/11/2021
Onset Date: 03/11/2021
Rec V Date: 03/12/2021
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: During observation felt hot and sweating No LOC vision blurred Responded to lying down

Other Meds:

Current Illness:

ID: 1095463
Sex: F
Age: 61
State: OH

Vax Date: 03/06/2021
Onset Date: 03/06/2021
Rec V Date: 03/12/2021
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: Pt. c/o "feeling high" like she had some drink. She felt light headed. Denies SOB denies chest pain. @ 1040 BP 160/100, HR 84, RR 18. @ 11:49 BP 160/82. @ 1050 BP 160/90, HR 80, RR 18, no dizziness, Ox.Sat 97%, 160/82. Stated she is fine and wants to go home.

Other Meds: Vitamin B12

Current Illness: none

ID: 1095464
Sex: M
Age: 66
State: NY

Vax Date: 02/24/2021
Onset Date: 02/26/2021
Rec V Date: 03/12/2021
Hospital:

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

Lab Data:

Allergies: Walnuts - but no other nut, Sulfa

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

Symptoms: Started with Hives like rash on left elbow and left knee. Progressed to Angioedema affecting upper area over lips, left palm and left foot sole.

Other Meds: Finasteride, Hydrochlorothiazide

Current Illness: None

ID: 1095465
Sex: F
Age: 34
State: NY

Vax Date: 03/01/2021
Onset Date: 03/12/2021
Rec V Date: 03/12/2021
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: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: Doctor sent the pt to us to the back to watch because she told them that she had allergic reactions to vaccines. I set her up on the heart monitor to watch her SPO2 and to take a BP, manually did HR and RR. I took these vitals every 10 mins for a half hour. Nothing happened and we sent her home.

Other Meds:

Current Illness:

ID: 1095466
Sex: M
Age: 58
State: TX

Vax Date: 03/10/2021
Onset Date: 03/10/2021
Rec V Date: 03/12/2021
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: Patient was administered a prefilled Covid-19 vaccine injection in L deltoid. Patient was monitored for 15 minutes following vaccine administration. Post injection the clinic soon realized the injection was empty without the vaccine present. The "prefilled' Johnson and Johnson vaccine was pulled back to 0.5 ml and individually packed and appeared to be a single use vaccine. The patient was called and notified via phone call of the situation and that the patient unintentionally did not receive COVID-19 immunization. Advised patient to FU for any questions or concerns. The Health Department was notified. Patient was understanding and denies acute concerns.

Other Meds:

Current Illness:

ID: 1095467
Sex: F
Age: 49
State: CO

Vax Date: 03/10/2021
Onset Date: 03/10/2021
Rec V Date: 03/12/2021
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: I have Glactosemia. Basically lactose intolerant, no diary, sulphur, and perhaps some kind of gluten allergy.

Symptom List: Vomiting

Symptoms: Dizzy, weakness, rapid heartbeat, splitting headache, nausaus, all while still at the vaccine clinic. I remained there for 90 minutes and the symptoms did not change. Still have splitting headache and some dizzyness here we are two days later . . .

Other Meds: I am filling this information out at the local library. I did not know that questions such as this one were going to be asked. So here goes . . . Methamizole (sp), Gemfibrozile (sp), Estrodial (sp), Progestrone (sp), Famodidne (sp), Omega

Current Illness: None

ID: 1095468
Sex: F
Age: 57
State: OH

Vax Date: 03/11/2021
Onset Date: 03/11/2021
Rec V Date: 03/12/2021
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: Sulphate drugs, Eurythromicin

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Soreness at site

Other Meds: Amlodapine, Effexor and Eloquis

Current Illness: None

ID: 1095469
Sex: F
Age: 64
State: FL

Vax Date: 03/06/2021
Onset Date: 03/08/2021
Rec V Date: 03/12/2021
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: mussels

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

Symptoms: Got a fever and chills which seemed expected on Sunday evening the day after the shot on 3/6/21. On Monday, I was fine but tired and went to bed about 11PM. I awoke to the feeling that the room was spinning even with my eyes closed and when I opened my eyes the room continued to spin around me. I could barely stand up when I tried. Felt nauseated but did not vomit. The vertigo continued off and on on Tuesday, Wednesday, and Thursday especially when I would lay flat either on my back or stomach if I turned my head. I went to my doctor this morning who ruled out an ear infection or wax build up. She encouraged me to contact her if it continued after a week. I have only had vertigo two times in my life, both after a physical trauma to my head (car accident when I as 30, and surprise tackle during touch football) when I was 53. This struck me as an unusual side effect from the vaccine since I have never had vertigo without a prior event like an accident. I am in good health otherwise.

Other Meds: multi-vitamin

Current Illness: none

ID: 1095470
Sex: M
Age: 60
State: MN

Vax Date: 03/10/2021
Onset Date: 03/10/2021
Rec V Date: 03/12/2021
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: Iodinated Diagnostic agents - hives, Ioxaglate - Hives, Levofloxin - hives, Penicillins - hives, Compazine - Anaphylaxis, Diatrizoate - Rash

Symptom List: Injection site swelling, Limb discomfort

Symptoms: 08:10 vaccine administered 08:14 dizzy, light headed, room spinning. Sat down 08:25 felt lump in throat, contacted clinic nurse in waiting area. Uncomfortable but never to the point of difficulty breathing. ~08:30, BP 128/99 (I think) Systolic up only a bit. Diastolic very high for me sent to urgent care part of clinic. Monitored BP, oxygen, did EKG (normal), symptoms started easing ~ 09:40. Sent home. Attending PA though it might just be a Vaso-Vagel response, but, after hundreds upon hundred of needles, I've never had such a response, and, my symptoms did not involve a low BP, fainting or nausea, rather I remained conscious, had throat constriction with increased BP and a narrowed pulse pressure range.

Other Meds: Certirizine HCI Tab 10 MG (daily - taken earlier that morning) Cholecalciferol (tab) 25 MCG (daily - taken earlier that morning) Cyanocobalamin (tab) 1000MCG (daily - taken earlier that morning) Also taken previous day but not yet on Mar

Current Illness: none

ID: 1095471
Sex: M
Age: 25
State: NM

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

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

Lab Data:

Allergies: no known

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

Symptoms: 5 minites after receiving vaccine felt lightheaded, dizzy Passed out with brief LOC No SOB, chest pain Resolved after lying down, oral hydration

Other Meds:

Current Illness:

ID: 1095472
Sex: M
Age: 34
State: CA

Vax Date: 01/08/2021
Onset Date: 01/14/2021
Rec V Date: 03/12/2021
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: None

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

Symptoms: Swollen painful unilateral cervical (neck) lymph nodes (rock hard firm) on side of injection . Lasted for two weeks gradually dissipating in firmness and tenderness without any treatment

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm