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: 1096972
Sex: F
Age: 43
State: IL

Vax Date: 03/13/2021
Onset Date: 03/13/2021
Rec V Date: 03/13/2021
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: Patient complained of feeling a burning sensation in her throat and ears 30 minutes after receiving the vaccination. The burning sensation subsided within 10 minutes.

Other Meds: Losartan

Current Illness:

ID: 1096973
Sex: F
Age: 24
State: IL

Vax Date: 03/11/2021
Onset Date: 03/13/2021
Rec V Date: 03/13/2021
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: Nope

Symptom List: Anxiety, Dyspnoea

Symptoms: Numbness on left side of face.

Other Meds: No

Current Illness: Nope

ID: 1096974
Sex: F
Age: 65
State: CA

Vax Date: 03/03/2021
Onset Date: 03/06/2021
Rec V Date: 03/13/2021
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: allergic to iodine (as a topical disinfectant-- not in food)

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

Symptoms: A few days after Modera shot #2 there was a patch of redness (about the size of my palm), and some itching just below the shot site, on the upper left arm. There had been some tenderness and a little bit of swelling at the injection site for about 2-3 days, as usual -- same thing after shot #1. But this redness was different -- it did not happen after shot #1. I Googled and discovered this is "covid arm" aka "delayed cutaneous hypersensitivity". It is now 10 days since the shot (#2) and a week since I noticed the redness. It is still red /pink, but diminishing. I've put some Cortizone on the area about once a day.

Other Meds: Metformin, Allopurinol, Lipitor, Lisinopril, Levothyroxene Multi-Vitamin, Vit D, Vit B-12

Current Illness: none

ID: 1096975
Sex: F
Age: 24
State: GA

Vax Date: 02/10/2021
Onset Date: 02/22/2021
Rec V Date: 03/13/2021
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: After my first dose vaccine I went to see my hematologist. At the time of the vaccine, I was 24 weeks pregnant. I am now 30 weeks pregnant and the reason I went to see my hematologist is because my platelets dropped. I had lab work done the week of 02-22-2021 through 02-26-2021. I also had soreness at the injection site and a palpable lymph node under my armpit that was present for 24 hours then it resolved. I will also be receiving treatment with IV, IG and prednisone medication starting this week of 03-15-2021 through 03-19-2021.

Other Meds:

Current Illness:

ID: 1096976
Sex: F
Age: 40
State: CA

Vax Date: 03/13/2021
Onset Date: 03/13/2021
Rec V Date: 03/13/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

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

Symptoms: Immediately after administer, I felt ?weird?. Almost a little light headed. As the minutes passed, I began feeling dissociated. Almost out of body, like I was under the influence. I began to struggle to answer questions and stay awake. I willed myself to stay calm and stay awake. I was given water and observed for an hour. My face began to feel numb and the roof of my mouth itchy. The ?high? feeling was eventually replaced by the feeling of being extremely tired. After and hour I was good to drive but extremely tired when I got home. About an hour after the shot I can taste a blood or metallic taste in my mouth. I still feel ?drugged? or tried.

Other Meds:

Current Illness:

ID: 1096977
Sex: M
Age: 86
State: CA

Vax Date: 03/13/2021
Onset Date: 03/13/2021
Rec V Date: 03/13/2021
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: The syringe plunger broke while injecting the vaccine into the patient's LD, only 0.25ml administered. The remaining dose (0.25ml) of the vaccine was drawn into a new syringe and administered to patients LD. The patient notified of the event and gave consent to receiving the remaining dose.

Other Meds:

Current Illness: n/a

ID: 1096978
Sex: F
Age: 67
State: PA

Vax Date: 03/13/2021
Onset Date: 03/13/2021
Rec V Date: 03/13/2021
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: Lovenox (itching, chronic over months)

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Tingling of lips and tongue, immediate after vaccination

Other Meds:

Current Illness: none

ID: 1096979
Sex: F
Age: 67
State: NJ

Vax Date: 02/17/2021
Onset Date: 02/26/2021
Rec V Date: 03/13/2021
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: redness in the arm that spread after one day to the whole body and remained for more than a week as per patient, sensitive to the touch.

Other Meds:

Current Illness:

ID: 1096980
Sex: F
Age: 56
State: AZ

Vax Date: 03/10/2021
Onset Date: 03/11/2021
Rec V Date: 03/13/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Nausea, weakness, severe body aches, very painful injection site

Other Meds: Lyrics, flexeril, Trazadone, melatonin

Current Illness: None

ID: 1096981
Sex: F
Age: 43
State: LA

Vax Date: 03/13/2021
Onset Date: 03/13/2021
Rec V Date: 03/13/2021
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: Patient developed redness at the injection site and arm and complained of generalized itching. Benadryl 25 mg capsule given. Patient watched for 30 minutes and then left. Patient felt better after receiving Benadryl.

Other Meds: none

Current Illness: none

ID: 1096982
Sex: F
Age: 66
State: FL

Vax Date: 03/04/2021
Onset Date: 03/12/2021
Rec V Date: 03/13/2021
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: Vaccination site erythema, Vaccination site pruritus, Vaccination site swelling

Symptoms: Woke up on March 12 with a bit of pain and swelling at the injection site. By evening, around 7:00, the area was warm to the touch and beginning to turn red. Today, March 13, symptoms continue.

Other Meds: Caltrate Calcium

Current Illness: None

ID: 1096983
Sex: F
Age: 73
State: NC

Vax Date: 03/06/2021
Onset Date: 03/08/2021
Rec V Date: 03/13/2021
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: Penicillin, Meloxicam

Symptom List: Rash, Urticaria

Symptoms: Nausea, Sudden vomiting, extremely low blood pressure, and then started having a seizure... no previous seizures or seizure disorders.

Other Meds: Metformin, Lotrel, Rosuvastatin, Letrisole, Naprosyn

Current Illness: None

ID: 1096984
Sex: F
Age: 42
State: TX

Vax Date: 03/12/2021
Onset Date: 03/13/2021
Rec V Date: 03/13/2021
Hospital:

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

Lab Data:

Allergies: Clindamycin, augmenting, keflex, doxycycline, fiorecet, Ativan, shellfish, pineapple, onions, peppers, garlic

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

Symptoms: Tennis ball size lump, red, hard, hot

Other Meds: Atenelon, Statin, hctz,spirinalactone, isosorbite, met Forman, singular, allergra, Flonase, zofran, benedryl, Tylenol , Prilosec

Current Illness: Migraine

ID: 1096985
Sex: F
Age: 54
State: IN

Vax Date: 03/11/2021
Onset Date: 03/12/2021
Rec V Date: 03/13/2021
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: No known

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

Symptoms: Body aches, chills, fever up to 101?. Started about 26 hours after the injection. The fever lasted about 12 hours.

Other Meds: Montelukast, buspirone, tolterodine tartrate, fish oil, daily vitamin, biotin, black elderberry, magnesium glycinate, vitamin k2, vitamin d3, b12, vitamin C, melatonin

Current Illness:

ID: 1096986
Sex: M
Age: 68
State: NC

Vax Date: 02/20/2021
Onset Date: 02/20/2021
Rec V Date: 03/13/2021
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: Penicillin Cipro

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

Symptoms: Approximately 7 hours after vaccination, suffered an almost immediate nausea, weakness and dizziness which lead me to pass out for several minutes; these symptoms passed within 24 hours. Had pain in the right lower jaw below a dental implant and pain below the hip in the right ischium (in the hip with an artificial hip replacement). The jaw pain disappeared in 2 weeks, and the hip pain still evident after 3 weeks. X-ray of right hip revealed no abnormalities.

Other Meds: Fish Oil 4 g/day Multi-vitamin B MgSO4 500 mg/daily CoQ10 400 mg/daily ASA 81 mg/daily B12 1 mg/daily

Current Illness: None

ID: 1096987
Sex: F
Age: 24
State: AZ

Vax Date: 03/12/2021
Onset Date: 03/13/2021
Rec V Date: 03/13/2021
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: Latex Pineapple

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

Symptoms: Fever, headache, chills

Other Meds: Doxepin Claritin Ester c Flonase

Current Illness:

ID: 1096988
Sex: F
Age: 67
State: CA

Vax Date: 02/18/2021
Onset Date: 02/18/2021
Rec V Date: 03/13/2021
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: Yes--unknown allergens; Has hx of immunosuppression antigen therapy, (allergy injections)

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

Symptoms: Patient developed generalized itching within hours of administration of the vaccine. She stated that her PMD and allergist said that she could have 2nd dose but 2 MDs , 1 PA and 1 RN at our public health facility did not feel safe in doing this. We declined to give the 2nd dose of Pfizer vaccine.

Other Meds:

Current Illness: no

ID: 1096989
Sex: F
Age: 43
State: NY

Vax Date: 03/10/2021
Onset Date: 03/13/2021
Rec V Date: 03/13/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Infection at injection site

Other Meds: Bisopropalal7.5 mg daily

Current Illness:

ID: 1096990
Sex: M
Age: 69
State: SC

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

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

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Fever to 104 F, shaking chills, nausea, generalized aches, fatigue, intractable hiccups, tongue blister, diarrhea. Seen at urgent care 3/12 and had negative rapid COVID test. Given prescription for zofran and taking Tylenol for fever. Returned home that afternoon and developed intractable hiccups and noticed tongue blister. Again seen at urgent on care on 3/13 and given baclofen for hiccups.

Other Meds: Fish oil, vitamin b complex

Current Illness:

ID: 1096991
Sex: F
Age: 36
State: AZ

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

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

Lab Data:

Allergies: Cloderm Gallate

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

Symptoms: Abdominal pain, chills, fever, join pain, body aches, head ache

Other Meds: Levothyroxine, Cryselle, Vitamin D, Baby Asprin, Healthy Blood Vitamin Code, VitaMedMD One Rx, Mega CoQ10 Ubiquinol, Goli apple cider vinegar,

Current Illness:

ID: 1096992
Sex: F
Age: 67
State: MA

Vax Date: 03/13/2021
Onset Date: 03/13/2021
Rec V Date: 03/13/2021
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:

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

Symptoms: Pt developed Chest pressure 20 minutes post injection, BP was 150/90 Transported to medical center via Amb CAOx3

Other Meds:

Current Illness:

ID: 1096993
Sex: F
Age: 54
State: TN

Vax Date: 03/12/2021
Onset Date: 03/13/2021
Rec V Date: 03/13/2021
Hospital:

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

Lab Data:

Allergies: Bacitracin, Neosporin, sulfa drugs, neomycin, eggplant. hazelnuts

Symptom List: Unevaluable event

Symptoms: Moderna COVID-19 vaccine EUA Headache - 18 hours after Fever - 100.5 (26 hours after) Arm soreness

Other Meds: Rosuvastatin, Omeprazole, montelukast, escitalopram, pramipexole, zolpidem ER, gabapentin, atomoxetine HCL,, Estradiol, Progesterone, amoxicillin, diflucan, Turmeric Curcumin Gummy, One A Day Women's VitaCraves Multivitamin Gummies, B-12

Current Illness: Ear infection, yeast infection

ID: 1096994
Sex: M
Age: 38
State: FL

Vax Date: 03/13/2021
Onset Date: 03/13/2021
Rec V Date: 03/13/2021
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: no known drug allergies

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

Symptoms: Patient stated his tongue felt heavy or thick

Other Meds: atorvastatin; additional medications unknown.

Current Illness: high blood pressure; high cholesterol

ID: 1096995
Sex: F
Age: 38
State: NC

Vax Date: 03/09/2021
Onset Date: 03/12/2021
Rec V Date: 03/13/2021
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: I developed hives that started with my hands, but spread to my arms, lips, and knees. It wasn?t impacted by OTC Benadryl and hydrocortisone cream, so I went to urgent care and was prescribed prednisone and an antihistamine

Other Meds: None

Current Illness: None

ID: 1096996
Sex: M
Age: 75
State: MI

Vax Date: 03/12/2021
Onset Date: 03/12/2021
Rec V Date: 03/13/2021
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: Fever of 102. Pulse rate of 109

Other Meds: Flowmax plus high blood pressure meds

Current Illness: None

ID: 1096997
Sex: F
Age: 21
State: IL

Vax Date: 03/10/2021
Onset Date: 03/11/2021
Rec V Date: 03/13/2021
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: Penicillin

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

Symptoms: Sight of injection started swelling, getting red, and getting hot about a day later. Redness has progressively grown in size over the past two days and it has continued to be swollen and hot to the touch. It?s now about 2 x 3 inch blotch and has started itching in the past 24 hours. I did not have any reaction to the first vaccine except a very sore arm.

Other Meds: Norethindrone, Boluoke

Current Illness:

ID: 1096998
Sex: M
Age: 48
State: WI

Vax Date: 03/13/2021
Onset Date: 03/13/2021
Rec V Date: 03/13/2021
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: Nausea, Pain in extremity, Pyrexia

Symptoms: Client reported shortness of breath with gradual onset within 30 minutes of vaccination. Monitored by paramedics and symptoms resolved without treatment.

Other Meds:

Current Illness:

ID: 1096999
Sex: F
Age: 55
State: NJ

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

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

Lab Data:

Allergies: Pennicillin, Iodine and IV Contrast First Shot reaction treated with benadryl. Ths is second dose incident

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Patient, soon after developed a tingling in her lips, followed by a feeling of itching and small amount of noted rash around the upper chest which developed to small portions of the arms and back. Patient with a sensation of throat tighness. No chest pain, no SOB, skin warm and dry, lungs clear, radial pulses present. Initial vital signs of 138/88, 85, 98% room air. Patient did not pre-treat with any medications, even though she was treated with an allergic reaction on her initial dose. Rask and itching continued, decison to transprt, 50mg of Benadryl Given IM in Right Arm. EMS care and transprt to ED

Other Meds: Metformin, Ozempic, Vit D

Current Illness: None

Date Died: 02/26/2021

ID: 1097000
Sex: M
Age: 69
State: PA

Vax Date: 02/19/2021
Onset Date: 02/26/2021
Rec V Date: 03/13/2021
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: None known

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

Symptoms: No adverse events were immediately reported, but patient died on 7th day following vaccine

Other Meds: Eliquis, Ezetimibe/Simvast, Humira, Hydrochlorothiazide/Valsartan, Mercaptopurine, Metformin HCl

Current Illness:

ID: 1097001
Sex: F
Age: 47
State: TX

Vax Date: 02/01/2021
Onset Date: 02/10/2021
Rec V Date: 03/13/2021
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: Next day after first vaccination (Feb9) I developed large purple- pinkish spot below the place of a shot with a purple dot in the middle, looked like a ring worms ( I googled) but it did not itch. Looked very weird. I applied anti fungal cream and it got better. I decided it was not related to a vaccination. But a day after second doze of vaccine ( March 4) I developed huge bright red spot below the place of a shot the size of my palm. It was tender and looked very strange. It took 4 days for it to turn purple and then it started to disappear.

Other Meds: Lisinopril, hydrochlorocothiazide. Supplements - Detox Probiotic, Lectin Defense.

Current Illness:

ID: 1097002
Sex: F
Age: 0
State: MI

Vax Date: 03/13/2021
Onset Date: 03/13/2021
Rec V Date: 03/13/2021
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: Pt is a 47 year old female who presented to the vaccination site organization. PT received vaccine in her left arm and 5 minutes post injection she had numbness and tingling in her left hand. Pt reported very mild symptoms with no other associated complications. Pt had normal strength and sensation was intact. PTs vitals were taken with showed BP 135/96, HR 85, SPo2 98%. PT was observed for the next 25 minutes with her symptoms resolving upon observation of 30 minutes.

Other Meds: none

Current Illness: none

ID: 1097003
Sex: F
Age: 54
State: PA

Vax Date: 03/13/2021
Onset Date: 03/13/2021
Rec V Date: 03/13/2021
Hospital:

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

Lab Data:

Allergies: penicillin sulfa

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

Symptoms: Sudden jump in heart followed by pounding, rapid heart rate which lasted about 2-3 minutes. Somewhat light feeling throughout body.

Other Meds: Pantoprazole Sod Dr 40mg per day

Current Illness: n/a

ID: 1097004
Sex: F
Age: 17
State: TN

Vax Date: 03/13/2021
Onset Date: 03/13/2021
Rec V Date: 03/13/2021
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: none reported

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

Symptoms: patient felt faint and that her throat was closing up after 2 minutes.. called 911 and administered 1 epipen in left lateral thigh. patient responded quickly with proper color and felt much better according to patient. I observed patient for 30 minutes and after her mother and her confirmed her as feeling just fine, the patient and mother left the pharmacy.

Other Meds: none reported

Current Illness: none reported

ID: 1097005
Sex: F
Age: 51
State: MI

Vax Date: 03/13/2021
Onset Date: 03/13/2021
Rec V Date: 03/13/2021
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: compazine, tigan, phenagren

Symptom List: Tremor

Symptoms: Patient complained of headache, metallic taste and numbness on the sides of tongue. She was given 50mg oral benadryl at 11:55am. No further intervention required. Discharged to home.

Other Meds:

Current Illness:

ID: 1097006
Sex: F
Age: 67
State: PA

Vax Date: 03/10/2021
Onset Date: 03/11/2021
Rec V Date: 03/13/2021
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: Sulfa drugs, broccoli

Symptom List: Erythema, Pruritus

Symptoms: Fever 100.6, muscle and joint pain, fatigue and weakness

Other Meds: Wellbutrin, finasteride, doxycycline, biotin, D3, multi vitamin, pepcid, mucinex

Current Illness: None

ID: 1097007
Sex: M
Age: 67
State: FL

Vax Date: 03/10/2021
Onset Date: 03/11/2021
Rec V Date: 03/13/2021
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: None

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

Symptoms: Fever of over 100, chills, severe body aches, headache, light nausea, Fatigue

Other Meds: Lisinopril, atorvastatin, famotidine, tadalafil, cetirizine, krill oil, immune support vitamins with elderberry, Turmeric

Current Illness: Sore back

ID: 1097008
Sex: F
Age: 77
State: NY

Vax Date: 03/13/2021
Onset Date: 03/13/2021
Rec V Date: 03/13/2021
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: SWOLLEN UPPER LIP, BILATERAL EYE SWELLING

Other Meds: NONE

Current Illness: NONE

ID: 1097009
Sex: F
Age: 69
State: IL

Vax Date: 03/10/2021
Onset Date: 03/10/2021
Rec V Date: 03/13/2021
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: PENCILLIN

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: PATIENT STATED SHE FELT ITCHY GENERALIZED, 20 MINUTES AFTER VACCINE WAS ADMINISTERED. VITALS SIGNS TAKEN. ALL NORMAL LIMITS FOR PATIENT. ASSESMENT WAS MADE AND FOUND NO REDNESS, NO HIVES, NO SHORTNESS OF BREATH.

Other Meds: ANTIHISTAMINE

Current Illness: N/A

ID: 1097010
Sex: M
Age: 48
State: FL

Vax Date: 03/11/2021
Onset Date: 03/11/2021
Rec V Date: 03/13/2021
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: Tetracyclime

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

Symptoms: Chills lasted for about 16 hours Fever in the middle of the night Muscle pain in injection arm (current) Pain in arm pit of injection arm (current) Headache lasted about 24 hours

Other Meds: Propecia

Current Illness: None

ID: 1097011
Sex: F
Age: 34
State:

Vax Date: 03/13/2021
Onset Date: 03/13/2021
Rec V Date: 03/13/2021
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: Heart racing/trouble breathing. Evaluated by EMS (Refusal to transport) Cleared

Other Meds:

Current Illness:

ID: 1097012
Sex: F
Age: 43
State: PA

Vax Date: 03/12/2021
Onset Date: 03/12/2021
Rec V Date: 03/13/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Pain in extremity

Symptoms: Fever of 101.7, chills starting at night. Headache. Muscle and joint aches. Arm and shoulder soreness near injection site.

Other Meds: Low dose aspirin, tamoxifen, multivitamin, probiotic, vitamin d, doxycycline

Current Illness: Staph marginal keratitis

ID: 1097013
Sex: F
Age: 66
State: NC

Vax Date: 02/26/2021
Onset Date: 03/08/2021
Rec V Date: 03/13/2021
Hospital: Y

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

Lab Data:

Allergies: Codeine HcTZ

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

Symptoms: Saddle blood clot in lung. Place in ICU for 1 day. Then regular room. Heparin drip to Apixaban. No activity. All medical tests indicated no cause of blood clot. Vitals great. Past out twice and threw up night it started

Other Meds: Ozempic .5 once a week Amlodipine Besylate. 10 mg once daily

Current Illness: None

ID: 1097014
Sex: F
Age: 64
State:

Vax Date: 03/13/2021
Onset Date: 03/13/2021
Rec V Date: 03/13/2021
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: Lightheaded, flushing. Evaluated by EMS (refusal to transport) Cleared

Other Meds:

Current Illness:

ID: 1097015
Sex: M
Age: 27
State: ND

Vax Date: 03/13/2021
Onset Date: 03/13/2021
Rec V Date: 03/13/2021
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: Within 5 minutes of receiving the vaccine, patient stared to feel warm, and clammy. He was assessed by EMS in the Observation Areas. He was assessed by EMS. He did have low BP. Initial was 114/77, and lowest was 58/38. No dizziness or loss of consciousness.

Other Meds:

Current Illness:

ID: 1097016
Sex: M
Age: 74
State: MD

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 03/13/2021
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: I did not sense any vaccine being injected on my 2nd shot. Was it just a saline shot?

Other Meds:

Current Illness:

ID: 1097017
Sex: F
Age: 67
State: MI

Vax Date: 03/04/2021
Onset Date: 03/04/2021
Rec V Date: 03/13/2021
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: Penicillin, Amoxicllin

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Suddden onset of feeling very hot in my face and neck.. I went to bathroom and looked at my face no swelling noted. My neck had a pouch of fluid accumulating with small redden areas on my neck and upper chest area. No other symptoms noted. My breathing was good.

Other Meds: Norvasc 5mg

Current Illness:

ID: 1097018
Sex: M
Age: 55
State: CA

Vax Date: 03/13/2021
Onset Date: 03/13/2021
Rec V Date: 03/13/2021
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: Amoxicillin, aspirin, NSAIDs

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

Symptoms: Numbness in middle finger of right hand. Right hand colder than left. Lasted about one hour. Took two Benadryl capsules as per pharmacist.

Other Meds: N/A

Current Illness:

ID: 1097019
Sex: F
Age: 42
State: CO

Vax Date: 03/10/2021
Onset Date: 03/12/2021
Rec V Date: 03/13/2021
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: Intense arm pain lingering for 72+ hours post injection. 24 hours post injection, 103 degree fever lasted above 101 for 22 hours. Moderately severe headache lasting 72+ hours.

Other Meds: Vitamin C, Elderberry, Multi Vitamin

Current Illness: None

ID: 1097020
Sex: F
Age: 59
State: CA

Vax Date: 03/06/2021
Onset Date: 03/11/2021
Rec V Date: 03/13/2021
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: Chills, Diarrhoea, Fatigue, Feeling abnormal, Headache

Symptoms: initially sore arm that went away; few days later headache, rash on face which developed gradually. could be reaction to mask or vaccine not sure. been very noticeable the last 2 days. bright red by nose and mouth not really on forehead or anywhere else, does not itch

Other Meds: magnesium; vitamin D

Current Illness: none

ID: 1097021
Sex: F
Age: 80
State: IL

Vax Date: 01/22/2021
Onset Date: 01/31/2021
Rec V Date: 03/13/2021
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: A week after Pfizer injection, I got a raised, red area about 2 or 3 inches by five inches on my arm. It was hot and very itchy. Over the net two weeks it got larger, but less red. It was gone about the time I received the second shot, After the second shot, I got the rash sooner, but it was larger and not raised or hot It lasted several weeks. I took antihistamines and tried Cortisone cream. They didn't seem to help

Other Meds: generic Synthroid, Temazepam

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm