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: 0934316
Sex: M
Age: 19
State: WV

Vax Date: 01/04/2021
Onset Date: 01/07/2021
Rec V Date: 01/11/2021
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: N/A

Symptom List: Dysphagia, Epiglottitis

Symptoms: I had pain at the injection site and headaches for three days then since then from the seventh I had had red dots appear around my neck and left shoulder

Other Meds: Guanfacine, Methylphenidate, and Escitalopram

Current Illness: Had the flu around thanksgiving

ID: 0934317
Sex: F
Age: 59
State: TX

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 01/11/2021
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: Codeine, sulfa, erythromycin, medrol, chloroprep,

Symptom List: Anxiety, Dyspnoea

Symptoms: Pain began about 6hours after I received the shot, and lasted about 24 hours. Today when showering I noticed that there's an area 4? wide that is still bright red and bruised. It looks pretty bad.

Other Meds: Cell Cept 500 mg Lisinopril 5 mg Crestor 5 mg (2 x/week) Levothyroxine 50 mcg Calcium citrate 600 mg Vit D 50 mcg Vit C 500 mg Multivitamin Niacin 500 mg (2x/week)

Current Illness:

ID: 0934318
Sex: M
Age: 77
State: LA

Vax Date: 01/05/2021
Onset Date: 01/07/2021
Rec V Date: 01/11/2021
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: Sulfa, Crlebrex

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

Symptoms: Chills, low grade fever, generalized muscle aches, headache . Lasted approximately 36 hours. Treated with Tylenol and Inuprofen.

Other Meds: Flecanide, toprol xl, Crestor, enapril, bit D, Magnesium, Calcium,

Current Illness: No

ID: 0934319
Sex: F
Age: 53
State: IN

Vax Date: 01/06/2021
Onset Date: 01/07/2021
Rec V Date: 01/11/2021
Hospital:

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

Lab Data:

Allergies: Morphine, hydrocodone

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Aches, chills, generalized soreness, inj. site pain, localized redness and swelling. Cough, minimal yellow phlegm, hoarseness. Most sx were better after 24 hrs. The non-productive cough decreased over the next 3 days . * I did not check my temp when chilled- the chills lasted about 2 hours only.

Other Meds: Lexapro, Wellbutrin, multivitamin, probiotic

Current Illness: Covid positive 12/6/2020

ID: 0934320
Sex: M
Age: 45
State: TX

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 01/11/2021
Hospital:

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

Lab Data:

Allergies: Codeine/Percocet- rash

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

Symptoms: All symptoms occurred at the 12-24hr mark: metallic taste, chest tightness, limb (needle like) itching, cold sweats, body ache/pain, chills, nausea. All symptoms resided except for malaise after the 24hr mark. Malaise current through today(11JAN21)

Other Meds: none

Current Illness: none

ID: 0934321
Sex: M
Age: 57
State: WA

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/11/2021
Hospital:

Vax Type: FLUC4
Manufacturer: SEQIRUS, INC.
Vax Name: INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT)
Lot: 276563
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: none

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

Symptoms: C/O DIZZINESS AND LIGHTHEADNESS AT 1020 PM . B/P 140/90,P74, O2 97% MONITORED & GIVEN 5 CUPS OF H2O.1030PM 142/74, 80, 96% STILL DIZZY AND GIVEN MORE H2O, 1055PM 130/76,64,100% STATES FEELING BETTER NO SYMTOMS, CALLED NEXT DAY 9/8 FEELING BETTER HYRD/EAT instructed to call provider or 911 if symptoms worsen

Other Meds: none

Current Illness: none

ID: 0934322
Sex: F
Age: 46
State: OH

Vax Date: 12/29/2020
Onset Date: 01/06/2021
Rec V Date: 01/11/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Enlarged (L)Supraclavicular Lymph node. Myalgias

Other Meds: Align probiotic, HCTZ, Amlodipine, Effexor XR.

Current Illness: None.

ID: 0934323
Sex: F
Age: 31
State:

Vax Date: 01/06/2021
Onset Date: 01/09/2021
Rec V Date: 01/11/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Itchy rash on both left and right upper arms. Symptoms subsided after taking Benadryl 25mg

Other Meds:

Current Illness:

ID: 0934324
Sex: F
Age: 35
State: NJ

Vax Date: 12/31/2020
Onset Date: 01/09/2021
Rec V Date: 01/11/2021
Hospital:

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

Lab Data:

Allergies: Zithromax

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Red rash on right arm around the site where vaccine was administered

Other Meds: Vegan prenatal vitamin and vegan calcium and vitamin d supplement

Current Illness: Nonr

ID: 0934325
Sex: F
Age: 32
State: NY

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/11/2021
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: Chills Headache Joint pains Muscle pains Fever >102

Other Meds: None

Current Illness: None

ID: 0934326
Sex: F
Age: 55
State: CO

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 01/11/2021
Hospital:

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

Lab Data:

Allergies: Unknown

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

Symptoms: Patient states ''I received a COVID vaccine yesterday''. Shot was given yesterday at 2:30 pm. Patient states allergic reaction started 10-15 minutes after shot was given. Patient states her eyes are itching and red. Patient states redness around her eyes and legs. RN triaged patient and recommended patient to go to ED now. Patient states she is going to wait and see if she feels better. Denies difficulty breathing or difficulty to swallow.

Other Meds: Unknown

Current Illness: Unknown

ID: 0934327
Sex: F
Age: 40
State: TN

Vax Date: 12/21/2020
Onset Date: 12/23/2020
Rec V Date: 01/11/2021
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: Levaquin

Symptom List: Rash, Urticaria

Symptoms: I had large red and hot welt. I had lip node enlargement. It lasted for a week.

Other Meds: None

Current Illness: None

ID: 0934328
Sex: F
Age: 58
State: MA

Vax Date: 01/05/2021
Onset Date: 01/05/2021
Rec V Date: 01/11/2021
Hospital:

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

Lab Data:

Allergies: Allergic to prednisone.

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

Symptoms: Extremely sore arm at the injection site, ice applied, minimal relief. Took ibuprofen x 2 days. The 3rd day, my arm was fine, but I experienced extreme fatigue, no energy, and actually had to take a nap!! By day 4, I was fine.

Other Meds: Vit. C, cherry extract, calcium with vit. D, COQ-10, selenium, baby asa.

Current Illness: N/A.

ID: 0934329
Sex: F
Age: 59
State: MA

Vax Date: 12/30/2020
Onset Date: 01/07/2021
Rec V Date: 01/11/2021
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: amox

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

Symptoms: about 7 days later, acute onset pruritis at the injection site, looked like a mosquito bite. then resolved 2 hrs later

Other Meds: vit D omega oil sertraline

Current Illness:

ID: 0934330
Sex: M
Age:
State: AZ

Vax Date:
Onset Date:
Rec V Date: 01/11/2021
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: Statins

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

Symptoms: None stated.

Other Meds: alirocumab 75/mg metoprolol succinate 25/mg amiodarone 200/mg warfarin na 2 1/2 mg eplerenone 50/mg levothyroxine na 75/mg ezetimibe 10/mg

Current Illness:

ID: 0934331
Sex: F
Age: 47
State:

Vax Date: 01/09/2021
Onset Date: 01/09/2021
Rec V Date: 01/11/2021
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: Valtrex. Trazodone.

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

Symptoms: Fever 103, myalgias, HA, insomnia, SOB, hallucinations, rigors. Symptoms lasted longer than 24 hrs.

Other Meds: Seroquel 25 mg, Clonazepam 1 mg, Omeprazole 20 mg, Bentyl 10 mg, Imitrex 25 mg, levothyroxine 50 mcg. Vitamin D, Calcium, Turmeric, multi-vitamin, CBD oil, B-complex.

Current Illness: none known

ID: 0934332
Sex: F
Age: 60
State: WI

Vax Date: 01/09/2021
Onset Date: 01/10/2021
Rec V Date: 01/11/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Have very bad body aches and hot and cold sweats . I have been taking ibuprofen 2 times and symptoms get better.

Other Meds: None

Current Illness: None

ID: 0934333
Sex: F
Age: 34
State: CO

Vax Date: 01/09/2021
Onset Date: 01/10/2021
Rec V Date: 01/11/2021
Hospital:

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

Lab Data:

Allergies: shellfish

Symptom List: Ear pain, Hypoaesthesia

Symptoms: fever and body aches beginning at 2AM. treated with Ibuprofen with resulting reducting in fever but continued body aches/myalgias that lasted until 1pm on 1/10/21. Fatigue starting 5pm 1/9 and lasting until 5pm 1/10

Other Meds: Nortrel, levothryroxin (88micrograms), fenofibrate (145mg)

Current Illness: N/A

ID: 0934334
Sex: F
Age: 50
State: GA

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

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

Lab Data:

Allergies: morphine, tramadol, sulfa, steroids,

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: fever, chills, sore throat, difficulty swallowing, body aches, joint pain, hypertensive, tightness in chest. Went to ER @ Hospital

Other Meds: n/a

Current Illness: n/a

ID: 0934335
Sex: F
Age: 28
State: KY

Vax Date: 12/30/2020
Onset Date: 12/31/2020
Rec V Date: 01/11/2021
Hospital:

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

Lab Data:

Allergies: NKA

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

Symptoms: Injection site redness large area with raised borders , hot to the touch

Other Meds: Sertaline 75mg Sprintec Tagamet

Current Illness: NO

ID: 0934336
Sex: F
Age: 53
State: ND

Vax Date: 01/06/2021
Onset Date: 01/07/2021
Rec V Date: 01/11/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

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

Symptoms: 5am on 1/7 woke up with chills, bodyaches, fever, lethargy and headache. Lasted through day, temperature up to 101.5. On 1/8, temperature resolved, still bodyaches. On 1/9, symptoms resolving, but at 12:00pm temperature of 99.9 and fatigue. On 1/10 right deltoid where vaccine was administered, sight is warm to touch and swollen, painful.

Other Meds: Wellbutrin, Fiber pill, Milk Thistle, Pepcid

Current Illness: Elevated liver enzymes, possible ulcer

ID: 0934337
Sex: F
Age: 44
State: ND

Vax Date: 12/28/2020
Onset Date: 01/09/2021
Rec V Date: 01/11/2021
Hospital:

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

Lab Data:

Allergies: prozac

Symptom List: Unevaluable event

Symptoms: Covid vaccine administered in right deltoid on Dec 28. On Jan 9, 2021, client noticed a rash and warmth at the injection site. Does not itch, but has some discomfort with pressure.

Other Meds:

Current Illness: no

ID: 0934338
Sex: M
Age: 12
State: CA

Vax Date: 01/01/2019
Onset Date: 01/01/2019
Rec V Date: 01/11/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: After the first dose in 2018, he started with having fainting or dizzy spells every time he would get up. He had several full on blackout fainting episodes all the way up until Jan. 2019. Then he had his second dose. After the second dose, the fainting spells increased and that year I took him to his pediatrician followed by several other doctors and tests to determine the reason for the fainting.

Other Meds: None

Current Illness: None

ID: 0934339
Sex: F
Age: 54
State: DC

Vax Date: 12/30/2020
Onset Date: 01/06/2021
Rec V Date: 01/11/2021
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: sulfur

Symptom List: Injection site pain, Pain

Symptoms: Exactly one week following receipt of vaccine, my injection site became pruritic. I scratched and the site began swelling, became warm to touch, along with site tenderness. It is slowly resolving.

Other Meds: Tylenol, Low dose ASA, Benicar, fish oil, zinc, vit c, vit d, eldeberry

Current Illness: none

ID: 0934340
Sex: F
Age: 63
State: IL

Vax Date: 12/22/2020
Onset Date: 12/22/2020
Rec V Date: 01/11/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Three hours after the vaccine I started developing chest pressure that lasted 45 minutes. After an hour after I had disnea rest which last 55 hours. I put a call into my patient care provider and went it to get a Coivd test that came back negative. I was told If it got worse to go to the emergency room . After the 55th hour I was back to normal.

Other Meds: Lisinopril -20mg daily

Current Illness:

ID: 0934341
Sex: F
Age: 36
State: IL

Vax Date: 01/09/2021
Onset Date: 01/10/2021
Rec V Date: 01/11/2021
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: No known allergies

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

Symptoms: Headache, body aches, chills, fatigue, dizziness, confusion, extremity tingling in first 24 hours. At 26 hours post injection, severe left axillary lymphadenopathy noted with axillary pain.

Other Meds: Lexapro 10 mg tablet

Current Illness: None

ID: 0934342
Sex: F
Age: 37
State: CA

Vax Date: 01/05/2021
Onset Date: 01/08/2021
Rec V Date: 01/11/2021
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: Nausea, Pain in extremity, Pyrexia

Symptoms: balls palsy headache arm sore

Other Meds:

Current Illness:

ID: 0934343
Sex: F
Age: 96
State: MA

Vax Date: 01/08/2021
Onset Date: 01/11/2021
Rec V Date: 01/11/2021
Hospital:

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

Lab Data:

Allergies: nka

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Left arm, red, tender to touch, warm, slightly swollen.

Other Meds: AmLODIPine Besylate Tablet 5 MG Give 1 tablet by mouth in the morning for blood pressure Aspirin EC Tablet Delayed Release 81 MG Give 1 tablet by mouth in the morning for blood thinner Atorvastatin Calcium Tablet 10 MG Give 10 mg by mouth o

Current Illness: None

ID: 0934344
Sex: F
Age: 51
State: CA

Vax Date: 01/10/2021
Onset Date: 01/10/2021
Rec V Date: 01/11/2021
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: Shortness of breath Arm pain Lump under left arm pit Pain goes across chest and down arm No fever Achy all over Left arm down to fingers and up the arm and across the chest to swollen arm under arm pit is in pain

Other Meds:

Current Illness:

ID: 0934345
Sex: F
Age: 34
State:

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 01/11/2021
Hospital:

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

Lab Data:

Allergies: Turkey, Rabbit Fur

Symptom List: Nausea

Symptoms: Pfizer-BioNTech COVID-19 Vaccine EUA: Developed headache (about 3 hours after injection), diarrhea (about 20 hours after injection) and sneezing/runny nose (about 4 days and 3 hours after injection)

Other Meds: N/A

Current Illness: N/A

ID: 0934346
Sex: F
Age: 52
State: UT

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 01/11/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: Symptoms started 1/4/21 @ 1800 with dry heaving, body aches, fever, then started coughing and shortness of breath that night. Next day still had fever, severe body aches and cough got worse with shortness of breath. I did home nebulizer several times and started prednisone 40mg. 1/6/21 shortness of breath worsened to the point I couldn't talk, chest tightness with burning. Went into ED at hospital where they gave me another breathing treatment x 2, magnesium sulfate, IV solu medrol. They were going to admit me but I decided against it with all the covid patients.

Other Meds: Has inhalers and nebulizer for Asthma treatment. Unknown specifics.

Current Illness:

ID: 0934347
Sex: F
Age: 32
State: NE

Vax Date: 01/05/2021
Onset Date: 01/08/2021
Rec V Date: 01/11/2021
Hospital:

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

Lab Data:

Allergies: morphine, latex

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

Symptoms: 33 weeks gestation. sudden onset of upper abdominal pain, constant with palpable tenderness over b/l CVA, lower abdomen and upper abdomen. urine and labs normal. vitals normal, afebrile. sent to L and D to monitor. good fetal activity and cervix closed. sx gradually decreased and was able to go home but today 1/11 still with diffuse tenderness, worse with activity and some braxton hix contractions.

Other Meds: iron, prenatal vitamin, linzess, zofran prn, protonix, valtrex prn

Current Illness: no

ID: 0934348
Sex: F
Age: 33
State: NY

Vax Date: 01/01/2021
Onset Date: 01/11/2021
Rec V Date: 01/11/2021
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: none

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

Symptoms: Started with a rash on both sides of my hips and then each day the rash appeared on my thighs, buttocks and now randomly on my elbows and knees

Other Meds: none

Current Illness: none

ID: 0934349
Sex: F
Age: 36
State: TX

Vax Date: 01/09/2021
Onset Date: 01/09/2021
Rec V Date: 01/11/2021
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: N/A

Symptom List: Tremor

Symptoms: nausea and vomiting for 1 hour, approx. 15 hours after vaccine receipt. Accompanied by low grade fever (99.3F), chills, rigors, headache

Other Meds: Zoloft 50mg QD, Vitamin D 5000 units weekly

Current Illness: N/A

ID: 0934350
Sex: F
Age: 37
State: CA

Vax Date: 01/05/2021
Onset Date: 01/08/2021
Rec V Date: 01/11/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: balls palsy headache sore arm

Other Meds:

Current Illness:

ID: 0934351
Sex: F
Age: 32
State: MO

Vax Date: 12/22/2020
Onset Date: 12/29/2020
Rec V Date: 01/11/2021
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: latex

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

Symptoms: 1 week after vaccine administration (12/29/20), I developed diarrhea that has persisted for ~2 weeks at the time of this report and is ongoing. Currently pregnant with EDD 2/22/21. Uncomplicated pregnancy so far.

Other Meds: Prevacid, Unisom, prenatal vitamin

Current Illness: none

ID: 0934352
Sex: F
Age: 23
State: SC

Vax Date: 12/17/2020
Onset Date: 12/23/2020
Rec V Date: 01/11/2021
Hospital:

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

Lab Data:

Allergies: sulfa

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

Symptoms: lymphadenopathy on left side of neck. It happened 5 days after first dose and has stayed swollen since first vaccine, but otherwise had no other issues. After she received her second vaccine, it has doubled or tripled in size and is painful.

Other Meds: celexa 20mg

Current Illness: no

ID: 0934353
Sex: F
Age: 68
State: VT

Vax Date: 12/31/2020
Onset Date: 12/31/2020
Rec V Date: 01/11/2021
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: Iodine - bees, shellfish, IVP Dye

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Burning/pain in throat, itching around mouth, wheezing, coughing, and BP 195/100. Taken to the ER, received epinephrine breathing treatment and Benadryl Observed for 2 hours then discharged. Slept most of the following day.

Other Meds: Lexapro Allegra Omeprazole Advir Inhaler Advil

Current Illness: None

ID: 0934354
Sex: F
Age: 27
State: CA

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

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

Lab Data:

Allergies: None

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

Symptoms: Hives and lip filler swelling 1/11/21 at 8:30am

Other Meds: Biotin 10,000mcg qd Spironolactone 50 mg qd Adderall XR 10 mg qd Nutrafol

Current Illness: None

ID: 0934355
Sex: F
Age: 37
State: WA

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/11/2021
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: none

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

Symptoms: C/O DIZZINESS/LIGHTHEADED, NO SOB, 905P 150/80,75,100%, 919PM 122/92,75,93% NO CHANGE, H/A, GIVEN H2O,926PM NO CHANGE, 946PM MORE H2O, 124/78,61, 97% NO MORE DIZZINESS STILL H/A FRIEND DROVE HER HOME, 01/08 AT 11AM HA NO DIZZINESS, TOLD TO CONTACT PCP OR 911 IF SYMPTOMS WORSEN

Other Meds: TAKING LISINPROL/HCTZ AND ASPRIN

Current Illness: none

ID: 0934356
Sex: F
Age: 48
State: TX

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/11/2021
Hospital:

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

Lab Data:

Allergies: Lisinopril/ Wasp stings

Symptom List: Pain in extremity

Symptoms: throat swelling, wheezing, headache, palpitations immediate, took 50mg Benadryl and 650 tylenol Q 12 hours x 2 days, Severe, debilitating joint pain starting second day lasting 3 days, low grade fever, pain and swelling to L deltoid. Swelling in arm lasted 10 days

Other Meds: Lexapro 20mg/ norvasc 5 mg, MVI

Current Illness: High BP

ID: 0934357
Sex: F
Age: 44
State: OK

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 01/11/2021
Hospital:

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

Lab Data:

Allergies: Sulfa

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

Symptoms: about 2 hours after injection I got very itchy, face, arms torso red and itchy lasted for twos even with Bendryl. End of second day had sore "fiery" throat. Felt like throat was on fire lasted for a week. Nothing made it better.

Other Meds: Lisinopril 10mg @0430 Mobic 10mg@0430

Current Illness:

ID: 0934358
Sex: M
Age: 32
State: TX

Vax Date: 01/09/2021
Onset Date: 01/09/2021
Rec V Date: 01/11/2021
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: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: Myalgia began on 1/9/2021 mid day. Sunday 1/10/2021 at noon fever to 100.7. Symptoms since have resolved with no interventions.

Other Meds:

Current Illness:

ID: 0934359
Sex: F
Age: 34
State: TN

Vax Date: 01/09/2021
Onset Date: 01/09/2021
Rec V Date: 01/11/2021
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: one allergy to an unknown medication last year; she had hives to it and nobody knew from what

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

Symptoms: rash/hives (deep red) over chest, face, and ear treated with (1) benadryl 50mg capsule

Other Meds: Z-pak

Current Illness: she was COVID negative the week of the vaccine, being treated for an upper respiratory infection and strep (even though strep was negative)

ID: 0934360
Sex: F
Age: 46
State: CT

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 01/11/2021
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: NKDA

Symptom List: Vomiting

Symptoms: Metallic taste to left side of mouth started at 4 pm on 1/8/2021 and continued until 1/9/2021@ 3am after Loratadine 10 mg po at 4pm and Allegra 180 mg at 9 pm. Left tongue numbness and tingling started at 4 pm on 1/8/2021 and continued until 1/9/2021 @ 3pm after Loratadine 10 mg po at 4 pm, Allegra 180 mg po @ 9 pm, and Benadryl 50 mg IM at 12 pm.

Other Meds: Vitamin b12 Vitamin D3

Current Illness: None

ID: 0934361
Sex: F
Age: 35
State: ND

Vax Date: 12/31/2020
Onset Date: 01/01/2021
Rec V Date: 01/11/2021
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:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: One day following injection developed rash around the injection site. Since then reports continued rash that gets better then returns. Today the rash is faint per report.

Other Meds:

Current Illness:

ID: 0934362
Sex: F
Age: 36
State: CO

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 01/11/2021
Hospital:

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

Lab Data:

Allergies: NKDA

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

Symptoms: Ten minutes after receiving injection patient started to feel like her throat was swelling, 20 minutes after started to turn red and having rash to neck

Other Meds: Levothyroxine 200 mcg oral one tablet daily

Current Illness: N/A

ID: 0934363
Sex: F
Age: 53
State: NY

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 01/11/2021
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: Animal Dander, in past have skin tested positive to multiple allergens ( > 30 years ago)

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Within 5 minutes of injection, felt mild tightness in throat and chest. Did not report at time as it was mild. Symptoms did not resolve after a few hours. ~ 3 hours later, took Benadryl and bronchodiolator and symptoms improved. Also since injection have had mild GI distress gradually improving. Reporting now because I learned reaction could be worse to second injection, and 30 minute observation period would likely be prudent.

Other Meds: Phenobarbital, Synthroid, OTC: Magnesium, Calcium, Vitamin D, Probiotic

Current Illness: N/A

ID: 0934364
Sex: F
Age: 33
State:

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 01/11/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: 1). Headache (on &off) since 1/6. Tylenol and ibuprofen seem to be effective. 2). Fever with Temperature btn 99-100.3 these past three days. 3). Pulse (btn 104-110) the night of 1/6. 4). Muscle aches and swelling at injection site. This has been my biggest obstacle. I am having a hard time lifting and typing. . - I have been utilizing ice packs, range of motion/exercise, ibuprofen.

Other Meds:

Current Illness:

ID: 0934365
Sex: F
Age: 35
State: WA

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 01/11/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Brain fog, inability to think clearly, headache

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm