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: 1099177
Sex: F
Age: 70
State: MA

Vax Date: 02/24/2021
Onset Date: 03/04/2021
Rec V Date: 03/14/2021
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: none

Symptom List: Dysphagia, Epiglottitis

Symptoms: Moderna COVID-19 Vaccine EUA Fever, headaches, tired, vomitting, no appetite

Other Meds: levothyroxine .075mg

Current Illness: none

ID: 1099178
Sex: F
Age: 66
State: MD

Vax Date: 03/14/2021
Onset Date: 03/14/2021
Rec V Date: 03/14/2021
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: ampicillin, aspirin, erythromycin, flagyl, iodine, NORTRIPTYLINE penicillin, Venlafaxine Hclz, Vioxx [Rofecoxib]

Symptom List: Anxiety, Dyspnoea

Symptoms: a 66 yr old female In observation area began c/o dry throat, itchiness in eyes, diaphoresis and dizziness @17-20 minutes post Moderna COVID vaccine. Prior to this pt was interacting with RN doing V safe registration. Pt requested Water, drank 8 ounces of water without swallowing difficulty. Then pt became pale and requested PO Benadryl. Per adverse drug reaction kit, 25 mg /10 ml PO Benardyl given. Lot # 502935 exp 2/28/22 BP 146/87 large cuff on left arm -pt reported "I have high blood pressure" Pt advised to wait additional 15 minutes. Within 5 minutes pt skin pallor resolved, diaphoresis resolved along with dry throat and eye itchiness. Within 10 minutes pt drank another mini water bottle and again stated " I feel much better" Advised pt to call daughter from parking garage area to help assist pt to d/c. pts daughter is an RN also. Pt was able to ambulate independently though c/o feeling slightly tired stated "Benadryl usually makes me very sleepy" Pt d/c to home w/daughter @6:35 pm. Advised to call KP advice PRN any s/s worsening and to notify MD for precautions prior to second dose of Moderna scheduled. Pt agreed w/plan and verbalized understanding.

Other Meds:

Current Illness: unknown

ID: 1099179
Sex: F
Age: 66
State: MO

Vax Date: 03/13/2021
Onset Date: 03/13/2021
Rec V Date: 03/14/2021
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: Statin

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

Symptoms: Fatigue, HA, pain at site (3-4 out of 10), muscle aches, flank pain bilat (tender to touch)

Other Meds: Lamictal, levothyroxine, spironolactone, Calcium Citrate withD, multivitamin, Cholestyramine

Current Illness:

ID: 1099180
Sex: F
Age: 66
State: CA

Vax Date: 03/13/2021
Onset Date: 03/14/2021
Rec V Date: 03/14/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Fever, pain in arm, increase blood pressure, back of head pain, body aches

Other Meds: N/A

Current Illness: N/A

ID: 1099181
Sex: F
Age: 25
State: OH

Vax Date: 03/13/2021
Onset Date: 03/14/2021
Rec V Date: 03/14/2021
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: Fever: 100.9, fatigue, nausea, muscle pain, chills and headache

Other Meds:

Current Illness: Fever, chills, fatigue, headache, muscle pain, nausea

ID: 1099182
Sex: F
Age: 62
State: KY

Vax Date: 03/10/2021
Onset Date: 03/11/2021
Rec V Date: 03/14/2021
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: Allergic to Bactrum

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

Symptoms: Fever, chills, nausea, headache, extreme fatigue. I thought I had COVID again.

Other Meds: Caltrate vitamins

Current Illness: None, but I did positive for Covid in November 2020.

ID: 1099183
Sex: M
Age: 73
State: CA

Vax Date: 02/12/2021
Onset Date: 02/21/2021
Rec V Date: 03/14/2021
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: Tetnus

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: 1ST dose- Right arm- had a sore arm for almost 2 weeks, after 9 days, developed a rash a bout 4"x1" across the injection site. 2ND dose- Left arm- had very sore arm, within 1/2 hr, next day had a fever of 100.5, chills, and a red circle about 4" in diameter, with swelling and heat at the site.

Other Meds: Xeralto, fenofibrate, allopurinol, multivitamin

Current Illness:

ID: 1099184
Sex: F
Age: 65
State: NY

Vax Date: 03/11/2021
Onset Date: 03/11/2021
Rec V Date: 03/14/2021
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: Pharyngeal swelling

Symptoms: At 8:00pm on day of injection started with rash on neck. During night started with fever ranging from 100.6-102 which went on till 7pm following day, Friday the 12th. Woke up Friday morning with face swollen with rash that kept spreading. Was unable to move from bed. Saturday went to urgent care once. I could get out of bed. Elevated heart beat at 100.

Other Meds: Cytomel 5mg VitaminC

Current Illness: None

ID: 1099185
Sex: M
Age: 66
State: IN

Vax Date: 03/12/2021
Onset Date: 03/12/2021
Rec V Date: 03/14/2021
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: Severe Body weakness/aches, fever, chills, loss of appetite.

Other Meds: Atorvastatin, Metformin, Glipizide, Lisinopril, Aspirin 81 mg, Januvia, Pioglitazone, Vitamins A, C, D, Garlic, Iron, CoQ10, Multivitamins.

Current Illness: None

ID: 1099186
Sex: F
Age: 65
State: IN

Vax Date: 03/11/2021
Onset Date: 03/13/2021
Rec V Date: 03/14/2021
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: dizzy sweats developed deep cough

Other Meds: chlorthalidone

Current Illness: none

ID: 1099187
Sex: F
Age: 56
State: IN

Vax Date: 03/12/2021
Onset Date: 03/13/2021
Rec V Date: 03/14/2021
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 known

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

Symptoms: significant body aches, fever of 100.7 on Tylenol, headache

Other Meds: Tylenol, Meloxicam, Lisinopril-Hydrochlorothiazide, Vitamin D, Multi-vitamin

Current Illness: None

ID: 1099188
Sex: F
Age: 38
State: WA

Vax Date: 03/14/2021
Onset Date: 03/14/2021
Rec V Date: 03/14/2021
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: Unknown

Symptom List: Rash, Urticaria

Symptoms: Most of the dose leaked out of the client's arm during administration. The nurse was certain that less than half a dose was given. The dose was repeated in the other arm and full dose was administered.

Other Meds: Unknown

Current Illness: Unknown

ID: 1099189
Sex: F
Age: 67
State: MO

Vax Date: 03/13/2021
Onset Date: 03/14/2021
Rec V Date: 03/14/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: Fever of 101 F, muscle aches, chills, headache

Other Meds: Gabapentin 100MG 2 capsules-three times per day Ropinirole 1MG 2 tablets three time daily Estradiol 10MCG Vaginal Tabs 8s 1 inserted twice a day

Current Illness:

ID: 1099190
Sex: F
Age: 44
State: OR

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 03/14/2021
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: Ct scan contrast I have to take two Benadryl before as I get sneezing attack.

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

Symptoms: After waiting my 15 min, and left the facility about 10 min later my left side of face tingled. Then about 1 hour after getting the shot I had a horrible leg crap in left leg to the point it was hard to walk. Went to ER and ruled out blood clot and I also developed sores in my mouth. That night I started feeling warm sensation down both arms and tingling in both hands and this had been going on each day throughout the day where I have a warm sensation down my arms and through my upper chest and is not going away, today 3/14/21 I went to urgent care again as now left side has swelling in my lymph nodes in my chest and I still have the tingling in my face and my head does not feel right. Urgent care did a neurological base test and I seem fine in that department but told me to report the warming sensation as it?s not my skin but I feel it inside.

Other Meds: Protonix for acid reflux that is all I took the Morning of before my shot

Current Illness: Crohn?s disease

ID: 1099191
Sex: F
Age: 44
State: CT

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 03/14/2021
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: Erythromycin Milk Pork Beef Bees Environmental (mold,trees,grass)

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

Symptoms: Immediate intense deep itching at injection site. Itchy throat and mild swelling of mouth. Treated with Benadryl

Other Meds: Synthroid, Vitamin D3, Pepcid

Current Illness: None

ID: 1099192
Sex: M
Age: 17
State: LA

Vax Date: 02/09/2021
Onset Date: 03/14/2021
Rec V Date: 03/14/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: None

Other Meds: None

Current Illness: None

ID: 1099193
Sex: F
Age: 46
State: NY

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 03/14/2021
Hospital: Y

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: Went to bed around 10pm on 2/10, experienced right arm stiffness and hemiparesis. Lived by herself, unable to reach her until 1/11. Admitted with Left MCA infarct, several foci on left occipital lobe points to cardioembolic etiology. No motor deficits, mixed aphasia. Central embolic etiology. No fam hx of coagulopathy.

Other Meds: Metoprolol 25 QD Atorvastatin 80 qhs Acetazolamide 250 mg

Current Illness: IIH HTN

ID: 1099194
Sex: F
Age: 30
State: CA

Vax Date: 02/28/2021
Onset Date: 03/03/2021
Rec V Date: 03/14/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List: Ear pain, Hypoaesthesia

Symptoms: I have been having shortness of breath since the a few days after vaccination. Have been in Urgent Care twice and the ER once. They dismiss it as asthma because of my history but no asthma medication works plus it feela different. My regular Dr. said it was the vaccine.

Other Meds: Symbicort, Pro-Air

Current Illness: Asthma

ID: 1099195
Sex: F
Age: 42
State: MN

Vax Date: 03/12/2021
Onset Date: 03/13/2021
Rec V Date: 03/14/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Fever of 102.1 Body aches Chills Fatigue Nausea

Other Meds: Sertraline 100 mg

Current Illness: None

ID: 1099196
Sex: F
Age: 50
State: MN

Vax Date: 02/27/2021
Onset Date: 03/12/2021
Rec V Date: 03/14/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: My left arm was red, hot, raised and itchy. It is 3 days, and it is better, but still a little red, hot and itchy.

Other Meds: None

Current Illness: None

ID: 1099197
Sex: F
Age: 64
State: CT

Vax Date: 03/14/2021
Onset Date: 03/14/2021
Rec V Date: 03/14/2021
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, Keflex and Neulasta

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

Symptoms: Face became deep red and very warm to touch. No breathing problems; no dizziness or any other symptoms.

Other Meds: Anastrozole 1 mg every evening; Vitamin D 2000 IU every morning; Fish Oil

Current Illness: No other illness

ID: 1099198
Sex: F
Age: 54
State: NJ

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 03/14/2021
Hospital:

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

Lab Data:

Allergies: Seasonal, cats

Symptom List: Unevaluable event

Symptoms: Severe headache and ?brain fog? for several days. Unable to work the following day due to intensity of headache. Headache continued from Thursday through Tuesday.

Other Meds: Trileptal

Current Illness: None

ID: 1099199
Sex: F
Age: 39
State: IL

Vax Date: 03/02/2021
Onset Date: 03/06/2021
Rec V Date: 03/14/2021
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: bacitracin colophony gold nickel

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

Symptoms: I developed hives from head to toe. It didn't really itch or feel uncomfortable. Went to immediate care and got a steroid shot and some steroid pills. It started to disappear on Tuesday morning.

Other Meds: Amoxicillin for a sinus infection Levora birth control

Current Illness: sinus infection

ID: 1099200
Sex: F
Age:
State: CA

Vax Date:
Onset Date:
Rec V Date: 03/14/2021
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: Phenazopyridine

Symptom List: Injection site pain, Pain

Symptoms: Intestinal Cramping, fever, chills. Whole middle section of body aching. So painful I could barely get out of bed. The worst part lasted about 15 hours. I didn?t feel totally normal for a few days prior but able to function & do my normal life.

Other Meds: Over Centrum Silver vitamin, B-12 1000 mcg, D3 25 mcg, ibuprofen 200 mg, Flonase.

Current Illness: None

ID: 1099201
Sex: F
Age: 51
State: OR

Vax Date: 03/10/2021
Onset Date: 03/11/2021
Rec V Date: 03/14/2021
Hospital:

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

Lab Data:

Allergies: Vicodin; sulfa medications

Symptom List: Injection site pain, Menorrhagia

Symptoms: All the basics - pain in arm and shoulder; extreme fatigue; body aches and head ache; slight nausea; brain fog; and a rash over my chest and shoulders with a little on my back and face that itches and burns so that I couldn?t sleep and nothing would make it stop to the point where I went into urgent care

Other Meds: Metformin; Atorvastatin; Amlodipine; Loratadine; Fibercon; SuperLysine; Vit D; Fish oil

Current Illness:

ID: 1099202
Sex: F
Age: 46
State: TX

Vax Date: 03/14/2021
Onset Date: 03/14/2021
Rec V Date: 03/14/2021
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:

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

Symptoms: Pt vomited

Other Meds:

Current Illness:

ID: 1099203
Sex: M
Age: 65
State: IN

Vax Date: 03/13/2021
Onset Date: 03/14/2021
Rec V Date: 03/14/2021
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 that I know of

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Pain in my left arm where I received the shot, terrible Headache, internal fever, chills, tiredness, feeling of having a cold, feeling symtoms of vomiting, not wanted to eat.

Other Meds: Losartan 100MG Tab cam, Hydrochlorothiazide 12.5 MG Tab Act, Metformin 1000MG Tab Leg

Current Illness: High blood pressure

ID: 1099204
Sex: F
Age: 68
State: WA

Vax Date: 03/12/2021
Onset Date: 03/12/2021
Rec V Date: 03/14/2021
Hospital:

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

Lab Data:

Allergies: Flagyl old contrast dye Doxycycline Cyanoacrylate (band-aids and tegaderm)

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Right upper arm swollen reddened warm to touch (large area of redness) fever 102 headache

Other Meds: Vitamin D Glucosamine Chond Cmp

Current Illness: none

ID: 1099205
Sex: F
Age: 37
State: CA

Vax Date: 03/13/2021
Onset Date: 03/13/2021
Rec V Date: 03/14/2021
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

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

Symptoms: Fever, chills, joint/body pain, headache Tylenol relieves temporarily

Other Meds: None

Current Illness: None

ID: 1099206
Sex: F
Age: 17
State: WA

Vax Date: 03/14/2021
Onset Date: 03/14/2021
Rec V Date: 03/14/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List: Nausea

Symptoms: Her age group (17) is not yet approved to receive Moderna vaccination.

Other Meds: no

Current Illness:

ID: 1099207
Sex: F
Age: 66
State: VA

Vax Date: 03/04/2021
Onset Date: 03/05/2021
Rec V Date: 03/14/2021
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 known

Symptom List: Injection site pain

Symptoms: Swelling and pain in left hand major knuckles (particularly in the ring and pinky fingers). Unable to make a fist. Consulted virtually with Nurse at noon on 3/8/21. Prescribed Meloxicam 15 MG 1x daily for 15 days. Welling has reduced. major knuckle joints still stiff, but with less pain. Able to make a fist.

Other Meds: Irbesartan, hydrochlorothiazide, Citalopram, Naltrexone, multiple vitamin, B-12, biotin, niacin

Current Illness: none

ID: 1099208
Sex: F
Age: 57
State: NM

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 03/14/2021
Hospital:

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

Lab Data:

Allergies: PCN & bee stings

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

Symptoms: Chills, fever, malaise, headache, body aches & nausea x 2 full days. I was bedridden. Then extreme vertigo which caused nausea & projectile vomiting . I could not even walk. I had to crawl to get to the bathroom.

Other Meds: Balsalazide Disodium, Estrodial & Progesterone, plus various vitamins & minerals.

Current Illness: None

ID: 1099209
Sex: F
Age: 35
State: WA

Vax Date: 03/13/2021
Onset Date: 03/13/2021
Rec V Date: 03/14/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: P c/o dizziness. Juice PO administered. Pt improved p 5-10 min. Released w/o interventions. BP & HR wnl. Pt required no primary medical help.

Other Meds:

Current Illness:

ID: 1099210
Sex: M
Age: 26
State: MN

Vax Date: 02/23/2021
Onset Date: 02/24/2021
Rec V Date: 03/14/2021
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: As I was going to bed, my legs, back, torso, and arms started convulsing involuntarily. I was having trouble controlling my breathing because of my abdomen constricting. I could sort of control my body to move into a laying position then a seated position, but the trembling continued throughout that movement. I remained conscious and the event lasted about 5 minutes.

Other Meds: N/a

Current Illness: Mild cold-like symptoms. Sore, dry, or mucousy throat during the month prior to vaccination.

ID: 1099211
Sex: F
Age: 22
State: PA

Vax Date: 03/14/2021
Onset Date: 03/14/2021
Rec V Date: 03/14/2021
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: KNDA

Symptom List: Erythema, Pruritus

Symptoms: Shortly after receiving the vaccine, patient started to feel a warm sensation start from her feet and move up her legs up her boday and she started to feel flushed and lightheaded, and was warm and had a tingling feeling in her throat. She denied any feelings of SOB or that her throat was getting thick or that she could not swallow, her lungs were CTA. She was removed from the vaccine cell and taken to the observation area. Vital signs on arrival were 176/110, she was placed on a litter and history obtained. She was assessed and continued to be observed with sequential vital signs. She denied any tunnel vision, and nausea or any bowel or bladder urgency. Her f/u vital signs were 132/95, HR 85, and 100% O2 on room air. Patient was given water, and was observed for a total of 40 minutes. Final vital signs were 108/72. Patient stated that her symptoms resolved, her cheeks were flushed, her throat tingling was gone, and she stated that she felt better. Patient was able to ambulate off of the site.

Other Meds: Topimax, Zoloft, symbicort

Current Illness: None

ID: 1099212
Sex: F
Age: 32
State: OH

Vax Date: 01/26/2021
Onset Date: 03/10/2021
Rec V Date: 03/14/2021
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: Chantix and Nicoderm patch

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

Symptoms: Bells palsy to left side of my mouth

Other Meds: Multi vitamins, vitamin c zinc

Current Illness: None

ID: 1099213
Sex: F
Age: 57
State: FL

Vax Date: 03/13/2021
Onset Date: 03/13/2021
Rec V Date: 03/14/2021
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: eggs leviquin

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

Symptoms: approximately 5 hours after receiving the vaccine, I became very ill, nasua, diarrahea, shortness of breath, severe headache, body aches, extreme fatigue

Other Meds: Trulicity Levemir

Current Illness: none

ID: 1099214
Sex: F
Age: 42
State: KS

Vax Date: 03/05/2021
Onset Date: 03/13/2021
Rec V Date: 03/14/2021
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: no known allergies

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Pt said she had redness around her injection site which she received 3/5/21. It still persisted when she reported it on 3/14/21. She also had a swollen gland in her arm pit, that was still swollen on 3/14/21. She said she just felt exhausted.

Other Meds: celexa, seroquel, doxycycline,hydroxyzine, rexulti

Current Illness: unknown

ID: 1099215
Sex: F
Age: 72
State: CO

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 03/14/2021
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: morpheine, codiene, penicilin, seafood, beestings, DPT, some a

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

Symptoms: After first shot, pain in arm, up neck across back and into arms and fingers. Hives on the inside of upper thighs. After second shot, severe headache. I couldn't stand light for first 24 hours then continuing headache for 4 days. First 24 hours, pain in arms to fingers, neck, upperback, ache all over. Second and third day nausea.

Other Meds: 5000Vitamin D, Omeprazole 100, multi vitamin 112 levothyroxine

Current Illness: none

Date Died: 03/07/2021

ID: 1099216
Sex: F
Age: 84
State: FL

Vax Date: 02/15/2021
Onset Date: 03/07/2021
Rec V Date: 03/14/2021
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: PATIENT'S SISTER REPORTED PATIENT PASSED AWAY 03/07/2021

Other Meds:

Current Illness:

ID: 1099217
Sex: F
Age: 57
State: IN

Vax Date: 02/25/2021
Onset Date: 02/26/2021
Rec V Date: 03/14/2021
Hospital:

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

Lab Data:

Allergies: no known allergies

Symptom List: Pain in extremity

Symptoms: Extreme fatigue, some shortness of breath, soreness in injected arm, general feeling of malaise (felt like a dog!) for over 24 hours. Rest, hydration, prayer.

Other Meds: indapimide 1.25 mg levothyroxine 50 mcg Vitamin C Vitamin D Vitamin E potassium Ocuvite magnesium/zinc

Current Illness: no known illnesses in the past month

ID: 1099218
Sex: F
Age: 63
State: NY

Vax Date: 02/01/2021
Onset Date: 02/21/2021
Rec V Date: 03/14/2021
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: Shellfish, N95 Masks,Latex

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

Symptoms: On 2/21/21 I had severe abdominal pain that lasted for 10 hours. The pain came back on 2/33/21, and moved from the abdomen to the left side. When I was unable to sit or stand or lie down, I went to the Hospital ER. They did a CAT scan, and found a splenic infarct.

Other Meds: Levothyroxin,clarinex,Singulair, and Valsartan.

Current Illness: None.

ID: 1099219
Sex: F
Age: 41
State: WA

Vax Date: 03/08/2021
Onset Date: 03/08/2021
Rec V Date: 03/14/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Environmental allergies only

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

Symptoms: About 6 hours after vaccine, started to feel chills and shivering, followed shortly after by body aches, flu-like feeling, temperature reading of 99.2, then 100.5 about an hour later. I went to bed very early and slept 12 hours. In the morning I felt fine. However later that evening (around 36 hours after vaccination), I had a bout of severe diarrhea and two more the following day (03/10/2021).

Other Meds: Birth Control Pill, Omeprazole, Vitamins C, D, Multi (daily vitamin), Calcium, Iron, Fiber Pre/probiotic

Current Illness: None

ID: 1099220
Sex: F
Age: 83
State: OR

Vax Date: 03/01/2021
Onset Date: 03/12/2021
Rec V Date: 03/14/2021
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: Allergic to Sulfa medications and latex tape.

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

Symptoms: The day following the vaccine, I experienced extreme fatigue and body aches. I took naps several times during the day. A red rash appeared just below the injection site. The next day I did not experience the fatigue and body aches. The red rash is still present. There is some itching, but not severe. I have been applying Benadryl Cream two to three times a day.

Other Meds: Centrum Silver-Women, Citracal-D, Slow FE, PreserVision, ProOmega 2000, Fosamax 70 mg., Protonix 40 mg, T-Sal Shampoo, Ketoconazole 2% Shampoo, Fluocinonide 0.05% Solution, Zyrtec 10 mg., Relief Eye Drops.

Current Illness:

ID: 1099221
Sex: F
Age: 75
State: VA

Vax Date: 03/03/2021
Onset Date: 03/04/2021
Rec V Date: 03/14/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: propylene glycol, latex, shellfish/dyes, penicillin, sulfa meds, nitrofurantoin, tape

Symptom List: Vomiting

Symptoms: The day after the shot started coughing and short of breath which worsened until shortness of breath was severe enough to go the ER on 3/9/21 at which time admitted to the hospital with fluid overload and hypoxia. Stayed in the hospital until 3/12/21, discharged home on oxygen and still coughing intermittently. Additional symptom of extreme fatigue.

Other Meds: Losartan, Metoprolol, Diphenoxylate-atropine, prn bentyl

Current Illness: C-diff which had resolved, urinary tract infection

ID: 1099222
Sex: F
Age: 60
State: VA

Vax Date: 02/13/2021
Onset Date: 02/22/2021
Rec V Date: 03/14/2021
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: Paralysis on Left side of Face. Was prescribed and took 5 days of prednisone, following orders from ER 02/23/2021 visit - diagnosed with Bells Palsy. Followed up with PCP Dr. and was prescribed to physical therapy but insurance would not cover so I followed online Bells Palsy exercises. I currently have about 50% of my movement back.

Other Meds: None

Current Illness:

ID: 1099223
Sex: M
Age: 64
State: CA

Vax Date: 03/06/2021
Onset Date: 03/07/2021
Rec V Date: 03/14/2021
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: penicillin

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

Symptoms: I normally have an a1c value of 5.9 My blood sugar went up to 275 and I had to take triple the amount of insulin to bring it down. My blood sugar is still elevated 1 week after the shot, although not at 275 now. Headaches and sleeplessness

Other Meds: basaglar insulin long acting Novolog insulin short acting

Current Illness: type 1 diabetic

ID: 1099224
Sex: F
Age: 81
State: WA

Vax Date: 03/13/2021
Onset Date: 03/13/2021
Rec V Date: 03/14/2021
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:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: 9:45am pt c/o a "little tingling on upper and lowers lips". Pt speech and mental status at baseline. Pt able to swallow water and mental status at baseline. No noted redness or hives on patient body. Pt refusing Benadryl x 2. Pt reports at 10AM " I am feeling better or less tingling only a "tiny bit". Pt at 10:10am "I am better now". Pt able to ambulate safely to checkout area.

Other Meds:

Current Illness:

ID: 1099225
Sex: F
Age: 52
State: PA

Vax Date: 03/12/2021
Onset Date: 03/12/2021
Rec V Date: 03/14/2021
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 known

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

Symptoms: Chills, muscle pain, joint pain, nausea, fatigue, rash.

Other Meds: None

Current Illness: No

ID: 1099226
Sex: F
Age: 72
State: CT

Vax Date: 03/11/2021
Onset Date: 03/11/2021
Rec V Date: 03/14/2021
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 known

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

Symptoms: Nausea, aches, fever, loss of balance

Other Meds: Advair, Olmesartan, Simvastatin, Fluticanase Vitamins B12, C, D Calcium Aspirin

Current Illness: none

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm