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: 1100765
Sex: F
Age: 68
State: LA

Vax Date: 03/14/2021
Onset Date: 03/14/2021
Rec V Date: 03/15/2021
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: Error: Booster Given Too Early

Other Meds:

Current Illness:

ID: 1100766
Sex: F
Age: 55
State: FL

Vax Date: 03/13/2021
Onset Date: 03/13/2021
Rec V Date: 03/15/2021
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: Penicillin, Demerol

Symptom List: Anxiety, Dyspnoea

Symptoms: Started feeling achy around 5:30 p.m., around 7 p.m. began experiencing aching and chills. Took my 10 mg Paxil (usual evening dose). By around 8:45 had a temp of 99.2 aching, chills, and very hot feverish, and then began experiencing fast heart rate and feeling like I was going to pass out or vomit, wave of nausea and broke out in a cold sweat, chest tightness. I had taken two 500 mg acetaminophen tablets from 8:45 to 9:30 p.m. My heart rate would not slow down so 911 was called and I was taken the ER. I was given IV fluids and Toradol. Blood work was done and EKG showing sinus tachycardia. After receiving the IV fluids and Toradol, felt better and was released.

Other Meds: Paxil 10 mg, Prilosec 20 mg, vitamin D3

Current Illness: None.

ID: 1100767
Sex: F
Age: 34
State: MO

Vax Date: 03/13/2021
Onset Date: 03/14/2021
Rec V Date: 03/15/2021
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: None that I know of

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

Symptoms: Beginning 1 day after vaccine I developed a red, raised, hard, and hot rash at the injection site about the size of a softball

Other Meds: Multi Vitamins, Buspirone 5mg daily

Current Illness: None

ID: 1100768
Sex: F
Age: 79
State: LA

Vax Date: 03/14/2021
Onset Date: 03/14/2021
Rec V Date: 03/15/2021
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: Error: Booster Given Too Early

Other Meds:

Current Illness:

ID: 1100769
Sex: M
Age: 62
State: VA

Vax Date: 01/30/2021
Onset Date: 01/30/2021
Rec V Date: 03/15/2021
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

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

Symptoms: Bad chills and shaking followed by extreme headache. Lasted 24 hours and then gone..

Other Meds: None

Current Illness: no

ID: 1100770
Sex: M
Age: 85
State: GA

Vax Date: 02/18/2021
Onset Date: 02/21/2021
Rec V Date: 03/15/2021
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: Hallucinations (first time ever experienced), confusion, paranoia, loss of appetite loss of balance, dizziness, decline in ambulation ability. Dragging feet on ground, unable to use steps.

Other Meds:

Current Illness: prostate cancer, heart disease, HTN

ID: 1100771
Sex: M
Age: 74
State: LA

Vax Date: 03/14/2021
Onset Date: 03/14/2021
Rec V Date: 03/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Error: Booster Given Too Early

Other Meds:

Current Illness:

ID: 1100772
Sex: M
Age: 64
State: OH

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

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

Lab Data:

Allergies: NKDA

Symptom List: Pharyngeal swelling

Symptoms: Patient was in recovery area per protocol. Patient developed light headedness, diaphoresis, irritability and then collapsed into chair and then floor (helped by nursing staff) patient appeared unconscious but was breathing, oxygen applied, emergency response initiated

Other Meds: omeprazole

Current Illness: None

ID: 1100773
Sex: F
Age: 26
State: PA

Vax Date: 03/06/2021
Onset Date: 03/13/2021
Rec V Date: 03/15/2021
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

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Vomiting, increase in blood sugar levels, headache, muscle aches

Other Meds: Tylenol, Motrin, Humalog,

Current Illness:

ID: 1100774
Sex: F
Age: 49
State: LA

Vax Date: 03/14/2021
Onset Date: 03/14/2021
Rec V Date: 03/15/2021
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:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Error: Booster Given Too Early

Other Meds:

Current Illness:

ID: 1100775
Sex: F
Age: 46
State: LA

Vax Date: 03/14/2021
Onset Date: 03/14/2021
Rec V Date: 03/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Error: Booster Given Too Early

Other Meds:

Current Illness:

ID: 1100776
Sex: M
Age: 74
State: NC

Vax Date: 03/02/2021
Onset Date: 03/06/2021
Rec V Date: 03/15/2021
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: None

Symptom List: Rash, Urticaria

Symptoms: Rash with elevate bumps, left shoulder, lymph nodes on right and left groin, rash and bumps on 3&4 left fingers, right & left Scilla.

Other Meds: Imbrutinib

Current Illness: None

ID: 1100777
Sex: F
Age: 65
State: FL

Vax Date: 03/14/2021
Onset Date: 03/14/2021
Rec V Date: 03/15/2021
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: Pt. c/o dizziness and states that no other symptom was felt. Pt. seen and assessed by EMT. Assessment of vital are: BP 140/79, O2 98. Pt. verbalized that she has no history of chronic illness and she anxious about 1st dose. Pt. cleared to go home by EMT.

Other Meds: none

Current Illness: none

ID: 1100778
Sex: F
Age: 57
State: LA

Vax Date: 03/14/2021
Onset Date: 03/14/2021
Rec V Date: 03/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Error: Booster Given Too Early

Other Meds:

Current Illness:

ID: 1100779
Sex: F
Age: 36
State: NJ

Vax Date: 03/03/2021
Onset Date: 03/03/2021
Rec V Date: 03/15/2021
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: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: Received the vaccine in the morning (Wednesday). While a sore arm developed throughout the day about 12 hours later started getting severe chills. Was awake all night alternating between freezing chills and a hot fever. Extreme body aches and could not get comfortable. Felt extremely bad the entire next day (Thursday) with the same symptoms and could not work but towards the evening symptoms subsided. That following day (Friday) I felt better but started getting a headache before bed and that night after going to bed woke up at 2am with a migraine. Worst headache of my life. Felt so bad thought I was going to throw up. Pain subsided with Tylenol. Went back to bed and woke up the next morning nauseous (Saturday). Felt very nauseous through the morning and in the afternoon evening it was less extreme but still present. Felt fine when I woke up the next day (Sunday).

Other Meds: Multivitamin

Current Illness: None

ID: 1100780
Sex: F
Age: 49
State: LA

Vax Date: 03/14/2021
Onset Date: 03/14/2021
Rec V Date: 03/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Error: Booster Given Too Early

Other Meds:

Current Illness:

ID: 1100781
Sex: M
Age: 54
State: IN

Vax Date: 03/12/2021
Onset Date: 03/13/2021
Rec V Date: 03/15/2021
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: Levaquin

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

Symptoms: Night sweats, headaches, intense pain in wrist and ankle joint going on 3 days now

Other Meds: Verapamil, Esomeprazole

Current Illness: N/A

ID: 1100782
Sex: F
Age: 51
State: LA

Vax Date: 03/14/2021
Onset Date: 03/14/2021
Rec V Date: 03/15/2021
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: Error: Booster Given Too Early

Other Meds:

Current Illness:

ID: 1100783
Sex: F
Age: 41
State: TX

Vax Date: 03/12/2021
Onset Date: 03/12/2021
Rec V Date: 03/15/2021
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: Site: Itching at Injection Site-Medium, Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium, Systemic: Allergic: Rash (specify: facial area, extremeties)-Medium, Systemic: Headache-Medium

Other Meds:

Current Illness:

ID: 1100784
Sex: F
Age: 43
State: FL

Vax Date: 03/14/2021
Onset Date: 03/14/2021
Rec V Date: 03/15/2021
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: Client verbalized mild lightheadedness after receiving the vaccine. Full assessment done by onsite Paramedics. Client was observed for additional 15 min. and released to go home at 8:49 am accompanied by spouse.

Other Meds: none

Current Illness: none

ID: 1100785
Sex: F
Age: 47
State:

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

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

Lab Data:

Allergies: penicillin

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

Symptoms: severe headache, stiff neck and extreme fatigue

Other Meds: none

Current Illness: none

ID: 1100786
Sex: F
Age: 26
State: CA

Vax Date: 03/14/2021
Onset Date: 03/14/2021
Rec V Date: 03/15/2021
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: Unevaluable event

Symptoms: Systemic: Fainting / Unresponsive-Mild, Systemic: Flushed / Sweating-Mild, Systemic: Shakiness-Mild, Systemic: Weakness-Mild, Additional Details: patient has a history of fainting after vaccine administration

Other Meds:

Current Illness:

ID: 1100787
Sex: M
Age: 57
State: TX

Vax Date: 03/14/2021
Onset Date: 03/14/2021
Rec V Date: 03/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Error: Wrong Dose of Vaccine - Too High

Other Meds:

Current Illness:

ID: 1100788
Sex: F
Age: 27
State: NJ

Vax Date: 03/14/2021
Onset Date: 03/14/2021
Rec V Date: 03/15/2021
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:

Symptom List: Injection site pain, Pain

Symptoms: Uncontrollable shaking, high fever, slight tachycardia, severe head and body pain, sweating

Other Meds:

Current Illness:

ID: 1100789
Sex: M
Age: 44
State: NY

Vax Date: 03/14/2021
Onset Date: 03/14/2021
Rec V Date: 03/15/2021
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: Systemic: Dizziness / Lightheadness-Mild, Systemic: Fainting / Unresponsive-Mild, Systemic: Patient was feeling paralized. However, we can cleary see the patient moving all his extremities-Mild, Systemic: Headache-Mild, Systemic: Weakness-Mild

Other Meds:

Current Illness:

ID: 1100790
Sex: M
Age: 66
State: NY

Vax Date: 03/05/2021
Onset Date: 03/10/2021
Rec V Date: 03/15/2021
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: ester type anesthetics, Aspirin, Ciprofloxicin, food preservatives

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

Symptoms: Patient present to ED stating that the right side of his mouth was not moving right when he woke up at 06:00 am that morning (3.10.21). Physician documented patient had trouble fully opening his right eye. Patient reported right upper dental for for several days prior to presentation. Diagnosed by physician with Bell's Palsy.

Other Meds:

Current Illness:

ID: 1100791
Sex: M
Age: 23
State: NY

Vax Date: 03/13/2021
Onset Date: 03/13/2021
Rec V Date: 03/15/2021
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: Systemic: Fainting / Unresponsive-Mild, Systemic: Flushed / Sweating-Mild

Other Meds:

Current Illness:

ID: 1100792
Sex: F
Age: 55
State: NY

Vax Date: 03/14/2021
Onset Date: 03/15/2021
Rec V Date: 03/15/2021
Hospital:

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

Lab Data:

Allergies: Nk

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Extreme body fatigue, sharp shooting pain throughout body, red/warm/swollen injection site.

Other Meds: Cymbalta, Vit D, statin, ropinirole

Current Illness: None

ID: 1100793
Sex: F
Age: 96
State: CA

Vax Date: 03/14/2021
Onset Date: 03/14/2021
Rec V Date: 03/15/2021
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: Error: Wrong Vaccine Formulation (ex. different manufact. initial and booster)

Other Meds:

Current Illness:

ID: 1100794
Sex: F
Age: 90
State: FL

Vax Date: 03/14/2021
Onset Date: 03/14/2021
Rec V Date: 03/15/2021
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: Client verbalized watery right eye without pain or discomfort. Client evaluated by Rescue Paramedics onsite. Client was observed for additional 15 mins. Client released by Paramedics at 10:05 am after symptoms were resolved.

Other Meds: none

Current Illness: none

ID: 1100795
Sex: F
Age: 57
State: IN

Vax Date: 03/11/2021
Onset Date: 03/12/2021
Rec V Date: 03/15/2021
Hospital:

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

Lab Data:

Allergies: Penicillin Morphine

Symptom List: Injection site pain

Symptoms: 21 hours after injection my hands started felling like they were on fire but not hot to the touch, then the body aches, extreme joint pain in my back and right leg started, then my hands started to freeze I had the chills bad body aches, the chills and a fever. Very fatigued. That lasted until about 7:30 pm. Only symptom on Saturday was fatigue , I still get winded when I do physical stuff today (Monday)

Other Meds: Sulindac 20 mg 2x day Omeprezol. 40 mgs 1x day Tylenol extra strength as needed

Current Illness:

ID: 1100796
Sex: F
Age: 58
State: PA

Vax Date: 03/14/2021
Onset Date: 03/15/2021
Rec V Date: 03/15/2021
Hospital:

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

Lab Data:

Allergies: Bees and cats

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

Symptoms: Started with a headache then Nassau and throwing up. Also have the shakes after throwing up. Low grade fever.

Other Meds: Multi vitamin - calcium pills, vitamin c

Current Illness: None

ID: 1100797
Sex: F
Age: 69
State: FL

Vax Date: 03/02/2021
Onset Date: 03/10/2021
Rec V Date: 03/15/2021
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: Severe nerve/muscle pain starting 3/10/2021. Appearance of shingles blisters on 3/14/2021. Pain worsening.

Other Meds: Yuvafam, biotin, multivitamin, citrucel

Current Illness: none

ID: 1100798
Sex: F
Age: 62
State: NC

Vax Date: 03/14/2021
Onset Date: 03/14/2021
Rec V Date: 03/15/2021
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: Tremor

Symptoms: Error: Incorrect Reconstitution

Other Meds:

Current Illness:

ID: 1100799
Sex: F
Age: 45
State: NC

Vax Date: 03/14/2021
Onset Date: 03/14/2021
Rec V Date: 03/15/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Erythema, Pruritus

Symptoms: 9:20am vaccine 3:30pm Severe chills & nausea. 4:00pm - 9pm Body Aches, fatigue, HEADACHE & Fever 103.1 03/15/2021 7:00am Fever & nausea has subsided but severe headache remains.

Other Meds: None

Current Illness: None

ID: 1100800
Sex: M
Age: 24
State: FL

Vax Date: 03/14/2021
Onset Date: 03/14/2021
Rec V Date: 03/15/2021
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:

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

Symptoms: Systemic: Nausea-Medium, Systemic: Seizure-Medium

Other Meds:

Current Illness:

ID: 1100801
Sex: F
Age: 57
State: AL

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

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

Lab Data:

Allergies:

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

Symptoms: Site: Bruising at Injection Site-Mild, Site: Itching at Injection Site-Mild, Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Mild, Site: Swelling at Injection Site-Mild, Systemic: Skin peeled off around injection site-Medium

Other Meds:

Current Illness:

ID: 1100802
Sex: M
Age: 66
State: MN

Vax Date: 03/14/2021
Onset Date: 03/14/2021
Rec V Date: 03/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Vaccine was administered on 3-14-21 but Covid-19 Vaccination Record Card was back dated to 3-13-21. It is believed that vial had been open for more than 6 hours at time of administration.

Other Meds:

Current Illness:

ID: 1100803
Sex: F
Age: 51
State: OK

Vax Date: 03/14/2021
Onset Date: 03/14/2021
Rec V Date: 03/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Systemic: Allergic: Difficulty Breathing-Medium, Systemic: Allergic: Difficulty Swallowing, Throat Tightness-Medium, Systemic: Allergic: Itch (specify: facial area, extremeties)-Medium, Systemic: Allergic: Itch Generalized-Medium, Systemic: Flushed / Sweating-Medium, Systemic: Shakiness-Medium

Other Meds:

Current Illness:

ID: 1100804
Sex: F
Age: 57
State: WI

Vax Date: 03/05/2021
Onset Date: 03/05/2021
Rec V Date: 03/15/2021
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: other vaccine/ injectable med,bees, ciprofloxacin, "long list"

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

Symptoms: Pt reports waiting 30 min post injection at clinic and leaving without any s/s. States about 1.5 hours later, noticed hives on chest and abdomen as well as a headache and reports her "mouth was raw". She did not take any medications or seek medical attention then. The next day around 10 am, she took one dose of Benadryl. The rash on her chest resolved thereafter, but patient states she then noticed a rash under her panus, the top of her legs, and upper buttocks. Pt states rash totally resolved by Monday. Reports headache was worst on Saturday and Sunday. Reports taking Excedrin Migraine as part of her daily routine for other chronic pain and reports headache relief. Denies SOB, tongue swelling, or dyspnea.

Other Meds:

Current Illness:

ID: 1100805
Sex: M
Age: 56
State: CT

Vax Date: 03/14/2021
Onset Date: 03/14/2021
Rec V Date: 03/15/2021
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: Pain in extremity

Symptoms: Systemic: Shakiness-Medium, Systemic: Tachycardia-Medium

Other Meds:

Current Illness:

ID: 1100806
Sex: M
Age: 36
State: OH

Vax Date: 03/13/2021
Onset Date: 03/14/2021
Rec V Date: 03/15/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: 102.7 fever, chills, body aches, headache

Other Meds: Lisinopril (40 mg daily) Clonidine (0.2 mg daily)

Current Illness: Tooth ache

ID: 1100807
Sex: F
Age: 47
State: TX

Vax Date: 03/11/2021
Onset Date: 03/12/2021
Rec V Date: 03/15/2021
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: Iv dye (ct)

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

Symptoms: Low grade fever Body aches Red and swollen injection site Headache

Other Meds: Sotalol 80 mg bid Magnesium oxide 400mg bid Zinc glucometer 50 mg side Potassium glucometer 595mg side B12 5000mcg sid Aspirin 81mg sid D3 250mcg bid Coreplex multivitamin (advocare) sid Flonase

Current Illness:

ID: 1100808
Sex: F
Age: 54
State: FL

Vax Date: 03/14/2021
Onset Date: 03/14/2021
Rec V Date: 03/15/2021
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: Systemic: Allergic: Itch (specify: facial area, extremeties)-Medium, Additional Details: Patient c/o itching in right throat, right neck, along left hair line. Patient took own hydroxyzine 50 mg.

Other Meds:

Current Illness:

ID: 1100809
Sex: M
Age: 68
State: AZ

Vax Date: 03/07/2021
Onset Date: 03/08/2021
Rec V Date: 03/15/2021
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: none

Symptom List: Vomiting

Symptoms: Intense dreams every night. Last night was the sound of a door slamming that woke me up. I don't usually dream much at all. However since being vaccinated I have intense dreams every night.

Other Meds: none

Current Illness: none

ID: 1100810
Sex: F
Age: 42
State: FL

Vax Date: 03/05/2021
Onset Date: 03/14/2021
Rec V Date: 03/15/2021
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: None

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: On 3/14 I woke up with a sore arm and burning at the injection site. The injection site also felt hard. On 3/15 I woke up with the injection site being sore and also two red patches on the arm near the injection site.

Other Meds: Zoloft

Current Illness: None

ID: 1100811
Sex: M
Age: 82
State: WA

Vax Date: 02/17/2021
Onset Date: 02/17/2021
Rec V Date: 03/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Error: Wrong Dose of Vaccine - Too High

Other Meds:

Current Illness:

ID: 1100812
Sex: F
Age: 44
State: AL

Vax Date: 03/12/2021
Onset Date: 03/12/2021
Rec V Date: 03/15/2021
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: PATIENT STATES HAS NAUSEA AND DIZZINESS ALONG WITH TINGLING SENSATION TO FACE AND LIPS. PULSE IS 100 AND REGULAR. PATIENT HAS NO SHORTNESS OF BREATH, NO RASH OR ITCHING. PATIENT WATCHED AND EXTRA 15 MINS BUT REFUSED TO GO FOR FURTHER TREATMENT.PATIENT INSTRUCTED TO FOLLOW UP WITH EMERGERGENY DEPARTMENT OR CLINIC IF HAD FURTHER NEDDS OR ISSUES DID NOT RESOLVE.

Other Meds: ?

Current Illness: ?

ID: 1100813
Sex: F
Age: 63
State: NY

Vax Date: 03/10/2021
Onset Date: 03/10/2021
Rec V Date: 03/15/2021
Hospital:

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

Lab Data:

Allergies: Sulfa drugs, Brazil nuts

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

Symptoms: Tachychardia, chest pressure, belching, hard to take a full breath

Other Meds: Probiotic, Prebiotic, Afterbiotic, Magnesium, Vitamins A, D3, K, Iodine, Ubiquinol, Krill Oil, Liposomal Vitamin C, Zinc and Copper, Cognitive Aminos, Eye Armour, Quercetin and Terostilbene, L-Argenine, DGL, Krill Oil

Current Illness: None

ID: 1100814
Sex: F
Age: 30
State: CA

Vax Date: 03/12/2021
Onset Date: 03/12/2021
Rec V Date: 03/15/2021
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: Systemic: Dizziness / Lightheadness-Mild, Systemic: Fainting / Unresponsive-Mild

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm