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: 0934705
Sex: F
Age: 56
State: CO

Vax Date: 01/04/2021
Onset Date: 01/10/2021
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: Penicillin, sulfa, erythromycin nine

Symptom List: Dysphagia, Epiglottitis

Symptoms: Have a swollen lymph node under my left arm. Got the shot in this arm. This started yesterday. Other symptoms I got were: very sore arm through Friday, second day nausea, fatigue, aches.

Other Meds: Multi vitamin, omega 3, vh essential, vitamin c,

Current Illness: None

ID: 0934706
Sex: F
Age: 56
State: IL

Vax Date: 12/30/2020
Onset Date: 12/31/2020
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: aspirin products, generic cholesterol meds, metoprolol.

Symptom List: Anxiety, Dyspnoea

Symptoms: Started with dry throat and nose. Then felt tired, sleepy, low energy. Muscle joint pain. Still chills. temp 97.4. Now having ear pressure. SOB on Saturday.

Other Meds: Thyroid, Cozaar, Imitrex, Ambien, vitamin C, TRICOR, vitamin D,

Current Illness: no

ID: 0934707
Sex: F
Age: 39
State: MT

Vax Date: 01/08/2021
Onset Date: 01/11/2021
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:

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

Symptoms: Redness, pain injection site, swollen armpit

Other Meds:

Current Illness:

ID: 0934708
Sex: F
Age: 25
State: TX

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: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data:

Allergies: NKA

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: No symptoms after first vaccine besides soreness to the injection site. After second vaccine, only symptom was soreness in the injection site for approximately the first 20 hours. Shortly after that I started experiencing chills and fatigue. Afebrile at 98.2F. Took an OTC Ibuprofen tablet and symptoms subsided. That same night fatigue and chills returned as well as I started experiencing a headache. By the morning headache subsided after a OTC Tylenol tablet but fatigue remained.

Other Meds: Oral contraceptives

Current Illness: None

ID: 0934709
Sex: F
Age: 25
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:
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: After receiving the vaccine, the patient-reported "not feeling well" and then turned pale/ felt like she was going to pass out. The patient was placed in a reclining chair and given juice/crackers for 20-30 minutes and reported a vast improvement. Patient-reported no other signs of allergic reaction and stated that this has happened to her in the past with vaccinations.

Other Meds:

Current Illness:

ID: 0934710
Sex: F
Age: 76
State: OH

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

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: Codeine, Prednisone, latex

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

Symptoms: New onset Seizures

Other Meds: See attatched

Current Illness: Uti

ID: 0934711
Sex: F
Age: 56
State: IN

Vax Date: 01/07/2021
Onset Date: 01/08/2021
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: norvasc

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: fever, chills, body aches, runny nose for @ 24 hours. took ibuprofen, tylenol and antihistamines

Other Meds: metoprolol, losartan, HCTZ, atorvastatin, singulair, synthroid, asa,

Current Illness: no

ID: 0934712
Sex: F
Age: 32
State: CA

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: fatigue headache fever chills diarrhea vomiting body aches left lymph node is swollen still after three days

Other Meds:

Current Illness:

ID: 0934713
Sex: F
Age: 34
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Morphine

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Joint and Muscle aches, chills, Hypersensitivity of skin, Fatigue, weakness, Malise, Sweating in sleep

Other Meds: Fluoxitine,Dioxipin,Biotin

Current Illness: Anxiety, Depression

ID: 0934714
Sex: F
Age: 23
State: NY

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: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: headache soon after vaccine (gone ), hard to take a deep breath(denies anaphylaxis), wheezing with activity, coughing, fatigue later the same day as vaccine

Other Meds:

Current Illness:

ID: 0934715
Sex: F
Age: 61
State: AZ

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:
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: none

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

Symptoms: joint pain starting one week after vaccine and lasting more than 5 days

Other Meds: multivitamins

Current Illness: none

ID: 0934716
Sex: F
Age: 46
State: GA

Vax Date: 01/08/2021
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: SYR
Vax Site: RA

Lab Data:

Allergies: none

Symptom List: Rash, Urticaria

Symptoms: Slight flu symptoms the following day- headache & fatigue. Only lasted 1 day.

Other Meds: Calcium, Vit D, Xanax, Lexapro, Trazadone, Fantomadine, Atenelol, mirolax, citrucel

Current Illness: none

ID: 0934717
Sex: M
Age: 47
State: IL

Vax Date: 01/07/2021
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: none

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

Symptoms: fever >100 , body aches/whole body muscle spasms, chills, nausea (no vomiting), headaches, physical exhaustion, all symptoms resolved approx 1.5 days of vaccine administered, symptoms began approx 12 after vaccine received.

Other Meds: none.

Current Illness: none

ID: 0934718
Sex: U
Age: 62
State: OR

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: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: none known

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

Symptoms: Patient immediately felt unwell after injection lost color and became unresponsive. He remained unresponsive but continued to breathe x 15 seconds. He then stopped breathing and as he was being checked for pulse, he had a seizure that last approximately 10 secs

Other Meds: reports none

Current Illness: none

ID: 0934719
Sex: F
Age: 50
State:

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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: bactrim

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

Symptoms: Chills, body aches, slight headache

Other Meds:

Current Illness:

ID: 0934721
Sex: F
Age: 30
State: MA

Vax Date: 12/28/2020
Onset Date: 01/05/2021
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: Had vaccine on 12/28, then on 1/5 in the evening noticed a rash from top of left shoulder halfway down arm. Had not noticed rash immediately after injection and did not notice until 1/5. Mild itching around sight, not raised or warm to the touch. Does not appear as cellulitis, not tender to touch, otherwise asymptomatic currently.

Other Meds:

Current Illness:

ID: 0934722
Sex: F
Age: 41
State: VA

Vax Date: 12/22/2020
Onset Date: 12/31/2020
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: No allergies

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

Symptoms: I received my first vaccine 12/22/2020 at 3:45pm. My right arm was sore like I would have expected and everything else was fine, until 12/31/2020. My left upper thigh had a burning feeling around the outer part and in the goin on that thigh a painful lymph node. That afternoon I had a burning sensation on my left butt cheek. When I looked I noticed a very small rash with blisters. I waited through the weekend because I knew the OBGYN was not open. I called first thing Monday morning and made an appointment as soon as they could see me which was the next day (1/5/2021)at 3:30pm. The doctor took samples and sent them to the lab for testing. The test was positive for shingles. I am now taking valtrex for shingles.

Other Meds: Nothing at the time

Current Illness: Nothing

ID: 0934723
Sex: M
Age: 34
State:

Vax Date: 01/11/2021
Onset Date: 01/11/2021
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:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: body aches, some headaches. 30 minutes after the shot and still persisting.

Other Meds:

Current Illness:

ID: 0934724
Sex: F
Age: 49
State: MA

Vax Date: 01/05/2021
Onset Date: 01/05/2021
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:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Woke with chills, shaking, fever( up to 103) increased hart rate O2 sat between 92-95%, Symptoms lasted intermittently from 10:30 pm 1/5/21 until 0500 am 1/6/21. Continued with low grade fever on 1/6/21, fever resolved 1/7/21. Continued with episodes of increased heart rate baseline 70"s, intermittently up to 100-130.1/8/21 noted a few episodes of increase heart rate 100-120 lasting for only a few minutes.

Other Meds:

Current Illness:

ID: 0934725
Sex: F
Age: 33
State: PA

Vax Date: 01/08/2021
Onset Date: 01/08/2021
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: Humera, Reglan

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

Symptoms: Rash, Facial flushing. Stabbing head pain Diarrhea (1-09-2021), Fever 100.4,Headache Took Loratadine and Benadryl - symptoms resolved

Other Meds: Enbrel Injection

Current Illness: none

ID: 0934726
Sex: F
Age: 23
State: UT

Vax Date: 12/29/2020
Onset Date: 01/05/2021
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:

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

Symptoms: Employee noticed bilateral hives on her lower legs on 01/05/2021. She took Benadryl and applied steroid cream with little resolution of her symptoms. She contacted her PCP who told her to seek evaluation at the urgent care. She went to the urgent care on 01/05/21 and was tested for COVID (negative) and was given an Rx for steroid cream. CG called me back on 01/07/21 stating that she now has developed a "circular rash" around her injection site, which her PCP was able to assess. The CG reports that her PCP told her she is ok to receive the second dose, but with close monitoring and to pre-medicate with Benadryl.

Other Meds:

Current Illness:

ID: 0934727
Sex: F
Age: 31
State: MT

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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: Fever gone after 24 hours

Other Meds:

Current Illness:

ID: 0934728
Sex: F
Age: 58
State:

Vax Date: 01/07/2021
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: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

Symptoms: Friday morning after the vaccination - fever, chills, body aches & nausea. Saturday morning, went to the ED with hives that went into her mount & swollen tongue - resolved as of 1/11/2021

Other Meds:

Current Illness:

ID: 0934729
Sex: F
Age: 42
State: CA

Vax Date: 01/07/2021
Onset Date: 01/07/2021
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: Bee Venom

Symptom List: Injection site pain, Pain

Symptoms: Thursday night shortly after the vaccine I was exhausted and headed home to go lay down. While driving, I developed a severe headache. I went home and went to sleep really early. Friday morning, woke up, went to work. Extreme lethargy and severe headache. Left work early (2 ish) with joint pain, headache, lethargy. In the evening (still Friday) I went to the grocery store and walking in the parking lot to the store my joints hurt with every step. I sent my partner in and I went back to the car. I could not do it. Went to sleep soon thereafter. Saturday morning, we woke up and had planned to go to the cabin. We were trying to run errands (coffee shop, post office, bank...simple errands) and I was exhausted and feeling bad. Still headache, lethargy, achy. Assumed it was flu like which was a side effect, so I continued to press on through the discomfort. Left for the mountains. less than 1 mile from home, started to feel tingling and "buzzing" throughout my body, like a vibration sort of. Stayed quiet and thought about this. Another block or two and the feeling was in my tongue. Then I felt it in each tooth root and spoke up. I asked to go home and rest for 30 minutes before going to the cabin. At this point, I could not move my hands. We got to the house and I could not open my car door or take off my seatbelt. I had hand paralysis for about 10 minutes. Made it in the house. Got to the couch and laid down for about 60 seconds. Got up had to use the restroom. Solid, not diarrhea, but took 45 minutes. Apparently, I was pale like a piece of paper. I do not remember being in the bathroom for 45 minutes, I felt like it was 5 minutes, partner said 45 minutes. Made it back to couch, laid down, freezing! Under 2 blankets, one of them was an electric blanket on high. Began throwing up, clear bile. Had not eaten anything yet. Stayed on couch, also lost track of time, was there for 5 ish hours. Tried to eat something so I could take Tylenol for the headache. Barely ate anything, so I never took the Tylenol. It lessened. Cabin trip cancelled. Still lethargy and dizzy yesterday but no joint pain, no nausea. Now, Monday morning, still dizzy/lightheaded. Symptoms are subsiding, but not gone.

Other Meds: Humira, 6MP, Multivitam, Iron, Vitamin D3, Calcium, Melatonin, CALM

Current Illness: COVID (12/7/2020, over 1 month ago)

ID: 0934730
Sex: F
Age: 27
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:
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: fever, chills, muscle ache, headache. called in sick to work.

Other Meds:

Current Illness:

ID: 0934731
Sex: F
Age: 52
State: IA

Vax Date: 01/11/2021
Onset Date: 01/11/2021
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:

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

Symptoms: red, blotchy rash. Given 50 mg Benadryl po

Other Meds:

Current Illness:

ID: 0934732
Sex: F
Age: 45
State: MN

Vax Date: 12/29/2020
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: a red circle where I got the vaccine, it is still a firm nodule, itches lightly and is slightly warm (although I may just have warm skin in this office).

Other Meds:

Current Illness:

ID: 0934733
Sex: F
Age: 59
State: OH

Vax Date: 01/11/2021
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: Contrast Dye, Sulfa and Phenergan

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Caregiver was in the observation room for her 30 minutes but two minutes (11:29am) after her stay, she developed itching on her back, redness on her chest and a burning feeling in her chest. At 11:33 she also c/o itching of the scalp. BP: 139/69, HR: 99, RR: 16 and Sao2: 100% on room air. Caregiver stated her itching was getting worse. At 11:35 caregiver given 60mg of Fexofenadine PO per protocol for itching in back and head. At 11:40, caregiver states neck was itching as well but no swelling, difficulty breathing or shortness of breath. AT 11:54 BP: 117/48, HR:75, RR: 14 Sao2: 100% on room air. When using a scale system to rate itchiness, caregiver states itching in back is 4/10, neck is 4/10, head is 5/10 and chest burning rated 4/10. At 12:10, caregiver states the itching in her back and neck was gone rated 0/10. She also states chest burning was gone rated 0/10 and only had slight itchy feeling in head rated 1/10. At 12:20 the itching was resolved. BP: 119/47, HR: 70, RR: 14, Sao2: 100% on room air. Caregiver states she feels "back to normal." Caregiver allowed to leave observation area. Gait steady. No complaints voiced. Occupational Health manager aware of situation and involved in treatment plan.

Other Meds: Synthroid

Current Illness: None

ID: 0934734
Sex: M
Age: 44
State: OH

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:
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: Fever 100.3 Body aches Head aches Nausea Treatment: Naproxen and Tylenol

Other Meds:

Current Illness:

ID: 0934735
Sex: F
Age: 28
State: AL

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:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: none

Symptom List: Nausea

Symptoms: 5pm injection, felt fine. 505pm hr 150s, chest tight, winded, no rash- BP 140s/70s and sat upper 90s. 515 HR 120s-140s and felt slightly better. 520pm HR back up to 150s w chest tighness so pt taken to local ER. In wait room FR 140s plus, sat dropped to mid 80s and mucosal sweeling (tongue/oral mucosa) Sat in ER wait room 5 more min then taken back, tx w steroid injection, benadryl iv then medrol dose pack at dc observed in ER a few hours

Other Meds:

Current Illness: none

ID: 0934736
Sex: F
Age: 41
State: TX

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:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: HA, fatigue, low grade fever, body aches treatment include Tylenol with improvement.

Other Meds:

Current Illness:

ID: 0934737
Sex: F
Age: 58
State: NY

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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Sulfa Drugs Long standing environmental allergies: dust mites, tree pollens, grass, mold etc.

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

Symptoms: Dose administered @ 9:30 am, at 1 PM began with throat clearing and coughing with mild tightness, intermittently. By 1:30-1:45 pm nose and mouth became itchy. I took 12.5 mg Benadryl and used my Xopenex ( rescue inhaler) x 2 puffs with effect. Itching resolved first and residual inflammation in airway was gone by 3-3:30 pm. This reaction is familiar to me from when I received Allergy Immunotherapy a few years ago. I had my Epipen and additional Benadryl. Did not need it.

Other Meds: Diltiazem 180 mg bid Losartan 100 mg qd duloxetine 30 mg bid Gabapentin 100 mg hs Trazodone 100 mg HS Qvar inhaler 180 mcg 2 puff bid Xopenex MDI 2 puffs q 4 hrs prn Tumeric 1500 mg qd Magnesium glycinate 400 mg qd New Chapter Plant Calciu

Current Illness:

ID: 0934738
Sex: M
Age: 66
State: TN

Vax Date: 01/11/2021
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: No known drug allergies

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

Symptoms: Vaccine was incorrectly reconstituted with 0.8mL NS instead of 1.8mL by LPN. After incorrect reconstitution, 0.3mL of the vaccine solution was administered IM. Patient stayed in office for 15 minutes after administration. During that time, no adverse effects were reported by patient or noted by healthcare providers.

Other Meds: Unknown

Current Illness: Unknown

ID: 0934739
Sex: F
Age: 61
State: NJ

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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Codiene

Symptom List: Tremor

Symptoms: Elevated heart rate to 120, fever, shortness of breath, headache

Other Meds: Atorvastatin 190 mg daily Norvasc 5 mg daily

Current Illness: COVID 19 positive 11/10/20

ID: 0934740
Sex: F
Age: 37
State: TX

Vax Date: 12/19/2020
Onset Date: 12/19/2020
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: NKDA

Symptom List: Erythema, Pruritus

Symptoms: extreme fatigue with, headache. Went to ER And Received fluids And meds for headache. SEEN IN E.D 1/7 & 12/19 (after both 1st & 2nd vaccine) ZOFRAN & FLUIDS IN E.D. DIAGNOSIS "NEAR SYNCOPE"

Other Meds: Metoprolol, Keppra

Current Illness:

ID: 0934741
Sex: M
Age: 64
State:

Vax Date: 01/03/2021
Onset Date: 01/06/2021
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:

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

Symptoms: Arm was very sore for 4 days after vaccination. Have never had a sore arm from vaccinations in the past. At day 4 post vaccination, developed a cough and congestion -- had none previously. Now on day 9 post vaccination and it is tapering down.

Other Meds:

Current Illness:

ID: 0934742
Sex: F
Age: 27
State: IA

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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Environmental allergies (pollen)

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

Symptoms: Red, itchy rash, hot to touch, appeared around injection site, around 3 inches in diameter, 12 days after receiving injection. Rash increased in size the following day but had less clearly defined borders. Rash began to resolve within 24 hours after taking antihistamine.

Other Meds: Sertraline, calcium, vitamin D, NuvaRing

Current Illness: None

ID: 0934743
Sex: F
Age: 28
State: TX

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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Vancomycin, penicillin, doxycycline

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Urticaria-starting at 0645 1/11/2021

Other Meds: Oral contraceptives Multivitamin

Current Illness:

ID: 0934744
Sex: F
Age: 45
State: ID

Vax Date: 01/08/2021
Onset Date: 01/09/2021
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: codeine, hydrocodone

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

Symptoms: Headache, muscle soreness, diarrhea, fatigue

Other Meds: none

Current Illness: none

Date Died: 01/12/2021

ID: 0934745
Sex: F
Age: 79
State: IA

Vax Date: 01/09/2021
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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NKA

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

Symptoms: Resident had seizure like activity followed by a vagel response with large bowel movement. Resident then began to show signs of blood clot to left lower extremity. No pedal pulse, area on leg warm to touch. Left lower leg now cold to touch, stiff, purple and white in color. No other signs of modeling, body warm to touch, no fever noted. Respirations and pulse increased with low oxygen levels. Resident not responding to stimuli.

Other Meds: Exelon 13.3 mg daily, APAP 500 mg three times a day, Namenda 10 mg two times a day, Senna 8.6 mg two tablets daily, Mirilax 27 grams two times a day, 2 cal 4oz three times a day, Amlodipine 5 mg daily

Current Illness: NA

ID: 0934746
Sex: F
Age: 44
State: OK

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: -shellfish -walnuts -mango -caffeine -Amoxicillin -Keflex -Latex

Symptom List: Pain in extremity

Symptoms: Due to clients extensive history of allergies, client was placed in 30 minutes post vaccine observation by EMS. It was there client started experiencing " tingling and scratchy throat." Client's VS were taken at 1148 and as follows: BP 144/103, Pulse 85, O2 Sat 100%-EMS took over care and continued to monitor patient. At 1159 BP has increased to 158/95. At 1200 50 mg Benadryl IM was given in RDM. At 1204 BP had decreased to 148/86. EMS made the call to transport the client to Hospital for further evaluation and treatment.

Other Meds: no prescriptions reported

Current Illness: no illnesses reported

ID: 0934747
Sex: F
Age: 84
State: CO

Vax Date: 01/01/2021
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: PNC

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

Symptoms: 10X7 cm, red patchy colored area on left arm at injection site warm to the touch. hive like appearance. Began 2-3 days after IZ administration. symptoms are reducing at this time.

Other Meds: Ibuprofen

Current Illness:

ID: 0934748
Sex: F
Age: 63
State: RI

Vax Date: 12/30/2020
Onset Date: 01/10/2021
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: erythromycin

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

Symptoms: Pt. noticed on Sunday ( 11 days post vaccine) a rash at vaccine site. Not warm to touch, not itchy and swelling.

Other Meds: NA

Current Illness: NA

ID: 0934749
Sex: F
Age:
State:

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

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: 38-year-old female who is healthcare worker and received first dose of COVID vaccine (Pfizer). Immediately after receiving the vaccine, patient developed lightheadedness, flushing, hives, wheezing and throat swelling. Patient was treated in an emergency department with epinephrine, gradually improved and was able to be sent home with an EpiPen, prednisone, hydroxyzine, and famotidine. The next day, patient again developed shortness of breath and her husband administered the EpiPen. EMS arrived and gave another dose of IM epinephrine and IV diphenhydramine. On arrival to the emergency department, the patient was altered, diaphoretic, tachypneic, tachycardic, and stridulous. Patient was given multiple doses of IM epinephrine and started on epinephrine drip. Stridor continued and was unresponsive to nebulized albuterol. Patient was then intubated and placed on mechanical ventilation. Other treatments included solumedrol, pepcid, magnesium sulfate, nebulized epinephrine, and IV fluids. admitted to the intensive care unit, weaned off epinephrine drip, and extubated the next day. Patient was monitored on hospital floor for one additional day and was then discharged with no residual symptoms.

Other Meds: Imitrex, Effexor XR, COVID-19 Vaccine (Pfizer)

Current Illness:

ID: 0934750
Sex: F
Age: 46
State: NY

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: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: 01/09 shortly after vaccine for right arm soreness and right eye swelling, about 6 hours after vaccine 01/09 body aches, headache couldn?t move neck due to stiffness; 01/10 left arm soreness, armpit pulsation, fever range 102 F,; 01/11 vomiting. seasonal allergy eye drops for right eye swelling (went away), Benadryl 50 mg.; ibuprofen and Tylenol around the clock starting 01/09 to present day, 01/11/2021

Other Meds:

Current Illness:

ID: 0934751
Sex: F
Age: 60
State: UT

Vax Date: 01/08/2021
Onset Date: 01/10/2021
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: Codeine - Vomiting

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Patient reported soreness/painful up into clavicle area of right side where injection occurred. Patient also reports swollen and painful lymph nodes on right side where injection occurred.

Other Meds: None reported

Current Illness: None reported

ID: 0934752
Sex: M
Age: 26
State: NJ

Vax Date: 01/07/2021
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: None

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

Symptoms: 1 day after vaccination I experienced muscle pain, weakness, and chills. Symptoms lasted for roughly 1 day.

Other Meds: None

Current Illness: None

ID: 0934753
Sex: F
Age: 85
State: CA

Vax Date: 01/05/2021
Onset Date: 01/09/2021
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:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: soreness in chest fever chills slight nausea body aches

Other Meds:

Current Illness:

ID: 0934754
Sex: F
Age: 24
State: FL

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: RA

Lab Data:

Allergies: Codeine

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

Symptoms: Employee felt dizzy and lightheaded. Stated she "felt like she was going to pass out." Gave her orange juice placed her in Exam room lying down took B/P, O2 and Kept Eye on her. Dr. examined her and had her stay lying down for at least 30 mins. Employee was feeling much better and left at 4:00pm with someone to drive her home.

Other Meds: Zyrtec

Current Illness: None

ID: 0934755
Sex: F
Age:
State:

Vax Date:
Onset Date:
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: Patient is a healthcare worker who received the COVID-19 vaccine (Pfizer). Within 1 hour of vaccine, patient began experiencing nasal passage tightness, nasal congestion, and facial numbness. No wheezing, rash, visible swelling, tachycardia, or hypotensions. Given diphenhydramine, famotidine, and prednisone in emergency department. During observation in ED, started having throat and chest tightness with hyperventilation. This improved with lorazepam. Patient felt improved and was discharged with Epi pen and told to follow-up with her allergist.

Other Meds: cetirizine, fluticasone, ranitidine, COVID-19 vaccine (Pfizer)

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm