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: 1103100
Sex: F
Age: 66
State: LA

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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Sulfa, vibramycin

Symptom List: Dysphagia, Epiglottitis

Symptoms: Woke up around 2 am with stomach cramps, loose bowels, nausea, chills, sweating, dizziness, sore left arm, very shaky feeling. Went to bathroom for bowel movement, had trash can in front of me in case of vomiting. Apparently passed out and fell off toilet. Woke up on floor, on my right side, with very cold chills and sweating. Finished going to bathroom. Noticed small cut on forehead, with dried blood, probably from hitting my head on trash can I was holding. Went back to bed. Still dizzy, chills, sweating, stomach cramps, nausea, sore arm, and aching all over. These symptoms persisted for hours. Finally fell asleep, woke up around 7:30 am, still dizzy, stomach cramps. Took temperature, normal, took blood Additional information for Item 18: pressure, also normal. Called office of primary care doctor, not open on Friday, declined appointment with another doctor, left detailed message, and was told they would contact me on Monday. Went back to sleep, woke around 11:15 am, still nauseous and stomach cramps and dizzy. Went back to sleep until around 2:30 pm. Woke up feeling better, still sore left arm, sore stomach, achy and very tired.

Other Meds: Armour Thyroid, Alendronate Sodium, baby aspirin, cod liver Additional information for Item 9: oil capsule, calcium, cranberry, olopatadine hydrochloride opthalmic solution

Current Illness: None

ID: 1103101
Sex: F
Age: 22
State: TX

Vax Date: 03/01/2021
Onset Date: 03/14/2021
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: None

Symptom List: Anxiety, Dyspnoea

Symptoms: Pain in left arm came 14 days after receiving 2nd vaccination. Deltoid on left arm is very sore. There?s a red spot and warmth where the shot was injected, but not visible swelling. Arm feels very weak, it shakes when I lift my arm. I feel a throbbing pain while my arm is at rest.

Other Meds: Adderall, escitalopram, Lo lo estrin, multivitamins

Current Illness: None

ID: 1103102
Sex: F
Age: 27
State: FL

Vax Date: 03/11/2021
Onset Date: 03/12/2021
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: No

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

Symptoms: First Woke up at 2 am on 3/12/21 with a headache. Then at 5:30 am massive headache still present and a mild fever reading at 100.1. Fever broke later that day. Muscle aches in injection site for a few days. Slight overall muscle aches and feelings of tiredness persist as of 3/15/21.

Other Meds: Claritin

Current Illness:

ID: 1103103
Sex: F
Age: 48
State: MI

Vax Date: 03/05/2021
Onset Date: 03/13/2021
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: n/a

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: rash, redness, itchiness, hot to the touch. I have a picture.

Other Meds: daily vitamin, biotin, omerprazole

Current Illness: n/a

ID: 1103104
Sex: F
Age: 73
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: penicillin, amiodarone, oxycodone, hydrocodone

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

Symptoms: First injection - had Covid rash 2 weeks later in left arm Second injection - 45 min after injection, constant clearing of throat and chest issue, took 25 mg benadryl, helped. Next morning woke up with fever 100.8, nauseaus, headache, very tired and hot and cold. next day, still fever and chills, tired and sweaty, headache. Fever dropped in the afternoon of second day (3rd day after shot). Hopefully better by next day or I will call my doctor. taking Tylenol regularly.

Other Meds: Atorvastatin, metoprolol, losartan, ezetimibe, spiralactone, baby aspirin, colace, multi vitamin, b6, d3, lansoprazole, zyrtec, magnesium, collagen

Current Illness: none

ID: 1103105
Sex: M
Age: 72
State:

Vax Date: 03/11/2021
Onset Date: 03/12/2021
Rec V Date: 03/15/2021
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: BEE POLLENS; SULFAMETHOXAZOLE-TRIMETHOPRIM

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

Symptoms: Chest pain; Chronic hepatitis C with cirrhosis; Cirrhosis; Fatigue

Other Meds:

Current Illness:

Date Died: 01/24/2021

ID: 1103106
Sex: M
Age: 80
State: MS

Vax Date: 01/15/2021
Onset Date: 01/16/2021
Rec V Date: 03/15/2021
Hospital: Y

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

Lab Data:

Allergies: NA

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Patient died on 01/24/2021. Began exhibiting symptoms similar to Covid 1 day after vaccination.

Other Meds: UNK

Current Illness: NA

ID: 1103107
Sex: M
Age: 76
State: TX

Vax Date: 02/26/2021
Onset Date: 02/27/2021
Rec V Date: 03/15/2021
Hospital: Y

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 presented to ER the following day after receiving first dose with hemolytic anemia. He is still receiving work-up, but at this time, the cause of this event is unknown.

Other Meds: Gabapentin, lisinopril, metformin, simvastatin, aspirin, ciprofloxacin, flagyl, fluticasone nasal spray, lantus, glipizide

Current Illness: diverticulitis

ID: 1103108
Sex: M
Age: 74
State: HI

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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: n/a

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: severe headache, diarrhea, loss of appetite, loss of sense of smell, loss of sense of taste, significant aches and pains, dizziness, chills, sweats these symptoms began within 12 hours of getting 2nd dose of vaccine, and persist to right now - 3 days after getting shot

Other Meds: allopurinol, trazodone, ropinorole, lipitor, propranol, preservision, aspirin

Current Illness: n/a

ID: 1103109
Sex: M
Age: 65
State: PA

Vax Date: 03/11/2021
Onset Date: 03/11/2021
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: gapapentin, tramadol, duloxetine, Roflumilast

Symptom List: Diarrhoea, Nasal congestion

Symptoms: felt like he had something in his throat, dizzy and wheezing BG was 54 Provided OJ, Benadryl, Epi pen , albuterol and dexamethasone 4mg Symptoms continued called 911 to sent to ED BG improved to 120

Other Meds: Benadryl liquid Epi pen Albuterol inhaler Dexamethasone

Current Illness: unknown

ID: 1103110
Sex: F
Age: 45
State: CA

Vax Date: 01/12/2021
Onset Date: 01/15/2021
Rec V Date: 03/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Three days after vaccination I noticed painful urination and frequent urination. Blood in urine on 01/15/2021. Telehealth consultation antibiotics prescribed Keflex 500mg/ 3X daily for 7 days. Prescription worked quickly. No history of bladder infection previously. Second dose only mild symptoms.

Other Meds:

Current Illness:

ID: 1103111
Sex: M
Age: 22
State: TX

Vax Date: 02/17/2021
Onset Date: 02/19/2021
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: Keflex

Symptom List: Rash, Urticaria

Symptoms: The patient describes immediate alopecia areata that began two days after the second vaccine and began in the crown area of the scalp. It quickly moved to multiple sites on the scalp within five days. Patient was sent to Dermatology who initiated injections of Triamcinolone into the areas of alopecia. Patient was seen today, which is 26 days later and the diffuse areas of alopecia are noted but with new small hair growth beginning in the sites where the triamcinolone was administered. There were no other abnormal labs to suggest other causes and the temporal relationship with the second Moderna vaccine coincides with the event. The first vaccine was administered on January 16, 2021 with no adverse events.

Other Meds: Venlafaxine Clindamycin topical gel Remicade

Current Illness:

ID: 1103112
Sex: F
Age: 67
State: MD

Vax Date: 03/06/2021
Onset Date: 03/08/2021
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: Joints extremely sore, body aches, fatigu

Other Meds: Enbrel, Celebrex, Xarelto, Lisinopril,Metoprolol. Pantoprazole

Current Illness: Rheumatoid arthritis, high BP, blood clots (DVT & PE's), heartburn.

ID: 1103113
Sex: M
Age: 67
State: TX

Vax Date: 02/11/2021
Onset Date: 02/12/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: Tamiflu

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

Symptoms: 4 days of body aches and lethargy

Other Meds: bupropion, metformin, glipizide, lisinopril, fenofibrate, doxazosin, simvastatin, montelukast, mometasone, fluticasone, alfuzosin, levothyroxine

Current Illness: none

ID: 1103114
Sex: F
Age: 20
State: NC

Vax Date: 03/11/2021
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: Gluten sensitivity

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

Symptoms: Three days after I got the vaccine I woke up with a bad case of vertigo and still recovering it the next day (today)

Other Meds: Vitamins gummies (c,d, calcium)

Current Illness:

ID: 1103115
Sex: F
Age: 73
State: AZ

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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: allergic to sulfa

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

Symptoms: Approximately 10 hours after the injection I began having chills so bad I could not hold onto anything, then my temperature began to rise. I went to bed at 9:00 pm bundled up with numerous blankets, clothes, etc. . My neck, lower back ached then a terrible headache set in. I took motrin, acetaminophen then an Aleve migraine pill. The migraine pill seemed to be the only thing that helped with the headache. I was too tired, sore and weak to get out of bed until 11:00 the next day - The headache returned about 3:00 p.m on Saturday so I took another migraine pill. Needless to say I was extremely fatigued and probably confused. On Sunday morning I had multiple bowel movements - my ibs had been under control until this.

Other Meds: premarin cream, estradiol hrt patch, multi vitamin, probiotic

Current Illness:

ID: 1103116
Sex: F
Age: 68
State: CO

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: Non that I know of. Did have allergies as a child and would break out in hives.

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

Symptoms: After about 12 hours my arm at injection site became sore but this happened on the first dose. When I woke up the following morning my arm was still hurting. I felt my arm and it had a large, red, hard, lump and was warm to the touch. Today, three days later it is now itchy. I looked it up on line to see what I should do so I am now taking an antihistamine along with the Ibuprofen I was already taking. The area affected is between 6 and 7 cm.

Other Meds: None

Current Illness: None

ID: 1103117
Sex: F
Age: 39
State: MO

Vax Date: 03/15/2021
Onset Date: 03/15/2021
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: sulfa codeine

Symptom List: Ear pain, Hypoaesthesia

Symptoms: pt had numbness and redness in face on the left side. she left here feeling ok but got 1/2 hr down the road and stopped at a urgi-car center

Other Meds: diltiazem 120mg er, albuterol inhaler prn

Current Illness: obesity, high blood pressure, chronic allergies

ID: 1103118
Sex: F
Age: 42
State: TN

Vax Date: 03/11/2021
Onset Date: 03/11/2021
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: Benedryl, Sudafed, Codeine, Tetracycline, Fluconazole, Carafate, Pepcid, Sulfa Drugs, Seasonal Pollen

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Severe Flushing (Head, Ears, Neck, Chest) for hours following injection; Slightly subsided after taking Allegra; Flushing came back less severe the following day

Other Meds: Yasmin, Clonazepam, Dexilant, Sertraline, Vitamin D, Cholestyramine

Current Illness: GERD/Bile Reflux Gastritis

ID: 1103119
Sex: F
Age: 58
State: FL

Vax Date: 01/06/2021
Onset Date: 02/23/2021
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: Albuterol

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

Symptoms: Bell's Palsy

Other Meds: Aromasin, Calcium, Vitamin D3, Ozempic, Taltz, Crestor, Losartan, Ambien, Taltz

Current Illness: None

ID: 1103120
Sex: M
Age: 81
State:

Vax Date: 03/11/2021
Onset Date: 03/12/2021
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: NKA

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

Symptoms: Chest pain

Other Meds:

Current Illness:

ID: 1103121
Sex: F
Age: 38
State: IL

Vax Date: 03/10/2021
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: codine

Symptom List: Unevaluable event

Symptoms: Janssen COVID-19 Vaccine EUA pain in the collar bone

Other Meds: Diazepham, apple cider vinegar dummies, candida complex, furosemide, lamotrigine, citalopram, levothyroxine, meloxicam, A-C carbamide,

Current Illness:

ID: 1103122
Sex: F
Age: 62
State: AZ

Vax Date: 03/11/2021
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: Sulpha

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

Symptoms: Fever, 101.5, rash on legs arms, muscle aches

Other Meds: Metoprolol, Losartan, amiodarone, amlodipine, Multi-vitamin, calcium

Current Illness:

ID: 1103123
Sex: F
Age: 51
State: PA

Vax Date: 03/13/2021
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: penicillin

Symptom List: Injection site pain, Pain

Symptoms: chills, lethargy, fever 103.5

Other Meds: Iron, mekinist, tafinlar

Current Illness: being treated for melanoma

ID: 1103124
Sex: M
Age: 22
State: CA

Vax Date: 03/15/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: NKDA

Symptom List: Injection site pain, Menorrhagia

Symptoms: Lightheaded 10 mins after injection. no LOC. Walked to guerney. Appeared pale. able to converse at all times. 14:35 BP 150/59 P 76 and regular, O2 sat 99%. given water and juice and crackers and felt better within minutes. no other complaints or severe adverse reaction sxs. States he did not eat or have fuids since early in day. 14:43 116/64, P 72, O2 sat 100%. 14:50 119/67, P 68 O2 sat 100% 14:55 had cookies. sitting up. 1504 "back to normal". good color to skin. able to stand and ambulate without dizziness 117/71, P 66 and regular, O2 Sat 100%. Discharged home, ambulatory in very stable condition.

Other Meds: Gabapentin, Zofran,Lithium

Current Illness: chemical dependency Bipolar 1

ID: 1103125
Sex: F
Age: 68
State: TN

Vax Date: 03/01/2021
Onset Date: 03/08/2021
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: Latex

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

Symptoms: Started developing what they are calling COVID arm about a week after getting the vaccine. The rash has now grown to about four inches in diameter right around the injection site.

Other Meds: None

Current Illness: None

ID: 1103126
Sex: F
Age: 57
State: KS

Vax Date: 03/05/2021
Onset Date: 03/06/2021
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: None

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Headache tiredness

Other Meds: Effexor. Gabapentine Zyrtec vitamin C B D, calcium, mucinex, pseudoephedrine

Current Illness: None

ID: 1103127
Sex: M
Age: 51
State: NY

Vax Date: 03/06/2021
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: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: ibuprofen- rash

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Bell Palsy

Other Meds: allopurinol 100mg a day

Current Illness:

ID: 1103128
Sex: F
Age: 30
State: TX

Vax Date: 03/12/2021
Onset Date: 03/12/2021
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: Sulfa Drugs

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

Symptoms: Pain and swelling at the injection site that began 3/12/2021 and remain 3 days later Muscle soreness beginning 3/12/2021 to 3/14/2021 Fatigue beginning 3/13/2021 to 3/14/2021

Other Meds: MICRONOR 0.35 mg tablet (birth control)

Current Illness: None

ID: 1103129
Sex: M
Age: 60
State: WA

Vax Date: 03/15/2021
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: RA

Lab Data:

Allergies: Tradjenta, acetaminophen, penicillin

Symptom List: Nausea

Symptoms: RN responded to pt's report of centralized face numbness (reaching out to eyebrows, mid-cheek, upper chin). Denied other symptoms. VS: BP 130/80, SpO2 98%, HR 55, RR 18. RN stayed with pt for 10 minutes, pt reported numbness stayed the same, no new symptoms reported. VS rechecked at 15 min: BP 130/90, HR 55, RR 16, SpO2 99%. Arm strength 5/5 bilaterally. RN called EMS due to facial numbness; gave report when EMS arrived. EMS assessed pt, released him to home with instructions to call 911 if any further symptoms. Pt said that he was returning home and he would have a family member there.

Other Meds:

Current Illness:

ID: 1103130
Sex: F
Age: 38
State: MS

Vax Date: 03/08/2021
Onset Date: 03/08/2021
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: Latex/Sulfa

Symptom List: Injection site pain

Symptoms: Patient has developed a bump under the skin along with itching at the site. She did go to a doctor for follow up and received an antibiotic for treatment.

Other Meds: Celexa 40mg, Trazodone 50mg, Xiidra 5%, Lisinopril 5mg

Current Illness: No known illness at time of vaccination.

ID: 1103131
Sex: F
Age: 73
State: NJ

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: LA

Lab Data:

Allergies: Miralax, Proton Pump Inhibiters Mold, Cats

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

Symptoms: I received vaccine at 2:00 PM on 3/10//2021. I was tired afterwards. By 11:00 that same night I felt nauseous, has a headache and every joint and muscle in my body was painful. I could not sleep or get into a position where I was comfortable. The pain level was a 10. I took Tylenol in the middle of the night but it did not help. In the morning I was unable to contact my physician's nurse so I called the 24 hour Nurse Line. The nurse took all my information and told me that I could take Ibuprofen. I took 400 mg. and found a lot of relief from that. I still had some symptoms for the next few days. By 3/14/21 I felt fine. Now today I have a stuffy nose which could be an allergy to something else. I don't know yet.

Other Meds: Synthroid, Imipramine, Valium, Vitamin D, Vitamin B-12, DGL, Gaviscon, ProAir, Guaifenesin, Tylenol, Estrace Vaginal Cream

Current Illness: Vaginal Yeast Infection

ID: 1103132
Sex: M
Age: 81
State:

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

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

Lab Data:

Allergies: PENICILLIN; PENICILLINS; SUCRALFATE; VIT E-NONOXYNOL 9-ALOE VERA

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

Symptoms: A-fib; Acute hypoxemic respiratory failure; Acute on chronic congestive heart failure, unspecified heart failure type; Arrhythmia; Febrile; Multifocal pneumonia; SOB (shortness of breath) on exertion

Other Meds:

Current Illness:

ID: 1103133
Sex: F
Age: 50
State: PA

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

Lab Data:

Allergies: no

Symptom List: Tremor

Symptoms: Facial tightness, scratchy throat, tingling fingers, "feels heavy". sent to the ED

Other Meds: synthroid Tecfidera Wellbutrin XL Gabatentin Multi-Vitamin

Current Illness: MS

ID: 1103134
Sex: F
Age: 42
State: AL

Vax Date: 03/10/2021
Onset Date: 03/11/2021
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: RESTING HEART RATE 110-120 FOR APPROXIMATELY 24 HOURS, BEGINNING 12 HOURS AFTER DOSE

Other Meds: NONE

Current Illness:

ID: 1103135
Sex: F
Age: 45
State: CA

Vax Date: 03/12/2021
Onset Date: 03/12/2021
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: Sulpha and laytex

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

Symptoms: In the evening I became very dizzy and vomited. In the morning at 5:00am I woke up with a severe migraine and vomited 2 more times. Around 10:30am I ate a small amount of cereal so I could take an aspirin. I had excruciating pain, nauseous, hot flashes, chills, and sweats throughout the day and only could lie in bed in the dark and quiet. I slept on and off for almost 36 hours. The following day my migraine was gone but I was very dizzy and nauseous and did not want to eat. The third day I am finally feeling fine.

Other Meds: Nextplanon implant and weekly vitamin D

Current Illness: None

ID: 1103136
Sex: F
Age: 66
State: NC

Vax Date: 03/06/2021
Onset Date: 03/07/2021
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: Codeine Vitamin Amoxicillin Percoset

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

Symptoms: Severe bone and head pain also cold like symptoms for 5 days

Other Meds: Lyrica Effector Metroporol Zyrtec Anastrozole

Current Illness: None With this vaccine I was sick with severe bone pain and headache for 5 days.

ID: 1103137
Sex: M
Age: 33
State: CA

Vax Date: 03/15/2021
Onset Date: 03/15/2021
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: raw eggs, tree nuts

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Patient is a 33 y.o. male who received the Moderna Covid-19 Vaccine, mRNA-1273 (PF) 100 mcg/0.5 mL IM Susp, Lot 044A21A on 3/15/2021. The patient experienced the following reaction(s) during the immediate of observation: 3:06pm Patient c/o itchiness to bilateral arms. Patient reports feeling anxious and lightheaded s/t fears of needles prior to coming in. Patient arm color appeared within normal limits. No swelling noted to face or mouth. Denies shortness or breath or difficulty breathing. Patient was treated/managed as follows: 3:07pm VS BP 132/88, HR 83, RR 18, O2 sat 99% on room air. Reports feeling better. 3:17pm VS BP 128/90, HR 74, RR 18, O2 sat 99% on room air. Patient reports symptoms have improved. Patient given educational material regarding vaccine and advised to continue to self-monitor per the CDC guidance. 3:45pm Escorted to car by RN.

Other Meds: inhaler, zoloft

Current Illness: none

ID: 1103138
Sex: F
Age: 60
State: TX

Vax Date: 03/12/2021
Onset Date: 03/13/2021
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: none

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

Symptoms: My second vaccination........injection site red and warm and sore. I had severe body aches, joint aches, head aches, fatigue, low grade fever, productive cough. I felt like I had the flu. With my first vaccination I had slight joint aches and fatigue.

Other Meds: none

Current Illness: none

ID: 1103139
Sex: M
Age: 67
State: ID

Vax Date: 02/15/2021
Onset Date: 02/15/2021
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: dairy products, strawberries, wheat, puffer for asthma -pro air hfa - only used when needed

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

Symptoms: numbness to left side of face approximately 30 minutes after vaccine.. lasted 3 days ( 2/15-2/18) weakness, fatigue , shortness of breath, used my asthma puffer, went out for walk with my dogs as I usually do on a mountain path, elevation 5-6,000 ft and broke out in heavy sweats, and shortness of breath. these symptoms lasted about 3 days.. I was scheduled for the 2nd moderna covid shot today 3/15/21 but after talking to the nurses there they advised me to fill out this report and postpone the 2nd shot until I hear from you,

Other Meds: low dose aspirin, omega 3 fish oil, saw palmetto

Current Illness: none

ID: 1103140
Sex: F
Age: 31
State: CA

Vax Date: 03/08/2021
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: None

Symptom List: Pain in extremity

Symptoms: Stiffness and redness about 2 inches around the shot location, hot to touch, and itchy. Started at about 7:30am 7 days after the vaccination took place.

Other Meds: None

Current Illness: None

ID: 1103141
Sex: M
Age: 85
State: MT

Vax Date: 03/12/2021
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: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: History of severe allergic reaction to cortisol injection.

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

Symptoms: Around mid-day the day after vaccination the patient started to experience chills, muscle aches, and flu-like symptoms. Throughout the day, he developed edema in his legs and feet. The following day, he noticed a rash on his feet, which resolved after about 24 hours. He had severe pain through the right side of his body, and some tenderness at the vaccination site.

Other Meds: plavix, lasix, losartan, aspirin, spironolactone, furosemide

Current Illness: ER visit after first dose of vaccination.

ID: 1103142
Sex: F
Age: 65
State: PA

Vax Date: 02/26/2021
Onset Date: 03/04/2021
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: Codine

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

Symptoms: Day after shot, slight fever, chills, aches then ok the second day. Day 5 started getting tenderness/ache in left upper leg and trunk area on left side. Day 9, and since have had rash on left leg and has progressed to left butt area. Saw MD today and she confirmed Shingles. Now being treated for shingles. I did have shingles vaccine 5 years ago.

Other Meds: Amlodepine, Indomethacine, vitamin B2, Magnesium, vitamin D,

Current Illness: None

ID: 1103143
Sex: F
Age: 59
State: OK

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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Arm was very sore. Hurt enough to wake me from a sound sleep. 24 hours after injection, extreme fatigue and low fever. All symptoms managed with Tylenol and sleep. All symptoms resolved after 24 hours.

Other Meds: Pepcid, vitamin A, D, C, turmeric, probiotic, fiber, Zyrtec, singular

Current Illness: None

ID: 1103144
Sex: F
Age: 38
State: AL

Vax Date: 03/15/2021
Onset Date: 03/15/2021
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:

Symptom List: Vomiting

Symptoms: RESTING HEART RATE 110, MILD ANXIETY

Other Meds:

Current Illness:

ID: 1103145
Sex: F
Age: 76
State: CA

Vax Date: 03/11/2021
Onset Date: 03/11/2021
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: 102.6 fever; chills; bad headache Onset about 8 hours after injection and symptoms lasted about 40 hours. Fever treated by Advil and dropped to 100+ after 24 hours.

Other Meds: Irbesartan; Spironolactone; Evista; Pepcid; Lipitor; Vitamins D, C, B6; Magnesium; Tumeric; Gentle Iron; Baby Aspirin

Current Illness: None

ID: 1103146
Sex: F
Age: 66
State: WA

Vax Date: 02/24/2021
Onset Date: 02/26/2021
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: Phenergyn

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

Symptoms: Shortness of breath, chest pain, chills, fatigue, pain in back, nausea - Went to ER Feb 28, 2am - symptoms continue for another week.

Other Meds: Doxicillan antibiotic, synthroid, prozac, amlodopine, atorvastatin, hyrochlorathiazide, Vit B, D, C, multivitamin, lysine,

Current Illness: None - minor skin cancer surgery one day before vaccine

ID: 1103147
Sex: F
Age: 69
State: IN

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

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Very hard chills, fever, nausea, night sweats & dizziness

Other Meds: LosartanHCTZ, Amlodipine, Atortavastin aspirin 81mg, 3 fish oil, silver centrum vitamin, meloxicam

Current Illness: None

ID: 1103148
Sex: F
Age: 72
State: CA

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: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Shrimp, insect stings

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

Symptoms: Chills some time between 11p 3/11 to 4am 3/12 Neck ached on awakening 6am lasted all day Achy joints on awakening 6am lasted till 3/13 12n Shooting pains in neck and in head throughout 3/12 3/13 Rash on injection arm approx 3 in. Wide x 8 in. Long Felt quite hot to the touch but not painful or itchy 3/15 redness in rash diminished, just warm to the touch

Other Meds: Multivitamin, Vitamin D3, Rose Hips, Calcium, Magnesium

Current Illness: None

ID: 1103149
Sex: M
Age: 38
State: CA

Vax Date: 03/12/2021
Onset Date: 03/13/2021
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: None

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

Symptoms: approx 24 hours after vaccine, he started with a rash on arms and above knee. It has spread to neck, chest, and face few hours after.

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm