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: 1103801
Sex: M
Age: 66
State: IN

Vax Date: 03/12/2021
Onset Date: 03/12/2021
Rec V Date: 03/16/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Dysphagia, Epiglottitis

Symptoms: chills, fever, arm sore, fatique

Other Meds: none

Current Illness: none

ID: 1103802
Sex: F
Age: 51
State: GU

Vax Date: 02/26/2021
Onset Date: 02/26/2021
Rec V Date: 03/16/2021
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: allergic to bactrim

Symptom List: Anxiety, Dyspnoea

Symptoms: I am fine now, and this adverse event resolved, but I worked in a pharmaceutical company and know that you need to know about adverse events. I had the vaccine on Friday morning and was fine all day. In the middle of the night, I felt like ice water was rushing through my veins, and it was actually somewhat pleasant. Then I got out of bed and realized something was wrong, and I felt dehydrated. I took my temperature, and it was 102.8. I drank seven glasses of water and took two Tylenol and could tell after a little while that the temperature was not as high, but I still had it. I had a fever that night and all day Saturday of 101 degrees and was continuing to take two tylenol every six hours. I had no aches (my husband immediately had aches and chills after getting his second vaccine, but his fever was not as high. We have not filled out a form for him, yet). On Sunday, I think my fever was not as high, getting better, but I still felt too out of it to even watch a tv show. I slowly started getting back to normal on Monday and by Tuesday was fine. Thank you. I'm grateful for the vaccine. We knew that people had difficulties after the second dose, so we were prepared for it. But only when I saw an article about reporting adverse events today did I remember that this is data that needs to be known. I am sure that most people where I live have no idea that they should report a fever after getting the vaccine.

Other Meds: Synthroid

Current Illness:

ID: 1103803
Sex: F
Age: 49
State: SC

Vax Date: 03/06/2021
Onset Date: 03/15/2021
Rec V Date: 03/16/2021
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: Amoxicillin, Ciprofloxin

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

Symptoms: Red, hot, swollen at injection site 9 days after

Other Meds: Actos, Metformin, Welchol, Brilanta, Metoprolol , Trulicity, Lantus, Asprin, Zoloft

Current Illness:

ID: 1103804
Sex: F
Age: 34
State: NC

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

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

Lab Data:

Allergies: Adhesive Augmentin Celebrex (Anaphylaxis) Insulins Glargine, Aspart Sulfa antibiotics (Anaphylaxis) Gluten protein Iodinated contrast material Penicillins Tree nut (anaphylaxis) Barium sulfate Clindamycin Wheat (anaphylaxis)

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Tingling in tongue, felt like tongue was a bit puffy - 5 minutes in. Lightheaded, dizzy -5-10 minutes in. BP higher than typical for me Given dose of diphenhydramine 50mg and famotidine 40mg and 4oz of juice to stabilize blood glucose (which, by CGM alert, dropped as well).

Other Meds: Azelastine 0.15% spray 1 spray in each nostril twice a day Tizanidine 4mg tablet 1 tablet TID Tramadol 100mg ER 1 tablet twice per day (BID) Sertraline 250mg 2.5 100mg tablets qAM Clonazepam 0.5/1mg 0.5mg qAM/1mg qHS Bupropion 450mg 1 30

Current Illness: Sinus congestion, chronic health conditions

ID: 1103805
Sex: F
Age: 65
State: TN

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

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

Lab Data:

Allergies: Alphagan Combigan

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

Symptoms: Mild facial flushing, lip tingling, tightness in forehead within 10 minutes of injection; providers checked pulse/ox and BP9BP 140/90 which is higher than normal). Symptoms subsided within 25 minutes, but recurred less acutely more than twelve hours later after use of Travaprost eyedrops, then Dorzolamide Timelol drops. Symptoms subsided again within half an hour afterward.

Other Meds: Travoprost Dorzolamide Timelol Zyrtec Viactive Flonase{day before vaccination)

Current Illness: none

ID: 1103806
Sex: F
Age: 54
State: MI

Vax Date: 03/10/2021
Onset Date: 03/11/2021
Rec V Date: 03/16/2021
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: Fever and headache 1st day. Body/joint pain second day low grade fever

Other Meds: Prozac, omezprozol, gabapentin, calcium, vitamin D, iron, biotin, Zyrtec

Current Illness: None

ID: 1103807
Sex: F
Age: 32
State: OK

Vax Date: 03/12/2021
Onset Date: 03/12/2021
Rec V Date: 03/16/2021
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: Amoxicillin

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Fatigue for three days, worsening in the evening

Other Meds: None

Current Illness: None

ID: 1103808
Sex: F
Age: 51
State: FL

Vax Date: 03/06/2021
Onset Date: 03/06/2021
Rec V Date: 03/16/2021
Hospital:

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

Lab Data:

Allergies: mango allergy

Symptom List: Pharyngeal swelling

Symptoms: Face numbness that lasted 36 hours. Lips remained numb for about 72 hours.

Other Meds: None

Current Illness: none

ID: 1103809
Sex: F
Age: 37
State: SC

Vax Date: 03/07/2021
Onset Date: 03/16/2021
Rec V Date: 03/16/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: Red itchy welt on arm

Other Meds:

Current Illness:

ID: 1103810
Sex: F
Age: 53
State: SC

Vax Date: 03/10/2021
Onset Date: 03/12/2021
Rec V Date: 03/16/2021
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: Nothing.

Symptom List: Diarrhoea, Nasal congestion

Symptoms: The patient is having severe allergic reactions all over her body with lots of hypes. This started on 3/12/2021 around 7 PM. The patient was then given Benadryl allergy over the counter medication along with calamine lotion to help with the rashes and itchiness. We tried giving the same medication for 36 hours after that we decided to take the patient to Urgent care on 3/14/2021. The doctor took a look at the patient and prescribed prednisolone storied to help the patient with rashes and hypes. Till today 3/16/2021 the patient is still suffering from the same severe allergic reaction. The Patient doesn't have insurance and also has low income she is worried about the expenses that's costing her now.

Other Meds: Benadryl Allergy, Calamine Lotion and hydrocortisone cream 1%.

Current Illness: Nothing.

ID: 1103811
Sex: F
Age: 57
State: SC

Vax Date: 03/12/2021
Onset Date: 03/12/2021
Rec V Date: 03/16/2021
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: Syncope, arrhythmia, chills,

Other Meds: None

Current Illness: None

ID: 1103812
Sex: M
Age: 54
State: OH

Vax Date: 03/15/2021
Onset Date: 03/15/2021
Rec V Date: 03/16/2021
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: Moderna Covid-19 vaccine eua

Other Meds: None

Current Illness: None

Date Died: 03/13/2021

ID: 1103813
Sex: F
Age: 67
State: NY

Vax Date: 02/28/2021
Onset Date: 03/02/2021
Rec V Date: 03/16/2021
Hospital: Y

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 was vaccinated on 2/28 and on 3/2 began to experience worsened sob from baseline, development of sternal chest pain, abdominal bloating, nausea and fatigue. She presented to the hospital on 3/9 c/o intractable pain and nausea/vomiting that was worsening. Imaging revealed no change in her cancer from same imaging in jan 2021. PE ruled out. No sepsis. She had acute kidney injury/dehydration. started on ivf. renal imaging normal. echo normal. ekg normal. she rapidly progressed to anuric renal failure and died 3/13/2021. oncology ruled out tumor lysis. she was not felt to be a candidate for dialysis.

Other Meds: Ibrance, vit d, femara, losartan, hctz

Current Illness: HTN, Mild COPD, Breast cancer

ID: 1103814
Sex: F
Age: 26
State: CT

Vax Date: 03/13/2021
Onset Date: 03/13/2021
Rec V Date: 03/16/2021
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: n/a

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

Symptoms: Fever Couldn't talk Sharp join & chest pains Painful to move eyes Fatigue Bedridden- couldn't move on my own Shortness of breath Lasted 7 hours; took 3 Tylenol @ 500mg each; lots of fluids

Other Meds: n/a

Current Illness: n/a

ID: 1103815
Sex: M
Age: 62
State: IN

Vax Date: 03/13/2021
Onset Date: 03/13/2021
Rec V Date: 03/16/2021
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: Tip of tinge swollen and tingly

Other Meds: Zinc, vitamin C , magnesium, fish oil, B12

Current Illness: None

ID: 1103816
Sex: F
Age: 57
State: MA

Vax Date: 03/11/2021
Onset Date: 03/15/2021
Rec V Date: 03/16/2021
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: Sulfur drugs

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

Symptoms: Started having pain and difficulty urinating last night. Had to get up during the night to go a few times as well. Calling doctor?s office this morning. It is a bit concerning as my brother ended up with a UTI a few days after his second shot and was treated with antibiotics

Other Meds: None

Current Illness: Sinus infection treated with antibiotics 3-1-2021- 3-5-2021

ID: 1103817
Sex: F
Age: 52
State: IN

Vax Date: 03/12/2021
Onset Date: 03/12/2021
Rec V Date: 03/16/2021
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: Sulfa

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

Symptoms: Unable to lift arm within 10 hours. In 18hrs was shaking and extremely cold. Had temp of 100.9. That lasted for 6 hours and transitioned to burning up. During this time I had severe pain in all joints from my neck to my hips. My fingers swelled as well. My legs felt fine and no headache. Tylenol and ibuprofen helped my fever but did not alleviate my pain symptoms. My shot was Friday evening. By sunday afternoon my fever was gone as well as the pain in all but my arm. But is was down to manageable.

Other Meds: Hydrochlorothiazide 12.5mg, Topiramate 125mg

Current Illness: n/a

ID: 1103818
Sex: F
Age: 52
State: OH

Vax Date: 03/10/2021
Onset Date: 03/10/2021
Rec V Date: 03/16/2021
Hospital:

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

Lab Data:

Allergies: Sulpha drugs Penicillin

Symptom List: Ear pain, Hypoaesthesia

Symptoms: flu-like fatigue and weakness, chills, no fever high blood pressure, usually have a little low pressure felt ready to pass out, several times foot went numb

Other Meds: Azaletine Symbicort Multi-vitamin Vit C Vit D

Current Illness: Allergies

ID: 1103820
Sex: F
Age: 25
State: NY

Vax Date: 03/14/2021
Onset Date: 03/14/2021
Rec V Date: 03/16/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: High fever of 103.3 which dropped to 101.1. Lasted 24 hours. Tylenol dropped it to 99, then it would rise again. Pounding headache. Lasted 24 hours. Tylenol helped.

Other Meds: Birth control and spironolactone

Current Illness:

Date Died: 03/12/2021

ID: 1103821
Sex: M
Age: 86
State:

Vax Date: 01/20/2021
Onset Date: 02/18/2021
Rec V Date: 03/16/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: Weakness Death

Other Meds:

Current Illness:

ID: 1103822
Sex: F
Age: 42
State: NC

Vax Date: 03/15/2021
Onset Date: 03/16/2021
Rec V Date: 03/16/2021
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: none

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

Symptoms: body aches, low fever, chills

Other Meds: birth control (Junel)

Current Illness: none

ID: 1103824
Sex: F
Age: 69
State: TN

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 03/16/2021
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

Symptom List: Unevaluable event

Symptoms: Delayed anaphylactic reaction - intense flushing of entire body with itching and hives, drop in BP, swelling of tongue

Other Meds: None

Current Illness: None

ID: 1103825
Sex: M
Age: 57
State: PA

Vax Date: 03/10/2021
Onset Date: 03/13/2021
Rec V Date: 03/16/2021
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: TETRACYCLINE, SULFA EYE DROPS

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

Symptoms: Days 1 to 3: Slight pain and tenderness at injection site with Day 2 being the worse. Day 4: Slight irritation started on surface of outside left ankle. Day 5: Outside left ankle became more sore and rash was noticed while taking shower that night. Skin surface in that area became very dry associated with small scabs. Day 6: Outside left ankle not sore anymore and just dry skin surface remaining. Day 7: No complaints.

Other Meds:

Current Illness:

Date Died: 03/12/2021

ID: 1103826
Sex: M
Age: 87
State:

Vax Date: 01/25/2021
Onset Date: 03/06/2021
Rec V Date: 03/16/2021
Hospital: Y

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: chest pain, acute heart failue death

Other Meds:

Current Illness:

ID: 1103827
Sex: F
Age: 67
State: PA

Vax Date: 02/19/2021
Onset Date: 02/19/2021
Rec V Date: 03/16/2021
Hospital:

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

Lab Data:

Allergies: Eggs, Fish

Symptom List: Injection site pain, Menorrhagia

Symptoms: EXTREME Left shoulder pain.

Other Meds:

Current Illness:

ID: 1103830
Sex: F
Age:
State: MI

Vax Date: 01/19/2021
Onset Date: 01/29/2021
Rec V Date: 03/16/2021
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: She also experienced shortness of breath/out of breath; heart out of sync; new heart rhythm abnormality; she has heart rhythm problem (premature atrial contraction); feeling exhausted; This is a spontaneous report from a contactable Nurse (patient). A 61 -year-old female patient received her first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, lot number: EL3249), via an unspecified route of administration on 19Jan2021 (at the age of 61 -years-old), single dose for COVID-19 immunization. Medical history included covid infection over a year ago. The patient had no concomitant medicines were not reported. The patient She had flare ups when she took Hep b vaccine before and did not get the 2 remaining doses because of the reaction. She has had so many vaccines over the years and had her flu shot every year. Patient had the 1st dose of the PFIZER-BIONTECH COVID-19 VACCINE last 19Jan2021. Consulted the doctor 01Feb and told she has heart rhythm problem (premature atrial contraction). She also experienced shortness of breath. Not sure if it is vaccine related or due to her age. She will have the 2nd dose on 09Feb2021. Stated that she was feeling exhausted (29Jan2021) and out of breath. Stated that the doctor told her that her heart rhythm out of sync. Stated that in Dec she had her heart checked and it was okay. Stated that her other Covid is due to be given 09Feb. Does not know if the vaccine is contributing to her heart rate's bivalvular rhythm. Stated that she had Covid infection over a year ago. Stated that she is worried that the vaccine caused an abnormal rhythm to her heart. Stated that she has a new heart rhythm abnormality. Stated that she had all of her lab work done on 11Jan2021 and it was okay. Stated that on 27Jan-28Jan that she tried to pick up a watermelon and was short of breath for no reason. Stated that it happened a couple of times. Stated with her rhythm being out of sync that it feels like her heart is failing. The outcome of the event dyspnea was recovered, heart disorder and fatigue was not recovered, other events was unknown.; Sender's Comments: A possible contributory effect of suspect BNT162B2 on reported arrhythmia cannot be excluded. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.

Other Meds:

Current Illness:

Date Died: 03/15/2021

ID: 1103831
Sex: F
Age: 96
State:

Vax Date: 02/16/2021
Onset Date: 03/15/2021
Rec V Date: 03/16/2021
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: death

Other Meds:

Current Illness:

ID: 1103832
Sex: M
Age: 37
State: GA

Vax Date: 03/12/2021
Onset Date: 03/15/2021
Rec V Date: 03/16/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Vertigo. Dizziness upon laying down and standing up again. Severe enough to cause room to spin.

Other Meds: ToproL XL 2 baby aspirin 10mg water pill Multi vitamin 20mg zyrtec

Current Illness: None. Seasonal allergies

ID: 1103833
Sex: F
Age: 41
State: SC

Vax Date: 03/08/2021
Onset Date: 03/09/2021
Rec V Date: 03/16/2021
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: Sore arm all the way down to my fingertips. Sore body. Tender to the touch. Headache and fever.

Other Meds: Birth control. Junel

Current Illness: None

ID: 1103834
Sex: M
Age: 51
State: NY

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

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

Lab Data:

Allergies: Bees

Symptom List: Nausea

Symptoms: Patient became dizzy and suffered from diaphoresis after vaccination. Reclined patient, gave HiC, vitals taken and stable throughout. After 15 minutes patient was able to walk and leave clinic.

Other Meds:

Current Illness:

ID: 1103835
Sex: F
Age: 80
State: NY

Vax Date: 02/06/2021
Onset Date: 02/16/2021
Rec V Date: 03/16/2021
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: ACE inhibitors

Symptom List: Injection site pain

Symptoms: Immune thrombocytopenia

Other Meds: None

Current Illness: None

ID: 1103836
Sex: M
Age: 25
State:

Vax Date: 03/15/2021
Onset Date: 03/16/2021
Rec V Date: 03/16/2021
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 induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: severe nausea, anorexia, epigastric pain. Symptoms lasted 10 hours are required 4L NS IV, 16mg zofran IV, 50mg phenergran IV

Other Meds:

Current Illness:

Date Died: 03/13/2021

ID: 1103837
Sex: M
Age: 73
State:

Vax Date: 02/19/2021
Onset Date: 02/23/2021
Rec V Date: 03/16/2021
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:

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

Symptoms: shortness of breath, dizziness death

Other Meds:

Current Illness:

Date Died: 03/10/2021

ID: 1103838
Sex: F
Age: 85
State: TX

Vax Date: 03/09/2021
Onset Date: 03/10/2021
Rec V Date: 03/16/2021
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: Patient found deceased at home on 3/10/2021.

Other Meds:

Current Illness:

ID: 1103839
Sex: F
Age: 83
State: PA

Vax Date: 02/17/2021
Onset Date: 02/24/2021
Rec V Date: 03/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: right arm extensive erythematous, papular rash with crusting lasting more than 10 days, radiating from right lateral upper arm to right wrist. some pain and mild itching.

Other Meds:

Current Illness:

ID: 1103840
Sex: F
Age: 72
State:

Vax Date: 03/11/2021
Onset Date: 03/13/2021
Rec V Date: 03/16/2021
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: Red rash in 3 areas on upper arm, proximal to injection site. Not raised. Itchy. Hot to touch.

Other Meds:

Current Illness:

ID: 1103841
Sex: F
Age: 39
State: IN

Vax Date: 03/14/2021
Onset Date: 03/14/2021
Rec V Date: 03/16/2021
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: 4:13pm vaccine given 4:20 dizziness, flush feeling in the face bp 72/45 hr 51 oxygen 99% 4:27 112/65 hr 62 oxygen 98 no dizziness, feeling better 4:40 113/61 hr 65 oxygen 99 sitting up ,no dizziness, feels like able to walk 4:45 108/71 hr 66 oxygen 99 feeling fine, no symptoms

Other Meds:

Current Illness:

ID: 1103842
Sex: F
Age: 69
State: NY

Vax Date: 03/03/2021
Onset Date: 03/08/2021
Rec V Date: 03/16/2021
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: Asthenia, Chills, Headache, Myalgia

Symptoms: Chills at onset only; then fever, occassional headache & backache, and lethargy for 48 hours. Temp averaged 100, hit 101 once, 102 once. Took acetaminophen 3X during the 48 hour period. After 48 hours 100% normal.

Other Meds: quinapril,vitamins,calcium,acidophilus

Current Illness: none

ID: 1103843
Sex: F
Age: 67
State: MI

Vax Date: 03/13/2021
Onset Date: 03/16/2021
Rec V Date: 03/16/2021
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 known

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

Symptoms: Redness and itchy at injection site

Other Meds: Raloxifene One a day vitamin Calcium

Current Illness: None

ID: 1103844
Sex: M
Age: 45
State: IN

Vax Date: 03/12/2021
Onset Date: 03/12/2021
Rec V Date: 03/16/2021
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: Vancomycin Sensitivity-Redman?s Syndrome Keflex-Chest Pain

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

Symptoms: Left injection soreness (3/12/21) Right knee pain where replacement is (3/14/21). Right hip pain where replacement is(3/14/21). Right scapular pain (3/14/21). Bilateral hand coldness (3/14/21. Taking Naproxen 220mg 1 tablet daily since 3/14/21.

Other Meds: Levothyroxine 150mcg 1 tablet daily Spironolactone 50mg 1 tablet daily Folic Acid 1mg tablet daily Pravastatin 20mg tablet daily Acyclovir 400mg 1 tablet twice daily Testosterone Topical Gel 1.62% 1 packet topical daily Sulfamethoxazole-t

Current Illness: None

ID: 1103845
Sex: F
Age: 27
State: MO

Vax Date: 03/13/2021
Onset Date: 03/14/2021
Rec V Date: 03/16/2021
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

Symptom List: Pain in extremity

Symptoms: Janssen COVID-19 Vaccine EUA. Headache, nausea, and vomiting. Beginning about 12 hours after injection, I was throwing up for about 24 hours.

Other Meds: spironolactone

Current Illness:

ID: 1103846
Sex: F
Age: 54
State: MD

Vax Date: 03/03/2021
Onset Date: 03/04/2021
Rec V Date: 03/16/2021
Hospital:

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

Lab Data:

Allergies: Penicillin and sulfa

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

Symptoms: Weakness in arms and legs and muscle spasms in arms and legs causing me to fall to the ground and repeatedly flail my arms.

Other Meds:

Current Illness:

Date Died: 03/13/2021

ID: 1103847
Sex: M
Age: 84
State:

Vax Date: 02/06/2021
Onset Date: 02/11/2021
Rec V Date: 03/16/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: weakness fever death

Other Meds:

Current Illness:

ID: 1103848
Sex: M
Age: 19
State: CA

Vax Date: 03/15/2021
Onset Date: 03/15/2021
Rec V Date: 03/16/2021
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: G6PD

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

Symptoms: 19 y/o M AD USMC with Hx G6PD Def was brought in by ambulance with complaints of abdomen discomfort, chills, fever, dysphagia/dysphasia, nausea and headaches following administration of Janssen vaccine 7-8 hours prior. Evaluation significant for edema/inflammation of the oropharynx, abdomen tenderness, down-trending BP, fever (>102 F), tachycardia (>115), despite the fluid resuscitation IV, Epinephrine, steriods, Antipyretic and diphenhydramine. Vital signs and symptoms significantly improved 2.5 hours into the treatment. Over the evening care, member had a unremarkable observation. Vital signs maintained stable in the morning and he was discharged with appropriate therapies and follow up instructions.

Other Meds: Ibuprofen

Current Illness:

ID: 1103849
Sex: M
Age: 70
State: FL

Vax Date: 03/05/2021
Onset Date: 03/06/2021
Rec V Date: 03/16/2021
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: Amoxicillan Penicillan

Symptom List: Vomiting

Symptoms: Received shot on the 5th. - Friday On Saturday I started noticing my heart rate increased and my BP was up. Then it seem to go away. Then Sunday while at church I felt like it was acting up. By Sunday evening my BP and heart rate were jumping all over. The highest was BP 196/91 with a heart rate of 130. Like I said it was going up and down. I considered calling 911 but a nurse suggested I just monitor it as they would not do anything at the hospital but monitor me. On Monday I stayed in contact with my cardiologist and these symptoms lasted till Wednesday morning. Since then everything has been great. I know they say the second dose is worse when it comes to reaction and part of me DOES not want to get the second dose. I have a Defibrillator / pacemaker and am starting to question the real need of this shot. Thank you

Other Meds: Patient?s Meds - 2021 Carvedilol ? 12.5 mg ? 1 ? 2 x a day ? AM & PM Atorvastatin - 20 mg ? 1 ? 1 x a day -- PM Eliquis ? 5 mg ? 1 ? 2 x a

Current Illness: Heart Dease, Diabetic

ID: 1103850
Sex: F
Age: 61
State: SC

Vax Date: 03/07/2021
Onset Date: 03/15/2021
Rec V Date: 03/16/2021
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: Swollen red area on arm at injection site. Felt like a bug bite but area was raised (2 inches x 3inches) Very itchy and bumpy and a little tender.

Other Meds: Zyzal

Current Illness: None

ID: 1103851
Sex: F
Age: 54
State: NC

Vax Date: 03/15/2021
Onset Date: 03/15/2021
Rec V Date: 03/16/2021
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: NA

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

Symptoms: Extreme fatigue. Slept. Felt better. Moderate soreness at injection site. Soreness continues 2nd day.

Other Meds: adderall, singulair, cetrizine hydrochloride, flonase

Current Illness: NA

ID: 1103852
Sex: F
Age: 53
State: FL

Vax Date: 03/14/2021
Onset Date: 03/14/2021
Rec V Date: 03/16/2021
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: iodine, oysters

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Janssen COVID-19 Vaccine EUA. Approximately 7 hours after the shot, my body was in a continuous state of needing to stretch. It is like when you wake up in the morning and need to stretch - a whole body stretch- but this was continuous. Over and over and over, right after each other. It went on for many hours. Also, 40 hours after the shot, I noticed a body rash (it could have been there the previous day but I was in bed all day feeling horrible and didn't notice). I also have a rash on my sacrum area, and I could barely walk with the pain in my bones in that area. As the morning has progressed, I am feeling better in that area but it is still sore. It has been 40 hours after my vaccine and I am still not 100%. Aside from the horrible headache, chills and flu-like symptoms, these are the other side effects I thought need to be reported.

Other Meds: n/a

Current Illness: n/a

ID: 1103854
Sex: F
Age: 45
State: NC

Vax Date: 03/13/2021
Onset Date: 03/15/2021
Rec V Date: 03/16/2021
Hospital:

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

Lab Data:

Allergies: prednisone, hydrocodone, codeine

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

Symptoms: body rash, itching, shortness of breath

Other Meds: Prilosec

Current Illness: none

ID: 1103855
Sex: F
Age: 90
State: IL

Vax Date: 03/03/2021
Onset Date: 03/04/2021
Rec V Date: 03/16/2021
Hospital: Y

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

Lab Data:

Allergies: benzocaine cephalexin-hallucinations levetiracetam-hallucinations methylprednisolone-hives after joint injections oxybutynin-rash

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

Symptoms: Patient is a 90 y.o. female who presented to ER complaining of generalized shivering which began late last evening (3/3/21). Patient states she received her 2nd dose of her Moderna COVID 19 vaccine yesterday (3/3/21). She states she went to bed, woke up in generalized shaking which has yet to stop that she came to the ER (on 3/4/21). In ER patient's initial blood work was unremarkable which include CMP and CBC. CT brain was done to rule out any underlying neurological deficits or acute CVA which was unremarkable. She denies any numbness tingling no blurry vision no headache no sensory motor deficits. She denies any recent falls.

Other Meds: aspiring 325 mg daily atorvastatin 10 mg daily furosemide 40 mg daily

Current Illness: n/a

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm