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: 1103956
Sex: F
Age: 49
State: OK

Vax Date: 03/12/2021
Onset Date: 03/14/2021
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: PCN, flu shot, steroids, etc.

Symptom List: Dysphagia, Epiglottitis

Symptoms: Sore arm up into neck, headache, racing heart that felt like I could pass out, fatigue, heart palpitations frequently, tongue went numb, and burning sensation in hands and fingers, with joint stiffness.

Other Meds:

Current Illness: Autoimmune disease, Rheumatoid Arthritis, carpel tunnel, positive ANA. And heart issues

ID: 1103957
Sex: F
Age: 74
State: PA

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: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Tylenol w codein

Symptom List: Anxiety, Dyspnoea

Symptoms: Red rash on both hands. Not itchy or burning, just there. The rash eventually went away. I never went to the dr as I read that that could be a side effect.

Other Meds: Areds 2 D3 1000 IU

Current Illness: None

ID: 1103958
Sex: F
Age: 60
State: MD

Vax Date: 03/09/2021
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: Illisone; penicillian; bactrim; bee stings; latex

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

Symptoms: Large Itchy Red Rash on both arms, small rash on top of foot, small rash on wrist.

Other Meds: Pantoprazole Sodium chewable probiotics

Current Illness: GERD flare up on 2/21/21- started taking Pantoprazole on 3-4-21.

ID: 1103959
Sex: F
Age: 55
State: FL

Vax Date: 03/12/2021
Onset Date: 03/13/2021
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: NKA

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: SWOLLEN LYMPH NODE UNDER LEFT ARM

Other Meds: PHENTERMINE Hcl 37.5 MG TABS

Current Illness:

ID: 1103960
Sex: M
Age: 45
State: WI

Vax Date: 03/10/2021
Onset Date: 03/11/2021
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: None

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

Symptoms: Flu Like symptoms. Fever/chills/Nausea/Headache

Other Meds: Xarelto, Multivitamin

Current Illness: None

ID: 1103961
Sex: F
Age: 24
State: IN

Vax Date: 03/14/2021
Onset Date: 03/15/2021
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: N/A

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

Symptoms: Symptoms began roughly 29 hours after 1st vaccine injection. -Symptoms include: Sore throat, stuffy nose/nasal drip, fever, chills, nausea, headache, arm soreness, fatigue, and body aches

Other Meds: Venlafaxine, 75 mg tablet, once daily Acetazolamide, 500 mg capsule, twice daily Albuterol Inhaler as needed

Current Illness: N/A

ID: 1103962
Sex: F
Age: 33
State:

Vax Date: 03/04/2021
Onset Date: 03/04/2021
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: Pyrexia, White blood cell count decreased

Symptoms: Flushing and facial rash immediately following vaccine administration; spontaneously resolved in a few hours; no anaphylactoid symptoms.

Other Meds:

Current Illness:

ID: 1103963
Sex: F
Age: 60
State: UT

Vax Date: 03/09/2021
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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Pharyngeal swelling

Symptoms: Developed extreme dizziness, fatigue, and rash on back.

Other Meds: Vitamin D,E,C, Biotin, Calcium, Zinc, Collagen and 81mg aspirin

Current Illness: None

ID: 1103964
Sex: F
Age: 74
State: IN

Vax Date: 03/01/2021
Onset Date: 03/01/2021
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: butazolidin, codeine

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Acute body aches, all over. Elevated temperature. Went to bed, drank a lot of water. Slept through, until 7:00 pm. Got up and ate a sandwich (tuna salad) and went back to bed. Symptoms abated with no residual effect.

Other Meds: Levothyroxine, Claritin, Guaifenisin 1200, Calcium/Magnesium, B-complex, Iron + C

Current Illness: None

ID: 1103965
Sex: F
Age: 65
State: NC

Vax Date: 02/18/2021
Onset Date: 02/19/2021
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: None

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Day after vaccine woke up with mild temp of 99 but otherwise OK. By 2:00pm had temp of 101.6 and very tired. Temp continued but fluctuated with Tylenol for 48 hours. Fatigue continued 2/22/21, then felt normal.

Other Meds: Hydrochlorothiazide Glucosamine Chondrotim Centrum Women Multivitamin CoQ10 - Kirkland brand Cetirizine 10mg

Current Illness: None

ID: 1103966
Sex: F
Age: 55
State: NC

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

Lab Data:

Allergies: Cipro and sulfur drugs

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

Symptoms: Fever and headache for approximately 14 hours

Other Meds:

Current Illness: None

ID: 1103967
Sex: M
Age: 66
State: IN

Vax Date: 03/10/2021
Onset Date: 03/11/2021
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: Fatigue, headache, muscle and joint ache, general malaise, chills, lack of appetite. Pain and slight swelling of injection site. Slept for 36 hours. Treated with 650 mg aspirin every 4 hours. Fully recovered in two days

Other Meds: Lisinopril 20mg daily Aspirin 85mg daily Diclofenac 75 mg 2x day am and pm Vitamin D3 2000 IU

Current Illness: None

ID: 1103968
Sex: F
Age: 48
State:

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:

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

Symptoms: Anxiety, hx of anxiety, dizzy Takes Lithium and xanax

Other Meds:

Current Illness:

ID: 1103969
Sex: M
Age: 24
State: NY

Vax Date: 03/03/2021
Onset Date: 03/12/2021
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: Hives on hands and lips

Other Meds: Advair. Singulair

Current Illness: N/A

Date Died: 03/12/2021

ID: 1103970
Sex: M
Age: 66
State: WV

Vax Date: 03/11/2021
Onset Date: 03/11/2021
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: no

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

Symptoms: Reported by EMS per report from wife that he was "sick after shot" and got worse during the night. Wife found him the following morning cold and pale, pulseless. Dispatch called at 719AM. Pt pronounced on the scene and taken to Funeral Home. Uncertain if Medical Exam is planned

Other Meds: unknown

Current Illness: unknown

ID: 1103971
Sex: F
Age: 65
State: OH

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

Lab Data:

Allergies: Cymbolta

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

Symptoms: Rash inside forearms March 13-16.... March 14th only! (fever, chills, body ache, fatigue, cough, loss appetite.)

Other Meds: Flonase

Current Illness: None

ID: 1103972
Sex: F
Age: 73
State: NY

Vax Date: 03/04/2021
Onset Date: 03/09/2021
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:

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

Symptoms: Patient reports itchy red rash began on upper thighs a few days after receiving first dose of Covid vaccine on 3/4, has appeared on arms as well. States is worse after showering (admits to taking hot showers and rash looking worse with heat) Denies that she has attempted to treat at all. Denies SOB or airway involvement.

Other Meds:

Current Illness:

ID: 1103973
Sex: F
Age: 84
State: ND

Vax Date: 02/06/2021
Onset Date: 02/10/2021
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: gold containing compounds

Symptom List: Ear pain, Hypoaesthesia

Symptoms: rash at injection site and on shoulders

Other Meds:

Current Illness:

ID: 1103974
Sex: F
Age: 42
State: GA

Vax Date: 03/13/2021
Onset Date: 03/16/2021
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: None

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: I started feeling achy when I went to bed, which was 12 hours after my vaccine shot. I woke up around 1:00 am and felt awful. My body hurt so badly that I couldn't get up to go the bathroom or get pain reliever. I also had the chills with chattering teeth and was freeing cold. This lasted for about 6 hours. The next day, I had mild body aches and some fatigue. All of the symptoms were gone 48 hours after the vaccine.

Other Meds: None

Current Illness: None

ID: 1103975
Sex: F
Age: 69
State: NY

Vax Date: 01/16/2021
Onset Date: 02/24/2021
Rec V Date: 03/16/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Shortly after my second dose of Moderna, I started experiencing pain in my upper left thigh, while sleeping and upon waking. This pain caused me to have to alter my sleep habit of laying on my left side. As soon as I stepped on my leg, I felt a shooting pain. This leg/thigh continues today. I've been able to relieve this pressure with over the counter pain pills and a heating pad. I've started using a walking cane, in the mornings. The first appointment I was able to secure is June 8, 2021.

Other Meds: Hydrochloroth-Iazide 25mg.....Fluoxetine HCL 20 Mg, Ibrophren 200

Current Illness: Non

ID: 1103976
Sex: F
Age: 70
State: IN

Vax Date: 03/11/2021
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: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Penacillin; sulfa drugs

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

Symptoms: Extreme redness and swelling at site of shot, in bullseye pattern about 2.5 to 3 inches across; headache, body aches; weariness.

Other Meds: Levothyroxine; metropolol; metformin; One-A-Day 50+; Slo-Mag;

Current Illness:

ID: 1103977
Sex: M
Age: 34
State: DC

Vax Date: 02/22/2021
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: Penicillin

Symptom List: Unevaluable event

Symptoms: None stated.

Other Meds:

Current Illness:

ID: 1103978
Sex: F
Age: 96
State: WI

Vax Date: 02/11/2021
Onset Date: 03/07/2021
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: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

Symptoms: Bell's Palsy Left side-3/08/2021 Seen at Emergency Room and was given treatment of Prednisone, ValAcyclovir, and ointment to left eye at night. She experienced severe left sided neck and left ear pain on Saturday 3/06/2021 and then got drooping of left mouth and left eye around 3 pm on Sunday, 3/07/2021, and was seen at healthcare Clinic and Emergency Room 3/08/2021 2 Doses Pfizer given: #1 on 1/21/2021 and #2 on 2/11/2021

Other Meds: Aspirin 81 mg daily, Lipitor, Tums, Chlorthalidone, Vitamin D, Lasix & potassium chloride every other day , Lidoderm patch to right knee, Areds

Current Illness:

ID: 1103979
Sex: F
Age: 34
State: NE

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: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Very bad headache, nausea, pain at injection site. (third pregnancy, due August 12th) Headache started at 3 am the next day, nausea started later that day, have been nauseous for five days, headache lasted three days.

Other Meds: prenatal

Current Illness:

ID: 1103980
Sex: F
Age: 77
State: NH

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

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

Lab Data:

Allergies: Penicillin's, Sulfur, Environmental: trees, grass and dust

Symptom List: Injection site pain, Menorrhagia

Symptoms: Received vaccine on 2/11 around 2:30pm. About 5 days later she had some redness to her arm ( whole upper portion of arm from elbow to shoulder ) and was very itchy. Lasted for several days.

Other Meds: Vitamin c, Vitamin D3 + K2, Qubrcetin with Bromelian, atenalol, tumeric , Nasacort PRN

Current Illness: No

ID: 1103981
Sex: F
Age: 50
State: NJ

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

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

Lab Data:

Allergies: NKA

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

Symptoms: Pt c/o hypoglycemia. Healthcare provider indicated pt has been trending down ( in the 50's) with blood glucose over the past few days prior to receiving the vaccine. Mother of patient insists the hypoglycemia is from the vaccine.

Other Meds: Information is unavailable

Current Illness: Pt is a known diabetic.

ID: 1103983
Sex: M
Age: 46
State: PA

Vax Date: 03/10/2021
Onset Date: 03/11/2021
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: Shellfish

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Starting about 13 hours after injection, abdominal pain, cramping, nausea, upset stomach, upper stomach pain. Woke up 31 hours after injection with fever (100 F) and abdominal pain. Abdominal pain continuing throughout day and night since (now 6 days after). Loss of appetite, Continued pain in upper stomach. Just had blood labs taken to check pancreas. Labs not received yet.

Other Meds: Protonix Lisinipril Budesinide Singulaire Synthroid

Current Illness: None

ID: 1103984
Sex: F
Age: 35
State: MS

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: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: NKA

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Employee vaccine clinic given at Central Office. Employee/Pt seen by post-vaccine observation RN, . Pt c/o dizziness w/HA within minutes after 2nd Dose Moderna. This is same reaction pt had after 1st dose at an earlier employee clinic. Per, RN: Pt was Monitored and VS taken q 10 minutes and over approx. 45 minutes. HR, Resp and temp WNL. BP elevated beginning at 142/85 -155/100 over course of observation. Pt given 25 mg Benadryl. Both HA and dizziness resolved after 30 minutes of observation. Pt sent home from work instructed to take another 25 mg Benadryl and to continue monitoring BP as pt states she has a self-monitor cuff at home from another family member. Instructed to notify RN once arrived safely at home which she did at 1255 pm indicating that all adverse symptoms had subsided. Pt instructed to see PCP asap for F/U and HTN eval. Pt verbalized understanding. Physical copy of VAERS completed by RN and scanned in to EPIC, Pts's EHR.

Other Meds: nk

Current Illness: NKA denies pre-exsiting hypertension

ID: 1103985
Sex: F
Age: 49
State: CT

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: N/a

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

Symptoms: Temp of 101.4 Achiness Right arm is so sore unable to lift it Nasal congestion Lethargy Exhaustion Loss of appetite Basically feel like I have COVID all over again except I have not had diff breathing at this time

Other Meds: Vitamin D 1.25mg Weekly Kombiglyze XR 5/1000 mg Daily Kombiglyze XR 2.5-1000mg 2 Tab Evening Glipizide ER 10 mg Daily Pioglitazone HCL 45mg Daily Losartan Potassium 100mg Daily Propranolol ER 60mg Daily Trintellix 10mg Daily Aspirin 81mg Da

Current Illness: N/a

ID: 1103986
Sex: M
Age: 70
State: NY

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: IM
Vax Site: RA

Lab Data:

Allergies: NONE

Symptom List: Nausea

Symptoms: passed out three hours later, came to fine. was light headed and cold like for a day.

Other Meds: TRAZADON. 50 MG HS BUPROPION HCL 10 MG HACL ESCITALOPRAM 15 MG HS TRIAMENTERENE-HCTZ 37.5-20 OLMESTARTAN MEDOXOMIL 5 MG ALLEGRA 100 MG OD DUCALAX SAW PALMENTO MINOXIDIL CO Q 10 200 MG GIGKG0 BILBOA 120 MG PRESERVISION SPECTRVITE LIPO FLAV

Current Illness: NONE

ID: 1103987
Sex: F
Age: 40
State: TX

Vax Date: 01/15/2021
Onset Date: 03/16/2021
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:

Symptom List: Injection site pain

Symptoms: I started with a headache, running nose. For 2 weeks exp congestion to throat,water draining from nose ,no body aches and getting dehydrated. I went to Urgent Care had Covid, Test done results negative.

Other Meds: Singular, Claritin, Benadryl

Current Illness: No

ID: 1103988
Sex: M
Age: 47
State: NJ

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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

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

Symptoms: As bad as flu after first dose, aches, pain all over especially knees and groin area. Hard to breath at times as I have bad cough/fluid in lungs though not bad enough to require medical attention. Headache, fatigue I am currently on day2 of feeling like this. Note: this is not life threatening I justed wanted to provide honest feedback to you on my side effects. Advil/Tylenal does help a bit

Other Meds: Cymbalta, Vyvance

Current Illness: none

ID: 1103989
Sex: F
Age: 48
State: OH

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: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: none known

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

Symptoms: Rash on chest and down my back.

Other Meds: none

Current Illness: none

ID: 1103991
Sex: F
Age: 33
State: MO

Vax Date: 02/17/2021
Onset Date: 02/17/2021
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: n/a

Symptom List: Tremor

Symptoms: Achy / Chill started about 8 hours after shot. Vomiting started about 13 hours after shot and lasted through the night. Following day chills, achiness, and low-grade fever. Symptoms were gone within 48 hours of receiving shot. After 3-5 days, left armpit swelling, fluid like pocket formed. This lasted about 2-3 weeks then disappeared.

Other Meds: Norgest/e Es(estarylla) tb 28s0.25/35 (birth control) Metoprolol Succinate Er Tabs 50 mg (beta blocker) Pot Chlor Er (klor-con M20) tb20 meq (Pottasium) 81 mg aspirin

Current Illness: none.

ID: 1103992
Sex: M
Age: 81
State: MS

Vax Date: 03/01/2021
Onset Date: 03/10/2021
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: None

Symptom List: Erythema, Pruritus

Symptoms: Bad headache, fatigue, loss of appetite, chills sore arm at point of injection.

Other Meds: None

Current Illness: None

ID: 1103993
Sex: F
Age: 49
State:

Vax Date: 02/03/2021
Onset Date: 02/24/2021
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: none

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

Symptoms: numbness and tingling in both hands, pain in muscle at injection site, worse at night, unable to sleep

Other Meds: none

Current Illness: none

ID: 1103994
Sex: F
Age: 49
State: MI

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

Lab Data:

Allergies: N/A

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

Symptoms: BLEEDING GUMS/MOUTH

Other Meds: Bleeding gums

Current Illness: N/A

ID: 1103995
Sex: F
Age: 53
State: MI

Vax Date: 03/06/2021
Onset Date: 03/07/2021
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: morphine, demerol, darvon, darvocet, percodan, percocet, iodine contrast

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Had the vaccine in my right arm at 1:30 on Saturday March 6. Felt fine throughout the day and evening with just a little arm tenderness and slight headache. Felt feverish, shivering, achy, sensitive skin throughout the night. Woke at 7 a.m. and as I passed a mirror, noticed a large lump behind my left armpit (not sure what to call this area--back of shoulder/arm), the size of 1/2 tennis ball. Not painful, but alarmingly large, having had nothing there the day before. Saw my Dr. on Monday March 8. She prescribed a round of prednisone and an ultrasound. Ultrasound on Tuesday March 9 described as "lipoma-like mass", but could not explain sudden appearance so MRI recommended. (Appointment scheduled for Thursday March 28 for MRI) Re-visited Dr. on Friday March 12, as even after prednisone, swelling seemed slightly increased. Dr. described as "orange sized". Still not painful, but uncomfortable and very tight. Dr. suggested I visit a surgeon for further investigation. Sheduled to see surgeon at Hospital today March 16

Other Meds: flonase, vitamin D, calcium, multi-vitamin, ambien, motrin

Current Illness: none

ID: 1103996
Sex: M
Age: 30
State: FL

Vax Date: 03/12/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Fever, headache, fatigue/tiredness, chills, and body aches occurred after falling asleep for the night on the day the vaccine was administered. Fever, headache, and chills were gone 24 hours after receiving the vaccine. Tiredness, fatigue, and general weakness persisted for several days. Chronic Back pain has become more intense and still present to a significant degree .

Other Meds: Adderall, klonopin, mirtazapine

Current Illness:

ID: 1103997
Sex: F
Age: 39
State: NC

Vax Date: 03/11/2021
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: none

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

Symptoms: intense body aches and fatigue for approximately 24 hours after shot. Onset of body aches - approx. 3:00 am 3/12/21.

Other Meds: Junel, Atenolol, Metformin, Vitamin D3, low dose aspirin, Elderberry/Zinc/Vitamin C supplement, Adult multi-vitamin, Zyrtec

Current Illness: none

ID: 1103998
Sex: F
Age: 60
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Augmentin Avelox Sulfa Biaxin Ceftin E-Mycin Quinolones

Symptom List: Pain in extremity

Symptoms: Fatigue (10 hours post), headache (3+ days) , severe pain under right armpit (10 hours post--lasting 2 days), dull pain under right arm 3+days, chills 36 hours post vaccine

Other Meds: omeprazole 20-40 mg 1x day Alendronate sulfate 70 mg 1 X week Nasonex Calcium 500 mg L-Lysine Biotene Vitamin C Vitamin D

Current Illness:

ID: 1103999
Sex: F
Age: 39
State: PA

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:
Dose Series: 2
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: The patient was given 0.1 ml of Pfizer instead of the correct dosage of 0.3ml. This was a vaccinator error and was caught by our pharmacist on site on 3/12/2021.

Other Meds:

Current Illness:

ID: 1104000
Sex: F
Age: 41
State: IL

Vax Date: 02/10/2021
Onset Date: 02/10/2021
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: birth control pills orbital swelling

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

Symptoms: left arm swelling at site approximately egg size lasted for 3 days, left arm numbness and discomfort lasted currently described as "bone deep pain." Joint swelling and pain at knees, ankles and hips and headache.

Other Meds: multi vitamin

Current Illness: NA

ID: 1104001
Sex: F
Age: 68
State: FL

Vax Date: 03/10/2021
Onset Date: 03/11/2021
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: None

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

Symptoms: Onset - 23 hrs. Short term fatigue, headache (2 hrs) responded to 1 alleve. Swelling at injection site with soreness, followed by itchy rash size of a silver dollar. Swelling subsided in 2 days. Rash became tiny dots of scab at day 5. Still have scabs at day 6.

Other Meds: Metoprolol, hcl, synthroid, losartan, atorvastatin, temazapam, low dose aspirin, vit D3, fosamax, calcium

Current Illness: None

ID: 1104002
Sex: F
Age: 49
State: GA

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

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: Headache, tiredness and nausea. Next day and 2 days later still felt these symptoms.

Other Meds: Levothyroxine

Current Illness:

ID: 1104003
Sex: M
Age: 19
State: OH

Vax Date: 03/11/2021
Onset Date: 03/11/2021
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: 3-11-21 4:26PM CALLED TO VACCINE STATION. PARENT STATES PT HAS BEEN HAVING SEIZURES OFF & ON X ARPOX. 20MIN. SEIZURES STARTED BEFORE VACCINATION. 4:40PM PT POST ICTAL; PINK, W/D, RESP REG WITH EASE - NO RESP DISTRESS. TO EXIT PER W/C TO BE TAKEN HOME PER MOM. NO SEIZURES AT THIS TIME. 3-12-21 9:30AM MOM STATES PT IS '100% BETTER TODAY'.

Other Meds:

Current Illness:

ID: 1104004
Sex: M
Age: 50
State: TN

Vax Date: 03/05/2021
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:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: N/A

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

Symptoms: Swollen left subclavicular lymph node

Other Meds: N/A

Current Illness: N/A

ID: 1104005
Sex: F
Age: 28
State: FL

Vax Date: 03/12/2021
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: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Moderna Covid-19 vaccine EUA Pain on left side of abdomen in underarm area for 72 hours. 99.1 degree fever the day after the shot for about 12 hours

Other Meds: Fish oil

Current Illness: None

ID: 1104006
Sex: F
Age: 48
State:

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

Lab Data:

Allergies:

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

Symptoms: fever 99.9 for 12 hours

Other Meds:

Current Illness:

ID: 1104008
Sex: M
Age: 66
State: TX

Vax Date: 03/06/2021
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: RA

Lab Data:

Allergies: none

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

Symptoms: constant mild headache general feeling of tiredness

Other Meds: daily multi-vitamin tablet 25mcg vitamin D3 capsule 28mg iron capsule

Current Illness: none

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm