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: 1106363
Sex: F
Age: 42
State: TX

Vax Date: 03/01/2021
Onset Date: 03/03/2021
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: N/a

Symptom List: Dysphagia, Epiglottitis

Symptoms: Developed Large Bruise on inside calf left leg after 1.5 day.s. Large bruise above inside left ankle on day 16 after 1st shot.

Other Meds: Fish oil

Current Illness: N/a

ID: 1106364
Sex: F
Age: 22
State: OH

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

Lab Data:

Allergies: no known allergies

Symptom List: Anxiety, Dyspnoea

Symptoms: Within minutes of 2nd dose of vaccine, pt started urinating dark brown urine. This turned bloody / dark red in color. Over the next several days she had migraines, fever, nausea, diarrhea. She had a very heavy period that was not normal for her. She was treated twice for presumed UTI (once with macrobid and then with cefuroxime) in the days after the vaccine though cultures ended up negative. She was referred to me, a hematologist, when she was noted to have a dropping hemoglobin and platelet count. She appears to have a Coombs-negative hemolytic anemia and possibly ITP. She is feeling a little better but her labs remain abnormal. Please note this was reported on Pfizer website as well but I have not been contacted. Guidance would be sincerely appreciated. My cell phone was provided.

Other Meds: Junel FE, spironolactone, oil of oregano, Olly probiotic/prebiotic, topical tretinoin

Current Illness: none

ID: 1106365
Sex: F
Age: 78
State: IL

Vax Date: 03/16/2021
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: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NKA

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

Symptoms: Lightheaded BP 152/83

Other Meds: HCTZ,Ace inhibitor, Aspirin,

Current Illness: none

ID: 1106366
Sex: F
Age: 42
State: PA

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: No

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Nausea and headache

Other Meds: Met forming ozempic

Current Illness: None

ID: 1106367
Sex: M
Age: 65
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Penicillin

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

Symptoms: Chills, neck stiffness, sore throat, fever (101), lethargy, headache,

Other Meds: Lisinopril, Metformin,Prinivil, Thyroxine

Current Illness:

ID: 1106368
Sex: F
Age: 39
State: MA

Vax Date: 03/15/2021
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: Augmentin and Remeron Melons Bee stings Pineapple

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

Symptoms: Throat became itchy and scratchy. My neck (throat area) was also itchy.

Other Meds: Venlafaxine Bupropion Omeprazole Abilify

Current Illness: N/A

ID: 1106369
Sex: F
Age: 82
State: WA

Vax Date: 02/23/2021
Onset Date: 02/25/2021
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: Aspirin Quinnine

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Pain for 4 or 5 days in left leg (that leg also has varicose veins), some swelling and tender to the touch . Fifth day became raised and warm to the touch, so went to Urgent Care Diagnosis: Occlusive and nonocclusive thrombus within a superficial vein underlying the region of concern

Other Meds: Levothyroxine 0.05 mg Trazadone 50 mg Calcium w/ magnesium, zinc, & vitamin D-3 Cranberry Concentrate 500 mg EmergenCy 1packey D-3 2000 units Preservision , one tablet Women?s multiple vitamin Pepcid Complete Bromondine 10 ml 0.2% Dorzolam

Current Illness: None

ID: 1106370
Sex: F
Age: 28
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:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Pine trees Oak trees

Symptom List: Pharyngeal swelling

Symptoms: About 7-8 minutes later I started feeling pressure in the right side of my head. It went away a bit. I was walking after the 15 minutes and started feeling weird in my face, I just sat in my car and waited because I had to drive. I started feeling numbness under my eye and down the rest of my face. The thing that worried me the most I had so much pressure under my eye like it was inside my brain. The numbness and pain caused me to freak out. I went to back to the convention center to let them know, they brought the Paramedic to me they started checking me and doing a work up. They told me I wasn't a life threatening emergency and my vitals were ok. They offered to take me to the ER and I declined and I decided to leave because I have been there for 1hr 45mins. I felt like my symptoms were at 70%. When I got home I freaked out again because the numbness didn't go away and my face looked like it was a little lower and had a panic attack and went to the ER. They checked on me and told me I didn't have a stroke. They told me It was a side effect to the vaccine. They told me to follow up with the Neurologist if I have any more symptoms, I have an appointment with them in a couple weeks. I'm a little concerned because there is a minor pain that I didn't have before on my right side and it worries me.

Other Meds: Unitroy Vitamin B Vitamin C

Current Illness:

ID: 1106371
Sex: F
Age: 75
State: TN

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: Zofram, Morphine

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: She slept for 30 hours and was not answering her phone. She was completely incoherent when my Husband went to check on her. An ambulance was called and she was in hospital for two nights.

Other Meds: Folic acid, Amlodipine, Besylate, Atorvastatin, Gabapentin, Pantoprazole, Levothyroxine, Trazadone, Buspirone, Duloxetine, Isosorbide, Labetalol, aspirin, Symbicort, Hydrocodone

Current Illness:

ID: 1106372
Sex: F
Age: 44
State: CA

Vax Date: 01/14/2021
Onset Date: 01/14/2021
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: environmental allergies

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Immediately I had a severe headache and body aches. I went home and took Benadryl and went to sleep. Next morning, itching skin and burning skin like it was on fire. Asthmatic symptoms and I had hives all over my neck and back ( and still had headache and body aches). That night - all the same symptoms but just increased. I also started having weird neurological speech problems - could think of a word but couldn't get the word out. I went to ER - They treated me with a breathing treatment - six rounds of Provental and gave me an epi-pen and told me to take Zyrtec for next 15 days. Told me to go to allergist/immunologist - that appt was two days later - Private practice. He diagnosed that I was allergic Polyethylene Glycol that was in the vaccine. He put me on Prednizone for a week. That with the Zyrtec and the inhaler pretty much cleared up everything.

Other Meds: Tricyclene

Current Illness: no

ID: 1106373
Sex: F
Age: 39
State: WI

Vax Date: 03/16/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: none

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

Symptoms: Became light headed right after injection. Sat down and monitored by EMS onsite. No additional follow up required

Other Meds: unknown

Current Illness: none

ID: 1106374
Sex: F
Age: 25
State: PA

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: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Rash, Urticaria

Symptoms: -slight fever -headache -body aches -chills -fatigue -nausea -diarrhea

Other Meds: -sertraline -progesterone only birth control -multivitamin

Current Illness:

ID: 1106375
Sex: F
Age: 24
State: TX

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: LA

Lab Data:

Allergies: No known allergies

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

Symptoms: Friday, March 12th, 2021 at 11am I had a severe anaphylactic reaction to the Moderna COVID-19 vaccine. My throat began to swell and became very short of breath. My chest was tight and felt as if it was being crushed. A nurse walked by me and noticed me grabbing my chest and immediately put me on a gurney. They took my mask off and discovered my lips were swelling and turned blue. My vitals were taken and was was given epinephrine in my left thigh. EMS was called and on board was given an IV Benadryl and steroids. Once at the hospital I was given Ativan, Pepsid and more Benadryl. I was discharged around 4pm and was back at the ED 3/13/21 early morning when I woke up with not being able to breathe, my throat swelling and crushing feeling in my chest. I was given more Benadryl and fluids, and was released 8am. 3/16/21 I came back to the ED as advised by a triage nurse on the phone, as I was having trouble breathing and the same crushing feeling in my chest.

Other Meds: Paxil, Wellbutrin, Birth Control

Current Illness: None

ID: 1106376
Sex: F
Age: 17
State: IA

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

Lab Data:

Allergies:

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

Symptoms: The patient was administered the vaccine, but she is under the approved age of 18.

Other Meds:

Current Illness:

ID: 1106377
Sex: F
Age: 68
State: WA

Vax Date: 03/16/2021
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:

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

Symptoms: Hives on face

Other Meds:

Current Illness:

ID: 1106378
Sex: F
Age: 17
State: CA

Vax Date: 03/07/2021
Onset Date: 03/07/2021
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: Cashew Nut, Eggs (edible), Peanut-Dietary, Pecan Nut

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

Symptoms: Unauthorized age group- 17 year old patient received Moderna instead of Pfizer

Other Meds: Unknown

Current Illness: Unknown

ID: 1106379
Sex: F
Age: 33
State: WI

Vax Date: 03/16/2021
Onset Date: 03/16/2021
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: opioids

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

Symptoms: shortness of breath and heaviness

Other Meds: pantoprazole, tizanidine, eszopiclone, meloxicam, lamotrigine, prazosin, escitalopram, propranolol, levocetirizine, estradiol, montelukast, levothyroxine

Current Illness:

ID: 1106380
Sex: F
Age: 94
State: CA

Vax Date: 03/11/2021
Onset Date: 03/12/2021
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: Beclomethasone (swelling); Cephalexin (Hives); sulfa (unknown); green pepper (heartburn)

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Hypoxia on 3/12/21 in afternoon around 3pm. New Right lower lobe Infiltrate on Chest Xray 3/12/21. Cough 3/13/21. Worsening generalized weakness 3/12/21 7am, Nausea 3/12/21 7am, No appetite 3/12/21 7am. Malaise 3/12/21 7am. Encouraged fluids. Placed on oxygen via nasal canula. Started Levaquin antibiotic. Started on Guaifenisin cough syrup. Patient is still on Oxygen and antibiotic as of this report. Incentive spirometer ordered 3/15/21

Other Meds: Calcium w/ D, Allopurinol, Colace, Salonpas, Systane eye drops, Tylenol, Calmoseptine, Coreg, digoxin, Aricept, Eliquis, Lasix, Potassium chloride, ocuvite, lidoderm, gabapentin, xalatan, timolol, predforte, Rocaltrol, zocor, Senna, Prolia

Current Illness: COVID-19 Pneumonia 1/19/2021 L1 Compression fracture due to Fall 12/21/20. S/P L1 Balloon Kyphoplasty 2/17/21 Generalized weakness 1/19/21

ID: 1106381
Sex: F
Age: 65
State: MN

Vax Date: 01/28/2021
Onset Date: 01/28/2021
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: Novocaine

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Time of injection felt a stinging sensation, lasted a few minutes. Within hour, iced arm as was quite sore. Woken during night with chills, sweats and feeling of numbness from shoulder down to elbow and unable to raise arm. Took 2 acetominophen and iced arm, able to fall back to sleep. Very sore and difficulty in raising arm for 2 days.

Other Meds: Vit's C, D3

Current Illness: None

ID: 1106382
Sex: F
Age: 73
State: OR

Vax Date: 03/06/2021
Onset Date: 03/06/2021
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: Reclast, Fosamax, Atorvastatin

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

Symptoms: Angioedema

Other Meds: Low dose adult aspirin, Breo, Ventolin inhaler, Calcium+D3, Levothyroxine, Lisinopril, Multivitamin/Mineral, VitaminD3, Nasacort, Voltaren, Systane Eye drops, Zaditor Eye drops, Temovate, Prolia

Current Illness: No

ID: 1106383
Sex: F
Age: 81
State: LA

Vax Date: 03/06/2021
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: 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: red spots on stomach and muscle ache side of stomach area

Other Meds: none

Current Illness: none

ID: 1106384
Sex: M
Age: 64
State: CA

Vax Date: 03/02/2021
Onset Date: 03/03/2021
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: Unevaluable event

Symptoms: I took my nightly statin pill about 6 hours after receiving my 1st vaccination shot and went to bed. About 4 hours later, I woke from a sound sleep with the most painful cramps in both lower legs that I've ever experienced. Both feet were flexing upwards and my lower calf muscles taught uncontrollably. I managed to get out of bed and onto my feet to put my weight on them; but had to balance on a nearby chair. Only after an intensely painful 45 minutes did the muscles begin to relax!! (When first prescribed statins 10 years ago, I found they particularly could cause a cramp in one of my legs at night. Only after trying several varieties of statins and lower doses did I find one --the generic Pravastatin-- and dose that would not trigger this nighttime cramping. In further defense, I also try to stay hydrated and drink a glass of water before going to bed each night.) *NOTE: In order to avoid that incredible pain, I DO NOT plan to take my statin pill the night when I get my 2nd dose!!

Other Meds: Taken together in A.M.: Benazepril HCL-20mg; aspirin-81mg; and a multi-vitamin Taken alone before bed in P.M.: Pravastatin sodium-40mg;

Current Illness: None.

ID: 1106385
Sex: F
Age: 54
State:

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: LA

Lab Data:

Allergies:

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

Symptoms: Post vaccine, patient reported feeling "strange", HR 170, BP elevated. Reported feeling "anxious". Patient stated she had not taken her blood pressure medicine today. Oxygen applied at 2 lpm for report of chest "pressure". Patient refused EMS transport to hospital for evaluation. Benadryl 50 mg given PO. Prior to discharge, HR in low 100's, BP remained elevated.

Other Meds:

Current Illness:

ID: 1106386
Sex: M
Age: 52
State: OH

Vax Date: 03/16/2021
Onset Date: 03/16/2021
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: Dust, grass, ragweed

Symptom List: Injection site pain, Pain

Symptoms: After receiving the vaccination, he started feeling lightheaded, then started sweating. He asked for water and drank water prior to a brief episode of syncope. He denies any trauma to his head or any part of his body. No mental status changes. He was assisted to the supine position on the floor, then was able to ambulate to a private section of the area and lay recumbent on an EMT gurney. He has a history of syncope with needlesticks.

Other Meds: Paxil, Lamictal

Current Illness: Epilepsy

ID: 1106387
Sex: M
Age: 44
State: MI

Vax Date: 03/04/2021
Onset Date: 03/05/2021
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: Penicilin

Symptom List: Injection site pain, Menorrhagia

Symptoms: Hives

Other Meds: Escitalopram, Finasteride

Current Illness: None

ID: 1106388
Sex: F
Age: 41
State: VT

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

Lab Data:

Allergies: None

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

Symptoms: Severe headache, fever, chills, extreme fatigue, weakness, loss of appetite, body aches, and pain in arm at and around injection. As a high level endurance athlete, I was unable to get out of bed for 24 hours. Symptoms improved gradually after that. Minor headache continued through 48 hours. Inability to fully exert myself has continued through day 4, although gradually improving each day.

Other Meds: None

Current Illness: None

ID: 1106389
Sex: M
Age: 42
State: CA

Vax Date: 03/16/2021
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: PCN, Amoxicillin, erythromycin

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Patient recieved first dose of the Moderna vaccination and about five minutes after recieving the vaccine, started to feel lightheaded, dizzy, and tingling of the tounge. Patient was assesed by onsite medical staff and ALS resources were called. The patient was transported by local EMS to Hospital.

Other Meds: Gabapentin, Concerta, Clonezipine

Current Illness: None

ID: 1106390
Sex: F
Age: 43
State: CO

Vax Date: 03/08/2021
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: not that I know of

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: red, swollen, itchy rash in spot of injection and all over legs and spots on ar

Other Meds: Claritin and a maca supplement

Current Illness: no

ID: 1106391
Sex: F
Age: 74
State: CA

Vax Date: 03/16/2021
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:
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: Patient is 74 yo female complained of dizziness after vaccination. Vitals at 11:40 B/P 179/104, HR 64, Temp 97.5, Respirations 16, O2 stats 97%. She complained of pain on her left side. She also informed us that she takes medication for A-fib usually in the afternoons which she hadn't taken yet. Patient waited for over an hour. B/P at 11:58 161/96 HR 59 and then again at 12:15 PM 165/99 HR 59. Charge Nurse walked with patient for a while before she left and no complaints of dizziness. Pt. felt safe to drive home will follow up with PCP on B/P readings.

Other Meds: N/A

Current Illness: Unknown

ID: 1106392
Sex: M
Age: 24
State: WI

Vax Date: 03/16/2021
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: RA

Lab Data:

Allergies: Unknown.

Symptom List: Nausea

Symptoms: Client received 1st dose of Moderna vaccine series on 3/10 and then received 1 dose of Janssen vaccine on 3/16.

Other Meds: Unknown.

Current Illness: Unknown.

ID: 1106393
Sex: F
Age: 44
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:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Sulfa, unasyn, melon fruits, bananas - environmental allergies

Symptom List: Injection site pain

Symptoms: 6 hours in - very sore arm. 12 hours in - sore arm that required tylenol. 12-24 hours headaches, fatigue. 24 hours later - itchy throat/roof of mouth (took benadryl). 36-48 hours itchy throat/roof of mouth continued but became itchy on arms and legs. 2-4 days post vaccine it progressed to itchy spots on my entire body. No hives - but a rash and redness. Feels like pin and needles.

Other Meds: Zyrtec, birth control

Current Illness: none

ID: 1106394
Sex: F
Age: 54
State: MO

Vax Date: 03/09/2021
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: Lavender, codeine

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

Symptoms: "COVID 19 arm" I had no side effects and then on the 7th day I woke up in the middle of the morning, my arm itching. It's got a knot and a rash and is a little painful to move. I contacted my doctor and he suggested I ice it and contact him if it lasted longer than a week or worsened

Other Meds: Oxycodone, xanax, gabapentin, aspirin therapy, zyrtec

Current Illness: None

ID: 1106395
Sex: F
Age: 25
State: KY

Vax Date: 03/03/2021
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: RA

Lab Data:

Allergies: None

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

Symptoms: Extreme Dizziness can?t get up or lay down without getting dizzy

Other Meds: Vyvanse

Current Illness: None

ID: 1106396
Sex: F
Age:
State: GA

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

Symptom List: Tremor

Symptoms: Swollen lymph nodes under left arm and in chest area presenting 4 days after shot and persisting for 3-4 days with pain. Severe fatigue presented 3 days after shot persisting for 4-5 days. Chest pains.

Other Meds: Cymbalta, Buspirone

Current Illness: Migraines

ID: 1106397
Sex: M
Age: 77
State: SC

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

Lab Data:

Allergies: Bactrim caused vasculitis, Hydrocodone causes swelling ankles

Symptom List: Erythema, Pruritus

Symptoms: Itchy pink splotches head to toe became noticeable irritation during the second night after the vaccination, confirmed in the morning. Went to urgent care the following Monday afternoon. Consultation verified the symptoms. Doctor concluded that the timing indicated a reaction to the vaccination rather than a reaction to the penicillin that I had been taking several days for a UTI. I have never had any problems with any of the medications or supplements that I take regularly. The doctor prescribed Prednisone, Cetirizine, and Tagamet, which I am currently taking. There has not yet been any reduction in my extensive symptoms.

Other Meds: Penicillin, Lumigan, Timolol, Berberine, Policosanol, Healthy Direction Advanced Cholesterol Solutions, Healthy Directions Prostate Health, Life Extension Tri-Sugar Solution, Healthy Directions Vision Essentials

Current Illness: UTI

ID: 1106398
Sex: F
Age: 26
State: CA

Vax Date: 02/09/2021
Onset Date: 02/18/2021
Rec V Date: 03/16/2021
Hospital: Y

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: No

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

Symptoms: Initial prenatal visit on 2/4/2021, pregnancy measuring 6 weeks with visible cardiac activity. Vaccine received 2/9/2021. Repeat ultrasound 2/18/2021, no cardiac activity seen, pregnancy still measuring 6 weeks. D&C procedure on 2/23/2021 for missed abortion.

Other Meds: Prenatal vitamins

Current Illness: No

ID: 1106399
Sex: F
Age: 59
State: IL

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

Lab Data:

Allergies: Bactrim Gabapentin

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

Symptoms: Significant red rash lower than vaccine site seen Friday morning , warm to the touch. This was more of a big red blob on the arm. On the right truck there was a scattered hive like rash. Both sites had extreme itchiness, controlled by benedryl.

Other Meds: Losartan

Current Illness: fever/aches/joint pain/headache/chills started 3/10/2021 after vaccine

ID: 1106400
Sex: F
Age: 31
State: SC

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

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: After she waited 15 minutes after having the injection, she was fine. Starting driving home, she had a light headache. She had itching, tenderness, body rash and fever. She went to ER.

Other Meds: Fluoxetine

Current Illness: no

ID: 1106401
Sex: F
Age: 59
State: MO

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

Lab Data:

Allergies: sulfa, penicillin, macrodantin

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

Symptoms: headache, chills fever lasting 8 hours. Then headache only for 10 hours. Tylenol taken 2x

Other Meds: levothryoxine sodium .05mg SID

Current Illness: none

ID: 1106402
Sex: M
Age: 60
State: TX

Vax Date: 03/05/2021
Onset Date: 03/05/2021
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:

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

Symptoms: Patient received Pfizer vaccine on 3/5/21. On 3/13/21 patient had fever, headache, diarrhea and tested positive for COVID 19 on 3/15/21 in our office.

Other Meds:

Current Illness:

ID: 1106403
Sex: F
Age: 50
State: NV

Vax Date: 02/09/2021
Onset Date: 02/11/2021
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: Erythromycin, dust, pollen

Symptom List: Pain in extremity

Symptoms: Blood clots in the left leg, same side as the vaccine was given. Woke up approximately two days afterward (2/11/21) with muscle pain in the left thigh. The pain did not lessen over the week, assumed it was just muscle. The pain migrated down to my calf and then was too painful to stand on or walk on 2/18/21.

Other Meds: lo Loestrin, sprinolactone, Allegra

Current Illness: allergies

ID: 1106404
Sex: F
Age: 74
State: PA

Vax Date: 03/13/2021
Onset Date: 03/14/2021
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: aerosol sprays

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

Symptoms: extreme exhaustion, sleepiness, shortness of breath,loss of appetite, dizziness and cognition problems

Other Meds: none

Current Illness: autoimmunine disease, high blood pressure

ID: 1106405
Sex: F
Age: 55
State: AK

Vax Date: 03/16/2021
Onset Date: 03/16/2021
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: NKDA

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

Symptoms: After the patient's 15 minute wait, she left the facility, only to feel like her legs were "weak." She was brought back to the facility to sit down and recover. After several minutes, the patient stated that he throat felt itchy, and she began to cough and described dyspnea. She also developed nausea. She denied cutaneous symptoms, but with her multiple symptoms that were consistent with anaphylaxis, the patient was administered an EpiPen. Her symptoms did not improve, and 16 minutes later she was administered another EpiPen (as well as 25 mg of diphenhydramine). She was transported via EMS to the base ER for further treatment and evaluation.

Other Meds: temazepam, duloxetine, lurasidone, clonazepam,

Current Illness: None

ID: 1106406
Sex: F
Age: 83
State: ID

Vax Date: 02/25/2021
Onset Date: 02/28/2021
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: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: Client had Nausea and dizziness for 3-4 days: then on the 3rd or 4th day client blacked out. Client informed by her Physician that she had a concussion. On 3-16-2021 on a follow-up call it was reported by her son that she is now fine.

Other Meds:

Current Illness:

ID: 1106407
Sex: F
Age: 66
State: FL

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

Lab Data:

Allergies: penicillin, sulfa drugs, latex, seasonal allergies (grasses, trees, dust mites, dust, mold)

Symptom List: Vomiting

Symptoms: The dose was administered at 10 am on 3/13/21. At approx 4 am 3/14/21 while using the bathroom I had an episode of severe dizziness and weakness that lasted about 15 minutes. I did not pass out but did want to lie down. I eventually was able to walk quickly to bed and lie down and fell asleep. In the am when I awoke I felt ok, just a bit drained.

Other Meds: Levothyroxine, theophylline, monteleukast,pravastatin, trazadone, estradiol,pantoprazole, loratidine, diltiazem, citalopram, fluticasone nasal, Flovent HFA 220mcg, estradiol, vitamin D, supplement with b vitamins

Current Illness: n/a

ID: 1106408
Sex: F
Age: 14
State: WA

Vax Date: 02/27/2021
Onset Date: 03/16/2021
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: N/A

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Moderna COVID-19 Vaccine EUA Found patient with scribbled out age making her old enough for vaccine, patient documented that she was not younger than 18. Called and verified that patient is, in fact, 14 - birthdate in 2006. Patient's 2nd dose - unable to find 1st dose under patient's name. Found patient under name of, birthdate 5/30/2003 - prior VAERS entry for that patient. No adverse events reported

Other Meds: N/A

Current Illness: N/A

ID: 1106409
Sex: F
Age: 66
State: NV

Vax Date: 03/06/2021
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: Erthromycin

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

Symptoms: On day five after receipt of the vaccine, I began to experience an itch at the injection site. By the following morning the same site was hard to the touch and began to get red. The redness and itch continued to get larger. As of today, 3/15/2021, the injection site area is still red, itchy, warm to the touch, and hard underneath the skin. As needed, I have been applying a topical hydrocortisone for the itch.

Other Meds: Valsartan, Atorvastatin, Sertraline, Albuterol Sulfate (con't)

Current Illness: None

ID: 1106410
Sex: F
Age: 40
State: TN

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: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Injection site swelling, Limb discomfort

Symptoms: 12hours after vaccine developed headache, chills, and body aches. Within 24hours also developed severe fatigue. Symptoms resolved within 48 hours except for continuing fatigue and recurrent headache.

Other Meds: Armour thyroid, Contrave, Ozempic, Losartan, zyrtec, flonase, singulair

Current Illness: None

ID: 1106411
Sex: F
Age: 69
State: CT

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

Lab Data:

Allergies: Sulfa medication

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

Symptoms: Extreme fatigue for two days Saturday and Sunday; very "fuzzy" headed and unable to concentrate on anything important. Chills - I was hot, then cold. Seemed to be over by Monday morning.

Other Meds: Buproprion 450 mg Sythroid 88 mcg

Current Illness: None

ID: 1106412
Sex: F
Age: 77
State: WA

Vax Date: 03/14/2021
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: IM
Vax Site: RA

Lab Data:

Allergies: Indomethacin Lisinopril Ciprofloxacin Oxycodone Iodine Prednisone

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

Symptoms: Headache Nausea Dizziness

Other Meds: Atenolol Losarton Gabapenton Rovustaten Epinephrine Vantolin

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm