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: 1115822
Sex: M
Age: 72
State: FL

Vax Date: 03/18/2021
Onset Date: 03/19/2021
Rec V Date: 03/19/2021
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: Chocolate

Symptom List: Dysphagia, Epiglottitis

Symptoms: About 15 hours after the shot I experienced chills all over my body even though I was under a sheet and two wool blankets. The outside temperature was 72F. I also could not fall a sleep all night after it started.

Other Meds: None

Current Illness: None

ID: 1115823
Sex: M
Age: 54
State: WA

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Anxiety, Dyspnoea

Symptoms: Less than minute after shot, pain in arm, nausea, sick feeling, had to lay down, passed in 5 minutes. Fatigue and flue-like aches and pains for the rest of the day. Pain in arm remained for 2 days.

Other Meds: None

Current Illness: None

ID: 1115824
Sex: F
Age: 79
State: TX

Vax Date: 03/05/2021
Onset Date: 03/05/2021
Rec V Date: 03/19/2021
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: Sulfa

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

Symptoms: About one and half hours after receiving vaccine I broke out in was on stomach and back. that was 03-05-2021 Its now 03-19-2021 and I am broken out on body and arms and legs. It feels more like a sunburn and its peeling in spots. Very painful and itchy

Other Meds: Vitamin D3 Pilocarpine 5mg Hydroxychor 200mg

Current Illness:

ID: 1115825
Sex: F
Age: 54
State: IN

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

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

Lab Data:

Allergies: sulfonamides

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: high fever for 2 days, headache, shoulder/armpit area hurts

Other Meds: none

Current Illness: none

ID: 1115826
Sex: M
Age: 37
State:

Vax Date: 02/25/2021
Onset Date: 02/26/2021
Rec V Date: 03/19/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: BODYACHES, HEADACHE, FATIGUE

Other Meds:

Current Illness:

ID: 1115827
Sex: M
Age: 43
State: TX

Vax Date: 01/06/2021
Onset Date: 02/13/2021
Rec V Date: 03/19/2021
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: Latex

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

Symptoms: Severe spinning, nausea, vomiting, occurred at 2:15 a.m. while on duty, was transported to ER and diagnosed with Peripheral Vertigo. Follow ups with ENT, Neuro and PCP have continued with Vestibular Rehabilitation. While in ER, the MRI, MRA, CT, CT with Contrast was done, showed no signs of anything that could have caused this. Ironically tracking back, I received my 2nd Dose of the Pfyzer Vaccine on January 6, 2021 at 8:45 a.m. and this occurred on February 13th at 2:15 a.m. I have not had any other issues before this nor any signs of damage to the nerve or ear that regularly affects Vertigo Patients per my Neuro and ENT. The incident took place 4 weeks and 2 days after the 2nd vaccine. 2 days after the 2nd dose, I experienced Low grade fever, chills, and body aches that lasted only 12 hours, but nothing with the 1st vaccine nor anything after the 2nd dose issue until the Vertigo. I am unable to drive, conduct my job, which requires me to go to emergency calls and carry a Taser (CEW). I have been off work since this occurred and still not eligible to go back to work.

Other Meds: Omeprozal 40 mg Lisonpril 20 mg Fenofybrate 160 mg

Current Illness: None

ID: 1115828
Sex: F
Age: 32
State: MI

Vax Date: 02/05/2021
Onset Date: 02/12/2021
Rec V Date: 03/19/2021
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: nkda

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: patient received 1st dose of Moderna COVID vaccine on 2/5/2021. On 2/11/2021 patient developed body aches, cough, headache, nasal congestion. COVID test positive.

Other Meds: albuterol MDI, apri, vitamin C, cyanocobalamin, fexofenadine, fluticasone, montelukast, ondansetron

Current Illness: none

ID: 1115829
Sex: F
Age: 64
State: TX

Vax Date: 03/18/2021
Onset Date: 03/18/2021
Rec V Date: 03/19/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List: Pharyngeal swelling

Symptoms: Around 2:00 pm I had pain in my left shoulder blade going up to my neck it lasted for about 10 minutes, since then it has come and gone but neck pain stayed. I got chills and ran a slight fever so I took Ibuprofen. The fever left and the chills are still going on, since yesterday, I can't seem to get warm .I have no energy I'm very lethargic. Arm is sore but that's like any shot.

Other Meds: Sulfameth/Trimethoprim

Current Illness: Popliteal Cyst behind knee

ID: 1115830
Sex: F
Age: 66
State:

Vax Date: 03/15/2021
Onset Date: 03/16/2021
Rec V Date: 03/19/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: Chills, achiness, headache, flu-like symptoms.

Other Meds: Synthroid, Liothyronine, Vitamin D, Calcium, Glucosamine/Chondroitin, Vitamin C, Urinary medication, Multivitamin, Allegra, Probiotic.

Current Illness: None

ID: 1115831
Sex: M
Age: 39
State: AK

Vax Date: 03/10/2021
Onset Date: 03/18/2021
Rec V Date: 03/19/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Localized swelling at injection site; red, itchy rash; tenderness

Other Meds: Daily multi-vitamin, Echinacea, Zinc

Current Illness:

ID: 1115832
Sex: M
Age: 45
State: CA

Vax Date: 01/20/2021
Onset Date: 01/26/2021
Rec V Date: 03/19/2021
Hospital:

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

Lab Data:

Allergies: Brazil nut allergy

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

Symptoms: Beginning 6 days after 2nd vaccine dose, had one day of low grade fever (first day only), 2 days of arthralgia of MCP and IP joints of hands, knees, ankles, MTP joints of feet; 4 days of peripheral worse than central neuralgia (mild on anterior torso and thighs, increased over both forearms and legs, and extreme/severe of hands & feet, with even light touch, clothes, bedsheets causing burning pain. Neuralgia responsive to Gabapentin, but not acetaminophen or ibuprofen. After 4 days of neuralgia resolved, then still had altered heat and cold sensation/perception for hands and feet (palms & soles more than dorsa) for 3-4 more days, but no pain.

Other Meds: None

Current Illness: None

ID: 1115834
Sex: F
Age: 67
State: WI

Vax Date: 03/15/2021
Onset Date: 03/16/2021
Rec V Date: 03/19/2021
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: Atracurium - hives

Symptom List: Rash, Urticaria

Symptoms: On March 17 I developed herpes Zoster on the left side of my nose. My NP ordered valacyclovir 1gram which I am taking three times a day for 10 days.

Other Meds: Pantoprazole, atenolol, xxidra,Bactrim, duloxetine, areds2, Celebrex, amitripyline, lorazepam, rosuvastatin,

Current Illness: None

ID: 1115835
Sex: F
Age: 73
State: KS

Vax Date: 02/19/2021
Onset Date: 02/27/2021
Rec V Date: 03/19/2021
Hospital:

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

Lab Data:

Allergies: Piperacillin Sulfa Drugs Vancomycin Gentamycin Coumadin Spiriva Boniva Dust mites Cats Shell Fish Peanuts Dairy Soy Sensitivity

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

Symptoms: Shortly after the injection Pt experienced disorientation. (Received the vaccine at 0900 and disorientation happened later that morning. Saturday February 27, 2021 experienced muscle weakness and pain. This progressed into the inability to stand or walk. Seemed to migrate up the ankle and into the legs. Was confined to a wheelchair for a few days. Was being seen daily or every other day by APRN who works with Dr. By March 10, 2021 was able to stand with a walker. Was improving daily. Talked with Pt on March 15, 2021 and she is now walking without any assistance and feels back to normal

Other Meds: Valsartan Amlodipine Cyanocobalamin Furosemide Folic Acid Citrucel Cholestyramine Potassium Chloride ProAir HFA Zyrtec Clindamycin Vitamin D

Current Illness: Developed pneumonia the first week of March 2021

ID: 1115836
Sex: F
Age: 58
State: MI

Vax Date: 03/18/2021
Onset Date: 03/18/2021
Rec V Date: 03/19/2021
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: Patient had general malaise unknown cause. Onsite EMS was called vitals BP 178/96 99%O2 HR 78 Patient refused evaluation or care and released against medical advise.

Other Meds:

Current Illness:

ID: 1115837
Sex: M
Age: 41
State:

Vax Date: 02/25/2021
Onset Date: 02/26/2021
Rec V Date: 03/19/2021
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: FEVER

Other Meds:

Current Illness:

Date Died: 03/08/2021

ID: 1115838
Sex: M
Age: 79
State:

Vax Date: 02/18/2021
Onset Date: 03/08/2021
Rec V Date: 03/19/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: NA History - CAD,CKD-Stage 3 DMII HTN

Other Meds:

Current Illness:

ID: 1115839
Sex: F
Age: 46
State: TX

Vax Date: 03/04/2021
Onset Date: 03/10/2021
Rec V Date: 03/19/2021
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: none

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

Symptoms: Began with a sharp pain on buttocks on the left side. Later noticed what might have been a bug bite. The next day had ache type pain in lower left quandrant on back. Then determined the "bite" was part of a rash. Diagnosed with shingles (mild to moderate)

Other Meds: Remicade every 8 weeks, Omprezole, BioTe Hormones, Progesterone

Current Illness: none

ID: 1115840
Sex: M
Age: 35
State:

Vax Date: 02/25/2021
Onset Date: 02/26/2021
Rec V Date: 03/19/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: BODYACHES

Other Meds:

Current Illness:

ID: 1115841
Sex: M
Age: 44
State: OH

Vax Date: 03/19/2021
Onset Date: 03/19/2021
Rec V Date: 03/19/2021
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: Five minutes after receiving the vaccination on her left arm, she developed nausea and lightheadedness and weakness. No vomiting or syncope. She was escorted to a private session of the arena and monitored. Her initial blood pressure was 140/80. She was given water to drink and ate an apple.

Other Meds: Pepcid, Zyrtec, Flonase

Current Illness: None

ID: 1115842
Sex: M
Age: 39
State: IL

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

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

Lab Data:

Allergies: NKA

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

Symptoms: 39 y/o found in chair having a syncope episode. Patient retained consciousness and moved to ambulance. Vital stable. complained of dizziness, and feeling light headed. Patient refused transport to hospital. Refusal signed.

Other Meds: none

Current Illness: none

ID: 1115843
Sex: F
Age: 65
State: FL

Vax Date: 03/13/2021
Onset Date: 03/13/2021
Rec V Date: 03/19/2021
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: no

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

Symptoms: pt stated that after she took the covid vax her arm was red and hurting very badly. Later she felt nauseas, had muscle pain and headache. Temp was 100.4. She took 2 Tylenol and felt some better. By 3/17/2021 she began having more muscle pain in her arms and legs and her arm is still very sore. Pt states she will call her PCP for medical advice.

Other Meds: no

Current Illness: no

ID: 1115844
Sex: F
Age: 43
State: NV

Vax Date: 03/17/2021
Onset Date: 03/18/2021
Rec V Date: 03/19/2021
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

Symptom List: Unevaluable event

Symptoms: Fever- 101.2 at highest, chills, sweating, extreme body aches, extreme fatigue, injection site pain

Other Meds: Primidone Duloxetine

Current Illness: No

ID: 1115845
Sex: F
Age: 23
State: CO

Vax Date: 02/27/2021
Onset Date: 02/27/2021
Rec V Date: 03/19/2021
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: Patient received initial dose of Moderna in Washington DC. She is a recent employee, and onboarded. She received her vaccine invite and signed up for her Pfizer vaccine. She came in received her dose and then presented her previous card which showed her first dose being Moderna. Pharmacy notified. Counseled patient regarding the vaccines. Per, no need to receive booster at this time.

Other Meds:

Current Illness:

ID: 1115847
Sex: M
Age: 59
State: NC

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 03/19/2021
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: none

Symptom List: Injection site pain, Pain

Symptoms: Patient began having substernal chest pain that radiated to his left arm that started 2 hours after his second dose of the COVID-19 vaccination. Pain lasted for 30 hours and then he presented to the emergency department. He was diagnosed with an NSTEMI and underwent myocardial perfusion scan and cardiac catheterization.

Other Meds: Prilosec Multivitamin Lisinopril Nifedipine Neurontin Vistaril Belsomera Imitrex Colace Topamax Atarax

Current Illness: n/a

ID: 1115848
Sex: F
Age: 39
State: MI

Vax Date: 03/12/2021
Onset Date: 03/19/2021
Rec V Date: 03/19/2021
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: Injection site pain, Menorrhagia

Symptoms: Typical symptoms starting 3-12-21 at ~9pm of mildly elevated temperatures (~99.8 degrees F), body aches, headache. These continued for ~24 hours and I felt well from ~9pm on 3-13-21 until mid-afternoon on 3-14-21 started having mild intermittent upper abdominal pains. These continued until ~7pm that day when I started experiencing abdominal distention, cyclical abdominal cramping, nausea and frequent and deep belching. Around 9pm 3-14-21 experienced several episodes of small volume but urgent episodes of diarrhea but with sensation of needing to go more but couldn't. Abdominal distention, cyclical abdominal cramping, nausea, and belching all increased throughout the evening/night until around 2am had a episode of large vomiting. Continued to feel need to have diarrhea but no actual stools occurred throughout the night. Continued through night to have belching, distention, cyclical abdominal cramping. 3-15-21 experienced significant fatigue, some continued abdominal cramping, abdominal distention increased again (after going down some after episode of vomiting), fever intermittently (up to ~101), nausea to point of not being able to eat anything, significant body aches and headache. Weight dropped ~ 7lbs between am of 3-14 and 3-16. The evening of 3-15 I started to feel better, was able to keep down Tylenol, most symptoms improved, able to sleep that night. Have felt well other than fatigued and some mild uneasiness in stomach since waking up on 3-16. Myself and husband are both physicians and we are concerned I experienced symptoms of partial small bowel obstruction evening of 3-14. I was going to seek ER evaluation evening of 3-15 but started feeling better

Other Meds:

Current Illness: None

ID: 1115849
Sex: F
Age: 59
State: CA

Vax Date: 03/18/2021
Onset Date: 03/18/2021
Rec V Date: 03/19/2021
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: Face numbing, mainly in cheek and eye area, eye twitching, eyes very dry, part of lip and chin. it started off as becoming very tight, then the tingling. it has been over 24 hours and still sum tingling in the check bone and chin area.

Other Meds: zinc vitamin C

Current Illness: N/a

ID: 1115850
Sex: F
Age: 67
State:

Vax Date: 03/01/2021
Onset Date: 03/01/2021
Rec V Date: 03/19/2021
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: penicillin

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: started immediately after injection - 4 days of arm pain, fever, lymph node swelling, headaches, poor sleep, extreme chills; 3 days later - hot arm rash, fever, lymph node swelling, headaches, poor sleep, chills, body aches - had this for 3-1/2 days; 2 days later got the arm rash with same symptoms again - had this for 3 days.

Other Meds:

Current Illness:

ID: 1115851
Sex: F
Age: 91
State: TN

Vax Date: 03/09/2021
Onset Date: 03/14/2021
Rec V Date: 03/19/2021
Hospital:

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

Lab Data:

Allergies: Patient marked no on vaccination consent form.

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: One week after receiving the second dose of the Moderna Covid-19 Vaccine, the patient had some swelling and itching at the injection site. The second dose was received on 3/9/2021, and the reaction began on 3/14/2021. The patient reported the event to the pharmacy on 3/18/2021. This reaction is known as "Covid arm". She has tried aloe cream as well as cortisone cream during the day. The patient has taken Tylenol PM (acetaminophen and diphenhydramine) at night.

Other Meds: Warfarin

Current Illness: Patient did not mention other illnesses at clinic.

ID: 1115852
Sex: F
Age: 66
State: WI

Vax Date: 03/19/2021
Onset Date: 03/19/2021
Rec V Date: 03/19/2021
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: adhesives, penicillins, ranitidine, zetia, benadryl, hydrocortone, dapsone, levofloxacin, clindamycin, vicodin, zocor, lipitor

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

Symptoms: Patient was observed for 30 minutes and she left. She returned a short time later and reported feeling flush and a bit of chest and throat tightness. Stated having many trips to the ER in the past for anaphylaxis, she no reaction to her first dose and says her allergist told her she was safe to receive the second dose. We sent her to the ER following her elevated blood pressure and assessment of her swollen hard/red injection spot.

Other Meds: unknown

Current Illness: unknown

ID: 1115853
Sex: F
Age: 63
State: KS

Vax Date: 03/10/2021
Onset Date: 03/18/2021
Rec V Date: 03/19/2021
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, Tramadol, Metronidazole, Milk

Symptom List: Nausea

Symptoms: Day 8 an itchy arm at injection site. Day 9 red and itchy at vaccine site, slightly swollen

Other Meds: Evista, Vagifem,Calcium, magnesium, CoQ10, folic acid, B12

Current Illness: None

ID: 1115854
Sex: M
Age: 30
State:

Vax Date: 02/25/2021
Onset Date: 02/26/2021
Rec V Date: 03/19/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: CHILLS, HEADACHE,

Other Meds:

Current Illness:

ID: 1115855
Sex: F
Age: 61
State: IN

Vax Date: 03/17/2021
Onset Date: 03/18/2021
Rec V Date: 03/19/2021
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 headache, chills, fever and mild nausea

Other Meds:

Current Illness:

ID: 1115856
Sex: F
Age: 66
State: IL

Vax Date: 03/11/2021
Onset Date: 03/19/2021
Rec V Date: 03/19/2021
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: Moderna arm, red spot on arm, hot and itchy

Other Meds: None

Current Illness: None

ID: 1115857
Sex: M
Age: 73
State: AL

Vax Date: 03/12/2021
Onset Date: 03/12/2021
Rec V Date: 03/19/2021
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: - Moderna COVID- 19 Vaccine EUA The patient may have been given a partial dose of the Moderna COVID- 19 Vaccine on 3/12. Per Moderna and CDC recommendations, the patient returned to the clinic on 3/19 and the Moderna COVID- 19 Vaccine was administered.

Other Meds: N/A

Current Illness: N/A

ID: 1115858
Sex: F
Age: 66
State: NJ

Vax Date: 03/02/2021
Onset Date: 03/09/2021
Rec V Date: 03/19/2021
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: Tylenol codeine

Symptom List: Erythema, Pruritus

Symptoms: Medium sized rectangular swelling. Hot to touch. Very itchy. Used ice packs, Benadryl for itching and hydrocortisone

Other Meds: Eliquis, tegretol, atorvastatin,amlodipine,bystolic,telmisartin,eplerenone, vitamin D, iron supplement, restasis, travoprost

Current Illness: None

ID: 1115859
Sex: M
Age: 56
State: IN

Vax Date: 03/17/2021
Onset Date: 03/18/2021
Rec V Date: 03/19/2021
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: Extreme cold and chills; eased by morning

Other Meds: Tamsulosin

Current Illness: None

ID: 1115860
Sex: F
Age: 41
State: CA

Vax Date: 03/18/2021
Onset Date: 03/18/2021
Rec V Date: 03/19/2021
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: Cephalosporin

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

Symptoms: Pt had anaphylactic reaction including throat, mouth swelling and SOB, administered Epinephrine 0.3mg, sent patient to ER via ambulance.

Other Meds:

Current Illness: none

ID: 1115861
Sex: M
Age: 47
State: IN

Vax Date: 03/17/2021
Onset Date: 03/18/2021
Rec V Date: 03/19/2021
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: None

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Initially body aches. Took temperature at 4:00 pm and it was 101. Took Tylenol and slept until morning of 3/19. Have felt fine and no fever on 3/19.

Other Meds: Zyrtec, fiber, omeprazole

Current Illness: Tested positive for COVID on 02/09/2021

ID: 1115862
Sex: M
Age: 85
State: FL

Vax Date: 02/19/2021
Onset Date: 02/20/2021
Rec V Date: 03/19/2021
Hospital: Y

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

Lab Data:

Allergies: none

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

Symptoms: I could not wake him up fully in the morning after the shot. He was terribly lethargic. Instead of him using the rollater to come from his bedroom I got the wheel chair out of the care and got him to the table where I fed him a little breakfast. His blood pressure was low then high (I don't now have the readings) By 5 pm I called the ambulance. He was in the hospital until I transferred him to hospice 6 days later. He died in hospice 4 days after that.

Other Meds: Alprazolam, Amlodipine, Atenolol, Elliquis, Ferrex, Flecainide, Furosemide, ProAir Resiclick Aer, Simvastatin, eye drops: Vyzulta, Simbrinza Centrum Silver Men, Caltrate, Vitamin C Nebulizers: Yupelri, Perforomist, Budesonide

Current Illness:

ID: 1115863
Sex: M
Age: 40
State:

Vax Date: 02/25/2021
Onset Date: 02/26/2021
Rec V Date: 03/19/2021
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: CHILLS, BODYACHES

Other Meds:

Current Illness:

ID: 1115864
Sex: F
Age: 70
State: IN

Vax Date: 03/16/2021
Onset Date: 03/17/2021
Rec V Date: 03/19/2021
Hospital:

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

Lab Data:

Allergies: MED ALLERGIES NOT APPLICABLE...HAVE NOT HAVE THOSE MEDS FOR MANY YEARS. NOT ALLERGIC TO ANY FOOD.

Symptom List: Pain in extremity

Symptoms: FEELING QUEESY, VERY WEAK, VERY TIRED AND ARM VERY SORE AND SWOLLEN IN THE A.M. EARLY EVENING MUSCLE ACHES FROM HEAD TO TOE. DIFFICULT TO MOVE AROUND. I AM AFRAID OF THE SECOND DOSE!

Other Meds: DID NOT TAKE ANY VITAMIN SUPPLEMENTS THAT MORNING. DID NOT TAKE ANY PAIN MEDS FOR 36 HOURS PRIOR TO THE VACCINE. JUST TOOK OMEPRAZOLE AND FLUVOXAMINE IN THE MORNING.

Current Illness: NO ILLNESSES. STILL HEALING FROM KNEE SURGERY IN SEPT 2020. NOT GOING SO WELL. HAVE HAD DEPRESSION DUE TO THE KNEE PROBLEM. ON AND OFF PALPATATIONS.

ID: 1115865
Sex: F
Age: 61
State: IN

Vax Date: 03/17/2021
Onset Date: 03/18/2021
Rec V Date: 03/19/2021
Hospital:

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

Lab Data:

Allergies: Am-peniciline

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

Symptoms: Extreme dizziness, nausea, mild pain all over body. Tome Meclizine, 25, 2 pil,, 3 p.m. Advil 7p.m. 200 mg Some relief by 12p.m.march 19, 2021 Still dizziness, mild pain, cloudy thinking, not able to function

Other Meds: None

Current Illness: NOT

ID: 1115866
Sex: F
Age: 50
State: VA

Vax Date: 03/09/2021
Onset Date: 03/16/2021
Rec V Date: 03/19/2021
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: None known

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

Symptoms: Pain and swollen lymph node in right armpit began week after the shot, not sure if there is a connection. Ibuprofen taken for pain when needed. Pain is not constant, it seems to improve slightly during the day but by evening, around 5:30 or 6:00 pm it begins to hurt again. No rash or injury that may have caused it

Other Meds: Adderall XR, Lexarpo

Current Illness: none

ID: 1115867
Sex: M
Age: 68
State: AL

Vax Date: 03/16/2021
Onset Date: 03/17/2021
Rec V Date: 03/19/2021
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: peanut and nut allergies causes pt to swell up

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

Symptoms: redness and heat at injection site in 4x5 size. patient still experiencing symptoms and is trying to use benadryl and an ice pack to alleviate. Patient said he would go to doctor if worsened or didn't improve by tomorrow.

Other Meds: none

Current Illness: none

ID: 1115868
Sex: F
Age: 47
State: OH

Vax Date: 01/15/2021
Onset Date: 01/15/2021
Rec V Date: 03/19/2021
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: No

Symptom List: Vomiting

Symptoms: Around 6PM my arm was very swollen and the injection side was swollen, it was very painful the pain continued throughout the night. It was impossible to sleep. Then I used cold compress and the next day I started taking Motrin to help with the pain. The swelling started going down after 2 days and the pain was present for about 3 for days. The pain was excruciating, nothing like the flu shot pain or anything like that.

Other Meds: No

Current Illness: No

ID: 1115869
Sex: M
Age: 33
State:

Vax Date: 02/25/2021
Onset Date: 02/27/2021
Rec V Date: 03/19/2021
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:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: BODYACHES

Other Meds:

Current Illness:

ID: 1115870
Sex: F
Age: 74
State: PA

Vax Date: 03/15/2021
Onset Date: 03/15/2021
Rec V Date: 03/19/2021
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: Morphine, Cypro, shellfish, environmental.

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

Symptoms: Joint ache, head and neck ache, skin ache, chills, slight fever. Started night of second shot, Monday, stopped about 24 hours laterTuesday. Started again third night, Wednesday, stopped next morning. Started again Thursday night and is continuing on Friday (today). Secondary starts are not as strong as first night but are still very uncomfortable and do not allow for a good night?s sleep. Have been taking aspirin and Advil.

Other Meds: Nexium, Walphed (allergy medicine), vitamin D3, Magnesium.

Current Illness: None

ID: 1115871
Sex: F
Age: 34
State: TX

Vax Date: 03/11/2021
Onset Date: 03/18/2021
Rec V Date: 03/19/2021
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: "Covid arm". Developed a red irritated lesion around the injection site about 6 days after vaccination. Approx. 1" x 2"

Other Meds: Adderrall, Biktarvi, Loestra

Current Illness: None

ID: 1115872
Sex: F
Age: 50
State: AL

Vax Date: 12/30/2020
Onset Date: 12/31/2020
Rec V Date: 03/19/2021
Hospital:

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

Lab Data:

Allergies: penicillin

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

Symptoms: Nausea; body chills; severe headache. Those I had for about 36 hours - for the severe end of them. I had to hold me head - and felt like I had blood vessels rupturing. I have had migraines before and never had anything like that. From scale to 1-10 it was an 18. I took the Tylenol and that helped the symptoms to ease somewhat.

Other Meds: Tylenol; Effexor

Current Illness: no

ID: 1115873
Sex: M
Age: 36
State: MI

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

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

Lab Data:

Allergies:

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

Symptoms: Pt had 1 dose of Moderna @ hospital. Rec'd Moderna 3/5/21. Rec'd J&J 3/16/21

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm