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: 1117430
Sex: F
Age: 70
State: OH

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

Symptom List: Dysphagia, Epiglottitis

Symptoms: giving the patient her second moderna vaccination and the vaccine came out of the connector at the site of the needle and syringe , they both were tight but the vaccine ran down her arm from coming out of that site. patient then received the second dose to complete her series . under direction of the pharmacy director was notified. and if less than 50 % was received then give another dose .

Other Meds: issue was that the first vaccination the syringe at connector site of needle was tight but the vaccination came out of that area and went down her arm a second dose was administered under direction of the phar

Current Illness:

Date Died: 03/19/2021

ID: 1117431
Sex: F
Age: 92
State:

Vax Date: 03/10/2021
Onset Date: 03/12/2021
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: Sulfa,

Symptom List: Anxiety, Dyspnoea

Symptoms: Found in chair lethargic less than 48 hours after her first civid vaccine by facility staff where she lives in an independent living facility. Nursing staff felt she had a stroke with right sided weakness. Slurred speech, weak, unable to walk without two person assistance. Patient was under hospice care so hospitalization was given.

Other Meds: Carvedilol, eliquis, furosemide, isosorbide, seroquel

Current Illness: None

ID: 1117432
Sex: F
Age: 68
State: MI

Vax Date: 03/18/2021
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: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NKDA

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

Symptoms: 15 minute wait to see if pt has any adverse effects to vaccine

Other Meds: Senna, Dulcolax, Lorazepam, Seroquel, Amitriptyline, Elavil, Aspirin, Oxybutynin, Caltrate, Lisinopril

Current Illness: N/A

ID: 1117433
Sex: F
Age: 57
State: NY

Vax Date: 03/08/2021
Onset Date: 03/08/2021
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: sulfur, codeine, humira

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: headache for 3 days left ear rang for 5 days (shot in left arm) both ears ring since (normal tinnitus not loud and different sound than sound after shot)

Other Meds: lasix took other supplements following day; took pm meds, otezla, aspirin

Current Illness:

ID: 1117434
Sex: F
Age: 51
State: CA

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:
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: Raised, red area with itchy rash near the injection site. Site is a bit swollen and warm to the touch.

Other Meds: Daily multivitamin

Current Illness: None

ID: 1117435
Sex: F
Age: 47
State: MD

Vax Date: 03/09/2021
Onset Date: 03/12/2021
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: Ace inhibitors causes coughing spells

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

Symptoms: Had vaginal ulcers and pain/burning upon urination. Went to a medical facility to be evaluated. The physician was convinced I had genital herpes. Symptoms lasted about 7 days

Other Meds: Amlodipine, Vitamin D, and fish oil

Current Illness: none

ID: 1117436
Sex: M
Age: 28
State: ID

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

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: 2nd dose given too early, 1st dose 1/8/21, 2nd dose 1/28/21

Other Meds: unknown

Current Illness: none known

ID: 1117437
Sex: M
Age: 36
State: NY

Vax Date: 02/26/2021
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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Pharyngeal swelling

Symptoms: Severe 90 % hearing loss of the right ear which started the morning after the vaccine. Distorted sound in the right ear which has not improved in 3 weeks!

Other Meds: none

Current Illness: none

ID: 1117438
Sex: F
Age: 74
State: AL

Vax Date: 03/01/2021
Onset Date: 03/10/2021
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: allergy to verapamil

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: The patient developed a rash on her neck a week after receiving the vaccine and it has not gone away. She has treated with benadryl cream and calamine lotion and it is still red and itchy

Other Meds: Blood pressure and diabetic medications and heart medication

Current Illness: None

ID: 1117439
Sex: M
Age: 54
State: RI

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: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Raw Peanuts

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Right-sided facial numbness and slight facial drooping right after receiving vaccine. Tingling and pins/needles sensation. Numbness has prolonged up til this day. Received medical treatment from physician who mentioned bells palsy and prescribed Prednisone 20mg take 3 tablets by mouth everyday for 7 days and Valacyclovir 1 gram 3x a day for 7 days.

Other Meds: Vitamin C B-12 Bayer Aspirin Osteo Bi-flex Garlique 1 pill Omega 3-Acid Atorvastatin 20mg Vitamin D3

Current Illness:

ID: 1117440
Sex: F
Age: 64
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:
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: 15 minute wait to see if pt has any adverse effects to vaccine

Other Meds:

Current Illness:

ID: 1117441
Sex: F
Age: 65
State: SC

Vax Date: 03/06/2021
Onset Date: 03/14/2021
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: None

Symptom List: Rash, Urticaria

Symptoms: Began eight days, 3/14/2021, after first dose of Moderna vaccine. Large, warm, raised, red, slightly sore, very itchy area appeared at injection site. Lasted about two days, then went away. Then, on 3/19/2021 the itching began again, and I have another red spot on my left arm at injection site just like before.

Other Meds: Bupropion, Mirtazapine, metoprolol

Current Illness: None

ID: 1117442
Sex: M
Age: 44
State:

Vax Date: 03/19/2021
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: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: pt got vaccine and was sitting for observation. Pt thought he was having a panic attack so he put his head between his knees, he fainted, hit is head on the floor, and a witness said he was shaking on the floor. The patient came to quickly and said he passed out due to stomach cramps . EMS was on site and did an evaluation. Pt was given ice for his head and had vitals checked and and EKG done. EMS recommended hospital transport but patient refused.

Other Meds: prozac

Current Illness:

ID: 1117443
Sex: F
Age: 54
State: MO

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: Avacado, Vicodin, polysporon eye drops

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

Symptoms: Arm pain mild fever fatigue mild nausea mild diarrhea

Other Meds: Omeprozole and Aslign(probiotic), Pepcid

Current Illness: None

ID: 1117444
Sex: F
Age: 67
State: IN

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

Lab Data:

Allergies: none

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

Symptoms: Shot was given to the upper left arm. Began feeling dizzy, nausea, chills, headache, and tiredness early morning on 3/16/21. Notified primary doctor and was told I could take tylenol and that the symptoms should be gone in a couple days. The injection site was warm, red, and swollen. By tuesday night, my head was worse and all I could do was sleep. Wednesday, 3/17/53 I felt better and tried to start my day. Within a short period of time, I was dizzy and nausea had started again along with the tiredness. The injection site was still warm, red, and swollen.

Other Meds: Victoza, Famcyclovir, Omprezole, Oxybutynin, Fluoxitine,

Current Illness: none

ID: 1117445
Sex: F
Age: 23
State: NY

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

Lab Data:

Allergies: minocycline

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

Symptoms: swollen and painful lymph nodes in collarbone area and under armpit, both on the side of the injection

Other Meds: spironolactone, doxycycline, fluoxetine, trifemynor, probiotic

Current Illness: n/a

ID: 1117446
Sex: F
Age: 68
State: MI

Vax Date: 03/18/2021
Onset Date: 03/18/2021
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:

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

Symptoms: 15 minute wait to see if pt has any adverse effects to vaccine

Other Meds:

Current Illness:

ID: 1117447
Sex: F
Age: 63
State: WA

Vax Date: 03/19/2021
Onset Date: 03/19/2021
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: Not report

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Guest received first dose of Pfizer Vaccine. While in the Observation Area she reported - Metallic Taste, Left arm tingling, cold feeling, and light ? headedness.? Vital signs assessed. Discussed symptoms and guest reported improvement within two to three minutes. VS: B/P: 150/72, P ? 71, SPO2 ? 100% R/A. Interventions: Water, snack, observed for 30 minutes. Guest reports no further symptoms upon departure.

Other Meds: None reported

Current Illness: None reported

ID: 1117448
Sex: F
Age: 38
State: MO

Vax Date: 03/11/2021
Onset Date: 03/18/2021
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: Hydrocodone, e-mycin ointment, imitrex iv

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: 7 days after injection, arm swollen and hard to touch. Painful, tender, hot, small rash. Swollen area circular about 5 inches in diameter

Other Meds: N/A

Current Illness: None

ID: 1117449
Sex: F
Age: 37
State: VA

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

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

Symptoms: Itching, numb tongue and throat within hour after vaccine. Diarrhea within two hours. Rash on cheeks three days later.

Other Meds: Aldactone

Current Illness: None

ID: 1117450
Sex: F
Age: 20
State: CA

Vax Date: 03/18/2021
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: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Chills, fever from 5 am to 6:30 am, body aches, nausea

Other Meds: Mirtazepine Methylphenidate XR

Current Illness:

ID: 1117451
Sex: M
Age: 74
State: OH

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

Symptoms: while giving the shot the vaccine went down his arm due to faulty connector of the needle and syringe the parts were very tight before the injection this happened to his wife first so I gave him the other shot and it di the same thing so the needles were then taken out of service. and given back to the pharmacy and reports were made out. managers notified and pharmacy director stated if 50% of less was received to given another dose completed this was his 2nd dose of moderna

Other Meds:

Current Illness:

ID: 1117452
Sex: F
Age: 63
State: CA

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: LA

Lab Data:

Allergies: Nine

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

Symptoms: Patient received the COVID 19 vaccine (Pfizer) at 1700. She became anxious. Nurses lied her down on a cot where she had a vasovagal response with loss of consciousness. Pt was disoriented x 2minutes. VS: BP 124/80, HR 86, O2 sat 100% room air, RR 18. Paramedics were called to evaluate patient. She was medically cleared by paramedics. Pt had a friend drive her home. Pt was stable when leaving.

Other Meds: None

Current Illness: None

ID: 1117453
Sex: F
Age: 48
State:

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 03/19/2021
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: Painful body aches (much worse than the flu), tiredness, temperature fluctuation. All peaked at around 12-24 hours post vaccine and have gradually subsided since.

Other Meds: Lexapro

Current Illness:

ID: 1117455
Sex: M
Age: 71
State: CA

Vax Date: 02/19/2021
Onset Date: 02/22/2021
Rec V Date: 03/19/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: cervical cord edema with decrease motor and sensory function all extremities

Other Meds:

Current Illness:

ID: 1117456
Sex: F
Age: 70
State: AZ

Vax Date: 03/13/2021
Onset Date: 03/14/2021
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: Large bright red raised area the size of an large egg. Hard Painful Bright Red No muscle pain in arm as with the 1st injection.

Other Meds: Atorvastatin 20 mg Omega-3 Fatty Acids 600 mg total EPA & DHA Black Cohosh 540 mg Stool Softener Probiotic 3 Billion Live Bacteria Cells Naproxen Sodium Tablets 220 mg Calcium plus Vigtamin D2 600 mg

Current Illness: None

ID: 1117457
Sex: F
Age: 35
State: TX

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: LA

Lab Data:

Allergies: None

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Significant nausea and vomiting, with body aches and tingling in fingers.

Other Meds: None

Current Illness: None

ID: 1117458
Sex: F
Age: 56
State: CA

Vax Date: 03/19/2021
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: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Iodine

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: "PFIZER COVID 19 VACCINE EUA". Patient received first dose Pfizer vaccine (right deltoid) today at vaccination site. Due to Pt's hx of moderate allergice reaction to IV iodine during a medical procedure "years ago", pt placed on 30-minute ovservation period. Approx 10 minutes into observation, pt notified staff that she felt some itching on her right arm in crease of elbow. Pt. also saw what she described as bumps or hives the size of a half dollar. Pt moved to private restroom and redness and swelling found progressing behind pt's right knee 5 minutes later. IM Benedryl administered to patient and transport medic unit called. Full report given to transport crew. Pt transported to ED.

Other Meds: Motrin

Current Illness: none

ID: 1117459
Sex: M
Age: 23
State: IL

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: No known allergies

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

Symptoms: Syncope, patient awoke on his own after ~15 seconds

Other Meds: Unknown

Current Illness: No disease states reported

ID: 1117461
Sex: F
Age: 22
State: MD

Vax Date: 03/19/2021
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: IM
Vax Site: RA

Lab Data:

Allergies: sulfa

Symptom List: Nausea

Symptoms: fever chills body aches joint pain

Other Meds: lexapro 10mg junel 1.5

Current Illness: n/a

ID: 1117462
Sex: F
Age: 57
State: TX

Vax Date: 03/06/2021
Onset Date: 03/10/2021
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: Benadryl

Symptom List: Injection site pain

Symptoms: I smell cigarette smoke, several times a day. No one around me smokes. No one is smoking in my vacinty when I smell it. Sometimes last a few min, other times last about30 min.

Other Meds: Venafaxine 150mh daily Simvastatin 20mg daily

Current Illness: None

ID: 1117463
Sex: F
Age: 51
State: DE

Vax Date: 03/10/2021
Onset Date: 03/11/2021
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: Contrast dye

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

Symptoms: Fever, chills, fatigue, leg pain, body aches

Other Meds: Nortriptyline 10 mg once daily

Current Illness: None

ID: 1117464
Sex: M
Age: 65
State: MO

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

Lab Data:

Allergies: None

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

Symptoms: Constipation for 2 days and no relief as of writing

Other Meds: Amlodipine Simvastatin Sulfasalizime

Current Illness: None

ID: 1117465
Sex: F
Age: 61
State: NJ

Vax Date: 03/01/2021
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: Tremor

Symptoms: Fever, chills, muscle aches

Other Meds: Apriso Metoprolol

Current Illness: Colitis

ID: 1117466
Sex: M
Age: 62
State: AK

Vax Date: 02/18/2021
Onset Date: 02/20/2021
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: No

Symptom List: Erythema, Pruritus

Symptoms: A serious gout episode that lasted 3 weeks.

Other Meds: Multiple medications for blood pressure, diabetes and AFIB.

Current Illness: No

ID: 1117467
Sex: F
Age: 57
State: ID

Vax Date: 02/05/2021
Onset Date: 02/05/2021
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: sulfa

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

Symptoms: 2nd dose given too early, 1st dose 1/15/21, 2nd dose 2/5/21

Other Meds: unknown

Current Illness: none known

ID: 1117468
Sex: F
Age: 61
State: AZ

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

Lab Data:

Allergies: PCN, Sulfa, Cipro

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

Symptoms: Itching on shoulder and neck during first 15 minutes after Janssen COVID vaccine administration. Observed for additional 20 minutes by EMS. No treatment provided.

Other Meds: Unknown

Current Illness: Unknown

ID: 1117469
Sex: F
Age: 34
State: WA

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

Lab Data:

Allergies: None reported

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Guest vaccinated at 1307, reported bilateral hand tingling to post vaccination observation staff at 1326. Guest reported history of anxiety, vital signs taken at tingling onset were as follows: Blood Pressure 120/85, Heart rate 68, Respirations 20, O2 98% on room air. Guest reported not having eaten since 1030 and was given a granola bar. Aid arrived to assess guest per aid call but guest declined additional assessment as they reported improvement of tingling. Vital signs retaken at 1344 were as follows: Blood Pressure 110/80, Heart rate 81, Respirations 18, O2 98% on room air. Guest left post observation to go home at 1345. Was told to seek care if tingling returns or other symptoms of concern develop or worsen.

Other Meds: Patient denies

Current Illness: Unknown

ID: 1117470
Sex: F
Age: 71
State: CA

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

Lab Data:

Allergies: Duck ;embryo used in rabies vaccination serum base in 1965. Chicken or duck feathers.

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

Symptoms: I woke up at 3am with pain in my shoulders.. Soon after I felt sharp pain in random places and times in my body, and I would shake shortly at random time. As time went on the pain seemed to move down my body from my shoulders to my arms then my hands and then to my legs. I fell back to sleep for a couple hours and woke with sharp random short pains and continuing aching in my joints. I noticed my speech was gravelly. I had no appetite and did not eat at all that day. I mostly slept. When out of bed I felt very weak so was up for only short times. I took one alleve pill because I was so uncomfortable. I was not hot and did not have a fever. When I woke in themorning on 3/19/21 all that pain was gone and I felt very rested.

Other Meds: 60mg duloxytene x2/day daily

Current Illness:

ID: 1117471
Sex: F
Age: 59
State: GA

Vax Date: 03/18/2021
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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Generic Levothyroxine

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

Symptoms: Instantaneously upon receiving the vaccine, I had a severe adverse reaction when my left arm swelled up as big as a tennis ball right at the injection site. My arm turned very red and hard and started hurting immediately. I also got the chills. The pharmacist who administered the vaccine was quite concerned. She gave me two doses of children's Benadryl and made me drink some water. Then she had me sit for 30 minutes so she could monitor my symptoms and condition. In that time she took my temperature and watched my breathing. After 30 minutes passed, she asked me to stay for an additional 30 minutes of observation. After an hour had passed, she released me to drive home. She told me to seek medical treatment if I started having difficulty breathing after leaving the facility.

Other Meds: Synthroid 75 mcg daily Vitamin D3

Current Illness: None

ID: 1117472
Sex: F
Age: 57
State: UT

Vax Date: 03/17/2021
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: None

Symptom List: Pain in extremity

Symptoms: tingling of the tongue, lips and gums within 5 minutes of the vaccine struggling to breath while asleep at 7:00 am on 3/18/21

Other Meds: vitamin D

Current Illness: None

ID: 1117473
Sex: F
Age: 73
State: NC

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: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: none per pt

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

Symptoms: Patient got COVID shot today at 4 pm. She stated that her arm started stinging at 4:05pm. She waited till 4:30pm and stated that her arm was not stinging anymore. She signed a paper saying she was ok and wanted to leave.

Other Meds: unknown

Current Illness: rheumatoid arthritis

ID: 1117474
Sex: F
Age: 69
State: MO

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

Lab Data:

Allergies: None

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

Symptoms: Pt was stuck with an empty syringe and a slight bubble was injected. Then the pharmacist realized that the syringe hadn't been filled yet and the volume she saw was air and not the clear vaccine. The patient then received the vaccine.

Other Meds: None

Current Illness: None

ID: 1117475
Sex: F
Age: 51
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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: 15 minute wait to see if pt has any adverse effects to vaccine

Other Meds:

Current Illness:

ID: 1117476
Sex: F
Age:
State: NY

Vax Date: 01/23/2021
Onset Date: 01/25/2021
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: Sulfa fentinyl morphine

Symptom List: Vomiting

Symptoms: Legs and feet experience swelling and discoloration Still experiencing to date 3/19/2021

Other Meds: Hydrochorizide/spirolactine. 25 mg Gabapentine 400 mg

Current Illness: None

ID: 1117477
Sex: F
Age: 56
State: OH

Vax Date: 03/19/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: Bee venom, chlorzoxazone, erythromycin, influenza vaccine,iv dyes,sulfa antibiotics, sulfites,tysabri

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Throat tightness, hoarseness, cough shortly after administration

Other Meds: Eliquis,aubagio,ranitidine,topamax,ambien, prednisone,ampyra,requip,epipen, vitamin D,folvite, singulair,adalat cc,ventolin,voltaren gel,flovent, imdur,benlysta iv,loratadine, methotrexate

Current Illness: Ibs, ms, celiac disease, lupus, raynaud's, hx blood clots

ID: 1117478
Sex: F
Age: 63
State: CA

Vax Date: 03/12/2021
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:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: none

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

Symptoms: I was vaccinated on Friday morning. Everything seemed OK. On the next day Saturday, I felt some numbness on me left upper lip and right tooth. The numbness increased and changed to my left face paralysis. I could not chew or close my left eye totally. My husband brought me to the ER on Tuesday morning. They diagnosed that I had peripheral Bell's palsy and gave prescription to me with antivirus medicine, prednison, eye oilment and eye drops, and shield to cover my left eye while I go to sleep. Today is Friday, one week after I got vaccinated. I also go to get acupuncture.

Other Meds: Metformin 1000 mg bid. Januvia 100 mg qd, Propanolol 20 mg bid, Olmesartan 40 mg qd.

Current Illness: none

ID: 1117479
Sex: F
Age: 47
State: MN

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: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: penicillin, sulfates, two previous blood pressure medications

Symptom List: Injection site swelling, Limb discomfort

Symptoms: 8 days after first dose of Moderna vaccine, developed two red spots on upper left arm slightly below injection site. They were hot and red and tender to the touch. Flesh also felt somewhat hard/firm in that area. It hurt to move my arm. Took photo in the morning, and two hours later the spots had almost doubled in size, coming together as one larger red area that eventually covered most of my upper, outer arm. By the end of the day, the red area was approximately 7 inches long by 4 inches wide. For context, on the day of the vaccine, I had heaviness and some discomfort in my arm (same as I experienced with the flu shot this year), but no redness. All discomfort disappeared in less than 2 days. Was very surprised to have an issue 8 days later.

Other Meds: amlodopine (5MG) , cod liver oil, women's multivitam, vitamin D, iron supplement, probiotic

Current Illness: none

ID: 1117480
Sex: F
Age: 55
State: MT

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: RA

Lab Data:

Allergies: Augmentin, Levaquin

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

Symptoms: Received 2nd Pfizer shot 2/25/2021. To stave off side effects, I took 2 Ibuprofen before bed. In the morning, I was more wobbly than usual, but could make it to the bathroom and return to bed. A couple of hours later I had chills, bladder was not functioning well. I could not walk or stand and, could barely maneuver in bed. Went to hospital by ambulance, where I was given 125 MG of IV Solumedrol intravenously. Less than an hour later, I could walk and leave the hospital using my quad cane and the arm of a loved one. I continued to improve and am currently at the condition I was in before the 2nd vaccine injection . Walking was impaired after the first injection two weeks prior, but I was not forced to call an ambulance for help.

Other Meds: Ocrevus

Current Illness: Multiple sclerosis, Type 2 diabetes

ID: 1117481
Sex: F
Age: 28
State: TX

Vax Date: 02/26/2021
Onset Date: 02/26/2021
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: Methlyprednisolone, tamiflu, compositae family

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

Symptoms: After about 10 minutes my arms had red splotches on them, my face turned red and my tongue and neck felt swollen.

Other Meds: Allegra, montelukast, lo ogestrol 28

Current Illness: N/a

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm