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: 1117586
Sex: F
Age: 71
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: IM
Vax Site: LA

Lab Data:

Allergies: NKDA

Symptom List: Dysphagia, Epiglottitis

Symptoms: a 71 year old female presented to clinic for the first of 2 c-19 vaccines. She verbalized nervousness. She stated she felt well today; afebrile, denies n/v/d, malaise or fatigue. No known sick contacts. Daughter with her. Much discussion about which arm to vaccinate and how it will affect her ability to watch TV tonight [staying with mom to be watched for any vaccine reaction. Mom is 96]. I admin Moderna covid vaccine into left delt at 7:40 and continued chatting with patient/ daughter. Daughter going to drive mom to the grandmother's house for the evening, has left her own car somewhere. PT asked if she has to go to the waiting room to wait or if she could just wait in exam room? I reminded her several others waiting and she is suppose to wait out there. She stated she didn't think she could make it, starts to slide sideways in her seat. Never losing consciousness, never falling to floor, her head lolled back and her speech began to slur. I put her feet up in second chair and pulled her arms into her lap. Called to reception for help, had her call 911 and obtain E kit. PT was still speaking/ rambling. + pallor, weakness. Obtained VS at 7:47pm [WNL: 118/74, 69, 18 97% on RA]. Color began to improve without any intervention. by the time EMS arrived, PT was able to stand and to speak clearly. She declined to go to hospital for further evaluation.

Other Meds: BP PILL, LYRICA

Current Illness: NONE TO MY KNOWLEDGE; STATED SHE FELT WELL PRIOR

ID: 1117587
Sex: F
Age: 22
State: FL

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

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Patient became dizzy and weak a few minutes after shot. She started to see spots and felt like she was going to faint, she was sitting and we brought extra chair for her to put up legs.

Other Meds:

Current Illness:

ID: 1117588
Sex: F
Age: 55
State: AZ

Vax Date: 03/17/2021
Onset Date: 03/17/2021
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: sensitivities to NSAIDS and latex

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

Symptoms: Received the shot at 2:45 pm with no issues. At 11:30 pm 2 hours after going to bed I woke to muscle clenching/shakes (no fever) and a high heart rate between 104 -118 ( documented by my Fitbit ) this lasted 3 hours until I fell back asleep at 2:00 am

Other Meds: Lisinopril-HCTZ 20-25 MG TAB, Levothyroxine 75 MCG TAB

Current Illness: none

ID: 1117589
Sex: F
Age: 42
State: MD

Vax Date: 03/14/2021
Onset Date: 03/15/2021
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: Fresh fruit

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: The right side of my nose, mid way up thru the first part of my eyebrow has been twitching/wuovering since Monday evening 3/16 pretty much non stop. I received covid 19 vaccine step 1 on 3/15

Other Meds: Vitamin C Tumeric

Current Illness: None

ID: 1117590
Sex: F
Age: 75
State: IL

Vax Date: 02/23/2021
Onset Date: 02/28/2021
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: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Soreness began five full days after injection in my left arm. Excruciating soreness starting from the base of my neck across the left shoulder down my upper arm to the elbow and below. It lasted for 7 days and then the soreness left as fast as it began.

Other Meds: Alendronate 70mg Losartan 100mg Allopurinol 300mg Metformin 500mg Asperin EC 81mg Metoprolol tartrate 25mg Atorvastatin 40 mg CarBAMazepine 200mg latanoprost 0.005

Current Illness: None

ID: 1117591
Sex: F
Age: 42
State: MI

Vax Date: 03/11/2021
Onset Date: 03/13/2021
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: Orap, citrus fruit

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

Symptoms: Tiredness (1 week), muscle aches (48 hours) torso numbness in the skin (ongoing), itchy torso (ongoing), swollen and sore lymph nodes under left arm (ongoing), large bump on back (ongoing)

Other Meds: Sudafed, Allegra, Zyrtec, birth control

Current Illness:

ID: 1117592
Sex: F
Age: 56
State: AZ

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

Lab Data:

Allergies: None

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: 7 hours post vaccine administration I developed severe abdominal pain, nausea and vomiting. Called 911 and was taken via ambulance to a local ER and admitted for Severe Ideopathic Pancreatitis. I do not abuse alcohol and did not present with gallstones.

Other Meds: Hormone replacement therapy

Current Illness: None

ID: 1117593
Sex: F
Age: 41
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:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Penicillin, Sulfa, Macrobid, Cipro Environmental Allergies (Indoor & Outdoor) Had an allergic reaction to surgical glue used on incisions after laparoscopic procedure

Symptom List: Pharyngeal swelling

Symptoms: Received the vaccine at 12:35pm and at 12:44pm noticed a hive on my neck and a mild rash across the top part of my chest. I felt a flushing sensation and started to notice some difference when swallowing. Within a few minutes my lips began to tingle. After getting some fresh air and sitting with the EMS my symptoms were starting to improve but not resolved. I was given a dose of Benadryl (pill form) and within 15 minutes all symptoms started to improve. Within 30 minutes all symptoms resolved. Total time, I spent about 45-50 minutes before leaving the station. I would also like to note that when I was given the injection I did experience some bleeding, which seemed a little more than normal. It was ok within a minute or two. Since, I have a small bruise where the injection was given.

Other Meds: Zyrtec and Flonase

Current Illness: none

ID: 1117594
Sex: F
Age: 42
State: NY

Vax Date: 03/09/2021
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:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Nasuea, Fever, chills, headache, body aches, swollen lymph node, arm pain for 24 hours that began 14 hours after shot continual runny nose since shot, ongoing chills since shot, sore nostril,

Other Meds:

Current Illness:

ID: 1117595
Sex: F
Age: 57
State: OH

Vax Date: 03/12/2021
Onset Date: 03/14/2021
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: Na

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Started with chills, progressed to a headache, then body aches, fatigued, muscle pain, lack of appetite, lethargy, inability to concentrate, duration 86 hours (3 1/2 days)

Other Meds: Metformin, levothyroxine, enalapril, hydroclorothyazide

Current Illness: Na

ID: 1117596
Sex: F
Age: 58
State: CA

Vax Date: 03/05/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: sulfa drugs

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

Symptoms: Tongue swelled Two shots of steroids and Benadryl

Other Meds:

Current Illness: none

ID: 1117597
Sex: F
Age: 40
State: TX

Vax Date: 03/08/2021
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: Small, red rash developed at injection site 6 days after receiving vaccine. Each day it has grown in diameter. It was very sore to the touch for the first three days but now is feeling more itchy. It is slightly raised and warm to the touch. It currently has a diameter of roughly 4-5 inches.

Other Meds: None

Current Illness: None

ID: 1117598
Sex: F
Age: 56
State: WI

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: none

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

Symptoms: Woozy, headache, nausea, fever first day

Other Meds: B-12, VitaminD3 IU 2000, Magnesium 250mg, Zinc, Biotin, Xanax, Buproprion, Omeprazole, stool softener, Gabapentin, Tizanadine

Current Illness: none that I can remeber

ID: 1117599
Sex: M
Age: 49
State: IN

Vax Date: 03/17/2021
Onset Date: 03/01/2021
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: None

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

Symptoms: Soreness around injection site (normal) for two days. On Friday (two days after shot) noticed rash and some swelling about the size of three quarters at injection site.

Other Meds: None

Current Illness: None

ID: 1117600
Sex: F
Age: 29
State: GA

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:

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

Symptoms: Pain and redness at injection site began immediately. 24 hours after vaccine, it had grown into a swollen and inflamed weal about 3-4 inches long, 2 inches wide. Some itching. Pain with movement of arm, some chills. Has not yet resolved at this time, 36 hours after shot. Treating with anti-inflammatories and cold compress.

Other Meds:

Current Illness: Positive Covid test 02/04/2021; symptoms lasted until 2/20/2021. Still have not regained sense of smell.

ID: 1117601
Sex: F
Age: 53
State: CT

Vax Date: 03/09/2021
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: Betadine Penicillin

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

Symptoms: Always itched/mild arm pain after vaccination, started getting hives and redness day 9, by day 10 (today) it is a big red welt at injection site, Warm to touch, itchy. Taking Benadryl oral and pain relief. No effect/improvement so far.

Other Meds:

Current Illness:

ID: 1117602
Sex: F
Age: 37
State: CA

Vax Date: 12/30/2020
Onset Date: 01/29/2021
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: Lingering chills that start midback and run up to shoulders and down the arms lasting a few seconds (10-15 chills per day) everyday since the last the second dose. Have not seek medical treatment as of now.

Other Meds: None

Current Illness: None

ID: 1117603
Sex: F
Age: 41
State: GA

Vax Date: 03/18/2021
Onset Date: 03/18/2021
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: OTC Yeast Cream

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Tiredness Flushed cheeks Body Aches

Other Meds: Lithium, Olanzapine, vitamin D

Current Illness: None

ID: 1117604
Sex: M
Age: 17
State: LA

Vax Date: 03/13/2021
Onset Date: 03/13/2021
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: unknown

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: none

Other Meds: Jannsen

Current Illness: unknown

ID: 1117605
Sex: F
Age: 52
State: CA

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: Eggs, Dairy, Shell Fish

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

Symptoms: Swelling and sunburn feeling in right eyebrow, right eyelid, right inner ocular area. Itching and sensitivity in left outer earlobe.

Other Meds:

Current Illness: None

ID: 1117606
Sex: F
Age: 38
State: WA

Vax Date: 01/27/2021
Onset Date: 01/28/2021
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: Lamictal and bacitracin

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

Symptoms: I got up around 8 am to use the restroom was the last thing I remember. I had a syncopal event and my partner found me unconscious on the bathroom floor. When I fainted I hit my forehead causing a large hematoma. I also got a laceration on my chin about 2 inches across. I hit my right cheek as well but no skin was broken just a big bruise. The chin laceration required stitches. I have never fainted in my life. All the medications I am currently taking I have been on for years.

Other Meds: Gabapentin, Prozac, Liothyronine, Levothyroxine. Fish oil, vitamin C, vitamin B, acidophilus, vitamin D.

Current Illness: No illnesses one month prior

ID: 1117607
Sex: F
Age: 43
State: FL

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

Lab Data:

Allergies: Red ants

Symptom List: Unevaluable event

Symptoms: Within the first hour I broke out into hives all over my body and my throat, tongue and lips swelled. Went back to pharmacy took 50 mg of Benadryl orally and applied topical Benadryl.

Other Meds: Wellbrutin Buspar

Current Illness: Common cold

ID: 1117609
Sex: M
Age: 48
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Headache, injection site pain, muscle aches, tiredness, loss of concentration

Other Meds: Multi-Vitamin

Current Illness: None

ID: 1117610
Sex: F
Age: 64
State: MO

Vax Date: 03/05/2021
Onset Date: 03/13/2021
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: Sulpfa

Symptom List: Injection site pain, Pain

Symptoms: 8 days after the shot my shoulder started feeling sore to the touch. I started feeling a little under the weather. With weak joints and run down. On Sunday a circular red mark about the size of a baseball appeared. Every day the mark became larger and then started to become raised. And redder. That lasted 6 days through 3/18/21. Today it is starting to fade. The red blotch was slightly itchy but not unbearable.

Other Meds: Omeprazole, Biotin, vitamin d, vitaminBcomplex, bio identical hormones, tylenol

Current Illness: None

ID: 1117611
Sex: F
Age: 36
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:
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Sulfa, Amoxicillan, Clindamycin

Symptom List: Injection site pain, Menorrhagia

Symptoms: Woke up on day 8 with red, swollen, itchy rash at injection site. Approximately 3? in diameter. There was no allergic reaction on days 1-7.

Other Meds:

Current Illness:

ID: 1117612
Sex: F
Age: 63
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: 025J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: 15 hours after receiving the second dose, I developed a fever of 100 degrees, chills, headache, muscle aches, and fatigue that lasted for 24 hours -even though I took extra strength tylenol every 6 hours for 36 hours. In addition to a sore right arm injection site, I developed very large / swollen (the size of an egg) and tender lymph nodes in the right axilla that still persisted even after more than 48 hours since receiving the injection.

Other Meds: Extra Strength Tylenol (1000mg) started at 10:00am on 3/17/21 before dose given and taken every 6 hours for 36 hours to help ward off any potential side effects that could possibly develop after the second dose of Moderna vaccine received.

Current Illness: None

ID: 1117613
Sex: U
Age: 16
State: LA

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

Lab Data:

Allergies: unknown

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: none.

Other Meds: unknown

Current Illness: unknown

ID: 1117614
Sex: F
Age: 27
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:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Client came to charge nurse complaining of red rash appearing on arms and chest 15 minutes after vaccine administration. Patient was not in any visible distress. Vitals taken, blood pressure 148/111, HR 103, O2 97%, RR 20. Patient does not complain of any pain or discomfort, trouble breathing or itchiness. Benadryl 25 mg PO administered for red rash on arms and chest. Patient rested, upright in chair for additional 15 minutes. No new complaints brought up by patient. Vitals at 5:09 pm 134/90, 98 pulse, 96% O2, 98.5 temp, RR 18. Lung sounds clear. Patient able to tolerate walking and was accompanied by partner. Patient left site without incident.

Other Meds:

Current Illness:

ID: 1117615
Sex: M
Age: 58
State: PR

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

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

Symptoms: Unable to swallow Shaking chills Loss of air Abdominal pain Dizziness Pain in the face

Other Meds: Lisinopril 20mg

Current Illness: Kidneys

ID: 1117616
Sex: F
Age: 45
State: OR

Vax Date: 02/23/2021
Onset Date: 02/23/2021
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: Octopus

Symptom List: Nausea

Symptoms: High fever (103) Severe pain in arm at injection site, even when not touched/moved Dull headache Chills/sweats Began that evening, chills and sweating throughout night, and all next day. Fever started going down the second evening, and temp was normal by the third morning. Arm pain was tolerable by second afternoon.

Other Meds: Fish oil, vitamin c, vitamin d, St. John?s wort

Current Illness:

ID: 1117617
Sex: F
Age: 47
State: NV

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: LA

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: Severe pain and heat radiating down right leg from the lower back down the buttock and front of right thigh

Other Meds: Buprenorphine 8mg Sublingual Calcium B12 Multivitamin Collagen supplement

Current Illness:

ID: 1117618
Sex: F
Age: 64
State: NY

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: NKDA

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

Symptoms: Moderate to severe dizziness and lighdeadedness.

Other Meds: Blood pressure medication.

Current Illness: COVID-19 infection - Tested positive on 2/17/21.

ID: 1117619
Sex: M
Age: 28
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: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

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

Symptoms: After patient received the vaccine the patient sat down for 5 minutes before noticing he blacked out for a few seconds. The patient alerted the staff of the black out. The patient stated he had an elevated heart rate and that he was sweating. The pharmacy staff took the patient's blood pressure which was 97/77 mmHg. 911 was called and the paramedics arrived shortly. The paramedics took the patient blood pressure and screened them and ask if the patient would like to seek medical attention. The patient denied a visit to the emergency room and stated he was feeling much better.

Other Meds: Unknown

Current Illness: none

ID: 1117620
Sex: M
Age: 30
State: OR

Vax Date: 03/16/2021
Onset Date: 03/19/2021
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: Fresh fruit allergy

Symptom List: Tremor

Symptoms: Red rash around injection site that is firm and warm to the touch. Symptoms were first noticed around 7:45 am on 3/19. I have just started taking Tylenol.

Other Meds: Zyrtec, Multivitamins, and Vitamin C

Current Illness: None

ID: 1117621
Sex: F
Age: 31
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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Shellfish Reglan Flu Vaccine

Symptom List: Erythema, Pruritus

Symptoms: Headache Muscle and bone pain all over body Fatigue

Other Meds: Amlodipine 5mg Trintellix 5mg Atorvastain 20mg Amovig Injection 70ml Centrum Womens Multi Vitamin

Current Illness: High Blood Pressure High Cholesterol Migraines Degenitive Disc Disease in Neck Arthritis in Spine

ID: 1117622
Sex: F
Age: 38
State: IL

Vax Date: 03/18/2021
Onset Date: 03/19/2021
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: Codeine

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

Symptoms: At 2 am diarrhea, upset stomach, slight arm pain at injection site. At 3 pm nausea and exhaustion, woken from nap at 10 pm, temperature taken (100.0 degrees Fahrenheit), shooting stomach pains, headache, neck pain and general aches in joints.

Other Meds: Vitamin d, multivitamin, vitamin c, tri-linyah

Current Illness:

ID: 1117623
Sex: F
Age: 57
State: TX

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

Lab Data:

Allergies: Codeine Sulpha

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

Symptoms: 1. Arm hurt so much I could not sleep. It got better as the week progressed, but on Friday it began to itch. 2. When I woke up on Tuesday, after receiving the shot on Monday, I had diarrhea which reminded me of having covid. 3. I was weak or exhausted until today (Friday) after receiving the shot on Monday. I am scheduled to receive my second shot and I will do it, but I am apprehensive about it.

Other Meds: Lithium 600mg Fluoxetine 20 mg Liothyronine 12.5 mg Ingrezza 80 mg Acetaminophen 500 mg

Current Illness: None

ID: 1117624
Sex: M
Age: 18
State: OR

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

Lab Data:

Allergies: Penicillin

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Deep soreness in the left arm making it hard to lift the arm

Other Meds:

Current Illness:

ID: 1117625
Sex: F
Age: 28
State: KS

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

Lab Data:

Allergies: Mild allergy to adhesives

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

Symptoms: Mild pain in spleen, starting 24 hours after injection, lasting 8 hours.

Other Meds: Daily multivitamin, Vitamin D3

Current Illness:

ID: 1117626
Sex: F
Age: 25
State: CA

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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Benadryl, penicillin, onions

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

Symptoms: The same day I started breaking out in hives in the face and chest area, experienced swollen throat - mild. Took sudifed and over the counter DayQuil swollen throat disappeared. Rash went away, 3 days later my face felt a burning itching sensation, woke up to burning itching rash all over my forehead and chin breaking out in a large area. Called advice nurse, went to emergency room, and dermatologist for biopsy. Awaiting results

Other Meds: Aygestin

Current Illness: n/a

ID: 1117627
Sex: F
Age: 34
State: CA

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

Lab Data:

Allergies: None

Symptom List: Pain in extremity

Symptoms: Injection site reaction, chills, body aches, fatigue

Other Meds: Omeprazole, escitalopram, probiotics

Current Illness: None

ID: 1117628
Sex: M
Age: 51
State: CT

Vax Date: 03/12/2021
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

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

Symptoms: Minor tightness/swelling for 24 hrs after 1st shot. (Not what I?m reporting here.) Exactly one week following first shot, injection site became red, itchy and slightly swollen. Applied Eucerin skin lotion and no longer itchy, less red.

Other Meds: Superbeets concentrated beet crystals

Current Illness: None

ID: 1117629
Sex: F
Age: 33
State: CA

Vax Date: 03/11/2021
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: IM
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Vaccine received Thursday evening 5pm; fatigue all day Friday, but back to normal the following day. Sunday morning arm began feeling very sore. It is now the following Friday so 1 week later and arm still sore and there is a hard lump near injection site and bruised. Other than arm soreness for the entire week, I feel fine with no other adverse side effects.

Other Meds: Melatonin

Current Illness: None

ID: 1117630
Sex: F
Age: 45
State: MO

Vax Date: 02/01/2021
Onset Date: 03/03/2021
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: Ceclor Sulfa bee stings shellfish

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

Symptoms: Adverse allergic reaction to Pfizer Covid Vaccine

Other Meds: Topomax, Clonazepam, Trintellix, vitamin d3,

Current Illness:

ID: 1117631
Sex: F
Age: 30
State: KS

Vax Date: 03/03/2021
Onset Date: 03/04/2021
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: Milk allergy

Symptom List: Vomiting

Symptoms: Found out pregnant after taking 1st dose. Due date would be 11/17/21. Day following dose - injection site reaction = red, raised, itchy, tender to touch. Lasted 5 days

Other Meds: Citalopram, One a Day Woman's prenatal vitamin

Current Illness:

ID: 1117632
Sex: M
Age: 62
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: 037K20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Penicillin

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Joint muscle pain, twitching of lips on the left side, (minor) My niece had a severe reaction of twitching on both sides of face for 5-6 days, now she has right side drooping

Other Meds: Probiotic, calcium, Zyrtec, Advil, Doxycycline Monohydrate, Allopurinol, Pravastin

Current Illness:

ID: 1117633
Sex: F
Age: 21
State: MS

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

Lab Data:

Allergies: none

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

Symptoms: arm soreness, fatigue, body aches, low grade fever, headache

Other Meds: Loseasonique tablet

Current Illness: none

ID: 1117634
Sex: F
Age: 60
State: WV

Vax Date: 02/11/2021
Onset Date: 02/19/2021
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: None

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Covid arm

Other Meds: Numerous due to MBC

Current Illness: MBC with bone mets

ID: 1117635
Sex: F
Age: 41
State: UT

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:

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

Symptoms: Fatigue, headache, malaise, brain fog, body aches, mild nausea within 2 - 3 hours of shot

Other Meds:

Current Illness:

ID: 1117636
Sex: F
Age: 37
State: RI

Vax Date: 03/15/2021
Onset Date: 03/17/2021
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: N/A

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

Symptoms: Severe headaches that won?t go away

Other Meds: Warfarin Lexapro

Current Illness: N/A

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm