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: 1117847
Sex: U
Age:
State: MI

Vax Date:
Onset Date:
Rec V Date: 03/20/2021
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: Friday evening arm & neck pain. Saturday arm and neck pain, got hot went turn heat down and fainted landed on tail bone. . Felt nauseated, flush and sweaty. Sunday to current neck pain and very foggy in the head, lightheadedness.

Other Meds:

Current Illness:

ID: 1117848
Sex: F
Age: 63
State: KY

Vax Date: 03/16/2021
Onset Date: 03/17/2021
Rec V Date: 03/20/2021
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: Magnesium stearate Intolerant to milk products

Symptom List: Anxiety, Dyspnoea

Symptoms: Rash at vaccine site about 1.5? in diameter Itchy and red Still minor symptoms 4 days out

Other Meds: Losartan-hctz 50-12.5 Omeprazole 40 mg Vita D 125 mcg Fish oil 1000 mg Flax seed oil 1000 mg Occasional NutriFeron 1 caplet (Shaklee product)

Current Illness: N/A

ID: 1117849
Sex: F
Age: 44
State:

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 03/20/2021
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: Kiwi

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

Symptoms: Felt like a lump in throat, which I suppose was slight swelling. Occurred approximately 30 minutes after receiving vaccine, and we had already left vaccination clinic. I felt like I needed to clear my throat, drank lots of water and after 10 minutes, the ?lump? sensation stopped. No other allergic reactions after that.

Other Meds: Allegra Women?s multi vitamin

Current Illness: None

ID: 1117850
Sex: F
Age: 26
State: IN

Vax Date: 03/11/2021
Onset Date: 03/19/2021
Rec V Date: 03/20/2021
Hospital:

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

Lab Data:

Allergies: Clindamycin

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Redness/rash at injection site (8 days post-vaccine). Itching. Roughly 1-1.5" in size to start, then overnight increased another 1-1.5" in length. More itching.

Other Meds: Collagen gummies. Probiotic gummies. Ibuprofen.

Current Illness: Sinus infection from (roughly) 2/28-3/2

ID: 1117851
Sex: F
Age: 29
State: IN

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

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

Lab Data:

Allergies: Ibuprofen

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

Symptoms: Shoulder pain, impingement

Other Meds: Prozac

Current Illness: No

ID: 1117852
Sex: F
Age: 44
State: NY

Vax Date: 03/18/2021
Onset Date: 03/18/2021
Rec V Date: 03/20/2021
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: none reported

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

Symptoms: pt experienced a small rash on the right side of neck. No other reaction was reported

Other Meds: none reported

Current Illness: none reported

ID: 1117853
Sex: F
Age: 67
State: IA

Vax Date: 01/14/2021
Onset Date: 01/27/2021
Rec V Date: 03/20/2021
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: sulfa

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: extreme hives all over the body (head to toe) - still having hives to-date Treatment: zyrtec, famotidine, singular, docepin, hydroxyzine, lexapro

Other Meds: multivitamin, fish oil tablet, calcium with vitamin D, extra vitamin D 800mg, lexapro, probiotic

Current Illness: none

ID: 1117854
Sex: F
Age: 51
State: MI

Vax Date: 03/16/2021
Onset Date: 03/16/2021
Rec V Date: 03/20/2021
Hospital:

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

Lab Data:

Allergies: Latex

Symptom List: Pharyngeal swelling

Symptoms: Headache, Cough

Other Meds: Estradiol Patches .05mg

Current Illness: None

ID: 1117855
Sex: F
Age: 68
State: VA

Vax Date: 03/08/2021
Onset Date: 03/18/2021
Rec V Date: 03/20/2021
Hospital:

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

Lab Data:

Allergies: Rx pain meds generally Some antibiotics Bee stings

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Bruising, which is typical for me Exactly 10 days post vaccination, on 03/18/2021 I developed swelling, rash and itching at injection site Uncomfortable, but not miserable Treating w/topical Benadryl during day and oral Benadryl at night

Other Meds: none; hadn't taken meds for a few days although I routinely take Rx for high BP. high cholesterol, antacid, probiotic, CoQ-10, Vit D-3, Vit B-12 and Biotin

Current Illness: None

ID: 1117856
Sex: F
Age: 65
State: CT

Vax Date: 03/20/2021
Onset Date: 03/18/2021
Rec V Date: 03/20/2021
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: Melons

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Severe headache and nausea

Other Meds: Calcium supplement

Current Illness: None

ID: 1117857
Sex: M
Age: 82
State: MI

Vax Date: 01/21/2021
Onset Date: 03/15/2021
Rec V Date: 03/20/2021
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: none

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

Symptoms: bilateral internal jugular thrombus and subclavian thrombus

Other Meds: atenolol. zocor. wellbutrin. timolol

Current Illness: none

ID: 1117858
Sex: F
Age: 31
State:

Vax Date: 03/12/2021
Onset Date: 03/14/2021
Rec V Date: 03/20/2021
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: cat dander

Symptom List: Rash, Urticaria

Symptoms: pain, swelling, redness at site after 2 days. this went away. came back 7 days post-injection with edema, induration, pruritis. no pain. size about 2.5in in diameter.

Other Meds: Junel Fe birth control propranolol 60mg

Current Illness:

ID: 1117859
Sex: F
Age: 36
State: AR

Vax Date: 03/11/2021
Onset Date: 03/12/2021
Rec V Date: 03/20/2021
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: I woke up the morning after getting my first shot with a 100.3 fever, very lightheaded, and had muscle aches. Lasted for one day and then I felt back to normal. A week after the first shot I woke up with intense pain at the injection site on Thursday and Friday.

Other Meds: Birth control, probiotics, fish oil, adderall XR

Current Illness:

ID: 1117860
Sex: F
Age: 58
State: NJ

Vax Date: 03/10/2021
Onset Date: 03/18/2021
Rec V Date: 03/20/2021
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: Minor soreness at injection site for 48 hours after injection. Redness, itchiness and swelling at the injection site first began 8 days after injection.

Other Meds: almotriptan for migraine

Current Illness: None

ID: 1117861
Sex: F
Age: 61
State: ME

Vax Date: 03/11/2021
Onset Date: 03/11/2021
Rec V Date: 03/20/2021
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: Latex, antibiotics,polyethylene glycol,stone fruit, some nuts, hay fever

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

Symptoms: Chills, 103 fever, nausea, dizziness,aches, headache, fatigue. Came and went within 24 hours. Red face. On and off since vaccine Elevated blood pressure. Ongoing Tinnitus. Noticed last night, getting worse.

Other Meds: Vitamins b,c,d. Cod liver oil, topical medical marijuana lotion

Current Illness:

ID: 1117862
Sex: F
Age: 51
State: IL

Vax Date: 03/10/2021
Onset Date: 03/11/2021
Rec V Date: 03/20/2021
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: Banana Tree Nuts Morphine Dust, pollen, trees, grass, etc

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

Symptoms: Swelling, itching for 4 days following injection Some relief with OTC Benadryl 10 days following injection site is raised, red and itching again

Other Meds: Xyzal 5mg, Carvedilol 20mg, Amlodipine (2mg), Vitamin C and D3, B-Complex, B-12, Multi-Vitamin

Current Illness: None

ID: 1117863
Sex: F
Age: 33
State: MI

Vax Date: 03/15/2021
Onset Date: 03/16/2021
Rec V Date: 03/20/2021
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: On the second day of the vaccine, I experienced a severe headache, muscle pain in both of my legs, and a mild fever, on Wednesday I felt better, but on thursday I began to have a mild headache with shooting pain to the back of my head near my right ear and it has been painful ever since.

Other Meds: None

Current Illness: None

ID: 1117864
Sex: F
Age: 56
State: GA

Vax Date: 03/10/2021
Onset Date: 03/16/2021
Rec V Date: 03/20/2021
Hospital:

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

Lab Data:

Allergies: Sulfa

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Headaches on day 6,7,8 Swollen lymph node on neck ...same side as the injection And still present

Other Meds: Progesterone,estradiol patch

Current Illness: None

ID: 1117865
Sex: M
Age: 32
State: NY

Vax Date: 03/20/2021
Onset Date: 03/20/2021
Rec V Date: 03/20/2021
Hospital:

Vax Type: PNC13
Manufacturer: PFIZER\WYETH
Vax Name: PNEUMO (PREVNAR13)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies: Penicillin

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Immediately after needle withdrawal during vaccine administration a small amount of vaccine estimated to be less than 1/4 dose exuded from the vaccine site. Clinical lead was called to the table to evaluate. It was determined that greater than 3/4 dose was successfully administered therefore per protocol no further counter measures were taken.

Other Meds:

Current Illness:

ID: 1117866
Sex: F
Age: 38
State: CA

Vax Date: 02/10/2021
Onset Date: 02/13/2021
Rec V Date: 03/20/2021
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: Shingles received 7 day course of valtrex.

Other Meds: None

Current Illness: None

ID: 1117867
Sex: M
Age: 59
State: AZ

Vax Date: 03/20/2021
Onset Date: 03/20/2021
Rec V Date: 03/20/2021
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: some Antibiotics

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

Symptoms: Paine in shoulder of inoculation for three days, Head aches for three days, sleight temperature rise for two days, Nausea for two days.

Other Meds: too many to describe

Current Illness: none

ID: 1117868
Sex: F
Age: 60
State: FL

Vax Date: 03/11/2021
Onset Date: 03/16/2021
Rec V Date: 03/20/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Unevaluable event

Symptoms: severe vertigo, vomiting, migraine headache... dehydrated to the point of needing hospital IV for hydration

Other Meds: letrozole, lexapro, d3 vitamin, calcium caltrate

Current Illness: none

ID: 1117869
Sex: M
Age: 61
State: FL

Vax Date: 03/01/2021
Onset Date: 03/12/2021
Rec V Date: 03/20/2021
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: chills, cold sweats, cough

Other Meds: Metformin, telmisartan, simvastin

Current Illness: na

ID: 1117870
Sex: F
Age: 84
State: GA

Vax Date: 03/16/2021
Onset Date: 03/16/2021
Rec V Date: 03/20/2021
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: none

Symptom List: Injection site pain, Pain

Symptoms: Patient received Moderna 2nd dose. Appointment for patient had been made for Moderna and confirmed through appointment schedule. Patient was provided prescription receipt, vaccine facts sheet and side effect hotline form. Immunization Record was reviewed. Patient did not have vaccine card from previous provider and stated did not recieve a card.. When filling out vaccine card for patient I offered to fill out info from previous provider on the vaccine card. It was at this time, patient and I confirmed drugstore as provider and as I began to write Moderna as 1st dose patient stated Pfizer as 1st dose. Patient remained in waiting area 20 minutes and had no reaction.

Other Meds: not known

Current Illness: not known

ID: 1117871
Sex: M
Age: 74
State: AZ

Vax Date: 03/18/2021
Onset Date: 03/19/2021
Rec V Date: 03/20/2021
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: Fever, Chills, Body aches

Other Meds: Irbesartan, hydralazine, zegerid, zolpidem, imbruvica allopurinol

Current Illness: none

ID: 1117872
Sex: M
Age: 65
State: TX

Vax Date: 03/12/2021
Onset Date: 03/13/2021
Rec V Date: 03/20/2021
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: On Friday, March 12, 2021, at the pharmacy I had an 8:00 am appointment to receive the Johnson & Johnson?s Janssen COVID-19 Vaccine. I received my vaccine in the left arm but the injection seemed to me (and my wife) to be in an odd location, which was very high up on the shoulder near the shoulder joint. Things seemed fine until Saturday evening when I started to feel some tightness in my left trapezius between my scapula and my occipital bone. By Sunday morning that same area was very tight and painful; what we used call a ?crick.? Sunday afternoon I began to feel some sharp pain in my left shoulder joint. I had very little sleep on Sunday night and by Monday morning I had significant pain in what felt like my humerus. I made an appointment with a chiropractor for Monday afternoon and he suggested the vaccine shot might have started an inflammation that led to the tight trapezius, which in turn was causing the cervical spinal nerves to react, thus causing the pain in my arm. At this point I was in a lot of pain and the pain was moving further down toward my elbow. The chiropractor did his usual things and told me to put ice on it and take OCT Ibuprofen and or Naproxen. I was a bit better on Tuesday and decided to attend a three-day pastors? retreat. By Tuesday afternoon the pain had expanded to just below my elbow. I consulted with a doctor friend and he thought it was likely that I was having a reaction to the vaccine and that it would pass. He as concerned to hear of the odd location of my injection. I had another sleepless night and on Wednesday I noticed that the ends of my left thumb and index finder were numb and by that night the numbness had expanded to include most of my index finder. The other arm and shoulder pain continued but varied in intensity. On Wednesday morning I called my wife and asked her to come get me at the retreat and that afternoon I called my doctor's office office and made an appointment for Thursday morning (3-18-21). I'm feeling the cumulative effects of the pain and fatigue. My overall pain level is a little less but still present, as is the numbness in my index finger and thumb. My doctor suggested the nerve inflammation was a reaction tot he vaccine.

Other Meds: Lantus 100 UNIT/ML Inject 40 units subcutaneous daily Atorvastatin 40mg Take 1 tablet by mouth daily oral daily Metoprolol Tartrate 25mg 1 tablet with food orally twice a day GlyBURIDE 5mg 1 tablet orally two times a day Ramipril 10

Current Illness: None

ID: 1117873
Sex: F
Age: 62
State: IN

Vax Date: 03/17/2021
Onset Date: 03/18/2021
Rec V Date: 03/20/2021
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: Codein causes vomiting

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: My arm has remained sore since the shot 4 days ago. Specifically in the armpit but aches all the way down to my hand at time. My armpit is swollen and painful. The pain goes thru my underarm down to my hand. The pain makes it difficult to sleep. Tylenol doesn't take the pain away. At first I thought the pain was a side effect to the initial vaccine, but it got worse as time went on. Finally I researched it on line and saw that lymph nodes have been reported as swelling due to the vaccine.

Other Meds: Glimerpiride 2mg, Potassium CL ER 20 MEQ, Omerparazole DR 20 MG, Bayer Aspirin 81 mg, vitamin D3 2000 IU, Centrum Silver, Zinc 50 mg, Valsartan (Diovan)

Current Illness:

ID: 1117874
Sex: F
Age: 37
State: TX

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

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

Lab Data:

Allergies: Tetracycline

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Patient complaint of nausea 15 minutes after received Covid -19 Vaccine.

Other Meds: Symbicort,

Current Illness: None

ID: 1117875
Sex: M
Age: 62
State:

Vax Date: 03/18/2021
Onset Date: 03/20/2021
Rec V Date: 03/20/2021
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:

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

Symptoms: Yesterday evening he was lifting some boxes and moving them to the right and started to experience left-sided upper chest pain. It is described as "tightness" and is constant, radiating to the shoulder with movement. He denies cough, fever or shortness of breath. Ibuprofen taken this AM has helped and over the past couple hours the pain has resolved completely. No recent prolonged travel

Other Meds:

Current Illness:

ID: 1117876
Sex: F
Age: 31
State: WI

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

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

Lab Data:

Allergies: Ceftin, Ibuprofen, Naproxen

Symptom List: Nausea

Symptoms: Patient had nausea immediately after receiving vaccine. Woke up during the night with fever of 103. Feels her heart is racing and is short of breath when walking up stairs. Has also had a headache.

Other Meds: venlafaxine (Effexor) 75 MG tablet; Paragard Intrauterine Copper IUD; prenatal 27-1 MG tablet

Current Illness:

ID: 1117877
Sex: F
Age: 65
State: PA

Vax Date: 03/01/2021
Onset Date: 03/06/2021
Rec V Date: 03/20/2021
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: Sudden onset burning feet.

Other Meds: Trazodone, montelukast, baclofen, mucinex max, multivitamin, vitamin d3.

Current Illness:

ID: 1117878
Sex: M
Age: 26
State: MA

Vax Date: 03/18/2021
Onset Date: 03/19/2021
Rec V Date: 03/20/2021
Hospital:

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

Lab Data:

Allergies: allergic to cefprozil

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

Symptoms: 1:00 after getting vaccine the day before, woke up to chills, body aches, temperature of 99.1 and extreme right arm pain. Fell back to sleep at 6:30 woke up at 11:30 with same symptoms but no fever and an additional strange occurrence of brain fog, felt out of it and disoriented.

Other Meds: Sertraline, aripiprazole, guanfacine

Current Illness: None

ID: 1117879
Sex: F
Age: 61
State: IN

Vax Date: 03/18/2021
Onset Date: 03/19/2021
Rec V Date: 03/20/2021
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: Flu like symptoms. Chills, muscular pain and joint inflammation

Other Meds: Plaquenil, Folic acid. Xeljanz. Singular. Lisinopril. Pro tonic. Prednisone

Current Illness: None

ID: 1117880
Sex: M
Age: 17
State: TX

Vax Date: 03/19/2021
Onset Date: 03/19/2021
Rec V Date: 03/20/2021
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:

Symptom List: Tremor

Symptoms: Patient is 17 years old, EUA is only for age 18 and order

Other Meds:

Current Illness:

ID: 1117881
Sex: F
Age: 63
State: IN

Vax Date: 03/18/2021
Onset Date: 03/18/2021
Rec V Date: 03/20/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Erythema, Pruritus

Symptoms: Chills started 11pm day of shot.. Headache started shortly after. Aches pains especially in legs , fever, and sore injection area.

Other Meds: None

Current Illness: Lactose intolerance

ID: 1117882
Sex: F
Age: 81
State: NC

Vax Date: 01/06/2021
Onset Date: 01/13/2021
Rec V Date: 03/20/2021
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: Macrodantin

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

Symptoms: Within a week of 1st shot, I began to have joint pain... shoulders/neck, hips/top of legs, & knees. Called Dr. after 2 weeks. He said common complaint. Wait Took 2nd dose of Moderna. 2/3/21. Pain continued. By March 1st Dr. setup lab work. Diagnosis: PMR - polymialgia rheumatica My symptoms were fatigue-physical & mental, loss of appetite & weight, aching muscles, and stiffness. Rx: 15mg prednisone which will be reduced gradually. Also worked with physical therapist for 4 sessions to gain strength & flexibility. Still tired, but gradually becoming more active. In

Other Meds: Atorvastatin 10 mg daily Caltrate COQ10

Current Illness: None

ID: 1117883
Sex: M
Age: 47
State: SC

Vax Date: 03/19/2021
Onset Date: 03/19/2021
Rec V Date: 03/20/2021
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: Mango Some fish toxin bees and wasps pollen

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

Symptoms: Started with sore throat and mild cough. By 11:00 PM I had body aches and chills. I could not sleep at all due to chills and body aches. I then had a horrible headache and a fever of 100.4 at 4:00 AM. I still have a headache and body aches at 10:00 AM the next morning.

Other Meds: Atorvastatin Loratindine Vitamin D Singulair CO-Q10

Current Illness: N/A

ID: 1117884
Sex: F
Age: 49
State: NC

Vax Date: 03/19/2021
Onset Date: 03/19/2021
Rec V Date: 03/20/2021
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: Patient states multiple allergic reactions including throat tightness with penicillin, sulfur, nitrofurantoin. Has used Epi Pen in past for allergic reactions - last approximately one year ago.

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Moderna Covid Vaccine EUA: Patient developed sensation of throat tightness approximately 15 to 20 minutes after administration of vaccine while in observation area for 30 minute observation. Evaluated by physician on site. No visible swelling of neck, lips, mouth, face, tongue; no palpable swelling of neck; breath sounds and heart rate normal. Single hive noted on frontal neck above collar bone. Patient took oral diphenhydramine 25 mg and oral famotidine 20 mg. Observation period extended with one on one monitoring. Symptoms resolved within 15 minutes. Total observation of 1 hour after vaccination. Patient and family instructed on management of possible recurrent symptoms. They have managed multiple allergic reactions in past and are comfortable with returning home.

Other Meds: Unknown

Current Illness: Unknown

ID: 1117885
Sex: F
Age: 84
State: CA

Vax Date: 02/19/2021
Onset Date: 02/24/2021
Rec V Date: 03/20/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: A few days after receiving my second vaccine shot I lost my hearing. it was mostly in my right ear . Went to Dr he gave me Afrin for 3 nights, flonaze during day and claritin. After one week no improvement. Went back and was given predzone for 10 days and went for a hearing test. Test showed way below normal both ears. Now have an appointment with an ENT specialist next week. Ears seem to build up with pressure and noise and cause lightheadedness.

Other Meds: Levothroxine, pravachol, zinc, D3, Airborne,

Current Illness: none

ID: 1117886
Sex: F
Age: 29
State: MI

Vax Date: 03/19/2021
Onset Date: 03/20/2021
Rec V Date: 03/20/2021
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: Extremely painful hard lymph node in left armpit

Other Meds:

Current Illness:

ID: 1117887
Sex: F
Age: 26
State: LA

Vax Date: 03/19/2021
Onset Date: 03/19/2021
Rec V Date: 03/20/2021
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: Pain in extremity

Symptoms: Fever (moderate to mild), body aches, chills, nausea.

Other Meds: Lamotrigine (250mgs) & Fluoxetine (20mgs)

Current Illness: N/A

ID: 1117888
Sex: F
Age: 63
State: PA

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

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

Lab Data:

Allergies: Penicillin; cat dander; grass; dust mite; Sensitivity to garlic; gluten Lactose intolerant

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

Symptoms: I started coughing for about an hour around 10pm while I was on a phone call; then developed a fuzziness in my throat and felt like I had mucus in my chest. I took 120 mg Allegra. I started to feel relief after about 10 minutes. I had to relieve my throat of mucus this morning. Other than muscular aches, especially at the site of the vaccine and behind my shoulder, I am ok. About 10 - 11 hours after my first vaccine on 2/26/2021, I developed a similar reaction, however much milder, and took Allegra, which relieved the symptoms.

Other Meds: Synthroid; Metformin; Fenofibrate; Ventolin; Vit D; Multivitamin & Biotin; Beano; Lactase enzyme

Current Illness: Abdominal discomfort Right arm and shoulder pain

ID: 1117889
Sex: F
Age: 29
State: FL

Vax Date: 03/12/2021
Onset Date: 03/12/2021
Rec V Date: 03/20/2021
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: Penicillins Sulfa

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

Symptoms: Day 0- L arm pain, joint pain, body aches, vertigo, headache, exhaustion Day 1- fever, thirst, vertigo, chills, just didn't feel good Day 2- fever, thirst, exhaustion, sun sensitive vertigo (seeing black with in the sun), nausea, chills Day 3- fever, exhaustion, thirst, vertigo, headache, nausea Day 4- fever, exhaustion, thirst, vertigo, headache, nausea Day 5- thirst, exhaustion, vertigo, headache, nausea, large migraine Day 6- extremely exhausted, L arm pain all over again, joint pain, vertigo, headache, just felt off Day 7- exhaustion, thirst, face rash with swelling and warmth and itching, vertigo, headache Day 8- exhaustion, thirst, face rash continues...

Other Meds: Juice Plus Fruits, Veggies, Berries, Omegas Claratin OTC saline nasal spray

Current Illness: seasonal allergies, no other illnesses, negative COVID SARS rapid test

ID: 1117890
Sex: F
Age: 36
State: PA

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

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

Lab Data:

Allergies: None

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

Symptoms: Throwing up 14 hours post vaccine dose

Other Meds: None

Current Illness: None

ID: 1117891
Sex: F
Age: 63
State: IN

Vax Date: 03/18/2021
Onset Date: 03/19/2021
Rec V Date: 03/20/2021
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 drugs and codeine

Symptom List: Vomiting

Symptoms: Existing Osteoarthritis flared up throughout body.

Other Meds: Synthroid 150mg, meloxicam 15mg, sertraline 50mg Ocuvite, one a day women?s 50+

Current Illness: None

ID: 1117892
Sex: F
Age: 45
State: IN

Vax Date: 03/18/2021
Onset Date: 03/18/2021
Rec V Date: 03/20/2021
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: Sulfa

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Chills, body aches, headache, fever started around 4 PM on the date of the injection. Fever increased to 102.3 while taking Tylenol and then started to decrease. Symptoms lasted about 16 hours and have not returned. Only symptom that continued after the 16 hours was a headache but that went away by the following evening.

Other Meds: Birth control, multi-vitamin, probiotics

Current Illness: N/A

ID: 1117893
Sex: M
Age: 80
State: FL

Vax Date: 03/19/2021
Onset Date: 03/19/2021
Rec V Date: 03/20/2021
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: Fever, weak, hallucinating, shaking profusely, cold.

Other Meds: Aspirin 81 mg. Daily Pravastatin 40mg. Daily Plavix 75 mg. Daily Digoxin 125 mcg. 2 times daily Prinivil 2.5 mg. Daily Metoprolol Tartrate 25 mg. Daily

Current Illness: None

ID: 1117894
Sex: M
Age: 61
State: IN

Vax Date: 03/18/2021
Onset Date: 03/18/2021
Rec V Date: 03/20/2021
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: The injection site was painful for a couple of days and I had a red splotchy rash on my chest and neck the day after the vaccination

Other Meds: Fenofibrate 145 mg

Current Illness: Type 2 diabetes

ID: 1117895
Sex: M
Age: 67
State: IN

Vax Date: 03/18/2021
Onset Date: 03/19/2021
Rec V Date: 03/20/2021
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: body aches muscle tightness legs slightly elevated temperature (99degrees)

Other Meds:

Current Illness:

ID: 1117896
Sex: F
Age: 71
State: NM

Vax Date: 03/12/2021
Onset Date: 03/19/2021
Rec V Date: 03/20/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: redness, slight rash, swelling on arm at injection site-delayed reaction

Other Meds: none

Current Illness: none

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm