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: 1118157
Sex: M
Age: 41
State: IL

Vax Date: 02/11/2021
Onset Date: 02/19/2021
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: LA

Lab Data:

Allergies: None

Symptom List: Dysphagia, Epiglottitis

Symptoms: COVID Arm -- Painful rash that was symmetrical around the injection site in left arm. This lasted for 3-4 days and then faded. It measured around 5" diameter on average and was more or less a circle on my shoulder moving down my arm.

Other Meds: None

Current Illness: None

ID: 1118158
Sex: F
Age: 69
State: PA

Vax Date: 03/20/2021
Onset Date: 03/20/2021
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: Amiodarone, amoxicillin, aspirin, erythromycin, gabapentin, keflex, linzess, meloxicam, Naprosyn, prednisone, lyrica, protonix. soma, sotalol, valium

Symptom List: Anxiety, Dyspnoea

Symptoms: Patient stated that after 10 minutes she started to develop tinging in the back of throat. She made healthcare provider aware after sitting for 30 minutes. Benadryl given and patient sat for 20 more minutes. Symptoms worsened with irritation down her throat and tingling into the tongue. 911 called

Other Meds:

Current Illness:

ID: 1118159
Sex: M
Age: 62
State: AK

Vax Date: 02/19/2021
Onset Date: 02/19/2021
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: N/A

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

Symptoms: Difficulty breathing, throat swelling (feels like it is) dizziness and weakness, nausea, feeling unwell, fever headache, tiredness and injection site pain

Other Meds: Lisonapril, Synthroid, Metforman

Current Illness: N/A

ID: 1118160
Sex: M
Age: 51
State: CA

Vax Date: 02/05/2021
Onset Date: 02/06/2021
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: Compazine

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Slight injection site pain following morning (2/6). By late evening 2/6 approx 1830 hours, my joints ached and I got very sleepy. Generally just felt worn out. Went to bed and woke up 2/7 perfectly fine. No more fatigue or aching joints, just slight injection site pain for a couple more days.

Other Meds: Sumatriptan

Current Illness: TBI induced migraines from combat zone

ID: 1118161
Sex: F
Age: 23
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: LA

Lab Data:

Allergies: none

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

Symptoms: The first day I got my vaccine, I felt fine, but my arm with the injection sight was very sore and body slightly achy. The second day I woke up and my arm was sore, but other than that I felt normal. Around 4pm on the second day, my back started to hurt where the break break in my spine is. It was just a normal amount of pain at first, but within an hour there was throbbing pain in my lower back, spreading into my legs. This is where I normally feel my chronic pain, but I had a spinal injection a little over 6 months ago and doesn't usually stop working until about a year. It is the normal pain I experience in the normal places, but the pain is worse and out of no where. That is not usually how the pain comes on when the spinal block wears off. It is much more gradual. It could be a coincidence, but the pain is not the way I have ever experienced the pain. My back hurts too much to do things I need to do to function, which only happens to me when I have done something with a lot of physical activity that puts tension on my back like jumping, dancing, roller coasters. Before I started experiencing this pain, it was just a normal day for me where I didn't exert my back any more than normal, which is very little.

Other Meds: CBD, charlotte 24 Fe

Current Illness: No illnesses

ID: 1118162
Sex: F
Age: 53
State: OH

Vax Date: 03/13/2021
Onset Date: 03/15/2021
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

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

Symptoms: On Monday, March 15th patient experienced a muscle tightening in her right leg, similar to a Charlie horse. Then on Thursday, March 18th patient experienced a lump, tightening sensation on the inner side of her right inner elbow.

Other Meds: none

Current Illness: none

ID: 1118163
Sex: F
Age: 68
State: NC

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: LA

Lab Data:

Allergies: none

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: 3:00 am woke up and vomited, Continued to wake up with 3 bouts of diarrhea, had chills & fever of 101, slept in until 10:00, got up and took 1st dose of ibuprofin, felt achy and very lethargic all morning and afternoon, Continued to take doses of ibuprofin, Fever came down and some achiness went away due to ibuprofin, felt better by evening (24 hrs. after shot) but still had slight fever and still fatigued. By morning of 3/20 I felt much better.

Other Meds: Calcium, Vitamin D, Collagen powder, Tretinoin cream (face)

Current Illness: none

ID: 1118164
Sex: M
Age: 30
State: UT

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: LA

Lab Data:

Allergies: None

Symptom List: Pharyngeal swelling

Symptoms: Seizure, nausea, tingling in fingers, stiffness in arms, patient felt hot

Other Meds: None

Current Illness: None

ID: 1118165
Sex: F
Age: 65
State: CA

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

Lab Data:

Allergies: Cantaloupe

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Pfizer-BioNtech COVID-19 Vaccine EUA: 3/16 Left arm was sore at injection site, ached when I moved my arm, No Treatment. But, not as sore as it was after 1st injection. 3/17 Day after injection, very tired all day. Went to bed at 7:30pm. Arm soreness waning. No Treatment. 3/18 Noticed slight dizziness, sometimes. Not as tired. Arm pain almost gone, just a bruised feeling at injection site. No Treatment. 3/20 Dizziness more noticeable, today. My head feels like it's full of cotton. No Treatment.

Other Meds: Levothyroxine 50mcg, Zyrtec 5mg

Current Illness: None

ID: 1118166
Sex: M
Age: 65
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: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Codeine

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Headache fever coughing

Other Meds: Synthroid,lisonipril,glucosamine, montelukast,allopurinol, pravastatin, aspirin

Current Illness: None

ID: 1118167
Sex: F
Age: 46
State: AR

Vax Date: 03/20/2021
Onset Date: 03/20/2021
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: NKA

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

Symptoms: No adverse event. Just the needle malfunction

Other Meds: Needle retracted early. Patient did not receive the full dose.

Current Illness: NA

ID: 1118168
Sex: F
Age: 72
State: IN

Vax Date: 03/04/2021
Onset Date: 03/05/2021
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: none

Symptom List: Rash, Urticaria

Symptoms: vomiting ,diarrhea, headache, muscle weakness, chills, fever, loss of conscious, fatigue. Loss of conscious resulted in hitting my as I hit the floor. Sustained a sore spot and bruise. More severe effects lasted for about 24 hrs, fatigue about 1 week or so.

Other Meds: timolol lumigan

Current Illness: none

ID: 1118169
Sex: F
Age: 76
State: FL

Vax Date: 03/08/2021
Onset Date: 03/08/2021
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 various chemicals etc for example dye in fake crab. .dont know I am allergic till Ii experience it then avoid item

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

Symptoms: half hour after receiving shot tongue and throat swelled up and short of breathe. Throat was sore for few days and short of breathe remained for almost a week It is 12 days and feel better but do not know if I should get second shot

Other Meds: lisinopril, eliquis, singular, duloxetine, ,simvastatin, metoprolol, vitamins

Current Illness: none

ID: 1118170
Sex: F
Age: 24
State: IL

Vax Date: 03/20/2021
Onset Date: 03/20/2021
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: None

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

Symptoms: Light headed, hot, dizzy. Started within 5 minutes of vaccination. Provided apple juice and water to patient. Felt better after 25 minutes.

Other Meds: Non reported

Current Illness: No

ID: 1118171
Sex: F
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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Penicillin

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

Symptoms: Fever of 99 to 101 until 4pm 3/19. Extreme fatigue.

Other Meds: Estradiol

Current Illness:

ID: 1118172
Sex: F
Age: 27
State: CO

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

Lab Data:

Allergies:

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

Symptoms: Large hive on upper arm that was injected

Other Meds:

Current Illness:

ID: 1118173
Sex: M
Age: 73
State: IN

Vax Date: 03/18/2021
Onset Date: 03/18/2021
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: Severe headache, pain in left arm, and on Saturday severe neck pain left side.

Other Meds:

Current Illness: RA

ID: 1118174
Sex: M
Age: 73
State: KY

Vax Date: 03/15/2021
Onset Date: 03/17/2021
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: PCN

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Legs became weak and unable to stand

Other Meds: Norco, amlodipine, spironolactone, irbesartan, Sotalol, Finasteride, Tamsulosin, prednisone, Aspirin, Furosemide, cyclobenzapr, Gabapentin

Current Illness: COPD, HTN, Chronic Pain, BPH, hyperlipidemia

ID: 1118175
Sex: F
Age: 90
State: MI

Vax Date: 01/20/2021
Onset Date: 01/21/2021
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: NSAIDS

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: unrelenting pain for 6 days, then in the area on the right side, opposite to the injection site, she broke out in shingles

Other Meds: lisinopril, levothyroxine sodium 0.05mg, omeprazole 20 mg, trazodone, doxepin

Current Illness:

ID: 1118176
Sex: M
Age: 39
State: MI

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

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

Symptoms: Soreness at the injection site and heart palpitations.

Other Meds:

Current Illness:

ID: 1118177
Sex: M
Age: 26
State: CT

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: no

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

Symptoms: While in observation for 15 minute post vaccination observation period, recipient complained of dizziness, numbness, light headed, tight chest

Other Meds: unknown

Current Illness: none

ID: 1118178
Sex: F
Age: 39
State: NY

Vax Date: 03/15/2021
Onset Date: 03/15/2021
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: fungus, pollen

Symptom List: Unevaluable event

Symptoms: Generalized urticaria, diffuse erythematous, blue bruise like marks on legs.

Other Meds: No

Current Illness: No

ID: 1118179
Sex: F
Age: 57
State: MT

Vax Date: 03/11/2021
Onset Date: 03/11/2021
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: Medication and food allergies. No previous vaccine reactions; just the COVID19 vaccine.

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

Symptoms: - Slightly elevated temperature of 99.9 degrees F - Diarrhea - Nausea - Chills - Headache - Soreness at vaccine site - Dizziness

Other Meds: None.

Current Illness: Currently undergoing treatment for stage 4 breast cancer.

ID: 1118180
Sex: F
Age: 48
State: TX

Vax Date: 03/10/2021
Onset Date: 03/10/2021
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: Allergies to Flexeril and Codeine

Symptom List: Injection site pain, Pain

Symptoms: Approximately thirty minutes after the injection, i started having right leg muscular pain and spasms. The next morning I woke up with with full body spams, extreme fatigue and severe migraine. The left side of my face has continued spasms that has not stopped and under my left eye continues to spasm and has spasmed non stop. I'm feeling very weak. My symptoms have not improved and it has been over a week.

Other Meds: Tamoxifen 20 mg - one tablet daily. Dexilant 60 mg - one capsule daily. Amoxicillin 500 mg - three capsules daily x seven days. 03/10/2021 first day of seven. Topiramate 25 mg - one tablet three times per day. Cambia 50 mg - packet as need

Current Illness: Tooth infection. Allergies

ID: 1118181
Sex: F
Age: 78
State: SD

Vax Date: 03/09/2021
Onset Date: 03/09/2021
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: tetracycline, amaxaylin

Symptom List: Injection site pain, Menorrhagia

Symptoms: Brain confusion (1 hour), headache (3 days), body aches (3 days), vomiting (2 days). weakness & tiredness (5 days). No treatment for any of above.

Other Meds: multi vitamin, fish oil, calcium citrate, D3, MSM, saw palmetto

Current Illness: none

ID: 1118182
Sex: F
Age: 58
State: IA

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: SYR
Vax Site: LA

Lab Data:

Allergies: Hydrocodone, oxycodone, PCN, latex

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

Symptoms: She had received her first Covid vaccination this afternoon and following that she became dizzy and had a syncope spell. She tells me that with previous vaccinations this has routinely happened and so it is not different. She was not aware of her surroundings for about 2 minutes after this happened although there was no witnessed jerking or seizure movement. At this point she feels about 90 to 95% back to normal and denies any pain anywhere including in her chest. Initially she had some tingling in her arms although that has resolved.

Other Meds:

Current Illness:

ID: 1118183
Sex: M
Age: 77
State: IN

Vax Date: 02/18/2021
Onset Date: 02/18/2021
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: None

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Flu like symptoms. Chills and fever, weakness, headache

Other Meds: Metoprolol Lovastatin Losartan Aspirin Multi vitamin

Current Illness: None

ID: 1118184
Sex: M
Age: 63
State: MI

Vax Date: 03/20/2021
Onset Date: 03/20/2021
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: Seroquel and shell fish

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Patient signed up for vaccination clinic with Healthcare. He answered his screening questions indicating that he had not previously received a Covid vaccination or another other vaccination in the last 14 days. However, when the pharmacy went to bill the prescription to the patients prescription insurance it was found out that the patient received their fist dose of Moderna vaccine on 3/16/21 at Pharmacy. Healthcare called Pharmacy and confirmed the dose was administered on 3/16/21.

Other Meds: n/a

Current Illness: n/a

ID: 1118185
Sex: F
Age: 73
State: AZ

Vax Date: 03/17/2021
Onset Date: 03/17/2021
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: n/

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

Symptoms: Sore right arm, fever, nausea chills, rash, headache

Other Meds: n/a

Current Illness: n/a

ID: 1118186
Sex: M
Age: 56
State: IN

Vax Date: 03/15/2021
Onset Date: 03/17/2021
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: None

Symptom List: Nausea

Symptoms: First Shot of the covid vaccine. Started with a slight headache, chills, and muscle ache approximately 36hrs. after the shot. The symptoms progressively worsened throughout the day followed with an additional symptom of a slight fever (99.5?F) around 48 hrs. after the shot. A dose of Ibuprofen, plenty of fluids, and rest resulted in all of the symptoms running their course with 60 hr. after the shot.

Other Meds: None

Current Illness: None

ID: 1118187
Sex: F
Age: 68
State: AR

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: LA

Lab Data:

Allergies: Gluten

Symptom List: Injection site pain

Symptoms: Severe chills for 1.5 hr despite multiple heated blankets, comforter, etc.; high fever, severe headache (pain in ears and eyes as well as head), severe muscle and joint pain body-wide, skin painful to touch. Symptoms so severe that sleep was impossible for most of night. Headache severity lessened by 8a.m. 3/20, but is still present, and widespread joint pain, myalgia and fatigue continue up to the time of this report (24 hrs after injection).

Other Meds: Multivitamin, Omega-3 Fatty Acids, Glucosamine/Chondroitin

Current Illness: None

ID: 1118188
Sex: F
Age: 64
State: FL

Vax Date: 03/20/2021
Onset Date: 03/20/2021
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: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Metallic taste in mouth, mild headache

Other Meds: Cartia XT 120mg

Current Illness: None

ID: 1118189
Sex: F
Age: 32
State: WI

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

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

Symptoms: Patient had the second dose of vaccine on 03/15/21. On 03/16/21 patient began to develop some feelings of cold feet and foot swelling in the evening. The following day the patient's care giver noted a purple-ish rash of the feet and ankles. By the following day the rash was progressing and more prominant. On 03/19/21 Patient presented to the emergency department with progressive rash on legs and new rash on hands. Patient had no other symptoms, rash was otherwise asymptomatic except for feelings of cold extremities. Rash was identified by myself as Livedo Reticularis which is a moderate sized vessel vasculitis. This can be immune complex mediated. Sent to Dermatology for same day punch biopsy. Results currently pending.

Other Meds: ? prazosin (MINIPRESS) 1 MG capsule Take two tablets by mouth at bedtime ? meclizine (ANTIVERT) 12.5 MG tablet Take 1 tablet by mouth 3 times daily as needed for Dizziness. 90 tablet 3 ? medroxyPROGESTERone (DEPO-PROVERA) 150 MG/ML inje

Current Illness: New diagnosis of asymptomatic UTI.

ID: 1118190
Sex: F
Age: 43
State: ME

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: Dust

Symptom List: Tremor

Symptoms: Soreness in upper left arm for at least 18 hours.

Other Meds: Nasacort

Current Illness: None

ID: 1118191
Sex: M
Age: 27
State: IL

Vax Date: 03/15/2021
Onset Date: 03/16/2021
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: 3x days pain at injection site 3x days headaches 3x days loss of appetite 2x days fever 2x days debilitating neck pain fully recovered 4 days after injection

Other Meds: none

Current Illness: none

ID: 1118192
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: 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: Shellfish Cashews

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

Symptoms: Extreme Nausea Diarrhea Body Aches Chills Neck ache

Other Meds: Metformin Lunseta Nexletol Muilt Vitamin Fish oil

Current Illness: None

ID: 1118193
Sex: M
Age: 45
State: NY

Vax Date: 03/20/2021
Onset Date: 03/20/2021
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: denies, NKDA

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

Symptoms: pt felt lightheaded and was taken to triage area. vitals taken and were bp 147/83, HR 86, Po2 97. pt had a vasovagal episode and lost consciousness for 1 second. regained consciousness. pt states this has happened before. last time was 1 .5 years ago at work. pt states he is feeling well and feels fine to go home.

Other Meds: Amlodipine, Zoloft, singular

Current Illness: High blood pressure, hx of syncopal episodes, seasonal allergies,

ID: 1118194
Sex: F
Age: 51
State: NJ

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

Lab Data:

Allergies: Sulfa medication

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: I had stomach pain about 2 hours after the injection. I went to sleep at 10 pm and woke up at 2 am to go to the bathroom. My legs felt like I could barely move them but I was able to go the bathroom. Once I got up and walked toward the bathroom door I hit my head into the door. I ended up on the floor. I sat up and my husband came in. He said I was mumbling incoherently and then passed out for about 28 seconds. He said my arms were moving up and down while passed out. I woke up covered in sweat and he put me in bed. I slept until 8 am and then woke up with a headache, nausea, body aches and dizziness. The headache and dizziness lasted until 3/18/21.

Other Meds: Lorzepam .5 ml

Current Illness: Shingles Urinary Tract Infection

ID: 1118195
Sex: M
Age: 71
State: TN

Vax Date: 03/10/2021
Onset Date: 03/15/2021
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: Shingles

Other Meds:

Current Illness:

ID: 1118196
Sex: F
Age: 42
State: CA

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

Lab Data:

Allergies: NKDA

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

Symptoms: Chest pain, palpitations, dizziness, LT arm tingling

Other Meds: Diltiazem 120mg PO QD

Current Illness:

ID: 1118197
Sex: M
Age: 85
State: CA

Vax Date: 03/15/2021
Onset Date: 03/17/2021
Rec V Date: 03/20/2021
Hospital: Y

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

Lab Data:

Allergies: none

Symptom List: Pain in extremity

Symptoms: 2 days after receiving the second moderna vaccine my father experienced a stroke. He was transported to the emergency room medical center where he went thru a procedure to remove a clot in his left side brain. Prior to this vaccine my father was in good health and was very active and still works and owns and operates a restaurant. He has never had any problems like this before the vaccine. One day after the vaccine he was complaining about a pain on the left side of his neck area. He was doing paperwork at approx 7:40pm when he experienced the stroke. I had to call 911. My father is currently at the medical center recovering from the incident.

Other Meds: none

Current Illness: none

ID: 1118198
Sex: F
Age: 71
State: HI

Vax Date: 03/08/2021
Onset Date: 03/11/2021
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

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

Symptoms: A few days after injection low grade fever - 99-100 degrees F, fatigue, severe aching neck and back After about 7-8 days intense itching arm, raised red area, swelling at injection site. Still with me today

Other Meds: InderalLA80, Lomotil, Lipitor10mg Advil, Forteo, vitamin D 10,000 units, Ritual women?s Multiple Vitamin

Current Illness: None

ID: 1118199
Sex: F
Age: 40
State: TX

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

Lab Data:

Allergies: None

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

Symptoms: flat, red, non-itchy rash about 1.5"x3" appearing 9 days following injection. General lethargy presenting, but no other discomfort or illness.

Other Meds: Melatonin

Current Illness: None

ID: 1118200
Sex: M
Age: 68
State: GA

Vax Date: 03/19/2021
Onset Date: 03/20/2021
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: NA

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

Symptoms: Pain at vaccination site and chills

Other Meds: Omerprazole

Current Illness: NA

ID: 1118201
Sex: M
Age: 23
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: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: Felt fine after the shot all day. Around midnight (between March 19/20) began to have cold chills and headache. Woke up periodically through the night for stomach queasiness + sweating heavily

Other Meds:

Current Illness:

ID: 1118202
Sex: F
Age: 38
State: CA

Vax Date: 01/28/2021
Onset Date: 02/24/2021
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 Cipro

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: I was not pregnant when I got the vaccine. I think I found out on 2/10 and 2 weeks into the pregnancy, I started bleeding. I called my doctor and was told to come in. I had an ultrasound and there was not sign of the pregnancy, so I had to have a Rhogam shot due to being B-. I bled about 5-7 days afterwards.

Other Meds: Zoloft

Current Illness:

ID: 1118203
Sex: F
Age: 65
State: IN

Vax Date: 03/16/2021
Onset Date: 03/16/2021
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: No

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

Symptoms: Started with chills in the evening of the day of my vaccination, had body aches, headache and fever of 102 by the next day at 2 pm.

Other Meds: Calcium, Phillips Fiber Gummies, Vitamins B-12, and Solaray Multidophilus 20 Billion CFU and Omeprazole

Current Illness: No

ID: 1118204
Sex: M
Age: 51
State: CA

Vax Date: 03/06/2021
Onset Date: 03/06/2021
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: Compazine

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Same evening, 3/6 at about 2000 hours, got cold chills and the shakes. Felt exhausted and all muscles ached. The next morning 3/7 at approximately 0830, same effects as previous, but also a horrible migraine and vomiting. Took one 6ml injection Sumatriptan for migraine in opposite arm from Covid vax, no effect and no relief. 1300 hours, migraine was so intense, I advised my wife I would do a 2nd Sumatriptan injection and if it didn't work, I would need to be brought to the emergency room. 2nd injection was successful in relieving migraine approx 45 min after injection. Felt run down, but was able to go to work the next morning 3/8. Felt tired and run down on 3/8, but symptoms went away by late evening. This was surprising, since my first Covid vax dose 4 weeks prior didn't affect me as bad as this 2nd dose

Other Meds: Sumatriptan

Current Illness: TBI induced migraines from combat

ID: 1118205
Sex: M
Age: 74
State: AZ

Vax Date: 03/08/2021
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: LISINOPRIL

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

Symptoms: ON DAY 11 AFTER VACCINATION DEVELOPED TENDER LUMP IN IPSILATERAL AXILLA

Other Meds: AMARYL, METFORMIN, MICARDIS, LIPITOR, CHLORTHALIDONE, ASPIRIN,

Current Illness: NONE

ID: 1118206
Sex: F
Age: 62
State: CA

Vax Date: 03/20/2021
Onset Date: 03/20/2021
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: PCN, Erythromycin

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

Symptoms: Lightheadedness. Observation with juice.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm