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: 1399118
Sex: F
Age: 41
State:

Vax Date: 01/09/2021
Onset Date: 01/09/2021
Rec V Date: 01/11/2021
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: Headache, Myalgia, Arthralgia, Fever, Diarrhea, redness and swelling at injection site, runny nose

Other Meds:

Current Illness:

ID: 1399119
Sex: F
Age: 41
State:

Vax Date: 01/06/2021
Onset Date: 01/08/2021
Rec V Date: 01/11/2021
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: Headache, Myalgia, Arthralgia, fatigue Narrative:

Other Meds:

Current Illness:

ID: 1399120
Sex: F
Age: 25
State:

Vax Date: 12/28/2020
Onset Date: 01/04/2021
Rec V Date: 01/11/2021
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:

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

Symptoms: + AXILLARY SWELLING LEFT SIDE WITH LYMPHADENOPATHY ONLY AT LEFT AXILLARY REGION. ITCHING AT Narrative:

Other Meds:

Current Illness:

ID: 1399121
Sex: F
Age: 28
State:

Vax Date: 01/06/2021
Onset Date: 01/07/2021
Rec V Date: 01/11/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Headache, Myalgia, Fever, NauseaVomiting, Injection site pain Narrative:

Other Meds:

Current Illness:

ID: 1399122
Sex: F
Age: 48
State:

Vax Date: 01/05/2021
Onset Date: 01/07/2021
Rec V Date: 01/11/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Numness/Tingling distal to injection site Narrative:

Other Meds:

Current Illness:

ID: 1399123
Sex: F
Age: 55
State:

Vax Date: 12/28/2020
Onset Date: 12/29/2020
Rec V Date: 01/11/2021
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:

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

Symptoms: Myalgia & Fever Experienced severe body aches/pain, terrible chills, fever 100 degree and sore arms. Symptoms lasted 24 hours

Other Meds:

Current Illness:

ID: 1399124
Sex: F
Age: 57
State:

Vax Date: 01/05/2021
Onset Date: 01/07/2021
Rec V Date: 01/11/2021
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: Pyrexia, White blood cell count decreased

Symptoms: Headache, Fever & SkinRash Narrative:

Other Meds:

Current Illness:

ID: 1399125
Sex: F
Age: 43
State:

Vax Date: 12/28/2020
Onset Date: 01/05/2021
Rec V Date: 01/11/2021
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: Pharyngeal swelling

Symptoms: Headache & Myalgia Narrative:

Other Meds:

Current Illness:

ID: 1399126
Sex: F
Age: 60
State:

Vax Date: 01/05/2021
Onset Date: 01/11/2021
Rec V Date: 01/11/2021
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: Myalgia, Fever chills, fatigue Took a couple of days off from work, laid in bed x2 days and let it run it course.

Other Meds:

Current Illness:

ID: 1399127
Sex: M
Age: 50
State:

Vax Date: 01/05/2021
Onset Date: 01/05/2021
Rec V Date: 01/11/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Fatigue Narrative:

Other Meds:

Current Illness:

ID: 1399128
Sex: F
Age: 57
State:

Vax Date: 12/28/2020
Onset Date: 12/29/2020
Rec V Date: 01/11/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Left arm swelling and itching Narrative: Left arm with swelling and itching around border. Swelling about 3-4 inches wide and about 2 inches long. No pain.

Other Meds:

Current Illness:

ID: 1399129
Sex: M
Age: 42
State:

Vax Date: 12/28/2020
Onset Date: 01/06/2021
Rec V Date: 01/11/2021
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:

Symptom List: Rash, Urticaria

Symptoms: Fever & Rash Narrative:

Other Meds:

Current Illness:

ID: 1399130
Sex: F
Age: 57
State:

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 01/11/2021
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: Myalgia, Fever Fatigue

Other Meds:

Current Illness:

ID: 1399389
Sex: F
Age: 44
State:

Vax Date: 12/31/2020
Onset Date: 01/01/2021
Rec V Date: 01/11/2021
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: fatigue, deep pain in ears and neck Pt reported fatigue x24 hours and pain in both ears and neck

Other Meds:

Current Illness:

ID: 1399400
Sex: F
Age: 51
State:

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 01/11/2021
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: Headache FATIGUE, INJECTION SITE PAIN

Other Meds:

Current Illness:

ID: 1399528
Sex: F
Age: 73
State:

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/11/2021
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: Headache Narrative:

Other Meds:

Current Illness:

ID: 1399529
Sex: M
Age:
State:

Vax Date:
Onset Date: 01/06/2021
Rec V Date: 01/11/2021
Hospital:

Vax Type: DTAPHEPBIP
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: DTAP + HEPB + IPV (PEDIARIX)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies:

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

Symptoms: Fever ACHES & PAINS, CHILLS, DIZZY, FATIGUE, POOR APPETITE, INJECTION SITE PAIN Narrative:

Other Meds:

Current Illness:

ID: 1399531
Sex: F
Age: 53
State:

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/11/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Headache ACHES & PAINS, CHILLS Narrative

Other Meds:

Current Illness:

ID: 1399533
Sex: M
Age: 48
State:

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/11/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Headache, Fever, CHILLS, FATIGUE Narrative

Other Meds:

Current Illness:

ID: 1399535
Sex: M
Age: 27
State:

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/11/2021
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: Headache, Fever, ACHES & PAINES, CHILLS Narrative:

Other Meds:

Current Illness:

ID: 1399537
Sex: M
Age: 61
State:

Vax Date: 01/05/2021
Onset Date: 01/06/2021
Rec V Date: 01/11/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Headache, Myalgia, !/6-1/7 Chills, fatigue Narrative:

Other Meds:

Current Illness:

ID: 1399538
Sex: M
Age: 56
State:

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/11/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: Headache, Myalgia, Fever, NauseaVomiting, fatigue, sore arm Narrative: Employee reports 1/7 one hour later his arm started hurting. Then throughout the day the pain got worse and he took Tylenol and ibuprofen. Onset of fatigue and body aches last night. 1/8 0300 woke up with nausea and started throwing up. This afternoon he still has headache, body aches and arm pain. He continues to experience vomiting. Temp to 99.1 He's drinking ginger tea and water and can keep that down. He's staying hydrated. 1/11 employee reports all symptoms have resolved. He felt better around 7:30-8:00 Saturday night.

Other Meds:

Current Illness:

ID: 1399539
Sex: M
Age: 40
State:

Vax Date: 12/28/2020
Onset Date: 12/31/2020
Rec V Date: 01/11/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Myalgia, Arthralgia, NauseaVomiting, fatigue, weakness Narrative:

Other Meds:

Current Illness:

ID: 1399540
Sex: M
Age: 36
State:

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/11/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: HYPOtension Narrative: improved without medication-legs elevated- BP returned to normal-probable vasovagal reaction

Other Meds:

Current Illness:

ID: 1399541
Sex: F
Age: 54
State:

Vax Date: 12/28/2020
Onset Date: 12/28/2020
Rec V Date: 01/11/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Dizziness & Diarrhea Narrative:

Other Meds:

Current Illness:

ID: 1399542
Sex: F
Age: 45
State:

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/11/2021
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:

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

Symptoms: Headache, Myalgia & Fever Narrative: Employee reports body aches, fever, and headache. Temp was up to 103. 1/11 - Employee reports resolution of her symptoms as of 1/9 in the afternoon. Sunday she felt normal.

Other Meds:

Current Illness:

ID: 1399543
Sex: F
Age: 56
State:

Vax Date: 01/05/2021
Onset Date: 01/06/2021
Rec V Date: 01/11/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Headache, Myalgia, Arthralgia, Fever, Fatigue, Chills Narrative:

Other Meds:

Current Illness:

ID: 1399544
Sex: M
Age: 36
State:

Vax Date: 12/23/2020
Onset Date: 12/26/2020
Rec V Date: 01/11/2021
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: Dizziness, Fever, NauseaVomiting, chills, ocular pressure, fatigue Narrative: Employee states that he had vaccine on 12/23, starts having symptoms 3 days after vaccine. Employss noted nausea, fatigue, ocular pressure, chills and fever. Employee states he felt slightly better on day4. Symptoms worsened on day 5. Employee states resolution of symptoms as of 01/02/21.

Other Meds:

Current Illness:

ID: 1399545
Sex: M
Age: 42
State:

Vax Date: 01/05/2021
Onset Date: 01/06/2021
Rec V Date: 01/11/2021
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: Headache, Myalgia, SkinRash & Rash Narrative: Employee reports arm soreness, redness at injection site and 2-4 inch raised "hive." Employee further reports headache, body ache, sweat and fatigue. She has taken Tylenol with relief, reports that condition is improving.

Other Meds:

Current Illness:

ID: 1399546
Sex: F
Age: 24
State:

Vax Date: 12/28/2020
Onset Date: 12/29/2020
Rec V Date: 01/11/2021
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: Nausea

Symptoms: Arm pain, redness Narrative:

Other Meds:

Current Illness:

ID: 1399547
Sex: F
Age: 60
State:

Vax Date: 12/31/2020
Onset Date: 01/01/2021
Rec V Date: 01/11/2021
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: Fever Fatigue Narrative:

Other Meds:

Current Illness:

ID: 1399548
Sex: M
Age: 52
State:

Vax Date: 01/06/2021
Onset Date: 01/07/2021
Rec V Date: 01/11/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Myalgia, Arthralgia, Fever, Diarrhea, Nausea Vomiting, fatigue Narrative:

Other Meds:

Current Illness:

ID: 1399549
Sex: F
Age: 46
State:

Vax Date: 12/22/2020
Onset Date: 12/23/2020
Rec V Date: 01/11/2021
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:

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

Symptoms: Myalgia Fatigue Narrative:

Other Meds:

Current Illness:

ID: 1399550
Sex: M
Age: 38
State:

Vax Date: 01/05/2021
Onset Date: 01/05/2021
Rec V Date: 01/11/2021
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: Headache, Myalgia, NauseaVomiting, 1/5 lethargic. 1/6 severe lethargy, low grade fever, headache, muscle aches. 1/7 nausea, headache, muscle aches, lethargy. 1/8 headache. Narrative: 1/5 lethargy 1/6 severe lethargy, feeling sick, afternoon fever 37.2C up to midnight 38 C, headache, muscle aches. 1/7 nausea headache, muscle aches, lethargy. 1/8 headache. Instructed to call COVID result negative.

Other Meds:

Current Illness:

ID: 1399551
Sex: F
Age: 42
State:

Vax Date: 01/01/2021
Onset Date: 01/05/2021
Rec V Date: 01/11/2021
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: Erythema, Pruritus

Symptoms: Headache, Myalgia, Fatigue, Chills Narrative:

Other Meds:

Current Illness:

ID: 1399552
Sex: F
Age: 38
State:

Vax Date: 12/26/2020
Onset Date: 01/02/2021
Rec V Date: 01/11/2021
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:

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

Symptoms: Rash, UrticariaPruritus, Redness, slightly tender and warm Narrative:

Other Meds:

Current Illness:

ID: 1399553
Sex: F
Age: 44
State:

Vax Date: 12/31/2020
Onset Date: 01/04/2021
Rec V Date: 01/11/2021
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: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: Headache, Diarrhea, Stomach cramps, nausea Narrative:

Other Meds:

Current Illness:

ID: 1399554
Sex: F
Age: 43
State:

Vax Date: 12/30/2020
Onset Date: 01/01/2021
Rec V Date: 01/11/2021
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: Asthenia, Chills, Headache, Myalgia

Symptoms: ErythemaMultiform Injection site pain, edema erythema Narrative:

Other Meds:

Current Illness:

ID: 1399555
Sex: F
Age: 31
State:

Vax Date: 01/07/2021
Onset Date: 01/09/2021
Rec V Date: 01/11/2021
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: Headache, Myalgia, CoughWheeze, sore throat Narrative: Started having a sore throat and cough 3 days later, voice is hoarse sounding. Taking OTC medication for headache, nothing for cough or sore throat today.

Other Meds:

Current Illness:

ID: 1399556
Sex: F
Age: 38
State:

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/11/2021
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: Fever Chills, tingling left side of her face Narrative: 1/7 - felt like the watch on her wrist was heavy. Took tylenol and went home. At 1:00 onset of chills. At 9:00 pm onset of fever to 103. She also reports her face tingled like it did last time. The tingling is on the left side under her eye and above her lip. 1/8 her temperature is down to 100 degrees and the tingling is still present. 1/11 all symptoms resolved except minor tingling in her face. She is seeing her neurologist tomorrow for underlying neurological diagnosis and will let me know if the tingling doesn't resolve.

Other Meds:

Current Illness:

ID: 1399557
Sex: M
Age: 38
State:

Vax Date: 12/29/2020
Onset Date: 12/30/2020
Rec V Date: 01/11/2021
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: Pain in extremity

Symptoms: Dizziness, Headache, Arthralgia, Fever, Tachycardia, Chills Narrative:

Other Meds:

Current Illness:

ID: 1399558
Sex: M
Age: 28
State:

Vax Date: 01/05/2021
Onset Date: 01/05/2021
Rec V Date: 01/11/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Fever CHILLS Narrative:

Other Meds:

Current Illness:

ID: 1399559
Sex: M
Age: 59
State:

Vax Date: 12/30/2020
Onset Date: 12/31/2020
Rec V Date: 01/11/2021
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: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: Myalgia, Diarrhea 12/31 severe body aches (back,neck,hip aches), GI distress (diarrhea) 12/31 severe body aches (sometimes happens using laptop): back, neck, and hip aches, GI distress (diarrhea). 1/1 faded away. previous Covid positive 3/23/2020. Patient reports these were the symptoms he had when he had COVID

Other Meds:

Current Illness:

ID: 1399560
Sex: F
Age: 31
State:

Vax Date: 12/23/2020
Onset Date: 12/23/2020
Rec V Date: 01/11/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Myalgia Narrative: Since receiving the vaccine, pain in my left shoulder has increased. At first, I thought it was related to standard injection site soreness. Pain progressed and on New Year's Day, I heard crackling (sounded like crepitus) when trying to rotate my shoulder, Ibuprofen has been adequate for pain control but without it, I'd give the pain a 7/10 with movement and 4/10 at rest.

Other Meds:

Current Illness:

ID: 1399561
Sex: F
Age: 37
State:

Vax Date: 12/28/2020
Onset Date: 12/28/2020
Rec V Date: 01/11/2021
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: Myalgia Narrative:

Other Meds:

Current Illness:

ID: 1399562
Sex: F
Age: 47
State:

Vax Date: 12/29/2020
Onset Date: 12/30/2020
Rec V Date: 01/11/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Headache Narrative:

Other Meds:

Current Illness:

ID: 1399563
Sex: M
Age: 57
State:

Vax Date: 01/11/2021
Onset Date: 01/06/2021
Rec V Date: 01/11/2021
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: Back pain, Cold sweat, Headache, Nausea, Vomiting

Symptoms: Myalgia arm sore and chills Narrative: missed two days of work

Other Meds:

Current Illness:

ID: 1399564
Sex: M
Age: 55
State:

Vax Date: 01/05/2021
Onset Date: 01/06/2021
Rec V Date: 01/11/2021
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:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Diarrhea exhausted, diarrhea, and chills Narrative:

Other Meds:

Current Illness:

ID: 1399565
Sex: F
Age: 59
State:

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/11/2021
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: Myalgia bruising at injection site-size of a quarter Narrative:

Other Meds:

Current Illness:

ID: 1399566
Sex: M
Age: 53
State:

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/11/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Myalgia Narrative:

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm