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: 1121046
Sex: F
Age: 37
State: LA

Vax Date: 03/11/2021
Onset Date: 03/18/2021
Rec V Date: 03/21/2021
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: N/A

Symptom List: Dysphagia, Epiglottitis

Symptoms: Redness and hardness at injection site on left arm.

Other Meds: 20 mg lexapro 100 mg trazadone

Current Illness: N/A

ID: 1121047
Sex: M
Age: 30
State: GA

Vax Date: 03/21/2021
Onset Date: 03/21/2021
Rec V Date: 03/21/2021
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: N/A

Symptom List: Anxiety, Dyspnoea

Symptoms: PATIENT PASSED OUT OF CHAIR ABOUT 12 MINUTES AFTER RECIEVING VACCINATION. SLOWLY FELL TO GROUND. DID NOT HURT HIS HEAD OR ANY OTHER BODY PART. IMMEDIATELY REGAINED CONSCIOUSNESS. KNEW WHO HE WAS AND WHERE HE WAS. REQUESTED WATER WHICH WAS GIVEN TO HIM. WAS VERY WARM TO TOUCH AND LIGHTLY SWEATING AROUND THE FOREHEAD. 911 WAS CALLED. EMTS CHECKED VITAL SIGNS AND COGNITIVE FUNCTIONS. PT COULD STAND UP AND WALK ON HIS OWN BUT WAS ESCORTED OUT OF STORE ON STRETCHER FOR SAFETY.

Other Meds: N/A

Current Illness: N/A

ID: 1121048
Sex: F
Age: 38
State: CA

Vax Date: 03/19/2021
Onset Date: 03/20/2021
Rec V Date: 03/21/2021
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: Allergy to Keflex Lactose and caffeine intolerant

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

Symptoms: Pain, rash, swelling, itchiness at/around injection site. Slight tingling from elbow to fingertips on same arm as injection. This feeling is similar to when a body part falls asleep and then gets tingly when waking up. Time and ice pack are the treatment. Still experiencing event a day after initial onset.

Other Meds: Valacyclovir 1 gram pill daily Fish oil gel cap daily Children?s multivitamin daily

Current Illness: N/A

ID: 1121049
Sex: M
Age:
State: NH

Vax Date:
Onset Date:
Rec V Date: 03/21/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Sinus congestion 3/20 and arm muscle spasms 3/21

Other Meds: Vitamin D and B12

Current Illness: None

ID: 1121050
Sex: F
Age: 74
State: AZ

Vax Date: 03/20/2021
Onset Date: 03/20/2021
Rec V Date: 03/21/2021
Hospital:

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

Lab Data:

Allergies: Naprosyn 30 years ago

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

Symptoms: Nose bleeding after 15 hours of vaccine

Other Meds: Losartan, Amlodipine Atorvastatin, Aspirin, Fish Oil, Vitamin D, Centrum, Vitamin C

Current Illness: High Blood Pressure , Head Ache

ID: 1121051
Sex: F
Age: 61
State: CA

Vax Date: 03/05/2021
Onset Date: 03/12/2021
Rec V Date: 03/21/2021
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: Sulfa drugs and penicillin antibiotics

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

Symptoms: When I received my vaccination the nurse mentioned there was a little blood. One week to the day I started experiencing an itch around the injection sight. I was woken a few times thru the evening itching my arm. In the morning the area of my arm that received the injection was warm to touch, swollen and it looked like I was punched in the arm. The red bruise that appeared was round and the diameter of an orange. This lasted till Monday. I took 1 Benadryl tablet Monday evening and went to sleep Woke up Tuesday morning and the redness, itch and swelling were gone

Other Meds: Prednisolone acetate ophthalmic suspension USP 1% 4x daily Ofloxacin Ophthalmic Solution, USP 0.3% 4x daily Vital Reds concentrated Polyphenol Blend Dietary Supplement

Current Illness: NONE

ID: 1121052
Sex: F
Age: 66
State:

Vax Date: 02/18/2021
Onset Date: 02/18/2021
Rec V Date: 03/21/2021
Hospital:

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

Lab Data:

Allergies: Codeine

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Tinnitus, still continuing

Other Meds: Levothyroxine

Current Illness: None

ID: 1121053
Sex: F
Age: 63
State: PA

Vax Date: 03/18/2021
Onset Date: 03/18/2021
Rec V Date: 03/21/2021
Hospital:

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

Lab Data:

Allergies: NKA

Symptom List: Pharyngeal swelling

Symptoms: Shortly after receiving the vaccine my left arm in the elbow turned red and welts arose. I received 2 doses of children's benedryl and after 10 or 15 minutes the adverse effects were better, less redness and welts subsiding

Other Meds: anastrozole metformin farxiga montelukast B-12 paroxotene metropolol furosemide aspirin calcium

Current Illness: none

ID: 1121055
Sex: F
Age: 76
State: WI

Vax Date: 03/13/2021
Onset Date: 03/20/2021
Rec V Date: 03/21/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: Moderna COVID-19 Vaccine EUA 2 hour episode of diarrhea day of injection. Rash on upper biceps area appeared 1 week after vaccine.

Other Meds: Carvedilol, spironolactone, lisinopril, 81mg aspirin, glucosamine and chondroitin, magnesium, calcium and phosphorous, probiotic,

Current Illness: None

ID: 1121056
Sex: M
Age: 42
State: NC

Vax Date: 03/19/2021
Onset Date: 03/19/2021
Rec V Date: 03/21/2021
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: Diarrhea

Other Meds:

Current Illness:

ID: 1121057
Sex: M
Age: 58
State:

Vax Date: 03/16/2021
Onset Date: 03/17/2021
Rec V Date: 03/21/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

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

Symptoms: Severe abdominal pain, vomiting, diahrea, chills, headache, body aches, pain in wrist, these lasted about 2 days.

Other Meds: Lisinopril, Amlodipine, Cardiverol, Atorvistatin, Omeprazole

Current Illness: None

ID: 1121058
Sex: F
Age: 62
State: NH

Vax Date: 03/21/2021
Onset Date: 03/21/2021
Rec V Date: 03/21/2021
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: When recipient arrived, it was believed she had received Pfizer in the past due to a screening issue before recipient saw the vaccinator. Previous dose was not documented in VAMS. Vaccinator administered the Pfizer vaccine, then the patient brought back her card to show that she initially got the moderna vaccine. Patient showed no adverse signs or symptoms. Vitals normal. We took her information. After 20 minutes of observation, the patient felt fine, so we sent her home and told her to seek medical attention if she felt symptoms. Nothing follows.

Other Meds: Taking blood thinners

Current Illness: None known

ID: 1121059
Sex: M
Age: 27
State: NY

Vax Date: 03/19/2021
Onset Date: 03/19/2021
Rec V Date: 03/21/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: This is to the best of my ability. I took notes, but they started after my symptoms were bad. This starts at about 12:40pm. It should also be noted that I have been feeling symptoms of either mono or IBD for over a year now (I got diagnosed around the same time and it's difficult to discern what is causing my feelings of general fatigue and headaches, however I haven't experienced muscle fatigue, per se). 0-3 hours: mildly sore arm at injection site only (happened immediately) 3-5 hours: headache, slight nausea, slight muscle fatigue 5+ hours: strong headache, severe muscle fatigue, nausea, chills, fever of 102.6 Started taking notes at the time they occurred, I will note when symptoms went away. 4:38am- 102.0 fever, chills stop (However, I was buried under blankets) 9:00am- 101.6 fever, loss of appetite... muscle fatigue and headache improve but are still present 7:56pm- 100.4 fever, other symptoms remain Next day (in general) Muscle fatigue is virtually gone, fever is gone, headache is present, slight nausea (when eating anything other than small amounts of white rice) and loss of appetite still remain

Other Meds: Mesalamine: 3.6 grams once a day in am with food

Current Illness:

ID: 1121060
Sex: F
Age: 62
State:

Vax Date: 03/18/2021
Onset Date: 03/18/2021
Rec V Date: 03/21/2021
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: Highly allergic to sulfa drugs, codeine, reactive to Theophylline

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

Symptoms: Triggered Trigeminal Neuralgia symptoms. 5 minutes after injection left shoulder sore. 25 minutes after injection left side of lips became numb. Medics responded, as we were talking, realized numbness had followed the trigeminal nerve back to the ear, and then from the ear, toward the nose. we determined it was not life threatening, and I was asked to contact my healthcare provider. Left lower quandrant of cheek/face was swollen for between 24 - 36 hours. Developed diarrhea 24 hours after injection.

Other Meds: Addyl, Juice +, Vitamin D and Calcium, Lansoprazole, Famotidine

Current Illness:

ID: 1121061
Sex: F
Age: 54
State: NY

Vax Date: 03/20/2021
Onset Date: 03/20/2021
Rec V Date: 03/21/2021
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: Shellfish (crab), tree pollen

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

Symptoms: At around 7pm, the symptoms started first with diarrhea. 10-20 minutes later, she started sneezing a lot. She took a Claritin, then took a shower. In the shower, she began feeling itchy everywhere, especially in the face. She developed hives around the body (3-4 small patches on underarm, legs). There was also a hive patch on her left eyelid, which started as a small bump, but worsened while she was in the shower. It grew bigger, taking up half of her eyelid. She came out of the shower 10-15 minutes after she began sneezing. 20 minutes after that, her body hives subsided but the eye hive worsened further. The hive took up her entire left eyelid and the eye was swollen nearly shut. Before going to bed (9:30pm), she took a Benadryl. The eye was still swollen in the morning but less so than the night before. Now, 24 hrs after the symptoms began, the eye hive has almost entirely subsided. She feels less severe symptoms now, like fatigue and scalp tenderness.

Other Meds: None

Current Illness: None

ID: 1121062
Sex: M
Age: 54
State: TN

Vax Date: 03/16/2021
Onset Date: 03/17/2021
Rec V Date: 03/21/2021
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: Sulfates

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

Symptoms: Chronic Diarrhea for five days, fever of 102 degrees, severe chills, sweats, severe abdominal pain, dizziness, horrible side effects like I experienced were not listed on any other website. I am fearful now to schedule a 2nd shot. Please advise, thank you.

Other Meds:

Current Illness:

ID: 1121063
Sex: F
Age: 79
State: AZ

Vax Date: 03/15/2021
Onset Date: 03/16/2021
Rec V Date: 03/21/2021
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: Patient came to the pharmacy 3/20/21 complaining of Gas, uncontrollable diarrhea, fatigue and headache for the last 5 days. She stated that the symptoms started 3/16/21 the day after vaccination. Anti-diarrhea medication was unsuccessful at stopping the symptoms.

Other Meds:

Current Illness:

ID: 1121064
Sex: F
Age: 67
State: CO

Vax Date: 03/01/2021
Onset Date: 03/12/2021
Rec V Date: 03/21/2021
Hospital:

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

Lab Data:

Allergies: Latex (none used w vaccine)

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Bad taste in mouth followed by increasing chest pain. B/p 200/100 (nl low) increase chest pain gradually better over 45?. Tried to leave didn?t get out of bldg, collapsed in chair bad chest pain felt really bad. Ambulance called, gradually progresses to weak r side hi b/p slurred stammering speech inability to swallow tongue thrusting to Uc health ct w contrast ok. Gradually improved discharged at 1700. Saw doctor following Monday. Cardiac work up scheduled 4/5/21 She does not want 2nd vaccine until cleared by cardiologist. I have had bouts of chest pain. Hospital tadmitted me as Jane doe. Severe fatigue sleeping 12-14 h/ d for 5-6 d no fever flu sx. Low energy. Hospital never took he from me once better discharged as migraine but I don?t have migraines

Other Meds: Synthesis, requip

Current Illness: None

ID: 1121065
Sex: F
Age: 52
State: TX

Vax Date: 02/26/2021
Onset Date: 02/26/2021
Rec V Date: 03/21/2021
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: Ringing in the ear has not stopped some times a lot pounder than others.

Other Meds:

Current Illness:

ID: 1121066
Sex: F
Age: 60
State: TN

Vax Date: 03/18/2021
Onset Date: 03/18/2021
Rec V Date: 03/21/2021
Hospital:

Vax Type: RV1
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: ROTAVIRUS (ROTARIX)
Lot:
Dose Series: 1
Vax Route: PO
Vax Site: MO

Lab Data:

Allergies: Sulfa, codeine, kiwi

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

Symptoms: Very sore arm, fatigue, chills lasting 24 hours

Other Meds: Metformin, prednisone, omeprazole, lisinopril, ezetimibe, duloxetine, atorvastatin, carvedilol,low dose aspirin, ocular vitamin

Current Illness:

ID: 1121067
Sex: F
Age: 66
State: NJ

Vax Date: 03/17/2021
Onset Date: 03/18/2021
Rec V Date: 03/21/2021
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: Sulfa Amoxycillin

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

Symptoms: One day after receipt of vaccine, had extreme pain in left arm (the injection arm) from top of shoulder to elbow. Pain felt like I was having a bursitis attack with a pain level of 7 out of 10. Took two days to get to a "2". Did not sleep for two nights. Extreme "fogginess" in head, numb feeling around nose, mouth and eyes. Fatigue, depression, sadness . Anxious feeling in the chest which is continuing as of this writing (3/21/21) I do not take any medications and do not have any history of depression or mental illness. This is all very unusual for me.

Other Meds: None

Current Illness: None

ID: 1121068
Sex: F
Age: 31
State: TN

Vax Date: 03/20/2021
Onset Date: 03/20/2021
Rec V Date: 03/21/2021
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: Fever, Chills, Nausea, Headache, Fatigue

Other Meds: Armor Thyroid, Tri Sprintic (Birth Control)

Current Illness:

ID: 1121069
Sex: F
Age: 46
State: AZ

Vax Date: 02/08/2021
Onset Date: 03/15/2021
Rec V Date: 03/21/2021
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: Painful rash and lumps on arm.

Other Meds: None

Current Illness: None

ID: 1121070
Sex: M
Age: 68
State: MI

Vax Date: 02/18/2021
Onset Date: 02/19/2021
Rec V Date: 03/21/2021
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: ARB's

Symptom List: Injection site pain, Pain

Symptoms: Headache, chills, joint pain, muscle pain, tiredness,fever.2/19/2021 thru 2/26/2021

Other Meds: Photonic 20mg, Norvasc 5mg, Cymbalta30mg, Baclofen 20mg Placid 75mg Lunesta 3mg Norco 5/375

Current Illness:

ID: 1121071
Sex: M
Age: 63
State: CA

Vax Date: 03/03/2021
Onset Date: 03/14/2021
Rec V Date: 03/21/2021
Hospital:

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

Lab Data:

Allergies: rarely laundry detergent

Symptom List: Injection site pain, Menorrhagia

Symptoms: illness onset 1 day post vaccine (headache, fever, chills, aches) Severe body rash and Prurtus appearing over multiply locations on the torso, back, head, legs and arms approximately 2 weeks after second (2nd) Moderna vaccination shot. Other symptoms include headache, fatigue, dizziness, asthenia, Current course of treatment prescribed for rash is Prednisone 20mg. Symptoms as yet NOT resolved.

Other Meds: Diskus 250/50, Montelukast SOD 10 mg, Loratadine 10 mg, Flonase, Multi Vitamin & mineral supplement, Hi-potency B-Complex & vitamin C, Vitamin D3 (5000 IU every other day)

Current Illness:

ID: 1121072
Sex: F
Age: 50
State: CA

Vax Date: 03/21/2021
Onset Date: 03/21/2021
Rec V Date: 03/21/2021
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: A rash on my inner forearm near my wrists. It looked like tiny pinprick sized blood dots at first. Now it looks more like a traditional rash. Also a little swollen. I felt a wave of dizziness. That has passed.

Other Meds: Ointment: clobetasol propionate .05% last used 3/19

Current Illness: None that I know of? except for a rash on arms and legs that lead me to a tele health appointment and the ointment prescription

ID: 1121073
Sex: F
Age: 70
State: MA

Vax Date: 03/18/2021
Onset Date: 03/18/2021
Rec V Date: 03/21/2021
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: Percoset, possible anesthesia used for colonoscpy

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Fever of 100 degrees (normal is 97.6 for me), chills, nausea and sinus type headache started around 11 PM and lasted all night. Fever still present until mid-afternoon the next day but other symptoms were mostly gone by 11 Am on the 19th

Other Meds: Vitamins B, C, D3, Fish Oil, Azalastine Nasal Spray

Current Illness: none

ID: 1121074
Sex: F
Age: 52
State: IL

Vax Date: 03/10/2021
Onset Date: 03/10/2021
Rec V Date: 03/21/2021
Hospital:

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

Lab Data:

Allergies: Fluroquinolones Bee venom Environmental

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Within 20 minutes nausea, dizzy lasted 24 hours, day 10 injection site is swollen, slightly red, itchy, sore to the touch raised area is round and about 2" circumference

Other Meds: Advair, nitrofurantoin, amitriptyline, meloxicam, spironolactone, lansoprazole, levocetirizine, bisoprolol, bactrim, multivitamin

Current Illness: Uti Sinus infection

ID: 1121075
Sex: F
Age: 38
State: VT

Vax Date: 12/24/2020
Onset Date: 12/25/2020
Rec V Date: 03/21/2021
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: Seasonal to pollen

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

Symptoms: Tinnitus, progressively worsening

Other Meds: Wellbutrin 300mg

Current Illness: None

ID: 1121076
Sex: F
Age: 56
State: VA

Vax Date: 03/03/2021
Onset Date: 03/03/2021
Rec V Date: 03/21/2021
Hospital:

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

Lab Data:

Allergies: Codeine, nitrofarantain mono- mcr 100t

Symptom List: Nausea

Symptoms: Swollen tongue, diarrhea, throat closing, numb tongue, numbness on left cheek on face.

Other Meds:

Current Illness:

ID: 1121077
Sex: M
Age: 74
State: AZ

Vax Date: 03/18/2021
Onset Date: 03/19/2021
Rec V Date: 03/21/2021
Hospital:

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

Lab Data:

Allergies: bee stings

Symptom List: Injection site pain

Symptoms: chills cough body aches extreme tiredness (the same symptoms I had when I contracted the Coronavirus 11 weeks ago)

Other Meds: Warfarin Metoprolol Furosemide Trazodone Vitamin C

Current Illness: None

ID: 1121078
Sex: F
Age: 38
State: CA

Vax Date: 03/13/2021
Onset Date: 03/13/2021
Rec V Date: 03/21/2021
Hospital:

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

Lab Data:

Allergies: Allergy to penicillin, doxycycline, adhesive tape

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

Symptoms: About 30 min after injection, I felt slight tingling in my face and metallic taste in my mouth. The tingling went away about 15 min later. Metallic taste stayed all day and all day the following day, but went away the next day. Metallic taste however returned on day 6 for one day only. Day 7 my left armpit was very sore all day. Day 8 armpit pain went away but injection site became hot and progressively more pink/red in the site and itchy.

Other Meds: Multivitamin

Current Illness: N/a

ID: 1121079
Sex: M
Age: 64
State:

Vax Date: 03/18/2021
Onset Date: 03/18/2021
Rec V Date: 03/21/2021
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: c/o chest tightiness (midline) w/ h/o asthma & 4 CABG. HR 68-80 Reg Resp 16/unlabored; SpO2 97% 152/95 h/o HTN; self medicated with own ventolin 2 puffs & NTG 0.4ml SL with increase in symptoms. Asymptomatic after additional 15 mins.

Other Meds:

Current Illness:

ID: 1121080
Sex: F
Age: 65
State: CO

Vax Date: 02/01/2021
Onset Date: 03/02/2021
Rec V Date: 03/21/2021
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: Demerol?hallucinate Tetracycline-rash

Symptom List: Tremor

Symptoms: About 12 hours after my 2nd dose of Pfizer vaccine I had extreme chills, fever of 102 degrees, vomiting, and severe headache. Most lasted about 36 hours and all gradually went away. Severe headache was the last symptom to go away but receded about 6 hours after other symptoms . About a week after 2nd dose my injection site became very sore for 3 days. Had not been very sore prior.

Other Meds: Wixela discus 2xday, vitamin D, calcium, Glucosamine/chondroitin

Current Illness: None

ID: 1121081
Sex: F
Age: 61
State: IL

Vax Date: 03/21/2021
Onset Date: 03/21/2021
Rec V Date: 03/21/2021
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: Patient received the Covid-19 vaccine. She reports symptoms of sudden onset itching throughout entire body 5 minutes post-injection along with sudden onset severe headache. Vaccine injection time 1715, symptom onset at 1720. Vitals: @1720: BP 148/94, HR 79, O2 98 @1725: BP 148/83, HR 80, O2 99 (PO benadryl 50mg given at this time) @1730: BP147/80, HR 70, O2 96 @1735: BP 148/82, HR 71, O2 99 @1745: 149/92, HR 74, O2 98 @1755: BP 148/71, HR 73, O2 97 @1805: patient ambulated to restroom. Patient stated that "symptoms aren't improving at all after benadryl -- I think I should go to the emergency room. Wait until I get back from the bathroom to call 911." @1814: Patient returned from restroom, 911 called @1820: EMS arrived, care handed off to EMS @1825: EMS transported patient to ER

Other Meds:

Current Illness:

ID: 1121082
Sex: M
Age: 54
State: NY

Vax Date: 03/21/2021
Onset Date: 03/21/2021
Rec V Date: 03/21/2021
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: unknown

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

Symptoms: Epistaxis at 1320 following a fifteen minute observation of Pfizer vaccine at 1305. Patient denied any HX of epistaxis. Patient observed for an additional 20 minutes. Cold pack was applied and bleeding stopped and was released home.

Other Meds: unknown

Current Illness: n/a

ID: 1121083
Sex: F
Age: 64
State: TX

Vax Date: 03/13/2021
Onset Date: 03/13/2021
Rec V Date: 03/21/2021
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, tetanus, streptomycin, gentamicin and some cleaning products

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

Symptoms: 5 minutes after shot shoulder pain then down to forearm. 10 minutes after shot, fast heartbeat and a little trouble breathing, headache, feel cold, stomach ache, belly ache, wanted to throw up, muscles shaking, throat sore. Drank vitamin C 1000mg. After 15 minutes I felt better. About every 15 minutes there would be another wave of the same pains. Then I would feel better and then another wave. There were five waves. After 1 1/2 hours, it stopped and I went home. Later that night, I was very thirty, couldn't sleep and my kidneys were sore. Next morning, I could not raise my arm from the pain. Every day since, I have had another wave of the same pains once in the morning and then again in the evening. Each wave lasted 1 to 2 hours. I would sleep and afterwards felt better. Saturday March 20th, the wave at night was the worst one and it lasted 3 hours. The wave today March 21st, the wave was smaller and then I could sleep. Today my arm is better, I could move it normally.

Other Meds: Vitamin C

Current Illness: no

ID: 1121084
Sex: F
Age: 61
State: TX

Vax Date: 03/19/2021
Onset Date: 03/20/2021
Rec V Date: 03/21/2021
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: Doxycycline, cipro, amoxicillin, hydrocodone, morphine, dilaudid, elavil, most macrolide antibiotics

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Fever as high as 100.7, muscle aches, headache severe, fatigue moderate to severe, Three asthma attacks. One was severe taking 2 hours to resolve. Worse on 3/20 than today on 3/21. I?ve taken 2 Tylenol and used my rescue inhaler 4 times. The inhaler improves my breathing, but I don?t feel normal yet. Oxygen saturation between 93-96%. If still experiencing symptoms will call PCP and/or go to urgent care. If I?m still coughing I will have to reschedule a hematologist appointment.

Other Meds: Levothyroxine 50mcg Maxalt Metoprolol 20 mg bid Atorvistatin 40 mg dinner Mestinon 60 mg tid Gamunex-c q 28 days 70 gram infusion Xarelto dinner 20 mg dinner Hyosciamine 0.125 when have IBS, tid Singulair dinner Dulera 2 inhalations b

Current Illness: Respiratory infection, staph sinus infection,

ID: 1121085
Sex: F
Age: 70
State: WA

Vax Date: 03/18/2021
Onset Date: 03/19/2021
Rec V Date: 03/21/2021
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: Codine

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

Symptoms: Left arm swollen at site of injection. Arm and finger swollen next morning. Tingling in toes. Tongue raw and sore and loss of taste. Very tired and achy. Low grade fever and chills. Unable to put two sentences together. Fill like my head is full of fog.

Other Meds: Basaglar insulin, victoza, metformin, pansoprazole, amlodipine, fluoxetine, atenolol, atorvastatin, lisinapril.

Current Illness: None

ID: 1121086
Sex: F
Age: 49
State: TN

Vax Date: 03/20/2021
Onset Date: 03/20/2021
Rec V Date: 03/21/2021
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: Hydrocodone

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

Symptoms: Jansen COVID-19 Vaccine EUA Chills, headache, body aches, fever (101.3), trouble sleeping and pain at injection site.

Other Meds: Temazepam Escitilopram Spirinolactone Amlodopine

Current Illness: N/A

ID: 1121087
Sex: F
Age: 44
State:

Vax Date: 03/18/2021
Onset Date: 03/18/2021
Rec V Date: 03/21/2021
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: SOB Headache, but resolved O2 98; HR 87

Other Meds:

Current Illness:

ID: 1121088
Sex: F
Age: 66
State: TX

Vax Date: 03/06/2021
Onset Date: 03/07/2021
Rec V Date: 03/21/2021
Hospital:

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

Lab Data:

Allergies: cephalexin

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

Symptoms: day after shot on the 7th had fever all day and arm swelled up at vaccination site. Not sure if it is connected, but I have shingles that blisters appeared on the 16th after a weekend (3/12- 3/15) of pain in leg prior to blisters appearing. Pain and blisters are still ongoing.

Other Meds: ibuprofen

Current Illness:

ID: 1121089
Sex: F
Age: 37
State: MA

Vax Date: 03/19/2021
Onset Date: 03/20/2021
Rec V Date: 03/21/2021
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: only known adverse reaction for medication is Reglan- severe akathesia. Gluten sensitivity

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

Symptoms: Pfizer-BioNTech COVID-19 Vaccine EUA approx 4:45 pm on 3/20/21: severe bloating, abdominal cramps, nausea, headache, fatigue (lasted throughout the time). Nausea was severe. Symptoms occurred again approx 2:45pm on 3/21/21: nausea, headache, fatigue. Lasted into the evening .

Other Meds: Paroxetine 10 mg, fever few, magnesium, fish oil, xiidra eye drops

Current Illness: No illness prior to and at the time of vaccination

ID: 1121090
Sex: F
Age: 44
State: IL

Vax Date: 03/21/2021
Onset Date: 03/21/2021
Rec V Date: 03/21/2021
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: Syncopal episode following vaccination

Other Meds: none

Current Illness: none

ID: 1121091
Sex: M
Age: 42
State:

Vax Date: 03/18/2021
Onset Date: 03/18/2021
Rec V Date: 03/21/2021
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: Pressure in ears / nose; similar to when flying" NKDA. 130/92, HR 83, talking, 99%

Other Meds:

Current Illness:

ID: 1121092
Sex: F
Age: 67
State: IN

Vax Date: 03/19/2021
Onset Date: 03/19/2021
Rec V Date: 03/21/2021
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: Fever 101.5, headache, chills, 1 1/2 day

Other Meds: Hydrochlorothiazide, amlodopine,citalopram,,venlafaxine, Centrum vitamin

Current Illness:

ID: 1121093
Sex: F
Age: 67
State: VA

Vax Date: 02/28/2021
Onset Date: 03/01/2021
Rec V Date: 03/21/2021
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: Fever, chills, muscle and joint pain, extreme fatigue, nausea. Pain and stiffness at injection site.

Other Meds:

Current Illness:

ID: 1121094
Sex: F
Age: 58
State: MN

Vax Date: 03/10/2021
Onset Date: 03/20/2021
Rec V Date: 03/21/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Penicillin, Shell fish, Cephalexin

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Ten days after the first injection, I developed a red rash on my left arm in the area of the injection. The rash is about 2 inches in diameter with some slight itching.

Other Meds: Mornings 1 ? Lansoprazole (Prevacid) 30 mg 1 ? Losartan (Cozaar) 50mg 1 ? Advair ? inhaler 500/50 mcg 1 ? Klor-Con M20 (Potassium) 1 - Mometasone-Ipratropium-Diphenhydramine 1 ? Multivitamin (Centrum) 1 - Fish Oil Tablets 1120 mg 1 - Vit

Current Illness: None

ID: 1121095
Sex: M
Age: 39
State:

Vax Date: 03/18/2021
Onset Date: 03/18/2021
Rec V Date: 03/21/2021
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: lightheadednes, nausea, "I think I had an anxiety attack!" "when I have had mutli vials blood drawn I get the same feeling" 143/107- take BP meds " I have white coat syndrome"

Other Meds:

Current Illness:

ID: 1121096
Sex: F
Age: 52
State: IA

Vax Date: 03/12/2021
Onset Date: 03/13/2021
Rec V Date: 03/21/2021
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: Sick the day after shot with fever, chills, headache, body aches, nausea for 2 days.

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm