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: 1122320
Sex: F
Age: 48
State: MA

Vax Date: 03/18/2021
Onset Date: 03/22/2021
Rec V Date: 03/22/2021
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: Shrimp, lobster

Symptom List: Dysphagia, Epiglottitis

Symptoms: Initial headache, increased blood pressure and pain at injection site directly after injection. Warm, redness and knot in arm with limited use day after injection. Pain on left side of head, neck, ribs second day after injection, Skin rashes and bleeding gums third day after injection.

Other Meds: None

Current Illness: None

ID: 1122321
Sex: F
Age: 59
State: GA

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 03/22/2021
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: NO NSAIDS?causes extreme elevation in BP, wheat gluten

Symptom List: Anxiety, Dyspnoea

Symptoms: see below

Other Meds: see below

Current Illness: none

ID: 1122322
Sex: F
Age: 64
State: OH

Vax Date: 03/19/2021
Onset Date: 03/20/2021
Rec V Date: 03/22/2021
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: covid arm spreading to abdomen/breast area, 101 fever

Other Meds:

Current Illness:

ID: 1122323
Sex: M
Age: 67
State: SC

Vax Date: 02/15/2021
Onset Date: 03/13/2021
Rec V Date: 03/22/2021
Hospital: Y

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

Lab Data:

Allergies: None indicated

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Patient developed Gilliam Barre after administration of the second dose of Covid vaccine on 2/15/21; After multiple calls, clinic was where patient received vaccine with LOT #EN6200 (expiration date unavailable in computer system per pharmacist); pt then went to a hospital and was diagnosed as above; treated in the ED for several days per notes at the hospital and was not put in a room due to bed shortages so was transferred to another hospital; patient subsequently developed an NSTEMI, seizures, and was intubated.

Other Meds: rosuvastatin 10 mg daily; clopidogrel 75 mg daily; tadalafil 20 mg up to twice per week; vitamin D3 2000 units Daily; Neurontin 400 mg tid

Current Illness: s/p hip replacement, s/p shoulder replacement; blindness in one eye; nicotine dependence

ID: 1122324
Sex: F
Age: 21
State: VA

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 03/22/2021
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: Per client, approximately forty-five minutes post first vaccine- she stated her throat felt like it was closing and she become short of breath. She stated she did not require any medical assistance. She stated it slowly resolved itself. Client presented to get her second Moderna vaccine on 3/05/2021 and informed staff at that time of reaction post first vaccine. Client stated she had informed her PCP. Who felt it was alright for her to get her second shot. Client was informed at the time of her second shot, that she would not be receiving it that day. The clinic that day was as a POD site. Client was informed that the health department would get in touch with her at a later time to determine if she was eligible to get second dose. Client verbalized understanding. It was determined that due to client having an immediate reaction after the first vaccine, that she would not be eligible to receive the second vaccine at the health department. Client was called to inform her of this the following week and the client did not answer the phone.

Other Meds:

Current Illness:

ID: 1122325
Sex: F
Age: 71
State: OH

Vax Date: 03/19/2021
Onset Date: 03/19/2021
Rec V Date: 03/22/2021
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: x-ray dye

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

Symptoms: exhausted and soreness from shoulder to shoulder (across back) 2nd vaccine

Other Meds: Black Elderberry, collagen, turmeric, vitamin D, aspirin metformin, Jardiance, Atorvastatin, glipizide, lisinopril

Current Illness: N/A

ID: 1122326
Sex: F
Age: 61
State: OK

Vax Date: 03/05/2021
Onset Date: 03/06/2021
Rec V Date: 03/22/2021
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: n/a

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Horrible Headache. I couldn't hold my eyes open for 36 hours. Generally feeling lousy.

Other Meds: Potassium; 5mg Lisinopril; 25 mg hydrochlorothiazide; 100 mcg levothyroxine; 1200 mg fish oil, 500 mg turmeric complex, super B complex, zinc, D3, and vitamin C

Current Illness: n/a

ID: 1122327
Sex: F
Age: 55
State: PA

Vax Date: 03/19/2021
Onset Date: 03/20/2021
Rec V Date: 03/22/2021
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: Dizziness Tired Muscle & joint pain swelling of lymph nodes terrible headache chills fever nausea

Other Meds:

Current Illness: none

ID: 1122328
Sex: F
Age: 77
State: FL

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 03/22/2021
Hospital:

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

Lab Data:

Allergies: No

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: I was itching all over for a good two hours. I put topical caladryl and it helped. I tried not to scratch. It happened 2 nights in a row.

Other Meds: Insulin, creon, Vitamin D2, Vitamin D3, Biotin, Calcium, Magnesium, Vitamin B12

Current Illness: No

ID: 1122329
Sex: F
Age: 69
State: WI

Vax Date: 03/17/2021
Onset Date: 03/21/2021
Rec V Date: 03/22/2021
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: None

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Moderna COVID-19 Vaccine EUA. 2ND injection. Mild red rash around injection site. Itchy.

Other Meds: Eliquis

Current Illness:

ID: 1122330
Sex: M
Age: 52
State: IA

Vax Date: 03/15/2021
Onset Date: 03/16/2021
Rec V Date: 03/22/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Began experiencing chills/headache/fever symptoms at 1 pm. Fever spiked to 105 degrees at 8pm. At this time, took measures to reduce fever (Tylenol, Cold Water, Removed clothing). Went to bed around 104 degrees. Fever broke overnight.

Other Meds: None

Current Illness: None

ID: 1122331
Sex: F
Age: 45
State: GA

Vax Date: 03/01/2021
Onset Date: 03/01/2021
Rec V Date: 03/22/2021
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: Allergy to Tape, IMDUR, Surgical Glue, Keflex

Symptom List: Rash, Urticaria

Symptoms: Within a minute pain radiates down my arm into my fingers, 2 minutes later I felt like my sinus cavity got full then felt like my throat felt full but mostly my sinus cavity felt very swollen. My arm hurt for 6 days and I had general fatigue and headache. Going for number 2 today will post if more effects

Other Meds: Oxycodone, cardezium, Nasonex, Aspirin, propranolol, singular, amolodophine, thyroid levothyroxine, gabapentim, zanaflex, prednisone

Current Illness: Pulmonary Hypertension, Lupus Anticoagulant disorder, fibromyalgia, spinal degenerate disk disease, osteoarthritis, lymph node infection, sinusitis, TIA repetitive, peripheral nueropathy mild, COPD and cancer survivor

ID: 1122332
Sex: F
Age: 35
State: MD

Vax Date: 03/11/2021
Onset Date: 03/12/2021
Rec V Date: 03/22/2021
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: Large, red, itching welt at location of the injection

Other Meds: Oral Contraceptive

Current Illness: None

ID: 1122333
Sex: F
Age: 58
State: OH

Vax Date: 03/17/2021
Onset Date: 03/22/2021
Rec V Date: 03/22/2021
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: Swollen lymph nodes in left arm pit - started Monday am, 4th day after 1st shot. No evidence to date in right arm.

Other Meds: none

Current Illness: none

ID: 1122334
Sex: M
Age: 70
State: SD

Vax Date: 03/10/2021
Onset Date: 03/11/2021
Rec V Date: 03/22/2021
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: peas, glucagon, levaquin

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

Symptoms: 102.3 fever, body aches, fatigue - missed work for the whole weekend

Other Meds: sildenafil 100mg 1 prn, Vit D3 5000 units daily, Glucosamine Chondroitin with MSM daily, roflumilast 500 mgc daily, Stiolto respimat 2.5mg-2.5mcg 2 inh neb daily, fluticasone 250mcg 1 puff bid inhaler, cyclobenzaprine 10 mg TID prn, diclof

Current Illness: none

ID: 1122335
Sex: F
Age: 71
State: ND

Vax Date: 01/29/2021
Onset Date: 02/12/2021
Rec V Date: 03/22/2021
Hospital: Y

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

Lab Data:

Allergies: NKDA

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

Symptoms: Patient presented with frequent falls and left sided weakness with severe headaches for greater then 24 hours.

Other Meds: Digoxin 125mcg po as directed, atorvastatin 10mg po daily, warfarin sodium 5mg po daily, spironolactone 25mg po daily, levothyroxine 25mcg po daily, furosemide 80mg po bid, advair 100-50 1 puff inh bid, digoxin 250mcg po as directed, albute

Current Illness: noted to have increased falls at home.

ID: 1122336
Sex: M
Age: 73
State: IA

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 03/22/2021
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: Patient got first dose of Moderna in Feb and got second dose Pfizer in March. He reports just a sore arm. No other ADR's

Other Meds:

Current Illness: unknown

ID: 1122338
Sex: M
Age: 57
State: TX

Vax Date: 03/19/2021
Onset Date: 03/20/2021
Rec V Date: 03/22/2021
Hospital:

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

Lab Data:

Allergies: Morphine

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Fever - 101, chills and dizziness. Rotating Tylenol and Motrin every 6 hours. Was seen by primary care physician.

Other Meds: Tylenol, Motrin, Emergn-C

Current Illness:

ID: 1122339
Sex: F
Age: 70
State: NY

Vax Date: 03/22/2021
Onset Date: 03/22/2021
Rec V Date: 03/22/2021
Hospital:

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

Lab Data:

Allergies: Penicillin Iodine contrast Hepatitis B vaccine

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Pt states immediately after receiving the vaccine her lips became numb. Pt denies any swelling, difficulty swallowing, rash, or hives. NP and EMT determined the pt is having anxiety. Pt refused vitals. After 30 minutes the pt stated she is feeling better and would like to leave. Pt didn?t require transport to hospital. NP referred pt to high risk clinic for second dose.

Other Meds: Pt refused stated she has a ?long list she doesn?t remember ?

Current Illness:

ID: 1122340
Sex: M
Age: 61
State: OK

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 03/22/2021
Hospital:

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

Lab Data:

Allergies: Not before this vaccine

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

Symptoms: Developed bad, itchy hive-like rash all over trunk of body front and back within 6-7 hours of injection. Treated with 25mg Benadryl for very little relief. By four days post vaccine it has spread to groin and head. Mild nausea and fatigue

Other Meds: Lisin/HCTZ 10/2.5 Simvastatin 40mg VIT C 1000mg D3 50mcg/2,000iu

Current Illness: None

ID: 1122341
Sex: F
Age: 50
State: MN

Vax Date: 03/13/2021
Onset Date: 03/13/2021
Rec V Date: 03/22/2021
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: Bee stings, Sulfa, Codeine, Cefzil

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

Symptoms: Palpitations, hypertension, fatigue, chest tightness following injection

Other Meds: levothyroxine, losartan, B12

Current Illness: None

ID: 1122342
Sex: F
Age: 58
State: FL

Vax Date: 01/27/2021
Onset Date: 03/01/2021
Rec V Date: 03/22/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Unevaluable event

Symptoms: I am having tingling down my left arm, daily, multiple times. I am also having deep pain in legs, when laying down to sleep, daily.

Other Meds: Prozac 80mg/day Tumeric 500mg /day Glucosamine 500 mg /day ALIVE Daily vitamin 50+women 1/day

Current Illness: None

ID: 1122343
Sex: F
Age: 63
State: PA

Vax Date: 03/21/2021
Onset Date: 03/21/2021
Rec V Date: 03/22/2021
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: racing heart.. dizziness.. felt like she was going to pass out said tongue was swelling and hard to breath

Other Meds: depression and anti anxiety

Current Illness: none

ID: 1122344
Sex: F
Age: 31
State: TX

Vax Date: 03/12/2021
Onset Date: 03/20/2021
Rec V Date: 03/22/2021
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: Cephalexin

Symptom List: Injection site pain, Pain

Symptoms: injection site had a hard knot under it. area around injection site started to turn red on day 8 and spread and became more red in the following days. I took benadryl and put an ice pack on the site. The area faded a bit but continued to grow in size.

Other Meds: Milli Birth Control, Levothyroxin

Current Illness:

ID: 1122345
Sex: F
Age: 41
State: CT

Vax Date: 03/19/2021
Onset Date: 03/19/2021
Rec V Date: 03/22/2021
Hospital:

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

Lab Data:

Allergies: Latex

Symptom List: Injection site pain, Menorrhagia

Symptoms: Vaccine dose 1 rash and itchy for 3 weeks and slight shortness of breath and tightness Dose 2 severe rash on neck and chest with mild shortness of breath and tightening in chest lasting 24 hours.

Other Meds: None

Current Illness: None

ID: 1122346
Sex: F
Age: 20
State: WA

Vax Date: 03/21/2021
Onset Date: 03/22/2021
Rec V Date: 03/22/2021
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, nausea, pain at injection site, fatigue, body aches, shortness of breath, dizziness.

Other Meds: Ibuprofen

Current Illness:

ID: 1122347
Sex: F
Age: 63
State: TX

Vax Date: 03/15/2021
Onset Date: 03/15/2021
Rec V Date: 03/22/2021
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: Codeine, Penicillin, latex, perfume

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Approximately 3 hours after my injection I became very lethargic and my heart began to race. I had fever of 101 and became very weak and tired. I experienced nausea, pain in my upper back and my heart raced for approximately 10 hours. On Tuesday, March 16, 2021 I slept on and off for the entire day and continued to have a fever. My heart rate came down within 24 hours after my injection and the fever came down to normal 36 hours after the injection. I felt weakness for approximately 3 days after the injection. I am currently recovered from all symptoms as of March 22, 2021.

Other Meds: Allegra, Mucinex

Current Illness: None

ID: 1122348
Sex: F
Age: 24
State: MI

Vax Date: 03/10/2021
Onset Date: 03/17/2021
Rec V Date: 03/22/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: 3/17/21 patient developed body aches, headache, nasal congestion, and pharyngitis. tested COVID positive.

Other Meds: acetaminophen, amitriptyline, colace, drysol external solution, estradiol, robaxin, saline nasal spray

Current Illness: single kidney, iliotibial band syndrome affecting lower leg, sacroiliitis, patellofemoral syndrome L knee, lumbar facet joint syndrome, segmental dysfunction of lumbar region

ID: 1122349
Sex: F
Age: 66
State: IL

Vax Date: 03/20/2021
Onset Date: 03/21/2021
Rec V Date: 03/22/2021
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 medication allergies known. Allergic reaction/digestive reaction to pork products.

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

Symptoms: The left arm injection site became more sore and itchy and a red rash below the injection site.

Other Meds: Tylenol extra strength

Current Illness: NOne

ID: 1122350
Sex: F
Age: 33
State: OK

Vax Date: 03/11/2021
Onset Date: 03/11/2021
Rec V Date: 03/22/2021
Hospital:

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

Lab Data:

Allergies: Penicillin, Benadryl, Bactrim, Lymictal, Dayquil, Acyclovir

Symptom List: Nausea

Symptoms: 3-11-21 @ 9:30am -Nausea 3-12-21 @ 7:30am- Woke with nausea, headache, joint aches, extremely sore arm, low grade fever and tinnitus in left ear 3-12-21 @ 1:00pm- Hearing impairment in the left ear and tinnitus in both ears. 3-14-21 @ 7:30am- Woke with only sore arm, tinnitus in both ears and hearing impairment in both as well. 3-22-21 @ 10:00am- Still have hearing impairment and tinnitus in both ears. Slight improvement in hearing but tinnitus is worsening.

Other Meds: Levothroxine Birth Control

Current Illness:

ID: 1122351
Sex: F
Age: 55
State: AZ

Vax Date: 03/16/2021
Onset Date: 03/17/2021
Rec V Date: 03/22/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List: Injection site pain

Symptoms: Fever reached high of 102.2, extreme body aches, headache. Extreme lasted 8 hrs. Slightly improved until following afternoon. Body aches were bad in the very begin that my clothes & bedsheets hurt me.

Other Meds: Losartan, Fenofibrate, Estroven, multi vitamin, fish oil.

Current Illness: N/A

ID: 1122352
Sex: F
Age: 28
State:

Vax Date: 03/19/2021
Onset Date: 03/20/2021
Rec V Date: 03/22/2021
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: Localized swelling to right arm at the site of the injection, beginning the day after injection.

Other Meds: none

Current Illness: none

ID: 1122353
Sex: F
Age: 51
State: MA

Vax Date: 03/20/2021
Onset Date: 03/20/2021
Rec V Date: 03/22/2021
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: sulfa, penicillin

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

Symptoms: my lips started tingling 20 minutes after vaccine, only on one side of my mouth, same side as vaccine, right. Then my throat started to feel funny, like there is something in it. I called 911, went by ambulance received Benadryl through IV then at hospital I received IV Pepcid. I am still taking Benadryl and pepcid. Still experiencing the lump in my throat feeling.

Other Meds: Flonase

Current Illness:

ID: 1122354
Sex: F
Age: 51
State: NC

Vax Date: 03/19/2021
Onset Date: 03/19/2021
Rec V Date: 03/22/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: Patient complains of tightness in throat. Was quite anxious about getting the vaccine

Other Meds: ALBUTEROL MDI, CITALOPRAM 10MG DAILY, FLEXERIL 10MG TID PRN, HCTZ 25MG DAILY, METFORMIN 850MG DAILY, ZAROXOLYN 2.5MG DAILY, TOPROL XL 50MG DAILY, SINGULAIR 10MG DAILY, SPIRONOLACTONE 50MG DAILY,

Current Illness:

ID: 1122355
Sex: F
Age: 67
State: MN

Vax Date: 03/19/2021
Onset Date: 03/20/2021
Rec V Date: 03/22/2021
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: LYMPH NODE SWELLING IN THE RIGHT ARMPIT. LARGER THEN THE PALM OF MY HAND

Other Meds: pravastatin, lisinopril/hctz, citalophram, vitamin D, B12, iron

Current Illness: none

ID: 1122356
Sex: F
Age: 31
State: NJ

Vax Date: 03/16/2021
Onset Date: 03/21/2021
Rec V Date: 03/22/2021
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: Patient received vaccine on 3/16 @ 1:30 PM. Rash developed 3/21....turn into painful red rash on 3/22 in the morning (pt had hard time putting on shirt). Rash is on left lower arm/left side of body. Patient describes it as pulsating. I informed patient that it may be related to the vaccine, to contact her primary or got to an Urgent care ASAP and recommended OTC products in the mean time (anti-histamine+iburpofen/apap for pain) Patient will report back to me what her physician thinks is causing the rash. I will continue to document and follow up with patient

Other Meds: Birth control, multi-vitamin

Current Illness:

ID: 1122357
Sex: F
Age: 17
State: NY

Vax Date: 03/22/2021
Onset Date: 03/22/2021
Rec V Date: 03/22/2021
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 Known

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

Symptoms: Felt scratchiness in back of throat. Denied difficulty breathing. Chest clear, no wheeze. BP 118/76, PO2 97%, Pulse 71. Patient given Benadryl 25 mg PO x 1. Within 15 minutes felt normal again.

Other Meds: Prozac BCP

Current Illness: none

ID: 1122358
Sex: M
Age: 65
State: WV

Vax Date: 03/18/2021
Onset Date: 03/20/2021
Rec V Date: 03/22/2021
Hospital: Y

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: Asthenia, Chills, Headache, Myalgia

Symptoms: Patient had vaccination at an outpatient site 2 days prior to presenting to our hospital with severe bilateral pneumonia and hypoxia.

Other Meds: ninlaro, diltiazem, acyclovir, dexamethasone, pantoprazole, Tamsulosin

Current Illness: multiple myeloma

ID: 1122359
Sex: F
Age: 59
State: TN

Vax Date: 03/19/2021
Onset Date: 03/19/2021
Rec V Date: 03/22/2021
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: None

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

Symptoms: Dry heaves started within 4 hours: every 15 minutes for 9 hours: I tried Pepto bismal but it didn?t help. I found an anti nausea pill from a previous surgery which was able to stop the dry heaves. Chills Horrible debilitating headache non stop Aches, pain, fatigue

Other Meds: Bupropion 150 x2 daily Progesterone 100 daily Estradiol1. Daily

Current Illness:

ID: 1122360
Sex: M
Age: 67
State: VA

Vax Date: 03/07/2021
Onset Date: 03/09/2021
Rec V Date: 03/22/2021
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: No immediate adverse reaction. No fever. Day 2 post vaccination fatigue, blurred vision, confusion, weakness, lethargy, inability to concentrate, loss of balance, anxiety feeling weird. Symptoms would come- had to lay down-last ~2 hours-feel okay. Again, same symptoms would start; 4-5 times a day every day. By day 7 post vaccination symptoms were severe; activities of daily living severely compromised. Blood pressure elevated 180's/100's (no history of hypertension). Emergency room visit was unremarkable. Next morning, 03/15/2021, EMS called to home. Blood pressure 217/112 finger stick 178 (no history diabetes). Transported to ER. B/P remained elevated. Cardiac negative. Head CT negative. Medications given in ER: Labatelol 10mg IV. Monitored and released to home. Diagnosis: Hypertensive Encephalapathy with TIA's. New onset hypertension. Meds: Lisinopril 10 mg daily. Seen by primary care on 03/17/2021. Elevated blood pressure continued 150/100's.

Other Meds: ASA 81mg

Current Illness:

ID: 1122361
Sex: F
Age: 53
State:

Vax Date: 03/06/2021
Onset Date: 03/06/2021
Rec V Date: 03/22/2021
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: c/o dizziness, chest pressure and palpitations after vaccine administration.

Other Meds:

Current Illness:

ID: 1122362
Sex: F
Age: 65
State: FL

Vax Date: 03/16/2021
Onset Date: 03/16/2021
Rec V Date: 03/22/2021
Hospital:

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

Lab Data:

Allergies: estrogen, erythromasin, key limes, mushrooms, nickle, bee stings. pollen

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

Symptoms: numbness in chin, lower lip and gum, part of upper gum and lip

Other Meds: none

Current Illness: lactic acidosis

ID: 1122363
Sex: F
Age: 65
State:

Vax Date: 03/20/2021
Onset Date: 03/20/2021
Rec V Date: 03/22/2021
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: Client received the Janssen covid vaccine to right deltoid and became very anxious following. Patient does have a history of Anxiety per her husband and responds this way to most events concerning her health. Client stated this is "Normal" for me . Client alert and oriented with blood pressure at 200/85 and pulse at 130 initially. Client stated "I am fine" She reported not taking any medications for her blood pressure prior. Second blood pressure 192/86 . Client monitored by EMS and finally transported to hospital. Attendees nurse and doctor.

Other Meds:

Current Illness:

ID: 1122364
Sex: F
Age: 66
State: MD

Vax Date: 03/20/2021
Onset Date: 03/21/2021
Rec V Date: 03/22/2021
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: Sulfa drugs Many antibiotics Vancomycin - Stevens Johnson Oxycodone

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

Symptoms: Chills, aches, fatigue, nausea

Other Meds: Opiates, cholesterol, blood pressure, thyroid

Current Illness: Chronic pancreatitis Alopecia aerata Hypothyroid

ID: 1122365
Sex: F
Age: 77
State: NH

Vax Date: 03/11/2021
Onset Date: 03/18/2021
Rec V Date: 03/22/2021
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: none

Symptom List: Vomiting

Symptoms: Patient started to develop itching and a little pain to right arm at area of vaccine site 1 week after vaccine. At that point, had 3 small red dots. Progressed over the last several days to a red, warm area c/w cellulitis. To be treated today with Keflex.

Other Meds: tums, prevacid, vitamin D3, Tylenol, Claritin, prolia

Current Illness: none

ID: 1122366
Sex: M
Age: 73
State: KS

Vax Date: 03/09/2021
Onset Date: 03/10/2021
Rec V Date: 03/22/2021
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: Given early

Other Meds:

Current Illness:

ID: 1122367
Sex: M
Age: 17
State: GA

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 03/22/2021
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: There was no adverse reaction. We are reporting that we administered the vaccine to someone that is under the age of 18. This person volunteers at our clinic.

Other Meds:

Current Illness:

ID: 1122368
Sex: F
Age: 28
State: TX

Vax Date: 03/21/2021
Onset Date: 03/22/2021
Rec V Date: 03/22/2021
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: Allergy to birch that cross-reacts with food items like carrots, tomatoes, cherries, cranberries, apples, etc.

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Overall achiness, tiredness, sore throat, back pain. Symptoms have persisted since early in the morning the day after receiving the vaccination.

Other Meds: Spironolactone, 50mg; Fluoxetine, 10mg.

Current Illness: N/A

ID: 1122369
Sex: M
Age: 61
State: AZ

Vax Date: 03/15/2021
Onset Date: 03/15/2021
Rec V Date: 03/22/2021
Hospital:

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

Lab Data:

Allergies: shellfish

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

Symptoms: migraine head ache, back ache, fever, nausea, lack of apatite , brain fog,, i had covid in november, felt about the same, was very sick for 5 days, felling much better 8 days after the vaccine, very afraid to get the second dose, if reaction is more severe as reported in the second dose, i'm afraid i won't servive

Other Meds: losartin, triamterene

Current Illness: none

ID: 1122370
Sex: F
Age: 62
State: WI

Vax Date: 03/19/2021
Onset Date: 03/19/2021
Rec V Date: 03/22/2021
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: TMP/SMX, doxycycline

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

Symptoms: Developed chest tightness shortly after vaccine. Denies shortness of breath. Patient was taken to urgent care for evaluation, but ultimately did not need any further work-up. Questionable if patient even needed to be taken to urgent care based on our adverse reaction algorithm for COVID vaccination, but since she was transferred there, do feel obligated to submit report. Patient has had a history of reactions to other medications (primarily chemotherapeutic agents) that have manifested similarly to this. Discharged in stable condition.

Other Meds:

Current Illness: N/A

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm