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**
PLEASE CHECK BACK SOON
Download the files above while you wait.






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: 1123390
Sex: F
Age: 72
State: KY

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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Penicillins - Anaphylaxis Bactrim - Hives Clindamycin - Anaphylaxis

Symptom List: Dysphagia, Epiglottitis

Symptoms: Patient felt that her throat was constricting about 5 minutes after receiving her vaccine. She was given 25mg of diphenhydramine, and symptoms did not worsen. O2 saturation never fell below 96%, and patient did not outwardly show signs of difficulty breathing. Patient remained at the clinic for 40 minutes after vaccination. She refused to be taken anywhere other than home. She was able to walk herself out of the building with no labored breathing or need to take breaks.

Other Meds:

Current Illness:

ID: 1123391
Sex: U
Age: 23
State: VA

Vax Date: 02/06/2021
Onset Date: 02/06/2021
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: NONE

Symptom List: Anxiety, Dyspnoea

Symptoms: DIZZINESS,PALE DIAPHORESIS,BRADYCARDIA

Other Meds: NONE

Current Illness: NONE

ID: 1123392
Sex: F
Age: 60
State: FL

Vax Date: 03/18/2021
Onset Date: 03/19/2021
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: Site: Bruising at Injection Site-Mild, Site: Itching at Injection Site-Medium, Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium, Additional Details: Patient stated started next day, reddness, used coritsone and the spot began to grow, now is red and hot to touch, but no longer painful. Thinks it may be celluilitis and is going to check with primary MD as follow up.

Other Meds:

Current Illness:

ID: 1123393
Sex: M
Age: 45
State: MI

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: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data:

Allergies: Sulfa, fish, seafood

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: 6 min after receiving vaccine dose, patient stood up, reported feeling light-headed and lost consciousness, striking his head while falling to floor. LOC x 10-15 sec, regained consciousness on own and was speaking immediately after. EMS was activated and patient was transported to local ER for eval via ambulance.

Other Meds: None

Current Illness: none

ID: 1123394
Sex: F
Age: 62
State: CO

Vax Date: 03/10/2021
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: nasonex

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

Symptoms: On 3/19 random red, itchy spots appeared on both hands, wrists, and elbows. Suspected bug bites, however this morning 3 more smaller spots appeared on hand near thumb as I worked out. Not bites. Wondering if this is a delayed sided effect of moderna vaccine. I would also note my mother, who live in , ( I'm in ), received Moderna vaccine 3 days after I and has had similar effects.

Other Meds: none

Current Illness: none

ID: 1123395
Sex: F
Age: 32
State: WA

Vax Date: 03/14/2021
Onset Date: 03/15/2021
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:

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

Symptoms: "increased fatigue, mild cough shortness of breath, headache and then some isolated left leg pain. Patient denies any trauma, any swelling, nonpainful to the touch no difficulty walking or specific joint pain. Patient has no prior history of blood clots or DVTs, not currently on OCPs"

Other Meds:

Current Illness:

ID: 1123396
Sex: F
Age: 18
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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Received first COVID shot on 3/19/21. On 3/20/21 presenting to ER with weakness, achiness, fever, shortness of breath after having coronavirus vaccination yesterday. Patient is sure she had coronavirus back in November. Received the vaccination yesterday about 11 am. Within a couple hours she developed severe myalgias, low-grade fever. Reports she feels a little short of breath from a myalgias. No history of DVT or PE, urinary complaints. Patient has syncopal episode while in triage. No seizure activity. Felt lightheaded with standing. Clinical Impression: 1. Syncope 2. Vaccination reaction, initial encounter Presentation consistent with orthostatic, vasovagal episode from recent vaccination. Patient coronavirus previously stimulating a stronger immune response. doubt infection, PE, worrisome arrthymia. Advised against second vaccination. return if any problems, worsening

Other Meds:

Current Illness:

ID: 1123397
Sex: F
Age: 16
State: GA

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Unknown

Symptom List: Pharyngeal swelling

Symptoms: 11:57am C/O difficulty breathing. Vital signs: 118/68 101 16; 12:10pm 112/68 74 16; 12:25pm 112/70 71 16; Disposition: Patient left with Mother. No signs of distress. Full ambulatory.

Other Meds: Unknown

Current Illness: Unknown

ID: 1123398
Sex: M
Age: 76
State:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Received 2nd vaccine on 3/5/21 & developed symptoms on 3/6/21. Symptoms lasted 2 days. Symptoms included confusion, Fever > 100, Oxygen Saturation upper 80's, & body aches.

Other Meds:

Current Illness:

ID: 1123399
Sex: F
Age: 63
State: ID

Vax Date: 03/06/2021
Onset Date: 03/18/2021
Rec V Date: 03/22/2021
Hospital: Y

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

Lab Data:

Allergies: combid

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Just walked in the house from work. Sudden total numbness of left arm. Had hard time speaking, words were slow coming out and were slurred. After about 10 minutes the numbness gave way to weakness. The speech was improving but slurred slightly for another 20 minutes. Checked out by emt's and paramedics, then husband drove me to hospital.

Other Meds: Maloxicam Myrbetriq Atorvastatin low dose aspirin

Current Illness: none

ID: 1123400
Sex: M
Age: 16
State: KY

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:
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: His heart was racing, BP 72/35, HR 48 BPM. Epi-Pen was injected at 12:02PM. EMS called to scene. BP 105/67 and HR 91BPM after Epi dose.

Other Meds: none

Current Illness:

ID: 1123401
Sex: F
Age: 46
State: KS

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

Symptom List: Rash, Urticaria

Symptoms: Notes (Nurse Practitioner) ? ? Nurse Practitioner Cosigned by: MD at 3/19/2021 9:22 AM Expand AllCollapse All 3/18/2021 Subjective female who was seen at Clinic today for her first dose of the COVID 19 vaccination. She was given the Pfizer vaccination in the left deltoid muscle. During her 15 minute waiting period after the injection, the patient began to experience lightheadedness and dizziness. She denied rash, hives, welts, difficulty breathing, difficulty swallowing, wheezing, throat tightness, hoarseness, stridor, itching, facial swelling, lip swelling and tongue swelling. This provider was notified of patient reaction and she was then assessed in the emergency bay area. Monitored patient for severe reaction symptoms, including but not limited to abdominal pain, blood pressure abnormality , chest pain, collapse, drooling, hypotension, increased swelling, rapid progression of symptoms, respiratory distress, skin changes, tongue swelling and vomiting. Pt became hot and light headed after receiving her shot. She was brought by WC to the bay. She was given water and an ice pack was laid on the back of her neck. ALLERGY REVIEW OF SYSTEMS: Patient complains of dizziness Hot and sweaty: CONT negative HENT negative Eyes negative Respiratory negative Skin negative GI negative Musculo negative Previous Reactions: None Objective Vitals Vitals: 03/18/21 1535 03/18/21 1550 BP: 131/67 130/75 Pulse: 84 65 SpO2: 100% 100% Physical Exam Vitals and nursing note reviewed. Constitutional: Appearance: She is well-developed. HENT: Head: Normocephalic and atraumatic. Right Ear: External ear normal. Left Ear: External ear normal. Nose: Nose normal. Eyes: Conjunctiva/sclera: Conjunctivae normal. Pupils: Pupils are equal, round, and reactive to light. Cardiovascular: Rate and Rhythm: Normal rate and regular rhythm. Heart sounds: Normal heart sounds. Pulmonary: Effort: Pulmonary effort is normal. Breath sounds: Normal breath sounds. Abdominal: General: Bowel sounds are normal. Palpations: Abdomen is soft. Musculoskeletal: General: Normal range of motion. Cervical back: Normal range of motion and neck supple. Skin: General: Skin is warm and dry. Capillary Refill: Capillary refill takes less than 2 seconds. Neurological: Mental Status: She is alert and oriented to person, place, and time. Assessment/Plan Treatment included: water and ice pack Follow up response to treatment: excellent. Patient discharge: Stable to go home and follow up with PCP. Differential Diagnosis: Local reaction (arm pain, bleeding/bruising, mechanical irritation, localized rash) Pt dismissed to go home at 3:57pm with coworker. Electronically Signed 3/18/2021 4:00 PM

Other Meds:

Current Illness:

ID: 1123402
Sex: F
Age: 40
State: CA

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

Lab Data:

Allergies: NKA

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

Symptoms: Patient was observed for 15 minutes and then left the building. She returned a few minutes later complaining about a neck and face rash, as well as throat swelling. She was given Benadryl 50 mg IM. O2 sats were 99-100% on RA, lungs clear . HR 105, B/P 158/80. She was taken t0 Treatment area of the clinic for further observation with Dr. .

Other Meds: Seroquel, gabapentin, Cymbalta, Verapamil

Current Illness: na

ID: 1123403
Sex: F
Age: 86
State: VA

Vax Date: 02/27/2021
Onset Date: 02/27/2021
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: no

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

Symptoms: pt states by noon after taking 2nd dose she had developed itching, chills, headache, body pain, and head was foggy. Pt had very odd body aches and pains, itching, and headaches that would come and go for weeks. These symptoms lasted at least 22 days before subsiding. Pt contacted her PCP and was told to take Claritin. Pt also had an annual appt w/ PCP where she did blood work but pt has not received any results. Pt no longer has these symptoms.

Other Meds: hydrochlorothiazide 13 mg qd, calcium citrate 250mg, omega 3 fish oil concentrate 1000mg, B Complex 100, Vitamin C 500mg, Alpha Lipoic Acid 600mg, magnesium citrate 210 mg, magnesium l-threonate 60mg, turmeric 450 mg, vitamin D3 25mcg, resv

Current Illness: no

ID: 1123404
Sex: F
Age: 35
State: OH

Vax Date: 12/28/2020
Onset Date: 01/07/2021
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: No

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

Symptoms: Migraines, dizziness, nausea, blurred vision about 10 days after vaccination. Very unsteady gait, sensitivity to light, numbness and tingling in my face, both sides, some vomiting. Still to this date, I feel numbness on my face, more common on the right side of my face. Arm pain, no swelling.

Other Meds: No

Current Illness: No

Date Died: 03/19/2021

ID: 1123405
Sex: F
Age: 80
State: MA

Vax Date: 03/02/2021
Onset Date: 03/19/2021
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: codeine, hydrocodone

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

Symptoms: None stated.

Other Meds: Flovent, Magnesium, Senna

Current Illness: ESRD, aortic stenosis, DM

ID: 1123496
Sex: F
Age: 57
State: IN

Vax Date: 03/20/2021
Onset Date: 03/21/2021
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: penicillin

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

Symptoms: Chills, fever, severe headache, neck and shoulder muscle pain, dizziness and almost passed out.

Other Meds: none

Current Illness: none

ID: 1123497
Sex: F
Age: 72
State: PA

Vax Date: 02/25/2021
Onset Date: 02/27/2021
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: Iodine, shell fish, kiwi and almonds

Symptom List: Ear pain, Hypoaesthesia

Symptoms: I felt fatigue even the day of the second vaccine. Then about 2 days after I had a severe and sudden bout of plantar facsitis, then increase in other arthritis symptoms. Then a week after I suffered a stomach virus. Then latter that same week for two days I experienced severe right leg pain. Then developed cluster rashes on the whole right leg. Went to Urgent care since we are wintering out of state. Was diagnosed with Shingles which I have never had and hope to never have again. The blisters are improving but the pain remains. I very strongly feel this is ALL due to the second dose of this vaccine. I certainly feel the second dose of this vaccine should not be given for at least 6 months.

Other Meds: nexium, Metoprolol succinate, crestor, tumeric

Current Illness:

ID: 1123498
Sex: F
Age: 34
State:

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

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Nausea and vomiting ,SOB - EPI given transported to the ED

Other Meds:

Current Illness:

ID: 1123499
Sex: F
Age:
State: NV

Vax Date: 03/03/2021
Onset Date: 03/06/2021
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: milk, eggs, propranolol, pepto bismol

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

Symptoms: Severe painful muscle spasms lasting ten days, foggy-headed for two weeks, trouble sleeping for one week, canker sores in mouth and sensitive gums for two weeks.

Other Meds:

Current Illness:

ID: 1123500
Sex: M
Age: 21
State: VA

Vax Date: 03/20/2021
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: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NONE

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

Symptoms: PATIENT EXPERIENCED A VAGAL REACTION DUE TO ANXIETY. BLOOD PRESSURE WAS LOW. ORAL REHYDRATION GIVEN WITH WATER. BP IMPROVED. MONITORED FOR 15 ADDITIONAL MINUTES AND RELEASED WITH MOTHER

Other Meds: NONE

Current Illness: NONE

ID: 1123501
Sex: M
Age: 57
State: TX

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

Lab Data:

Allergies: Aleve

Symptom List: Unevaluable event

Symptoms: lower back pain, brown urine, lasted for 24 hours, maybe 30 hours. I feel about 80% recovered

Other Meds: Bayer aspirin

Current Illness: lower back pain near center to right - at slightly above navel, brown urine (might be blood happened one time), fatigue. Started 3/21, lasted for about 24 hours. Feel 80% better now.

ID: 1123502
Sex: F
Age: 60
State: FL

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

Lab Data:

Allergies: None

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

Symptoms: Extreme fatigue starting next morning Saturday after vaccine. Slept almost continuously until Sunday afternoon.

Other Meds: None

Current Illness: Seasonal allergies

ID: 1123503
Sex: F
Age: 60
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: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Erythromycin, macrolides

Symptom List: Injection site pain, Pain

Symptoms: dizziness, flushing, slight chest tightness

Other Meds: Synthroid

Current Illness:

ID: 1123504
Sex: M
Age: 77
State: MI

Vax Date: 03/10/2021
Onset Date: 03/12/2021
Rec V Date: 03/22/2021
Hospital: Y

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

Lab Data:

Allergies: varenicline hydrocodone-ibuprofen niacin

Symptom List: Injection site pain, Menorrhagia

Symptoms: Pt received vaccine and two days later displayed reduced appetite, shortness of breath, chills, and cough productive of grayish thick sputum. Pt presented to hospital 5 days later (7 days after vaccination) with these symptoms, deemed to be in acute on chronic hypoxic/hypercarbic respiratory failure.

Other Meds: albuterol ammonium lactate topical aspirin atorvastatin bumetanide buspirone diltiazem empagliflozin escitalopram gabapentin hydroxyzine levothyroxine mesalamine metformin omeprazole trazodone warfarin

Current Illness: COPD HLD hypothyroidism PVD depression anxiety GERD diverticulosis atrial fibrillation

ID: 1123505
Sex: F
Age: 62
State: NY

Vax Date: 02/13/2021
Onset Date: 03/12/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: Penicillin

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

Symptoms: I had 2 gallbladder attacks, one 2 weeks after my 1 shot and then another attack 2 weeks after my 2nd shot. The 2nd attack put me in the hospital for 3 days.

Other Meds: Ursodol

Current Illness: PBC

ID: 1123506
Sex: M
Age: 69
State: CT

Vax Date: 03/15/2021
Onset Date: 03/19/2021
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: Darvon

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: I developed little (pimple size) red spots on my outer lower arms and on my outer upper legs.

Other Meds: Metformin, Victoza, Losartan,Lorazepam,Vitamin B6, Advil as needed,Pepcis as needed,Baby Aspirin

Current Illness: none

ID: 1123507
Sex: F
Age: 62
State: FL

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:
Dose Series: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Had shortness of breath, unable to breath properly

Other Meds:

Current Illness: Dialysis

ID: 1123508
Sex: F
Age: 56
State: IL

Vax Date: 03/22/2021
Onset Date: 03/22/2021
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: bees

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

Symptoms: Scratch in throat. Patient states has history of severe allergic reactions, states does not feel that sore

Other Meds: epi-pen

Current Illness: none

ID: 1123509
Sex: M
Age: 73
State: OH

Vax Date: 02/18/2021
Onset Date: 02/25/2021
Rec V Date: 03/22/2021
Hospital: Y

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

Lab Data:

Allergies: None

Symptom List: Nausea

Symptoms: Adverse Events: chills, dizziness, difficulty standing, weakness,confusion,light-headiness Treatment: zosyn,vancomycin,acyclovir Outcomes: spent 8 days in hospital and 5 days in acute rehab recovering. As of March 17, 2021, under primary physician care due to ongoing occurrences of weakness, sleepiness, nausea and chills.

Other Meds: allopurinol,amLODIPine,Nexium,levothyroxine,lisinopril,metopro

Current Illness: None

ID: 1123510
Sex: F
Age: 53
State: FL

Vax Date: 03/19/2021
Onset Date: 03/21/2021
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: Erythromycin

Symptom List: Injection site pain

Symptoms: Lump, redness, and heat in injection site on the day after the second shot. The second day after the shot developed swelling in the neck on left side between neck and shoulder area. Third day lymph node swelling and pain when swallowing. Arm still red, swollen and hot on third day after the shot. I have iced down both area which has not helped. I contacted occupational health as I work at a hospital and received the vaccine there. I was told to contact my PCP, which I did and am waiting to hear back.

Other Meds: Metformin ER 500mg 2x daily, Vascepa 1 gram 2 capsules 2x daily, Rebelus 14mg once a day, Lovastatin 20mg once a day, Multivitamin, Vitamin D2 50,000 units twice a week, Glucasamine HCI 1500mg/MSM 1500mg, Magnesium, Sambusus Elderberry 3

Current Illness: None

ID: 1123511
Sex: F
Age: 60
State:

Vax Date: 03/18/2021
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:

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

Symptoms: patient states "feels foggy" and dizzy starting 2 days post vaccine, still ongoing 4 days post vaccine

Other Meds:

Current Illness:

ID: 1123512
Sex: F
Age: 51
State: IN

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: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: iodine codiene

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

Symptoms: I felt like I had the flu. Extreme muscle pain in both arms and legs. Fever, tired, chills, overall weakness. The event occurred around 2:00pm the day following the shot.

Other Meds: telisartan oxybutin methotrexate trimeterine

Current Illness: Psoriatic Arthritis Lupus high blood pressure

ID: 1123513
Sex: F
Age: 37
State: TN

Vax Date: 02/26/2021
Onset Date: 02/26/2021
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: Penicillin seroquel

Symptom List: Tremor

Symptoms: Reports since having dose 2 of Moderna vaccine: feels flushed, anxious, nausea, off/on body aches, light headedness, and off/on diaphoresis that occurs daily. She has not seeked treatment/evaluation as of today 3/22/2021. She reported to provider today and scheduled her to f/u with physician 3/22/2021 at 1:40pm.

Other Meds: Alprazolam Oxcarbazepine trazodone bupropion fluoxetine

Current Illness: denies

ID: 1123514
Sex: F
Age: 42
State: GA

Vax Date: 03/05/2021
Onset Date: 03/13/2021
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: Latex

Symptom List: Erythema, Pruritus

Symptoms: Rash (red/raised) noted below the injection site. Faded by March 15, 2021 - Returned March 17, 2021 with additional spots below the original rash.

Other Meds: Multivitamin, Probiotic, L-Lysine 1000mg

Current Illness: None

ID: 1123515
Sex: M
Age: 23
State: ID

Vax Date: 03/12/2021
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: Large rash at site. Pain, swelling. extreme fatigue.

Other Meds:

Current Illness:

ID: 1123516
Sex: F
Age: 33
State: SC

Vax Date: 03/09/2021
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: LA

Lab Data:

Allergies:

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

Symptoms: Pain in muscle and bone on upper arm and shoulder that has not abated in several days; stiffness and sharp pain near injection site; pain has become unmanageable even with ibuprofen

Other Meds: Cetirizine hydrochloride 10 mg, azelastine hydrochloride and fluticasone propionate nasal spray 50 mcg per spray, smarty pants women?s formula supplements

Current Illness:

ID: 1123517
Sex: F
Age: 25
State: KY

Vax Date: 02/11/2021
Onset Date: 02/11/2021
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: seasonal environmental

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: headache, fever, muscle aches, joint pain, nausea, diarrhea

Other Meds: Protein powder, fluticasone, Zyrtec - PRN

Current Illness: none

ID: 1123518
Sex: F
Age: 49
State: TX

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: SYR
Vax Site: LA

Lab Data:

Allergies: unknown

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

Symptoms: client reported to EMS personnel that their lips, throat felt swollen and they were having difficulty breathing. patient transported to Hospital for further evaluation.

Other Meds: unknown

Current Illness: unknown

ID: 1123519
Sex: F
Age: 59
State: CO

Vax Date: 03/11/2021
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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: bees, aspirin, clindamycin, PCN, soma, strawberry, tomato

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

Symptoms: Patient presents to urgent care 4 days afer 1st covid vaccine with chest discomfort, SOB, body aches, arm pain. Mild vaccine reaction, follow up with PCP.

Other Meds:

Current Illness:

ID: 1123520
Sex: M
Age: 53
State: CT

Vax Date: 03/16/2021
Onset Date: 03/22/2021
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: penicillins

Symptom List: Pain in extremity

Symptoms: Low hemoglobin detected when attempting to donate blood. Completely asymptomatic, but was rejected from donating blood today because of a fingerstick Hgb 11.7 gm/dl. This result was duplicated when the fingerstick was redone. I've never been told that I am anemic before.

Other Meds: Azor 5/20 qd; escitalopram 10mg/d; atorvastatin 10mg/d

Current Illness: none

ID: 1123521
Sex: F
Age: 33
State: WA

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

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

Symptoms: Per vaccinator's account, patient became unresponsive immediately following IM injection at 1440 into left deltoid and slumped down in chair. Vaccine Floor Manager (reporter of this Adverse Event) was called over who then radioed for the on-site paramedics to respond. Vaccinator verified patient was still breathing. She was bradycardic with a pulse in the 40's per vaccinator. Within 15-20 seconds of becoming unresponsive, patient became responsive as paramedics came into vaccine room. Paramedics took vitals and measured a systolic blood pressure of 80 and pulse 44-50 BPM, 98% oxygen. Patient was alert and oriented at this time, transferred to a transport chair and sent to on-site Emergency Room for further evaluation. As staff were leaving the clinic site at approximately 1630 (including this reporter), we encountered patient self-ambulating in no apparent distress back to her car having been discharged from the emergency room.

Other Meds: unknown

Current Illness: unknown

ID: 1123522
Sex: F
Age: 67
State: WI

Vax Date: 03/17/2021
Onset Date: 03/19/2021
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: erythromycin, penicillin azithromycin morphine odansetron

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

Symptoms: Patient was hospitalized with fever, body aches, inability to transfer and SIRS. Increased liver enzymes as well

Other Meds: Bisacodyl, citalopram, docusate, furosemide, ibuprofen, florajen, levothyroxine, melatonin, sumatriptan succinate, calcium carbonate, ascorbic acid, oxycodone,

Current Illness: none

ID: 1123523
Sex: F
Age: 21
State:

Vax Date: 02/17/2021
Onset Date: 03/11/2021
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:

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

Symptoms: This employee was vaccinated on 1/27 and 2/17. On 3/9 employee saw her Uncle for 10 minutes, no masks but hugged each other. Uncle had been living with family for one month. On 3/10 Uncle tested Covid +. Patient immediately isolated from Uncle (he was removed from the household). Patient phoned Covid EHS on 3/11 and was set up for testing on 3/16 (asymptomatic). Patient obtained her own Covid test on 3/11 (not at Hospital) and resulted Covid negative. Hospital test completed on 3/16 (5 days post exposure) and tested Covid Positive. Patient's 5 year old brother now is Covid Positive, and employee's father is being tested, no results yet.

Other Meds:

Current Illness:

ID: 1123524
Sex: F
Age: 23
State: OK

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: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Percoset

Symptom List: Vomiting

Symptoms: client began feeling like tongue was thick, blurry vision, general itching all over body 3 minutes after receiving immunization. 10:05 am: Client was given 0.5 ml of Benadryl IM in the Right deltoid. Vital signs were bp 121/85, respirations @ 20, heart rate 90 bpm. Oxygen sats were 98%. Client was assessed by paramedics. 10:18 am: bp 114/82, Oxygen sats at 100%, heart rate 82. Client reported she felt less urticaria, less tongue thickness, and vision improved. Watched client for the next hour. Last assessment: 11:07 am: blood pressure 110/74, heart rate 80, no tongue thickness, no itching, no blurred vision. Client left on own accord and drove self home from vaccine pod. Recommended client follow up with primary care physician to discuss options for second dose of moderna vaccine.

Other Meds: Depakote, Albuterol inhaler

Current Illness: none

ID: 1123525
Sex: F
Age: 28
State: AZ

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: 037K20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Allergic to Pennecillin & Ibu Profin - both cause a mild body rash

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Shot taken at 4:45pm on 3/15/2021 in the left arm - intramuscular shot. Around 8:00pm the next day, 3/16/2021, I began to notice swollen lymph nodes under armpits. Upon waking up Wednesday morning, 3/17/2021 @ 8:00 AM, I had multiple severely swollen lymph nodes under both armpits note that my right armpit has been constantly more severe, Id began to get a mild sore throat and throughout the day I gained a cough. My swollen lymph nodes continued to get worse until Saturday 3/20, at which point they began to subside. As of today, 3/22/21 @ 11:20 AM, I currently still have 2 small swollen lymph nodes under my right armpit, as well as a sore throat, which seems to be getting worse with time.

Other Meds: Skyla IUD

Current Illness: none

ID: 1123526
Sex: M
Age: 41
State: MN

Vax Date: 03/19/2021
Onset Date: 03/19/2021
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: Patient received injection with no vaccine in it, was empty with just air. Pt showed no symptoms of adverse events, this is just a report of error in administration. He was then administered a dose of the vaccine separated by a couple of inches from the location of the original injection of air.

Other Meds:

Current Illness:

ID: 1123527
Sex: M
Age: 73
State: PA

Vax Date: 03/18/2021
Onset Date: 03/20/2021
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: Balsalazide Gluten Meal Augmentin Clindamycin Gliadin Lactose Levaquin [Levofloxacin] Wheat Bran

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Fatigue on March 20-21, 2021

Other Meds: 1) Allopurinol 300 mg tablet, take 300 mg by mouth daily. 2) Aspirin ec 81 mg ec tablet, take 81 mg by mouth daily. 3) Carvedilol 6.25 mg tablet, take 1 tablet by mouth 2 times a day. 4) Centrum silver or tabs, 1 tablet daily 5) Cholecalcif

Current Illness: NONE

ID: 1123529
Sex: F
Age: 73
State: GA

Vax Date: 02/22/2021
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: RA

Lab Data:

Allergies: None.

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

Symptoms: Got the vaccine, she had no side effects and about 3/12/201 noticed a major rash from above the elbow, inner aspect of her arm down to her wrist. This was bright red. She put cortisone on it, and now it's brownish and rough in nature. It is 4" above the elbow and probably down to about 2-3" above the wrist, watch area. It runs up the outer aspect of the arm to the elbow. She put cortisone cream on it, the redness and inflammation was there for about 2 days, and now it has changed to the brownish/rough area. She did not go to the doctor, just took the OTC Cortisone cream. It is not itching, it did not itch, just red and inflamed.

Other Meds: HCTZ, aspirin 81, vitamin D.

Current Illness: None.

ID: 1123530
Sex: F
Age: 54
State: CT

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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Pen VK, Sulfa,Vicodin

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

Symptoms: The patient received the vaccine and when she went to her car she was feeling short of breath. When the EMT arrived they gave her an epi-pen. We called and checked on the patient. She stated that they did not believe it was anaphylaxis but they gave her an Epipen as a precaution. The patient is doing well.

Other Meds: unknown

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm