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: 1123911
Sex: M
Age: 52
State: MD

Vax Date: 03/17/2021
Onset Date: 03/18/2021
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: Penicillin

Symptom List: Dysphagia, Epiglottitis

Symptoms: Red rash around my neck area, also on both insides of my elbows, and on my right armpit.

Other Meds: Lantus, Humulog, Diovan, Advair, Flonase, Aspirin

Current Illness:

ID: 1123912
Sex: M
Age: 64
State: PA

Vax Date: 03/09/2021
Onset Date: 03/18/2021
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: MOBIC, SULFA, PENICILLIN

Symptom List: Anxiety, Dyspnoea

Symptoms: I received my first Pfizer vaccine on 3/9. This past Thursday, 3/18/21, I woke up with increased tinnitus (I?ve always had some) and hearing reduction in my right ear. It reminded me of a middle ear infection I had in my youth but this one had resulted in no pain, fever, or dizziness. I do not have a cold or any infectious respiratory issues. I found that it did resolve somewhat if I?d move to a higher elevation and as the day progressed. My left ear would have short spells that would eventually resolve. This continued through Sunday evening when my right ear cleared and I noticed a foul taste in my mouth. Today it?s resumed somewhat, not to the level it was at before, with a little congestion in my left ear...it "crackles" a little when I swallow, but often will clear if I yawn or cough. I did a little research about the Pfizer vaccine and this situation is listed as a possible side effect that is supposed to be reported, so I am doing so.

Other Meds: CLARITIN, VITAMIN D3 5000 IU, PSYLLIUM FIBER 2.0 TSP

Current Illness: NONE

ID: 1123913
Sex: M
Age: 41
State: IL

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: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Pt's wife reports "he had a fever and swollen lymph nodes in his jaw and elbow. the injection site arm was tender to touch"

Other Meds:

Current Illness:

ID: 1123914
Sex: M
Age: 57
State:

Vax Date: 02/09/2021
Onset Date: 03/17/2021
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:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Cough Shortness of breath

Other Meds:

Current Illness:

ID: 1123915
Sex: F
Age: 64
State: NC

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 03/22/2021
Hospital:

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

Lab Data:

Allergies: Septra

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

Symptoms: Ongoing aching pain, tingling and weakness in joints, primarily in lower extremities. I have had to take extra strength Advil everyday since my vaccine to complete adls and work. I am a nurse. I have a high deductable insurance and have not sought medical care. I start Medicare in July. On 3/19/21 my right knee gave out on the stairs and I suffered a tibial plateau fracture. I did tell the ER that I thought I had had ongoing vaccine side effects prior to injury but I do not know if he documented that. I was seen at emergency room. I have an orthopedic appt on 3/24 .

Other Meds: Protonix, Fluoxitine, Buspirone, cephalexin

Current Illness: none

ID: 1123916
Sex: F
Age: 58
State: ID

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: NKDA

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

Symptoms: Dizziness, hypertension 210/120, chest tightness, normal HR. Treatment: 0.1mg Clonidine tablet x2PO. Improved sypmtoms, BP was stable at 160/69.

Other Meds: NO MEDICATIONS

Current Illness: None

ID: 1123917
Sex: F
Age: 60
State: CO

Vax Date: 03/12/2021
Onset Date: 03/18/2021
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

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Day 7 notes slight "rash" but unsure it was issue Day 8 ( Friday) maybe slightly more- did not itch- didn't pay much attention Day 9 -trunk to breasts (no back) - small red bumps- on tummy appears as large red areas - larger bumps both legs- slightly less on both arms- they do get small and red near ankles- tried benadryl oral - no change Day 10- as above- tried witch hazel only some spots- 2% hydrocortisone cream only some pots and combo some sport- noted no change Day 11 ( 3/22) as above- no real change

Other Meds: Estrogen patch testosterone cream- compound Progesterone Vit D Melatonin ASA ( post Knee surgery-) Miloxicam ( post surgery)

Current Illness: NO illness ( Meniscus surgery 2/24/21)

ID: 1123918
Sex: F
Age: 64
State: KY

Vax Date: 03/17/2021
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: None

Symptom List: Pharyngeal swelling

Symptoms: Rash from shoulder to elbow. It wasn?t itchy or irritated. The rash has reduced. I did not contact my doctor since I didn?t feel it was serious. I wanted to report this possible side effect.

Other Meds: Aspirin 81mg, Benazepril HCL 20mg, Hydrochlorothiazide 25mg, Methimazole 10mg, Potassium CL 20% Liquid, Metoprolol Succ 200mg and Simvastatin 40mg

Current Illness: None

ID: 1123919
Sex: F
Age: 42
State: IN

Vax Date: 03/14/2021
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: None

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: COVID arm or delayed cutaneous hypersensitivity. Redness, swelling, itchiness a week after first dose. A bit sore. I've taking Bandyl and iced the area and it seems to help

Other Meds: Nuvaring, pro-biotic, vitamin-D, complete aminos, pre-workout

Current Illness: None

ID: 1123920
Sex: M
Age: 35
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: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: following vaccine client complained of feeling dizzy and nervous. Per Dr he was experiencing a vasovagal event with no syncope. Blood pressure initially 83/43 then within 5 minutes 129/65. Pulse 54 then 79. 02 saturation 100%. juice given x 2 then released once symptoms resolved. EMS on site also.

Other Meds:

Current Illness:

ID: 1123921
Sex: M
Age: 52
State: NJ

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

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

Lab Data:

Allergies:

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

Symptoms: EUA Pfizer-BioNTech vaccine reaction About 101 min after receiving vaccine, patient complained of chest pain rated 7/10.

Other Meds:

Current Illness:

ID: 1123922
Sex: F
Age: 52
State: NY

Vax Date: 03/08/2021
Onset Date: 03/15/2021
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: None

Symptom List: Rash, Urticaria

Symptoms: Slowly increasing pain in muscles and tendons of wrist/thumb (previous tendinitis was 10+ years ago and no change of habit accounts for this pain). Occasional breast itchiness I have not experienced since discontinuing seasonal allergy shots 5+ years ago. Above two symptoms feel like general increase in body inflammation. Some minor fatigue and lymph node swelling.

Other Meds: Vitamin D, multivitamin, calcium, melatonin

Current Illness: None

ID: 1123923
Sex: M
Age: 57
State: FL

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: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: FEVER,CHILL,HEADACHE ,AND BACK MUSCLEACHES

Other Meds:

Current Illness:

ID: 1123924
Sex: F
Age: 38
State: FL

Vax Date: 03/13/2021
Onset Date: 03/13/2021
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: shell fish

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

Symptoms: upon initial injection, pins and needles down left arm. Immediate onset of high blood pressure. Few hours later developed typical "flu like symptoms". Next day woke up and both arms, hands, legs and feet and side of face had pins and needles and felt numb. Heart rate sky rocketed and went to ER. Felt like I was going to pass out. Took blood work at hospital and doctors reassured that the feeling should come back in my legs and arms. When I left 6 hours later my legs were still pins and needles and my joints began to hurt. A week later and this feeling continues to come and go, but is not consistent. My joints still randomly hurt and I am an active 38 year old with three kids.

Other Meds: n/a

Current Illness: n/a

ID: 1123925
Sex: M
Age: 54
State: MA

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: none

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

Symptoms: patient received first dose of COVID vaccine. while waiting in observation area patient felt dizzy with blurry vision. Began to feel a tingling sensation down both his legs. MD onsite assessed patient. . tingling sensation improved. Walked with with shoveling gait with assistance. Normally walks with cane since recent hospitalization. Not an allergic reaction. ER precautions reviewed client with patient then cleared to go home. Nurse called patient in pm, reports feeling better with mild soreness at injection site. Denies pain or tingling..Tingling sensation felt after vaccine has resolved, denies blurred vision and has his usually energy. BP again at home reported at 125/88 2 hours ago. No concerns at this time. Reminded of upcoming appointment and availability of on call providers eve and weekend if needed.

Other Meds: Amlodipine, Lisinopril

Current Illness:

ID: 1123926
Sex: F
Age: 37
State: MA

Vax Date: 01/08/2021
Onset Date: 03/15/2021
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: Symptomatic breakthrough COVID 19 disease after completing vaccine series

Other Meds: Methaltrexate po weekly

Current Illness:

Date Died: 03/16/2021

ID: 1123927
Sex: F
Age: 59
State:

Vax Date: 02/22/2021
Onset Date: 03/16/2021
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:

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

Symptoms: NA CAD, Chronic Abd pain with Opioid treatment - Chronic Pancreatitis

Other Meds:

Current Illness:

ID: 1123928
Sex: F
Age: 62
State: NY

Vax Date: 02/27/2021
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: none

Symptom List: Ear pain, Hypoaesthesia

Symptoms: I had a headache within an hour of the vaccination, followed shortly by nausea. My entire arm was extremely painful to the touch, not only the injection site, It was painful to move my arm at all. By 7:30 PM, I had a fever and chills. By the morning of the 28th all symptoms were gone except sensitivity at the injection site.

Other Meds: Vivelle 0.05mg/day Tirosint 112mg daily

Current Illness: No illnesses at the time of the vaccination.

ID: 1123929
Sex: F
Age: 84
State:

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

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: Shortness of breath leg swelling

Other Meds:

Current Illness:

ID: 1123930
Sex: F
Age: 16
State: CT

Vax Date: 03/07/2021
Onset Date: 03/07/2021
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: None noted.

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

Symptoms: Receipt of invalid dose of vaccine. Pt did not meet age criteria for EUA product. It is anticipated that patient will receive second dose of Moderna to complete the series.

Other Meds: None

Current Illness:

ID: 1123931
Sex: M
Age: 61
State: CA

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: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: N/A

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

Symptoms: PATIENT WAITED THE 15 MINUTES AS ADVISED BY THE VACCINATOR BECAUSE OF NO PREVIOUS HISTORY OF ADVERSE AFFECTS FROM VACCINES AND NO ALLERGIC REACTIONS TO MEDICATIONS. PATIENT WAS GIVEN FLUIDS AND FOOD. PATIENT STATES THAT HE FEELS BETTER NOW.

Other Meds: N/A

Current Illness: N/A

ID: 1123932
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: Treatment included: water, snacks and laying down. Follow up response to treatment: excellent. Patient discharge: Stable to go home and follow up with PCP

Other Meds:

Current Illness:

ID: 1123933
Sex: F
Age: 96
State: SC

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

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

Symptoms: Extreme redness and warmth over the injection site and larger area---involving almost entire upper arm. Complains of itching; not painful. Worse on day 3 (yesterday). Appears to be responding to steroid cream.

Other Meds: Memantine, Prozac, calcium, eye vitamin, tylenol

Current Illness:

ID: 1123934
Sex: F
Age: 63
State: MI

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: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: penicillins, sulfa drugs

Symptom List: Injection site pain, Pain

Symptoms: Brain fog (forgetfulness, wondering what I needed to do), unsteadiness when walking and on stairs; normally walk quickly and on stairs, vision was off a bit more. Reactions started 12 hrs. after receiving shot and the 2nd day. 3rd day was fine.

Other Meds: ibuprofen, levothyroxine, tramadol, estradiol, flexeril, vitamin C, biotin PO, vitamin D3, esomeprazole, pepcid, lisinopril, imodium, loratadine, multi-vitamin, simethicone, fiber supplement

Current Illness: N/A

ID: 1123935
Sex: M
Age: 52
State: WA

Vax Date: 02/28/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Ear congestion, tinnitus

Other Meds:

Current Illness:

ID: 1123936
Sex: M
Age: 66
State: IN

Vax Date: 02/03/2021
Onset Date: 02/05/2021
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: Penicillin

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

Symptoms: Lower legs felt tired and sore., muscle pain. Progressively got worse over the month of February making it nearly impossible to bend, raise and lower myself. Saw my personal doctor on March 1st. He does not think it is vaccine related. Rans some bloodwork tests. Put me on Prednisone for 3 weeks. That did alleviate the muscle soreness/stiffness but that seems to be starting to return now that I am no longer taking it. Have a Dr. appointment with a Rhuematologist on Friday 3/26/2021.

Other Meds: Lisinopril 20mg Atorvastatin 40 mg Low Dose Aspirin 81mg Men's Daily Vitamin Vitamin C 500 MG Vitamin D Omega 3 600mg Loratadine 10mg

Current Illness: No illness but I did have the Shingrix Shingles vaccinne on January 12, 2021.

ID: 1123937
Sex: F
Age: 51
State: GA

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: LA

Lab Data:

Allergies: White potato allergy.

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Diarrhea.

Other Meds: Bystolic 20mg, Valsartan 160mg, Multivitamin

Current Illness: None.

ID: 1123938
Sex: F
Age: 60
State: TX

Vax Date: 03/02/2021
Onset Date: 03/03/2021
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: pensaid atopical ointment

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: 3/3 - very sore arm & achyness, 3/4 - sore arm continued, 3/5 - woke up with vertigo that subsided quickly, but dizziness, and headache on right side with brain fog continued, 3/7 - lymph node under right arm swollen and very sore and lasted about 1 week. vertigo in the morning stopped, but dizziness and headache continued, 3/9 - soreness in the arm is back with swelling, redness and itchy. this only lasted a couple of days 3/17 - dizziness and headache continued. dizziness is worse in the morning. developed a back spasm probably unrelated to the vaccine, but started taking meloxican for inflamation of the back. Coincidentally, it seemed to help with headache and dizziness. Still taking meloxican and headache and dizziness are minimal, but still present. Will be getting off the meloxican on Friday, 3/26, and we'll see??? 3/ 20 - started with fever blisters and mouth ulcers(probably from shot or stress all this has brought on my body)

Other Meds: lisinopril, lovastatin, vitamins d3 & b12, nasacort, allegra

Current Illness: none

ID: 1123939
Sex: F
Age: 48
State: FL

Vax Date: 03/12/2021
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: RA

Lab Data:

Allergies: none

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

Symptoms: Covid Arm

Other Meds: Omeperazole Zertec Multi Vitamin

Current Illness: none

ID: 1123941
Sex: F
Age: 33
State: MA

Vax Date: 03/18/2021
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: IM
Vax Site: RA

Lab Data:

Allergies: Latex, shellfish, fish oil

Symptom List: Nausea

Symptoms: High fever (102.7 at peak): 20 hours post vaccine, lasted 11 hours Diarrhea: 24 hours post vaccine, lasted 24 hours Headache: 2 hours post vaccine, ongoing now (4 days out) Muscle and joint pain: 20 hours post vaccine, lasted 48 hours Swelling and rash on injection arm: 48 hours post vaccine, ongoing and spreading, hot to touch Exhaustion: 4 hours post vaccine, ongoing

Other Meds:

Current Illness:

ID: 1123943
Sex: F
Age: 45
State: LA

Vax Date: 02/02/2021
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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Injection site pain

Symptoms: About 3 weeks ago, I began to notice that coffee smelled odd. Since then, my sense of taste and smell have increasingly worsened to the point that I am extremely nauseated. It is awful.

Other Meds: Metformin Beyaz Synthroid Zoloft Wellbutrin

Current Illness: None

ID: 1123944
Sex: F
Age: 68
State: CT

Vax Date: 03/21/2021
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:

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

Symptoms: Fever, severe chills, fatigue., body aches, headache .

Other Meds:

Current Illness:

ID: 1123945
Sex: F
Age: 76
State: RI

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: RA

Lab Data:

Allergies: Multiple allergies

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

Symptoms: 30 Minutes after receiving the vaccine, patient began having a self reported allergic reaction. Complaining that her nose and face was beginning to swell. + nausea. When I arrived to assess the patient, she was tachypneic and trying to self administer benadryl

Other Meds: Unknown

Current Illness: Unknown

ID: 1123946
Sex: F
Age: 63
State: MN

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

Lab Data:

Allergies: Thimerosal, Celexa

Symptom List: Tremor

Symptoms: day after: bruise, 2 inch red circle, soreness in vaccination area - improved after icing 7 days later: area itchy, larger red circle/rash, area hard & warm to touch At day 13 - symptoms lessened, but not totally gone Similar symptoms to description of COVID arm

Other Meds: Wellbutrin SR, Atenolol, Triamterene-HCTZ, Vitamin D

Current Illness: none

ID: 1123947
Sex: F
Age: 51
State: UT

Vax Date: 03/11/2021
Onset Date: 03/14/2021
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: tetracycline

Symptom List: Erythema, Pruritus

Symptoms: Severe Rash on both arms. Centering in the creases in both elbows. Look like a severe sunburn

Other Meds: Montelukast 10 mg Celecoxib 200 mg Gabapentin 100 mg take other herbal medications

Current Illness: None

ID: 1123948
Sex: F
Age: 42
State:

Vax Date: 03/21/2021
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: 3/21/2021 Patient was observed post Covid-19 immunization for 30 minutes based on pre-vaccination screening . During the observation period, she experienced an adverse reaction with the following symptoms: Dizziness, patient reports" this always happens to me". Assessment : Time of assessment 1740pm. Alert and oriented. Actions taken: 1745pm- Lying on stretcher, VS- BP- 98/73, patient reports is her baseline, P- 81, O2- 99%. At 1810pm- Vs BP 113/64/ P- 72, O2- 100% Medications administered: No medication administered. Disposition: Reports no further symptoms of adverse reaction after observation for 30 minutes. Discharged home. Immunizations Administered Name Date Dose VIS Date Route Pfizer COVID-19 Vaccine 3/21/2021 5:26 PM 0.3 mL 12/11/2020 Intramuscular Manufacturer: Pfizer, Inc Lot: ER2613 NDC: 59267-1000-1 Electronically signed by RN at 3/21/2021 7:55 PM Immunization on 3/21/2021 Detailed Report Note shared with patient

Other Meds:

Current Illness:

ID: 1123949
Sex: F
Age: 19
State: IL

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: NKDA

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

Symptoms: Mild frontal headache. Subtle lightheadedness. Patient was given a bottle of water, box of orange juice, and recommended to take a dose of Acetaminophen.

Other Meds: unknown

Current Illness: None

ID: 1123950
Sex: F
Age: 28
State: TX

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

Lab Data:

Allergies: None

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Big round red bump. Looks like a big mosquito bite and itches.

Other Meds: Iron gummies over the counter

Current Illness: High blood pressure

ID: 1123951
Sex: M
Age: 42
State: TX

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

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

Symptoms: Hives. 11 hrs later

Other Meds:

Current Illness:

ID: 1123952
Sex: F
Age: 0
State: PA

Vax Date: 08/15/1949
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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Pollen Penicillin Cefdiner Tetracycline

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

Symptoms: Tongue irritated, Throat irritated Rash appearing on stomach back upper legs very itchy

Other Meds: Calcium citrate Hrdrochlorothiazide Magnesium Nasonex

Current Illness: None

ID: 1123953
Sex: F
Age: 40
State:

Vax Date: 03/12/2021
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: IM
Vax Site: LA

Lab Data:

Allergies: None known

Symptom List: Pain in extremity

Symptoms: Approximately one week after receiving my first dose of the COVID19 Pfizer vaccine, I experienced soreness, redness and itchiness at and around the injection site. All three symptoms lasted 3 days and then cleared. The itchiness was treated with a topical cortizone cream which did provide relief.

Other Meds: Apri (birth control)

Current Illness: None known

ID: 1123954
Sex: M
Age: 77
State: IL

Vax Date: 03/18/2021
Onset Date: 03/18/2021
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: none

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

Symptoms: Patient received a Pfizer vaccine at another clinic on 03/05/2021 and the Moderna vaccine on 03/18/2021 from this facility.

Other Meds: unknown

Current Illness: none

ID: 1123955
Sex: F
Age: 46
State: VT

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: penicillin, egg whites, other antibiotics

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

Symptoms: Rash, fever , severe headache for 2 days; exhaustion, body aches continuing on day 4 so far

Other Meds: Junel

Current Illness: none

ID: 1123956
Sex: F
Age: 26
State: CA

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:

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

Symptoms: 103 degree fever, headache, fatigue, muscle and joint pain, injection site pain, chills, fever, and nausea. Developed symptoms starting at about noon the day after vaccination and progressively got worse throughout the afternoon and evening. Symptoms made it impossible to conduct normal activities but have mostly resolved in the second day.

Other Meds: Spironolactone, birth control, Vitamin D

Current Illness:

ID: 1123957
Sex: F
Age: 62
State: IL

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

Lab Data:

Allergies: None

Symptom List: Vomiting

Symptoms: Diarrhea, Nausea, Extremely low energy for the course of a day and a half.

Other Meds: None

Current Illness: None

ID: 1123958
Sex: F
Age: 66
State: CA

Vax Date: 03/19/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: Sulfa

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Red rash at vaccination site.

Other Meds: Kisquali Vitamin B-12 Blood pressure meds Calcium w/ vitamin D

Current Illness: Stage 4 Breast Cancer

ID: 1123959
Sex: M
Age: 26
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: Penicillin

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

Symptoms: Sore Throat

Other Meds: None

Current Illness: Tonsilitis

ID: 1123960
Sex: M
Age: 71
State: VA

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: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Aspirin; Penicillin; Have to avoid blood thinners

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Night sweats that night and elevated blood pressure for 2 days.

Other Meds: Clonidine 0.2 mg; Lisinopril 20mg; Hydrochlorothiazide 25mg

Current Illness:

ID: 1123961
Sex: F
Age: 39
State:

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: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: Client unable to communicate in English, translation done by her son. Client complained of left arm and shoulder swelling following vaccination. Benadryl IM offered by Dr but refused as driving. Did agree to take po Benadryl she had at home. Blood Pressure 144/87 and pulse 70. No breathing issues. oxygen saturation was 100%. Released by Dr to home.

Other Meds:

Current Illness:

ID: 1123962
Sex: F
Age: 57
State: VA

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

Lab Data:

Allergies: None known.

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

Symptoms: Saturday, within 6-8 hours started with fatigue. Then later that evening chills, headache, fever, and aches. During the first night my ear started kind of ringing and feeling in a funnel or clogged or something (different from anything experienced before). Sunday, continued with fatigue, headache, fever, body aches, generally not feeling well, and ear continued to get worse with some hearing loss. Now today (Monday) I can't hear as well in my left ear and it's a type of ringing and still feeling clogged or in tunnel or something like that. Hard to describe... but I can't hear as well in that ear.

Other Meds: Generic Zyrtec seasonal allergy medicine. Ran out of my thyroid medication so I wasn't taking that.

Current Illness: Seasonal allergies.

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm