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: 1124122
Sex: F
Age: 52
State: CA

Vax Date: 03/05/2021
Onset Date: 03/05/2021
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: Hydrochodone

Symptom List: Dysphagia, Epiglottitis

Symptoms: 6 days of issues. Started with headache, nausea, tired, weak, off/on feverish, body aches and left arm hurt and tingled from shoulder to finger tips all 6 days. Still feel some off and on tingling where I received shot as of today's date.

Other Meds: Multi vitamin, elderberry, vit D3 5000 IU, zyrtec, microzide 12.5mg, losartan 25mg,

Current Illness: N/a

ID: 1124123
Sex: F
Age: 63
State: IL

Vax Date: 03/02/2021
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: None.

Symptom List: Anxiety, Dyspnoea

Symptoms: Two weeks after receiving the first Moderna vaccine for COVID-19, patient started to have a fever of 102, muscle aches, extreme fatigue, and extreme joint pain bad enough that she is suddenly needing to use a walker and a wheelchair (5 days on from onset of these symptoms). ? ?She had received the shingles vaccine 21 days prior to the first Moderna vaccine (she was told it was ok if it was at least 14 days prior). ? ?She has been tested three times for COVID-19 (multiple strains) since the onset of her symptoms (all negative) and her doctor, sent her for a bunch of follow-up tests at Hospital over the weekend (all normal). Patient has only ever had slight osteo-arthritis starting in her hands before, so this issue with suddenly not being able to walk is coming completely out of the blue. ? ?Have you heard of any delayed reactions to the vaccine like this? ? ?Is it possible? ?

Other Meds: None at time of vaccination. Tylenol, Advil, and Flonase were taken at various times since March 17, 2021 in response to onset of symptoms/potential reaction. Patient received the second dose of the Shingrix vaccine on February 9, 2021

Current Illness: None.

ID: 1124124
Sex: F
Age: 29
State: CO

Vax Date: 02/16/2021
Onset Date: 02/18/2021
Rec V Date: 03/22/2021
Hospital: Y

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: Adhesive, Latex

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

Symptoms: 29 y/o female presented to hospital with complaints of SOB, skin flares secondary to history of discoid lupus, protracted vomiting, and joint pain. Side effects began 2 days after her 2nd COVID vaccine. Pt was transferred to hospital from another institution due to O2 sat in the 60s (room air), leukocytosis, and AKI. Patient was treated empirically for sepsis/pneumonia as well as lupus flare. She was also initiated on high dose steroids. Possible reaction to vaccine. Chest CT showed diffuse ground-glass opacities and no signs of pulmonary embolism. Pt was transferred from hospital to another facility given progressive organ failure, most specifically liver failure.

Other Meds: Hydroxychloroquine, amlodipine, prn clonidine, prn APAP; aripiprazole, aspirin, clonazepam (prn), fluoxetine, lamotrigine, pregabalin, trazodone (prn), furosemide, sevelamer, prednisone

Current Illness: N/A

ID: 1124126
Sex: M
Age: 59
State: OH

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

Lab Data:

Allergies: NKA

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Shoulder pain and limited mobility (extremely limited d/t pain) for 48+ hours now; not quite 72 hours. pt taking high-dose ibuprofen and tylenol and will f/u this week with me if symptoms persist.

Other Meds: n/a

Current Illness: None.

ID: 1124127
Sex: F
Age: 92
State: HI

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: 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: ALLERGIC REACTION WAS RASH IN BLOTCHES AND HIVES THAT MOVED ALL AROUND THE BODY, SEVERE ITCHING. DIZZINESS, WEAKNESS, TIREDNESS, HOT AND COLD FLASHES ALL CONTINUEING FOR NOW THE 6TH DAY FOLLOWING VACCINE.

Other Meds: 5 mg. Ambien for sleep the night before vaccine.

Current Illness:

ID: 1124128
Sex: F
Age: 50
State: PA

Vax Date: 03/22/2021
Onset Date: 03/22/2021
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: N/A

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

Symptoms: Patient got light headed, laid down on ground, got nauseous. Patient left in ambulance, but was fully conscious and fine.

Other Meds: N/A

Current Illness: N/A

ID: 1124129
Sex: U
Age:
State:

Vax Date:
Onset Date:
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: Patient felt fine immediately after shot and walked around to sit and wait for 30 minutes. After 20 minutes of sitting, she starting seizing in her chair. Her head tipped to the side and her right arm straightened and she seized for approximately 5 minutes. She started coming to which took approximately 5 minutes until she was fully answering our questions. She was checked out by our on-call physician, Dr. We let her sit for a full 20 minutes or so and then she was able to leave and go home on her own two feet.

Other Meds:

Current Illness:

ID: 1124131
Sex: F
Age: 71
State: MA

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: Few

Symptom List: Pharyngeal swelling

Symptoms: 7-8 hrs after shot I was extremely tired, could not do simple things, layed down all day, bed early and following day felt better. My arm is still sore when used, 3 days later. I've had a slight headache every day, arm still swollen. Abdominal pain but could be something else.

Other Meds: Too many to list

Current Illness: Few

ID: 1124132
Sex: F
Age: 77
State: MD

Vax Date: 01/18/2021
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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Sensitivity to many medications, also citrus fruits

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: I had a slight fever, body aches and headache for 2 days, after each dose. Tinnitus, which I've had a few times over the years, started about 10 days after my first dose (01/18/21). I received my 2nd dose on 02/15/21. The tinnitus has continued, about 4-5 days per week. I have seen my ENT twice. He suggested I try melatonin.

Other Meds: Varied

Current Illness: High Blood Pressure, Minor COPD, Breast Cancer Survivor (4yrs), High Cholesterol

ID: 1124133
Sex: M
Age: 49
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: Vasovagal event without syncope post vaccine. Clammy and nauseous with tingling to hands. EMS and Dr on site. Blood pressure 90/49 at 18.10. at 18.15 blood pressure was 114/81. Released home and advised to seek medical attention later if needed, client verbalized understanding.

Other Meds:

Current Illness:

ID: 1124134
Sex: F
Age: 73
State: MI

Vax Date: 03/13/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: Penicillin - Hives Lamisil - rash Lidocaine with Epi - necrosis following biopsy in bilateral breasts

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

Symptoms: On Sunday 2/14, pt notes that she experienced chills and "just felt out of sorts." On 3/15 at 1:30pm, she was scheduled for a wellness exam with her primary care provider. She notes that when staff took her vital, they were concerned because she seemed short of breath. Pt notes that she is overweight and does have dypsnea on exertion at times, but staff were concerned because she had been at rest for some time and they considered the shortness of breath unusual. Pt reports that her blood pressure was normal and her O2 sats were running 97-98% on room air. However, her pulse was 150. An EKG was done and the physician voiced concern over how long her pulse had been elevated. She was transferred to the ED, where per her report another EKG showed that she was in atrial flutter. Pt reports that she was treated with IV Cardizem and given and IV bolus of magnesium. At approximately 4:30pm, a CT with contrast was completed to rule out blood clot or PE. A third EKG done in the ED revealed that she had returned to normal sinus rhythm. She was discharged home at 6:30pm. Pt reports that she was seen for follow up on 3/20. At that time, her physician ordered repeat labs - CMP, potassium, magnesium, and thyroid - all of which were normal per her report. He changed her medication from baby aspirin 81 mg to Zarelto 20 mg, noting that she is at high risk for stroke. Cardiology has been alerted and she has an ECHO scheduled . Since her discharge from the ED, pt has been monitoring her pulse daily and it have ranged from 66-72 bpm/

Other Meds: Arthrotec 75-0.25 mg BID HCTZ 25 mg PO qd Claritin 10 mg qd Prednisone 1 mg qd Fosamax 70 mg - 1 tablet weekly on Saturday Baby Aspirin 81 mg - 1 tab PO Hydroxychloroquine 200 mg BID D3 5000IU PO qd Mature Multiple Vitamin Vitamin B 12 sub

Current Illness: None

ID: 1124135
Sex: F
Age: 58
State: MO

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: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies: Sulfa , Penicillin

Symptom List: Rash, Urticaria

Symptoms: Swelling tongue, swelling throat, numbness on face, lips, headache nausea, numbness feet, numbness hands

Other Meds: Lisinopril, triatermeme

Current Illness: None

ID: 1124136
Sex: F
Age: 26
State: NM

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: Bee Stings - anaphylaxis Latex - Rash Triple Antibiotic - Unknown reaction Divalproex - Unknown reaction Prazosin - Unknown reaction

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

Symptoms: c/o feeling hot and nauseated after 25 minutes post vaccination.

Other Meds: unknown

Current Illness: unknown

ID: 1124137
Sex: F
Age: 68
State: MN

Vax Date: 03/11/2021
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: NKDA, allergies to molds

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

Symptoms: severe headache, severe dizziness, fatigue, and feeling of confusion. neurologic changes seen on exam include jerk horizontal nystagmus, dysmetria, and other imbalance

Other Meds: Pulmicort inhaler, albuterol inhaler, lisinopril, simvastatin, Claritin D, doxycycline oral, tobramycin eye drops

Current Illness: eyelid hordeolum/ infection dx 3/5/2021

ID: 1124138
Sex: F
Age: 43
State: NY

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: LA

Lab Data:

Allergies: Levaquin Augmentin

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

Symptoms: Headache Diarrhea Flushed/feverish (no fever)

Other Meds: Zomig as needed Xanax as needed Omeperazole Wellbutrin Candasartan Nortriptyline

Current Illness:

ID: 1124139
Sex: F
Age: 52
State: NJ

Vax Date: 02/27/2021
Onset Date: 03/03/2021
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: Day 4 after shot neck pain developed. Never experienced pain in my neck. Went to Rothman on day 8. They said it was arthritis. I never had an issue before. Pain in neck is on left side the same side as shot. Can sleep on that side. Pain is unbearable if I try sleeping on right side. Took a steroid for 5 days. Pain immediately went away and then return day 5 of steroid. Still have pain on day 24 since shot.

Other Meds: T3/T4 Balance D Fish oil D3 5 Hydroxytryptophan Evening Primrose

Current Illness: None

ID: 1124140
Sex: F
Age: 38
State: WI

Vax Date: 03/10/2021
Onset Date: 03/11/2021
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: Escitalopram Oxalate Tab

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

Symptoms: got her first Moderna COVID19 vaccination on Wednesday 03/10/2021. She had no immediate problems with the shot such as arm pain or any other concerns, but by the next day 03/11/2021 she woke feeling very exhausted. They were having tests, and she is one of the main people in charge of this, so she just wrote it off as a reaction to stress. However as the day went on she was feeling worse including low-grade chronic headache, nausea, intermittent palpitations and waves of dizziness. She even had a little anxiety attack, thus she went home Thursday afternoon. She forced herself to go back to school the next day, knowing that if she could get through that day, she'd have a whole week off for spring break. Unfortunately, despite decreased stress, she continued to feel poorly. She has a feeling of profound fatigue, constant headache at the base of the skull that Tylenol really doesn't touch, nausea, stomach rumbling, intermittent dizziness, and intermittent palpitations. Not surprisingly, her anxiety has increased, so she started sertraline 25 mg one half tab on Tuesday 03/16/2021, and on Saturday 03/20/2021 she increased it to a full tab. Now taking PharmaGABA at night to keep the anxiety and heart racing down.

Other Meds: Jolessa Tylenol Vitamin D Omega-3 Fatty Acids Melatonin

Current Illness: None

ID: 1124142
Sex: F
Age: 71
State: WA

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: Hay fever gluten sensitivity to wheat Opiods - Cipro - Vicadin latex items (gloves, tape)

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Within the 24 hours after I experienced an intense tightening of my back between my shoulder blades and more to the right side. It was painful breathing in fully, taking a deep breath, lesser so when I breathe shallowly. I felt very weak overall with multiple joints feeling pain (ankles, knees, wrist that was previously injured). The intensity of the back/between shoulder blades pain remained throughout the following day and a bit lesser so into day three (now).

Other Meds: Losartan - Potassium 25mg. taken at night

Current Illness: Sinusitis

ID: 1124143
Sex: M
Age: 17
State: MN

Vax Date: 03/18/2021
Onset Date: 03/18/2021
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: apples, dairy

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: 20 min after the injection, patient started to develop itchness on his arms and back. for the next 48 hours the itchness came and went. small rash (raised red pimps) around the injection spot. I have treated the itch with allergy meds and the rash with hydrocodone cream 4 days later, he still complains of sore arm, periodic metalic taste when he eats, sore joints and arm muscles. Saturday evening he had brief chills, and sunday reported sore throat.

Other Meds: vitamin D 5000Iu tab, multi vitamin, valproic acid 250MG/5L solution,

Current Illness: none

ID: 1124144
Sex: M
Age: 36
State: MD

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

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

Symptoms: Headache, body aches, insomnia, fever, rapid heart rate, brain fog

Other Meds: Omeprezole 40mg

Current Illness: None

ID: 1124145
Sex: M
Age: 29
State: TX

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: unk

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

Symptoms: person reported feeling lightheaded. It was right before lunch. Accucheck was done by EMS and person was able to ambulate out of clinic.

Other Meds: unk

Current Illness: unk

ID: 1124146
Sex: F
Age: 71
State: NC

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: Unevaluable event

Symptoms: Headaches, muscle aches, racing pulse, nausea, chills, temp of 101.7

Other Meds: Accupril, Eliquis, Multaq Multi Vitamin, Calcium

Current Illness: none

ID: 1124147
Sex: F
Age: 65
State: TX

Vax Date: 03/05/2021
Onset Date: 03/05/2021
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: Lysol

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

Symptoms: At 9:45 Patient complained of nausea after smelling Lysol being sprayed. Patient stepped outside to get fresh air and I stepped out also to observe her. V/SBP 153/89, 98 % O2 and HR 74. Gave patient water and had her sit for additional 30 minutes. Patient said no signs of difficulty breathing ans she felt better after breathing fresh air.

Other Meds: N/A

Current Illness: N/A

ID: 1124149
Sex: F
Age: 55
State: SC

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

Lab Data:

Allergies: codeine, dilaudid

Symptom List: Injection site pain, Pain

Symptoms: Friday afternoon: left arm started getting sore. by Friday evening developed pounding headache, complete body aches, fever through out the night. took Tylenol around 3 am Saturday morning. Saturday: chills, headache, feverish, and weakness. By Midnight was feeling better. Sunday 3/21/2021 back to normal self

Other Meds: linzess 145 mg, amlodipine 5 mg, vitamin D, cholesterol herbal,

Current Illness: high blood pressure, IBS

ID: 1124151
Sex: M
Age: 80
State: CA

Vax Date: 02/26/2021
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: none

Symptom List: Injection site pain, Menorrhagia

Symptoms: Adverse event occurred after 2nd dose. Rash developed under lower lip across middle of the face and a lump developed inside the left nostril. 5 days later, rash and lump in nose still present, mild pain in back right side of the head (behind the ear) developed. Pain behind the right ear grew more intense each day and on Thursday, March 11 was seen at Urgent Care with intense pain. Was diagnosed with Shingles and prescribed Valacyclovir and Prednisone, Acetaminophen-Codeine for pain. Saw Dr. on Monday, March 15. Pain is gradually reducing, but still present today, March 22, 2021.

Other Meds: Atorvastatin, 10 mg

Current Illness: none

ID: 1124152
Sex: M
Age: 70
State: WA

Vax Date: 03/04/2021
Onset Date: 03/10/2021
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: N/A

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

Symptoms: Maculopapular rash over back and torso, moving on to legs.

Other Meds: 1) Montelukast Sodium 10 Mg Oral Tablet (Montelukast Sodium) .... Take 1 tablet by mouth once a day for asthma or allergies. 2) Albuterol Sulfate Hfa 108 (90 Base) Mcg/act Inhalation Aerosol Solution (Albuterol Sulfate) .... 2 inhalations e

Current Illness: Adenocarcinoma, prostate (not currently being treated)

ID: 1124153
Sex: M
Age: 17
State: OR

Vax Date: 01/26/2021
Onset Date: 01/26/2021
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: Unknown

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Medication administration error. Patient was given the Moderna vaccine before the 18th birthday.

Other Meds: Unknown

Current Illness: Unknown

ID: 1124154
Sex: F
Age: 69
State: NE

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: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Penicillin, macrodantin

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: 12 hours after shot, every place my arthritis is diagnosed, I had pain and likely inflammation.

Other Meds: Cymbalta brand name, Meloxicam, Lisinopril, Simvistatin, Women?s One-Day 50+, potassium, Vitamin D Ocular Nutrition, Hair, skin, Nails supplement, Fish oil, Baby aspirin, Fexofenadine

Current Illness:

ID: 1124156
Sex: M
Age:
State: CA

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: NONE

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

Symptoms: A FEW MINUTES AFTER GETTING THE VACCINE, HE DEVELOPED WRINKLES AND RED DISCOLOURATION ON BOTH OF HIS HANDS ON THE DORSAL ASPECT. NO DIFFICULTY BREATHING, OR SHORTNESS OR BREATH OR ITCHING. THE SKIN CHANGES RESOLVED WHILE IN THE MEDICAL TENT.

Other Meds: NONE

Current Illness: NONE

ID: 1124157
Sex: F
Age: 50
State: KY

Vax Date: 01/29/2021
Onset Date: 01/29/2021
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: No

Symptom List: Nausea

Symptoms: My arm has been aching since the 1st one. I let the RN giving me the 2nd shot aware and he said that?s weird. I just happened to have the same person injecting both times. Never reported or had me speak with anyone at that time. He said I could get it in the left, but I denied due to I didn?t want the pain in both arms. When he gave me the 2nd shot I felt it so much more than the first shot that I blurted out that hurts and a felt a twinge in my arm, as if it hit something other than the muscle. My arm 2 mos later is not let up the pain. I can only raise it so high. I cannot sleep on either side w/o pain. Same days are worse than others. The pain is right at the injection site. This is the only thing I have had done to my arm so I know it has something to do with the vaccine. I alternate ice and heat along with ibuprofen and it does not touch the pain/aches. It is a constant ache in my arm. I did contact my employee health at work and she advised me to fill out report on this website and in the Hospital safety report.

Other Meds: Ibuprofen 200 mg x3

Current Illness: No

ID: 1124158
Sex: F
Age: 39
State: TN

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Injection site pain

Symptoms: Bright red, hot to the touch cheeks Itchy throat Difficult swallowing

Other Meds: Metformin B12 Vit d

Current Illness: None

ID: 1124159
Sex: F
Age: 65
State: IN

Vax Date: 03/16/2021
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: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Rash on face , ear and neck - Zyrtec and Benadryl

Other Meds: Amoxicillin - 500MG Capsules - 3 times a day-every 8 hours, Levothyroxine 100mg, Losartan- 100mg, Hydrochlorothiazide-25 mg, Amlodipine-5mg, Atorvastatin-20mg, Centrum Multi + Omega 3, Vitamin D3 -50mcg/2000IU, Generic Nexium- Esomeprazole

Current Illness: Double Ear infection

ID: 1124160
Sex: F
Age: 54
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: RA

Lab Data:

Allergies:

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

Symptoms: Patient returned to vaccination POD after developing tongue swelling within one hour of vaccine administration Patient took her own Benadryl with resolution of symptoms.

Other Meds:

Current Illness:

ID: 1124161
Sex: M
Age: 70
State: CO

Vax Date: 02/06/2021
Onset Date: 02/12/2021
Rec V Date: 03/22/2021
Hospital: Y

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

Lab Data:

Allergies: PET DANDER, BEE VENOM, HYDROCODONE, LOVENOX, HEPARIN

Symptom List: Tremor

Symptoms: Pt is a 70 year old male who received first dose of Pfizer COVID-19 vaccine on 02/06/2021. Pt describes that he was doing well for a few days after receiving the vaccine; however, on Friday February 12, 2021 pt states he began to feel poorly at dinner. His initial symptoms included back pain, myalgia, and fatigue. Pt got tested for COVID-19 and received positive results on 02/14/2021. Pt presented to ER on 02/15/2021 due to weakness, dizziness, fatigue, and confusion. Pt also reports dry cough, fever, chills, and loss of apetite. Pt was discharged on 02/16/2021 after improvement was observed.

Other Meds: GABAPENTIN, METFORMIN, METOPROLOL, SPIRONOLACTONE,

Current Illness:

ID: 1124162
Sex: F
Age: 57
State: GA

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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Cephalexin Zithromax Prednisone

Symptom List: Erythema, Pruritus

Symptoms: Tight chest on the way home from the Pharmacy. I did NOT wheeze though. I gave myself a Nebulizer Tx with Albuterol Solution after I got home. The Nebulizer Tx was effective.

Other Meds: Tirosint-Sol Bupropion Hcl Naltrexone L-Methylfolate Cortisol Manager Symbicort Albuterol Sulfate Solution Vitamin D with Vitamin K Pregnenolone Calcium Citrate

Current Illness: None

ID: 1124163
Sex: F
Age: 46
State: TX

Vax Date: 03/01/2021
Onset Date: 03/09/2021
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: Ace inhibitors

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

Symptoms: On day 8 after the shot I had a nickel size bump at the injection site. By day 11 the spot had grown to 4 inches, was red and itchy. It was also warm. I took allergy medicine and by day 15 it had all cleared up. Overall, the rash didn?t hurt but was annoying.

Other Meds: Birth control pills, olmesartan medox/hctz, metformin, metoprolol, sertraline, elderberry, women?s vitamins

Current Illness: N/a

ID: 1124164
Sex: M
Age: 70
State: NM

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: none

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

Symptoms: 22 hrs. after injection, on a Saturday 3/6/21, my husband suddenly felt chilled & shaky. 2 hrs. after that he felt nauscious & started a fever of 99 which climbed to 103 over the next 24 hrs. He took Tylenol every 4-5 hrs. & stayed in bed. By Sunday his fever slowly started to go down. And by the following Mon. morning, 3/8/21, his fever was gone. He felt weak but otherwise well enough to perform normal day-to-day activities/work. 12 days after that, on 3/20/21, he developed the exact same symptoms & went to bed immediately & took appropriate Tylenol. His fever, this time, only went to just under 100. He is scheduled for his second shot on 4/2/21. Should he get it? If not, what does he do???

Other Meds: Lisinipril, Metformin, Glipiside, Carvedilol, Atorvastatin,Tamosulin, 80mg. aspirin

Current Illness: none

ID: 1124166
Sex: F
Age: 68
State: CT

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

Lab Data:

Allergies: Ampicillin adverse reaction to codeine

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: 2nd dose resulted in fever, chills, headache, body aches sore arm one day after. Two days later my arm has red slightly itchy 5 by 2 patch at injection site. First dose resulted in dizziness and nausea 3 days later with need to go by ambulance to er

Other Meds: Synthroid

Current Illness: None

ID: 1124167
Sex: M
Age: 49
State: OK

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 stated

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

Symptoms: 1st vaccine given 3/10/21, 2nd given 3/19/21. No adverse reaction known.

Other Meds: unknown

Current Illness: none

ID: 1124168
Sex: F
Age: 24
State: WI

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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Bee, Mushrooms, Wasp, Bactrim, Benadryl, Latex, Peanuts.

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

Symptoms: Pt began having difficulty breathing 15 minutes after injection Vitals monitored, Oxygen 15 liters NRB applied. EMS alerted and gave EPI pen via Auto injector. Transported to local hospital by EMS ambulance.

Other Meds: Naprosyn 500 mg, Zanaflex 2 mg, Norco 5-325, Vyvanse 50, Insulin, Neurontin 300, Minpress 2 mg, Seroquel 100 mg, Trazadone 150 mg, Insulin Lispro, Metformin 750 mg, Albuterol Inhaler, Skyla IUD,

Current Illness: None known

ID: 1124169
Sex: F
Age: 70
State: RI

Vax Date: 03/03/2021
Onset Date: 03/04/2021
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: NSAIDS

Symptom List: Pain in extremity

Symptoms: Pt is experiencing swelling and redness in bilateral lips, tingling, itchiness.

Other Meds: Tylenol, Colace, Ketoconazole

Current Illness: none

ID: 1124170
Sex: F
Age: 64
State: TX

Vax Date: 03/15/2021
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: Codeine

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

Symptoms: Diarrhea started on 3/16/21 at 10:00 am and continues daily. Several bouts daily but is improving.

Other Meds: Zoloft, Crestor, Olmesartan and Cinacalcet

Current Illness: Chronic Kidney Disease, High Blood Pressure, High Cholesterol, and Clinical Depression

ID: 1124171
Sex: F
Age: 74
State: FL

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: doxycycline codeine moxifloxacin sulfa trimethoprim

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

Symptoms: pt reports intermittent redness and itching to administration site, sts some days appears to improve but then itching returns

Other Meds: unknown

Current Illness: none reproted

ID: 1124172
Sex: F
Age: 24
State: TX

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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: After receiving the first does of the Moderna vaccine the patient was observed for 30min. The patient states she felt heat in her chest and was very shaky. A rash started to appear just before EMS arrived. Pt was given 2 325mg of Tylenol and an icepack was placed on the patients back to reduce heat. We followed up with the patient on 3/20/21 (the day after injection) Patient states she received Benadryl at the ER and is feeling better.

Other Meds:

Current Illness:

ID: 1124173
Sex: M
Age: 63
State: WA

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

Lab Data:

Allergies: No known allergies

Symptom List: Vomiting

Symptoms: Patient experienced tingling down right lateral arm immediately following vaccination, symptoms had already started to resolve by 20 minutes, reassuring physical exam, no medications given

Other Meds: Aspirin, Atorvastatin, Esomeprazole

Current Illness: None

ID: 1124174
Sex: M
Age: 44
State: IN

Vax Date: 03/20/2020
Onset Date: 03/21/2020
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: First vaccine and had side effects of headache, nausea, muscle ache, chills and 100 deg F fever for 8 hours within 30 hours after the shot in the arm. Local soreness in the arm from the shot is still going 48 hours later otherwise all other systems have passed this morning the second day after receiving the shot. I also tested positive for Covid on November 30, 2020 and had the same effects for 3 weeks with it then.

Other Meds:

Current Illness:

ID: 1124176
Sex: F
Age: 65
State: CA

Vax Date: 03/13/2021
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: allergic to sulfa-based medications

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

Symptoms: Stark coloration differences in both hands, with fingers beyond first knuckle pale yellow and back of hand deep red, looking like images of Raynaud's. Numbness and loss of dexterity in both hands, to the point that it took more than 5 minutes to unbutton one button. Onset with cold; duration of 30-45 minutes. This was on 3/21/21. On 3/22/21 coloration changes returned with tingling in left hand but normal dexterity. Duration approximately 10 minutes but repeated episodes throughout day. Perhaps entirely unrelated to vaccine -- second vaccine was 3/13/21 and nothing like this happened after first vaccine on 2/13/21.

Other Meds: none

Current Illness: unusual scalp dryness

ID: 1124177
Sex: F
Age: 56
State: MN

Vax Date: 01/28/2021
Onset Date: 01/29/2021
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: NKA

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Pt received Covid vaccine injection in L Arm on Thursday 1/28/21. It became red and swollen so she had it evaluated at ED, was told injection site was not properly cleaned and was placed on an antibiotics (changed 1x d/t ineffectiveness). She reports redness has decreased but swelling remains, no other side effects noted.. Encouraged patient to submit a patient report through our website and assured her I would also submit a report. Pt declined FU assessment with provider. Agreed to phone call check in ~1 week. flag placed for follow up. Report submitted.

Other Meds: None

Current Illness:

ID: 1124178
Sex: F
Age: 56
State: KY

Vax Date: 03/20/2021
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: RA

Lab Data:

Allergies: PCN, LISINOPRIL

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

Symptoms: RECTAL BLEEDING AND EASILY BRUISING NOTED IN THE LAST 2 DAYS

Other Meds: FLONASE, LEVOYTHRYOXINE, LOSARTAN, OMEPRAZOLE, VITAMIN D-3

Current Illness: GASTROESOPHAGEAL REFLUX WITH ESOPHAGITIS,

ID: 1124179
Sex: F
Age: 59
State: MI

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: RA

Lab Data:

Allergies: note

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

Symptoms: Rash on the back of my neck, chest and the back of my right hand

Other Meds: Carvedilol, 25mg 2x day Mycophenolate, 2 500 mg, 2x day Tacrolimus, 1 Mg, in the AM Tacrolimus, .5 Mg, in the PM Nefedipine, 30 1 at night Metformin, 500mg 1 X day Calcitrol, ..50 mg 1X day Biotin, 10mg 1x day Iron 65 mg 3x week Kelp 600mg

Current Illness: none

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm