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: 1124492
Sex: F
Age: 72
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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: After injection pt states a "funny feeling like itchy" on the injection side LD. Vitals stable pt assess for 30 minutes. D/C arm feels normal.

Other Meds:

Current Illness:

ID: 1124493
Sex: F
Age: 34
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: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Patient complained of Nausea, scant emesis. She asked for water and was given a 16 oz bottle of water. She drank about a third of the bottle, said she felt better and asked to leave around 3:14 PM

Other Meds:

Current Illness:

ID: 1124494
Sex: M
Age: 38
State:

Vax Date: 01/26/2021
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: Bees

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

Symptoms: Transient symptomatic Sinus tachycardia and hypertension, abrupt onset

Other Meds: None

Current Illness: None

ID: 1124495
Sex: M
Age: 61
State: AZ

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Fever within 12 hours reached 102.5. Within 18 hours, fever subsided to near normal levels. Severe chills. Ongoing fatigue and muscle soreness and stiffness. Still mild fever after 30 hours.

Other Meds:

Current Illness:

ID: 1124496
Sex: F
Age: 47
State: IL

Vax Date: 01/11/2021
Onset Date: 01/11/2021
Rec V Date: 03/22/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: By that evening, I started experiencing severe chills, headaches and I was very weak. I took Tylenol. I tried to go to work the next day, but I could barely move my feet. Then, the diarrhea started to where I was having very watery stool about 10-15 times a day. I couldn't eat anything. I had never been that sick in my life. I was in the bathroom every few minutes. On Saturday, I went to urgent care to get rehydrated since I had lost so much fluids. I was given meds to stop my stomach cramping along with another prescription, but I still couldn't eat at that point. For the next week, I was still extremely sick. I ended up losing 10lbs. I have to see my doctor tomorrow to be evaluated for surgery since this has caused issues with my hemorrhoids. I still experience diarrhea occasionally, so I have to be really careful what I eat. I don't have much of an appetite, so I eat very light.

Other Meds: Topiramate - 50mg - twice a day Metoprolol - 50mg - twice a day Atorvastatin Calcium - 10mg - once a day

Current Illness:

ID: 1124497
Sex: M
Age: 68
State: AZ

Vax Date: 03/08/2021
Onset Date: 03/12/2021
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: Penicillin (hives)

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

Symptoms: Vertigo and nausea beginning on 3/12/21 at 8:00AM, and lasting for approximately 4-6 hours. Continued vertigo, but no nausea, for the rest of that day. Vertigo symptoms have continued, but eased considerably from severity at onset. As of 3/22/21, vertigo is induced by tilting head back and to the left, or by quickly moving from lying to sitting position. Condition is not severe enough at this point to inhibit any activities, but is still present.

Other Meds: Lisinopril/Htcz 20/12.5mg Lisinopril 20 mg Amlodipine besylate 2.5mg Omeprazole 20 mg Lovastatin 40 mg Tamsulosin 0.4mg Restasis

Current Illness: None

ID: 1124498
Sex: F
Age: 61
State: IN

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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Sore arm at injection site with both shots. With the second shot only: Next day @ Approximately 7:00 am started feeling dizzy. Approximately noon stated feeling chills and general body aches. 6:00 pm took ibuprofen and slept until 6:00 am next day . All symptoms then gone

Other Meds: Generic for Bactrim

Current Illness: Antibiotics for a boil

ID: 1124499
Sex: F
Age: 66
State: NV

Vax Date: 03/01/2021
Onset Date: 03/07/2021
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 known

Symptom List: Pharyngeal swelling

Symptoms: On the 10th day had a round red rash about 3 1/2? in diameter and a hard lump in middle. It itches alot

Other Meds: Blood pressure, water pill, estrogen, Mucinex, Famotadine

Current Illness: No

ID: 1124500
Sex: F
Age: 41
State: CA

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

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

Lab Data:

Allergies: Vancomycin antibiotic

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: The adverse event I experienced was more fatigue (than usual at 36 weeks pregnant) a day after receiving the Covid Janssen vaccine. I slept a good portion of the day and felt I didn?t have the energy to go about daily chores around the house. I am now 37 weeks pregnant and due on April 9th. I was able to return resume normal activities the next day and have not experienced any other side effects since then that have restricted me from performing my daily activities.

Other Meds: Prenatal vitamins

Current Illness: Gestational diabetes due to pregnancy

ID: 1124501
Sex: F
Age: 76
State: AZ

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: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Penicillin

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Phizer-BioNTech COVID-19 Vaccine EUA Injection site pain, tiredness, headache, chills, fever, nausea, feeling unwell, dizziness & weakness

Other Meds: Amlodipine (2.5), Atenolol (50), Omeprazole (20), Fluoxetine (20), Hydrochlorothiazide (25), Potassium (20)Bayer (81)

Current Illness: None

ID: 1124502
Sex: F
Age: 17
State: OH

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: SYR
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Child was 17 years old at the time of the vaccine administration.

Other Meds: Unknown

Current Illness: None

ID: 1124503
Sex: F
Age: 16
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: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Rash, Urticaria

Symptoms: Vaccine was given to patient that is 16 years of age - outside of manufacturer recommendation. No reaction noted. Call to Medical made, advised it is ok to administer "off label" and patient can obtain second dose.

Other Meds: None

Current Illness: None

ID: 1124504
Sex: M
Age: 49
State: CA

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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: 48 hours after injection, patient (me) began vomiting and feeling intense abdominal pain. Vomiting and pain increased, so I went to the ER. Dr. physically examined my abdomen. He exerted light pressure, which led to extreme pain, and I vomited 6 additional times in the exam room. Dr. ordered a CT scan. He and Dr. diagnosed a partial small bowel obstruction. The patient (me) has never had any abdominal surgery, or and problems whatsoever with bowel obstruction.

Other Meds: Trintellix, Truvada, clonidine

Current Illness:

ID: 1124505
Sex: F
Age: 51
State: MI

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: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Penicillin

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

Symptoms: I had what felt like food poisoning symptoms. Started with uncontrollable shivering, followed by fever, headache, nausea & vomiting. Headache was migraine-like. Worse symptoms lasted ~20 hours. I had a low grade fever for another 24-36 hours + headache.

Other Meds: None

Current Illness: None

ID: 1124506
Sex: M
Age: 63
State: NJ

Vax Date: 03/10/2021
Onset Date: 03/11/2021
Rec V Date: 03/22/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Numb, tingling, electric shock type sensation from middle finger up to teeth

Other Meds: Aspirin

Current Illness: None

ID: 1124507
Sex: F
Age: 59
State:

Vax Date: 12/23/2020
Onset Date: 12/23/2020
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: Employee received .2 cc of Pfizer inadvertently administrated by vaccine nurse. NO ADVERSE REACTION, just reporting medication error. Our Vaccine Task Force, after speaking with CDC and DOH, decided to offer the employee an additional COVID-19 vaccine dose. Note: same employee was vaccinated on 1/13/2021 by same vaccinator and .2 cc was incorrectly administered. Vaccinator was removed from process. Thanks.

Other Meds:

Current Illness:

ID: 1124508
Sex: F
Age: 55
State: NM

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

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: Anaphylaxis (tongue swelling, loss of airway, required oxygen)

Other Meds:

Current Illness:

ID: 1124509
Sex: F
Age: 80
State: TX

Vax Date: 03/06/2021
Onset Date: 03/08/2021
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 known

Symptom List: Ear pain, Hypoaesthesia

Symptoms: BP dropped to 81/57 Pulse 65 Limbs completely limp Unable to arouse Lasted for about 5-6 hours

Other Meds: Trazodone 50mg; Levothyroxine 0.025mg; Lorazepam .025mg/day; Senna 8.6mg; Cranberry Concentrate capsules 30,000 mg; Probiotic 30 billion/day; Vitamin D3 6,000units/ week

Current Illness: Alzheimer?s 5th stage Thyroid disease

ID: 1124510
Sex: F
Age: 36
State: TN

Vax Date: 03/13/2021
Onset Date: 03/20/2021
Rec V Date: 03/22/2021
Hospital:

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

Lab Data:

Allergies: Penicillin, Cephalosporins, Triptan migraine medications

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Tremors started one week after initial vaccine; full body - hands, arms, legs. Tremors occurred at rest and continued while extremities were in use. No treatment. Tremors stopped within 48 hours of onset. Neurologist was notified with no recommendation for additional treatment at this time.

Other Meds: Bupropion, Vyvanse, Topamax, Methotrexate, Folic Acid, Biotin, Elavil

Current Illness: NA

ID: 1124511
Sex: F
Age: 21
State: CA

Vax Date: 03/18/2021
Onset Date: 03/18/2021
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: Patient fainted in the waiting area after receiving her vaccination. Paramedics were called. While talking to the paramedics she began to faint again. They transported her to the ER. She was released from the ER

Other Meds: none

Current Illness: none

ID: 1124512
Sex: M
Age: 38
State: WY

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

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Arm hurt at injection site, upon lifting arm, felt a sensation in arm near injection site and had what appeared to be a seizure that lasted around 10-15 seconds. A few moments later another seizure occurred. Resulted in a hospital visit and a follow-up with a neurologist.

Other Meds:

Current Illness:

ID: 1124513
Sex: F
Age: 44
State: PA

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

Lab Data:

Allergies: Sulfa, penicillin, iodine

Symptom List: Unevaluable event

Symptoms: 3am- 15 hrs post injection: excruciating pain in joints to point of tears 6am- 18 hrs post injection: 10 min after waking sudden onset of extreme nausea and abdominal pain and urgency to vomit. I sat down on toilet and passed out, was unconscious and aware for approximately 2 minutes, falling off toilet onto floor. Woke hyperventilating and in dead sweat. Temp was 100.3. With help sat up and moved back to sitting on toilet for 10 min; then walked 10' to bed, blacking out again for about 15 seconds as i made it into bed. I rested in bed for approximately 4 hours prior to moving again. Moderate moments of lightheadedness and brief mild nausea continued through 24 hours but no further blacking out

Other Meds: Spironolactone 12 mg - 2xs/day Azelastine HCL 0.15% 1 spray/daily Vit C, D, B12

Current Illness: none

ID: 1124514
Sex: F
Age: 51
State: CA

Vax Date: 03/01/2021
Onset Date: 03/07/2021
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: Gluten (I am Celiac)

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

Symptoms: Overwhelming anxiety and severe depression? started shortly after receiving the vaccine and has progressively worsened (prior experience with both was over 10 years ago)

Other Meds: Levothyroxine, Liothyronine, Gabapentin, multivitamin, calcium, vitamin D, probiotic

Current Illness: None

ID: 1124515
Sex: M
Age: 37
State: WI

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

Lab Data:

Allergies: N/A

Symptom List: Injection site pain, Pain

Symptoms: Chills, fever, headache, body aches, tiredness, loss of appetite - lasted until roughly 3pm on 3/22

Other Meds: N/A

Current Illness: None

ID: 1124516
Sex: F
Age: 57
State: CA

Vax Date: 03/13/2021
Onset Date: 03/19/2021
Rec V Date: 03/22/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Rash around injection site on left arm, currently 2 inches in diameter; also itchiness, soreness at injection site

Other Meds: Jardiance, Losartan, Ozempic, Armour Thyroid

Current Illness:

ID: 1124517
Sex: M
Age: 23
State:

Vax Date: 03/07/2021
Onset Date: 03/10/2021
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: cats

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

Symptoms: Weakness in right shoulder, right deltoid not activating at all, potential axillary nerve damage

Other Meds: Vitamin D, Zinc, Vitamin C

Current Illness: none

ID: 1124518
Sex: F
Age: 73
State: OR

Vax Date: 03/16/2021
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: Aspirin, Tylenol, Aleve, Bextra, Motrin all give me hives. I do not eat gluten for better digestion, but not an allergy.

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Woke up at 8:00 with a headache and face ache. Coughed a few times and discovered it was very painful to my rib cage. Had slight fever all day and now it's 4:00 p.m. I still have headache and slight fever. Slept a few hours today. Very sore neck muscles. Might have sinus pressure and eyes very sensitive to light.

Other Meds: Centrum Silver Multivitamin - 1 per day. 1200 Fish oil - 1 per day. Cyclobenzaprine 5 mg - 1 per day. Levothyroxine 50 mcg - 2 per day.

Current Illness: None

ID: 1124519
Sex: M
Age: 32
State:

Vax Date: 12/23/2020
Onset Date: 12/23/2020
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: Employee received .2 cc of Pfizer instead of .3 cc inadvertently administrated by vaccine nurse. NO ADVERSE REACTION, just reporting medication error. Our Vaccine Task Force, after speaking with CDC and PA DOH, decided to offer the employee an additional COVID-19 vaccine dose. Thanks.

Other Meds:

Current Illness:

ID: 1124520
Sex: F
Age: 47
State: MS

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: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Penicillin

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

Symptoms: 1st shot only moderate soreness next day. 2nd shot in approx 5 hours I had chills, headache, body aches, extreme exhaustion, swollen throbbing ears, fever, nausea, and stomach ache went to bed woke up a 9 pm 102.5 fever barely able to function. Took Vicks 44 tried to sleep completely miserable. Took Tylenol to try to get fever down. Still so miserable I couldn't swollen because my ear pain was bad. My friend drove me to the nearest minor med. I couldnt tolerate any light, barely walk, dizzy and hurting all over. My lymph nodes started swelling up all over my body. I am still in pain and hurting , exhausted 5 days later. I have kept a constant headache, still exhausted, and can rest with pain meds.

Other Meds:

Current Illness:

ID: 1124521
Sex: F
Age: 68
State: CA

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: RA

Lab Data:

Allergies: None

Symptom List: Nausea

Symptoms: bad headache, fever, fatigue, body ached, hips hurt (hard to lay down or sitting) for about a day.

Other Meds: Calcium, Vitamin D, Synthroid

Current Illness: None

ID: 1124522
Sex: F
Age: 17
State: AR

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

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: Pt not 18 years of age.

Other Meds:

Current Illness:

ID: 1124523
Sex: F
Age: 64
State: IL

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 03/22/2021
Hospital:

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

Lab Data:

Allergies: No

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

Symptoms: The same day my heart rate increased. Had an asthma attack. Brain fog. Chills. Both legs hurt (front). Fatigue to point of exhaustion, sleep long hours. No energy at all. Made my chronic illnesses much worse

Other Meds: Tramadol, Klonopin,

Current Illness:

ID: 1124524
Sex: F
Age: 39
State: OH

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: None

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

Symptoms: Patient with PMH of poorly controlled siezures and no regular health care who reported symptoms of feeling warm and lightheaded after recieving her vaccine. Pt had a generalized siezure with postictal symtpoms, AOx2. She was then observed and evaluated by medical staff and EMS, during which time she had a second witnessed generalized seizure. Pt was sent by EMS to a local hospital.

Other Meds: Keppra, Carbamezapine taken this morning

Current Illness:

ID: 1124525
Sex: M
Age: 24
State: GU

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: IM
Vax Site: LA

Lab Data:

Allergies: no

Symptom List: Tremor

Symptoms: I kept a log of the events that occurred. Notes: 25mg amitriptyline taken nightly for the last month, 200mg motrin I?ve never taken pain killers before this, time is in military. Mar 18 1430 (1 hour 30 mins after my shot) i have a compressing headache toward the back of my head so i take 1 motrin. 1700 i head home, take 1 amitriptyline and head straight to sleep. ( i have no apatite so no dinner ) Mar 19 0100 The pain starts, it?s unbearable. I am sweating heavily and im also shivering cold. i have a high fever I have body aches which turns my shivering into shaking which keeps my wife up all night. In my dreams i feel pain. I talked to my deceased mother, i hold my deceased cat and i relive some of my most regrettable moments. 0700 I wake up, the bed is soaking wet. I take a motrin and get dressed. it takes me an hour longer to get ready for work because, the pain has sapped my energy. My supervisor sends me home seeing how horrible I look. 0900 I take an amitriptyline and lay down. I ask me wife to close to the storm shutters to darken the room. They are normally pretty quiet to close but, this time they are deafeningly loud. I struggled to get 1 hour of sleep. 1500 I wake up due to shaking so bad that i hit my head on the wall. I then take 2 motrin and about 30 mins later i notice theres a tightness in my chest. i take 1 tums. I know that my body is exhausted from the pain and my mind is clouded but i really wanted to do all of the tasks that i was planning on doing this weekend. All of the tasks end up failing. 2100 i try the tasks again and end up failing again. 20 Mar 0100. I eat a pear and 2 cheetos. i do not take a amitriptyline and i lay down. i have no pain or fever. (Dream start) The dream i had is of me watching myself get thrown around by a ghost. The ghost possesses my body for a short time. I grab some kittens (cats are a comfort to me so im guessing that my subconscious trying to reel me back in) I then wake my sleeping wife and tell her theres a ghost and we need to leave. We walk outside and im in an old neighborhood that i grew up in, everything darkens and im in pitch black feeling my way around a room. I open my eyes and im in a hotel. The front desk staff will not let me take the kittens up to my room so i leave them. When i walk into the room, it?s full of kittens (dream end) and i wake up 21 Mar 0900 I wake up and I have a sore throat and tightness in my chest. The soreness prevents me from going back to sleep and the tightness in my chest causing some anxiety. Once I calm myself down and convince myself that im not having a heart attack I take 2 motrin and some tums and the pain goes away from the day. These could be some withdrawals from not taking amitriptyline since 19 mar in the morning. This is still happening as I write this report. (23 March 2021)

Other Meds: 25mg amitriptyline taken nightly

Current Illness: no

ID: 1124526
Sex: F
Age: 64
State: OK

Vax Date: 02/08/2021
Onset Date: 02/10/2021
Rec V Date: 03/22/2021
Hospital:

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

Lab Data:

Allergies: None known

Symptom List: Erythema, Pruritus

Symptoms: Vaccine recipient had sudden and very significant cognitive decline upon waking approximately 1.5 days after receiving vaccine.

Other Meds: Memantine HCL (Namenda)10mg, 2x daily Losartan Potassium. 25mg Calcium Citrate +D3 (Citracal +D3) B12 1000mcg D3 4000iu Turmeric Curcumin, 1.5g, 2x daily I Omega 3 Acid Ethyl Esters 3 gr daily Atorvastatin 10mg Donepezil HCL , 10 mg(Are

Current Illness: Likely Early onset Alzheimer?s

ID: 1124527
Sex: M
Age: 76
State: TX

Vax Date: 03/11/2021
Onset Date: 03/11/2021
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: He had his Vivid shot and awoke blind in left eye 4 hours later. Went to ER and then on Friday went to eye Dr. at clinic.

Other Meds: VIT D2 (ERGOCAL), metFORMIN HCL, FINASTERIDE , METOPROLOL, Hydrocodone-ACETAMINOPHEN, VERAPAMIL, DULOXETINE HCL DR, ATORVASTATIN, CoQ-10, D3, tiZANidine HCL, Novolin N and R

Current Illness:

ID: 1124528
Sex: F
Age: 64
State: GA

Vax Date: 01/07/2021
Onset Date: 01/15/2021
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: Sulfa, codeine, Tramadol

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

Symptoms: Swelling hives and rash, itching, burning

Other Meds: Estradiol

Current Illness:

ID: 1124529
Sex: F
Age: 57
State: CA

Vax Date: 03/13/2021
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: House dust, unknown food allergy (probably allergic to some preservative)

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Yesterday, after 8days, the vaccine site has a tiny pink color that I don't think it was there yesterday. At the same time, the site I had BCG shot as a child became pink, warm, raised, and very itchy. It had never happened before. The size of reaction is small, about half-inch diameter. Location is about 2inch above the Covid vaccine site. Today, the 9th day since vaccine, previous BCG vaccination site is widely redder and warmer, and some pain to touch.

Other Meds: ADVAIR HFA

Current Illness: None

ID: 1124530
Sex: F
Age: 41
State: CA

Vax Date: 03/16/2021
Onset Date: 03/16/2021
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: Face went immediately numb. Over the next several hours felt numbness in whole body. Facial drooping. No paralysis, was able to move, minimal pins and needles, primarily a loss of sensation. It's 6 days later and I'm getting the sensation back but it hasn't fully returned. Facial flushing which continues to come and go, as well as flushing in hands and feet.

Other Meds:

Current Illness: Meniere's disease, past instances of numbness of unknown cause

ID: 1124531
Sex: F
Age: 53
State: FL

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

Lab Data:

Allergies: sulfa products

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

Symptoms: slight headache productive cough stuffy nose heart palpitations trouble falling asleep/restlessness

Other Meds: Claritin Carvidelol B-right Vitamin D Cumin Magnesium

Current Illness:

ID: 1124532
Sex: M
Age: 30
State: IL

Vax Date: 03/12/2021
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: Seasonal

Symptom List: Pain in extremity

Symptoms: Swollen gland on collarbone.

Other Meds: Venalaxifine, Alegria, Flonase

Current Illness: None

ID: 1124533
Sex: F
Age: 75
State: NC

Vax Date: 03/12/2021
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:
Dose Series: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: Codeine,oxiclean additive in detergent

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

Symptoms: Extreme chills, headache, body aches.

Other Meds: Amlodipine, Bupropion, Rabeprazole magnesium, omega-3

Current Illness: none

ID: 1124534
Sex: M
Age: 60
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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Oak pollen (seasonal allergy)

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

Symptoms: Flushed feeling and mild headache. Medical attention not sought. Resolved on own in a couple hours.

Other Meds: one-a-day Mens over-50 multivitamin, Amlodipine 2.5 mg am & pm Telmisartan 40 mg am Rosuvastatin 5 mg pm Atenolol 25 mg am Eliquis (apixaban) 5 mg am & pm Aspirin 81 mg am

Current Illness: No short term illness prior to vaccination.

ID: 1124535
Sex: F
Age: 29
State:

Vax Date: 12/23/2020
Onset Date: 12/23/2020
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: Employee received .2 cc of Pfizer instead of .3 cc inadvertently administrated by vaccine nurse. NO ADVERSE REACTION, just reporting medication error. Our Vaccine Task Force, after speaking with CDC and DOH, decided to offer the employee an additional COVID-19 vaccine dose. Thanks.

Other Meds:

Current Illness:

ID: 1124536
Sex: F
Age: 80
State: CA

Vax Date: 03/01/2021
Onset Date: 03/05/2021
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: Codeine

Symptom List: Vomiting

Symptoms: Left Bells Palsy

Other Meds: Levothyroxine. Topamax. Quetiapine.

Current Illness: None

ID: 1124537
Sex: F
Age: 65
State: AZ

Vax Date: 02/04/2021
Onset Date: 02/06/2021
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: None

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Developed a rash where the itching got increasingly worse. Skin red and very itchy. Finally went to the emergency room on February 8 and was prescribed two medications Famotidine and Hydroxyzine. Everything cleared within 3-4 days.

Other Meds: Novolog, Tresiba, Creon, Vitamin B6, Amlodipine, Bystolic, Vitamin C, Calcium, D3

Current Illness: None

ID: 1124538
Sex: F
Age: 44
State: AL

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: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: none

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

Symptoms: I started getting fatigued around 7:00 pm that evening. It was hard to finish walking my dog. I was getting the chills to the point that my teeth were chattering. I couldn't wear a shirt at this point because it felt like sandpaper on my back, but I did not have a rash. I went to bed earlier than normal and woke up around 11:30 with the worst headache of my life. My head was throbbing and pulsating and any little movement made it worse. The bottom of my head hurt, where my head connects to my neck. My lower back hurt. I woke up every 1 1/2 hours in pain, due to terrible headache. After suffering for several hours, I finally took some Aleve at 7:00 a.m. the morning following the vaccine.

Other Meds: none

Current Illness: none

ID: 1124539
Sex: M
Age: 20
State: MT

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

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

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Patient received Moderna vaccine for Prime dose on 2/23/2021. Received Pfizer as a booster dose on 3/11/2021

Other Meds:

Current Illness:

ID: 1124540
Sex: F
Age: 76
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:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Medrol

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

Symptoms: About 21 hours after receiving the vaccine, she developed a temp of 101.8, fatigue, headache, muscle aches and pain, chills and nausea, did not vomit. Back to normal today.

Other Meds:

Current Illness: no

ID: 1124541
Sex: F
Age: 24
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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: rashes / welts on legs, stomach ulcer, arm pain, muscle fatigue, chills, dull pain under the injection arm's armpit

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm