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: 1125125
Sex: F
Age: 30
State: IL

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

Lab Data:

Allergies: Sulfa

Symptom List: Dysphagia, Epiglottitis

Symptoms: 10 minutes after shot experienced vagovasal episode. Had a headache, sore muscles, and tiredness for 3 days after shot. Experienced a low grade fever and chills the 4th day on and off. Experienced brain fog for about 6 days.

Other Meds: Nexplanon birth control implant

Current Illness: None

ID: 1125126
Sex: F
Age: 35
State: IL

Vax Date: 03/04/2021
Onset Date: 03/05/2021
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: Nausea 3/4/21 3pm (about an our after vaccination) Tiredness 3/5 1pm Body aches 3/5 4pm (took 2 Tylenol at this time) Chills & fever 3/5 6pm 3/5 9:30pm no symptoms

Other Meds:

Current Illness:

ID: 1125127
Sex: F
Age: 36
State:

Vax Date: 03/10/2021
Onset Date: 03/12/2021
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: none

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

Symptoms: Janssen COVID-19 Vaccine EUA I have a known prior history of thrombocytopenia that has historically worsened with infections/flares in immune system. My platelet count was 111 two days prior to vaccination. Two days after receiving vaccine, my platelet count dropped to 73 (but I remained asymptomatic). At 6 days post vaccine, my platelet count increased to 88.

Other Meds: oral contraceptive pills

Current Illness: Known history of thrombocytopenia prior to vaccination. Baseline platelet count was 111 two days prior to vaccination. no other health conditions.

ID: 1125128
Sex: M
Age: 65
State:

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: 101 fever for 5 days straight. Still get a fever every afternoon/evening but about 99. Extreme fatigue for first 10 days. As soon as eat breakfast have to go back to bed for 1-3 hours. Same with lunch, eat, go back to bed about 3 hours and same with dinner. Then go to bed for evening. Extreme brain fog and forgetfulness. Can't think of words or make sentences. Can't remember anything. Feels like a very heavy feeling in head like head weighs a lot and very cloudy. Pain from shot in arm moved up to neck, ear and jaw the day after shot. Arm quit hurting but couldn't lift it. Pain stayed in neck, ear and jaw for a week and now is a stiff feeling. I think the lymph nodes are swollen. Effects eating, hard to keep food down. Nausea and stomach pain. I have appetite but have to eat while nauseous and pain. Still severely fatigued every day and have to sleep most of each day or at least sit and rest. So exhausted. Also night of shot started getting hot and cold chills. Still have them over 2 weeks after shot. Bad tinnitus started night of shot and still have it over 2 weeks after shot. Very loud and nothing makes it go away. Bad headache started morning after shot. I have had a headache pretty much everyday, all day since the shot over 2 weeks ago. I feel sick like I have flu.

Other Meds:

Current Illness:

ID: 1125129
Sex: F
Age: 76
State: AR

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

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

Lab Data:

Allergies: None

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

Symptoms: Moderna COVID-19 Vaccine EUA - In the night I wokeup feeling like all my muscles were being torn from my bones. Never had such pain. I took 2 tylonia around 3am. I finally after hours took 2 Aleve and by dinner time I did feel better. Layed around the rest of Saturday. Got a slow start on Sunday but felt okay. No fever, or headache

Other Meds:

Current Illness:

ID: 1125130
Sex: F
Age: 62
State: PA

Vax Date: 03/22/2021
Onset Date: 03/01/2021
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: Anaphylactoid reaction to contrast media. (Hives.)

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

Symptoms: Tinnitus since second dose.

Other Meds: None except hs Benadryl and intermittent vitamin D3.

Current Illness: None.

ID: 1125131
Sex: F
Age: 52
State: OR

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

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

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Immediately after vaccine I became nauseous and dizzy with a headache. I went home and slept for the next three days. My body ached but the dizziness subsided. Today 03/22 I still feel nauseous and mildly aches. However my left elbow has now swollen up. It hurts to bed it and pressure hurts. I have pins and needles going through my wrist into my fingers along with a full ache.

Other Meds: Lamictal

Current Illness:

ID: 1125132
Sex: M
Age: 27
State:

Vax Date: 03/19/2021
Onset Date: 03/21/2021
Rec V Date: 03/22/2021
Hospital:

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

Lab Data:

Allergies: None known

Symptom List: Pharyngeal swelling

Symptoms: Entire body relentlessly itchy

Other Meds: Vyvanse

Current Illness:

ID: 1125133
Sex: M
Age: 69
State: CA

Vax Date: 02/27/2021
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: Iodine allergy

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Dizziness and vertigo when getting up from bed or chair

Other Meds: Vitamin D, flomax

Current Illness: None

ID: 1125134
Sex: F
Age: 52
State: NY

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

Lab Data:

Allergies: PCN, tetracycline, tetanus

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Grapefruit sized lump in left axilla

Other Meds: Nucynta, Lyrica, losartan, bisoprolol, Prilosec, Vit d3, Ibuprophen

Current Illness: None

ID: 1125135
Sex: F
Age: 30
State:

Vax Date: 01/08/2021
Onset Date: 03/16/2021
Rec V Date: 03/22/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Positive for COVID19 2 months after completion of vaccination series

Other Meds: Yaz

Current Illness: None

ID: 1125137
Sex: F
Age: 26
State: WV

Vax Date: 03/17/2021
Onset Date: 03/20/2021
Rec V Date: 03/22/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies: Apples

Symptom List: Rash, Urticaria

Symptoms: ?COVID arm? - red, painful, swollen, hot, itchy skin around injection site, about 3 inches in diameter. Painful to sleep on.

Other Meds: 2 mg daily sirolimus

Current Illness: None

ID: 1125138
Sex: F
Age: 30
State: IL

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: N/A

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

Symptoms: Immediately after the injection and for the next 36 hours, I had soreness in my right arm where the injection was. Around 8:15pm, I started to develop chills. From there, I developed a fever, headache, neck soreness and body aches in my joints (particularly wrists, knees, elbows). I contained the fever with extra strength Tylenol taken according to the box instructions. The fever broke overnight. I had a 99 degree temperature the next day (3:00 pm) after the vaccine, and experienced fatigue and body aches. Those symptoms largely subsided by the morning of 3/21. I still (as of the PM on 3/22) have no appetite and a persistent feeling of "fullness" in my stomach.

Other Meds: L-lysine, Vitamin D

Current Illness:

ID: 1125139
Sex: F
Age: 51
State: TX

Vax Date: 03/11/2021
Onset Date: 03/19/2021
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: Zofran, dexamethazone, compazine, albuterol, adhesives, seasonal allergies (dust, hay fever, etc)

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

Symptoms: Bell?s Palsy treated with prednisone steroid and Valacyclovir anti-viral prescription

Other Meds: NP Thyroid, Metoprolol, Tamoxifen, Zyrtec, Atarax, Vitamin D, Vitamin B6, Multivitamin, Calcium, Probiotic, Digestive Enzymes, Amberen

Current Illness: Completed breast cancer treatments (chemo/radiation)in Sept 2020

ID: 1261980
Sex: M
Age: 86
State:

Vax Date: 01/19/2021
Onset Date: 02/25/2021
Rec V Date: 03/22/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: COVID-19 INFECTION Narrative: Pt received first dose of Moderna then RN was contacted for a report of patient having a mild case in early February. Pt was told by hospital at discharge that he should not receive 2nd dose until 5/2021.

Other Meds:

Current Illness:

ID: 1262002
Sex: M
Age: 56
State:

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

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

Lab Data:

Allergies:

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

Symptoms: atrial Fibrillation with rapid ventricular response Narrative: Patient presented in Atrial fibrillation with rapid ventricular response within 24 hours of receiving second dose of MODERNA COVID-19 vaccine. Required inpatient hospitalization and IV anti-arrhythmic medications.

Other Meds:

Current Illness:

ID: 1294883
Sex: M
Age: 58
State:

Vax Date: 03/20/2020
Onset Date: 03/20/2021
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: Narrative:

Other Meds:

Current Illness:

ID: 1294884
Sex: M
Age: 67
State:

Vax Date: 03/01/2021
Onset Date: 03/15/2021
Rec V Date: 03/22/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Pt covid POSITIVE Narrative: Pt received his dose #1 of covid vaccine on 1/26/21 and dose#2 of covid vaccine on 3/1/21. Pt was admitted to hospital on 3/15/21 with covid POSITIVE pneumonia. Pt started on remdisivir & dexamethasone therapy. Pt remains in ICU care. Of note, pt had prior recent hospital admission 2/24/21-3/3/2021 for HF exacerbation. Pt received the covid vaccine dose#2 during this admission on 3/1/21.

Other Meds:

Current Illness:

ID: 1300730
Sex: M
Age: 78
State:

Vax Date: 03/15/2021
Onset Date: 03/16/2021
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: Weakness, Fall, Rhabdomyolysis Narrative: Patient presented following a fall at home within 24 hours of the second COVID vaccine. Pt reported chills, weakness leading to fall, subsequently developed rhabdomyolysis requiring hospitalization due to weakness/prolonged period down after fall.

Other Meds:

Current Illness:

ID: 1300731
Sex: M
Age: 31
State:

Vax Date: 02/08/2021
Onset Date: 02/11/2021
Rec V Date: 03/22/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: pulmonary embolism Narrative:

Other Meds:

Current Illness:

ID: 1300733
Sex: M
Age: 73
State:

Vax Date: 02/28/2021
Onset Date: 02/28/2021
Rec V Date: 03/22/2021
Hospital: Y

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: GI pain. Pt had appendicitis next day and appendix removed in hospital on 3/1. Pt was hospitalized the day after his vaccine for appendicitis. He had appendix removed.

Other Meds:

Current Illness:

ID: 1300734
Sex: M
Age: 84
State:

Vax Date: 02/10/2021
Onset Date: 02/16/2021
Rec V Date: 03/22/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: Narrative: Per primary provider required hospitalization due to atrial fibrillation with RVR and heart rate in eh 150s. Was subsequently seen by cardiology with additional work-up. Cardiologist noted, "Unclear if presumed new systolic heart failure is related to longstanding atrial fib with RVR (tachycardia cardiomyopathy) or CAD with ischemia causing atrial fib and LV dysfunction. I explained both scenarios to pt and daughter." per 3/10/2021 Note. Per primary provider patient was verbally informed they though potentially related to vaccine.

Other Meds:

Current Illness:

ID: 1309777
Sex: M
Age: 59
State: MI

Vax Date: 02/03/2021
Onset Date: 02/04/2021
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: Iodine Contrast/latex

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

Symptoms: Next Day 2 days of constant coughing - got chest x-ray because I thought I broke ribs. Then 2 days of severe diarrhea/nausea NOW daily hourly coughing bouts NEVER had chronic cough before

Other Meds: Metoprolol, Cialis

Current Illness: None

ID: 1311817
Sex: M
Age: 56
State: TX

Vax Date: 02/27/2021
Onset Date: 03/02/2021
Rec V Date: 03/22/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NKDA

Symptom List: Injection site pain, Pain

Symptoms: Acute unprovoked pulmanary embolism 3 days after 2nd dose

Other Meds: sulfasalazine, empagliflozin , fluticasone/salmeterol,semaglutid losartan,metformin,montelukast, pantoprazole stela a

Current Illness: Diabetes, Asthma, Psoriasis

ID: 1381495
Sex: U
Age:
State: NH

Vax Date:
Onset Date:
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: After about 8 min customer passed out sitting in chair, easily awoke, all sweatty, lightheaded, tingling in hands, little nausea.

Other Meds:

Current Illness:

ID: 1381496
Sex: M
Age: 70
State: MD

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

Lab Data:

Allergies: NONE

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

Symptoms: Vaccine was given in the left arm. A brown bruise appeared on the right upper arm. the next day. No pain or discomfort.

Other Meds: NONE

Current Illness: NONE

ID: 1391878
Sex: F
Age: 33
State:

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

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

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: sensation of swelling hands Narrative: Checked with personnel and was approved for vaccination with 30 minute monitoring. At 1130, after receiving vaccine, patient reported dizzines and a sensation of swelling in their hands. Stated to lead RN that their "heart is racing." Leed RN assessed patient at 1130? 1145 and 1155 with the following results. 1130: symptoms described as above . HR 125, BP 104/59, RR 18 1145: symnotoms relieving HR 118, BP 109/66, RR 16 1155: HR 113 Patient reports that they celebrated last night and didn't sleep much, as well as not having time to eat or drink anyhthing this morning. Patient was given juice to drink and closely monitored. After 30 minutes of monitoring the reported symptoms as stated above subsided, although heart rate remained elevated. No signs of swelling, rash, or reported tightness in chest/throat. Patient was released after 30 minutes and stated that they felt better.

Other Meds:

Current Illness:

ID: 1391880
Sex: M
Age: 44
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:
Dose Series: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: tightness in jaw Narrative: At 11:00 Patient reported to this RN mild stiffness in his jaw. This RN sought and received assistance from lead RN. Lead RN assessed and provided care as needed/illustrated below: 11:00 -- vital signs -- offered water and ice pack HR 81, BP 103/66, RR 16, 02 98=7% 11:15 -- vital signs -- Patient denied symptoms at this point HR 72, BP 106/70, RR 12 patient denied concerns before leaving vaccine clinic. Was monitored for 30 minutes.

Other Meds:

Current Illness:

ID: 1391884
Sex: M
Age: 38
State:

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

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

Lab Data:

Allergies:

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

Symptoms: Hot, diaphoretic, lightheaded Narrative: felt lightheaded, dizziness, layed down, at 12:18 VS HR 78, BP 110/73, RR24, 12:28 HR 85, BP 129/92, RR12, 12:39 HR 70, BP 124/85, RR 14, felt better after H2O, pt left with sx resolved at12:39

Other Meds:

Current Illness:

ID: 1391886
Sex: M
Age: 93
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:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Narrative:

Other Meds:

Current Illness:

ID: 1391887
Sex: F
Age: 54
State:

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

Other Meds:

Current Illness:

ID: 1391889
Sex: M
Age: 81
State:

Vax Date: 02/25/2021
Onset Date: 02/25/2021
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: LEG WEAKNESS, CHILLS, SHORTNESS OF BREATH Narrative: Patient reported after taking his second dose of Moderna vaccine on 2/25/2021 he developed extreme leg weakness, shortness of breath, fever, chills and elevated blood pressure. States the fever and chills lasted for 5 days and the chills were so bad he "shook all over". Patient states the leg weakness and SOB are not completely resolved yet. He completed a chest xray this week and the results are: streaky opacities at the lung bases, likely atelectasis and/or scarring. Patient to complete PFT soon. States his BP has been running 167/88 until 3/15. However patient reports he doesn't take his metoprolol all the time. Legs are still weak 3/15, but began using an exercise machine yesterday for his legs and "feels that may help". Patient also reports he had purchased a "so clean" device to keep his cpap machine clean. He received a letter from the Clinic stating those devices have been linked to asthma and lung problems so he stopped it.

Other Meds:

Current Illness:

ID: 1391890
Sex: M
Age: 63
State:

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

Lab Data:

Allergies:

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

Symptoms: Narrative:

Other Meds:

Current Illness:

ID: 1391891
Sex: M
Age: 68
State:

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:

Symptom List: Tremor

Symptoms: Body Chills Narrative:

Other Meds:

Current Illness:

ID: 1391892
Sex: F
Age: 40
State:

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: anxiety Narrative: Veteran received injection in Left arm. Veteran notified monitoring staff of headache in forehead and dizziness stating "this is new since my injection." Veteran states they have anxiety due to PTSD and feels the new symptoms may be anxiety related but want additional monitoring just to be sure. Vet states "I have not left the house since last March." "I have PTSD, I feel this anxiety related but just want to make sure. Initial VS: 1343 BP: 148/92 HR: 68 RR: 18 PN: 01/10 SO2: 99% Veteran states "that is high blood pressure for me. Usually it is too low due to the medications I take for my anxity/PTSD." F/U VS:1400 BP:129/91 HR: 71 PN:01/10 SO2: 100% Pain 01/10-Headache middle of forehead-no change. Vet states "I think its anxiety." Declined Hot/Ice pack Agreed to a juice pouch. Declined EMS Veteran departed Vaccine Clinic. /es/ RN, BSN Signed :03/18/2021 14:53

Other Meds:

Current Illness:

ID: 1391893
Sex: M
Age: 72
State:

Vax Date: 03/03/2021
Onset Date: 03/12/2021
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: RASH AT INJECTION SITE, SOME SWELLING AND INTENSE ITCHING Narrative: Patient reported skin rash and some swelling around injection site that started 9 days after injection. Patient reported intense itching of rash. All symptoms resolved within 3 days from presentation of symptoms. Patient has no lasting symptoms from injection.

Other Meds:

Current Illness:

ID: 1391985
Sex: M
Age: 37
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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: othostatic Narrative: The patient looked pale, shaking, reported light headed after got the vaccine for COVID 19. The staff in the clinic put him down the ground with feet and legs lifting on the chair. Ice bag provided. At that moment (1250), checked his Vss: BP 103/62,HR 75, 02sat 98%, 10 mins later (1355),his Vss BP 120/80, HR70,02 sat 99%. He stated feeling better, face color turned to pink, the patient said no dizzy any more. Juice provided. Last Time (1330) checked the patient VSs: BP 117/77, HR 87,02 98%. The patient reported feeling OK. He has been released to home.

Other Meds:

Current Illness:

ID: 1392004
Sex: M
Age: 93
State:

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

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

Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: 3rd vaccine given Narrative: Report entered to document 3rd dose to Pfizer covid vaccine given by mistake in outpatient clinic. Patient is elderly and noted to have memory problems. Did not recall receiving second covid vaccine on 3/4/2021. Came to clinic for a lab/PCP appointment on 3/17/2021 and was taken back for a covid injection before the nursing staff could verify and check the medical record to see if he was already fully vaccinated. No adverse effects reported from any of the vaccinations.

Other Meds:

Current Illness:

ID: 1392005
Sex: M
Age: 54
State:

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

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

Lab Data:

Allergies:

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

Symptoms: lasted 30 days, Narrative:

Other Meds:

Current Illness:

ID: 1392006
Sex: M
Age: 80
State:

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

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: pain Narrative:

Other Meds:

Current Illness:

ID: 1392007
Sex: M
Age: 50
State:

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

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

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: diaphoretic Narrative: 3/10/21 50 yr old male received Moderna covid vaccine 0.5ml lot#044A21A exp 8/31/21. Within 5 min of receiving vaccine, patient became pale, diaphortic, hypotensive...lost consciousness. Pt has a hx of allergic rhinitis GERD,obese,vit D defi.,chronic leukocytosis,mild emphysema. Pt called prior to arrival, pt was placed in reverse trandeleburg with almost immediate return of consciousness and color. he was given some water and crackers. was observed for 30 minutes in clinic and was cleared and exan by dr to go home. was able to walk to care free of symptoms.

Other Meds:

Current Illness:

ID: 1392008
Sex: M
Age: 49
State:

Vax Date: 02/18/2021
Onset Date: 02/20/2021
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:

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

Symptoms: loss of smell

Other Meds:

Current Illness:

ID: 1392009
Sex: F
Age: 40
State:

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

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

Lab Data:

Allergies:

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

Symptoms: mild SOB, lightheaded Narrative: 03/12/2021: 40 year old female received in left arm lot#044A21A exp 08/31/2021 Moderna.approximately 10 minutes after 1st dose. vet stated she felt nauseated, and mildly short of breath. she was observed for extra minutes and she said she felt better.she attempted to walk from clinic and became lightheaded and was hyperventilating. "I feel tingling in my fingers and legs"vs's. sat 100% resp 24, pulse 100, bp 134/88. Hx of asthma and GERD. w/PMH s/f anaphylaxis to allergy shots (ER visit with Epi x2 the first time and epi x5 plus admission the second time) asthma, grass allergy, and eczema who presents to the ED With nausea and pain in the back of the head and shoulders, throat irritation, facial redness with small hives, SOB, occasional cough, and fatigue 30 min after Covid vaccine #1 followed by anxiety, hyperventilation and chest tightness alleviated by albuterol. Sx similar to the onset of anaphylaxis after allergy shots. No wheezing, lightheadedness, tongue or lip swelling, or abd pain

Other Meds:

Current Illness:

ID: 1392010
Sex: F
Age: 61
State:

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

Lab Data:

Allergies:

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

Symptoms: pruritus Narrative: 61 y/o female received COVID19 vaccine (Janssen) on 03/18/21 @0906. Has prior history to Shingrix vaccine on 02/2020 documented as causing diarrhea/facial numbness, but also had been exposed to Shingles prior to vaccination. Prior ADR was reviewed with RN and pharmD; was given the vaccine and observed for 30 minutes. @0930, was observed to be itching to back, legs, and left side of neck. @0935, diphenhydramine 50mg PO was given. @0944 itching continued and reports lips felt funny. @0947 patient reports feeling better and itching resolving, was observed until all symptoms resolved. Patient denied any shortness of breath. Patient stated symptoms of numbness/tingling in lips resolved. Patient left @1007. Instructed to seek emergency care if symptoms worsen or have any difficulty with breathing.

Other Meds:

Current Illness:

ID: 1392169
Sex: F
Age: 45
State:

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

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: Headache, Myalgia & Fever Narrative: Patient received vaccine on 3/9/21 and began experiencing symptoms that evening. Reported symptoms include fever (100 F), headaches, body aches, chills, and menstrual cramps. Reported took Tylenol (no dose, frequency provided). Did not see PCP for symptoms. Other Relevant History:

Other Meds:

Current Illness:

ID: 1392170
Sex: F
Age: 35
State:

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

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Patient received vaccine on 3/2/21 and began to experience symptoms within 12 hours. Reported symptoms include: injection site pain (within 6 hrs of shot), fever (101 F), chills, headaches, body aches, fatigue, nausea, as well as "a shooting pain below right cage x 3 short episodes the day after shot (3/3/21), and increased vaginal discharge 4 days later (3/6/21). Patient reported use of Tylenol 500mg x 1 dose on 3/3 for fever. Has fully recovered.

Other Meds:

Current Illness:

ID: 1392171
Sex: F
Age: 57
State:

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

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

Lab Data:

Allergies:

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

Symptoms: Headache & Myalgia Narrative: Patient received vaccine 3/9/21 with symptoms beginning 3/10/21 around 5am. Reported symptoms included headache, body aches, and stiff neck/sore throat. Reporter recommended patient to follow up with PCP. Reportedly used Advil, allergy medicines, and roll-on pain medicine.

Other Meds:

Current Illness:

ID: 1392173
Sex: F
Age: 37
State:

Vax Date: 03/10/2021
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:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Headache, Myalgia & Fever Narrative: Patient received 2nd dose of vaccine on 3/10/21 and began experiencing symptoms within one hour of receipt. Reported symptoms included injection site pain/discomfort, fever, chills, headaches, and body aches. Reports using Tylenol for symptom relief (unknown dose/frequency). Fully resolved as of date of report. Other Relevant History:

Other Meds:

Current Illness:

ID: 1392174
Sex: M
Age: 44
State:

Vax Date: 02/10/2021
Onset Date: 02/10/2021
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: Headache, Myalgia & NauseaVomiting Narrative: Patient received 2nd dose of vaccine 2/10/21 at 845am and began experiencing symptoms by that evening. Reported symptoms include headaches, body aches, and nausea. No medication were used per patient report.

Other Meds:

Current Illness:

ID: 1392176
Sex: F
Age: 36
State:

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

Lab Data:

Allergies:

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

Symptoms: Dizziness, Headache & Myalgia Narrative: Patient received 2nd dose of vaccine on 3/10/21 at 12:15pm and began experiencing symptoms 3/11/21 around 1am. Reported symptoms include chills, headache, body aches, tiredness. Only reported medication used for symptoms was Tylenol (no dose/frequency reported). Other Relevant History:

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm