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: 1132081
Sex: F
Age: 30
State: IN

Vax Date: 03/23/2021
Onset Date: 03/23/2021
Rec V Date: 03/25/2021
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: Tomato, Tree nuts, lactose intolerance, seasonal allergies,

Symptom List: Dysphagia, Epiglottitis

Symptoms: Fatigue around 7:00PM same day as the vaccine. Around 10PM several waves of chills. Fever from 10PM- 9AM. Woke up every two hours, usually I sleep all through the night. Body aches, and migraine. Took 600mg of ibuprofen. Migraine stopped, but fatigue continued. Laid on the couch all day, and slept from 2PM- 8:30PM, took a cold shower,and was back in bed at 10PM, fever returned. Day 3, slight headache, body aches, but fatigue has lessened. Back to general activites.

Other Meds: Zyrtec, Metadate, amoxicillin

Current Illness: None

ID: 1132082
Sex: F
Age: 39
State: SC

Vax Date: 03/11/2021
Onset Date: 03/11/2021
Rec V Date: 03/25/2021
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: very high BP, High resting pulse all day (felt like heart was going to come out of my chest)

Other Meds:

Current Illness:

ID: 1132083
Sex: F
Age: 34
State: FL

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

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: I had the second dose of the COVID shot yesterday and am having symptoms. I started vomiting last night and now have diarrhea as well. I've also had chills and whole body aches. I called into work today 2/3 and wanted to let you know as well. Back to work today 2/4, had vomiting, muscle aches, chills, and diarrhea for one day.

Other Meds:

Current Illness:

ID: 1132084
Sex: F
Age: 37
State: LA

Vax Date: 03/17/2021
Onset Date: 03/23/2021
Rec V Date: 03/25/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: red mark about 1" radius from injection site itchiness tenderness This occurred within 24 hours after the injection. These symptoms were resolved after 3-4 days, and then reappeared 6 days after injection.

Other Meds: Collagen Protein Super Greens

Current Illness: N/A

ID: 1132085
Sex: F
Age: 68
State: IL

Vax Date: 03/10/2021
Onset Date: 03/19/2021
Rec V Date: 03/25/2021
Hospital:

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

Lab Data:

Allergies: Penicillin and Sulfa.

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

Symptoms: Had the vaccine, had no problems until 9 days later when she noticed itching, redness that spread just along the forearm and swelling. She took one aspirin last Sunday 3/21/21. Today, 3/25/21, the rash is still present, red and is starting to dissipate but still large and light red.

Other Meds: Lisinopril.

Current Illness: None.

ID: 1132086
Sex: M
Age: 40
State: MA

Vax Date: 03/25/2021
Onset Date: 03/25/2021
Rec V Date: 03/25/2021
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: Needle was not fully secure to syringe. When vaccine was adminstered, the vaccine came out the side of the hub where needle meets syringe rather than going into the guest. No untoward issues with guest. Patient received a full dose of vaccine.

Other Meds: N/A

Current Illness: N/A

ID: 1132087
Sex: F
Age: 88
State: IN

Vax Date: 03/02/2021
Onset Date: 03/19/2021
Rec V Date: 03/25/2021
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: She's come down with what looks like a bad cold. She's coughing constantly but says she doesn't really feel bad.v

Other Meds:

Current Illness: None

ID: 1132088
Sex: F
Age: 53
State: MN

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 03/25/2021
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: Pharyngeal swelling

Symptoms: staff member was asked by writer if she had any anaphylactic reaction to any previous vaccines in the past and she stated NO but was nauseated and felt funky from the flu shot. covid vaccine given at 1523 and approx. 3 -4 minutes after in the observation area she started stating that she felt numbness in her mouth and felt funky. she also was a little tachy and shaky of her upper extremities. we followed standard protocol for infusion reaction and gave 1 dose of epinephrine stat and activated emergency response system. she started to feel better but was nauseous. EMS arrived and no other doses of epinephrine administered. EMS transferred to ER.

Other Meds:

Current Illness:

ID: 1132089
Sex: M
Age: 31
State: KY

Vax Date: 03/19/2021
Onset Date: 03/19/2021
Rec V Date: 03/25/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Patient passed out 5 minutes after vaccine was administered. Epipen was administered and 911 called. Patient was conscious before the arrival of EMS. Per patient's mum , the patient has a history of passing out with needle stick. She sees it as a normal reaction.

Other Meds:

Current Illness:

Date Died:

ID: 1132090
Sex: F
Age:
State: IL

Vax Date:
Onset Date: 03/09/2021
Rec V Date: 03/25/2021
Hospital: Y

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

Lab Data:

Allergies: No known allergies

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Patient reportedly received COVID vaccine doses on 1/23 and 2/15, but we are unsure of which manufacterer or lot number. Patient admitted to our hospital on 3/9/2021. Patient presented with elevated D-dimer with concern for septic shock. Ultrasound of patient revealed no VTEs. COVID test on 3/10 resulted POSITIVE. Patient was going to require vasopressors but patient requested to go on comfort measures only. Patient ordered comfort measures on 3/10 and pronounced deceased on 3/18.

Other Meds:

Current Illness:

ID: 1132091
Sex: F
Age: 60
State: MD

Vax Date: 03/11/2021
Onset Date: 03/22/2021
Rec V Date: 03/25/2021
Hospital:

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

Lab Data:

Allergies: Codine Oxycodone Hydrocodone Nickel

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

Symptoms: Large warm itchy red rash several days after injection

Other Meds: Welbutrain 300mg daily, Cymbalta 50 mg daily, Abilify 7mg, ocuvites,

Current Illness: Cancer

ID: 1132092
Sex: M
Age: 0
State: VA

Vax Date: 03/25/2021
Onset Date: 03/25/2021
Rec V Date: 03/25/2021
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: Pt is under the age of 18, pt is 16 years old.

Other Meds: No

Current Illness: No

ID: 1132093
Sex: F
Age: 62
State: VA

Vax Date: 03/24/2021
Onset Date: 03/24/2021
Rec V Date: 03/25/2021
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: Vaccinator administered one dose of Moderna vaccine to patient, reported that "it didn't feel like anything went in" and administered a second dose of Moderna vaccine to patient in same arm.

Other Meds:

Current Illness:

ID: 1132094
Sex: F
Age: 75
State: ID

Vax Date: 02/02/2021
Onset Date: 02/08/2021
Rec V Date: 03/25/2021
Hospital: Y

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:

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

Symptoms: Patient reportedly received first dose of COVID vaccine (unknown manufacturer or lot #) on 2/2/21. Patient was tested for COVID on 2/8/21 and resulted positive. Patient was transfered to our hospital on 2/14/21 with complaints of hypoxemia and COVID 19 infection. Patient required intubation, convelescent plasma, and 10 days of remdesivir therapy. Additionally patient was treated with levofloxacin, Zosyn, Augmentin, and vancomycin. By 2/19/21 patient was extubated and recovering from COVID illness. By 3/19, the patient was discharged home.

Other Meds:

Current Illness:

ID: 1132095
Sex: F
Age: 59
State: IN

Vax Date: 03/23/2021
Onset Date: 03/24/2021
Rec V Date: 03/25/2021
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: Low grade fever, fatigue, light headed for 6 -7 hours.

Other Meds: None

Current Illness: None

ID: 1132096
Sex: M
Age: 69
State: OH

Vax Date: 03/24/2021
Onset Date: 03/24/2021
Rec V Date: 03/25/2021
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: Peppers and some spices

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

Symptoms: Slight numbness at injection site and down lower arm. Woke up in middle of night with numbness in lower arm. Acute sinus condition at bedtime, congestion and sneezing for about two hours. Took two Benadryl tablets.

Other Meds: Amlodipine Besylate 10 Mg Tab, Rosuvastat-In Calcium 10 MG Tab, IC Valsartan 80 Mg Tab, Eqaute Daily Fiber Supplement, Equate Low Dose Asprin 81 Mg, Vitamin B-Complex, VitimanE 180 Mg, Omega-3 1080 Mg, Vitiman C, 1000 Mg, Airborne Im

Current Illness: None

ID: 1132097
Sex: F
Age: 56
State: FL

Vax Date: 03/24/2021
Onset Date: 03/24/2021
Rec V Date: 03/25/2021
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: almonds, some tree nuts, annatto, watermelon, ragweed, latex, Steri-Strips and medical adhesive

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

Symptoms: Experienced swelling of eyelids (both L/R), intense itching primarily in eyes, some itching on hands and feet, sneezing, runny nose Took 1 25mg Benadryl tablet within 5 minutes of start of symptoms, had to take another 25mg Benadryl tablet approximately 30 minutes later because eyes were continuing to swell and itch Also experienced onset of severe headache about 45 minutes after shot Went to bed and slept for 3 hours after taking the second Benadryl. Felt better after waking, still had slight swelling in eyelids. Experienced minor itching at 10:30 pm, took 2 more Benadryl tablets at 11 pm. Minor eyelid swelling next morning, minimal itching.

Other Meds:

Current Illness:

ID: 1132098
Sex: M
Age: 39
State:

Vax Date: 03/11/2021
Onset Date: 03/11/2021
Rec V Date: 03/25/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: 2ml of normal saline was used to reconstitute the vaccine instead of the directed 1.8ml. No adverse effects reported.

Other Meds:

Current Illness:

ID: 1132099
Sex: M
Age: 68
State: NY

Vax Date: 03/23/2021
Onset Date: 03/23/2021
Rec V Date: 03/25/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Day 1 - Very sore around injection site, did not sleep well through the night. Day 2 - More sore around injection site, tired throughout day, chills and low grade fever, 100.4 peak in the evening. Day 3 - Less sore around injection site, temperature normal in the morning, 97.3.

Other Meds: hydrochlorothiazide-10mg/multivitamin/fish oil/Ca w-vitamin D

Current Illness: urinary tract infection

ID: 1132100
Sex: F
Age: 53
State: NC

Vax Date: 03/24/2021
Onset Date: 03/24/2021
Rec V Date: 03/25/2021
Hospital:

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

Lab Data:

Allergies: no

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

Symptoms: Shortly after receiving the vaccine I started noticing a black dot that I thought was a gnat or fly only on one side in front of my eye. I received my shot in the right arm and that is the same side the dot was appearing.

Other Meds: no

Current Illness: no

ID: 1132101
Sex: F
Age: 20
State: GA

Vax Date: 03/24/2021
Onset Date: 03/25/2021
Rec V Date: 03/25/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: Fatigue, left arm swelling, left arm pain/soreness, nausea, stomach pain, headache, and severe vomiting

Other Meds: Claritin 24 hr Allergy Relief

Current Illness: none

ID: 1132102
Sex: M
Age: 63
State: OR

Vax Date: 03/23/2021
Onset Date: 03/24/2021
Rec V Date: 03/25/2021
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: Body aches, scratchy itchy tongue

Other Meds: Ibuprofen, probiotics

Current Illness: None

ID: 1132104
Sex: F
Age: 48
State:

Vax Date: 03/11/2021
Onset Date: 03/11/2021
Rec V Date: 03/25/2021
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: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

Symptoms: 2ml of normal saline was used to reconstitute the vaccine instead of 1.8ml. No adverse effects reported.

Other Meds:

Current Illness:

ID: 1132105
Sex: M
Age: 53
State: NY

Vax Date: 03/05/2021
Onset Date: 03/05/2021
Rec V Date: 03/25/2021
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: LEFT UPPER ARM PAIN STARTED AFTER RECIVING 2ND COVID VAX WITH RADIATION DOWN ARM, WORSE AT NIGHT WHEN LAYING ON AFFECTED SIDE. HAS TRIED ICE/HEAT WITH LITLE IMPROVMENT. SYMPTOMS LASTING 2 WEEKS.

Other Meds: N/A

Current Illness: N/A

ID: 1132106
Sex: F
Age: 49
State: SC

Vax Date: 03/23/2021
Onset Date: 03/24/2021
Rec V Date: 03/25/2021
Hospital:

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

Lab Data:

Allergies: seasonal allergies

Symptom List: Injection site pain, Menorrhagia

Symptoms: pt states that developed a red bump the size of a quarter on her left arm around the injection site. Lymph nodes are inflamed. she has cough, and headache. Pt still as these symptoms but has not taken any medication. She will contact her PCP.

Other Meds: none

Current Illness: no

ID: 1132107
Sex: F
Age: 69
State:

Vax Date: 02/12/2021
Onset Date: 02/19/2021
Rec V Date: 03/25/2021
Hospital:

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

Lab Data:

Allergies: Penicillin Amoxicillin

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

Symptoms: Dizzy spells, lightheadedness, tinnitus. Tinnitus continues 24/7, dizziness subsiding.

Other Meds: Synthroid Vit B Vit D Fish Oil

Current Illness: None

ID: 1132108
Sex: M
Age: 88
State: MI

Vax Date: 03/04/2021
Onset Date: 03/15/2021
Rec V Date: 03/25/2021
Hospital: Y

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: Patient vaccinated with first dose of Pfizer with subsequent infection and hospitalization due to COVID-19 infection. Initial H&P reads in part as, "Patients symptoms began on or around Thursday 3/11 when he began to feel fatigued. After two days of fatigue, he presented to an urgent care facility on Saturday 3/13. He was noted to have a fever there and was diagnosed with a presumed UTI, though patient reports at bedside that he has not had any dysuria. He was treated with nitrofurantoin and increased his furosemide temporarily per urgent care's recommendations. He then presented to the ER on 3/15 with continued fatigue and a low blood pressure at home. We were unable to clarify the method by which the blood pressure measurement was obtained and/or if it was repeated. Antibiotics were changed to cephalexin at that time despite a relatively clear UA. His daughter brought him back to the ER today (3/18) due to persistent issues with low grade fevers in the 100-100.5 range, significantly worsening fatigue, anorexia, and oxygen levels of 92-93% on nonproductive cough. Does not have a home O2 requirement. In addition, he endorses feeling chilled during the admission evaluation. Denies any chest pain, nausea, vomiting, fevers, diarrhea, constipation. # Fever Progression of symptoms from Saturday 3/13 may constitute original presentation of Covid-19. Presentations on 3/13 and 3/15 with dyspnea and fatigue. Initially thought to be UTI and was treated with nitrofurantoin and cephalexin. UA on 3/15 in ED was negative for leuk esterase and nitrites. Tested positive for covid-19 on 3/18 with lymphopenia, 90-92% on room air. No home O2 req. Given duration of symptoms and worsening fatigue and fevers, will admit for treatment of Covid- 19. Also considered CHF exacerbation, COPD exacerbation as explanations for dyspnea. Possible CHF exacerbation as well given 1+ bilateral pitting edema to mid-shin and JVD to ear lobe. Suspicion for COPD is low given no report of increased sputum production and questionable history in chart to begin with. Would be beneficial to clarify history with collateral history 3/19."

Other Meds:

Current Illness:

ID: 1132109
Sex: M
Age: 60
State: IN

Vax Date: 03/22/2021
Onset Date: 03/23/2021
Rec V Date: 03/25/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Body aches, chills, and head ache for approximately 48 hours. Took ibuprofen to help reduce symptoms.

Other Meds: multivitamin, lutein, fish oil, Naturo Sciences probiotic, latanoprost

Current Illness: none

ID: 1132110
Sex: F
Age: 32
State: MA

Vax Date: 03/25/2021
Onset Date: 03/25/2021
Rec V Date: 03/25/2021
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: N/A

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

Symptoms: Needle was not fully secure to syringe. When vaccine was adminstered, the vaccine came out the side of the hub where needle meets syringe rather than going into the guest. No untoward issues with guest. Patient received a full dose of vaccine.

Other Meds: N/A

Current Illness: N/A

ID: 1132111
Sex: F
Age: 47
State: VA

Vax Date: 03/12/2021
Onset Date: 03/25/2021
Rec V Date: 03/25/2021
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: I woke up this morning with a headache so bad that I can barely see out of my eyes. It feels like my eyes are going to pop out of their sockets, the headache is that bad.

Other Meds: Vitamin D, berberine, NAC, multivitamin, probiotic, HTB Rejuvenate, zinc and selenium

Current Illness: none

ID: 1132112
Sex: F
Age: 55
State: WI

Vax Date: 03/01/2021
Onset Date: 03/03/2021
Rec V Date: 03/25/2021
Hospital:

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

Lab Data:

Allergies: Tetnus vaccine

Symptom List: Injection site pain

Symptoms: Painful swollen lymph nodes in neck and lower jaw, left side. Symptoms were not completely gone for 2 1/2 weeks. I had a hard time opening my mouth very far, even eating was painful. Responded well to Ibuprofen.

Other Meds: Lisinopryl/Hydrochlorithyde Biotin Probiotic Trazadone

Current Illness: N/A

ID: 1132113
Sex: F
Age: 32
State:

Vax Date: 03/22/2021
Onset Date: 03/25/2021
Rec V Date: 03/25/2021
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: 3 days after the 2nd dose my right arm become extremely itchy. The injection site is swollen and painful. This did not happen with the 1st shot.

Other Meds: Multi vitamin, biotin, co q 10

Current Illness: None

ID: 1132114
Sex: F
Age: 40
State: IN

Vax Date: 03/23/2021
Onset Date: 03/23/2021
Rec V Date: 03/25/2021
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: Severe headache, muscle ache, fever, chills and dizziness

Other Meds:

Current Illness:

ID: 1132115
Sex: F
Age: 24
State: IN

Vax Date: 03/23/2021
Onset Date: 03/23/2021
Rec V Date: 03/25/2021
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: At 11:00pm on 03/23/2021 I started to feel sore from my shoulders to my knees. I also have a headache that is not relieved with ibuprofen or Tylenol. The sore muscles make it hard to walk. I did not develop a low grade fever, but I did have a few hot flashes. I?m more fatigued than normal and haven?t been sleeping well at night since the last dose of the vaccine.

Other Meds: Lamictal, Keppra, Folic Acid, Birth control

Current Illness:

ID: 1132116
Sex: F
Age: 71
State:

Vax Date: 03/24/2021
Onset Date: 03/24/2021
Rec V Date: 03/25/2021
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: EUA Pfizer-BioNtech vaccine reaction Patient complained 10 min after vaccine of shortness of breath. she was visibly shaking , she was speaking normally but difficulty breathing.

Other Meds:

Current Illness:

ID: 1132117
Sex: M
Age: 35
State:

Vax Date: 03/11/2021
Onset Date: 03/11/2021
Rec V Date: 03/25/2021
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: 2ml of normal saline was used to reconstitute the vaccine instead of 1.8ml. No adverse effects reported.

Other Meds:

Current Illness:

ID: 1132118
Sex: F
Age: 40
State: OH

Vax Date: 03/24/2021
Onset Date: 03/24/2021
Rec V Date: 03/25/2021
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: Denies

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

Symptoms: Pt began feeling lightheaded after receiving her vaccine. Medical staff was notified and witnessed a syncopal episode where pt was seen with flexed arms and bladder incontinence. Pt was AOx4 after regaining consciousness with SBP in the 80s, diaphoresis, and nausea. Pt did report history of syncopal events associated with needles and SBP around 90s. Pt was monitored and later released by medical staff and EMS after symptoms resolved. PT was instructed to follow up with PCM regarding possible concerns for seizures and hypotension.

Other Meds: Oral contraceptive

Current Illness: Denies

ID: 1132119
Sex: M
Age: 43
State: TX

Vax Date: 03/22/2021
Onset Date: 03/22/2021
Rec V Date: 03/25/2021
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 REPORT OF ALLERGIES NO KNOWN DRUG, FOOD, OR OTHER ALLERGIES

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: 03/22/2021 - 12:43PM: A 30mcg/0.3mL dose* of COVID-19 Pfizer BionTECH vaccine was drawn up into a 1mL syringe with a 23G 1? needle and prepared for administration in the left deltoid. This was the patient?s second dose of a 2 dose series. [*vaccine lot EN6207] After insertion of the needle into the left deltoid, the nurse was beginning to depress the plunger into the barrel of a needle-syringe combination, (to administer a 0.3mL dose of COVID-19 Pfizer BionTECH vaccine) when the needle and hub broke from the tip of the syringe. The needle hub effectively spooned the vaccine to splash in the reverse direction from that of the needle. The vaccine went into the nurses left eye and surrounding facial area(s). The needle and hub remained in the patient?s arm, but it was removed immediately with no adverse effect, bleeding, or leaking of the vaccine suspension. The nurse apologized to the patient who was to receive the vaccine. She told him that no vaccine was injected. She said she would immediately prepare another 0.3mL dose of COVID-19 Pfizer BionTECH vaccine and **repeat the administration. The man gave no vocal expression of refusal or display of guarding. Following the completed IM injection of a 0.3mL dose of COVID-19 Pfizer BionTECH vaccine, the patient was reported to express his wish that she make ?a note of what happened.? He was escorted to a post-immunization monitoring area for the recommended 15 minutes of observation. During this time he did not report any adverse effects, or other abnormal outcomes possibly associated with the vaccine administration.

Other Meds: PATIENT HOME MEDICATION LIST NOT AVAILABLE PATIENT REPORTED TAKING 'BLOOD THINNERS'

Current Illness: NO ACUTE ILLNESSES REPORTED

ID: 1132120
Sex: M
Age: 57
State: IN

Vax Date: 03/23/2021
Onset Date: 03/23/2021
Rec V Date: 03/25/2021
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

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

Symptoms: Headache, achiness, slightly elevated temperature

Other Meds: Aspirin, Time released Niacin, Methyl- Guard Plus, Thyrocin, D-3, Fish oil, Zinc, Vitamin C, Magnesium, Zetia, Omeprazole.

Current Illness: None

ID: 1132121
Sex: M
Age: 58
State: IN

Vax Date: 03/23/2021
Onset Date: 03/24/2021
Rec V Date: 03/25/2021
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: none

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

Symptoms: Chills, joint and muscle pain from 1:00 a.m. on 3/24 until 7:00 p.m. on 3/24. Treated with acetaminophen and naproxen.

Other Meds: Zyrtec, acetaminophen, allopurinol, CoQ10, Rosuvastatine

Current Illness: none

ID: 1132122
Sex: F
Age: 85
State: TX

Vax Date: 01/19/2021
Onset Date: 02/18/2021
Rec V Date: 03/25/2021
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: Pain in extremity

Symptoms: Vaccine 12/25, 1/19. admitted 2/18, tested COVID+ with PNA. Treated w/abx, dexa and convalescent plasma. DCd back to NH.

Other Meds:

Current Illness:

ID: 1132123
Sex: F
Age: 47
State: OH

Vax Date: 03/22/2021
Onset Date: 03/23/2021
Rec V Date: 03/25/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: SULFA

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

Symptoms: Dizziness, sinus congestion, runny nose, cough, sore throat, fatigue, mild body aches - 3 days Believe these to be due to the fact that I had Covid in November and reaction is to the first dose of vaccine. Just wanted to report it for data collection purposes.

Other Meds: ESTRACE, PROGESTERONE

Current Illness: N/A

ID: 1132124
Sex: F
Age: 46
State: NC

Vax Date: 03/24/2021
Onset Date: 03/25/2021
Rec V Date: 03/25/2021
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: Codeine, Sulfa, peanuts

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

Symptoms: Sore arm (entire arm), sore and swollen at injection site, swollen lymph node on injection arm

Other Meds: N/A

Current Illness: N/A

ID: 1132125
Sex: M
Age: 78
State: GA

Vax Date: 03/23/2021
Onset Date: 03/23/2021
Rec V Date: 03/25/2021
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: Medication: Reaction: Penicillin Skin Rash, swelling Erythromycin Skin Rash, Respiratory issues, swelling Demerol ? Certain Pain Relief Hiccups (uncontrollable) Dupixent Injection Severe swelling and irritation of eyes and eyelids, Constant itching rash around scalp, beard, head. Otezla Severe Rash all over Other Allergies: Substance: Reaction: Shellfish Mild Rash Dust Respiratory, rash Pollen Respiratory, rash Latex Swelling, itching, rash Pet Dander ? Especially Cats Eyes itch, swell, skin rash, respiratory Dust Mites Eyes itch, swell, skin rash, respiratory

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

Symptoms: Extremem muscle weakness, especially in legs, unable to stand, low grade fever, disoriented, confused, no appetite. Had to have 2 people help me up off the floor.

Other Meds: Rx Lipitor/Atorvastatin Tab PM 20 mg Tablet 1/d 12/27/2012 -40 / 20mg 2018-2-13 Rx Omeprazole PM 40 mg Capsule 1/d 1/1/2008 to present Rx Etodolac (Lodine) AM&PM 500 mg Tablet 2/d 1/1/2006 to present Rx Flomax/Tamsulosin HCL PM 0.4 mg Ca

Current Illness: None

ID: 1132126
Sex: F
Age: 66
State: NJ

Vax Date: 01/13/2021
Onset Date: 01/16/2021
Rec V Date: 03/25/2021
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: environmental allergies, ivp dye, rocephin, levoquin, raw pineapple.

Symptom List: Vomiting

Symptoms: 2/10 vaccination Later that evening low grade fever by 5pm. I was getting fatigued and little bit of dizziness on and off. Tingling started in my shoulder and arm where it was after the first vaccine. Fever, fatigue, lasted 24 hours. Symptoms for back lasted, intermittingly, 2 weeks.

Other Meds: levoxyl 112 microgram/daily; metformin 1000 2x daily, simvastatin 1/xdaily, cetia 10 mg/daily; tromethamine 100 mg/daily; aspirin 81 mg, triamterene-hctz 37.5-25 1x every other day; vit D 1000/dailyl vit B complex 1daily; fish oil 1 daily,

Current Illness: n/a

ID: 1132127
Sex: F
Age: 24
State: VA

Vax Date: 03/08/2021
Onset Date: 03/11/2021
Rec V Date: 03/25/2021
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: Bee stings

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Recurrent nose bleeds. I?ve never had them in my life i have now been getting them every single day sometimes 2-3 times a day

Other Meds: IUD

Current Illness: None

ID: 1132128
Sex: F
Age: 61
State:

Vax Date: 03/11/2021
Onset Date: 03/11/2021
Rec V Date: 03/25/2021
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: 2ml of normal saline was used to reconstitute the vaccine instead of 1.8ml. No adverse effects reported.

Other Meds:

Current Illness:

ID: 1132129
Sex: M
Age: 65
State: TX

Vax Date: 02/11/2021
Onset Date: 02/25/2021
Rec V Date: 03/25/2021
Hospital: Y

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: Vaccinated 1/12, 2/11. Admit 2/25 treated for resp fx r/t COVID with anx and Remdesivir. DC to home.

Other Meds:

Current Illness:

ID: 1132130
Sex: F
Age: 48
State: OH

Vax Date: 03/24/2021
Onset Date: 03/24/2021
Rec V Date: 03/25/2021
Hospital:

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

Lab Data:

Allergies: Codeine, sesame seeds, shrimp, and alcohol.

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

Symptoms: I waited onsite in my car for the recommended 10 minutes. Feeling fine, I drove away. I stopped at an Aldi about 7 minutes away to use the restroom and get a snack, as I had been at the fairgrounds for about an hour and had not had breakfast. While washing my hands, I noticed that my chest and neck were flushed red, much like when I drink certain alcoholic beverages. My left arm was also red up to my elbow. Feeling a little concerned, but still feeling generally okay, I bought a Snickers bar and a Coke, thinking it would perk me up. I checked out at 10:39AM, and got on the highway to head for home. I drank a bit of Coke, then took a bite of my candy bar. It felt a little weird when I swallowed, but went down okay. I took two more small bites, and each was more difficult to swallow than the last, with the third one not clearing the back of my throat without several sips of Coke to wash it down. I was starting to feel panicky, but figured response time would be relatively slow, as I was traveling in between jurisdictions. I remember my late husband giving me Benadryl after I had a weird reaction to a flu vaccine in 2014, so I focused on getting to a store down the road where I could stop quickly for some. This took another 5 minutes from where I was. I bought a box of Benadryl Liqui Gels, and took one in the parking lot. I could still breathe, so I decided to drive home to my daughter, who was home alone. The Benadryl kicked in when I was almost home, so I did not call EMS.

Other Meds: Pantoprazole 40mg

Current Illness: None

ID: 1132131
Sex: F
Age: 50
State: IL

Vax Date: 03/24/2021
Onset Date: 03/24/2021
Rec V Date: 03/25/2021
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: nkda

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

Symptoms: Fatique, lethargy, Patient states fatigue all day ,did not take insulin because she was getting vaccine

Other Meds: insulin, metformin

Current Illness: diabetic

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm