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: 1134271
Sex: F
Age: 58
State: PA

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: LA

Lab Data:

Allergies: Keflex, levofloxin

Symptom List: Dysphagia, Epiglottitis

Symptoms: Severe body aches, chills, fever 101.0 headache for first 6-8 hours. Then profuse sweating

Other Meds: Tylenol

Current Illness: None

ID: 1134272
Sex: M
Age: 78
State:

Vax Date: 01/26/2021
Onset Date: 02/16/2021
Rec V Date: 03/25/2021
Hospital: Y

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: Hospitalization within 6 weeks after receiving vaccine

Other Meds:

Current Illness:

ID: 1134273
Sex: M
Age: 28
State:

Vax Date: 03/21/2021
Onset Date: 03/21/2021
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: No adverse event, but pt received a more potent dose. Pharmacist reconstituted with 0.8ml instead of 1.8ml.

Other Meds:

Current Illness:

ID: 1134274
Sex: F
Age: 73
State:

Vax Date: 03/13/2021
Onset Date: 03/16/2021
Rec V Date: 03/25/2021
Hospital: Y

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: Seizure, aphasia, facial droop 3 days after receiving vaccination.

Other Meds:

Current Illness:

ID: 1134275
Sex: M
Age: 66
State: KY

Vax Date: 03/10/2021
Onset Date: 03/14/2021
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 known

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

Symptoms: ringing in the right ear and hearing loss

Other Meds: bisoprolol-hydrochlorothiazide 5-6.25, krill oil 500 mg, turmeric-curcumin, co-q10, mobic 15mg, milk thistle 175 mg

Current Illness: none

ID: 1134276
Sex: F
Age: 57
State: CA

Vax Date: 03/05/2021
Onset Date: 03/13/2021
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: Penicillin, codeine, contrast dye, Motrin, sulphate, floxin,

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

Symptoms: Exactly 8 days after receiving the shot (in my left arm) it was swollen, red, sore and itchy. Benedryl helped relieve the itch and swelling. Since then, my arm continues to ache, noticeably, and I still have a faint redness. I?m concerned about the aching as today it is the 21st day after my first shot,

Other Meds: Lexapro

Current Illness: None

ID: 1134277
Sex: M
Age: 36
State:

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

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Patient received less than the recommended dose. No adverse reaction.

Other Meds:

Current Illness:

ID: 1134279
Sex: F
Age: 52
State: MA

Vax Date: 12/30/2020
Onset Date: 01/01/2021
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: I had arm pain in my left arm initially with a 4" diameter pink circle around injection site. It became itchy 2 days post shot and the hives developed on my left shoulder which within another couple of days spread across my chest and upper back. By the end of the week, the hives covered my whole back and had spread across to my right shoulder.

Other Meds:

Current Illness:

ID: 1134280
Sex: F
Age: 31
State: OH

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

Lab Data:

Allergies: Ceclor

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Metal taste in mouth within 3 minutes of receiving the vaccine. Metal taste lingered in mouth for several hours after receiving the vaccine. Metal taste had disappeared completely after approximately 6 hours post vaccine administration. No anaphylaxis or allergic effects. Patient did not need medical treatment. Patient intends to receive the second dose on schedule.

Other Meds: Pristiq, Vyvanse

Current Illness: None.

ID: 1134281
Sex: F
Age: 51
State: NY

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

Lab Data:

Allergies: seasonal environmental allergies; septra; cipro

Symptom List: Diarrhoea, Nasal congestion

Symptoms: pain in chest felt like crystals in lungs off and on over a few hours- no shortness of breath hurt to move arm and could not lay on it , day after shot cannot get warm

Other Meds: hydrochlorothiazide accupril ceterazine mucinex fluticasone livaplex congaplex

Current Illness: none

ID: 1134282
Sex: M
Age: 36
State: FL

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

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

Symptoms: Client had a syncope episode after receiving the vaccine. Client states he has a history of syncope after vaccination. 97.9 degrees, HR 68, BP 127/72. 1:30 pm asst. to BR, gait steady, no c/o dizziness, continued to wait in observation area. Allowed to leave at 2pm.

Other Meds: n/a

Current Illness: n/a

ID: 1134283
Sex: F
Age: 25
State: CA

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: Unknown

Symptom List: Rash, Urticaria

Symptoms: Medical student accidentally pushed on the plunger of syringe causing vaccine to leak on arm prior to injection. Less than half the dose was administered to left deltoid. Full dose re-administered to right arm deltoid per her medical instructor, Dr.

Other Meds: Unknown

Current Illness: Unknown

ID: 1134284
Sex: U
Age: 44
State:

Vax Date: 03/12/2021
Onset Date: 03/12/2021
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: Patient received less than the recommended dose. No adverse reaction.

Other Meds:

Current Illness:

ID: 1134285
Sex: F
Age: 31
State: CA

Vax Date: 02/23/2021
Onset Date: 02/24/2021
Rec V Date: 03/25/2021
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: None

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

Symptoms: Since the vaccine, I have experienced extreme paraesthesia throughout my left head and face. It is chronic and lasts from the moment I wake up to the moment I go to bed. I am also experiencing a watering, itchy left eye and tingling behind the eyeball. Extreme neuropathy in brain, it feels like electric shocks coursing through my head and crabs pinching at the brain tissue. I have also deal with temporarily facial paralysis on the left side of my face, though those symptoms have since abated. I am on Lyrica, prednisone, indomethacin, and xanax in an attempt to get some relief but there are very few doctors who seem to understand what is causing this debilitating adverse reaction.

Other Meds: Albuterol and Symbicort

Current Illness: None before vaccination

ID: 1134286
Sex: F
Age: 27
State: CA

Vax Date: 03/10/2021
Onset Date: 03/16/2021
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: Sulpha

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

Symptoms: Broke out in a red itchy raised rash. It has since been diagnosed by my dermatologist as dermatographism. This is a new condition for me, and has been ongoing since the onset of symptoms, which is just over a week now.

Other Meds:

Current Illness: None

ID: 1134287
Sex: F
Age: 57
State: AZ

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: Demerol

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

Symptoms: Had dystonic reaction after vaccine. Contractions to arms and pulling of face. Has hx of dystonic reactions following administration of oral medications. Has never had happen after a vaccine, did not have any issues following 1st dose. Took own rescue medications of Benadryl and Ativan when felt coming on. Has additional doses if needed. Is getting better. Does not want medication from fire department or to be transported to hospital.

Other Meds: Methotrex, methylprednislone, Ativan, Benadryl, Tofactinih, Cogetin

Current Illness: none

ID: 1134288
Sex: F
Age: 54
State: NH

Vax Date: 03/23/2021
Onset Date: 03/23/2021
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: fish (anaphylactic), compazine, amoxicillin, sulfa antibiotics

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

Symptoms: Possible administration of expired vaccine. The electronic medical record created to record this dose shows an expiration date of 3/22/2021, the day before the vaccine was administered. When pointed out to the National Guardsman in charge, she stated that she thought this was caused by a bug in VINI (NH Vaccination and Immunization Network Interface) and that the vaccine was not expired, but I (Patient) have no confidence that I have been given a potent dose of the vaccine and am trying to figure out if re-administration is indicated and safe in this situation, and if so how to arrange for re-administration. PLEASE contact me to help me understand the next steps.

Other Meds:

Current Illness:

ID: 1134291
Sex: F
Age: 49
State: LA

Vax Date: 03/16/2021
Onset Date: 03/17/2021
Rec V Date: 03/25/2021
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: Percocet, Demerol, Citrus products, latex, adhesives, Flu vaccine, Typhoid Vaccine, Pneumovax vaccine, Bees, horses

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Developed pain/numbness to injection arm, headache, fever, chills. Then developed chest pains/tightness and shortness of breath. Admitted to hospital on 3/17/2021 in MICU for observation due to tachycardia and SOB.

Other Meds: Lisinopril, Xyzal, Claritin, Singulair, Symbicort

Current Illness: Seasonal allergies

ID: 1134292
Sex: F
Age: 69
State: MO

Vax Date: 02/08/2021
Onset Date: 02/12/2021
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: Unknown

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: After receiving the second dose of the Pfizer COVID vaccine patient reports developing a hard knot in her left arm. Approximately one month later she saw her PCP and was prescribed steroids. Pt had began taking them on 3/11/2021.

Other Meds: Unknown

Current Illness: Unknown

ID: 1134293
Sex: F
Age: 43
State: MO

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: none

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

Symptoms: Pt has experienced a full body rash, not just one specific to injection site. Rash presents as raised red, itchy bumps covering arms, legs, and torso of body. Pt has also experienced a racing heart upon presenting to pharmacy with reaction; may or may not be related to vaccination.

Other Meds: none

Current Illness: none

ID: 1134294
Sex: M
Age: 35
State:

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

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

Symptoms: Patient received less than the recommended dose. No adverse reaction.

Other Meds:

Current Illness:

ID: 1134295
Sex: M
Age: 16
State: AZ

Vax Date: 03/16/2021
Onset Date: 03/16/2021
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: 16 year old male , volunteered with his mother at COVID vaccination event - received vaccination at event. His parents approved of vaccination - he did not disclose age prior to vaccination . Would like to proceed with 2nd vaccination - parents approve . Mother spoke with pediatrician who would like patient to receive 2nd dose. Minor consent to be signed Minimal arm soreness post injection

Other Meds: none

Current Illness: none

ID: 1134296
Sex: M
Age: 68
State: NC

Vax Date: 02/11/2021
Onset Date: 02/17/2021
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: Unspecified antibiotic agent

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

Symptoms: Spoke with this patient regarding a full body rash after taking "an antibiotic for 5 days". This happened to follow his 2nd COVID-19 immunization by ~1 week. Patient has seen several different physicians and has had multiple rounds ofs oral steroids. Patient was sent to dermatology for a consult, however was sent to the ED due to an alk phos of 1,000. Patient denies use of any medications at home other than the prednisone/dexamethasone they received over the past 5 weeks.

Other Meds: Albuterol inhaler, ezetimibe 10mg, losartan 25mg, Montelukast 10mg, naproxen 375mg, omeprazole 40mg, rosuvastatin 40mg, Trelegy Ellipta Denied use of any OTC medications, dietary supplements, or herbal remedies.

Current Illness:

ID: 1134297
Sex: M
Age: 32
State:

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

Symptom List: Injection site pain, Pain

Symptoms: Patient received less than the recommended dose. No adverse reaction.

Other Meds:

Current Illness:

ID: 1134298
Sex: M
Age: 33
State: NC

Vax Date: 03/09/2021
Onset Date: 03/16/2021
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: None that are aware of

Symptom List: Injection site pain, Menorrhagia

Symptoms: I began having hive flare ups during the night of the event start date. It looked and felt like mosquito bites located on both of my elbows and scattered throughout my upper body. The following day I began to develop more hives that varied from small to large that were extremely itchy during the day and painful during the night. The hives continued to spread the following day and I visited my physician who prescribed several antihistamines. I have been taking those for seven days and although I still have the hives, they are starting to fade away for the most part.

Other Meds: None

Current Illness: none

ID: 1134301
Sex: F
Age: 33
State: CO

Vax Date: 02/06/2021
Onset Date: 02/07/2021
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: Flagyl

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

Symptoms: I had body aches, chills, extreme fatigue, arm soreness, and inflamed lymphnodes in the armpit of the arm I used for injection

Other Meds: women's multi-vitamin , biotin vitamin, b complex vitamin

Current Illness: none

ID: 1134302
Sex: M
Age: 34
State:

Vax Date: 03/12/2021
Onset Date: 03/12/2021
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: Nausea, Pain in extremity, Pyrexia

Symptoms: Patient received less than the recommended dose. No adverse reaction.

Other Meds:

Current Illness:

ID: 1134303
Sex: F
Age: 84
State: ND

Vax Date: 03/02/2021
Onset Date: 03/18/2021
Rec V Date: 03/25/2021
Hospital: Y

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: Hospitalization within 6 weeks after receiving vaccine

Other Meds:

Current Illness:

ID: 1134305
Sex: F
Age: 17
State: AZ

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

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

Symptoms: 17 year old female , - received vaccination at event. Her parents approved of vaccination - she did not disclose age prior to vaccination . Would like to proceed with 2nd vaccination - parents approve . Minor consent to be signed Minimal arm soreness post injection

Other Meds: none

Current Illness: none

ID: 1134306
Sex: F
Age: 64
State: FL

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

Lab Data:

Allergies: None

Symptom List: Nausea

Symptoms: On Day 4 after the vaccine she experienced a rapid heart rate of 132 ppm! Day 5 we called our family doctor and made an appointment!

Other Meds: Bisopropol Fumarate 5mg, Cholesterol360, Aspirin Low dose 81mg, Equate One Daily women health!

Current Illness: None

ID: 1134307
Sex: F
Age: 23
State: NJ

Vax Date: 01/18/2021
Onset Date: 01/18/2021
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: Nut, hickory nuts - anaphylaxis and swelling Banana - tongue itching Pineapple - tongue itching Nickel - rash

Symptom List: Injection site pain

Symptoms: About 10 minutes after administration of COVID-19 vaccine, began to have acute onset of shortness of breath, difficulty breathing and heart racing. Patient states she has a history of anaphylaxis with exposure to tree nuts and a food additive and self-administered EpiPen just prior to ED arrival. Patient states that after administration of EpiPen resolution of all symptoms. ED treatment: Prednisone 60mg PO x1 dose Benadryl 50mg capsule PO x1 dose Pepcid 20mg tablet PO x1 dose

Other Meds: Asteline 137mcg/spray, 2 sprays into nostrils BID Zyrtec 10mg PO daily Kelnor 1-35 mg-mcg 1 tablet PO daily Patanol 0.1% ophthalmic solution, 1-2 drops into both eyes BID PRN

Current Illness: No known

ID: 1134308
Sex: F
Age: 65
State: MN

Vax Date: 03/19/2021
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: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: I tested positive for Covid in early December, 2020. 5 days after I received the vaccine, I woke up to extreme dizziness with the room just spinning. My blood pressure increased to around 212/101 for much of the day. Normal is around 120/70. The dizziness finally subsided later in the day and the blood pressure went down to about 168/85 by evening. Then I minor developed a headache. I also developed sores in my mouth and on my tongue. I still have those today (the day after).

Other Meds:

Current Illness: None

ID: 1134309
Sex: M
Age: 17
State: AZ

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

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

Symptoms: 17 year old male, (will be 18 on 04/02/2021) - student, volunteered at COVID vaccination event - parents wanted student vaccinated - his father is a cancer patient undergoing stem cell transplant - he needs vaccine to be able to see his father . Parents want pt to proceed with 2nd vaccination (he will be 18 at that time) No adverse events - minimal arm soreness

Other Meds: none

Current Illness: none

ID: 1134310
Sex: M
Age: 30
State:

Vax Date: 03/12/2021
Onset Date: 03/12/2021
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: Patient received less than the recommended dose. No adverse reaction.

Other Meds:

Current Illness:

ID: 1134311
Sex: F
Age: 75
State: IN

Vax Date: 02/28/2021
Onset Date: 03/01/2021
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: Morphine, Latex, silver compounds, muscle relaxer (begins with M).

Symptom List: Erythema, Pruritus

Symptoms: Called local public health clinic to report adverse event because she was upset that she called pharmacy (where she received the vaccine) and was told "We don't know anything about that". Reports the morning after her vaccine she experienced itching and a rash over most of her upper torso and upper left arm. Took Benadryl for 2-3 days until resolved.

Other Meds: Novalin N, Novalin R, Lasix, HCTZX, ASA, Clopedigrel, potassium, probiotics, Tylenol.

Current Illness: None

ID: 1134313
Sex: M
Age: 64
State: CT

Vax Date: 03/21/2021
Onset Date: 03/21/2021
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: None

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

Symptoms: Fever over 101 degrees for 36 hours headache, chills and cough after 1 dose. Took Tylenol and Muscinex. Took about 48 hours for fever to subside and another day to feel better.

Other Meds: Amlodipine, Losartan, Atorvastatin, Multivitamin, CoQ-10, B-complex, Calcium, Fish Oil, chondroitin..

Current Illness: COVID-19

ID: 1134314
Sex: F
Age: 69
State: OR

Vax Date: 03/09/2021
Onset Date: 03/10/2021
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: Penicillin, azythromyacin, latex, flagyl

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

Symptoms: seizure in early morning, 6:00am

Other Meds: keppra xr, metrapol, anastrozol, vitamin d3, vitamin b6, melatonin, magnesium, omeprazole

Current Illness:

ID: 1134315
Sex: F
Age: 66
State: SC

Vax Date: 01/13/2021
Onset Date: 01/13/2021
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, shrimp

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: 1/13 vaccination I started having HA about 7pm that night. BP was elevated; 170/110. Kept monitoring. Would come down every day. Valcartin increase per PCM and it took care of the BP increase after 3 days.

Other Meds: levithyroxic 75 mg, valsartan 80 mg; singular 10mg, protonic 40 mg

Current Illness: n/a

ID: 1134316
Sex: M
Age: 33
State:

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

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

Symptoms: Patient received less than the recommended dose. No adverse reaction.

Other Meds:

Current Illness:

ID: 1134318
Sex: F
Age: 43
State: OH

Vax Date: 03/10/2021
Onset Date: 03/13/2021
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: Allergic to Penicillin and Bactrim

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

Symptoms: Two days after receiving the Johnson & Johnson vaccine in my right arm, I woke up the next morning with a raised bump on my chest and a feeling that something was in my left eye (that could have been my allergies). However, I do still have a raised bump that is slowly going away.

Other Meds: None

Current Illness: Seasonal Allergies

ID: 1134319
Sex: F
Age: 51
State: IL

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

Lab Data:

Allergies: No

Symptom List: Pain in extremity

Symptoms: Painful swollen and red arm at injection site 9 hours after shot, headache for 2 days, fevers for 2 days, stiff and sore body

Other Meds: Spironolactone 25 mg, Atorvastatin 10 mg, Asprin, Peak performance longevity vitamins

Current Illness: Sinus infection a month prior

ID: 1134320
Sex: F
Age: 33
State: CO

Vax Date: 03/06/2021
Onset Date: 03/07/2021
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: Flagyl

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

Symptoms: Extreme chills, body ache, and fatigue

Other Meds: Women's multi vitamin, biotin vitamin, B-complex vitamin

Current Illness: none

ID: 1134322
Sex: F
Age: 73
State: MI

Vax Date: 03/17/2021
Onset Date: 03/20/2021
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: none

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

Symptoms: Woke up at 3:00 am drenched in cold sweat, unable to focus, loss of equilibrium, nausea. Feeling better by noon. ongoing waves of brain fog, pressure behind my eyes. I seek no treatment, hope it will improve with time. Would like to know if it is advisable to have the second dose. I do not want to repeat the previous experience. Are you able to advise? Thank you

Other Meds: Women's 50+ multivitamin, CoQ10, L-Proline, L-Lysine

Current Illness: none

ID: 1134323
Sex: F
Age: 59
State: OH

Vax Date: 03/12/2021
Onset Date: 03/17/2021
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: bacterium and mild latex allergy, seasonal hay fever

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

Symptoms: 4 days after injection I experienced pain in my left armpit and in the muscle down the inside of my left arm to my elbow. Pain continues. This is the 9th day. The muscle feels rigid. I exercise it everyday (counter top push ups followed by stretching). The pain occurs with the stretch. Muscle feels like it will tear instead of stretch. Rigidity. I called my doctor and they told me to do this report.

Other Meds: macular degeneration vitamin and fish oil supplement

Current Illness: none

ID: 1134325
Sex: F
Age: 72
State: OK

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

Lab Data:

Allergies: History of hives inside mouth after flu shot

Symptom List: Vomiting

Symptoms: Pt stated tongue swelling - administered 12.5 mg of benadryl at 1:25, Pt stated improving at 1:27, pt stated swelling starting in her throat at 1:30, administered 0.3 MG of epi into left thigh called 911 and they took her to the hospital at around 1:37

Other Meds: Unknown

Current Illness: Unknown

ID: 1134326
Sex: F
Age: 36
State: CA

Vax Date: 02/04/2021
Onset Date: 02/05/2021
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: none aware

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Symptoms for 24 hours: Headache, slight fever (less than 100*), pain and inflammation around injection site, fatigue, feelings of weakness. Symptoms which lasted for only 15-20 minutes precisely 24 hours after dosage: severe feelings of illness: dizziness, nausea, diarrhea, chills while sweating, fever, extreme fatigue and muscle weakness.

Other Meds: hormonal birth control

Current Illness: none

ID: 1134327
Sex: M
Age: 30
State: GA

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:

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

Symptoms: Patient experienced dizziness, felt faint, nausea, and vomiting. Symptoms started approximately 3 minutes after vaccination. Symptoms lasted 10 to 12 minutes. Patient stated he felt better after 15 minutes. He remained another 20 minutes. He then left the Pharmacy area stating he felt normal and fully recovered,

Other Meds:

Current Illness:

ID: 1134328
Sex: M
Age: 65
State: DC

Vax Date: 03/13/2021
Onset Date: 03/15/2021
Rec V Date: 03/25/2021
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: Mycellin, Gabapentin, Acromycin, Oxycodone

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Increased intense Asthma events, new inhaler (Albuterol) prescribed and used for 3 days, Some vertigo, occasional body temperature fluctuation & SEVERE CHRONIC BRONCHITIS & intense coughing for over a week! - Tessalon Perles, NettiPot rinse routine 3x's/day, Flonase 3-4X's/day, Salt Solution oral & throat rinse, Tylenol & inhaler as needed. Very stressful & scary/unpleasant. I have very minimal confidence in injection repercussions now.

Other Meds: Oxcarbizapine, Lamictal, Lisinopril, Crestor, One a Day Mens Multi Vitamin

Current Illness:

ID: 1134329
Sex: F
Age: 56
State: MO

Vax Date: 12/29/2020
Onset Date: 01/15/2021
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:

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

Symptoms: After my first dose Pfizer vaccine, I developed enlarged lymph nodes found in a calcium scan. I underwent CT scan, mammogram and ultrasound of the axilla. They thought it could be breast cancer or lymphoma. Today my lymph noes are still present.

Other Meds: Synthroid, cardo tabs, baby aspirin, melatonin at night

Current Illness:

ID: 1134330
Sex: F
Age: 62
State: WV

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

Lab Data:

Allergies: None reported.

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

Symptoms: Patient felt hot and dizzy and had syncopal episode and vital signs BP 122/68, PR-86, SPO2-97. Blood glucose-129. EMS called and patient transported to hospital.

Other Meds: Not available at this time.

Current Illness: Not available at this time

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm