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: 1143592
Sex: M
Age: 75
State:

Vax Date: 02/12/2021
Onset Date: 02/20/2021
Rec V Date: 03/29/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Hospitalization within 6 weeks after receiving vaccine

Other Meds:

Current Illness:

ID: 1143593
Sex: F
Age: 67
State: MA

Vax Date: 03/19/2021
Onset Date: 03/28/2021
Rec V Date: 03/29/2021
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: on day 8-9 post vaccine pt developed a red itchy rash at injection site. no pain fevers chills or ssx of infx

Other Meds:

Current Illness:

ID: 1143594
Sex: F
Age: 70
State: MI

Vax Date: 03/25/2021
Onset Date: 03/25/2021
Rec V Date: 03/29/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: RN notified of patient having reaction and being taken by ambulance. Per EMT report, pt. began having chest pain radiating down her arm, chest heaviness, right arm numbness, and some shortness of breath. Vitals BP:146/78, O2 94% on room air. Patient also pale and diaphoretic. Taken by ambulance to emergency room. Patient has extensive cardia history per EMT report: has pacemaker, had stress test and scheduled for a cardiac procedure. 3/29/21 Phoned patients daughter to follow up with patient's status. Patient does not have cell phone and speaks Bosnian. During hospital stay, she reports her O2 sats were low, had a heart cath. procedure,

Other Meds:

Current Illness:

ID: 1143595
Sex: F
Age: 79
State: IN

Vax Date: 03/12/2021
Onset Date: 03/14/2021
Rec V Date: 03/29/2021
Hospital:

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

Lab Data:

Allergies: allergic to nitrous oxide and lisinopril intolerant of dairy, beef, high fructose corn syrup

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Very severe malaise, nausea, lack of appetite, weakness, urinary frequency (every 15 min x 2 days - urine totally colorless though I was not drinkiing anything, yellow tint gradually reappeared over next 3 days), no fever, memory and concentration much worse than usual, could not even think well, joint pain ,prolonged excessive sleepiness (nearly has resolved after 2 weeks)

Other Meds: Trimethoprim, Oxybutynin, losartan, omeprazole, carbamazepine, modafinil, gabapentin, duloxetine, trazodone, nifedipine, asa, myrbetriq, norco, guaifenesin, fexofenidine, rosuvasttin ocuvite, ibuprofen

Current Illness: painful rt shoulder

ID: 1143596
Sex: F
Age: 48
State: IN

Vax Date: 03/24/2021
Onset Date: 03/24/2021
Rec V Date: 03/29/2021
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: Throat thickness/swelling occurred about 5 times (feeling occurred off and on for 45 minutes) Tingling on left side of body (feeling lasting about 10 hours)

Other Meds: Lo loestrin Biotin D3 Zinc Olly daily energy gummies Goli Apple cider vinegar gummy

Current Illness: None

ID: 1143597
Sex: F
Age: 73
State: MA

Vax Date: 03/26/2021
Onset Date: 03/27/2021
Rec V Date: 03/29/2021
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, sulfa meds, extreme reactions to opiates prescribed after surgery (even one dose).

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

Symptoms: Was awoken w bad headache/eye ache in middle of night follow vaccination (2nd Covid) previous morning. Over the next few hours, experienced bad muscle pains throughout body, cd barely move. Chills, cd not get warm, even wearing thermal underwear top & bottom, fleece jacket, in bed w flannel sheets, one quilt, one thick heavy woolen blanket & a woolen throw blanket. Cd not get out of bed for many hours. Eventually, Saturday 3/27 took temp--100.5, v high for me as normal morning temp is 96.7-97.1. Oxygen saturation 94% (normal for me--89-99%). Most scary, pulse rate of 92 (normal resting pulse for me--68-72) while I was inert, in bed.

Other Meds: multiple vitamin, tumeric capsule

Current Illness: none

ID: 1143598
Sex: F
Age: 76
State: WI

Vax Date: 03/09/2021
Onset Date: 03/19/2021
Rec V Date: 03/29/2021
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: NKDA

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Presented at PCP's office for progressive shortness of breath for the past few days. During visit patient had a syncopal episode regained consciousness then lost pulse for which she received 4 minutes of resuscitative care with chest compressions. She did regain a pulse after about 4 minutes of chest compressions. During that time emergency room physician said he saw a slow narrow complex rhythm. No reports of ventricular arrhythmias. Troponin and d-dimer were elevated. Heparin was started in the ED. During stay she was started on warfarin and bridging with heparin.

Other Meds: amlodipine, donepezil, fluoxetine, rosuvastatin, MVI, calcium/vit D

Current Illness: none

ID: 1143600
Sex: M
Age: 27
State: VA

Vax Date: 03/26/2021
Onset Date: 03/26/2021
Rec V Date: 03/29/2021
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: 104.5 degree fever, chills and shaking, all started suddenly 7 hours after vaccination (around 10pm on 3/26). Fever was attenuated with extra strength Tylenol. Fever came back the following day with a max temperature of 101.5 (1pm on 3/27). Took Tylenol again and the temperature returned to normal (99.1). Temperature rose to 100.2 the following day (2pm on 3/28) and returned to normal (98.6) after Tylenol. Throughout all of these events, there was stiffness in the upper arm where the vaccine was injected.

Other Meds:

Current Illness:

ID: 1143601
Sex: F
Age: 49
State: OH

Vax Date: 01/13/2021
Onset Date: 01/23/2021
Rec V Date: 03/29/2021
Hospital:

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

Lab Data:

Allergies: gentamicin, morphine, Demerol,

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: 1/13 vaccination 1/23 I woke up at 2am and had welts on my legs. I got up in the morning, welts were over whole body. Within next 24 hours, spread out every day; very very itchy. I took Benadryl. Rash spread from tips of ears down to my toes. Saw PCM who referred me to dermatologist. 1/27 Steroid cream, Claritin and Benadryl. Started to calm the rash down. 2/3 Allergist and Dermatologist appts. Biopsy of rash; rash from something on 'the inside'. Allergist advised NOT to take 2nd vaccine as it may affect my immune system.

Other Meds: vitamins, Bactrim

Current Illness: recovering from diverticulitis

ID: 1143602
Sex: F
Age: 63
State:

Vax Date: 02/26/2021
Onset Date: 03/01/2021
Rec V Date: 03/29/2021
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: NKDA

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Shortly after 2nd vaccine patient developed local reaction with lymphadenopathy, then developed within a week a ropy painful vein extending to the wrist. Seen 1 month later, ultrasound in clinic with peripheral thrombosis of Left arm, no axillary or deep venous system thrombosis. No history of same. Given extent of thrombosis 45 days of anticoagulation for peripheral thrombosis prescribed.

Other Meds: metformin XL 500 Omeprazole 20 mg Lisinopril HCTZ 20-12.5

Current Illness: none

ID: 1143603
Sex: F
Age: 41
State: RI

Vax Date: 03/24/2021
Onset Date: 03/27/2021
Rec V Date: 03/29/2021
Hospital:

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

Lab Data:

Allergies: N/a

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

Symptoms: Started with a headache. Next day migraine and bodyaches. Day after that Migraine worsened and in a lot of pain with body movement because of bodyaches.

Other Meds: Lisinoprel

Current Illness: N/a

ID: 1143604
Sex: F
Age: 66
State: MI

Vax Date: 02/16/2021
Onset Date: 03/22/2021
Rec V Date: 03/29/2021
Hospital: Y

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

Lab Data:

Allergies: sulfa (hives), diltiazem (hives)

Symptom List: Rash, Urticaria

Symptoms: Presented to ED due to rectal bleeding and was tested for COVID-19 prior to admission to hospital. Patient was asymptomatic for COVID-19. Received Pfizer BioNTech vaccine on 1/26/21 and 2/16/21.

Other Meds: Aspirin, biotin, vitamin D, clopidogrel, coenzyme q 10, famotidine, felodipine, krill oil, quinapril, rosuvastatin, valacyclovir

Current Illness: Upper GI bleed

ID: 1143605
Sex: F
Age: 20
State: NC

Vax Date: 03/05/2021
Onset Date: 03/05/2021
Rec V Date: 03/29/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: Slight headache and fatigue by 7:30 that got increasingly worse. Muscle aches throughout whole body, especially around injection site. Extreme fatigue, muscle soreness and headache through the night and into next day. Woke up feeling like a terrible hangover. Took ibuprofen at 8am. Slept all day. By 4, soreness and headache was better. Slightly fatigued for 3 days after, sore arm for 4 days after.

Other Meds: Adderall Lamotrigine Rexulti Lunesta

Current Illness: None

ID: 1143607
Sex: F
Age: 25
State: NY

Vax Date: 03/20/2021
Onset Date: 03/20/2021
Rec V Date: 03/29/2021
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:

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

Symptoms: Nurse hit bone when giving dose.

Other Meds:

Current Illness:

ID: 1143608
Sex: F
Age: 55
State: MO

Vax Date: 03/29/2021
Onset Date: 03/29/2021
Rec V Date: 03/29/2021
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: Penicillins - Severe Ketorolac Tromethamine - Moderate Ibuprofen - Mild

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

Symptoms: MODERNA mRNA COVID-19 Vaccine (1st Dose) Lot# 019B21A EXP: 09/21/2021 INJ SITE: RT DELTOID PT MONITORED FOR 15 MIN POST VACCINE, WITH IN THE FIRST 5 MINUTES OF HAVING THE INJECTION MONITORED PT AND NOTED TO HAVE SWELLING OF THE RIGHT SIDE OF THE TONGUE AND THROAT. PT HAD BP CHECKED 134/82, PULSE WAS ELEVATED AND O2 HAD DECREASED. PT RECEIVED A STEROID INJECTION AND EXTENDED MONITORING. PT GIVEN O2 FOR COMFORT AND PRECAUTION, AND PT CONTINUED TO DO WELL. PT WAS GIVEN INFORMATION ON VAERS SIGN UP, AND ENCOURAGED HER TO SIGN UP FOR IT. PT WAS RELEASED FROM OFFICE AFTER AN HOUR AND NO ADDITIONAL SIGNS OF REACTION OCCURING. PT ADVISED THAT THEY COULD NOT GET THE SECOND INJECTION DUE TO REACTION.

Other Meds: Albuterol Sulfate (Albuterol Sulfate HFA) 108 (90 Base) MCG/ACT Inhalation Aerosol Solution Alprazolam (Xanax) 1 MG Oral Tablet Brexpiprazole (Rexulti) 3 MG Oral Tablet Bupropion HCl (Wellbutrin XL) 150 MG Oral Tablet Extended Release 24 Ho

Current Illness: Pt was seen at Hospital Emergency Room on 3/8/21. She went with complaints of chest pain. While there she did have an "acute allergic reaction, probably to aspirin therapy.." noted on her H&P that was faxed to our office for follow up care. In an addendum to the H&P from the hospital the following was stated: A stat team was called on the patient as the patient was found to have acute anaphylactic reaction, likely from the previous aspirin dosage. The patient did receive a stat order of Solu-Medrol 125mg daily, 50 mg of IV Benadryl, and an additional dose of 20 mg IV Pepcid. Additionally the patient did receive 0.4 mg of IM epinephrine as well as racemic Vaponefrin for anaphylactic reaction. The patient's symptoms did improve. At that time, she did report some ongoing chest pain, similar to her initial presentation. A 12-lead EKG shows sinus tachycardia, heart rate 117, QTc 496, some interior and lateral ST depressions, similar to prior. No STEMI was appreciated. The patient was escalated to intensive care unit. She indicates her respiratory status greatly improved. The patient has been otherwise hemodynamically stable with no other active complaints.

ID: 1143609
Sex: M
Age: 62
State: FL

Vax Date: 03/15/2021
Onset Date: 03/17/2021
Rec V Date: 03/29/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: No longer has symptoms, but 2 days after vaccination experienced swollen, and redness at injection site What happened as a result of the adverse event? patient saw provider and was recommended to take benadryl and ibuprofen which has helped resolve symptoms

Other Meds:

Current Illness:

ID: 1143610
Sex: F
Age: 55
State: OH

Vax Date: 03/04/2021
Onset Date: 03/04/2021
Rec V Date: 03/29/2021
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:

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

Symptoms: slight Bell's Palsy

Other Meds:

Current Illness:

ID: 1143611
Sex: F
Age: 58
State: IL

Vax Date: 03/27/2021
Onset Date: 03/27/2021
Rec V Date: 03/29/2021
Hospital:

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

Lab Data:

Allergies: UNKNOWN

Symptom List: Ear pain, Hypoaesthesia

Symptoms: c/o dizziness

Other Meds: N/A

Current Illness: UNKNOWN

ID: 1143612
Sex: F
Age: 61
State:

Vax Date: 02/04/2021
Onset Date: 02/09/2021
Rec V Date: 03/29/2021
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: Hospitalization within 6 weeks after receiving vaccine

Other Meds:

Current Illness:

Date Died: 02/19/2021

ID: 1143613
Sex: F
Age: 92
State: PR

Vax Date: 02/02/2021
Onset Date: 02/03/2021
Rec V Date: 03/29/2021
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 reported

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

Symptoms: He was going to be discharged from Hospice on Monday 2/15/2021. The patient was in Hospice due to a stroke. The nurse indicates after the vaccine she started with stomach pain and vomiting. Hospice evaluated her, she was given Pedialyte and then she died on 2/19/2021

Other Meds: Aspirin 81, Lisinopril 10 mg , Syntroid 75 mg

Current Illness: Patient was in hospice due to a CVA

ID: 1143614
Sex: F
Age: 28
State: KS

Vax Date: 03/25/2021
Onset Date: 03/25/2021
Rec V Date: 03/29/2021
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: amoxicillin (hives)

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

Symptoms: On 03/25/2021 client states she waited for her 30 minute waiting period following vaccine and about 10 minutes after leaving started to develop hives on hands/wrists/arms that continued spreading to sides and lower back. Client notified Health Dept on 03/26/2021, and client enouraged by writer to seek medical care. Writer spoke with client on 03/29/2021 and client states has not sought medical care or assessment. States she has no SOA, swelling, coughing, wheezing or any other s/s of adverse reactions. States hives remain.

Other Meds: zoloft 100 mg daily prenatal vitamin

Current Illness: none

ID: 1143615
Sex: F
Age: 70
State: IL

Vax Date: 03/20/2021
Onset Date: 03/21/2021
Rec V Date: 03/29/2021
Hospital:

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

Lab Data:

Allergies: NKA

Symptom List: Unevaluable event

Symptoms: Fever 102.5 Cold Uncontrollable shivers Horrible cough

Other Meds: Celexa simvastatin tolterodine Cholecalciferol B12 famotidine vit D Myrbetriq pantoprazole pramipexole

Current Illness: January I had Covid for 5 weeks

ID: 1143616
Sex: M
Age: 55
State: AZ

Vax Date: 03/28/2021
Onset Date: 03/29/2021
Rec V Date: 03/29/2021
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: None

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

Symptoms: The flu-like symptoms I was expecting. Aches and pains, fever, headache, cough. Initial slight numbness in right arm, which just became soreness. Symptoms came on this morning, just going to wait them out. I'm told they will just go off like a light switch.

Other Meds: Prescription: Bupropion (Wellbutrin) Supplements: Super B Complex, Vitamin D, Testosterol, FreeTE Herbal: Ginseng

Current Illness: None

ID: 1143617
Sex: F
Age: 78
State: MD

Vax Date: 03/10/2021
Onset Date: 03/23/2021
Rec V Date: 03/29/2021
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:

Symptom List: Injection site pain, Pain

Symptoms: 03/23/2021: Patient presented and was admitted through ED for right lower extremity pain after a recent fall. CT of the pelvis which showed to have Comminuted subtrochanteric proximal right femoral shaft fracture with angulation. She had difficulty walking, and difficulty with activities of daily living skills. Patient had PMH of arthritis. Per the EUA, hospitalizations are to be reported irrespective of attribution to vaccine.

Other Meds:

Current Illness:

ID: 1143618
Sex: F
Age: 44
State: OH

Vax Date: 03/23/2021
Onset Date: 03/23/2021
Rec V Date: 03/29/2021
Hospital:

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

Lab Data:

Allergies: Medicine allergy: amoxicillin Environmental allergies: pet dander, dust mites, cockroaches, pollen/tree allergies

Symptom List: Injection site pain, Menorrhagia

Symptoms: Within the first hour after receiving the vaccine, I experienced a flushing warm sensation in my skin on my face and neck area. About 2-3 hours after receiving the vaccine, I broke out in a skin rash on my face, neck, and upper body. About 2 days later, the rash began to diminish. Now (6 days later) it has continued to recede (although it is still somewhat visible).

Other Meds: Smarty Pants Organics with Probiotics Women's Formula

Current Illness: None

ID: 1143619
Sex: F
Age: 55
State: RI

Vax Date: 03/11/2021
Onset Date: 03/11/2021
Rec V Date: 03/29/2021
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: Constant and consistent spasms starting from top of shoulder, feels pressure, followed by spasms (feels like bugs under skin), then sharp pain down front of forearm with pins and needles in arm, wrist and fingers. Lasts about 3 minutes continuously throughout the day. There has not been any treatment yet. I notified the CDC, and others and no-one has offered any suggestions as to how to handle this effect. I AM SCHEDULED FOR MY 2ND SHOT ON APRIL 8, 2021 AND AM VERY RELUCTANT TO GET IT. I'VE READ BLOGS AND OTHER INFORMATION RELATING TO NERVE DAMAGE FROM VACCINES/ULNAR NEUROPATHY AND FEEL THAT THIS IS WHAT I'M EXPERIENCING.

Other Meds: D3, Escitalopram 20 mg, Buspirone 10 mg, Famotidine 40 mg, Alprazolam 1 mg, Mupirocin Ointment 2% 22 gm

Current Illness: Gerd, Broken right wrist, basal cell carcinoma on back

ID: 1143620
Sex: F
Age: 41
State: OH

Vax Date: 03/29/2021
Onset Date: 03/29/2021
Rec V Date: 03/29/2021
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: bee sting, Depakote, erythromycin, metformin, methylprednisolone, Neurontin, paxil, statins, sulfa, Wellbutrin, Maxalt, topomax

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Patient c/o nausea, light headed and dizzy, chest tightness, pain and pressure about 20 min following injection. No rash or shorness of breath. NO swelling or redness to injection site. Transported patient to hospital in wheelchair for evaluation.

Other Meds: meloxicam,pantoprazole, Ativan, Phenergan, roboxicam, insulin NPH, singulair, bentyl, Atrovent, glipizide, Humalog, lisinopril, atorvastatin, nurtec, erenmab, nizoral

Current Illness: Diabetes, panic disorder, asthma, GERD, vertigo

ID: 1143621
Sex: F
Age: 69
State: OH

Vax Date: 03/26/2021
Onset Date: 03/26/2021
Rec V Date: 03/29/2021
Hospital:

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

Lab Data:

Allergies: Drug allergies: Amoxicillin, Cephalexin, Bactrim (rashes) Novocain, Xylocaine (nausea, vomiting, vertigo)

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: I received my vaccine shot at 9:40 on Friday. Suddenly around 4:00pm, I experienced EXTREME chills. The shaking was uncontrollable for hours. Could not get warm. I know I was running a fever but was unable to take my temperature. Some nausea and some diarrhea. The shaking finally lessened around 2:00am. The next two days (Saturday and Sunday) I was very light-headed and dizzy. Saturday I laid flat all day, went to bed early, Experienced some chills but not as bad as the night before. Sunday was a bit better, I could sit up in a chair for some periods of time. Today (Monday) I would describe as what others have said was their reaction - sore arm, some achiness.

Other Meds: Losartan Levothyroxin Sodium Estroven Centrum Silver Multivitamin

Current Illness: none

ID: 1143622
Sex: F
Age: 29
State: PA

Vax Date: 03/26/2021
Onset Date: 03/27/2021
Rec V Date: 03/29/2021
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: Ringing in ears, ranging from high-pitched to loud persistent hissing, pulsating sound; ears plugged; symptom on-going three days after initial dose of Moderna vaccine (3/26/21); appointments with PCP and consultation with ENT scheduled for tomorrow (3/30/21)

Other Meds: Metformin

Current Illness:

ID: 1143623
Sex: M
Age: 54
State: MN

Vax Date: 03/24/2021
Onset Date: 04/17/2021
Rec V Date: 03/29/2021
Hospital:

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

Lab Data:

Allergies: Sulfa Drugs- SOB

Symptom List: Nausea

Symptoms: 15 minutes after receiving vaccine, patient report left ear turning red. Patient waited in the clinic an additional 30 minutes. Left ear was red and patient report left arm and neck felt warm. Patient was seen by a provider who recommended she take an oral Benadryl and report to the ER if any other anaphylaxis reactions.

Other Meds: Tessalon Perles

Current Illness: unknown

ID: 1143624
Sex: F
Age: 41
State: FL

Vax Date: 03/29/2021
Onset Date: 03/29/2021
Rec V Date: 03/29/2021
Hospital:

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

Lab Data:

Allergies: PCN

Symptom List: Injection site pain

Symptoms: urticaria-itching

Other Meds: vitamins

Current Illness: none

ID: 1143625
Sex: M
Age: 67
State: IL

Vax Date: 02/15/2021
Onset Date: 02/26/2021
Rec V Date: 03/29/2021
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: Resident was being transported to a doctor's appointment. Residents seat belt became unlatched causing resident to slide from his w/c. 911 was notified and the residents was transported to the emergency room.

Other Meds:

Current Illness:

ID: 1143626
Sex: F
Age: 56
State: ND

Vax Date: 03/17/2021
Onset Date: 03/19/2021
Rec V Date: 03/29/2021
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 for 10 days. Muscle aches, joint aches, chills, and fever of 105 degrees for two days

Other Meds: Neurontin, Lithobid

Current Illness:

ID: 1143627
Sex: F
Age: 73
State: NC

Vax Date: 03/06/2021
Onset Date: 03/06/2021
Rec V Date: 03/29/2021
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: Flu Vaccine; Trental

Symptom List: Tremor

Symptoms: Pt came in for her first dose of COVID vaccine. tongue swelling and wheezing started about 3-5 mins after vaccine injected. Oxygen stat at 93% Room air- Epi pen and IM Benadryl given. Vital signs obtained, EMS called. Oxygen level did improve to 98% BP was 164/82 with a pulse of 88. Pt taken to Pineville ER. Vaccine added to allergy list, pt informed to NOT get 2nd vaccine.

Other Meds:

Current Illness:

ID: 1143628
Sex: F
Age: 56
State: NJ

Vax Date: 03/11/2021
Onset Date: 03/11/2021
Rec V Date: 03/29/2021
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: Levaquin

Symptom List: Erythema, Pruritus

Symptoms: within 4 hours and 20 minutes of receiving the Pfizer vaccine I had a rash on my Right forearm that last approximately 3 hours and then disappeared. My throat was itchy for six days (I have No other allergies other than the medication Levaquin which was disclosed at the time of the vaccine. I was assured ingredients from Levaquin are not in the vaccine). That evening at approximately 9:30 my tongue swelled slightly and stayed that way for four days

Other Meds: None

Current Illness: None

ID: 1143629
Sex: F
Age: 66
State: MN

Vax Date: 03/26/2021
Onset Date: 03/28/2021
Rec V Date: 03/29/2021
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: sulfa

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

Symptoms: chills, dry heaves, dizzy, headache continuing for 13 hours so far

Other Meds: rusavatin, citlatram, temazepam, acyclovirmelatonin, CoQ10, vitamin D3, thornefish oil, magnesium, vitamin B, calcium, aspirin,

Current Illness: pneumonia UTI

ID: 1143630
Sex: F
Age: 59
State: MN

Vax Date: 01/04/2021
Onset Date: 01/28/2021
Rec V Date: 03/29/2021
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: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: Hospitalization within 6 weeks after receiving vaccine

Other Meds:

Current Illness:

ID: 1143631
Sex: F
Age: 60
State: FL

Vax Date: 03/24/2021
Onset Date: 03/25/2021
Rec V Date: 03/29/2021
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: HA, shivers at night , muscle cramps , mild fever

Other Meds: none

Current Illness:

ID: 1143632
Sex: M
Age: 56
State: CT

Vax Date: 03/28/2021
Onset Date: 03/29/2021
Rec V Date: 03/29/2021
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: nka

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

Symptoms: pt states later in the day after taking the vax he developed a bad headache and dizziness. Next day pt is still having some headache and dizziness. Pt will call his PCP if his symptoms don't improve.

Other Meds: Lexapro, levothyroxine,

Current Illness: no

ID: 1143633
Sex: F
Age: 49
State: FL

Vax Date: 03/28/2021
Onset Date: 03/28/2021
Rec V Date: 03/29/2021
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: After receiving vaccine client states she has tingling and numbness in the arm which she received the vaccine. Client states she feels better. Client discharged home

Other Meds: none

Current Illness: none

ID: 1143634
Sex: M
Age: 41
State: OH

Vax Date: 03/27/2021
Onset Date: 03/27/2021
Rec V Date: 03/29/2021
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: Pain in extremity

Symptoms: Light head and dizziness, chills, slightly elevated heart rate

Other Meds: None

Current Illness: None

ID: 1143635
Sex: F
Age: 37
State:

Vax Date: 03/21/2021
Onset Date: 03/28/2021
Rec V Date: 03/29/2021
Hospital:

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

Lab Data:

Allergies: Latex allergy

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

Symptoms: 7 days after vaccination: Large red circular rash at injection site. Swelling. Itching.

Other Meds: None.

Current Illness: None.

ID: 1143636
Sex: F
Age: 49
State: NJ

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 03/29/2021
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: Formaldehyde

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

Symptoms: Adverse reaction to dose 1 of Pfizer COVID-19 vaccine (lot# EN6207). Pt was vaccinated at 1735 and reported itchiness on arms, chest, and scalp at 1800. Immediate area around the vaccination (right deltoid) was not erythematous but PT's arms and chest had flat, erythematous patches. PT has a Hx of formaldehyde allergy (hives and itchiness). Denied SOB, swelling, or tingling in lips/tongue/mouth. Denied lightheadedness or racing heartbeat. Monitored PT for the remainder of her 30-minute observation period. Recommended that she call 911 if she experiences any of the aforementioned symptoms, and that she can take Benadryl when she returns home.

Other Meds: Albuterol Inhaler

Current Illness:

ID: 1143637
Sex: F
Age: 43
State: FL

Vax Date: 03/27/2021
Onset Date: 03/28/2021
Rec V Date: 03/29/2021
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: Fever, chills, aches 18 hours after the shot. Swollen lymph node 24 hours after shot

Other Meds: multi vitamin, probiotics, melatonin

Current Illness:

ID: 1143638
Sex: M
Age: 79
State: KY

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 03/29/2021
Hospital: Y

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: Patient advised Health Dept. (at time of 2nd dose) that approximately 45 minutes after 1st Moderna vaccine that he began experiencing blood in his urine. Patient contacted PCP and was admited to for further evaluation and treatment. Pt developed pneumonia while in hospital and spent a total of 4 days inpatient. Treating physician at hospital unable to identify cause of blood in urine. DR ADVISED THAT HE TREATED ANOTHER PATIENT WITH SAME SYMPTOMS AFTER INITIAL COVID VACCINATION but could NOT specifically attribute cause of blood in urine to COVID vaccination.

Other Meds:

Current Illness:

ID: 1143639
Sex: F
Age: 28
State: IL

Vax Date: 03/27/2021
Onset Date: 03/27/2021
Rec V Date: 03/29/2021
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: Unknown

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: C/O Chest Pain: Vital With in Normal limits

Other Meds: NA

Current Illness: Unknown

ID: 1143640
Sex: F
Age: 26
State: NC

Vax Date: 03/26/2021
Onset Date: 03/27/2021
Rec V Date: 03/29/2021
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 reported

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

Symptoms: 3/27: headache, fatigue 3/28: swollen lymph nodes, headache 3/29: itchy rash covering arms and legs with patchy areas on back and stomach; bottom lip swollen

Other Meds: Norlyda

Current Illness: None reported

ID: 1143641
Sex: F
Age: 48
State: NC

Vax Date: 03/05/2021
Onset Date: 03/19/2021
Rec V Date: 03/29/2021
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: Left arm is numb and tingles running from site of injection down to my wrist

Other Meds: Junel birth control tablets

Current Illness:

ID: 1143642
Sex: F
Age: 39
State: TX

Vax Date: 03/26/2021
Onset Date: 03/26/2021
Rec V Date: 03/29/2021
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: Administered vaccine at approximately 1:15PM. Monitored for 15 minutes. No reaction noted. Patient went back to the floor to complete her duties. Came back to the clinic around 3:00PM with noted lip swelling, skin rash. Clinic physician on site ordered Benadryl X2, IM Solumedrol. Also ordered to send patient home with a Medrol dose pack which was provided. Patient was sent home from work and a family member came to get her. Patient was instructed to call 911 for any further reactions. Vitals at time of reaction were: Pulse 96bpm, O2 99% on room air, BP 155/90, lungs clear.

Other Meds:

Current Illness:

ID: 1143643
Sex: F
Age: 44
State: LA

Vax Date: 03/20/2021
Onset Date: 03/21/2021
Rec V Date: 03/29/2021
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: Patient received 1st Moderna vaccine shot on 02/20/21; pt stated she experienced light to medium hair loss. It started within the first few days after the shot. She also experienced itching in the scalp which made her scratch more and more hair fell out. The patient received the 2nd dose on 3/20/21. That same day she experienced hair loss again on the sides of her head. She has a dermatologist appointment on 3/27/2021.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm