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: 1145899
Sex: F
Age: 23
State: HI

Vax Date: 01/12/2021
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: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: + COVID TEST 3/27/2021 FULLY COVID 19 VACCINATED

Other Meds:

Current Illness:

ID: 1145900
Sex: M
Age: 19
State: CA

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: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Approximately 5 minutes after vaccination, recipient became dizzy and reported that he felt like he was "going to pass out". Mask was removed and feet were elevated. Symptoms quickly began to improve. Kept in observation for approximately 45 minutes. Vaccine recipient reported feeling back to normal at time of release.

Other Meds:

Current Illness:

ID: 1145901
Sex: M
Age: 51
State:

Vax Date: 03/24/2021
Onset Date: 03/24/2021
Rec V Date: 03/29/2021
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: C/O dizzy, blurred vision, SOB, Right arm severe pain and tremors with Rt sided neck pain/spasms. Brought to Medical Tent by W/C. Verbalized had a Rt sides stroke 10 years ago, hx of pain/spasms in Rt arm if irritated. Had not eaten or drank fluids. Given OJ and Gatorade. Ice applied to neck & upper arm. No redness, rash/hives at injection site. Vitals stable. Home with wife after observation of 30 minutes. Advised to f/u with primary care physician if further adverse reactions. Advised not to have vaccinations in Rt arm.

Other Meds:

Current Illness:

ID: 1145902
Sex: F
Age: 43
State: UT

Vax Date: 03/16/2021
Onset Date: 03/26/2021
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: nkda

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: spontaneous abortion at approximately 8 weeks gestation, 10 days after vaccine administration

Other Meds: none

Current Illness: unknown

ID: 1145903
Sex: M
Age: 78
State: NJ

Vax Date: 03/24/2021
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: LA

Lab Data:

Allergies: Nka

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

Symptoms: Initially headache then weakness left side difficulty with balance, swallowing

Other Meds: Elequis lisinopril niphedine lasix

Current Illness:

ID: 1145904
Sex: F
Age: 57
State: WI

Vax Date: 03/17/2021
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: NKDA

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

Symptoms: delayed onset of erythema, warmth, discomfort (~ day 10 after injection)

Other Meds:

Current Illness: unknown

ID: 1145905
Sex: M
Age: 69
State: TX

Vax Date: 03/24/2021
Onset Date: 03/28/2021
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: NONE

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Constant itching at injection site, started 03/28/2021 per patient's wife, benadryl tablet used without relief

Other Meds: BENADRYL

Current Illness: NONE

ID: 1145906
Sex: F
Age: 67
State: MI

Vax Date: 03/09/2021
Onset Date: 03/17/2021
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: Hands, especially finger tips have become extremely sensitive to cold. If I cut up cold fruit or vegetables my hands turn white. Just taking items from fridge or freezer produces the same result. I've never had severe symptoms like this before and I cook all the time and used to handle cold and frozen food with no problems.

Other Meds: Raloxefene, olmesartan medoxomil, chlorthalidine, D Mannose, niacin

Current Illness:

ID: 1145907
Sex: F
Age: 70
State: MI

Vax Date: 03/26/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: Fever, chills, body aches, tired, sure arm at injection site, started 15 hours after shot and continued for 24 hours

Other Meds: Lopressor, Lisinipril, Pravastatin, Metforman, ASA,Omega3, Turmeric, D3, Biotin, Vitamin C. Folic Acid,

Current Illness: No e

ID: 1145908
Sex: F
Age: 71
State: OH

Vax Date: 03/26/2021
Onset Date: 03/28/2021
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: allergic to codeine and pollen

Symptom List: Diarrhoea, Nasal congestion

Symptoms: body ache and temperature started during Sunday evening and lasted until Monday at 8:30 pm

Other Meds: multi-vitamin, metformin, levothyroxin, Vitamin D3, atorvastatin

Current Illness:

ID: 1145909
Sex: M
Age: 37
State: WI

Vax Date: 03/25/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Sore arm the day after the injection. Like, more than any other shot or vaccination I've ever gotten.

Other Meds: Florajen3

Current Illness: None

ID: 1145910
Sex: F
Age: 42
State: CA

Vax Date: 03/23/2021
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: SYR
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: SORES ON HER BACK CHEST PAIN AND HEADACHES

Other Meds:

Current Illness:

ID: 1145911
Sex: M
Age: 45
State: NJ

Vax Date: 02/03/2021
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: About 24 hours later I experienced pink colored urine. It cleared up in 24 hrs.

Other Meds: Benicar 40mg one time a day

Current Illness: Iga nephropathy

ID: 1145912
Sex: F
Age: 40
State: SC

Vax Date: 03/27/2021
Onset Date: 03/29/2021
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: None

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

Symptoms: About a day and a half after receiving vaccination, I developed a headache and extreme fatigue. I also had some body aches.

Other Meds: Escitalopram 10 mg, Temazapram 30 mg, flonase

Current Illness: Fatigue, aches, headache

ID: 1145913
Sex: M
Age: 31
State: NY

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: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Pain in arm of injection. Flu-like symptoms - body aches, feeling cold, tired.

Other Meds: Atenolol, Advil

Current Illness:

ID: 1145914
Sex: M
Age: 69
State: MA

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

Lab Data:

Allergies: scallops

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

Symptoms: Very tired at night after morning vaccination. Awoke at 3 a.m. in extreme pain in left arm from hand to shoulder, into upper left of chest. Felt like I'd broken my arm in several places. Barely slept after that; resolved to call doctor on Monday. At 1 pm on Sunday, fever spiked to 100-101, slept four hours. Pain reduced. Went to sleep at 10 pm. Awoke with some soreness in left arm but pain absent. no fever. Took it easy today.

Other Meds: Allapurinol; pravastatin; vit D3; fish oil; baby aspirin;

Current Illness:

ID: 1145915
Sex: F
Age: 59
State: TX

Vax Date: 03/16/2021
Onset Date: 03/16/2021
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: None

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

Symptoms: Continuous muscle pain in left leg, back, & chest

Other Meds: Lisinopril, Co Q-10, Centrum Silver Multivitamins, Gabapentin, Rosuvastatin, Zyrtec

Current Illness: None

Date Died: 03/10/2021

ID: 1145916
Sex: F
Age: 59
State: CA

Vax Date: 03/07/2021
Onset Date: 03/07/2021
Rec V Date: 03/29/2021
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: NKA

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Extreme rigors, fever, shortness of breath/hypoxemia within hours of receiving vaccine according to staff at the care home. leukopenia, pulmonary edema, death

Other Meds: Aricept, ASA, atorvastatin, keppra, levothyroxine, loratadine, midodrine, lovenox

Current Illness: none

Date Died: 01/21/2021

ID: 1145918
Sex: F
Age: 28
State: IN

Vax Date: 01/19/2021
Onset Date: 01/20/2021
Rec V Date: 03/29/2021
Hospital:

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

Lab Data:

Allergies: No reported allergies

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: As reported by the patient's mother, the patient received the vaccine on 1/19/21, "got sick" on 1/20/21, and died in the early morning hours of 1/21/21. No further information was offered.

Other Meds:

Current Illness:

ID: 1145919
Sex: F
Age: 46
State: OR

Vax Date: 03/24/2021
Onset Date: 03/28/2021
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: Amoxicillin Rash High Allergy 3/29/2021 Erythromycin Not Specified 12/10/2012

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

Symptoms: sore throat, tonsil enlargement 5 days after vaccination

Other Meds: albuterol (PROVENTIL HFA;VENTOLIN HFA) 108 (90 Base) MCG/ACT inhaler INHALE 1 TO 2 PUFFS BY MOUTH EVERY 4 TO 6 HOURS AS NEEDED FOR COUGH cetirizine (ZYRTEC) 10 MG tablet Take 1 tablet by mouth Cholecalciferol (VITAMIN D HIGH POTENCY PO) T

Current Illness: had dental implant placed on March 18, 2021 and took clindamycin 300 mg tid from 3/18/2021 through 3/25/2021

ID: 1145920
Sex: F
Age: 70
State: MN

Vax Date: 03/17/2021
Onset Date: 03/18/2021
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: Shellfish, Latex, Metformin, Betadine

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

Symptoms: First 24hours post vaccination: headache, arm pain (whole arm up to collar bone down to hands), chills, and body aches 48 hours post vaccination: developed Covid19-like symptoms- shortness of breath, chest heaviness, body aches, extreme tiredness lasting for 7-10 days post vaccination. Minor effects may still be lingering. ** Note: Patient tested positive for Covid19 in November of2020 and symptoms 48 hrs post vaccination were similar to what she experienced with Covid19

Other Meds: Lisinopril, escitalopram, Preservision Areds2, Calcium, Vitamin D3, Jardiance, Biotin

Current Illness: none

ID: 1145921
Sex: F
Age: 28
State: GA

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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Sulfa drugs, Trimethoprim

Symptom List: Unevaluable event

Symptoms: Patient fainted after receiving her vaccine. EMTs came and found very low blood pressure, and took her to the hospital.

Other Meds: None known

Current Illness: none known

ID: 1145922
Sex: F
Age: 42
State: IL

Vax Date: 03/22/2021
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: Septra/Bactrim

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

Symptoms: Big Red circle/oval type of rash on around the injection site. In the morning, the spot inside the circle/oval felt warm to the touch. In the evening, the circle/oval has raised and can be felt with rubbing your finger around it and the spot inside the circle/oval felt warm to the touch.

Other Meds: Zyrtec Vitamin D Hair, Skin, Nails Vitamin

Current Illness:

ID: 1145923
Sex: F
Age: 51
State: CT

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

Lab Data:

Allergies: Minocycline

Symptom List: Injection site pain, Pain

Symptoms: Left outside of tongue became slightly numb. Numbness continued to left side of mouth on left lips side. Felt like the wearing off of a novicane shot.

Other Meds: Atorvastatin 20mg, Vallarta HCTZ 80-12.5mg, Montelukast SOD 10mg, Vitamin D3 1000IU, Allegra 180mg, Sprin Valley Womens probiotic

Current Illness: None

ID: 1145924
Sex: F
Age: 37
State: OH

Vax Date: 03/15/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Injection site pain, Menorrhagia

Symptoms: Swollen, red, painful itching arm that appeared 9 days after the vaccine. Has continued to get worse for the last 5 days

Other Meds: Levothyroxine

Current Illness: None

ID: 1145926
Sex: M
Age: 72
State: MI

Vax Date: 03/17/2021
Onset Date: 03/18/2021
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: Day after shot...achy, day after that ...achy, weakness, muscle aches, headache. This continued, especially the weakness and muscle aches and chills for 10 days. Then I began to have diarrhea, stomach ache and of course, continuation of weakness. Basically, I feel pretty crappy and have not gotten back to my normal self before the 2nd shot. I have no temp, no sore throat, no cough. It is hard to do anything although I did accompany my wife grocery shopping but sat in the car part of the time.

Other Meds: finasteride, vit C, CoQ 10, Geritol multivitamin, CTX 3 mouth rinse

Current Illness: none

ID: 1145927
Sex: M
Age: 29
State: FL

Vax Date: 03/01/2021
Onset Date: 03/10/2021
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: Dairy

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Numbness, lack of mobility, and stiffness in hands, wrists, and spreading up arms towards elbow.

Other Meds: None

Current Illness: IBSD, Lactose Intolerant

ID: 1145928
Sex: F
Age: 19
State: CA

Vax Date: 03/04/2021
Onset Date: 03/04/2021
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: None

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Severe all over body rash, including arms, back, legs, and face. Took benadryl for two weeks, did not subside. Received triamcinolone acetonide injection and medrol pak perscription on 3/22/21. Symptoms have subsided but there is hyperpigmentation on skin where rashes were.

Other Meds: None

Current Illness: None

ID: 1145929
Sex: F
Age: 76
State: IN

Vax Date: 01/21/2021
Onset Date: 02/11/2021
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: A few hours after injection, arm muscle started to hurt and it has never improved, I have used heat, muscle rubs, and pain relievers. It has been 6 weeks now with no improvement, Difficult to use that arm for many tasks

Other Meds: Tamoxifen, Levothyroxine, Atorvastatin, Iron, Colace, Celexa

Current Illness:

ID: 1145930
Sex: F
Age: 60
State: DE

Vax Date: 03/19/2021
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: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Itching, redness 10 days after injection

Other Meds: Duloxatine Levothyroxine Montelukast Apple Cider Vinegar

Current Illness:

ID: 1145931
Sex: F
Age: 30
State: CA

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Morphine

Symptom List: Injection site pain

Symptoms: Patient received first dose of Moderna around 1147 1150: Patient reported "feeling numbness in the hands, throat tightness and itching, heart racing, hot" while waiting in post observation area. Patient escorted to extended post vaccination observation room for monitoring. Dr. notified. 1153: Dr. at bedside. VS: 151/82, HR: 96, RR: 20, SPO2: 98% on RA. Patient throat assessed. AOx4. NAD. Able to communicate and make needs known without any difficulties. Pt appears anxious. C/o of throat swelling, itching, nausea, and feeling flushed. Denies any dyspnea or CP. Patient reports allergies to Morphine and history of anaphylaxis reaction from Morphine, per patient benadryl was given and helped with reaction. 1156: Benadryl 25 mg PO given per Dr.order. Patient able to swallow benadryl and drink water without any difficulties 1205: Patient given Albuterol inhaler per Dr. order. 1215: patient resting comfortably. Calm. Reports that throat feels better. Able to communicate without any difficulties. VS: 111/77, HR: 82, RR: 16, SPO2: 98%. 1230: patient remains stable. Dr. at bedside to reassess patient. Patient report feeling better and "ok to go home". Patient significant other, , at bedside. Patient discharge home safely.

Other Meds: medroxyPROGESTERone Norethin-Eth Estradiol-Fe (KAITLIB FE) 0.8-25 MG-MCG CHEW Prenat w/o A FeCbnFeGlu-FA &B6 (CITRANATAL B-CALM) 20-1 MG & 2 x 25 MG tablet spironolactone albuterol 90 mcg/act inhaler

Current Illness: UTI Hashimoto's disease HPV Generalized Anxiety Disorder ADHD Asthma

ID: 1145932
Sex: M
Age: 31
State: UT

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

Symptoms: Approximately 04:35 p.m. received 2nd Moderna dose. Approximately 05:30 p.m. experience very mild fever in cheeks. Approximately 06:30 p.m experienced mild brain fog. Approximately 07:30 p.m. experienced moderate pain in injection site and mild body aches lasting only seconds in random parts and joints in my body. Approximately 08:00 p.m. I experienced moderate lower back pain/stiffness ( I was lying in bed tossing and turning. Could not get comfortable) Approximately 10:30 p.m. after taking a hot shower and sitting upright for about 2 hours I no longer had any adverse affects. I was able to sleep soundly through the night. No affects the following day or since.

Other Meds: Amoxi-Clav (750mg, Tooth Infection) Humalog and Lantus insulin (Type 1 Diabetes) Atorvastatin (20mg, Cholesterol) Losartan Potassium / Hydrochlorothiazide (125mg, High Blood Pressure) Citalopram (20mg, Anxiety)

Current Illness: Tooth/Gum Infection

ID: 1145933
Sex: F
Age: 56
State: CA

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

Lab Data:

Allergies: NSAIDS, prednisone, iodine, tetracylines

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

Symptoms: Within four hours I was profusely sweating, had a fever, with severe body aches. I was bedridden and severely nauseous. I thought my symptoms would subside within a day or two. They continued for a solid week. Why doesn't anyone tell you this? When I was vaccinated with Typhoid, at least they gave me full disclosure of what to expect. I have improved enough to fill out this report; yet, I am still highly nauseous after a week and still fighting other symptoms.

Other Meds: Duloxetine 120 mg. osteoarthritis tramadol 50 mg up to 4x per day breakthrough pain gabapentin 1200 mg. neuropathy baclofen 10 mg muscle relaxant up to 4x per day topiramate 300 mg. anti-seizure omeprazole 40 mg 1x per day ritz

Current Illness: chronic pain, anemia

ID: 1145934
Sex: M
Age: 30
State: AZ

Vax Date: 03/28/2021
Onset Date: 03/28/2021
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: Cats and dogs

Symptom List: Tremor

Symptoms: Chills and night sweats, body aches, head ache, and fever

Other Meds:

Current Illness:

ID: 1145935
Sex: M
Age: 60
State: CT

Vax Date: 03/25/2021
Onset Date: 03/26/2021
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: none

Symptom List: Erythema, Pruritus

Symptoms: Severe nausea and vomiting, fever, body aches for 4 days; unable to keep food and water down

Other Meds: daily multi-vitamin

Current Illness: none

ID: 1145936
Sex: F
Age: 17
State: CA

Vax Date: 03/29/2021
Onset Date: 03/29/2021
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: None

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

Symptoms: Vaccine was administered to patient but she did not meet age criteria. Patient is 17 years old and 10 months.

Other Meds: Lexapro, Birth Control

Current Illness: None

ID: 1145937
Sex: F
Age: 58
State: TX

Vax Date: 03/02/2021
Onset Date: 03/02/2021
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: Adhesive tape

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

Symptoms: Chills, fever, fatigue, brain fog, muscle aches, joint pain, chest heaviness, headache, cough

Other Meds: Coreg, losartan, pantoprazole, osphena, sertraline, gabapentin, celebrex, vit E, vit D, fish oil, niacin, fiber, aspirin, B complex, probiotic

Current Illness: None

ID: 1145938
Sex: F
Age: 65
State: MI

Vax Date: 03/25/2021
Onset Date: 03/26/2021
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: Tetanus, ergotamine, dimetapp, lunesta, remeron, ambien ALL artificial sugars

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: 1:30 am 3/26 woke with chills, severe headache, all over body & joint aches, nausea, cough. No temp. Injection site swollen, red & painful. Minimal oral intake. 4:00 pm zofran. 8:00 pm Tylenol. Midnite zofran. 8:00 am 3/27 chills decreased. Allover aches & headache continue. No temp. Arm still red, swollen & painful. Zofran. Headache & body pain continue thru day. Tylenol noon & 8 pm. 3/28 Headache & all over pain continues. Decreases some with Tylenol aporox every 6-8 hours. Arm remains red, swollen & painful. No help with cold compress. 3/29 Reviewed with primary care doctor. Encouraged ice to site today & Aleve 3 tabs every 12 hours x 3 doses. May then use Aleve 1 tab every 12 hours & heat to site Tues. Continue fluids & small meals as tolerated.

Other Meds: Levothyroxine, modafinil, mvi, glucosamine, chondroitin, fish oil, b complex, iron

Current Illness: No

ID: 1145939
Sex: F
Age: 43
State: MD

Vax Date: 03/27/2021
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: No

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

Symptoms: Painful, sore, red, welts/rash on the top of both hands. The left hand welts/rash are more painful then the right hand welts/rash. Heat is coming off of the rash.

Other Meds: Levothyroxine, sertaline

Current Illness:

ID: 1145940
Sex: M
Age: 26
State: MN

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

Lab Data:

Allergies: none

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

Symptoms: Patient reported to immunizing technician before administration of vaccine that he had a history of fainting post-vaccination due to anxiety and nerve about needles. Pt stated that previously he had fainted immediately post-vaccination. After discussing patient's medical history the supervising pharmacist advised pt to stay in vaccination seat for direct observation for 10-15min. After about 10 minutes post-vaccination in observation period the pt alerted immunizing tech, "oh, its happening." The tech brought a wet paper towel and placed it on the back of patient's neck and pt replied, "oh, that feels good", then patient's head immediately dropped and he went out of consciousness. Pharmacist witnessed event and rushed over to support patient from falling off chair. Pharmacist was rubbing and patting patients back and chest, yelling his name to arouse him. Pharmacist directed tech to call code white and alert store manager. In total, the patient was approximately in and out of consciousness about 20 seconds. Pt responded to stimulus and recovered without other effects or injury. Patient was fully responsive and aware of event went he became conscious again. We offered him a cold water bottle and encouraged him to remove mask if it helped him to breath better. Pt was able to communicate with pharmacist about the sensations he had leading to the event where he described first tingling in his feet, than dissociation from body, where he felt like he was having a dream but could hear someone yelling at him. EMS arrived at the scene and performed vital check. Based on patient abnormal hypertension at scene and higher BMI, EMS offered to transport patient to the ED for further tests and observation but patient declined. Patient was accompanied by his emergency contact, his father (who also witnessed the events unfold).

Other Meds: n/a

Current Illness: anxiety about needles, past history of fainting post-vaccination (per patient ~5-10 yrs ago)

ID: 1145941
Sex: F
Age: 81
State: CA

Vax Date: 03/01/2021
Onset Date: 03/10/2021
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 known

Symptom List: Pain in extremity

Symptoms: On the date of first occurance March 10, felt fatigue and muscle ache in groin and legs, on first night felt restless, and sleepless with pain occuring in more joints. Next morning March 11, could not get up out of bed without assistance. Excruitiating joint and muscle pain . Sleeping 10-12 hours during day. Could barely walk pain persisting. Foggy brain, unable to consentrate. Feeling depressed. This last through weekend, subsiding some on Sunday March 14. Visited family physician, Dr. on Monday. Diagnosed with Serum Sickness. It has been a gradual decrease in joint pain, but still persists in my hips and legs as I write this on March 22.

Other Meds: synthroid, amlodipine, lorsartan, multi vitamin, tumeric curcumin

Current Illness: none known

ID: 1145942
Sex: F
Age: 37
State:

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: 2
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: Patient with syncope post vaccination. Placed on 3L O2 NC. Appeared to be in respiratory distress. BP initially 98/72. Recovered to 145/86. MD at bedside and discontinued O2 since patient alert and O2 ok. After a few minutes patient began to desat occasionally and appeared in respiratory distress. Placed on NRB 15L. IV placed and given Zofran 4mg IVP. EMT's at bedside and did EKG. Patient said "my heart hurts." Transferred via ambulance to ED.

Other Meds:

Current Illness:

ID: 1145943
Sex: F
Age: 37
State: IL

Vax Date: 03/22/2021
Onset Date: 03/28/2021
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: Allergies: Gluten, Dairy, Corn

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

Symptoms: COVID arm 3/27/2021 at 10:30pm noticed multiple he?d swollen hives in circular form around injection site 3/28/2021 6:00am hives were gone replaced by solid red raised mass about 3? by 3? in a circular shape. Resembled a spider bite. Extremely itchy, red, hot to touch, and the raised bump was hard. Hard lump has remained all day. Applied ice and spot remained hot to the touch.

Other Meds: D3 vitamin 125 mcg Probiotic 10 20 billion live cultures Nature made multi complete 1 a day

Current Illness: None

ID: 1145944
Sex: F
Age: 37
State: HI

Vax Date: 01/22/2021
Onset Date: 03/27/2021
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: Employee tested positive for covid-19 after fully vaccinated.

Other Meds:

Current Illness:

ID: 1145945
Sex: F
Age: 40
State: CT

Vax Date: 03/22/2021
Onset Date: 03/29/2021
Rec V Date: 03/29/2021
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: Vicodin (nausea)

Symptom List: Vomiting

Symptoms: Two left side swollen lymph nodes by collar bone. They are about the size of a dime and are very tender and sore.

Other Meds: HCTZ 25mg; propanolol 40 mg; lipitor 10 mg; fish oil; multivitamins

Current Illness: None

ID: 1145946
Sex: M
Age: 54
State: TX

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

Lab Data:

Allergies: None.

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Headache, chills, body aches, fever (maxed at 101-degrees Fahrenheit on the second day) lasting 3 days. Lymph nodes very swollen and painful under left arm, lasting 5 days.

Other Meds: Rosuvastatin 20mg, Olmesartan 20mg, Montelukast 10mg, Desipramine 50mg, Zyrtec 10mg, Claratin 10mg, AREDS-2, Multivitamin

Current Illness: None.

ID: 1145947
Sex: M
Age: 55
State: CA

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: RA

Lab Data:

Allergies: None

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

Symptoms: Beginning around 3 am, I began feeling chills and aches throughout my body. In getting up around 7:30 am, I felt more intense aches, fever, and some dizziness. Nausea set in around 12 pm. After resting until about 5 pm, the symptoms began to subside though aches continued.

Other Meds: Levothyroxine (75 mcg); Vitamin D3 (5000 IU); Vitamin B12 (1000 mcg); Methyl-Sulfonul-Methane (1000 mg); Salmon Oil (Omega-3 EPA & DHA - 150 mg); Magnesium Citrate (400 mg)

Current Illness: None

ID: 1145948
Sex: F
Age: 57
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: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Day 2: High Fever (101.2),intense fatigue, headache & arm pain Day 3: Some fever, some fatigue & arm pain Day 4: huge cold sore on lower lip and chin

Other Meds: none

Current Illness: no

ID: 1145950
Sex: F
Age: 36
State: MO

Vax Date: 03/21/2021
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: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Ceclore Erythromycin

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

Symptoms: Hard red bump, around 4cm diameter.

Other Meds: None

Current Illness: None

ID: 1145951
Sex: F
Age: 73
State: HI

Vax Date: 03/11/2021
Onset Date: 03/25/2021
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: Tylenol, Sulphur

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

Symptoms: On 3/25/2021, I started having chills; since then I have been running a fever; temperature up to 101. I predominately have the fever and muscle ache. No loss of taste or smell. Some diarrhea (2X).

Other Meds: Olmesartan; Sertraline; Vitamin C, D; Biotin' Multivitamin; Cranberry,; Joint Health.

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm