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: 1147281
Sex: F
Age: 56
State: CT

Vax Date: 03/25/2021
Onset Date: 03/26/2021
Rec V Date: 03/30/2021
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: onions, scallions, garlic, shallots, green onion, walnuts, tuna, broccoli, bananas, eggplant??

Symptom List: Dysphagia, Epiglottitis

Symptoms: Felt sick went to bed when I got home from work, some tummy upset, stomach upset on Saturday, Arm was sore for about 48 hours, felt a little tired, some bathroom issues

Other Meds: Zegerd, Zyrtec, vitamin c and vitamin D probiotic, azaphorine, levothroxine , pepcid , restatis

Current Illness: None

ID: 1147282
Sex: F
Age: 51
State: PA

Vax Date: 01/18/2021
Onset Date: 01/20/2021
Rec V Date: 03/30/2021
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: Erythromycin Sulfa antibiotics

Symptom List: Anxiety, Dyspnoea

Symptoms: Swelling in right armpit - initially swollen area was approximately 4 inches in diameter Diagnosed by an urgent care physician as a swollen lymph node Swelling has slowly decreased; still present today - swollen area now approximately 1 inch in diameter

Other Meds: OTC Prilosec once daily OTC Zyrtec once daily OTC Tylenol PM at bedtime

Current Illness: none

ID: 1147283
Sex: F
Age: 40
State: NH

Vax Date: 12/31/2020
Onset Date: 01/04/2021
Rec V Date: 03/30/2021
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: N/A

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

Symptoms: New onset Tinnitus

Other Meds: Adderall

Current Illness:

ID: 1147284
Sex: F
Age: 43
State: KY

Vax Date: 03/05/2021
Onset Date: 03/07/2021
Rec V Date: 03/30/2021
Hospital: Y

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

Lab Data:

Allergies: Bee venom, gold metals, Naproxen, Imitrex

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: high blood pressure, chest pain, shortness of air - intermittent after getting the dose. Patient experienced this 2x on different occasions, the first time was 3/7/21-3/8/21 and again 3/20/21-3/22/21. EKG, stress test, and ECHO were completed after second concerning episode and no urgent cardiac issues were found. Follow-up with PCP scheduled 4/7/21.

Other Meds: Tizanidine 4 mg PO q8Hours PRN muscle spasms, Metformin 500 mg PO BID, Levothyroxine 0.05mg PO daily, Tylenol 500 mg PO q4Hours PRN headache, Rizatriptan 10mg PRN migraine headache.

Current Illness: none

ID: 1147285
Sex: F
Age: 73
State: MA

Vax Date: 02/27/2021
Onset Date: 03/08/2021
Rec V Date: 03/30/2021
Hospital:

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

Lab Data:

Allergies: Diclophenac

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

Symptoms: The same reaction from both shots, a hot large (shoulder to elbow) red, itchy rash with a small white patch with a red center. The patch and red center were NOT the injection site. The reaction appeared on March 8 2021 after the first dose, and on March 29 after the second dose (which was administered on March 27, 2021 at 10:00 a.m.). On March 30 I still have both rashes.

Other Meds: Allopurinol, Metaprolol, Irbesarten HCL

Current Illness: Pityriasis (diagnosis uncertain)

ID: 1147286
Sex: F
Age: 32
State: NY

Vax Date: 03/22/2021
Onset Date: 03/29/2021
Rec V Date: 03/30/2021
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: Most antibiotics (amoxicillian, penacillian, etc), sulfa drugs, gluten-free due to gluten allergy /sensitivity.

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

Symptoms: Side effects day 1-4: severe fatigue, low grade fever, body aches, minor/slight headache, extremely sore/painful arm, nausea after eating. 1 week post 1st shot: "covid arm" swelling at injection site, swollen/ raised, red, hot to touch (over 100? on injection location-no fever anywhere else), itchy, extremely painful.

Other Meds: Clonidine, tizanidine, low-ogesterel, ra asprin, folic acid, cilostazol, creatine, levocarnitine, Nac, coq10

Current Illness: Reflex sympathetic dystrophy, raynaud's, mitochondrial myopathy, neurocardiogenic syncope, APS, mass in pituitary gland, chronic sinusitis

ID: 1147287
Sex: F
Age: 62
State: FL

Vax Date: 03/22/2021
Onset Date: 03/24/2021
Rec V Date: 03/30/2021
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: Sulfa, Penicillin Levaquin, Flagel, Doxycycline

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: 3/23 normal fatigue and arm pain, 3/24 woke up with body aches, 99 fever and it hurt to breath, between this day to the 27 there was an increase in pain in breathing, every breath it hurt. and still having pain breathing; I'm on a high dose of Prednisone

Other Meds: Bio-Identical hormones, C, V

Current Illness: no

ID: 1147288
Sex: F
Age: 49
State:

Vax Date: 03/27/2021
Onset Date: 03/28/2021
Rec V Date: 03/30/2021
Hospital:

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

Lab Data:

Allergies: Catfish, nickel

Symptom List: Pharyngeal swelling

Symptoms: 2 supraclavicular nodes on L (node 1- size of dime; node 2- size of penny); nodular swelling noted on March 28, 2021; symptoms still present. L arm swelling/ tenderness/ pain at injection site noted on March 27, 2021; symptoms are improving.

Other Meds: Metformin ER 500 mg, lisinopril/ HCTZ 10 mg/ 12.5 mg, cetirizine 10 mg, vitamin D3 5,000 IU, aspirin EC 81 mg

Current Illness: None

ID: 1147289
Sex: F
Age: 21
State:

Vax Date: 03/30/2021
Onset Date: 03/30/2021
Rec V Date: 03/30/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: The patient experienced dizziness and double vision after immunization.

Other Meds:

Current Illness:

ID: 1147290
Sex: F
Age: 54
State: AZ

Vax Date: 01/04/2021
Onset Date: 01/07/2021
Rec V Date: 03/30/2021
Hospital: Y

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

Lab Data:

Allergies: Sulfa

Symptom List: Diarrhoea, Nasal congestion

Symptoms: I did not have a reaction until I got home on Jan 4th, 2021. I had a headache for a solid 2 weeks. Lost my vision right eye on Feb 1st with extreme vertigo ended up in the hospital. After a few tests they found a heart defect ASD. Never in my life have I been told I have had a heart condition. I am correlating it to the vaccination because for the 4 solid weeks before I ended up in hospital I was so sick.

Other Meds: estrogen, progesterone's and Testosterone.

Current Illness: NONE.

ID: 1147291
Sex: F
Age: 34
State: AR

Vax Date: 03/30/2021
Onset Date: 03/30/2021
Rec V Date: 03/30/2021
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: Is 17 weeks pregnant with her first child. I do not know her estimated date of delivery. She fainted approximately 5 minutes after receiving her vaccine and fell from a chair. She landed on her side face down, so we turned her face up so we could see her face. Her eyes were barely open, but she nodded her head the second time we asked if she could hear us. We took her blood pressure, and it was 107/71 with a heart rate of 85. EMS came, and she felt better, so she decided not to go with them. They asked her to stand up to sit back in the chair. When they left, she slowly progressed to walking around while talking on the phone with someone to come pick her up so she didn't have to drive herself. She told us this was the first time she had fainted in 3 years and the first time ever fainting due to a vaccine.

Other Meds: Unknown

Current Illness: Unknown

ID: 1147292
Sex: M
Age: 38
State: AZ

Vax Date: 03/16/2021
Onset Date: 03/25/2021
Rec V Date: 03/30/2021
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: Penicillin, Lidocaine

Symptom List: Rash, Urticaria

Symptoms: I had a heart attack or major cardiac stress event after receiving the vaccine . This is concerning because when they did all of their imaging and test my heart is in perfect condition and there are no blockages and there was no reason for this to happen. After the vaccine I was fighting massive fatigue and muscle cramps. In the hospital ran my labs and found out that my potassium had bottomed out to critical level and is very likely the cause of this. But why did the vaccine cause my potassium to bottom out?? I eat healthy and take potassium supplements. I?ve been weight training and competing in bodybuilding and powerlifting competitions for about a decade. So having a healthy diet and understanding nutrition is something that I understand a lot more than the average person.

Other Meds: amlodipine besylate 10mg, chlorthalidone 50mg, potassium chloride 20MEQ, Acyclovir 400 mg

Current Illness: N/a

ID: 1147293
Sex: F
Age: 56
State: TX

Vax Date: 03/25/2021
Onset Date: 03/26/2021
Rec V Date: 03/30/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: Swollen 3x3 red bump under vaccination site, sore arm for last 5 days

Other Meds: Progesterone, nature thyroid, allergy meds

Current Illness: None

ID: 1147294
Sex: F
Age: 20
State: RI

Vax Date: 03/26/2021
Onset Date: 03/26/2021
Rec V Date: 03/30/2021
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: N/A

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

Symptoms: Roughly 12 hours after I recieved my second dose of the vaccine (around 11:00 PM on 3/26) I started to develop a fever, headache, and chills. These symptoms lasted throughout the night into the morning. In the morning on Saturday (3/27), and for most of the day I felt fatigued and slightly nauseous. At 5:00 PM that night, I was walking in the hall of my residence when I experienced a syncopal episode, which has never happened to me before. I fainted several times and my roommate brought me to the ER. Other than low BP, my EKG and other vitals looked fine, and the doctor sent me home with the conclusion it was likley related to the vaccine. The next day, Sunday 3/28, I felt naseua and dizziness all day.

Other Meds: N/A

Current Illness: N/A

ID: 1147296
Sex: M
Age: 28
State: NJ

Vax Date: 03/12/2021
Onset Date: 03/18/2021
Rec V Date: 03/30/2021
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: Swollen lymph nodes up to my left clavicle and just under it.

Other Meds:

Current Illness:

ID: 1147297
Sex: M
Age: 63
State: WA

Vax Date: 03/26/2021
Onset Date: 03/26/2021
Rec V Date: 03/30/2021
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: The Moderna COVID-19 vaccine was administered to patient. After vaccine administration, it was discovered that patient had indicated on his vaccination screening form that he had received the Shingrix vaccine 12 days ago on 03/15/21. This vaccine was given within 14 days of the administration of the COVID-19 vaccine. Clinical supervisor was notified of this incident right after it was discovered. According to the current CDC guidelines if a COVID-19 vaccine is given less than 14 days from another vaccine it is does not need to be repeated. Clinical supervisor provided counseling with this recommendation to patient along with her contact information in case he had additional questions.

Other Meds: NA

Current Illness: NA

ID: 1147298
Sex: F
Age: 42
State: OH

Vax Date: 03/23/2021
Onset Date: 03/23/2021
Rec V Date: 03/30/2021
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: Encounter Date: 3/23/2021 Hide copied text Hover for details 245PM Pifzer first dose Vaccination given. 320 Complaining of not feeling well. States she stayed beyond her 15 minutes as did not feel well. BP 119/80 P86 R 18 Pulse ox 100%. When asked how she was feeling she stated she feels something in her throat. Complains of itching to her back. When examined, found many reddened areas with scratch marks over mid back near bra line. Consulted Dr. regarding giving Benadryl 25 mg po. She advised to administer. 325 Benadryl 25 mg given po. Denies difficulty swallowing but states not getting air as well. Lung sounds audible but diminished at bases. Unable to auscultate heart sounds per NP due to acoustics. 335 BP 125/85 P 132 R 22. Pulse ox 99%. States more difficulty getting air. Epinephrine 0.3 mg IM given complains of lip feeling tight. 337 Squad arrived and given report. BP 124/67 P138 R 22. Pulse ox 98%. Shivering from Epinephrine administration. Patient taken to Emergency Department, unable to see records from that facility.

Other Meds:

Current Illness:

ID: 1147299
Sex: F
Age: 43
State: CA

Vax Date: 03/28/2021
Onset Date: 03/28/2021
Rec V Date: 03/30/2021
Hospital:

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

Lab Data:

Allergies: Sulfa drug allergy (reaction: increased heart rate)

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Patient arrived stable and afebrile; received first dose of Pfizer/BioNTech COVID19 vaccine, administered by pharmacist. During 15 minute monitoring period, patient and accompanying family reported to pharmacy team that she was feeling unwell and noticed some difficulty breathing. Temperature check revealed patient to still be afebrile. Pharmacist performed pulse check on left wrist - heart rate appeared even and steady; grip strength present. Patient denied any vision changes, but felt dizzy; difficulty in breathing remained stable and constant, not worsening nor improving. Pharmacist administered oral diphenhydramine 50 mg to patient, and technician dialed 911 to reach emergency services. Patient brought to front store with other pharmacist, where vitals taken and additional care provided.

Other Meds:

Current Illness:

ID: 1147300
Sex: F
Age: 54
State: FL

Vax Date: 03/11/2021
Onset Date: 03/15/2021
Rec V Date: 03/30/2021
Hospital:

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

Lab Data:

Allergies: NA

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Flu-like symptoms, nausea, chills since 3/ 15/2021 to present

Other Meds: Cyclosporin, prednisone, oxycodone, morphine, trazadone, vit c, d, lexapro gabapentin.

Current Illness: None

ID: 1147301
Sex: F
Age: 48
State: CA

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 03/30/2021
Hospital:

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

Lab Data:

Allergies: I am allergic to cantaloupe and seasonal allergies.

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

Symptoms: Got shot at 04:15 pm - symptoms started within 15 minutes; Excess mucus in my throat and having to clear throat constantly and the Benadryl kicked in and it went away within an hour. By evening of the next day, Chills and that started about 05:00 pm. On 2:30 am on Sunday, I woke up with a 103 fever. That only lasted a few hours and I was not allowed to come to work on Monday because of fever. I took a rapid Covid test and it came back negative. Temperature was back to normal.

Other Meds: Benadryl; Daily multi-vitamin

Current Illness: No

ID: 1147302
Sex: M
Age: 60
State: NJ

Vax Date: 03/29/2021
Onset Date: 03/30/2021
Rec V Date: 03/30/2021
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: Ampicillin

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

Symptoms: Pain in arm where vaccinated, body aches, fever

Other Meds: Lipitor, Vascepa, Metoprolol, Benicar

Current Illness: none

Date Died: 03/19/2021

ID: 1147303
Sex: M
Age: 72
State: MN

Vax Date: 01/31/2021
Onset Date: 03/19/2021
Rec V Date: 03/30/2021
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: Unevaluable event

Symptoms: Patient death within 60 days of receiving a COVID vaccine

Other Meds:

Current Illness:

ID: 1147304
Sex: F
Age: 25
State: TX

Vax Date: 03/26/2021
Onset Date: 03/27/2021
Rec V Date: 03/30/2021
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: No

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

Symptoms: Due date July 7th, 2021. 1st pregnancy. On 3/27 I had an elevated BP and HR in the evening, almost 24 hours after vaccination. BP was 135/72 and HR was 120. Normal BP for me is around 118/76 and HR is normally between 96 and 106. This was the second time I had elevated BP and HR after receiving the Pfizer vaccine.

Other Meds: Prenatal, Diclocylomine, Albuterol inhaler, Stool Softener

Current Illness: None

ID: 1147305
Sex: F
Age: 52
State: CA

Vax Date: 03/22/2021
Onset Date: 03/29/2021
Rec V Date: 03/30/2021
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: Sulfa

Symptom List: Injection site pain, Pain

Symptoms: My arm became very itchy around 2 pm on 3/29/2021 and was also sore around the injection site later in the evening. At around 9 am on 3/30/21, I noticed my arm was even itchier than yesterday, warm to the touch and still sore. I have not done anything for it as of yet, but I may take a Benadryl later as per what I read on the CDC site and try some cortisone and ice.

Other Meds: Vitamins

Current Illness: None. Only general allergies

ID: 1147306
Sex: F
Age: 52
State: IN

Vax Date: 03/27/2021
Onset Date: 03/27/2021
Rec V Date: 03/30/2021
Hospital:

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

Lab Data:

Allergies: Penicillin & family

Symptom List: Injection site pain, Menorrhagia

Symptoms: Chills, aches, started about 8.5 hrs after vaccination. Fever noticeable about 1 hour after, didn?t measure temp, lasted about 8 hrs. Still slightly achy and tired over next 10 hrs, but all okay about 30 hrs or so after vaccination.

Other Meds: Synthroid generic (Levothyroxine), calcium supplements, Vitamin D supplements

Current Illness: None

ID: 1147307
Sex: F
Age: 22
State: IL

Vax Date: 01/14/2021
Onset Date: 02/04/2021
Rec V Date: 03/30/2021
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: n/a

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

Symptoms: All over body rash diagnosed as pityriasis rosea. Occurred 20 days after second vaccination (2/24/21) presenting as acute and worsening to all over burning, hive like rash that has lasted for one month. symptoms are changing but not improving.

Other Meds: nexplanon

Current Illness: n/a

ID: 1147308
Sex: M
Age: 30
State: CA

Vax Date: 03/28/2021
Onset Date: 03/28/2021
Rec V Date: 03/30/2021
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: Allergic to sulfa antibiotics

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Approximately 6 hours and 30 minutes after vaccination, patient became slightly dizzy and nauseous, and went to bed. The morning after, the patient had body aches and a headache, and took 500mg of acetaminophen at approximately 5am. The patient also noticed swelling at the injection site (raised and approx 5 inches in diameter) and itching at this time as well. The patient took another 500mg of acetaminophen at 2pm, 200mg of ibuprofen at 3pm, and complained of a sensation of hypersensitivity and mild "burning" across the skin. These symptoms subsided by about 5pm, and patient felt well enough to stand up and have a small meal before returning to bed. At that point (~5pm), they developed a low fever (temp fluctuated between 99.5-100.6F), and took 400mg of ibuprofen and another 500mg of acetaminophen, and their temperature reduced to 98.6 at approximately 8PM. Afterwards, the patient had fatigue and some aches, and the swollen arm has not subsided at the time of report entry (~42 hours after vaccination).

Other Meds: Spironolactonse (300mg daily) Estradiol (8mg daily) Progesterone (100mg daily)

Current Illness: N/A

ID: 1147309
Sex: M
Age: 45
State: SC

Vax Date: 03/29/2021
Onset Date: 03/29/2021
Rec V Date: 03/30/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: 10 min after vaccination became diaphoretic, decreased level of consciousness, decreased BP EMS called to site, client stabilized and refused transport to hospital.

Other Meds:

Current Illness:

Date Died: 02/23/2021

ID: 1147310
Sex: M
Age: 73
State: TX

Vax Date: 02/16/2021
Onset Date: 02/01/2021
Rec V Date: 03/30/2021
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: diarrhea, vomiting, blood in stool, nausea, loss of appetite

Other Meds:

Current Illness: Hypertension

ID: 1147311
Sex: F
Age: 50
State: AZ

Vax Date: 03/26/2021
Onset Date: 03/28/2021
Rec V Date: 03/30/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List: Nausea

Symptoms: Fatigue day of... and continuing so far Diarrhea for 3 days...continuing so far

Other Meds: N/A

Current Illness: N/A

ID: 1147312
Sex: M
Age: 65
State: NV

Vax Date: 03/28/2021
Onset Date: 03/30/2021
Rec V Date: 03/30/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: Swelling under left upper armpit brest, larger then golf ball smaller then baseball.

Other Meds: Quetiapine, Buspar, Omeprazole, ibuprophen

Current Illness:

ID: 1147314
Sex: F
Age: 51
State:

Vax Date: 03/29/2021
Onset Date: 03/29/2021
Rec V Date: 03/30/2021
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: Angioedema, shortness of breath Patient administered 50mg IM Benadryl and 0.3mg Epinephrine IM on site. Ambulance transported stable patient to ED for further evaluation ED Note: 51 y.o. female with past medical history of DM, GERD, TIA, HTN, migraine, PUD, angioedema, and anaphylaxis to multiple agents who presents with complaints of tongue and throat swelling following first Moderna vaccine. Patient already received epinephrine and Benadryl at clinic, is having improvement in her symptoms with only slight voice change now, no residual shortness of breath or visualizable swelling. Patient states she is feeling better. Patient was provided with Pepcid and corticosteroids, was observed in the department for greater than 4 hours. Patient had full resolution of her voice change. Recommended that she follow-up with her primary care doctor, likely should not receive a second Covid shot but she discussed this with them. Did discharge her on Medrol Dosepak. Also recommended to the patient that she carry her EpiPen's at all times.

Other Meds:

Current Illness:

ID: 1147315
Sex: F
Age: 62
State: CO

Vax Date: 03/05/2021
Onset Date: 03/09/2021
Rec V Date: 03/30/2021
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: Penicillin, Methotrexate

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

Symptoms: I exp bilateral iritis and lupus flare which is still lasting over 3 weeks.

Other Meds: Thyroid, Prednisone, Coumadin, Luflonalide? Plaquenil

Current Illness: No

ID: 1147316
Sex: F
Age: 48
State: WI

Vax Date: 02/28/2021
Onset Date: 03/05/2021
Rec V Date: 03/30/2021
Hospital: Y

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

Lab Data:

Allergies: chlorpormazine, chlobazam, gluten, dairy

Symptom List: Tremor

Symptoms: 2/28/2021-received second dose of Moderna COVID Vaccine. 3/1/2021-Emergency Room visit for cough-after labs and xray, and she being at baseline, was discharged back to facility. Return to ED on 3/5/2021 with altered mental status, shortness of breath, wet cough, and fever. Patient admitted to hospital.

Other Meds:

Current Illness:

ID: 1147317
Sex: F
Age: 54
State: AZ

Vax Date: 03/27/2021
Onset Date: 03/28/2021
Rec V Date: 03/30/2021
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: Erytromycin and Codeine

Symptom List: Erythema, Pruritus

Symptoms: Swelling in lymph nodes through out body- initially in groin then under both arms. Intense fever that broke in 3 hours, then ongoing fever and chills for 12 hours. 24 Hours later- still have swelling in lymph under left arm where injection was. By 56 hours post injection lymph still swollen and arm very sore.

Other Meds: Aleve and Zyrtec

Current Illness: none

ID: 1147318
Sex: F
Age: 59
State: NV

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 03/30/2021
Hospital: Y

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: CIPRO

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

Symptoms: immediately following my left arm got a hot sensation, my hand went numb, and my fingers tingled. 1 hour later I was nauseated and I had flu like symptoms, body aches, chills and a horrific headache. By 4th hour I needed to go to bed.

Other Meds: vitamins and omega 3, garlic

Current Illness: none

ID: 1147319
Sex: F
Age: 59
State: TN

Vax Date: 02/27/2021
Onset Date: 03/01/2021
Rec V Date: 03/30/2021
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: Morphine

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

Symptoms: Ringing in ears, headache behind eyes, weak.

Other Meds: Vitamin D, baby aspirin, lisinopril. hydrochlorat, levothyroxine

Current Illness: Still had a headache behind my eyes and exhaustion from the first dose. My sever congestion, chills, fever and severe exhaustion has dissipated. Now this ear ringing started just after my second dose.

ID: 1147320
Sex: F
Age: 21
State: LA

Vax Date: 03/29/2021
Onset Date: 03/29/2021
Rec V Date: 03/30/2021
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 known

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Patient received the vaccine at 1:00pm and right after the shot she started to feel weak. When we asked if she needed anything she stated she couldn't stand up or move her muscles. The ambulance was called and they arrived within 10 mins. She was brought to the ER and told that her blood pressure was low. She was treated with fluids and rest. I followed up with the patient this morning at 10am she stated she was feeling better.

Other Meds: None known

Current Illness: None known

ID: 1147321
Sex: F
Age: 63
State: AZ

Vax Date: 03/30/2021
Onset Date: 03/30/2021
Rec V Date: 03/30/2021
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: Nothing

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

Symptoms: Body Ache, Covid like symptoms, Headeache. for about 24 hours.

Other Meds: Nothing

Current Illness: Migrane Headeache

ID: 1147322
Sex: F
Age: 65
State: PA

Vax Date: 03/30/2021
Onset Date: 03/30/2021
Rec V Date: 03/30/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Within 5 minutes of the injection recipient complained of headache, slight shortness of breath and sweaty palms. She was evaluated by an on-site EMT and refused transportation to the hospital.

Other Meds:

Current Illness:

ID: 1147323
Sex: F
Age: 53
State:

Vax Date: 03/03/2021
Onset Date: 03/10/2021
Rec V Date: 03/30/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: Injection site was itchy and mildly sore 7 days after the injection . This lasted for about 7 days

Other Meds: Vitamin D Probiotic Fish Oil Collagen Peptides

Current Illness:

ID: 1147324
Sex: F
Age: 19
State: MA

Vax Date: 03/24/2021
Onset Date: 03/27/2021
Rec V Date: 03/30/2021
Hospital: Y

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

Lab Data:

Allergies: None

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

Symptoms: Vaccine was given in left arm on 3/24/21. Had fever and myalgia x 24 hrs. No further fever. Myalgia continued for 1 more day at a lower level. Day 3, started to have chest pain. Came to Emergency room at the night of Day 3.

Other Meds: None

Current Illness: None

ID: 1147325
Sex: F
Age: 56
State: CO

Vax Date: 03/25/2021
Onset Date: 03/25/2021
Rec V Date: 03/30/2021
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: both ears were ringing consistently. I have prior "slight" hearing loss and thought that by cleaning my ears over and over again my hearing would improve. Drove up one of the streets that was a hill and ear "popped" and hearing improved, but then went back to the same ringing constantly and hearing loss as before. My arm was sore, but that went away in about a day and no adverse signs were noticed in the arm, no fever, just the ringing and loss of hearing. I can hear if someone talks loudly enough and I have to have the TV up to the loudest volume level. I am concerned now if I get the second vaccine that the loss will be permanent. It has been 5 days since the first dose and the ringing and hearing loss has not improved.

Other Meds: None

Current Illness: None

Date Died: 03/27/2021

ID: 1147326
Sex: F
Age: 76
State: IL

Vax Date: 03/24/2021
Onset Date: 03/27/2021
Rec V Date: 03/30/2021
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: NKDA

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

Symptoms: Patient received 1st vaccine on 3/24 with no issues reported. Patient returned on FRiday for routine treatment and was afebrile, BP within normal limits and no compliants. Left the unit stable post treatment. Patient passed away on Saturday morning. There was no hospitalization. Patient went straight from home to the funeral home. Daughter states that patient had been feeling warm since Wednesday.

Other Meds:

Current Illness:

ID: 1147327
Sex: F
Age: 41
State: AZ

Vax Date: 03/27/2021
Onset Date: 03/28/2021
Rec V Date: 03/30/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: Severe grogginess and ear congestion with tinnitus

Other Meds:

Current Illness:

ID: 1147328
Sex: M
Age: 23
State: AR

Vax Date: 03/30/2021
Onset Date: 03/30/2021
Rec V Date: 03/30/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Pt recived first shot of Covid Vaccine at 10:17 around 5 mins after pt started feeling dizzy, Diaphoretic, blurred vision. pt fell from the chair in the observation area, pt was immediately transported to ER .

Other Meds:

Current Illness:

ID: 1147329
Sex: F
Age: 38
State: VA

Vax Date: 03/29/2021
Onset Date: 03/29/2021
Rec V Date: 03/30/2021
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: dicloxacillin

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

Symptoms: fever, chills, nausea, body aches, fatigue

Other Meds: multi vitamin

Current Illness: none

ID: 1147330
Sex: M
Age: 48
State: NY

Vax Date: 03/23/2021
Onset Date: 03/23/2021
Rec V Date: 03/30/2021
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: aspirin

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Anaphylaxis - Benadryl, Epinephrine, Prednisone

Other Meds: meprazole dr 20 mg enalapril-hctz 10-25 mg cetrizine 10mg Vitamin D 5000 Daily Vitamin

Current Illness: none

ID: 1147331
Sex: F
Age: 67
State: NY

Vax Date: 03/02/2021
Onset Date: 03/12/2021
Rec V Date: 03/30/2021
Hospital:

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

Lab Data:

Allergies: penicillin

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

Symptoms: On 3/12/2021 pt states that her jaw was sore on the right side of her mouth when she was talking or chewing. On 3/14/2021 pt states her right side of her face felt swollen and tingly. She said her right ear felt swollen. She states the feeling was like she had been lidocaine on the right side of her face. Pt was going to go to the ER w/ these symptoms but subsided after 24 hours. She no longer has any symptoms.

Other Meds: none

Current Illness: none

ID: 1147332
Sex: M
Age: 57
State: WI

Vax Date: 03/25/2021
Onset Date: 03/25/2021
Rec V Date: 03/30/2021
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: Client received his first dose at County Public Health on 3/16/2021 (lot #046A21A). He used our link to schedule his second dose at County Public Health on 3/25/2021. He stated, "I knew there was a 28 day interval between the two doses but thought the system wouldn't have allowed me to schedule any earlier but it did, so I continued with my scheduled appointment." The client completed the screening questionnaire the day of his appointment, and reported receiving his first dose less than 10 days apart. He was not questioned or stopped at any point during clinic. He received his second dose of Moderna at County Public Health on 3/25/2021 (lot # 016B21A), this is less than 10 days after receiving his first dose.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm