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: 0938569
Sex: M
Age: 43
State:

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 01/12/2021
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: none

Symptom List: Dysphagia, Epiglottitis

Symptoms: High fever 103.4 F lasting 12-24 hours

Other Meds: none

Current Illness: COVID 11/17/2020

ID: 0938570
Sex: F
Age: 21
State: ME

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/12/2021
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: none

Symptom List: Anxiety, Dyspnoea

Symptoms: Nausea, lightheaded, dizzy, feels foggy or high about 10 minutes after the vaccine. BP and other VS were within normal limits. No chest pain, palpitations, changes in vision, diaphoresis or rash

Other Meds: none

Current Illness: none

ID: 0938571
Sex: F
Age: 57
State: ME

Vax Date: 01/07/2021
Onset Date: 01/09/2021
Rec V Date: 01/12/2021
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: bees, cillins, and sulfurs

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

Symptoms: Extreme Fatigue, Dizziness, diarrhea, nausea, right eye excessive twitching, with heavy eyelid. Muscle aches. Headache. Confusion. These lasted for most of Saturday into Sunday. Monday - still ill. Today the following symptoms still persist: fatigue, eye twitching with heavy eyelid, headache,

Other Meds: Furosemide, potassium

Current Illness: headache, fatigue

ID: 0938572
Sex: M
Age: 29
State: NY

Vax Date: 12/31/2020
Onset Date: 01/02/2021
Rec V Date: 01/12/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: 2 days after vaccine administration +fever 101, also had new lower back pain radiating down legs bilaterally, then new Rt lower back pain that radiates down scrotum and thigh/calf; also recent 2 days has had urinary hesitancy and increased urinary frequency, and mild fatigue

Other Meds:

Current Illness:

ID: 0938573
Sex: F
Age: 62
State: IN

Vax Date: 01/10/2021
Onset Date: 01/12/2021
Rec V Date: 01/12/2021
Hospital:

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

Lab Data:

Allergies: IV Contrast Dye (iodine) Sulfa Methelprednisone

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

Symptoms: I have a knot the size of a quarter that is raised, red and hot. My upper arm is sore and woke me several times during the night when I rolled on it.

Other Meds: Keppra Plaviix Nexium Simvastatin

Current Illness:

ID: 0938574
Sex: F
Age: 74
State: CA

Vax Date: 01/07/2021
Onset Date: 01/08/2021
Rec V Date: 01/12/2021
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: Dust, Mites

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

Symptoms: Pt started experiencing severe temperature night of 1/08/2021 with chills very fatigue. Severe all over the body.

Other Meds: Not aware

Current Illness: Mild GI upset Tested Postive COVID I'm December

ID: 0938575
Sex: F
Age: 34
State: CO

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 01/12/2021
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: Latex Avocado

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: 40 minutes after the vaccine administration, I experienced numbness on the right side of my face. Around my eye, to the side of my nose and around my mouth, only on the right side. Also on the right side of my tongue. This resolved after an hour and a half. It reoccurred about 6 hours later, at 4:00 p.m. . And continued for 48 hours. 12 hours post vaccine, a fever as high as 102 degrees Fahrenheit, severe body aches targeting especially the lower extremities, and chills occurred. The fever and chills lasted 24 hours. The body ach es lasted 48 hours.

Other Meds: None

Current Illness: None

ID: 0938576
Sex: F
Age: 22
State: NJ

Vax Date: 01/06/2021
Onset Date: 01/09/2021
Rec V Date: 01/12/2021
Hospital: Y

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

Lab Data:

Allergies: All seafood

Symptom List: Pharyngeal swelling

Symptoms: Back pain, bilateral PE and DVT

Other Meds: None

Current Illness: None

ID: 0938577
Sex: F
Age: 48
State: TN

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 01/12/2021
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: facial swelling, temporary loss of vision in one eye

Other Meds:

Current Illness:

ID: 0938578
Sex: F
Age: 60
State:

Vax Date: 12/16/2020
Onset Date: 12/18/2020
Rec V Date: 01/12/2021
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:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: endoscopy

Other Meds:

Current Illness:

ID: 0938579
Sex: F
Age: 54
State: MI

Vax Date: 12/29/2020
Onset Date: 12/30/2020
Rec V Date: 01/12/2021
Hospital:

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

Lab Data:

Allergies: nka

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

Symptoms: headache within 4 hours (not severe) arm pain (site of injection within 4 hours) lasted through 12/30 next morning - chills, muscle pains (sharp/fast) entire day 12/30 fatigue entire day 12/30 skin hurt (especially in shower, felt like water was burning my skin) entire day 12/30

Other Meds: Vit D Vit C Zinc

Current Illness: mo

ID: 0938580
Sex: M
Age: 45
State: ID

Vax Date: 12/29/2020
Onset Date: 01/04/2021
Rec V Date: 01/12/2021
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: n/a

Symptom List: Rash, Urticaria

Symptoms: Sharp head ache at all various times of the day. Onset is sharp and seems to go away if I rub where it hurts. As short as 30 seconds up to 30 minutes.

Other Meds: amlodopine and losartan for blood pressure

Current Illness: n/a

ID: 0938581
Sex: F
Age: 40
State: WI

Vax Date: 01/11/2021
Onset Date: 01/11/2021
Rec V Date: 01/12/2021
Hospital:

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

Lab Data:

Allergies: TramadolShortness Of Breath Belsomra [Suvorexant]Other (See Comments) Imitrex [Sumatriptan]Other (See Comments) Maxalt [Rizatriptan]Other (See Comments) Reglan [Metoclopramide Hcl]Other (See Comments)

Symptom List: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: Employee immediately felt flushed. States that by 0400 the next day she awoke to fever of 102.1'F, severe body aches, chills, and lethargy

Other Meds: albuterol (PROVENTIL HFA;VENTOLIN HFA;PROAIR HFA) inhaler TAKE 3 ML (2.5 MG TOTAL) VIA HAND-HELD NEBULIZER 3 TIMES DAILY. albuterol (PROVENTIL) 5 mg/mL nebulizer solution 2 puffs into the lungs Every 6 (Six) Hours As Needed Pharmacy to di

Current Illness: None

ID: 0938582
Sex: M
Age: 40
State: GA

Vax Date: 01/11/2021
Onset Date: 01/12/2021
Rec V Date: 01/12/2021
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: Fever, chills, body ache, malaise, arthralgia I started to have these symptoms the night after I received the second dose of the vaccine. Tylenol and Advil helped. But symptoms recurred after 8 hours.

Other Meds: None

Current Illness: None

ID: 0938583
Sex: F
Age: 29
State: PA

Vax Date: 01/06/2021
Onset Date: 01/07/2021
Rec V Date: 01/12/2021
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: Herpes zoster in C2 distribution on left. Prodrome for three days starting day after vaccination with lesions developing 4th day after vaccination.

Other Meds:

Current Illness:

ID: 0938584
Sex: M
Age: 30
State:

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 01/12/2021
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: Latex

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

Symptoms: 01/08/2021 (2330): Chills and body aches came on suddenly and quickly. Tried to warm self and sleep. During the night continued to wake with body aches, chills, fever, dizziness, headache and fatigue. 01/09/2021 (0520): Spoke to Doctor and informed of symptoms. Told to take tylenol and drink lots of fluids. Medication did seem to help with body aches. Had already been drinking lots of fluids. 01/09/2021 (0730): Feeling better. Still having Fatigue and headaches. 01/09/2021 (0900): Headaches, skin tingling, flashes of chills/fever, slight body aches. Noticed a dullness to sense of taste and smell. Continued for the rest of the day. Took tylenol again. 01/10/2021 (1130): Fatigue and slight bodyaches. 01/11/2021 (1300): Slight body aches. Was tested for COVID per Rapid test per work. Negative. 01/12/2021 (0600): Only symptom remaining is very infrequent body aches when exerting myself.

Other Meds: None

Current Illness: None

ID: 0938585
Sex: F
Age: 61
State: MD

Vax Date: 01/11/2021
Onset Date: 01/12/2021
Rec V Date: 01/12/2021
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: Penicillin, Shellfish

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

Symptoms: Vaccinate: 01/11/2021 Afternoon Onset: 01/12/2021 Morning Site: Rt Deltoid Adverse Event: Upon rising from bed, arm swollen and sore. Shortly thereafter she noticed: Fluid filled blister (approx. 5 mm), at the injection site, and superficial epidermal erosion 2 - 3 inches from injection site. Ice applied and f/u visit at Urgent Care. Advised to apply neosporin and monitor site.

Other Meds: . N/A

Current Illness: N/A

ID: 0938586
Sex: F
Age: 27
State: NV

Vax Date: 12/31/2020
Onset Date: 12/31/2020
Rec V Date: 01/12/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Flushing, itch, tachycardia. Resolved within 1 hr post administration of IM Benedryl

Other Meds:

Current Illness:

ID: 0938587
Sex: F
Age: 33
State: CO

Vax Date: 12/30/2020
Onset Date: 12/31/2020
Rec V Date: 01/12/2021
Hospital:

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: I received the vaccine yesterday at 9am and I start noticing the side effects from the vaccine at midnight. I had body aches, chills, fever, and now I have a headache.

Other Meds:

Current Illness:

ID: 0938588
Sex: F
Age: 55
State:

Vax Date: 12/23/2020
Onset Date: 01/03/2021
Rec V Date: 01/12/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: covid positive pneumonia

Other Meds:

Current Illness:

ID: 0938589
Sex: M
Age: 71
State:

Vax Date: 12/19/2020
Onset Date: 12/24/2020
Rec V Date: 01/12/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Covid positive

Other Meds:

Current Illness:

ID: 0938590
Sex: F
Age: 34
State: IL

Vax Date: 01/07/2021
Onset Date: 01/08/2021
Rec V Date: 01/12/2021
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: Developed muscle aches post vaccine- symptoms resolved and colleague able to work the following day

Other Meds:

Current Illness:

ID: 0938591
Sex: F
Age: 47
State: VA

Vax Date: 12/29/2020
Onset Date: 12/31/2020
Rec V Date: 01/12/2021
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: Nka

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

Symptoms: Fatigue, fever, chills, body aches

Other Meds: Synthriod Trazadone, klonapin Effexor

Current Illness: No

ID: 0938592
Sex: F
Age: 66
State: GA

Vax Date: 12/31/2020
Onset Date: 12/31/2020
Rec V Date: 01/12/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: c/o headache shortly after receiving Covid vaccine b/p 158/87 HR 81 Pulse ox 98% monitored ee, states feeling better nor headache upon leaving clinic. b/p121/74, HR 78 02 sat 98%

Other Meds:

Current Illness:

ID: 0938593
Sex: F
Age: 44
State: TN

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/12/2021
Hospital:

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

Lab Data:

Allergies: PNC, sulfur drugs, onions, ephedrine, SSRIs, Phenergan

Symptom List: Injection site pain, Menorrhagia

Symptoms: Received the COVID-19 vaccine on 1/7/21 at 1:30pm, had diarrhea at 2:45pm, 12 hours later had involuntary muscle movements and lasted for 3 days

Other Meds: Buspar 15mg TID, Xanax 1mg TID,

Current Illness: NA

ID: 0938594
Sex: F
Age: 41
State: OH

Vax Date: 01/04/2021
Onset Date: 01/05/2021
Rec V Date: 01/12/2021
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: NKA

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

Symptoms: Unknown

Other Meds: Lasiks Cymbalta Cranberry

Current Illness: Covid and double ear infection

ID: 0938595
Sex: F
Age: 55
State: DC

Vax Date: 01/05/2021
Onset Date: 01/12/2021
Rec V Date: 01/12/2021
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: Erythromycin, some citrus fruit, Augmentin, some seafoods.

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Rash (wheals) developed at injection site and adjacent area slightly less than 1 week later than vaccine. No pruritus or pain.

Other Meds: Vitamins, Gabapentin, Estrogen, Progesterone, Chase Wind Penetrate Bone Chinese Herbal formula, Collagen, pre and probiotics.

Current Illness: Gastroenteritis (food poisoning) the night prior.

ID: 0938596
Sex: F
Age: 61
State: CT

Vax Date: 12/31/2020
Onset Date: 01/07/2021
Rec V Date: 01/12/2021
Hospital:

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

Lab Data:

Allergies: latex, unknown ingredient in bacitracin and lubricant gels (possibly Polyethylene Glycol-PEG), codeine, garlic, onions (raw)

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: In addition to the expected soreness in site of injection, there was tiredness on day 2 and some redness on day 3 on left deltoid. However, on day 8, there was a marked increase in redness, swelling, and itching similar to hives on the left deltoid. After applying 2.5% cortisone cream (prescription I had on hand) and taking Ibuprofen and Tylenol for swelling and discomfort, the symptoms subsided over the next 3 to 5 days. On day 13 there is still occasional itching.

Other Meds: Vitamin D3, multi-vitamin

Current Illness: none

ID: 0938597
Sex: F
Age: 64
State: WI

Vax Date: 01/11/2021
Onset Date: 01/12/2021
Rec V Date: 01/12/2021
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: Amoxicillin Atorvastatin Fish

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

Symptoms: dizziness, nausea, chills, fatigue, body aches.

Other Meds: Hydrochlorothiazide 25 mg SID Lisinopril 5 mg SID Atenolol 50 mg SID Rosuvastatin 5 mg SID Cinnamon Bark 500 mg Vitamin D3 1,000 units multi vitamin Potassium gluconate 595 mg

Current Illness: NA

ID: 0938598
Sex: F
Age: 77
State: TX

Vax Date: 01/07/2021
Onset Date: 01/08/2021
Rec V Date: 01/12/2021
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: 12 hours after receiving vaccination, became "delirious" temp rose to 103.+ with chills malaise, joint pain, "head hurt worse than did during active Covid + HA lasted 2 days". Temp gradually decreased to 100 over 2 days. Injection site had "fever" for 3 days still sore 5 days later PCP ordered prednisone and z-pak for symptoms

Other Meds:

Current Illness:

ID: 0938599
Sex: F
Age: 40
State: MD

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 01/12/2021
Hospital:

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

Lab Data:

Allergies: Erythromycin, Doxycycline, chlorhexidine gluconate, mango

Symptom List: Injection site pain

Symptoms: Felt heart fluttering within a few minutes after receiving vaccination. Became tachycardic with my heart rate increasing to 140s along with light headedness, nausea and dizziness.

Other Meds: Vitamins C, D, zinc, multi-vitamin

Current Illness: None

ID: 0938600
Sex: F
Age: 46
State: WA

Vax Date: 12/29/2020
Onset Date: 01/11/2021
Rec V Date: 01/12/2021
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: Swelling, redness, tender to touch, itching with distinct margins on right upper arm.

Other Meds: Lexapro 20mg qd, melatonin 10mg prn

Current Illness: none

ID: 0938601
Sex: M
Age: 66
State: KY

Vax Date: 01/07/2021
Onset Date: 01/11/2021
Rec V Date: 01/12/2021
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: nka

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

Symptoms: Patient went to ED on 1/11 and was diagnosed with Bell's Palsy. Doctor ordered eye drops and an eye patch at night.

Other Meds: Zoloft Tablet Metoclopramide Mirtazapine Midodrine Veltassa Packet Oxycodone-Acetaminophen Clopidogrel Bisulfate Renvela Senna Omeprazole Proventil

Current Illness: n/a

ID: 0938602
Sex: F
Age: 28
State:

Vax Date: 01/11/2021
Onset Date: 01/11/2021
Rec V Date: 01/12/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: Patient became pale, felt weak, dizzy. Vital signs stable, 100% O2 on Room air

Other Meds:

Current Illness:

ID: 0938603
Sex: F
Age: 33
State:

Vax Date: 01/11/2021
Onset Date: 01/12/2021
Rec V Date: 01/12/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: Chills, aching body, sweating, nausea, upset stomach/vomiting, dizziness, loud static ringing in ears while dizzy/vomiting, injection site soreness. Vomiting subsided but other side effects remain in the afternoon the day after vaccination.

Other Meds:

Current Illness:

ID: 0938604
Sex: F
Age: 49
State: NJ

Vax Date: 01/11/2021
Onset Date: 01/11/2021
Rec V Date: 01/12/2021
Hospital:

Vax Type: UNK
Manufacturer: UNKNOWN MANUFACTURER
Vax Name: VACCINE NOT SPECIFIED (NO BRAND NAME)
Lot:
Dose Series: UNK
Vax Route: SYR
Vax Site: UN

Lab Data:

Allergies:

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

Symptoms: Pain in left arm began within 30 min. of injection and has lasted over 24 hours with radiation down into elbow, wrist, hand and fingers.

Other Meds:

Current Illness:

ID: 0938605
Sex: F
Age: 53
State: LA

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/12/2021
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: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: Severe Pain to entire arm. Described as "Nerve Pain". States Kept he awake all night and experienced tingling to hand and arm

Other Meds:

Current Illness:

ID: 0938606
Sex: F
Age: 37
State: NC

Vax Date: 12/31/2020
Onset Date: 01/08/2021
Rec V Date: 01/12/2021
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: Nuts and eggplants

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Received the vaccine on 12/31/20 at 1535 on the left arm. Swollen lymph node start on Friday 01/08/20 evening, around 2030 notice a lump on the left under armpit while doing self-breast exam during showering. On 01/09/20 the swollen increase, on 01/10/20 - 01/11/20 the swollen feel every painful, difficult, and comfortable when resting the left arm down, it feels like a golf ball under the armpit. Felt numbness and tingling on the left arm, hand and fingesr. On 01/12/20 lymph node still swollen, but less painful, with less numbness and tingling. Home treatment: Elevated the left arm while applying a warm compress and OTC Tylenol.

Other Meds: none

Current Illness: none

ID: 0938607
Sex: F
Age: 57
State: MT

Vax Date: 01/09/2021
Onset Date: 01/10/2021
Rec V Date: 01/12/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Fever, Headache, body aches, fatigued

Other Meds:

Current Illness:

ID: 0938608
Sex: F
Age: 57
State: IA

Vax Date: 01/04/2021
Onset Date: 01/08/2021
Rec V Date: 01/12/2021
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: no

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

Symptoms: I was extremely tired, I had a queasy stomach and a headache. This lasted approximately 48 hrs

Other Meds: Venlafaxine, levothyroxine

Current Illness: no

ID: 0938609
Sex: F
Age: 36
State: AZ

Vax Date: 01/11/2021
Onset Date: 01/12/2021
Rec V Date: 01/12/2021
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: Right arm pain (injection site), nausea, chills

Other Meds:

Current Illness:

ID: 0938610
Sex: F
Age: 46
State: NJ

Vax Date: 01/04/2021
Onset Date: 01/05/2021
Rec V Date: 01/12/2021
Hospital:

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

Lab Data:

Allergies: Augmentin, erythromycin, doxycycline

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

Symptoms: #2 vaccine on 1/4. She had side effects beginning that night, started with HA, body aches, fatigue, scratchy throat. Over next 2 days pain back of legs, which then evolved into burning and then numbness of palms of hands, soles of feet. Reported to me on 1/8. Over last 3 days, she has had slow improvement with slight tingling and numbness fingers. Over weekend, I had her get tested for COVID - both rapid and PCR neg. She went to ED for testing, and they also ran CT head and labs -- negative. She made appt with neurologist today and will follow up with her PCP. Testing for COVID was to rule out as cause for peripheral neuropathy. Might be due to vaccine vs some other undiagnosed condition including autoimmune. Due to the unique nature of this complaint, may be considered Adverse Reaction

Other Meds: Advair diskus Loestrin 24Fe

Current Illness:

ID: 0938611
Sex: F
Age: 78
State: MO

Vax Date: 01/11/2021
Onset Date: 01/12/2021
Rec V Date: 01/12/2021
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: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: Patient's husband called today 1/12/2021 after receiving her 2nd dose of shringrix vaccine on 1/11/2021. Patient reported headache, chills, no fever, and normal pulse. Patient also reported having a sore arm but denied redness and warmth. Patient had these same symptoms after the first dose but reported these symptoms are worse than the first dose. Patient was counseled to take ibuprofen or Tylenol to help with symptoms. Patient was directed to call back or contact doctor if symptoms do not improve.

Other Meds:

Current Illness:

ID: 0938612
Sex: F
Age: 30
State: OK

Vax Date: 01/10/2021
Onset Date: 01/12/2021
Rec V Date: 01/12/2021
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: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: Multiple near syncopal episodes. SVT runs and other arrhythmia. Symptoms lasted approximately 45 min- 1 hour. Tiredness and repetitive yawning lingered for another hour. Treatment: vagal maneuver, water, and apple Juice.

Other Meds: Synthroid Vyvanse

Current Illness: None

ID: 0938613
Sex: F
Age: 28
State: MA

Vax Date: 01/11/2021
Onset Date: 01/11/2021
Rec V Date: 01/12/2021
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: Allergy to reglan

Symptom List: Vomiting

Symptoms: ?Moderna COVID-19 Vaccine EUA Started to experience headache, fatigue, muscle aches, and nausea the day after the vaccine

Other Meds: Lamictal, cymbalta, rexulti, seasonique, zyrtec

Current Illness: None

ID: 0938614
Sex: F
Age: 32
State: IL

Vax Date: 01/07/2021
Onset Date: 01/08/2021
Rec V Date: 01/12/2021
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: Latex, Sulfonamides

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Developed muscle aches post vaccine- symptoms resolved

Other Meds:

Current Illness:

ID: 0938615
Sex: F
Age: 54
State: TX

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/12/2021
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: Crab Meat

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

Symptoms: Patient began to grow faint and lost color in her face. She was immediately taken into the evaluation room and the paramedics on scene found that she was having palpitations, pvc's and nausea. They stabilized her and transferred her to the hospital where she would be further evaluated by the hospital.

Other Meds:

Current Illness:

ID: 0938616
Sex: F
Age: 44
State: TX

Vax Date: 12/22/2020
Onset Date: 12/23/2020
Rec V Date: 01/12/2021
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: Body aches, temperature 99.5, weak, dizzy, chills, fatigue, upper chest congestion, nausea, upset stomach

Other Meds: None

Current Illness: None

ID: 0938617
Sex: F
Age: 41
State: PA

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/12/2021
Hospital:

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

Lab Data:

Allergies: Unknown. Been unable to diagnosis a specific allergy but I suffer from chronic hives. Currently on xolair monthly injections.

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

Symptoms: My mouth became tingly approximately 15min after injection. My throat felt weird and mucus was forming in there. Had to clear it a lot . Felt itchy and flushed on my aroma and neck. Took two Benadryl but it didn?t really do much.

Other Meds: Biotin, vitamin d, super cleanse, benefiber, xolair injection

Current Illness:

ID: 0938618
Sex: F
Age: 57
State: GA

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 01/12/2021
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: contrast dye's egg intolerance morphine sensitivity

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

Symptoms: I had light itching of my extremeties, red blotches on my face, bottom lip tingling. Nothing major

Other Meds: Trulicity .75 mg/1x per week Metform 1000 mg 2x/day Plant based multi-vitamin vitamin D3 vitamin B1 Magesium, Calcium citrate Red Rice Yeast

Current Illness: none

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm