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: 1147440
Sex: M
Age: 30
State: MI

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

Lab Data:

Allergies: some shampoos and fragrances

Symptom List: Dysphagia, Epiglottitis

Symptoms: A dull to pounding headache depending on motion and light, a little tightness of breath/mucus feeling, and intense vivid dreams that night

Other Meds: duloxetine

Current Illness: asthma

ID: 1147441
Sex: M
Age: 53
State: KS

Vax Date: 03/22/2021
Onset Date: 03/28/2021
Rec V Date: 03/30/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: penicillin

Symptom List: Anxiety, Dyspnoea

Symptoms: About one week after vaccination, patient had acute onset of severe multiple joint pains and calf pain to the point of inability to walk and was found to have ESR above 140. He does have history of chronic severe gout and rheumatoid arthritis, is not on immunosuppression, and reported he had not had similar episodes in the past. He was admitted to the hospital overnight and given IV solumedrol with marked improvement.

Other Meds: Vitamin C, Pantoprazole, sertraline, pravastatin, lurasidone, potassium, magnesium, hydrocodone-acetaminophen, glipizide, amlodipine, allopurinol, indomethacin

Current Illness:

ID: 1147442
Sex: M
Age: 43
State: NY

Vax Date: 03/10/2021
Onset Date: 03/18/2021
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: Amoxicillan, Biaxin

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

Symptoms: ITCHY RASH FEET, LOWER LEGS, HANDS AND ARMS.

Other Meds: Fish Oil, Multivitamins, Flonase, Vitamin D

Current Illness: na

ID: 1147443
Sex: M
Age: 23
State: GA

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: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data:

Allergies: cefzil

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Took vaccine at 3:05pm on 3/27/2021. At 11:30pm started symptoms of site pain injection in left arm. Also started to feel flu-like symptoms. On the 28th he had really bad flu-like symptoms and could not walk or move without muscle pain and weakness, overall malaise, arm hurt too much to move or touch, migraine, swelling in left arm at injection sight, slept 24 hours almost completely other than to urinate, fever of 102.3. The following day, 3/28/2021, still had same symptoms but not as severe and was able to drink some fluids. On 3/29/2021, he was able to eat and drink but slept a good portion of the 24hrs. On 3/30/2021, fever gone, can move around some, eating and drinking improved, flu-like symptoms mild. Still slept a lot.

Other Meds: Vyvanse, aklief, propanolol, melatonine, lamictal, hydroxyzine, guanfacine, escalopram, doxepin, fiorcet

Current Illness: none

ID: 1147444
Sex: F
Age: 25
State: VA

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: Vancomycin

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

Symptoms: Client complained of "tongue feeling tight" and "metallic taste" approximately 15 minutes after 2nd COVID vaccine injection. She was assessed, had no other symptoms - no SOB, no itching, no chest pain, etc. She waited in the clinic area over an hour after she was provided Benadryl liquid 25 mg po. She sat quietly reading a book and was able to drink a bottle of water. Per nurse's recommendation, her sister presented to the office to escort her home. She left the office walking and talking without any problems. BP prior to leaving the office was 126/89, pulse 85.

Other Meds:

Current Illness:

ID: 1147445
Sex: M
Age: 36
State: AZ

Vax Date: 03/25/2021
Onset Date: 03/26/2021
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:

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

Symptoms: Extreme fatigue. I?ve been sleeping double my normal amount of hours each day and still feel like I need more sleep. Body temperature feels high although my skin feels cool to the touch

Other Meds:

Current Illness:

ID: 1147446
Sex: F
Age: 37
State: GA

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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Chocolate Nutra shake

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Twelve Moderna vaccines were given in office today. Only 11 were drawn up this morning and the 12th dose was, most likely, a left over dose from yesterday. After incident was discovered, Moderna manufacturer was contacted per CDC recommendation. (Case #: MOD21-060693). Patient notified of the below message: The Moderna Vaccine Patient received may have been outside of the 6 hour thaw recommendation. We contacted the Moderna manufacturer and CDC. At this time, there are no recommendations for revaccination. Patient will still receive your 2nd dose as previously scheduled. Titers will be available at no cost in 2-3 months after your second vaccine.

Other Meds: acetaminophen (TYLENOL) 650 MG CR tablet b complex vitamins (B COMPLEX 1) tablet benztropine (COGENTIN) 1 MG tablet divalproex (DEPAKOTE) 250 MG delayed release EC tablet fLUoxetine (PROZAC) 10 MG capsule ibuprofen (MOTRIN) 600 MG tablet ke

Current Illness: none

ID: 1147447
Sex: F
Age: 62
State: IN

Vax Date: 03/18/2021
Onset Date: 03/20/2021
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: Pharyngeal swelling

Symptoms: swelling, redness, and rash at injection site

Other Meds:

Current Illness:

ID: 1147449
Sex: F
Age: 29
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: N/A

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: - Fever - Aches - Chills - Headache - Tired - Sore Arm - Nauseas

Other Meds: - Allegra - Breo Disk

Current Illness:

ID: 1147450
Sex: F
Age: 38
State: MA

Vax Date: 03/21/2021
Onset Date: 03/29/2021
Rec V Date: 03/30/2021
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: None

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Day two- small red bump, skin painful to light touch and then subsided over the next few days. Day 9 red bump appeared and gradually grew larger, lump felt under the skin, itchy rash around red bump.

Other Meds: Lexapro, omeprazole

Current Illness: None

ID: 1147451
Sex: F
Age: 64
State: FL

Vax Date: 03/26/2021
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: Sulfur allergies

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

Symptoms: Sweats, chills, lower back pain, weak, sleeping all day, diarrhea, feverish feeling in left arm.

Other Meds: Metformin, Paxil, Lisinopril, Suboxone

Current Illness: Sore throat, swollen glands, body aches

ID: 1147452
Sex: F
Age: 42
State: CT

Vax Date: 03/29/2021
Onset Date: 03/30/2021
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: No

Symptom List: Rash, Urticaria

Symptoms: Hot hive-looking red spot at injection spot, severe body aches, severe chills, severe headache, fatigue, dizziness, skin pain, back and neck pain, stiff neck, severe pain on entire left arm

Other Meds: Armour Thyroid, Alleve, Advil

Current Illness: No

ID: 1147453
Sex: U
Age:
State:

Vax Date: 03/27/2021
Onset Date:
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: 2nd dose Moderna patients were given dose one day earlier/outside of the CDC-recommended window due to calculation error when appointments were scheduled on prior system we were using. Number of patients affected unknown due to the fact that we are now using a new appointment system.

Other Meds:

Current Illness:

ID: 1147454
Sex: F
Age: 45
State: WI

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: 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: Hives in throat, treated with 10mg Zyrtec

Other Meds: n/a

Current Illness: n/a

ID: 1147455
Sex: M
Age: 61
State: CA

Vax Date: 03/01/2021
Onset Date: 03/28/2021
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: None

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

Symptoms: Developed mile flu like symptoms on Sunday night at 9:30 - chills, muscle aches, fatigue. Spent Monday in med. Feeling normal, if a little weak, on Tuesday morning. (Today.)

Other Meds: None

Current Illness: Mild asthma.

ID: 1147456
Sex: M
Age: 51
State: CA

Vax Date: 03/09/2021
Onset Date: 03/10/2021
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: Per pt c/o intermittent feeling of feeling hot lasted 5 minutes and lasted for 2 days. Only occurred 2 times. 1 episode 3/10/21 the other episode 3/11/21 then subsided.

Other Meds: Vitamin D Vitamin B12

Current Illness: None

ID: 1147458
Sex: F
Age: 36
State: MA

Vax Date: 03/01/2021
Onset Date: 03/16/2021
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: Bananas, Novocain

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

Symptoms: Rash on feet, legs, thighs, and forearms and painful calves cramps while standing and walking. Started Prednisone on Tuesday March 16th until April 2dn. 4x/4days, 3x/4days, 2x/4days, & 1x/4days.

Other Meds: Pro air inhaler, Multivitamins

Current Illness:

ID: 1147459
Sex: F
Age: 27
State: NY

Vax Date: 03/08/2021
Onset Date: 03/12/2021
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: peanuts, tree nuts, mustard, propylene glycol, limonene, linalool, dust, pollen, grass, trees

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Approximately 30-45 minutes after consuming a dessert that had coconuts, I started having an allergic reaction. While coconuts are tree nuts, I've never had an allergic reaction to them. My face and neck were very red and dotted but weren't raised like traditional hives. They looked more like petechiae. I started coughing and my lips started to swell mildly but this reaction didn't match the speed, severity, or overall symptoms of past experience with analyphylaxis to peanuts (which required 3 shots of epinephrine at urgentcare). After I realized I was having a reaction, it took another 45 minutes to get to a to get and take benadryl (was on vacation at the time). I was lightheaded and lost my balance and while I wasn't personally concerned my friends urged me to go to the hospital to get checked out. I was given steroids in pill form and put under observation for about 3-4 hours then released with a prescription for an epipen and 5 days of steroids. Several days after this ordeal I had an endometriosis flare up (which I expected post vaccine) as well as migraines and mental fog that lasted for about a week. I also experienced significant hair fall that week as well.

Other Meds: vyvanse, adderall, lamicatal, claritin, biotin, b5, zinc, magnesium, melatonin

Current Illness:

ID: 1147460
Sex: M
Age: 69
State: MI

Vax Date: 01/27/2021
Onset Date: 01/28/2021
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:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Increased volume and consistency of ringing (tinnitus)in both ears

Other Meds: Glucosamine/Chondroitin/MSM, NAC, Multi vitamins, Red yeast rice

Current Illness:

ID: 1147461
Sex: F
Age: 65
State: IA

Vax Date: 02/24/2021
Onset Date: 03/01/2021
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: Allergic to: Topamax/topiramates; Codeine (but not Vicodin); Gluten/Wheat (celiac disease); Zinc ricinoleate (topical in some deodorants)

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

Symptoms: Incidence of tinnitus: volume increased in evening/night; occurrences increased from evening/night only to during day as well.

Other Meds: MEDS: ESTRADIOL Estradiol/Climara .05 patch; FLUOXETINE HCL 35 MG; Metformin 2000 mg; Famotidine 20 mg; Lisinopril HCTZ 10/12.5 mg; TOVIAZ 2 mg; Ezetimibe + simvastatin 10/20 mg; Zyrtec/cetirizine 10 mg; zolpidem ER 12.5 mg PRN; SUPPLEMEN

Current Illness: None, although mild tinnitus already present (in late evenings)

ID: 1147462
Sex: F
Age: 61
State: IN

Vax Date: 03/09/2021
Onset Date: 03/09/2021
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: Cortisone

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

Symptoms: Lips were red and sunburned like with pain. Following day, fever blisters broke out. (common when my lips get sunburned). Treated with Carmex at onset and they went away in a couple days, fairly quickly.

Other Meds: Buproprion,

Current Illness: None

ID: 1147463
Sex: M
Age: 43
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Unevaluable event

Symptoms: Twelve Moderna vaccines were given in office today. Only 11 were drawn up this morning and the 12th dose was, most likely, a left over dose from yesterday. After incident was discovered, Moderna manufacturer was contacted per CDC recommendation. (Case #: MOD21-060693). Quality was also notified. Patient notified with The Moderna Vaccine you received may have been outside of the 6 hour thaw recommendation. We contacted the Moderna manufacturer and CDC. At this time, there are no recommendations for revaccination. You have received your 2nd dose as previously scheduled. Titers will be available at no cost in 2-3 months after your second vaccine.

Other Meds: lisinopriL (ZESTRIL) 10 MG tablet

Current Illness: none

ID: 1147464
Sex: F
Age: 47
State: OK

Vax Date: 03/01/2021
Onset Date: 03/08/2021
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: Eggs

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

Symptoms: Itching and redness all over including throat

Other Meds: Ventolin, escitalopram, atorvastatin, olmesartan, verapamil and metformin

Current Illness: None

ID: 1147465
Sex: F
Age: 38
State: NY

Vax Date: 12/31/2020
Onset Date: 02/09/2021
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: None

Symptom List: Injection site pain, Pain

Symptoms: I received my first Moderna COVID-19 vaccine on 12/31/20 at hospital. after my first vaccination I noticed that I was experiencing tinnitus intermittently in both ears. I received my second vaccination on 1/28/2021 at Hospital . At the beginning of February I noticed itching and some swelling and redness on my toes in both feet. I used over the counter lotrimen cream for two weeks with no improvement. I started using over the counter hydrocortisone cream which helped relieve the itching but the swelling was not improving and I developed red ulcers on my toes bilaterally and it became painful to walk. I went to an urgent care facility on 3/9. The physician at the urgent care facility expressed concern that I could have a vascular issue and referred me to a vascular surgeon. She also referred me to a podiatrist. She prescribed me a course of prednisone which I started on 3/10/2021 and completed. I saw the vascular surgeon on 3/11/2021 and was diagnosed with Raynauds Disease. The MD informed me that I had the beginning stages of Gangrene on my toes and prescribed me nifendrine 30 mg extended release daily. I consulted with a podiatrist on 3/11/2020 who noted that she agreed the symptoms on my toes were vascular in nature. She stated she has seen an increase of patients seen with ulcers recently. I am still experiencing intermittent tinnitus and still have symptoms in my toes that are better with medication, but not resolved.

Other Meds: Diazapam

Current Illness: Insomnia

ID: 1147466
Sex: M
Age: 62
State: CO

Vax Date: 03/16/2021
Onset Date: 03/23/2021
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: Sulpha, ciprofloxacin, Flu vaccine

Symptom List: Injection site pain, Menorrhagia

Symptoms: Starting on 03/23/2021 I started experiencing ringing and some pressure in both ears. The ringing is constant and a 6 on a scale of 1-10. I have never experienced constant ringing (Tinnitus) before. I am very healthy with no medical conditions.

Other Meds: None

Current Illness: None

ID: 1147467
Sex: M
Age: 37
State: TX

Vax Date: 03/05/2021
Onset Date: 03/09/2021
Rec V Date: 03/30/2021
Hospital: Y

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: I went to the ER on 3/9 and was diagnosed with Diverticulitis. I was given some IV antibiotics and then at home antibiotics treatment for 10 days. I developed further complications 3/24 and spent three nights in the hospital receiving IV antibiotics and fluids. I'm back at home on another week long regimen of antibiotics.

Other Meds: None

Current Illness: None

ID: 1147468
Sex: M
Age: 33
State: VA

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

Lab Data:

Allergies: pt denied

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Vaccinator administered vaccine using a vanish point needle. Needle malfunctioned and some vaccine came out around needle. Vaccinator estimates that more than 1/2 of vaccine was administered to patient. No additional vaccine was given.

Other Meds: pt denied

Current Illness: pt denied

Date Died: 03/15/2021

ID: 1147469
Sex: M
Age: 91
State: MN

Vax Date: 03/05/2021
Onset Date: 03/15/2021
Rec V Date: 03/30/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Patient was hospitalized and died within 60 days of receiving a COVID vaccine series

Other Meds:

Current Illness:

ID: 1147470
Sex: F
Age: 70
State: FL

Vax Date: 03/11/2021
Onset Date: 03/11/2021
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: Penicillin.

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

Symptoms: Got the vaccine, her arm didn't hurt to touch, but if she moved it the pain was terrible. The evening of the vaccine she started to feel achy, deep down in her muscles. She was extremely tired, sick to her stomach and headache for 4 days. She had a fever, and actually had chills, her hands were trembling. By Sunday 3/14/21 subsided now, but the headache, achiness, and other symptoms stayed until Monday. She is still achy and tired after almost 3 weeks. She took Advil or Tylenol for the reaction. The fever ranged from 100 - 101 sporadically at different times, which lasted for about a day and a half. Due to this reaction she has decided not to have the 2nd vaccine.

Other Meds: Losartan, Estradiol, Metoprolol ER succinate.

Current Illness: None.

ID: 1147471
Sex: F
Age: 49
State: FL

Vax Date: 03/11/2021
Onset Date: 03/11/2021
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: aspirin, penicillin

Symptom List: Nausea

Symptoms: day 1; Soreness in injection site. Slight dizziness at 3:00pm; chills and headache at 8:00 with night sweats all night long. day 2; chills and headache all day. Right hip and back pain started at 5:00pm. Noticed bruise in injection site at about 4:00pm. day 3: nausea at 8:00am and 11:15 am; knee and back pain + fatigue started at 11:00 am. Left eye pain at 11:08. Chills all day. Symptoms resolved completely on day 4 at 3:00pm. Soreness in injection site with bruise lasted 8 days.

Other Meds: Tylenol after vaccination.

Current Illness:

ID: 1147472
Sex: F
Age: 63
State: NJ

Vax Date: 03/14/2021
Onset Date: 03/14/2021
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: No

Symptom List: Injection site pain

Symptoms: I felt fine but arm got sore, 2-3 hours later I started having a tingling in hands and feet and that was all that I had, it also ran up my legs at one point but that stopped.

Other Meds: No

Current Illness: No

ID: 1147473
Sex: F
Age: 54
State: MI

Vax Date: 03/17/2021
Onset Date: 03/25/2021
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: Animal dander Dust Mold

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

Symptoms: On the 8th day after receiving the 1st shot the injection site was: itching, round area that was red/rash, warmer than other areas, slight swelling/tightness. Lasted 2.5 days

Other Meds: Omeprazole Nortriptyline Tylenol

Current Illness: None

ID: 1147474
Sex: M
Age: 24
State: GA

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: IM
Vax Site: RA

Lab Data:

Allergies: all denied

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

Symptoms: Pt observed another pt having reaction and stated to provider, "I think I am freaking out." He stated that his chest felt tight. He denied any itching, rash, difficulty breathing, SOB, numbness/tingling. EMT/medics were on site and immediately responded to pt. Initially pt was diaphoretic with thready pulse. Vitals were pulse 54-62, blood pressure 100 palpabale, pulse ox 92-98, respirations 24. Pt was safely transferred to the floor where vitals were observed for 15 minutes lying supine with feet elevated. Continued stable in ranges stated ablve. He was then transferred to sitting position safely and then to standing position safetly. His vitals were continuously observed for the next 30 minutes by medical/EMT. Pt was able to ambulate freely at time of discharge and denied any advserse effects

Other Meds: N/A

Current Illness: all denied

ID: 1147475
Sex: F
Age: 63
State: MA

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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: Bitter taste in mouth when eating; metallic taste.

Other Meds:

Current Illness:

ID: 1147476
Sex: F
Age: 60
State: NY

Vax Date: 03/19/2021
Onset Date: 03/26/2021
Rec V Date: 03/30/2021
Hospital: Y

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: Cerebellar ataxia, fever 103, severe headache 10 days after covid vaccine.

Other Meds: none

Current Illness: none

ID: 1147477
Sex: F
Age: 54
State: GA

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 03/30/2021
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: unknown

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

Symptoms: Chest pain and pain radiating from L arm to neck. Pt. transported to the ER on 03/15/2021 and ER stated that reaction was inflammatory process from the vaccine per school nurse.

Other Meds: Unknown

Current Illness: unknown

ID: 1147478
Sex: M
Age: 76
State: AZ

Vax Date: 01/30/2021
Onset Date: 02/04/2021
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: Sulfa, Ibuprofen

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

Symptoms: Severe tinnitus in both ears beginning shortly after first dose and continuing to this date. difficulty sleeping and concentrating with this condition. Prednisone burst has not affected the severity. Able to sleep somewhat with 2 Gabapentin capsules. Blood pressure under control with Ramipril. Tried acupuncture with negative results. I have seen many other reports of this side effect.

Other Meds: Lisinopril, Acyclovir, Tamsulosin, Vit C, Vit D, Vit B12

Current Illness: None

ID: 1147479
Sex: F
Age: 50
State: KS

Vax Date: 03/26/2021
Onset Date: 03/27/2021
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: Asthenia, Chills, Headache, Myalgia

Symptoms: Day 1- fever, chills, aches, dizziness, nausea, fatigue Day 2- aches, dizziness, nausea, fatigue Day 3- slight nausea, extreme fatigue* Day 4- slight nausea, extreme fatigue * Slept 20 out of 24 hours day 3-4 and still fatigued

Other Meds: Hydrochlorothiazide 12.5 mg Escitalopram 20 mg Methylphenidate ER 54 mg Bupropion HCl XL 150 mg Nature?s Bounty hair, skin and nails Centrum silver

Current Illness: None

ID: 1147480
Sex: F
Age: 49
State: AZ

Vax Date: 02/01/2021
Onset Date: 03/10/2021
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: PNC, Bactrum/Sulfa drugs. No know food allergies

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

Symptoms: Approx. 9-10 days post #2 maderna Vaccine, I broke out in Hives on the back of both upper arms, and entire back, I work at a dermatology office. One of the Physicians had his M.A. administer a Kenalog inj.- in my Glute. It did not help at all. Was prescribed a cream, triamcinilone, it did not help. I stopped taking ANY and ALL medications and Vitamins as of 2/25/21. It has been over 4 weeks- The hives have now spread to my buttox and down the back of my thighs, The hives are worsening on my back and are moving to the front of my abdomen and on breast. Again my physician gave me a kenalog shot yesterday 3/29/21 5 weeks after the 1st one. I have been on high doses of benadryl and antihistamines. NOTHING is working! I am miserable and now have worry and anxiety.

Other Meds: hydrocodone 7.5, Bijuva, Hydroxazine 25 mg, Vit. C, Vit. D3, Zinc

Current Illness: None

ID: 1147481
Sex: F
Age: 45
State: CA

Vax Date: 01/08/2021
Onset Date: 01/08/2021
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: no

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

Symptoms: In the evening - I had a mild headache and chills; And had generalized joint pain and soreness on the arm on Saturday and Sunday. Those all continued for a few days and then that resolved. Shortness of breath and chest pain started 10 days after - they lasted for about a week and they resolved simultaneously. I went to my doctor and he did some tests. Everything was normal. No treatment except diet and exercise.

Other Meds: Zyrtec; Omeprazole

Current Illness: no

ID: 1147482
Sex: F
Age: 73
State: GA

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

Lab Data:

Allergies: None

Symptom List: Pain in extremity

Symptoms: Twelve Moderna vaccines were given in office today. Only 11 were drawn up this morning and the 12th dose was, most likely, a left over dose from yesterday. After incident was discovered, Moderna manufacturer was contacted per CDC recommendation. (Case #: MOD21-060693). Patient called with: The Moderna Vaccine you received may have been outside of the 6 hour thaw recommendation. We contacted the Moderna manufacturer and CDC. At this time, there are no recommendations for revaccination. You will still receive your 2nd dose as previously scheduled. Titers will be available at no cost in 2-3 months after your second vaccine.

Other Meds: amiodarone (PACERONE) 200 MG tablet amLODIPine (NORVASC) 5 MG tablet aspirin 81 MG chewable tablet atorvastatin (LIPITOR) 40 MG tablet HISTORICAL MEDS AND SUPPLIES hydroCHLOROthiazide (HYDRODIURIL) 25 MG tablet losartan (COZAAR) 100 MG tabl

Current Illness: None

ID: 1147483
Sex: M
Age: 62
State: IN

Vax Date: 03/28/2021
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: 2
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: Achy, joint pain, nausea , headache

Other Meds: Alflusozin Atorvastatin Finestiride

Current Illness:

ID: 1147485
Sex: M
Age: 60
State: MA

Vax Date: 03/29/2021
Onset Date: 03/30/2021
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: Sulpha

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

Symptoms: A headache starting 4 AM Treated with 600MB Ibuprofen and later with 1000mg Tylanol Extra water

Other Meds: Simvastatin 40mg, lisiprinol 5mg, turmeric 750 mg

Current Illness: None

ID: 1147486
Sex: M
Age: 65
State: AS

Vax Date: 02/14/2021
Onset Date: 03/14/2021
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: no known drug or food allergies

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

Symptoms: No effects after first injection other than sore arm at injection site. 2nd injection at 11:30 a.m., onset of symptoms started at 9:30 p.m. - Chills, shakes ... lasted about 1 hour + - body aches, headache ..slower onset, about 10:30 p.m., lasted until midmornign next day, i.e., about 24 hours after injection. - General fatigue and residual headache persisted until following morning, 2/15 - Fully recovered by 2/15 12:00 p.m.

Other Meds: amlodipine; montelukast, Advair, Spiriva

Current Illness: none

ID: 1147487
Sex: M
Age: 25
State: CA

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

Lab Data:

Allergies: none

Symptom List: Vomiting

Symptoms: Patient started dry heaving. Could not stop. Then started a cold sweat.

Other Meds: Lexapro, melatonin, prozosin

Current Illness: none

ID: 1147488
Sex: M
Age: 67
State: CA

Vax Date: 03/16/2021
Onset Date: 03/18/2021
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: None

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: 1st dose pain @ injection site 9 hours later. 2 days later, chills, muscle pain, headache( mild) diarrhea.

Other Meds: Atorvastatin,

Current Illness: None

ID: 1147489
Sex: F
Age: 55
State: IN

Vax Date: 03/19/2021
Onset Date: 03/26/2021
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: Back pain, Cold sweat, Headache, Nausea, Vomiting

Symptoms: 3 inch knot, redness and itching at injection site one week after receiving vaccine.

Other Meds:

Current Illness:

ID: 1147490
Sex: F
Age: 53
State: MA

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: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Pt received covid19 vaccine. Pt was waiting in observation area for about 10 minutes when she began complaining of itchy dry throat, ears ringing, light headed. EMS responded to evaluate. EMS notified Fire/Rescue to respond for assistance. PT began to complain of chest pain. Fire/Rescue and PT opted in for transport to emergency room.

Other Meds:

Current Illness:

ID: 1147491
Sex: M
Age: 70
State: IL

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: RA

Lab Data:

Allergies: None

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

Symptoms: Chills, headache, slight fever, sore arm, achy feeling. Chills, headache and fever began about 12 hours after injection and lasted about 2 hours. Sore arm and achy feeling lasted until following morning.

Other Meds: Simvastatin 10 mg, Cetirizine Hydrochloride Allergy, 10 mg

Current Illness: None

ID: 1147492
Sex: F
Age: 35
State: IL

Vax Date: 03/25/2021
Onset Date: 03/29/2021
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: None

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

Symptoms: I developed a cold sore on my bottom right lip. I am just treating it with over the counter cream. This sore developed on monday 3/29/21 which was 4 days after my vaccine.

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm