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: 1148586
Sex: F
Age: 64
State: GA

Vax Date: 03/22/2021
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: IM
Vax Site: LA

Lab Data:

Allergies: NKA

Symptom List: Dysphagia, Epiglottitis

Symptoms: Day 8 arm became sorer and very itchy and red

Other Meds: Synthroid, Cytomel

Current Illness: None

ID: 1148587
Sex: F
Age: 33
State: TX

Vax Date: 02/04/2021
Onset Date: 02/15/2021
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: Penicillin, amoxicillin (sensitive)

Symptom List: Anxiety, Dyspnoea

Symptoms: When I woke up on 02/15/2021 I went to the bathroom I had again the burning sensation when urinating and also I could smell a foul odor. I went to my doctor's office again on 02/19/2021 and was diagnosed with an UTI again just like the 1st dose.

Other Meds: Cypro, Prenatal, Probiotics

Current Illness: No

ID: 1148588
Sex: F
Age: 51
State: TX

Vax Date: 03/25/2021
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: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Clindamycin, PCN, Crab

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

Symptoms: severe diarrhea, moderate vomiting, moderate muscle aches, moderate joint pain

Other Meds: Wellbutrin, levothyroxine, lisinopril, zyrtec

Current Illness: None

ID: 1148589
Sex: F
Age: 67
State: CA

Vax Date: 03/05/2021
Onset Date: 03/05/2021
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: None

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Soreness, slight pain and swelling around injection site

Other Meds: Atorvastatin 20mg, Lisinopril 40mg, Amlopidine 5mg, Vit D3 25mcg, Magnesium oxide 400mg, Multivitamins

Current Illness: None

ID: 1148590
Sex: M
Age: 66
State: LA

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

Lab Data:

Allergies: nka

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

Symptoms: he started with dizziness in early morning after the vaccine. As the day went on, it got worse. He is having nausea and severe dizziness. He will call his dr. tomorrow.

Other Meds: Meclizine 25mg, Metoprolol ER100mg, terazosin 20mg, ASA 81mg, Pravastatin 40mg,

Current Illness: dizziness, hypertension

ID: 1148591
Sex: F
Age: 58
State: TX

Vax Date: 03/12/2021
Onset Date: 03/16/2021
Rec V Date: 03/30/2021
Hospital: Y

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: unknown

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

Symptoms: Was reported by the patients primary care provider that the patient experienced a stroke approximately 4 days post vaccination.

Other Meds: unknown

Current Illness: unknown

ID: 1148592
Sex: M
Age: 57
State: AL

Vax Date: 03/17/2021
Onset Date: 03/27/2021
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: Pyrexia, White blood cell count decreased

Symptoms: 9 to 10 days post vaccine: Flu symptoms for 24 hrs, Fatigue the following day with headache and sinus discomfort. Monday the 29th, worked and arrived home feeling like I may have a sinus infection. Tuesday, no headache just extreme fatigue, left work early took a 2 hr nap and feel a bit better. Lower back discomfort during this time period, discomfort urinating. Feeling of constriction but no pain while peeing.

Other Meds: D3, Super B-Complex, Multi-vitamin, Glucosamine HCI with MSM

Current Illness:

ID: 1148593
Sex: M
Age: 54
State: OH

Vax Date: 03/18/2021
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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: aware of none

Symptom List: Pharyngeal swelling

Symptoms: On 3/25/21 developed a painful rash on my left side of my chest and back that has blistered. The areas were sore like a strained muscle days before the rash started.

Other Meds: centrum silver multivitamin, low dose aspirin

Current Illness: none

ID: 1148594
Sex: F
Age: 65
State: FL

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: Patient reported urticaria, she was noted to have erythematous hives upper and lower extremities and torso. Airway clear, respirations even and unlabored, HR 101. Patient administered 25mg PO Benadryl. Vital signs @ 5:58pm BP 152/98, HR 101, O2 sat 94%, Resp 22. Patient was then observed for 10 minutes , vitals then were 125/86, HR 101, O2 sat 94%, Resp 18. Additional Benadryl 25mg PO administered at 6:19pm. Patient reevaluated at 6:30pm- Improvement noted. Reassessment completed. Patient reports she is better and no longer itching all over. Hives improved. Patient was advised to follow up with her PCP as needed. Call 911 or report to nearest ER if emergency. Patient left at 6:45pm.

Other Meds:

Current Illness:

ID: 1148595
Sex: F
Age: 26
State: WA

Vax Date: 01/06/2021
Onset Date: 01/06/2021
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: shellfish; omeprazole; Imitrex

Symptom List: Diarrhoea, Nasal congestion

Symptoms: For the first two days, I had body aches, joint pain, headache, nausea, fatigue - and third day I vomited three times - whole body aches fatigue; fifth and sixth day - whole body aches and joint pain and fatigue but no nausea. By the seventh day, I just had some slight muscle aches and slight fatigue. No treatment. By the 8th day after, the symptoms resolved.

Other Meds: no

Current Illness: no

ID: 1148596
Sex: M
Age: 16
State: MO

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

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

Symptoms: Patient did not suffer from an adverse event to our knowledge. This is an administration error. Patient was too young for the moderna vaccine (18 and up) and this was not seen until after administration and the patient left. We tried to notify patient, but the phone number given to us is disconnected. Plan to notify patient when they arrive for their next dose. Per CDC guidelines, we will offer the second dose of the vaccine to the patient and guardian at that time.

Other Meds:

Current Illness:

ID: 1148598
Sex: F
Age: 55
State: MN

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: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies: Acetaminophen Macrolides And Ketolides Sulfa Antibiotics Lidocaine Morphine Hcl Wasp Venom Protein Anesthetics, Ester Gadolinium Derivatives Adhesive Sulfamethoxazole-Trimethoprim Clarithromycin Naproxen Nystatin Cetirizine Amoxicillin Fluorescein-Benoxinate Proparacaine Eye Lubricant Oxymetazoline Doxycycline Azithromycin

Symptom List: Rash, Urticaria

Symptoms: swollen right eye, vision was blurry, lost my voice and had difficulty swallowing: these started about 3 hours in burning/itching across face, neck, head and chest: 10 minutes after injection in the first hour: continued itching, dizziness, limbs were very heavy, dry heaves Benedryl 50 mg when swelling started, 25 mg Benedryl every 4 hours through Sunday 3/28

Other Meds: minocycline levothyroxine oxybutynin famotidine (VITAMIN D-3 MIRALAX

Current Illness: none

ID: 1148599
Sex: F
Age: 25
State: TX

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: N/a

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

Symptoms: Started feeling cold and nauseous. Symptoms then proceeded to having chills, body aches, nauseous, head ache, and fever.

Other Meds: Lo Loestrin Fe

Current Illness: N/a

ID: 1148600
Sex: F
Age: 25
State: NC

Vax Date: 03/24/2021
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: Strawberry allergy

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

Symptoms: Strong, knot-like pain developed in left deltoid/injection site. No rash. No hematoma. No heat or swelling.

Other Meds: Zyrtec

Current Illness: None known

ID: 1148601
Sex: M
Age: 61
State: LA

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

Lab Data:

Allergies: Sulfa drugs

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

Symptoms: Chills, shaking, cold, sleeplessness - 12 hrs after vaccination for a period of at least two hours. Exhaustion, fatigue, diarrhea for next three days after vaccination

Other Meds: Losartan, aspirin-81mg, pregabalin, metformin, crestor

Current Illness: none

ID: 1148602
Sex: F
Age: 30
State: OH

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

Lab Data:

Allergies: Amoxicillin

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

Symptoms: 30 y/o F who 2 minutes after receiving her vaccination, she reported feeling lightheaded. She was taken to a private section of the arena and monitored.

Other Meds: None

Current Illness: None

ID: 1148603
Sex: F
Age: 52
State: TX

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: Injection site pain - resolved by day 3 post vaccination. Headache - onset on March 25, 2021, continues 7 days post vaccine. light-headedness - onset March 25, 2021, continues 7 days post vaccine. Diarrhea - March 26 (multiple bouts) Nausea - occasional - continues 7 days post vaccine

Other Meds: Pantaprazole, IB Guard, Florastor, Vitamin D 5,000 mg.

Current Illness: Seasonal allergies

ID: 1148604
Sex: F
Age: 63
State: WA

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

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Patient reported experiencing fever, severe muscle and joint pain, joint and lymph node swelling, headache, and dizziness shortly after vaccination that lasted for 4 days. Patient continues to experience pain and swelling at injection site (left arm and axillary).

Other Meds: Aspirin, clonazepam, lamitrigine, Zoloft

Current Illness: NA

ID: 1148605
Sex: M
Age: 60
State: ME

Vax Date: 03/24/2021
Onset Date: 03/30/2021
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: None

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Itching and hives on inner arm - same arm as vaccination, but not at vaccination site. No other known exposures to substances that could have caused this reaction. No prior hive reactions. Taking OTC loratadine to allieviate symptoms.

Other Meds: Levothyroxine Tamsulosin Omeprazole Cholestyramine Prevagen

Current Illness: None

ID: 1148606
Sex: M
Age: 62
State: CA

Vax Date: 02/16/2021
Onset Date: 02/17/2021
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: abacavir, adhesive tape

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

Symptoms: Following 1st dose of vaccine, patient developed skin rash on 2nd day, mild maculopapular rash on anterior chest - persisted. Following 2nd dose of vaccine, developed skin rash involving anterior chest and lower back ~ 7 days after the vaccine. Rash is pruritic, painful, raised. No fevers/chills/sweats. No oral/ophtho lesions. Still getting worse. Unable to sleep last night due to itching/pain.

Other Meds: 1) AMITRIPTYLINE HCL 25MG TAB TAKE ONE TABLET BY MOUTH AT BEDTIME 2) CETIRIZINE HCL 10MG TAB TAKE ONE TABLET BY MOUTH DAILY AS NEEDED 3) CITALOPRAM HYDROBROMIDE 40MG TAB TAKE ONE TABLET BY MOUTH AT BEDTIME 4) CYANOCOBALAMIN 100MCG

Current Illness:

ID: 1148607
Sex: F
Age: 58
State: CA

Vax Date: 03/23/2021
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: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: nsaids

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

Symptoms: hot and cold alternating chills and sweats over night 6 days after the vaccine no fever

Other Meds:

Current Illness:

ID: 1148608
Sex: M
Age: 46
State: NY

Vax Date: 01/09/2021
Onset Date: 02/02/2021
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: UNKNOWN

Symptom List: Unevaluable event

Symptoms: POSITIVE COVID SWAB 02/02/2021

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1148609
Sex: F
Age: 59
State: OH

Vax Date: 03/22/2021
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: LA

Lab Data:

Allergies: none sensitivity to gluten

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

Symptoms: I have a rash at the site where the Moderna was administered.

Other Meds: none

Current Illness: none

ID: 1148610
Sex: F
Age: 65
State: IL

Vax Date: 03/22/2021
Onset Date: 03/23/2021
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 drugs and thimersol, a preservative

Symptom List: Injection site pain, Pain

Symptoms: Large rash on arm covering a 6 inch by 2 inch area.

Other Meds: Synthroid, Vitamin B12, folate, fish oil, probiotics. Occasional Advil and Claritin

Current Illness: None

ID: 1148611
Sex: F
Age: 48
State: CA

Vax Date: 03/24/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: Allergic to shellfish

Symptom List: Injection site pain, Menorrhagia

Symptoms: Vomiting 3 days (still going) loss of feeling in legs for about half an hour (completely no feeling and unable to stand or walk then uncontrollable shaking in legs since 3/29 at 5 pm. Still shaking although less. I can walk by using furniture to balance. (3/30 at 4 pm). Profuse sweating for last 24 hours.

Other Meds: Venlafaxine, buspar, lisinopril, lamotrigine

Current Illness: None

ID: 1148612
Sex: F
Age: 62
State:

Vax Date: 02/01/2021
Onset Date: 02/01/2021
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: Sulfa/sulfi gluten

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

Symptoms: First shot was sore neck about twenty minutes after, headache a couple hours later, headache lasted until next evening and next day also had fatigue and sore muscles and was fine next day Second shot was achy,exhausted, and did not feel good until next Tuesday, I received second shot on Feb 25, 2021

Other Meds: Vitamin D, Calcium, Oregano oil

Current Illness:

ID: 1148613
Sex: F
Age: 43
State: TN

Vax Date: 03/23/2021
Onset Date: 03/25/2021
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: Sulfa, Benzoyl Peroxide and Orange allergy

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: low grade fever. Highest temperature was 100 and fell to 99.3 after hours. I had a headache and muscle aches. My skin was sore to touch and body ached to the point t I could barely walk or raise my arms over my head. The symptoms subsided after day 4.

Other Meds: none

Current Illness: None

ID: 1148614
Sex: F
Age: 55
State: NY

Vax Date: 02/04/2021
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: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Sulfa

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: I developed Bells Palsy .....left side of face. Tinnitus in right ear. AFTER 2ND VACCINE>. I have had for 5 days and hoping for a full recovery.

Other Meds: Rocaltrol, Calcium, Multi Vit, Ezetimibe

Current Illness: Reactive Arthritis. Hypo-paratyroidism

ID: 1148615
Sex: M
Age: 60
State: LA

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: RA

Lab Data:

Allergies: None

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

Symptoms: Received the 1st dose of Pfizer Covid Vaccine on 3/18/21. Patient was scheduled for and received the 2nd dose on 3/30/21. When charting the dose the nurse noticed that the dose was received early. Should have received the 2nd dose on 4/8/21. Patient stated he was going out of town next week, so scheduled it early.

Other Meds: Amlodipine Hydralazine Hydrochlorothiazide Lorazepam Meclizine Mirtazapine Omeprazole Ondansetron Trazodone

Current Illness: History of stroke (Chronic) 2/18/2021

ID: 1148616
Sex: F
Age: 63
State: FL

Vax Date: 03/19/2021
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: RA

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: PT IS ON 4TH WEEK OF XELJANZ. SHE HAD HER 1ST MODERNA COVID VACCINE 12 DAYS AGO. PT STATES THAT EVERY JOINT IN BODY ACHES. THE SEVERE PAIN SEEMS TO ROTATE AROUND JOINTS - CURRENTLY HER RIGHT HAND IS WEAK & PAINFUL THAT SHE CAN'T PICK UP OBJECTS. HER RIGHT SHOULDER/ELBOW, WHOLE ARM IS SEVERE PAIN. SHE HAS HEADACHES. SHE IS EXHAUSTED & GOES TO BED ABOUT 7:30PM. IT'S HARD TO FALL ASLEEP & THEN HARD TO GET OUT OF BED SINCE SHE CAN'T LIFT HERSELF UP (HAS TO ROLL OUT OF BED). SHE IS A GOLFER & TRIED TO GOLF THE OTHER WEEK. SHE TOOK 2 ALEVE AT START & BY THE BACK 9 HOLES HAD TO TAKE AT LEAST 2 MORE. SHE IS TAKING ABOUT 6 ALEVE TABLETS IN A 12 HOUR PERIOD RIGHT NOW TO HELP ALLEVIATE THE PAIN. SHE STATES SHE WAS NEVER IN THIS SEVERE PAIN BEFORE XELJANZ OR COVID VACCINE. PT CAN'T PINPOINT WHEN THE SEVERE PAIN STARTED - PRIOR TO OR AFTER COVID VACCINE. PROVIDED CONSULTATION AND ADVISED PT TO F/U WITH MD TOMORROW MORNING.

Other Meds: Xeljanz XR 11 mg

Current Illness:

ID: 1148617
Sex: F
Age: 66
State: CT

Vax Date: 03/22/2021
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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Injection site pain

Symptoms: Event after second Covid vaccine: mild and periodic headache for first few days. On day 5, dizziness and increased tinnitus. On days 6 and 7, fatigue, dizziness, brain fog, headache and worsening tinnitus.

Other Meds: Vit D, Calcium with D, Colace, multi vitamin for eye care, fiber, Biotin, Furosemide

Current Illness: none

ID: 1148618
Sex: F
Age: 26
State: TX

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

Lab Data:

Allergies: None. n

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

Symptoms: Moderna COVID-19 Vaccine EUA: After 24 hours of taking the second dose, I have been having side effects of: - Fatigue - Fever - chills - swelling of muscle (left arm) - Muscle aches (rest of the body) - tenderness on area

Other Meds: None.

Current Illness: None.

ID: 1148619
Sex: M
Age: 48
State: PA

Vax Date: 03/11/2021
Onset Date: 03/22/2021
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: None

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

Symptoms: 10 days following the second dosage of the Pfizer vaccine, patient developed Bell's Palsy. While we are unsure if it was related to the vaccine, we wanted to report the condition in hopes of helping others in the future.

Other Meds: Vitamin D, Vitamin C, Glucosamine/Chrondroitin, Indomethacin Er 75Mg

Current Illness: None

ID: 1148809
Sex: F
Age: 56
State: WA

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: Codeine, shrimp, cats, mold, seasonal allergies

Symptom List: Tremor

Symptoms: 20 minutes after vaccine was driving home and noticed face feeling flush. Then itching, tingling on lips eyelids and cheeks along with mild chest tightness. My husband observed that my face was visibly flushed. We drove to Hospial and parked outside the emergency room in case it got worse. I took 20 mg hydrocortisone that I have as an emergency medication for my adrenal insufficiency. We waited until one hour after I?d been vaccinated and agreed my face was less red, the itching had also decreased and decided it was safe to go home. This is the same reaction I have if I eat shrimp, my perception is that it was a mild allergic reaction.

Other Meds: Prednisone, Levoxyl, lactase, elequis, potassium, vitamin d, calcium, metformin, flecainide, diltiazem, montelukast, levalbuteral, pulmacort, dymista, econozake nitrate, benedryl

Current Illness:

ID: 1148810
Sex: M
Age: 61
State: KS

Vax Date: 12/29/2020
Onset Date: 12/30/2020
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: Erythema, Pruritus

Symptoms: Memory problems, some increase in headaches. Also issues with balance and bumping into walls. Still to not have smell or taste. These symptoms have continued for 3 months after vaccine. Initially after vaccine became acutely ill with high fevers 102-104 f. Also became severely weak with severe muscle aches and severe headaches. This lasted for 7 days with worst at the beginning. Then I have had the memory loss and equilibrium and loss of ability to spell simples words that I had no issues with before. I have had these symptoms for 3 months. I thought it would all get better but it has not. I thought I better let you know these problems. I did not want to but because they have continued I thought I better tell you.

Other Meds: Bystolic, Hydrochlorothiazide, melatonin, methotrexate, oxycodone, zolpidem

Current Illness: Covid-19 symptoms started 2 days prior to vaccine. We were given vaccine 3 weeks late and it was decided to take vaccine. Did not know until later that had covid-19.

ID: 1148811
Sex: M
Age: 29
State: NY

Vax Date: 12/21/2020
Onset Date: 02/03/2021
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: POSITIVE COVID SWAB ON 02/02/2021

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1148812
Sex: F
Age: 44
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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Unknown antibiotic

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

Symptoms: Pt states her throat and eyes feel itchy, Pt taken to traige 1. 126/81 HR 108, 02 97% RA. 3:30 pt developed blanching rash on chest and left side of neck going under chin. Pt refused Benadryl stating it makes her tired and she has an hour drive home. She received in ER when allergy to unknown antibiotic and went to sleep. pt accepted Zyrtec 15:55: pt states she feels better. Agrees to go to ED if worsens. understands to not take 2nd dose of Pfizer until discussed with PCP.

Other Meds: Vittamins

Current Illness: NONe

ID: 1148813
Sex: M
Age: 58
State: UT

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: Sulfa?s, codeine, MP6, morphine,

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Sore at site of injection. GI symptoms (watery BM), Body aches, fever of 101.5 degrees, chills.

Other Meds: Stelara, methotrexate, synthroid, benazaphril, phenergan, methadone, oxycodone (PRN)

Current Illness: Crohn?s Disease, psoriasis,

ID: 1148814
Sex: F
Age: 61
State: CA

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: SYR
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: I had an odd reaction. Approx 20min (on my way home), after the jab I began to experience tingling at the injection site (left arm) that traveled down my arm, up to my shoulder, neck, jaw, then down the entire left side of my body. This lasted most of the day. ( an hour later also felt 30min of same in my right arm elbow-hand that on lasted 20min.) Lots of fatigue for first 3 days. My neck/jaw still feels faintly like novocaine wearing off. Right now (1 week post 1st vaccine) I'm feeling coolness in left side of body & right arm from elbow to hand. It began in left side of neck. (Very weird. I've never experienced anything like it before.) I've no pain in neck, or any cervical spine issues. I do have L5 degeneration, but it's not painful (yet...) Brain-related? Do I take 2nd dose or switch to J&J at 4 weeks? Id' love to hear from someone. I've contacted Pfizer, but haven't heard back.

Other Meds: Combi-Patch 50/250 (25% cut in quarters), nothing else within 12 hours other than tea w/milk Within 24hrs/daily: 81mg aspirin, Norco 5/325, Gabapentin 300, Magnesium, D3x6000mcg, K2, Folic Acid, Turmeric, C, Benadryl, Berberine, Quercetin,

Current Illness: None

ID: 1148815
Sex: M
Age: 65
State: NY

Vax Date: 01/19/2021
Onset Date: 02/16/2021
Rec V Date: 03/30/2021
Hospital: Y

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: Penicillin (Hives), Keppra (agitation/rage)

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

Symptoms: Patient was fully vaccinated (dose 1: 1/19 dose 2: 2/16). Patient developed fatigue on 3/1 then tested positive for COVID the following day (3/2). Was self-isolating at home and did not receive any COVID therapies. He reports progressively worsening fatigue, productive cough (white sputum), loss of taste, disorientation, and poor PO intake. Patient arrived to the ED for COVID-19 symptoms (3/13), tested positive and was admitted for severe hypoxic respiratory failure due to COVID-19. Patient with AKI (creatinine =2.48) Patient escalated to HFNC then down to 6L NC to 4L then slowly weaned to RA. Received dexamethasone 6 mg daily x 10 days. Patient was admitted from 3/13 to 3/18 for COVID-19. Creatinine on discharge was 1.29

Other Meds: Tacrolimus, mycophenolate, Clopidogrel, metformin, Depakote, losartan, calcium carbonate-vitamin D3, colchicine, Cymbalta, furosemide, pantoprazole

Current Illness:

ID: 1148816
Sex: F
Age: 47
State: GA

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: IM
Vax Site: LA

Lab Data:

Allergies: n/a

Symptom List: Pain in extremity

Symptoms: On the day after the shot, I had a headache and fatigue, which I was expecting. 3 days after, I was having some feeling of being a little out of it - spaciness and some light headedness. Although I would NOT classify it as a brain fog, I am switching words around regularly. Very randomly. My dreams are INCREDIBLY vivid.

Other Meds: Citalopram (10mg/day), Protefood (Standard Process), Zypan (Standard Process), Calcium Lactate (Standard Process), Cataplex B12 (Standard Process)

Current Illness: n/a

ID: 1148817
Sex: F
Age: 65
State: VA

Vax Date: 03/25/2021
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: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: penicillin, sulfa

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

Symptoms: Saturday 03/27/ 2021, suddenly loss my hearing in both ears after6 hours recovered rt ear hearing somewhat not fully, left ear complete hearing loss.no pain just complete loss in left ear

Other Meds: alendronate sodium,desvenlafaxine er succinate,famotidine, rosuvastatin,meloxicam. multivitamin, d3, calcium, low dose aspirin.

Current Illness: none,

ID: 1148818
Sex: F
Age: 38
State: CA

Vax Date: 03/08/2021
Onset Date: 03/08/2021
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: Penicillin

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

Symptoms: Hives 6 hours after and vomiting and extreme fatigue and migraine for 2 days

Other Meds: Aripiprazole, sertraline, trazadone, nuva ring

Current Illness: None

ID: 1148819
Sex: F
Age: 71
State: AZ

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

Lab Data:

Allergies: Sulfonamides

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

Symptoms: "Mild" flu-like symptoms including fever (100.4F), chills, muscle/joint aches, tiredness. Symptoms persisted for approximately 26 hours, & were untreated except for rest. Left upper arm soreness @ injection site was also present for approx. 3 days.

Other Meds: Multivitamins

Current Illness: Osteoporosis

ID: 1148820
Sex: F
Age: 45
State: TX

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:

Symptom List: Vomiting

Symptoms: Patient report itching and hives to neck area on the right side and spreading , shortness of breath, patient was assessed by EMS, she was placed on non rebreather mask and transported to Emergency Room.

Other Meds:

Current Illness:

ID: 1148821
Sex: F
Age: 55
State: CA

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

Lab Data:

Allergies: None

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Temp 101 for 48 hours with muscle cramps for first 24 hours and weakness to follow. Unusual "chickpox" lesions on thighs started to appear after first 24 hours - not sure if it is related to fever or injection. Started to fade after 72 hours.

Other Meds: Ambien 5mg, Progesterone/Estrogen treatment (pill and patch)

Current Illness: None

ID: 1148824
Sex: M
Age: 77
State: FL

Vax Date: 03/08/2021
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:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: NKDA

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

Symptoms: On the evening after the vaccine was given, the patient stated that his right leg started to itch excessively, this was alleviated with cortisone cream. On Wednesday morning, both of his hands began to itch and that's when he called his doctor to report the issue. On Tuesday, March 30, the patient reported swelling on his lower right lip.

Other Meds: Lisinopril

Current Illness: None

ID: 1148825
Sex: M
Age: 69
State: CA

Vax Date: 02/17/2021
Onset Date: 02/19/2021
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: none

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Two days after the first Vaccine I was mowing the yard it was warm suddenly i started feeling strong sharp needle like feelings in my chest, back, shoulders , neck . I went into the shade to rest it took a couple minutes for it to subside . I checked my pulce it was at 106 and gradually went down . I have been in construction for over 45 years and have worked hard in the sun and have never expirienced this. These episodes dont just happen in the sun . When i went to get my second dose on 01/10/2021 it was warm in the building. and when the nurse asked me if i had experienced side affects and i started to explain and an episode started right then . it seems that anxiety can bring it on as well as exertion . it was coming on strong so i refused the vaccine. My dr has no answers

Other Meds: Metformin 500 mg. twice a day. Tamsulosin 0.4 mg. 1 a day. Losartan 100 mg. 1 a day. Levothyroxine 0.075 mg. 1 a day. Simvastatin 20. mg. 1 a day. Omeprazole 20 mg. 1 a day. Allerclear 10 mg. 1 a day. Fluticasone 50 mg 1 each side 1 a

Current Illness: Diabetic . High blood pressure . Thyroid . High Cholesterol

Date Died: 03/22/2021

ID: 1148826
Sex: M
Age: 95
State: IL

Vax Date: 02/26/2021
Onset Date: 03/22/2021
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: PCN

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

Symptoms: Overall Decline w/congestion and ABT tx, Hospice Care, Crisis Care, Expired

Other Meds: ProHeal, calmoseptine, acetaminophen, Naproxen, Clopidogrel, Metoprolol tartrate, Lidocaine, Vit D3

Current Illness: Congestion, Pneumonia

ID: 1148827
Sex: F
Age: 76
State: CA

Vax Date: 03/26/2021
Onset Date: 03/27/2021
Rec V Date: 03/30/2021
Hospital: Y

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

Lab Data:

Allergies: Flagyl

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

Symptoms: Presented like a stroke approximately 22 hours later - slouched, leaning sideways, breathing, but unresponsive. Called EMTs who transported her to ER where tests showed slight fever and minor dehydration

Other Meds: METFORMIN HCL 500 MG ROSUVASTATIN CALCIUM 5 MG ESCITALOPRAM 20 MG Donepezel 5 mg Vitamin D3 125 mcg + K2 100 mcg Organo Iodine drops 5 drops Body Bio PC Theracumin - hp Vital Brain Powder Glutathion CarniClear ProOmega 2000 Melatonin 5 mg

Current Illness: NONE

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm