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

Date Died: 03/22/2021

ID: 1149492
Sex: M
Age: 73
State: MN

Vax Date: 03/12/2021
Onset Date: 03/22/2021
Rec V Date: 03/31/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Patient death within 60 days of receiving the COVID vaccine series

Other Meds:

Current Illness:

Date Died:

ID: 1149493
Sex: M
Age: 72
State: TN

Vax Date: 02/04/2021
Onset Date: 03/04/2021
Rec V Date: 03/31/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: WHEN CALLED TO SCHEDULE 2ND DOSE, FAMILY STATES HE IS DECEASED.

Other Meds:

Current Illness:

ID: 1149494
Sex: F
Age: 65
State: MA

Vax Date: 03/12/2021
Onset Date: 03/15/2021
Rec V Date: 03/31/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Rash all over body, itchiness, redness, dry skin, tingling scalp

Other Meds: Metformin, Atorvastatin, lisinopril

Current Illness:

ID: 1149495
Sex: M
Age: 53
State: OH

Vax Date: 03/30/2021
Onset Date: 03/30/2021
Rec V Date: 03/31/2021
Hospital:

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

Lab Data:

Allergies: Tetanus Vaccine

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Passing blood anally. consistent since last night

Other Meds: Metformin

Current Illness: None

ID: 1149496
Sex: F
Age: 64
State: IN

Vax Date: 03/29/2021
Onset Date: 03/29/2021
Rec V Date: 03/31/2021
Hospital:

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

Lab Data:

Allergies: Sulfa

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

Symptoms: Extreme chills and shaking Headache Major legs cramps Nausea Burning eyes

Other Meds: Aspirin Macrodantin Yuvafem

Current Illness:

Date Died: 03/19/2021

ID: 1149497
Sex: M
Age: 102
State: MN

Vax Date: 02/03/2021
Onset Date: 03/19/2021
Rec V Date: 03/31/2021
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: Patient death within 60 days of receiving the COVID vaccine series

Other Meds:

Current Illness:

ID: 1149498
Sex: M
Age: 45
State: OK

Vax Date: 03/30/2021
Onset Date: 03/31/2021
Rec V Date: 03/31/2021
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: Penicyllin

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Nausea, diarrhea, fever, light headedness.

Other Meds: Tylenol, Multivitamins.

Current Illness:

ID: 1149499
Sex: M
Age: 18
State: LA

Vax Date: 03/30/2021
Onset Date: 03/31/2021
Rec V Date: 03/31/2021
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: Pharyngeal swelling

Symptoms: Severe headache

Other Meds:

Current Illness: None

ID: 1149500
Sex: F
Age: 39
State: DC

Vax Date: 03/13/2021
Onset Date: 03/13/2021
Rec V Date: 03/31/2021
Hospital:

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

Lab Data:

Allergies: Flagyl Fish Shellfish

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Pain in the opposite arm at the time the shot was administered Nausea, heat, chills, dizziness, pain in both arms while in the waiting room Flu-like symptoms for the next 5 days, which included extreme fatigue, overall muscle pain weakness, coldness in my extremities , hip pain, lack of appetite, radiating joint pain, dry eyes, dry mouth, neuropathy, etc. Activating of an autoimmune disease flare, which still exist over 2 weeks after the original shot and includes weight loss, radiating joint pain, severe stomach pain, dry eyes, muscle weakness, extreme coldness in my extremities especially my fingers and toes, hip pain, numbness in my fingers, lower back pain, difficulty waking up, inability to do daily tasks, lethargy, soreness in the morning, etc. Additional symptoms that persist include hair loss, pruney fingers that are extremely painful, and fatigue, continued pain in the left arm where the shot was given and the opposite arm, shakey hands, etc. I have contacted my rheumatologist who has advised me to take ibuprofen and wait a few more weeks to see if symptoms persist for an appointment.

Other Meds: Hydroxychloroquine Restasis Omeprazole Fluconazole

Current Illness:

ID: 1149501
Sex: F
Age: 42
State: IN

Vax Date: 03/29/2021
Onset Date: 03/29/2021
Rec V Date: 03/31/2021
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: Headache same day, afternoon into evening. Ibuprofen helped. Fatigue same day, but worse following day until around 1pm Soreness in arm (shot location) same day and day after. Ibuprofen helped but never completely went away until 2nd day after injection.

Other Meds: None

Current Illness: None

ID: 1149502
Sex: M
Age: 58
State: TN

Vax Date: 03/12/2021
Onset Date: 03/13/2021
Rec V Date: 03/31/2021
Hospital: Y

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

Lab Data:

Allergies: NO KNOWN DRUG ALLERGIES.

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

Symptoms: ADVERSE EVENT: ACUTE MYOCARDIAL INFARCTION TREATMENT: LEFT HEART CATHETERIZATION, CORONARY ARTERIOGRAPHY, LEFT VENTRICULAR ANGIOGRAPHY, PLACEMENT DRUG-ELUTING STENT IN MID LEFT ANTERIOR DESCENDING ARTERY. OUTCOME: DISCHARGED HOME WITH FOLLOW UP APPOINTMENTS WITH CARDIOLOGY AND PCP.

Other Meds:

Current Illness: NONE KNOWN.

ID: 1149503
Sex: F
Age: 62
State: DE

Vax Date: 03/18/2021
Onset Date: 03/20/2021
Rec V Date: 03/31/2021
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: Bactrim, contrast dye, amoxicillin,

Symptom List: Rash, Urticaria

Symptoms: On 3/20/21 pt started having diarrhea. Then she started getting chills, body aches, headache, dizziness and nauseated. Her back and legs are hurting. She has had these symptoms for over a week. She has been taking anti-diarrhea meds and Tylenol and Advil. Pt will contact her PCP.

Other Meds: metoprolol 25mg, gaberdine 300mg, cranberry, aspirin, losartan potassium 50mg, etodolac 300mg, Flonase .01 mg, citalopram 40mg, Tylenol, rosuvastatin 500, calcium 5mg,

Current Illness: toenail removed on 3/19/2021

ID: 1149504
Sex: F
Age: 76
State: VT

Vax Date: 03/23/2021
Onset Date: 03/24/2021
Rec V Date: 03/31/2021
Hospital:

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

Lab Data:

Allergies: Seasonal allergies.

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

Symptoms: She got the vaccine, did have pain at the site and thinks it was the first day at the end of the day. When she laid down she could feel it and also on the 2nd day at night. On day #2 she felt like she was coming down the flu. She had skin sensitivity, chills and a fever, extreme fatigue and her nose was running. These symptoms lasted all day long and into the evening. By the third day she woke up and was fine. She was a little tired, which lasted for about 3 more days, but minimal. She cleaned an area in her kitchen and came across a detox that she had taken (herbal formula), and she thinks when she first found it she took it, and the next day she took it as well.

Other Meds: Stool softener, Omega 3 fish oil, glucosamine MSM, vitamin minerals, CoQ10, Melatonin. Lisinopril.

Current Illness: None.

ID: 1149505
Sex: F
Age: 34
State: MI

Vax Date: 03/30/2021
Onset Date: 03/31/2021
Rec V Date: 03/31/2021
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: No

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

Symptoms: Pain at injection site increasing to next day. Fatigue, headache (brain fog). Numbness in left side of face noticed morning of 3/31. Not full paralysis. No face drooping.

Other Meds: Multivitamin

Current Illness: No

ID: 1149506
Sex: F
Age: 60
State:

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 03/31/2021
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: 07:50 Client noiticed metalic taste in her mouth, tingling of her tongue and lower lip. 07:58 154/82 98%pso2 heart rate 81 said thought she should mention it once tingling of her tongue started. No signs of distress. 08:09 tingling gone just feels a sensation on her tongue does not want to be seen in ER or continued to be monitored. States she feels safe to go. Informed to seek medical attention for further problems. Also informed to notify her MD of the event so he can advise for 2nd covid vaccine. 140/82 pso298% heart rate 77. No signs of distress.

Other Meds:

Current Illness:

ID: 1149507
Sex: F
Age: 59
State: IN

Vax Date: 03/29/2021
Onset Date: 03/29/2021
Rec V Date: 03/31/2021
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: Lipitor

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

Symptoms: Headache, body aches and general not feeling well, raised high blood pressure

Other Meds: Candersartan Cilexetil, Metoprolol, Fish oil, garlic oil, Vitamin D

Current Illness:

ID: 1149508
Sex: F
Age: 72
State: NJ

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 03/31/2021
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: Denied

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

Symptoms: Received call from client stating that the evening of her second immunization she began to feel severe 'razor blade like' pain in her L arm (muscles), joints and several fingers as well as a sensation of severe heat in L hand (reports R hand is cool to normal in temp. No edema or errythema reported. Complains of random and fleeting moments of feeling flushed and feverish s/s with temp reaching 99.5 degrees F. L arm remained extremely painful for > two weeks which keeps her up at night. Ice is the only relief for pain. Saw private MD reportedly dx with myalgia and arthralgia. As of 3/30/21 she cannot lift her L arm above the height of her chest. Reports MD is ordering labwork to help dx possible infection, viral response, etc... non specific report given of medical plan for intervention.

Other Meds:

Current Illness: None reported

ID: 1149509
Sex: M
Age: 35
State: MI

Vax Date: 03/29/2021
Onset Date: 03/29/2021
Rec V Date: 03/31/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Ear pain, Hypoaesthesia

Symptoms: 1:58pm vaccine administered in left deltoid, immediately after shot patient said "I feel dizzy" then became pale, diaphoretic, and hard to rouse. Help called. RN's NP. Blood pressure taken 76/35, heart rate 46 b/m. EMS notified, patient protected from falls and head held stable, nausea and then patient vomited. Oxygen placed on pt. Patient air way assessed and patent, no sign of anaphylaxis, patient appears to be experience an vasovagal event related to vaccine administration. Blood glucose monitored with vitals every 3 to 5 minutes. 2:20 pm EMS arrived and patient transferred to their care.

Other Meds: hydrochlorothiazide

Current Illness: hypertension

ID: 1149510
Sex: F
Age: 72
State: MA

Vax Date: 03/27/2021
Onset Date: 03/27/2021
Rec V Date: 03/31/2021
Hospital:

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

Lab Data:

Allergies: Clams, erythromycin, rash from cat scan dye

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: I got up from my sofa about 6 hours after the 2nd Moderna shot, and felt lightheaded. My husband was concerned and walked with me up the stairs then started going back down. He heard a thud and I had collapsed on the floor and it took him a few seconds to wake me up. I don?t remember passing out, but do remember him calling my name. This event happened six times in a row, but I don?t remember it. He had to hold me upright to get into bed. He called clinic, and they wanted me to go to emergency, but I just wanted to sleep and did not go in until the next day. I went to hospital and they ran many tests, but everything seemed to be ok, so I went home and have been ok since. Because I was ok before the shot, I believe that I had a bad adverse reaction to the 2nd shot.

Other Meds: Levothyroxine, trazone, arimidex, paxil

Current Illness: None

ID: 1149511
Sex: F
Age: 29
State: VA

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 03/31/2021
Hospital:

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

Lab Data:

Allergies: NKAA

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

Symptoms: Vasovagal response

Other Meds: Wellbutrin

Current Illness: Asthma

ID: 1149512
Sex: F
Age: 54
State: MA

Vax Date: 03/27/2021
Onset Date: 03/27/2021
Rec V Date: 03/31/2021
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: BEE VENOM SPINACH CORN CONTAINING PRODUCTS LATEX NITRILE PEANUT CHICKEN

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

Symptoms: TONGUE SWELLING WITHIN 15 MINUTES

Other Meds: ACTIGALL

Current Illness:

ID: 1149513
Sex: F
Age: 41
State:

Vax Date: 03/19/2021
Onset Date: 03/25/2021
Rec V Date: 03/31/2021
Hospital:

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

Lab Data:

Allergies: No

Symptom List: Unevaluable event

Symptoms: Swollen, painful and red at vaccine site

Other Meds: Synthroid 100mcg daily

Current Illness: No

ID: 1149514
Sex: M
Age: 29
State: VA

Vax Date: 03/30/2021
Onset Date: 03/30/2021
Rec V Date: 03/31/2021
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:

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

Symptoms: Syncopal event, sweaty,altered mental status 1 min. BP 120/73. HR 80. Resp 18. O2 sat 99 15:05. 132/74 P 78. RESP 99% HOME WITH FRIEND

Other Meds:

Current Illness:

ID: 1149515
Sex: M
Age: 75
State: MD

Vax Date: 03/30/2021
Onset Date: 03/30/2021
Rec V Date: 03/31/2021
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: Both shots gave me muscle ache in both arms, shoulders and neck. Over all body ache.Flu type symptoms. Headaches

Other Meds:

Current Illness:

ID: 1149516
Sex: F
Age: 66
State: GA

Vax Date: 03/01/2021
Onset Date: 03/16/2021
Rec V Date: 03/31/2021
Hospital: Y

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

Lab Data:

Allergies: Penicillin and sulfur

Symptom List: Injection site pain, Menorrhagia

Symptoms: Constricted airway, unable to breathe, weak, loss of speech, increased heart rate, fatigue, loss of balance

Other Meds: Blood pressure medicine and diabetes medicine

Current Illness: None

ID: 1149517
Sex: F
Age: 58
State: IL

Vax Date: 02/08/2021
Onset Date: 02/12/2021
Rec V Date: 03/31/2021
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: Penicillin sulfa cephlasporins lactose

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

Symptoms: Some diarrhea after first dose Severe diarrhea on and off since the second dose with weight loss

Other Meds: Gabapentin losartin effexor cbd

Current Illness: None

ID: 1149518
Sex: M
Age: 43
State: IN

Vax Date: 03/29/2021
Onset Date: 03/30/2021
Rec V Date: 03/31/2021
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

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Started feeling heavy chills, deep dull pain in legs (joints, especially knees) for about 12 hours. Headache. Ran low-grade fever of 100.

Other Meds: Claritin

Current Illness: None

ID: 1149519
Sex: F
Age: 60
State:

Vax Date: 03/22/2021
Onset Date: 03/22/2021
Rec V Date: 03/31/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: pt. reported hx of anxiety and forgot to take medication. BP 152/84. HR-WNL. pt. now wants her BP checked. No interventions other than reassurance. pt. verbalized understanding to call 911 for any assistance after leaving clinic.

Other Meds:

Current Illness:

ID: 1149520
Sex: F
Age: 45
State: MA

Vax Date: 03/10/2021
Onset Date: 03/15/2021
Rec V Date: 03/31/2021
Hospital: Y

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 Latex

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

Symptoms: Pt received Moderna Dose 1 on 2/10/21 and Dose 2 on 3/10/21. On approximately 3/15 she began to develop intermittent fever, chills, diffuse myalgias, headache, followed by onset of sore throat and intermittent rash, leading to hospitalization on 3/21 after presenting with syncope. She is now undergoing evaluation for MIS-A vs. adult onset Still's.

Other Meds: Vitamin D

Current Illness: None

ID: 1149521
Sex: F
Age: 62
State: FL

Vax Date: 03/16/2021
Onset Date: 03/16/2021
Rec V Date: 03/31/2021
Hospital:

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

Lab Data:

Allergies: no

Symptom List: Nausea

Symptoms: 3/16/21-Obtained vaccine at 0800. At 1pm same day, began with cough then an asthma attack, chest tights, couldn't catch breath. Required rescue inhaler and Advair inhalers. by 3pm same day, fever 100.3 po, severe body aches, horrible neck pain, extreme fatigue, ringing in ears, 'brain fog'. Went to bed 5pm- slept 7 hours. Woke up midnight, fever broke, still horrible aches and extreme fatigue. Slept another 7 hours. 0730 on 3/17 woke up face was "red" like a sunburn- no fever, very weak, no appetite. called primary, told to rest, tylenol, fluids and go to ED if worse symptoms. revisit in person 4/19. From 3/17-3/26 fatigue, brain fog- had eye exam for employment on 3/26 and vision in left eye had changed- could not see the chart. By today 3/31, still poor vision right eye- will see physician 4/2- less fatigue and improving brain fog, occasional tinnitus. This was my 1ST in the series of Moderna vaccines. Concern- should I get the 2nd on 4/13?

Other Meds: Metroprolol, Losartan, Advair inhaler

Current Illness: no

ID: 1149522
Sex: F
Age: 41
State: DE

Vax Date: 03/21/2021
Onset Date: 03/29/2021
Rec V Date: 03/31/2021
Hospital:

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

Lab Data:

Allergies: Allergy to Sulfa

Symptom List: Injection site pain

Symptoms: After about 8 days I noticed a circular area around the injection site that was a little pink and slightly itchy. I contacted my doctor and she instructed me to make sure I reported it. I understand it may be a reaction called COVID Arm and the redness/itchiness tends to start a week or more after the injection and could last about 4-5 days. It is not affecting me enough to where I need any ibuprofen or an antihistamine and it's been about 2 days since I noticed it.

Other Meds: Equate one daily womens multivitamin taken that morning

Current Illness: None

ID: 1149523
Sex: F
Age: 60
State: NC

Vax Date: 03/19/2021
Onset Date: 03/28/2021
Rec V Date: 03/31/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: I noticed a little redness after and thought it was from the bandage. Sunday, 3/28, I noticed that the site was itching. The redness has spread and the itching continues . It?s almost like a bee sting. The redness is at least 2 to 3inches in diameter.

Other Meds:

Current Illness:

ID: 1149524
Sex: F
Age: 64
State: AL

Vax Date: 03/22/2021
Onset Date: 03/30/2021
Rec V Date: 03/31/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Penicillin

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

Symptoms: Rash on arm. Painful to touch.3 inch diameter.

Other Meds: Levethoroxine

Current Illness:

ID: 1149525
Sex: U
Age: 60
State:

Vax Date: 03/22/2021
Onset Date: 03/22/2021
Rec V Date: 03/31/2021
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: reported " it felt like the car was moving" " I was holding my breath" " I hate needles" " I did it to myself". Report she never does well with needles & today was no exception. Forgot to take her lorazepam. TX - emotional support. Mask removal. Fresh air. Waited 15 mins in observation lot.

Other Meds:

Current Illness:

ID: 1149526
Sex: M
Age: 44
State: AR

Vax Date: 03/30/2021
Onset Date: 03/31/2021
Rec V Date: 03/31/2021
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: MORPHINE

Symptom List: Erythema, Pruritus

Symptoms: PT ARRIVED VIA POV WITH WIFE DUE TO COMPLAINING OF HAVING JOHNSON AND JOHNSON VACCINE REACTION THAT HE RECEIVED YESTERDAY AT 1130 AM. PT VOICED HE WAS NOT ABLE TO SLEEP MUCH, HAD FEVER, CHILLS; WOKE UP WITH SWOLLEN UPPER LIP, RASH OVER HIS UPPER EXTREMITIES; RASH AND WHELPS SEEN TO HIS RIGHT RIB REGION-MODERATE AMOUNTS. PT ALSO VOICED, FEELING ITCHING ALL OVER HIS BODY. DENIED OTHER SYMPTOMS. PT IS STABLE. ER PROVIDER NOTIFIED. TX: FAMOTIDINE, BENADRYL, SOLU-MEDROL, DECADRON.

Other Meds: NONE

Current Illness: NONE

ID: 1149527
Sex: F
Age: 48
State: SC

Vax Date: 03/17/2021
Onset Date: 03/24/2021
Rec V Date: 03/31/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: Red, warm, itchy rash at injection site- 3" in diameter. Still present two weeks after vaccine.

Other Meds: Xyzal- once daily

Current Illness: none

ID: 1149528
Sex: M
Age: 18
State: VA

Vax Date: 03/30/2021
Onset Date: 03/30/2021
Rec V Date: 03/31/2021
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: Dizziness, vision blurred,dry mouth, BP 108/67,HR 80, O2 sat. 97%,Resp 18 Monitor, go home

Other Meds:

Current Illness:

ID: 1149529
Sex: F
Age: 63
State: OH

Vax Date: 03/11/2021
Onset Date: 03/11/2021
Rec V Date: 03/31/2021
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: ace inhibitors- beta adrenergic blockers (cough); see page 2

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Headache for 2 days and low fever; Large red, hard, warm inflamed site in upper arm for 8 days (thru March 19), then redness disappeared and on March 22, Day 11 a large circular raised welt (approx 4") around injection site appeared and lasted 2 days and then disappeared. Still experiencing general fatigue and muscle aches nearly 3 weeks after first dose of vaccine.

Other Meds: Losaartin, Fish Oil, Multi vitamin and Magnesium

Current Illness: none

ID: 1149530
Sex: F
Age: 27
State: TX

Vax Date: 03/28/2021
Onset Date: 03/29/2021
Rec V Date: 03/31/2021
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: Eggs

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

Symptoms: At approximately 12pm the day after the vaccine I experienced severe body aches, chills, lack of appetite, sweats, nausea, dizziness, headaches. The symptoms have persisted since that day .

Other Meds: Amid-clav

Current Illness: None

ID: 1149531
Sex: M
Age: 51
State: CT

Vax Date: 03/30/2021
Onset Date: 03/30/2021
Rec V Date: 03/31/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Pain at injection site; fatigue; headache; chills

Other Meds: only Vitamin D (1000mg) daily

Current Illness: None

ID: 1149532
Sex: F
Age: 59
State: FL

Vax Date: 03/27/2021
Onset Date: 03/27/2021
Rec V Date: 03/31/2021
Hospital:

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

Lab Data:

Allergies: codeine, augmentin

Symptom List: Pain in extremity

Symptoms: fever, chills, headaches. began 8pm day of vaccination. ended on Monday 3/29. very sore arm. still sore on 3/31

Other Meds: metotoprol 50mg (blood pressure med)

Current Illness: none

ID: 1149533
Sex: F
Age: 67
State: GA

Vax Date: 01/12/2021
Onset Date: 01/26/2021
Rec V Date: 03/31/2021
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 (although haven't had since I was a baby)

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

Symptoms: Dose 1 - Very swollen, red, and hot at the injection site Dose 2 - Fatigue, achy, low grade fever - the day after vaccine

Other Meds: Metaprolol, Metformin, Vit D, B vitamins, Lexapro, Restoril , Protonix

Current Illness: None

ID: 1149534
Sex: F
Age: 66
State: WI

Vax Date: 03/29/2021
Onset Date: 03/30/2021
Rec V Date: 03/31/2021
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: The next day at 1:00 pm I was just hit with extreme fatigue and chills. By the time I got home from work I ached all over and could not get warm. I had a slight fever. By 8:00 pm I was burning up on my skin, but no fever. I still had aches all over. I woke up again at 11:00 pm and I was fine. I have had covid back in October of 2020.

Other Meds: rosuvastatin multi-vitamin

Current Illness:

ID: 1149535
Sex: M
Age: 47
State: VA

Vax Date: 03/28/2021
Onset Date: 03/30/2021
Rec V Date: 03/31/2021
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: Headache

Other Meds: Zyrtec, Crestor, fish oil, CoQ10

Current Illness: none

ID: 1149536
Sex: F
Age: 55
State: TX

Vax Date: 03/22/2021
Onset Date: 03/29/2021
Rec V Date: 03/31/2021
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: puffy red knot at injection site

Other Meds: meloxicam 7.5mg

Current Illness: none

ID: 1149648
Sex: F
Age: 61
State: NY

Vax Date: 03/29/2021
Onset Date: 03/31/2021
Rec V Date: 03/31/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Dizziness

Other Meds: None

Current Illness:

ID: 1149649
Sex: F
Age: 48
State: AL

Vax Date: 03/29/2021
Onset Date: 03/29/2021
Rec V Date: 03/31/2021
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: Allergic to: Demerol (hives), and Minocycline (throat and tongue swelling)

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

Symptoms: Very sore arm at injection site, fever (99.7), chills, fatigue, body aches, headache

Other Meds: Claritin, Flonase, Symbicort, Spironolactone, Black Cohosh, Magnesium Oxide, Vitamin B Supplement

Current Illness: None

ID: 1149650
Sex: F
Age: 41
State: FL

Vax Date: 03/29/2021
Onset Date: 03/29/2021
Rec V Date: 03/31/2021
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: After 10 days of the first shot (first dose acquired on March 9) a lump appeared in the clavicular area. After the second dose, Loris had all the effects expected of the vaccine after 7-10 hours, and the lump got bigger and more sensible.

Other Meds: Contraceptive medication, potassium citrate, water away.

Current Illness: None

ID: 1149651
Sex: F
Age: 63
State: IN

Vax Date: 03/29/2021
Onset Date: 03/30/2021
Rec V Date: 03/31/2021
Hospital:

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

Lab Data:

Allergies: Shellfish

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

Symptoms: Chills(lasted appx 6 hours), low grade fever(highest was 100.7), fever lasted appx 18 hrs, headache, slight body aches,

Other Meds: Prednisone, Synthroid, losartan, cyclobenzaprine, turmeric, Vitamin D, melatonin

Current Illness: Polymyalgia Rheumatica

ID: 1149652
Sex: F
Age: 52
State: IN

Vax Date: 03/29/2021
Onset Date: 03/29/2021
Rec V Date: 03/31/2021
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: Penicillin - hives Oral allergy to bananas, carrots and melons

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

Symptoms: Waves of extreme fatigue, fever, body aches, upset stomach, diarrhea, slight sore throat and a wave of nausea. Nausea started about 2 hours after shot. Fatigue started at 5:30 pm along with body aches. Fever, upset stomach and diarrhea started at 11 pm . Fever lasted until 6pm next day (Tuesday) along with fatigue, body aches and sore throat. Upset stomach and diarrhea ended about 10 pm next day (Tuesday). As of Wednesday morning all symptoms are gone. Took ibuprofen 2 times for fever and aches.

Other Meds: Citalopram, Terbinafine, Fanotidine

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm