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: 0939226
Sex: F
Age: 37
State:

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

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

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: sore arm, 600mg PO motrin taken one hour after onset

Other Meds:

Current Illness:

ID: 0939227
Sex: M
Age:
State: AR

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

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

Lab Data:

Allergies: None

Symptom List: Anxiety, Dyspnoea

Symptoms: Head ache, sore throat,fever,chills,body aches arthritis cold sweats weakness

Other Meds: Fish oil vit D,magnesium,multi Vitamin,tamulsun ,norvasc,colonidine,leviasyn

Current Illness: None

ID: 0939228
Sex: F
Age: 50
State: OH

Vax Date: 12/30/2020
Onset Date: 01/04/2021
Rec V Date: 01/12/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: 5 days after getting the vaccine I began to feel a scratchy throat and developed a mild cough. The symptoms quickly developed into sore throat, more severe and productive cough, achiness, lethargy, severe headache, bilateral conjunctivitis, ear pain, chest pain, shortness of breath, fullness in the chest and the head and a low grade fever of 99.2-99.8

Other Meds:

Current Illness:

ID: 0939229
Sex: F
Age: 31
State: AZ

Vax Date: 01/08/2021
Onset Date: 01/09/2021
Rec V Date: 01/12/2021
Hospital:

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

Lab Data:

Allergies: NSAIDs ceclor

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: low grade fever x 6 hours severe body aches x 24 hours severe heartburn x 12 hours low grade headache x 4 days

Other Meds: levothyroxine prenatal vitamin

Current Illness: no

ID: 0939230
Sex: M
Age: 31
State: TX

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

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

Lab Data:

Allergies: Nkda

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

Symptoms: Chills. 101 fever. 12 hours after injection. Dizziness at time of injection. Cold. Aches. Sore arm.

Other Meds: None

Current Illness: None

ID: 0939231
Sex: F
Age: 37
State:

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

Vax Type: FLUC4
Manufacturer: SEQIRUS, INC.
Vax Name: INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT)
Lot: 276563
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: body aches 7-8 hours later, worse body aches, chills and rigors 14 hours later for which 600mg motrin taken, chills and rigors improved one later, body aches continued until 22 hours after vaccination where 600mg motrin taken again, minor body aches and fatigue until 36 hours after vaccination

Other Meds:

Current Illness:

ID: 0939232
Sex: M
Age: 29
State:

Vax Date: 01/10/2021
Onset Date: 01/11/2021
Rec V Date: 01/12/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Soreness of arm at injection site Fatigue Headache

Other Meds:

Current Illness:

ID: 0939233
Sex: F
Age:
State: AZ

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

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: None stated.

Other Meds:

Current Illness:

ID: 0939234
Sex: F
Age: 51
State: IA

Vax Date: 12/28/2020
Onset Date: 01/04/2021
Rec V Date: 01/12/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Cold symptoms including rhinorrhea, sore throat, fatigue and diarrhea. Covid testing by bilateral nares swab with a PCR test was positive on January 5, 2021

Other Meds: Imitrex

Current Illness: Migraine headache

ID: 0939235
Sex: F
Age: 44
State: CO

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

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

Lab Data:

Allergies: NKDA

Symptom List: Diarrhoea, Nasal congestion

Symptoms: I received the vaccine in the morning on 12/31/2020 and woke up on 01/01/2021 with a migraine, much worse than my usual migraines. It was gone by the morning of 1/2/21. I was advised to report this.

Other Meds: Synthroid, omeprazole

Current Illness: None

ID: 0939236
Sex: F
Age: 42
State: NY

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

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

Lab Data:

Allergies: NSAIDs

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

Symptoms: 1 hour after vaccine felt lightheaded. chest tightness. symptoms intermittent for an hour

Other Meds: none

Current Illness: none

ID: 0939237
Sex: F
Age: 50
State: NJ

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Rash, Urticaria

Symptoms: Left neck pain started 1/11/21 fatigue

Other Meds: Cymbalta, tinazidine, melatonin, vitamin D3, Sprintec

Current Illness: None

ID: 0939238
Sex: F
Age: 61
State: OH

Vax Date: 01/08/2021
Onset Date: 01/09/2021
Rec V Date: 01/12/2021
Hospital:

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

Lab Data:

Allergies: No known allergies

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

Symptoms: Day 1, 2, 3: injection site pain Day 2-5: Skin itching, scalp hives, wrist hives Day 5: vulva hives, enlarged cervical lymph node (left side)

Other Meds: Vitamin D Multivitamin Raloxifene Benicar HCT Propranolol

Current Illness: None

ID: 0939239
Sex: F
Age: 32
State: WA

Vax Date: 01/08/2021
Onset Date: 01/09/2021
Rec V Date: 01/12/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Penicillin

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

Symptoms: Fever, pain, chills for two days. Then an enlarged lymph node over my clavicle, pressure and pain in my neck and above clavicle, lymph node is still swollen and tender 4 post injection.

Other Meds: None

Current Illness: None

ID: 0939240
Sex: F
Age: 39
State: CA

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

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

Lab Data:

Allergies: Occasionally to Shellfish, seasonal allergies

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

Symptoms: On my 12th minute in the waiting area, I started having itchiness on my legs then it spread to my arms and face. I felt lightheaded and started having difficulty breathing. I approached the paramedic nearby. By then, the itchiness was all over my body from head to toe. They alerted 911 and monitored my vital signs. My 02 sat was 100% and BP was 140/90 mmHg. I asked if I can take Benadryl. They said wait for the ambulance. I declined to go to the hospital unless my symptoms get worse. I then took 25 mg of Benadryl. Shortness of breath and lightheaded ness was slightly relieved but the itchiness was still there. I waited for 30 more minutes in the waiting area. When the itchiness subsided a little bit, I went home. After 3 hours, the itchiness and SOB returned so I called my PCP and I was informed to take Benadryl q4 hrs until symptoms are resolved. As of today, 1/12/21 at 7:18pm, I still have itchiness but not as bad as yesterday.

Other Meds: Claritin, Proventil, Vitamin C and D

Current Illness: Asthma, eczema, allergic rhinitis

ID: 0939241
Sex: M
Age: 43
State: NM

Vax Date: 12/24/2020
Onset Date: 01/10/2021
Rec V Date: 01/12/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Patient developed Bells Palsy on day 19 after vaccine #1

Other Meds:

Current Illness:

ID: 0939242
Sex: F
Age: 31
State: IL

Vax Date: 01/05/2021
Onset Date: 01/06/2021
Rec V Date: 01/12/2021
Hospital:

Vax Type: DTAPHEPBIP
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: DTAP + HEPB + IPV (PEDIARIX)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies: No

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

Symptoms: Sore arm for first day after injection. Resolved about 36 hours after injection.

Other Meds: Birth control

Current Illness: No

ID: 0939243
Sex: F
Age: 41
State: CA

Vax Date: 01/04/2021
Onset Date: 01/11/2021
Rec V Date: 01/12/2021
Hospital:

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

Lab Data:

Allergies: Norco

Symptom List: Ear pain, Hypoaesthesia

Symptoms: One week after vaccine 01/11/21: site reaction, rash, red, swollen, hard, hot to touch, itchy ; 01/12/21- spreading redness and swelling (benadryl cream, Tylenol, no resolve yet) 01/11/21 severe vertigo x 6 hours, nausea (resolved after meclizine, Zofran, and sleep)

Other Meds: Wellbutrin, omeprazole, trazodone, multivitamin

Current Illness: None

ID: 0939244
Sex: M
Age: 55
State:

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

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

Lab Data:

Allergies: none

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: scratchy throat, difficulty swallowing

Other Meds: fexofenadine, fluticasone

Current Illness: none

ID: 0939245
Sex: F
Age: 33
State: TX

Vax Date: 01/05/2021
Onset Date: 01/13/2021
Rec V Date: 01/12/2021
Hospital:

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

Lab Data:

Allergies: Cephalosporins

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

Symptoms: Angioedema requiring ER visit and IV steroids

Other Meds: Venlafaxine, synthroid

Current Illness:

ID: 0939246
Sex: F
Age: 49
State: AR

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

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

Lab Data:

Allergies:

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

Symptoms: Patient is an Employee at the store. She received the vaccine at approximately 11am on 1/9/2021. She was watched for 15 minutes, with no adverse problems. She left the Facility at approximately12:30p, but returned around 3:15pm, to say she wanted to talk with me before I left. She stated her face was swollen, very puffy, and she was getting a rash. She had no other problems at that time and otherwise felt ok. She hadn't eaten or done anything differently during the day. I offered patient a dose of Benadryl, however she stated she could not take Benadryl. I told her to pick up some Zyrtec and take that, and see how she felt. I called patient at 6:35pm to check on her and she stated that the swelling had gone down and that she felt fine.

Other Meds:

Current Illness:

ID: 0939247
Sex: F
Age: 36
State: MD

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

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

Lab Data:

Allergies: None

Symptom List: Unevaluable event

Symptoms: Chills, body aches, low grade fever, headache

Other Meds: None

Current Illness: None

ID: 0939248
Sex: F
Age: 43
State: CA

Vax Date: 01/07/2021
Onset Date: 01/08/2021
Rec V Date: 01/12/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Within 12 hours localized reaction with redness, swelling, lump, hot to touch and extremely painful. Symptoms lasted for 48 hours. After that the area was itchy.

Other Meds: Levothyroxine 125mcg po daily

Current Illness: None

ID: 0939249
Sex: F
Age: 32
State: WA

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

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

Lab Data:

Allergies: Eggs, dairy, beef,pork, soy, nuts, gluten, wheat

Symptom List: Injection site pain, Pain

Symptoms: 1/9/2031: at time of shot extreme burning in left arm and into left shoulder blade. 15-30 minutes after vaccine: high pulse at 98 bpm, throat tightened, shake hands (lasted 1 hour)(had to take allergy pill for throat tightening) High anxiety the rest of the day. Sharp pain in left shoulder blade into neck, extreme fatigue. 1/10/2021: high fatigue, sharp shoulder blade pain and stiffness in neck. Right kidney/back pain, headache, fuzzy thinking, feeling blah and out of it 1/11/2021: arm, shoulder blade and neck pain, heart racing in the am. 1/12/2021: shoulder blade and neck pain. Afternoon nausea and feeling like I could throw up, clamy sweaty hands

Other Meds:

Current Illness:

ID: 0939250
Sex: F
Age: 54
State: OR

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

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

Lab Data:

Allergies: ciprofloxacin prozac sulfa

Symptom List: Injection site pain, Menorrhagia

Symptoms: pt had periorbital swelling within 20 minutes of vaccination to urticaria, no new sob, has asthma and had some mild sob day before vaccine

Other Meds: albuterol econazole cream

Current Illness: none

ID: 0939251
Sex: F
Age: 38
State: IL

Vax Date: 12/29/2020
Onset Date: 01/07/2021
Rec V Date: 01/12/2021
Hospital:

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

Lab Data:

Allergies: sulfa (rash)

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

Symptoms: localized skin reaction that started at about 2 inches wide and is now about 6 inches wide. swollen axillary lymph nodes in same arm.

Other Meds: Metformin, Spiralactone, BCP, Lexapro, MVI, Vitamin D

Current Illness: none

ID: 0939252
Sex: F
Age: 60
State: TX

Vax Date: 01/04/2021
Onset Date: 01/11/2021
Rec V Date: 01/12/2021
Hospital:

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

Lab Data:

Allergies: Codeine

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Large hard hot itchy tender lump at injection sight. Very large and hard like half of a golf ball

Other Meds: Levothyroxin Verapamil Metformin B12 injection Pantoprazole Lisinopril Wellbutrin Magnesium Asporotate Melatonin Biotin

Current Illness: None

ID: 0939253
Sex: F
Age: 60
State: NC

Vax Date: 12/29/2020
Onset Date: 01/08/2021
Rec V Date: 01/12/2021
Hospital:

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

Lab Data:

Allergies: amoxicillin

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: raised, itchy nodules in circular area approx 6 cm at injection site developing into mildly itchy, red, warm, induration in same area resolving over two days. Occurred on day 10 after injection

Other Meds: meloxicam, methotrexate, hydroxychloroquine, escitalopram, zolpidem, progesterone, imvexxy, acetaminophen

Current Illness: None

ID: 0939254
Sex: F
Age: 34
State: TX

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

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

Lab Data:

Allergies:

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

Symptoms: Fatigue, Body aches and chills about 7 hours post vaccine

Other Meds: 25mg Zoloft

Current Illness:

ID: 0939255
Sex: F
Age: 39
State: OR

Vax Date: 01/08/2021
Onset Date: 01/10/2021
Rec V Date: 01/12/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Nausea

Symptoms: Headache started 24 hours after vaccine lasted 2 days, diarrhea started about 36 hours after vaccine and lasted about 12 hours.

Other Meds: None

Current Illness: None

ID: 0939256
Sex: F
Age: 27
State: AZ

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

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

Lab Data:

Allergies: Bananas

Symptom List: Injection site pain

Symptoms: Dry and swollen mouth and back of throat about 25 min after shot

Other Meds: Metropolol Colchicine Lexothyroxine

Current Illness: Hypothyroidism

ID: 0939257
Sex: F
Age: 34
State: MA

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

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

Lab Data:

Allergies: Contact reaction to latex reported anaphylaxis to shellfish

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

Symptoms: The vaccine was administered on the following date: 1/12/21?and at approximately the following time: 3:50PM ? The symptoms began 20-25 min after administration of the vaccine.? The symptoms were: Chest tightness and dizziness that is moving up to her throat - similar to shellfish allergy reaction. Vitals all stable. No rash, no wheezing on exam, no facial or tongue edema. She was sent to the ED where she was treated with Tylenol, famotidine and methylprednisolone with resolution of symptoms.

Other Meds: albuterol PRN

Current Illness: unknown

ID: 0939258
Sex: F
Age: 43
State: WI

Vax Date: 12/22/2020
Onset Date: 12/24/2020
Rec V Date: 01/12/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: I had had minor intermittent teeth pain off and on for several weeks. With in a day of getting the vaccine the pain began increasing to the whole left side of my face and neck and increasing in intensity. I was unable to sleep 12/24 and 12/25 and ended up going to urgent care on 12/26. Despite not having sinus fullness/drainage they diagnosed it a sinus infection and gave me antibiotics. At the end of the 5 day course my symptoms had improved some but were not gone and I was still requiring frequent Tylenol for pain so the course of antibiotics were extended. I do not know if this was caused by the vaccine, but it coincided with the vaccine.

Other Meds: levothyroxine; omegas; B12; biotin; multivitamin; Vitamin D; Vitamin C

Current Illness: mild intermittent teeth pain left side of jaw

ID: 0939259
Sex: F
Age: 42
State: TX

Vax Date: 01/04/2021
Onset Date: 01/11/2021
Rec V Date: 01/12/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: My arm was warm all week, but now it is significantly harder, hotter and hurts

Other Meds: Armoire thyroid meds Magnesium Vitamin D Elderberry Tylenol

Current Illness:

ID: 0939260
Sex: F
Age: 50
State: WA

Vax Date: 09/08/2020
Onset Date: 09/09/2020
Rec V Date: 01/12/2021
Hospital:

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

Lab Data:

Allergies: UNKNOWN

Symptom List: Erythema, Pruritus

Symptoms: patient reported that after getting flu shot her arm has been sore, she has been taking tylenol for the pain and physical therapy,"The therapist encouraged me to continue the with exercise as this kind of Injury can persist for a long time" .heating pad helps with the symptoms for a short period of time

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 0939261
Sex: F
Age: 22
State: MD

Vax Date: 12/29/2020
Onset Date: 01/06/2021
Rec V Date: 01/12/2021
Hospital:

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

Lab Data:

Allergies: NKDA

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

Symptoms: Pt received the Moderna Covid vaccine 12/29/2020 at work. She works at Hospital as a Tech (pt care tech in ICU) She states she had soreness at right arm injection site for 2 days that resolved. Then, on post-vaccine day #8 (1/6/2021), she developed a rash at the injection site that was itchy. The area was raised, itchy and red. Measured at work = 5 x 5 cm. Used HCT cream TID and took zyrtec 10 mg at work yesterday. The rash looks a lot better today. Not itchy anymore. The area is tender but not as red as it was. No discharge/pus. No numbness or tingling. T97.6 Pt denies any other sxs except for SOB for about 30 min intervals over the first 2-3 days after the vaccine. Pt checked pulse ox when feeling short of breath and it was 96%. She states she's not sure if it was from anxiety.

Other Meds: Enskyce

Current Illness: NONE

ID: 0939262
Sex: F
Age: 35
State: PA

Vax Date: 01/04/2021
Onset Date: 01/06/2021
Rec V Date: 01/12/2021
Hospital:

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

Lab Data:

Allergies: Seasonal allergies, mostly handled through immunology shots a few years ago

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

Symptoms: A little over 2 days after the vaccine, I had a horrible headache. Thought nothing of it, took Excederin migraine and went to bed. Woke up Thursday feeling fine, then by 5 pm, was very run down, had a mild headache, and had an intense sinus pressure under my eyes. My neck hurt and was sore to the touch in the front. When I bent over, it felt like my head was going to explode from pressure. No other symptoms or anything to be alert about. Took a Mucinex before bed, hoping that it would move anything that might be clogging my sinuses, went to sleep. Woke up Friday feeling okay, with just a tiny remnant of a headache. Around 1 pm, intense sinus pressure returned, worse than the previous day. Decided to go to local healthcare clinic around 3:30 pm. PA looked at ears, throat, all looked okay. Only symptom was swollen lymph nodes in neck, same side as the vaccine was administered. Covid tested (subsequent results were negative). Saturday, had less pressure, and spent the day laying around. By Sunday, was feeling back to normal. Peak of incident was definitely Friday.

Other Meds: HaileyFE birth control, vitamin supplements: niacin, biotin, zinc, vitamin C, women?s multivitamin

Current Illness: None

ID: 0939263
Sex: F
Age: 35
State: IN

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

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

Lab Data:

Allergies: None

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Redness, swelling, inflammation at site of injection. Shot was 8 days ago and I?ve had no other symptoms in the last week.

Other Meds: Tri-sprintec Ibuprofen (as needed)

Current Illness: PMS began day before symptom started

ID: 0939264
Sex: F
Age: 37
State: CO

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 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: mild headache within hour of administration of vaccination. Fatique/malaise. foggy head.

Other Meds: none

Current Illness: none

ID: 0939265
Sex: F
Age: 23
State: MA

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

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

Lab Data:

Allergies: Amoxicillin - hives clindamycin - hives pineapple - throat itching No h/o anaphylaxis or requiring epinephrine prior to this reaction

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

Symptoms: The vaccine was administered on the following date: 1/8/21?and at approximately the following time: 4:00PM ? The symptoms began 30 minutes after administration of the vaccine.? The symptoms were: cough, throat itching and throat swelling + redness. No body itching, rash, or face/lip/tongue swelling. ? She presented to the ED for her reaction The treatment of the reaction was:?? o Antihistamines:?benadryl IV o Steroids:?solumedrol IV o Epinephrine: 1 dose? ? Currently ongoing cough but other symptoms resolved.

Other Meds: none

Current Illness: none known

ID: 0939266
Sex: M
Age: 19
State: WI

Vax Date: 01/10/2021
Onset Date: 01/11/2021
Rec V Date: 01/12/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Pain in extremity

Symptoms: Large swelling around injection site approximately golf ball sized.

Other Meds: Multi vitamin Epiduo Forte (Topical) Clindamycin gel

Current Illness: None

ID: 0939267
Sex: F
Age: 34
State: AL

Vax Date: 01/07/2021
Onset Date: 01/08/2021
Rec V Date: 01/12/2021
Hospital:

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

Lab Data:

Allergies: NKA

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

Symptoms: Pfizer-BioNTech COVID-19 Vaccine EUA. Received vaccine in left deltoid at 1300 on 1/7/21. Had sore left axillary lymph nodes upon waking the next morning around 0800 on 1/8/21 that lasted approximately 96 hours. No treatment needed; resolved.

Other Meds: Pepcid, Cryselle-28

Current Illness: n/a

ID: 0939268
Sex: F
Age: 36
State:

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

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

Lab Data:

Allergies: Cipro, poly-neomycin, pistachios, flu vaccine since placed in poly-neomycin base

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

Symptoms: Sore arm starting at 8pm. Through night- joint pain started.

Other Meds: IUD

Current Illness: None

ID: 0939269
Sex: F
Age: 27
State: FL

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

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

Lab Data:

Allergies: Laytex

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

Symptoms: Building pain throughout the evening in the arm of the injection site starting mildly around 5pm and increasing through the evening. Mild swelling of the arm around the injection site by 6pm. Chills developed around 6pm, no obvious fever. Aparent moderate fever with moderate chills developed around 9pm. Fever spiked around 10pm, chills continued. Consumed 2 benadryl tablets to assist with sleep. Fever, chills, and swelling were gone at time of waking up around 10am. Arm pain continued for 1 and 1/2 more days.

Other Meds: Sprinted- birth control

Current Illness: None

Date Died: 12/31/2020

ID: 0939270
Sex: M
Age: 48
State: HI

Vax Date: 12/22/2020
Onset Date: 12/31/2020
Rec V Date: 01/12/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: Sudden cardiac death

Other Meds:

Current Illness:

ID: 0939271
Sex: M
Age: 33
State: IN

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

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

Lab Data:

Allergies: None

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Tingling in hands and feet which started about 1.5 hour after I took the vaccine

Other Meds: None

Current Illness: None

ID: 0939272
Sex: F
Age: 54
State: OR

Vax Date: 12/30/2020
Onset Date: 01/07/2021
Rec V Date: 01/12/2021
Hospital:

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

Lab Data:

Allergies: Sulfa, ibuprofen, peanuts

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

Symptoms: One week after the shot I developed a local reaction at the injection site. A red circle (3in x 3in) showed on my right upper arm. The area was very red, warm to touch, tender, and hard. It lasted about 3 days. Redness is gone. Tenderness and muscle soreness remains.

Other Meds: atenolol, wellbutrin, celexa, estrace, Vit D, turmeric

Current Illness: none

ID: 0939273
Sex: F
Age: 61
State: MT

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Remicade Bactrim Humira

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Arm pain post injection Severe pain in shoulder joint, down arm, pain elbow, pain firearm and hand on left side. Diagnosed as reactive arthritis due to vaccine

Other Meds: Xeljanz, calcium

Current Illness: None

ID: 0939274
Sex: F
Age: 40
State: MT

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

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

Lab Data:

Allergies: mild reaction to artificial cinnamon, usually causes mouth sores

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

Symptoms: on day 7 post vaccine I developed a large lump in my upper left arm. It was red and hot to the touch, Itchy about the diameter of a baseball by evening about the size of a softball Day 8 the lump grew bigger and the redness started to spread and get more red, very hot to the touch and caused a burning sensation in my arm. On this day I saw a Dr at an urgent care clinic and it measured 9cm Day 9 again redness kept spreading almost to 12 cm, still hot to the touch and burning sensation., by then I had been treating with Benadryl every four hours for 24 hrs. Day 10 spread even more going down my arm almost to my elbow. Still hot to the touch but no longer burning. Still treating with Benaydryl Day 11 redness finally going away, lump almost gone, feels warm to touch and almost like a bruise if pressed Mild soreness Day 12, almost gone mild redness remains, no burning but still mildly warm to the touch. Still taking Benadryl at night.

Other Meds: Vitamin D3, Biotin,

Current Illness: none

ID: 0939275
Sex: F
Age: 52
State: IA

Vax Date: 01/07/2021
Onset Date: 01/08/2021
Rec V Date: 01/12/2021
Hospital:

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

Lab Data:

Allergies: Cipro, bee stings

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

Symptoms: Woke up with terrible headache, body aches, chills and nausea. Slept all day taking ibuprofen and acetaminophen as needed, lots of fluids. Lasted until 1130 pm same night. Next day did not have headache but still had body aches and chills, above medication helped. Felt better later that night but finally felt 100% on day 2.

Other Meds: Zoloft

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm