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: 1326290
Sex: F
Age: 58
State:

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

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

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Headache, Myalgia, Fever, fatigue, sore throat Narrative:

Other Meds:

Current Illness:

ID: 1326291
Sex: F
Age: 54
State:

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: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: UrticariaPruritus pinching in arm, hard/red at injection site Narrative:

Other Meds:

Current Illness:

ID: 1326292
Sex: F
Age: 66
State:

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: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Palpitations, HYPERtension, Anxiety Narrative: B/P=164/92, HR=115. Monitored for 30 minutes and HR and B/P did not subside. After 30 mins B/P=157/89, HR=110. Pt continued to state, " I just do not feel right, just anxious feeling inside." Pt remained alert and oriented. Assistance was called from the ER and taken down for further monitoring.

Other Meds:

Current Illness:

ID: 1326293
Sex: F
Age: 36
State:

Vax Date: 12/28/2020
Onset Date: 01/10/2021
Rec V Date: 01/12/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Myalgia, UrticariaPruritus, sore arm Narrative:

Other Meds:

Current Illness:

ID: 1326294
Sex: F
Age: 52
State:

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:

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

Symptoms: Headache, Myalgia, Arthralgia, fatigue, chills Narrative:

Other Meds:

Current Illness:

ID: 1326295
Sex: F
Age: 43
State:

Vax Date: 12/30/2020
Onset Date: 12/30/2020
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: Headache, Myalgia, Rash, Diarrhea & Nausea Vomiting Narrative: DAY 1-PAIN;DAY2- PAIN;SWELLING;HA;NAUSEA/BODYACHE;DAY 3-4 UNCHANGED Day 5- Developed a rash along with nausea and severe diarrhea. (These symptoms did impact my daily routine.) Day 6 ? Rash expanded, but still mild. Started getting body aches. However, the nausea and diarrhea were very severe. I did vomit a few times. The diarrhea was so severe it was worse than when I had done a bowel prep. (These symptoms did impact my daily routine.) Day 7 ? Rash mostly gone. Nausea and diarrhea continued to be severe. Did start to get a little bit better by late evening. (These symptoms did impact my daily routine.) Day 8 ? Continued with mild nausea and diarrhea. DAY 9: DIARRHEA ; DAY 10- RESOLVED

Other Meds:

Current Illness:

ID: 1326296
Sex: F
Age: 53
State:

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

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: SkinRash & UrticariaPruritus

Other Meds:

Current Illness:

ID: 1326297
Sex: M
Age: 34
State:

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

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Myalgia, Diarrhea, sore throat

Other Meds:

Current Illness:

ID: 1326298
Sex: M
Age: 63
State:

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

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

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Diarrhea, NauseaVomiting, Lymphadema

Other Meds:

Current Illness:

ID: 1326299
Sex: F
Age: 44
State:

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: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: NauseaVomiting HX of migraines. Started having nausea followed by vomiting within 15 minutes of vaccine.

Other Meds:

Current Illness:

ID: 1326300
Sex: F
Age: 35
State:

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

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

Lab Data:

Allergies:

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

Symptoms: Headache sore throat, runny nose, fatigue, arm soreness

Other Meds:

Current Illness:

ID: 1326301
Sex: F
Age: 36
State:

Vax Date: 12/28/2020
Onset Date: 12/30/2020
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:

Symptom List: Rash, Urticaria

Symptoms: Headache, Myalgia, Arthralgia, Nausea Vomiting, fatigue

Other Meds:

Current Illness:

ID: 1326302
Sex: M
Age: 41
State:

Vax Date: 01/04/2021
Onset Date: 01/08/2021
Rec V Date: 01/12/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: CoughWheeze cough, congestion

Other Meds:

Current Illness:

ID: 1326303
Sex: F
Age: 38
State:

Vax Date: 12/22/2020
Onset Date: 12/23/2020
Rec V Date: 01/12/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Headache fatigue, sore throat and weird nightmaresday after vaccine

Other Meds:

Current Illness:

ID: 1326304
Sex: F
Age: 59
State:

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 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: Myalgia, Arthralgia, swollen glands

Other Meds:

Current Illness:

ID: 1326305
Sex: M
Age: 79
State:

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

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

Lab Data:

Allergies:

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

Symptoms: Swelling noted at injection site post administration.

Other Meds:

Current Illness:

ID: 1326306
Sex: F
Age: 55
State:

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

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

Lab Data:

Allergies:

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

Symptoms: Rash, UrticariaPruritus, rash on her face

Other Meds:

Current Illness:

ID: 1399578
Sex: F
Age: 35
State:

Vax Date: 01/08/2021
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:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Dizziness, Myalgia, NauseaVomiting, fatigue, shaky, face flushed Narrative: Felt okay the day of vaccination and day after, then Sunday, felt tired, then today began to have waves of nausea, began to vomit and experience dizziness, feeling flushed and warm but temp is 97.6 F- afebrile, sent home from work. States she was foggy and fatigued after the 1st dose right after but the following day felt "totally fine".

Other Meds:

Current Illness:

ID: 1399579
Sex: F
Age: 58
State:

Vax Date: 12/29/2020
Onset Date: 01/01/2021
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:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Myalgia enlarged lymph node by left elbow Narrative: Employee noted an enlarged lymph node on injection side (left) elbow; she has a h/o lupus and discussed with rheumatologist

Other Meds:

Current Illness:

ID: 1399580
Sex: F
Age: 60
State:

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

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

Lab Data:

Allergies:

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

Symptoms: left deltoid immediate blood sprayed from administration site and swelling in area, nodule 1x1 cm at injection site. Narrative: in person apt with occupational health NP 1/11 @11:25. left deltoid immediate blood sprayed from administration site and swelling in area, nodule 1x1 cm at injection site. NP advised to take ibuprofen 2 400 mg tablet.

Other Meds:

Current Illness:

ID: 1399581
Sex: M
Age: 53
State:

Vax Date: 12/23/2020
Onset Date:
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: Headache, Myalgia, Arthralgia, Fever, Diarrhea, NauseaVomiting, pain swelling at injection site, chills Narrative: Prior covid ab+ 8/17/20 and hospitalized for presumed covid pna however no + NP swab tests + from the period. Evaluated after vaccination by pmd advised against #2 dose of covid vaccine

Other Meds:

Current Illness:

ID: 1399582
Sex: M
Age: 54
State:

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

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

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: Headache, Myalgia, Fever, Fatigue Narrative:

Other Meds:

Current Illness:

ID: 1399583
Sex: F
Age: 61
State:

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

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

Lab Data:

Allergies:

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

Symptoms: fatigue Narrative:

Other Meds:

Current Illness:

ID: 1399586
Sex: M
Age: 47
State:

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: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Headache irritated eyes Narrative:

Other Meds:

Current Illness:

ID: 1399587
Sex: F
Age: 42
State:

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

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Headache, Myalgia, Arthralgia, Fever, NauseaVomiting, Fatigue Narrative:

Other Meds:

Current Illness:

ID: 1399588
Sex: F
Age: 22
State:

Vax Date: 12/29/2020
Onset Date: 01/06/2021
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:

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

Symptoms: Headache, Myalgia, CoughWheeze, Diarrhea, NauseaVomiting, Fatigue, Chills, Dyspnea Narrative:

Other Meds:

Current Illness:

ID: 1399589
Sex: M
Age: 52
State:

Vax Date: 01/04/2021
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Dizziness, Headache, Myalgia, HYPERtension, Fatigue, Narrative:

Other Meds:

Current Illness:

ID: 1399590
Sex: F
Age: 60
State:

Vax Date: 01/05/2021
Onset Date: 01/05/2021
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:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Myalgia, Fever, fatigue, chills Narrative: 6-8 hours after the vaccine had chills and body aches. This lasted until the next day - 24-30 hours. She also developed a low grade fever to 100 degrees. Symptoms resolved by Thursday 1/7.

Other Meds:

Current Illness:

ID: 1399591
Sex: M
Age: 65
State:

Vax Date: 12/26/2020
Onset Date: 12/28/2020
Rec V Date: 01/12/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Headache Narrative: Stated had vaccine on 12/26/20. On Mon 12/28, noted severe HA. Took Tylenol which helped to relieve headache. No other symptoms noted any other days.

Other Meds:

Current Illness:

ID: 1399592
Sex: M
Age: 68
State:

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Headache, SkinRash, SKIN RASH APPEARED ON FACE BUT WENT AWAY ON JANUARY 3RD, 2021 Narrative: PATIENT USED HYDROCORTISONE CREAM ON FACE WHICH HAD HELPED RESOLVE THE RASH

Other Meds:

Current Illness:

ID: 1399593
Sex: F
Age: 50
State:

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

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

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: Dizziness tingling and subjective throat swelling Narrative: only taken to ER on account of employee health closed

Other Meds:

Current Illness:

ID: 1399594
Sex: F
Age: 40
State:

Vax Date: 12/23/2020
Onset Date: 12/24/2020
Rec V Date: 01/12/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Headache, Fever, 101, fatigue, HA Narrative:

Other Meds:

Current Illness:

ID: 1399595
Sex: M
Age: 33
State:

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

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

Lab Data:

Allergies:

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

Symptoms: Myalgia, Fever, Rash, Pain, swelling, redness at site, fever, myalgias resolved by day 4 Narrative:

Other Meds:

Current Illness:

ID: 1402023
Sex: M
Age: 51
State:

Vax Date: 01/11/2021
Onset Date: 01/07/2021
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: Dizziness injection site pain Narrative:

Other Meds:

Current Illness:

ID: 1402024
Sex: M
Age: 63
State:

Vax Date: 01/11/2021
Onset Date: 01/03/2021
Rec V Date: 01/12/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: Headache, Myalgia, injection site pain Narrative: Side effects began the day after Injection: site pain, significant myalgia and arthralgia, could not walk his dogs, rigors without fever, chills-has to take Acetaminophen every 6 hours, frontal headache. States fatigue is "disabling" Has had to take time off of work.

Other Meds:

Current Illness:

ID: 1402025
Sex: F
Age: 54
State:

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

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

Lab Data:

Allergies:

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

Symptoms: ErythemaMultiform, UrticariaPruritus, none Narrative: given benadryl in the clinic

Other Meds:

Current Illness:

ID: 1402026
Sex: F
Age: 47
State:

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 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: Myalgia fatigue, malaise arm pain Narrative:

Other Meds:

Current Illness:

ID: 1402027
Sex: F
Age: 46
State:

Vax Date: 12/28/2020
Onset Date: 01/05/2021
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: Asthenia, Chills, Headache, Myalgia

Symptoms: Itching, Redness, Swelling, Soreness which converted to cellulitis Narrative:

Other Meds:

Current Illness:

ID: 1402028
Sex: F
Age:
State:

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

Lab Data:

Allergies:

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

Symptoms: Myalgia, Arthralgia, Fatigue Narrative: Awoke morning after immunization with muscle and joint aches. Symptoms subsided by that evening.

Other Meds:

Current Illness:

ID: 1402029
Sex: F
Age: 48
State:

Vax Date: 01/07/2021
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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: NauseaVomiting sweats, stomach cramping Narrative:

Other Meds:

Current Illness:

ID: 1402030
Sex: F
Age: 44
State:

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

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

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: Dizziness, Headache, Myalgia, Fever, fatigue Narrative: fever for the last 2 days achy and fatigue. Fever to 102.1 on Sat morning 1/9 and 100.4 on Sunday morning 1/10. 1/8 onset of symptoms was about 6pm with Headaches and dizziness. Fever was in am on 1/9/21 @ 8:03 am Resolved as of 1/11.

Other Meds:

Current Illness:

ID: 1402031
Sex: F
Age: 57
State:

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:

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

Symptoms: Headache, Myalgia, Arthralgia, fatigue Narrative: 1/9 onset of body aches, joint aches, fatigue, headache. Felt better on 1/10 later in the day. Resolved as of 1/11. She reports the same symptoms with the first vaccine which was given on 12/17.

Other Meds:

Current Illness:

ID: 1402032
Sex: F
Age: 55
State:

Vax Date: 12/26/2020
Onset Date: 12/26/2020
Rec V Date: 01/12/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Headache, SkinRash, Site tenderness Narrative: Tenderness at site

Other Meds:

Current Illness:

ID: 1402033
Sex: M
Age:
State:

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

Lab Data:

Allergies:

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

Symptoms: Myalgia, Arthralgia, Diarrhea, NauseaVomiting, Lymphadenopathy clavicular & ipsilateral axillary. Fatigue. Light headed Narrative: This time light headed & nausea started almost immediately. Night of 1/7 kept waking up because left side was hurting. (left deltoid injection). Friday Tylenol - localized Friday night. Some lymph node swelling at clavicle & axilla & inguinal - painful. Called in sick. Saturday Sunday Fatigue, muscle pain & stomach cramps. Loose bowels. Chills/Sweats Not febrile. Arm still tender.

Other Meds:

Current Illness:

ID: 1402034
Sex: F
Age: 63
State:

Vax Date: 12/28/2020
Onset Date: 12/28/2020
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: Dizziness & HYPERtension Narrative: went to ER only b/c employee health office was not open

Other Meds:

Current Illness:

ID: 1402035
Sex: F
Age: 58
State:

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:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Angioedema Thoart sweling Narrative: ED Visit with EPI Pen given

Other Meds:

Current Illness:

ID: 1402079
Sex: M
Age: 32
State:

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

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

Lab Data:

Allergies:

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

Symptoms: I received the 1st vaccine on 12/28, later that night I started to experience nausea and body aches that last till the next night 12/29. On 12/30 I did not experience any symptoms and felt better.

Other Meds:

Current Illness:

ID: 1402080
Sex: F
Age: 28
State:

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

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: UrticariaPruritus Warm and raised at injection site. Narrative:

Other Meds:

Current Illness:

ID: 1402081
Sex: F
Age: 58
State:

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

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

Lab Data:

Allergies:

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

Symptoms: Headache, UrticariaPruritis, Raised at injection site. Narrative:

Other Meds:

Current Illness:

ID: 1402082
Sex: F
Age: 34
State:

Vax Date: 12/21/2020
Onset Date: 12/21/2020
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: RA

Lab Data:

Allergies:

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

Symptoms: Myalgia, Arthralgia, Fever, discomfort at injection site Narrative:

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm