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: 1156911
Sex: F
Age: 69
State: VT

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 04/01/2021
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: 25 minutes after vaccination started to have sensation of difficulty breathing. No wheeze. Reported lips felt tingly. No swelling. Vital signs monitored for 1 hour. Breathing normalized. Lip tingling resolved. Vital signs normal. WIll follow up with PCP if necessary. When left clinic site at 14:11: BP 138/82 Pulse: 62 Resp: 16 O2 Sat 99% on room air, lungs clear oropharynx normal

Other Meds:

Current Illness: none

ID: 1156912
Sex: F
Age: 60
State:

Vax Date: 03/24/2021
Onset Date: 03/24/2021
Rec V Date: 04/01/2021
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: History of orofacial granulomatosis, neurofibromatosis type 2, Sjogren's and trigeminal neuralgia. Around 10 minutes after reaching vaccine developed tinnitus, severe vertigo and left sided facial pain in typical character and pattern of her trigeminal neuralgia and then at 14:24 some lower lip swelling typical of what she develops with her orofacial granulomatosis patient took 1200 mg of her own IR gabapentin. Symptoms progressively worsened

Other Meds:

Current Illness:

ID: 1156913
Sex: F
Age: 27
State:

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 04/01/2021
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: PEG-asparaginase (anaphylaxis)

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

Symptoms: Night of: 103 degree fever, severe chills, night sweats, myalgia, nausea Next day: 99-100 degree fever, headache, brain fog, excessive fatigue

Other Meds: None

Current Illness: None

ID: 1156914
Sex: F
Age: 58
State: TX

Vax Date: 03/30/2021
Onset Date: 03/30/2021
Rec V Date: 04/01/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Fever chills like rigors for several hours. Terrible head ache and body pain. Next day just very tired and sore. Third day back to normal!

Other Meds: Zoloft, unisom.

Current Illness: None

ID: 1156915
Sex: F
Age: 39
State: KS

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 04/01/2021
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: Fever, chills, nausea, fatigue, muscle pain throughout whole body, sore arm, headache and migraines. Worst I have ever felt in my whole life.

Other Meds:

Current Illness:

ID: 1156916
Sex: F
Age: 37
State: GA

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 04/01/2021
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: Bactrim, Amoxicillin

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

Symptoms: Granuloma annulare; Circular raised lesions on hands, feet and chest. Most c/w GA. Bactrim and Prednisone rx by Dermatology. Eucrisa.

Other Meds: None known

Current Illness: None known

ID: 1156917
Sex: F
Age: 34
State: WA

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/01/2021
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: unknwon

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Pt returned back to the vaccination room within 2-3 minutes from the lobby. She had a feeling of rush all over her body, she mentioned that she felt her tongue was swollen. She felt very anxious and nervous at the moment. I didn't notice any lips swollen, I asked a staff call 911 and monitored her closely. She calmed down after few minutes and then in 5 mins paramedics showed up. They checked her and she was totally fine. They send her home after 10 mins or so.

Other Meds: unknown

Current Illness: none

ID: 1156918
Sex: M
Age: 54
State: PA

Vax Date: 03/31/2021
Onset Date: 04/01/2021
Rec V Date: 04/01/2021
Hospital:

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

Lab Data:

Allergies: Cephtin Tramadol

Symptom List: Pharyngeal swelling

Symptoms: Starting around lunch time 4/1/2021....headache in the morning Extreme fatigue , muscle and joint pain, hands hurt, chills, fever 99.1

Other Meds: Bisoprolol 3 - 2.5mg/ 6.25 Lisinipril Pramipexole .25 mg Buspirone 30mg Multivitamin Omprozole 20mg OTC Zyrtec

Current Illness:

ID: 1156919
Sex: M
Age: 46
State: ID

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/01/2021
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: Manufacturer/Syringe malfunction. Despite tightening of syringe to needle for vaccination, partial Moderna dose leaked at needle and syringe connection point during vaccination. Pt received remaining dose as needle in pt during leakage. Per CDC guidelines, Provider reports pt received greater than half of the dose and no additional dose given. Pt tolerated vaccine with no additional concerns.

Other Meds:

Current Illness:

ID: 1156920
Sex: F
Age: 49
State: IL

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/01/2021
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: 5 minutes after vaccine patient reported feeling dizzy and light headed. Patient assisted to a wheel chair and vital signs were taken. BP 140/90, pulse ox 100%, HR 66. Patients reports that she did not take her BP medication this morning. Patient was given water and asked to sit for 30 minutes. Vitals taken and BP 140/80 and HR 69. Patient reported feeling better and no longer feeling light headed. She walked herself out of clinic.

Other Meds:

Current Illness:

ID: 1156921
Sex: F
Age: 51
State: TX

Vax Date: 01/13/2021
Onset Date: 01/21/2021
Rec V Date: 04/01/2021
Hospital:

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

Lab Data:

Allergies: n/a

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

Symptoms: blood pressure became elevated about 1 1/2 weeks after the first shot. Tightness in my chest occurred - heart side. Squeezing in my chest occurred - heart side. Soreness across my chest occurred. Pain slightly under my left arm pit.

Other Meds: Amlodipine, valacyclovir

Current Illness: none

ID: 1156922
Sex: F
Age: 71
State: CA

Vax Date: 03/23/2021
Onset Date: 03/23/2021
Rec V Date: 04/01/2021
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: Unknow

Symptom List: Rash, Urticaria

Symptoms: Patient had received Pfizer (Lot# EN6201, )at another location on 2/20/2021. Patient did not disclose her prior dose and indicated the Moderna was her first dose.

Other Meds: Unknown

Current Illness: Unknow

ID: 1156923
Sex: M
Age: 55
State: AL

Vax Date: 03/15/2021
Onset Date: 03/17/2021
Rec V Date: 04/01/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: Ear Ringing has continued since 2 days after vaccinatation

Other Meds: Lexapro, Imetrex

Current Illness: None

ID: 1156924
Sex: F
Age: 57
State: WA

Vax Date: 03/02/2021
Onset Date: 03/02/2021
Rec V Date: 04/01/2021
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: fire ants

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

Symptoms: right after the injection, I felt a stiffening sensation in my jaw on the right side, about 1 hour later I started to feel a pressure on both of my temples and developed a migraine headache over night, the migraine intensified the following day, I felt nausea and vomitted for couple of hours during the evening on the second day following the vaccination. I have also felt pain in the site of the vaccination and the area was warm. The headache lasted for 5 days and I felt fatigued for 10 days following the vaccination.

Other Meds: probiotics, turmeric, vitamin D3, Vitamin C

Current Illness: none

ID: 1156925
Sex: F
Age: 18
State: TX

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/01/2021
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: - Swelling - Tenderness - Soreness - Cold sensation in left arm/hand - Pain

Other Meds: - Zoloft - Vyvanse - Birth Control - Two days before reviving the COVID vaccine, I revived two different meningitis vaccines.

Current Illness:

ID: 1156926
Sex: F
Age: 39
State: NC

Vax Date: 03/29/2021
Onset Date: 03/29/2021
Rec V Date: 04/01/2021
Hospital:

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

Lab Data:

Allergies: no

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

Symptoms: Arm soreness, abnormal fatigue, the next day (3/30) I had chills, muscle aches, fever, chills, night sweat, slept all day, lost appetite, threw up once. Next day (3/31), was much better, but had muscle aches all over my body that were so sore, they woke me up. Also took a nap. ON 4/1, I am feeling much better. Injection site is slightly tender, slightly tired still, but definitely on the mend.

Other Meds: Lamictal; Nuvaring

Current Illness: no

ID: 1156927
Sex: M
Age: 45
State: CA

Vax Date: 03/30/2021
Onset Date: 03/31/2021
Rec V Date: 04/01/2021
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: none

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

Symptoms: Chills, Fever starting 12-13 hours after injection, lasting 8 hours. Sore arm.

Other Meds: blood pressure medication

Current Illness: none

ID: 1156928
Sex: M
Age: 56
State: PA

Vax Date: 03/23/2021
Onset Date: 03/24/2021
Rec V Date: 04/01/2021
Hospital:

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

Lab Data:

Allergies: shellfish

Symptom List: Ear pain, Hypoaesthesia

Symptoms: acute aches muscles and joints, moderate headache, fever of 100.7 for 3 hours each immunization. Arm sore for 3 days at injection site. Took 1000mg Tylenol after fever onset, was helpful but extreme fatigue for approx 24 hours kept me in bed. After approx 36 hours from injection, 90% of symptoms were gone. After 48 hours 95% of symptoms were gone. Final symptom was lingering pain lower back.

Other Meds: apixaban 5mg 2x/day, 82mg aspirin 1x/day

Current Illness: none

ID: 1156929
Sex: M
Age: 71
State:

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 04/01/2021
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: Patient received his Moderna #2 around 9:40 AM. About 4 minutes later his wife signaled that he was in distress by honking her horn. Upon arrival to the patient, he was clutching at his throat, wheezing, and whispering he couldn't breathe. Dyspneic with respiratory rate 20-30, heart rate 60's. No hives/flushing or signs of syncope. Given significant respiratory distress, decision was made to give epinephrine IM right thigh. About 4-5 minutes after injection, patient's respiratory rate came down and he said he felt his throat open up. He was then sent to the ER, where he received Benadryl, Famotidine, Methylprednisone, and Albuterol/Atrovent nebulizer. Pt sent home at 1PM, after 3 hours of observation. Pt is still doing well via phone follow up 24 hours after event.

Other Meds:

Current Illness:

ID: 1156930
Sex: M
Age: 31
State: DC

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

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

Lab Data:

Allergies: None

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

Symptoms: Migraine headache lasting 2-4 minutes, room-spinning sensation, decreased motor functionality

Other Meds: None

Current Illness: None

ID: 1156931
Sex: M
Age: 51
State: NV

Vax Date: 03/26/2021
Onset Date: 03/27/2021
Rec V Date: 04/01/2021
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: Asprin

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

Symptoms: Sore arm, body aches

Other Meds:

Current Illness:

ID: 1156932
Sex: F
Age: 35
State: VT

Vax Date: 01/19/2021
Onset Date: 01/20/2021
Rec V Date: 04/01/2021
Hospital:

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

Lab Data:

Allergies: n/a

Symptom List: Unevaluable event

Symptoms: 1/19 vaccination 1/20 At about 3pm, I had symptoms of having my period. I started having really bad pain on lower back, I could not stand. I could not pick my baby up. I called my husband to come home. The pain was extremely bad, I could not walk. I took Ibuprofen, called clinic and they said you should call CDC or wait. I went to bed and around 6am I felt like I had to go to the bathroom. Walking back, I went to sit on edge of bed, I was in so much pain. I started feeling so bad, I fainted. When I woke up, my husband was asking me questions. We called 911, took vitals, transferred to ER. Gave Ibuprofen and did ultra sound. They discharged between 11-12. They said to follow up with PCM. It was so scary. Symptoms lasted for 4-6 days after. It became better each day. *still have not had second vaccine

Other Meds: n/a

Current Illness: n/a

ID: 1156933
Sex: F
Age: 40
State: NE

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/01/2021
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: Shellfish

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

Symptoms: 1535 Vaccine Administered 1550 - Pt. reported tingling around lips and heart palpitations. Moved to private room for monitoring. 1555 - Examined by APRN 1600 - Administered Benadryl 25 mg IM R) UE Lot #080127 Exp 8/22 Monitored until 1700 - symptoms resolved and pt. discharged.

Other Meds: Zyrtec

Current Illness: None

ID: 1156934
Sex: M
Age: 64
State: OH

Vax Date: 03/26/2021
Onset Date: 03/26/2021
Rec V Date: 04/01/2021
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: Severe allergy to bee stings

Symptom List: Injection site pain, Pain

Symptoms: Approximately 6 hours after receiving my second Pfizer Covid 19 vaccination I began feeling cold. This continued to he point of having chills and almost shivering. By 11:00 PM I felt like I was freezing. I took two generic Tylenol and went to bed. I woke up the next morning, (about 9 hours of sleep) feeling fine. However, a little over 48 hours later I got the same feeling of chills, but to a much lesser degree. I took generic Tylenol again, and went to bed early. It has now been a week and no other side effects have been noticed.

Other Meds: amlopidine-Benazepril Generic Lipitor

Current Illness: None

ID: 1156935
Sex: M
Age: 43
State:

Vax Date: 03/15/2021
Onset Date: 03/15/2021
Rec V Date: 04/01/2021
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: 43 y/o man with significant for asthma developed lightheadedness and the sensation of an object in the back of his throat with swallowing about five minutes after getting his vaccine. He denied difficulty breathing. His initial vitals were 160/100, HR 100, O2 saturations 96%. On examination, his tongue was not swollen and he had faint expiratory wheezing. He was given 12.5mg of liquid benadryl. He reported his symptoms slightly improved after five minutes of liquid benadryl. His vitals were measured again about 20 minutes after his first set of vitals and his vitals were 150/100, HR 105, O2 sats 95%. He was given a second dose of 12.5mg of liquid benadryl. After another 20 minutes, he reported that his symptoms were much improved. On examination, his tongue was not swollen and faint expiratory wheezing was heard. Last set of vitals were 140/95, HR 95, and O2 saturations 96%. He calm and relaxed and was released. He was told that he would not get his second dose with the current team due to the location being a non-clinical setting. He was told to follow up with his PCM and/or allergist regarding if he should get a second dose in a hospital setting.

Other Meds:

Current Illness:

ID: 1156936
Sex: F
Age: 58
State:

Vax Date: 03/30/2021
Onset Date: 03/30/2021
Rec V Date: 04/01/2021
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: Mild upper lip swelling after observation period. No airway compromise. Given zyertc 10mg.

Other Meds:

Current Illness:

ID: 1156937
Sex: M
Age: 57
State: VT

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/01/2021
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: Pt was vaccinated on day 14 vs day 21

Other Meds:

Current Illness:

ID: 1156938
Sex: F
Age: 48
State: NC

Vax Date: 03/19/2021
Onset Date: 03/20/2021
Rec V Date: 04/01/2021
Hospital:

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

Lab Data:

Allergies: Pecans

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Fever, chills, diarrhea, dizziness, aches, fatigue

Other Meds: Prednisone, insulin, Effexor, ramipril, fenofibrate, lamictal

Current Illness: None

ID: 1156939
Sex: F
Age: 25
State: DC

Vax Date: 01/08/2021
Onset Date: 01/22/2021
Rec V Date: 04/01/2021
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: Charcoal

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

Symptoms: I waited 15 min and my arm felt tingly, but I didn't think much of it b/c it was cold. It hurt like a normal shot. Around day 14, I noticed a rash that was about 2 in x 1 in. I asked my provider about putting anything on it, but she said not. It lasted about 3 days and resolved. Had 2nd dose and experienced basic symptoms.

Other Meds: Vienva (Birth control)

Current Illness:

ID: 1156940
Sex: F
Age: 72
State: IL

Vax Date: 03/23/2021
Onset Date: 04/01/2021
Rec V Date: 04/01/2021
Hospital:

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

Lab Data:

Allergies: antihistamine, tape

Symptom List: Nausea

Symptoms: Same day as vaccine, slight nausea & muscle ache. Eight days later, sudden onset of intense chills, low grade fever, muscle aches, headache, extreme sleepiness, no appetite - classic flu symptions. Most symptoms gone within 24 hours, except for headache, slight muscle aches, drowsiness, lack of appetite.

Other Meds: atorvastatin, fenofibrate, etodolac, lisinopril, sotalol, metformin, amlodipine, citalopram, hydrochlorozide, levothyroxine, digoxin, injectable insuline, warfarin, multiple vitamin, vitamins C, D & B12, krill,

Current Illness: none

ID: 1156941
Sex: F
Age: 51
State: PA

Vax Date: 03/20/2021
Onset Date: 03/27/2021
Rec V Date: 04/01/2021
Hospital:

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

Lab Data:

Allergies: No

Symptom List: Injection site pain

Symptoms: The day I received the shot I had a sore arm. My arm was sore for a few days. But then the soreness went away. I woke up one week after my first shot with a large red spot on my arm where the shot was given. It was warm to the touch. It itched as well. Additionally it was sore under my left arm in my arm pit. The soreness under my arm lasted 4 days. The redness has gone down 5 days later but is still visible.

Other Meds: No

Current Illness: No

ID: 1156942
Sex: F
Age: 66
State: NY

Vax Date: 03/24/2021
Onset Date: 03/24/2021
Rec V Date: 04/01/2021
Hospital:

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

Lab Data:

Allergies: possibly amoxycillin (dizziness)

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

Symptoms: My shoulder joints and back of neck felt sore about 30 mins after the vaccine. About 2 hours after the vaccine I felt exhausted. I tried to ignore it but could not concentrate on my work and ended up going to bed and falling asleep for 3 hours. Got up briefly and then slept through the night. The next day I was completely exhausted and couldn't work so I gave up and went to bed. I had mild chills but no fever (67.3). Basically stayed in bed all day. The next day I woke up feeling completely fine, except for a sore arm at the injection site. I had no treatment. I still have days when I feel exhausted. Since most get these symptoms after the 2nd shot I'm a bit concerned that my 2nd may be worse.

Other Meds: Metaprolol

Current Illness:

ID: 1156943
Sex: F
Age: 64
State: IN

Vax Date: 03/30/2021
Onset Date: 03/30/2021
Rec V Date: 04/01/2021
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: Sore right arm, aches and heavy fatigue. No fever.

Other Meds: Calcium

Current Illness: None

ID: 1156944
Sex: F
Age: 21
State: PA

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/01/2021
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: Pt arrives to the observation area following her vaccination with complaints of headache and dizziness. She is with her mother. She arrives at 1555 with a headache and dizziness and being flushed. BP 161/120 HR 99 Oxygen 100% room air she is Aox3 1605 BP 169/123 HR 100 oxygen 100% room air remains flushed apple juice given patient tolerated well 1610 manual BP done 148/120 1620 BP 172/120 HR 104 Pt is reluctant to go to the ED by ambulance but with mother she has agreed to go and EMS notified 1625 pt complaints of nausea bp 170/109 hr 104 oxygen 98% room air 1630 pt remains flushed still complaining of a headache and arms being cold, pt covered with a jacket 1640 report given to a Crew Member and pt transported to Hospital mom to follow ambulance

Other Meds:

Current Illness:

ID: 1156945
Sex: F
Age: 52
State: WA

Vax Date: 03/30/2021
Onset Date: 03/31/2021
Rec V Date: 04/01/2021
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: IV iodine

Symptom List: Erythema, Pruritus

Symptoms: Severe Dizziness

Other Meds: Duloxetine 90 mg, bupropion 75mg, lisinopril 10mg, estradiol .5 mg. Excedrine migraine

Current Illness:

ID: 1156946
Sex: F
Age: 35
State: KS

Vax Date: 03/30/2021
Onset Date: 03/31/2021
Rec V Date: 04/01/2021
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: At about 12 hours after injection I started running a fever of 102?f that lasted 24 hours some times it would spike up to 104?f. Had a headache that lasted 2 days soar muscles and joints over entire body skin all over turned red. Had no appetite. 30 hours after injection I broke out in a rash all over my chest and back. A very very bright patchy rash.

Other Meds: Tylenol.

Current Illness:

ID: 1156947
Sex: M
Age: 65
State: VA

Vax Date: 03/07/2021
Onset Date: 03/20/2021
Rec V Date: 04/01/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Tiredness, loss of appetite and dry mouth

Other Meds: Atorvastatin 40mg daily

Current Illness: None

ID: 1156948
Sex: M
Age: 35
State: MA

Vax Date: 02/18/2021
Onset Date: 02/25/2021
Rec V Date: 04/01/2021
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: NKDA

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Paresthesias in both hands and feet, fatigue, chills

Other Meds: mesalamine ER 0.375

Current Illness: -

ID: 1156949
Sex: F
Age: 42
State: NJ

Vax Date: 03/23/2021
Onset Date: 03/24/2021
Rec V Date: 04/01/2021
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: Chills, muscle aches, fever of 101.1, pain at injection site, nausea

Other Meds: None

Current Illness: None

ID: 1156950
Sex: F
Age: 79
State: CA

Vax Date: 02/17/2021
Onset Date: 03/30/2021
Rec V Date: 04/01/2021
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: Clindamycin; Erythromycin - whole-body rash at end of 10-day course of both antibiotics simultaneously post dog bite. Rash resolved after discontinuance of antibiotics. No other reactions in past from antibiotics.

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

Symptoms: Severe headache; muscle aches and stiffness; dizziness; elevated BP (related???)

Other Meds: Nortriptyline 10 mg. hs; Rosuvastatin 5 mg. hs; Acetyl L Carnitine 1000mg AM; Multivit 1 cap. AM

Current Illness: None

ID: 1156951
Sex: F
Age: 34
State:

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/01/2021
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: Pt reports itchy mouth. 25mg diphenhydramine PO admin per MD order. Vitals WDL, patient provided MD consult and discharge.

Other Meds:

Current Illness:

ID: 1156952
Sex: M
Age: 50
State: SC

Vax Date: 03/30/2021
Onset Date: 04/01/2021
Rec V Date: 04/01/2021
Hospital:

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

Lab Data:

Allergies: sulfa

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

Symptoms: Brief but very painful chest pain. Felt on left side about half way up my ribs. Thought I was having a heart attack for about a minute. No signs of arrhythmia or faintness. Feel fine now.

Other Meds:

Current Illness:

ID: 1156953
Sex: M
Age: 59
State: MI

Vax Date: 03/11/2021
Onset Date: 03/14/2021
Rec V Date: 04/01/2021
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 known

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

Symptoms: Patient arrived on 4/1/2021 to receive his second dose of the COVID vaccine. Patient reported he developed hives 3 days after the first dose of vaccine and that the hives are still present. Called by nurse and I advised to not give 2nd dose.

Other Meds: atorvastatin, diclofenac gel, nicoderm cq, procardia-XL

Current Illness: none

ID: 1156954
Sex: F
Age: 35
State: SC

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/01/2021
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 vancomycin

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

Symptoms: Soreness at injection, immediate Soreness of left arm, onset at 12:00pm Fatigue, onset at 4:30pm Sore throat, onset at 5:30pm Flushed, onset at 5:00pm Lightheadedness, onset at 5:30pm

Other Meds:

Current Illness: Gallstones Increased liver enzymes

ID: 1156955
Sex: F
Age: 86
State:

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/01/2021
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: Immediately developed swelling around the injection site. Gave patient an ice pack and she applied it for 15 minutes. Swelling went down to normal. Patient had no other symptoms.

Other Meds:

Current Illness:

ID: 1156956
Sex: F
Age: 49
State: AL

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/01/2021
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: Penicillin, fentanyl

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Lips and tongue tingling-gave 1 dose on Bendaryl

Other Meds: Benadryl

Current Illness: NA

ID: 1156957
Sex: F
Age: 42
State: TN

Vax Date: 03/23/2021
Onset Date: 03/31/2021
Rec V Date: 04/01/2021
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: Swelling, redness, pain

Other Meds: Metformin

Current Illness:

ID: 1156958
Sex: F
Age: 44
State: TX

Vax Date: 03/25/2021
Onset Date: 03/25/2021
Rec V Date: 04/01/2021
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: Berries

Symptom List: Injection site swelling, Limb discomfort

Symptoms: 5:15pm Pt c/o itching on face secondary to injection of first dose of Covid-19 vaccine. Before alerting staff, pt. self-treated with Benadryl 25mg. p.o. EMT on scene found BP 138/90, lungs clear bilaterally. This nurse called to assess pt. 3 minutes into 30 minute observation. Pt reports?, throat swelling? and history of anaphylaxis?. 5:18pm Epinepherine 0.3mg IM administered per protocol in Right anterolateral thigh. BP 130/90 p. 85, visual inspection with light shows airway appears open. Pt. alert and oriented. Skin warm and dry. 5:30pm Paramedics arrived and assume responsibility for follow-thru with patient. At that time patient reported feeling better. Declined transport to hospital and was driven home by husband.

Other Meds: Unknown

Current Illness: Unknown

ID: 1156959
Sex: M
Age: 52
State: NJ

Vax Date: 03/25/2021
Onset Date: 03/25/2021
Rec V Date: 04/01/2021
Hospital: Y

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

Lab Data:

Allergies: decadron

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

Symptoms: 106 fever for hours, violent chills vomiting, headaches, body aches, oxygen levels 85-91

Other Meds: hydrochlorothyazide ,Irbesartin,metformin,amlodopine,vitamin c,,vitamin d

Current Illness: side effects from covid,feet neurapathy aches in joints

ID: 1156960
Sex: M
Age: 67
State: MD

Vax Date: 03/20/2021
Onset Date: 03/20/2021
Rec V Date: 04/01/2021
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: N/A

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

Symptoms: Vaccination + 9.5 hours: sharp headache Vaccination + 15.5 hours: fever (98.5 - 100.0 ?F), sharp headache, extreme fatigue Vaccination + 20 hours: fever (98.5 - 100.0 ?F), sharp headache, extreme fatigue, near syncoptic episodes when standing Vaccination + 40 hours: resolved

Other Meds: rosuvastatin 20 mg LEVOthyroxine 50 mcg losartan 25 mg omeprazole 20 mg cholecalciferol 50 mcg aspirin 81 mg

Current Illness: N/A

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm