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: 0916805
Sex: M
Age: 52
State: NY

Vax Date: 12/30/2020
Onset Date: 12/31/2020
Rec V Date: 01/01/2021
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: citrate solution

Symptom List: Dysphagia, Epiglottitis

Symptoms: Started with acute onset fatigue and chills(at the same time,9pm). Spiked a 104.5 temp @ aprx 2 am. Went back and forth between chills/fever for 15 hours. Slept for 13 hours and felt fine when I woke up. Body Aches and headaches were also felt the whole time.

Other Meds: Lisinopril, synthroid, testosterone shot(8 week)

Current Illness: 6 weeks since recovering from covid exposure. I was very symptomatic during this period(aprx Nov18-26th w/symptoms)

ID: 0916806
Sex: F
Age: 59
State: IN

Vax Date: 12/31/2020
Onset Date: 01/01/2021
Rec V Date: 01/01/2021
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: PCN, TCN

Symptom List: Anxiety, Dyspnoea

Symptoms: PATIENT NOTICED SORENESS AT THE SITE OF INJECTION THE EVENING SHE RECIEVED THE VACCINE. THE MORNING AFTER SHE RECIEVED THE VACCINE SHE NOTED A 2 INCH PINK/RED AREA THAT WAS PAINFUL AND WARM TO THE TOUCH.

Other Meds: METFORMIN 500MG - 2BID; JANUVIA 100MG QD; SIMVASTATIN 20MG QHS; LISINOPRIL/HCTZ 20/25MG QD; CYCLOBENZAPRINE 10MG BID PRN

Current Illness: NONE

ID: 0916807
Sex: F
Age: 24
State: AR

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

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

Symptoms: metallic taste

Other Meds:

Current Illness:

ID: 0916808
Sex: F
Age: 58
State: CA

Vax Date: 12/29/2020
Onset Date: 12/31/2020
Rec V Date: 01/01/2021
Hospital:

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

Lab Data:

Allergies: sulfa, vytorin, ginger (spice)

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: painful right wrist and right hard that limits movement started appropriately at 2200 on 12/31/2020

Other Meds: benazepril hcl 10mg (1 daily),Women's formula one a day (1 daily), magnesium 250mg (2 daily), acetaminophen 250mg (2 daily), Aspirin 250mg (2 daily), ibuprofen 200mg (4 daily), turmeric 1000mg (2 daily)

Current Illness: none

ID: 0916809
Sex: F
Age: 40
State: WA

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

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

Symptoms: CAREGIVER RECEIVED FIRST VACCINE DOSE AND SOON AFTER BEGAN TO FEEL DIZZY AND HER EYES BEGAN TO TWITCH, FOLLOWED BY UNCONTROLLED SHAKING, WITH HIGH FEVER FOLLOWED BY SEVERE SHORTNESS OF BREATH AND GASPING, WITH TIGHTNESS AROUND THE CHEST. TRANSPORTED TO EMERGENCY DEPARTMENT. HAD MULTIPLE EPISODES OF ITEMS LISTED ABOVE WHILE IN ED, INCLUDING HEAVINESS IN HER LEGS AND TINGLING IN ARMS. SHE WAS DISCHARGED FROM ED AT 10:30PM BUT WAS READMITTED ON 12/24 TO ED FOLLOWING SIMILAR ISSUES. TO DATE SHE HAS HAD 5 RAPID RESPONSES IN HOSPITAL DUE TO REPEAT OF SIGNS/SYMPTOMS. CT AND PULMONOLOGY CONSULT SCHEDULED FOR 12/28/2020.

Other Meds: NA

Current Illness: None

ID: 0916810
Sex: M
Age: 27
State:

Vax Date: 12/30/2020
Onset Date: 12/31/2020
Rec V Date: 01/01/2021
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: none

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

Symptoms: Chills, headache, fatigue, muscle aches, hot flashes, profuse night sweats. Has lasted more than 24 hours.

Other Meds: none

Current Illness: COVID symptoms started 14 days (12/15) prior to vaccination. Tested positive for COVID 12 days (12/17) prior to vaccination. Mild covid symptoms quickly went away, was cleared from isolation 4 days prior to vaccination (12/26)

ID: 0916811
Sex: F
Age: 54
State: TX

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

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: No adverse reaction on the date the Moderna COVID-10 Vaccine EUA was given. The following day, Thursday, 12/24/20, I felt pain at the site of injection. When I checked my arm I had a large, painful, red, round, raised bump. It became more erythematous, painful, and larger the next day, Friday, 12/25/20. The pain, swelling, size, and erythema slowly started going away over the next few days. Wednesday 12/30/20 and Thursday, 12/31/20 the area was nearly back to normal. Today, Friday, 1/1/21, I felt itchy at the site of injection. When I checked it I had large round area of erythema at the site of injection.

Other Meds:

Current Illness: None

ID: 0916812
Sex: F
Age: 57
State: CO

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

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

Lab Data:

Allergies: BACTRIM

Symptom List: Pharyngeal swelling

Symptoms: REDNESS AT INJECTION SITE (WHICH IS COMMON) BUT BECAME MORE RED AND ITCHY AFTER 9 DAYS. STILL VERY SWOLLEN, RED AT SITE, AND PT REPORTS VERY ITCHY

Other Meds: UNKNOWN

Current Illness: NO KNOWN

ID: 0916813
Sex: F
Age: 62
State: NY

Vax Date: 12/22/2020
Onset Date: 12/29/2020
Rec V Date: 01/01/2021
Hospital:

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

Lab Data:

Allergies: sulfa alcyclovir

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: For several days, the usual arm soreness. Approx. 7 days following, a large red area with intense itching which continues today. Photos are available. No other symptoms (fatigue, fever, body aches, etc.) -- just the injection site area is now extremely itchy and still tender to the touch. To treatment.

Other Meds: vitamin D 2000 IU multi vitamin 1500 mg calcium (Tums)

Current Illness:

ID: 0916814
Sex: F
Age: 51
State: TX

Vax Date: 12/24/2020
Onset Date: 12/27/2020
Rec V Date: 01/01/2021
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: Bananans, Cat's, IV Zofran

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Blisters in mouth first, then on arms, chest and legs. Itchy red blisters-This is usually a symptoms on my Lupus

Other Meds: Nexium, Effexor, Lisinopril, Metoprolol, Hydroxychloroquine

Current Illness: No

ID: 0916815
Sex: F
Age: 41
State:

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

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

Lab Data:

Allergies: MRI Dye

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

Symptoms: redness and swelling over three days. red chest and itchiness along chest and back two hours after vaccination. no hives.

Other Meds:

Current Illness:

ID: 0916816
Sex: F
Age: 41
State:

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 01/01/2021
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: MRI Dye

Symptom List: Rash, Urticaria

Symptoms: redness and swelling over three days. red chest and itchiness along chest and back two hours after vaccination. no hives.

Other Meds:

Current Illness:

ID: 0916817
Sex: F
Age: 40
State: FL

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

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

Lab Data:

Allergies: Cats

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

Symptoms: Low grade fever 100 1800 12/30/20. Fever 103, chills, body aches 0100 12/31/20. Low grade fever 12/31/20 until 1400 Had to take Tylenol to break fever and relieve headache.

Other Meds: Levothyroxine, Xanax

Current Illness: N/A

ID: 0916818
Sex: F
Age: 29
State: NY

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

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

Symptoms: nausea, myalgia, chills, temp 100.5

Other Meds:

Current Illness:

ID: 0916819
Sex: F
Age: 33
State: OH

Vax Date: 12/23/2020
Onset Date: 12/31/2020
Rec V Date: 01/01/2021
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: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: I developed a red firm itchy raised rash at the injection site over a week after my vaccine, see dates listed above.

Other Meds: None

Current Illness: None.

ID: 0916820
Sex: M
Age: 55
State: TN

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/01/2021
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: None reported

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

Symptoms: Approximately 12 hours post vaccination employee reported hives consisting of raised, itchy whelps from their waist to their ears. Hives reported as moderate to severe - kept employee up all night due to severe itching. Employee reports no increased heart rate, no difficulty breathing or shortness of breath, no fever, no direct pain or redness aside from the hives a the injection site, no nausea no vomiting. Employee took a dose of Benadryl when hives started, this seemed to resolve about 50% of them by 8am the following morning, a second dose of Benadryl was taken at 8am 12/31/2020, and by 12pm 12/31/2020 the hives were gone.

Other Meds: Unknown

Current Illness: None reported

ID: 0916821
Sex: F
Age: 23
State: IL

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

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

Symptoms: Soreness at injection site , high fever later that night of 101.6 and chills and body aches

Other Meds:

Current Illness:

ID: 0916822
Sex: M
Age: 46
State: TX

Vax Date: 12/23/2020
Onset Date: 12/30/2020
Rec V Date: 01/01/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Itching, swelling and tenderness to injection site starting 7 days after injection

Other Meds:

Current Illness:

ID: 0916823
Sex: F
Age: 41
State: NV

Vax Date: 12/23/2020
Onset Date: 12/29/2020
Rec V Date: 01/01/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Moderna COVID-19 Vaccine EUA; Painful swelling in lymph nodes in the axilla of the injection side; localized redness, swelling, and itching of injection site, and full body hives.

Other Meds: None

Current Illness: None

ID: 0916824
Sex: F
Age: 39
State: CA

Vax Date: 12/28/2020
Onset Date: 12/31/2020
Rec V Date: 01/01/2021
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: First dose of Moderna COVID-19 EUA. about 3 days after first dose developed mild nausea, weakness, fatigue/mental fog, mild dizziness/feeling lightheaded, dry throat and mildly sore throat and ear (nasopharyngeal) Still feeling this way on day 4 (that is today the day I am reporting)

Other Meds: multivitamin, omega-3, have been taking these a long time

Current Illness: Suspected autoimmune type reaction following Fluvax October 2020- developed Cold Urticaria (hives in response to cold stimulus) a few days after flu vaccine

ID: 0916825
Sex: F
Age: 45
State: AR

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

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

Symptoms: metallic funny taste and heart palpitations

Other Meds:

Current Illness:

ID: 0916826
Sex: F
Age: 78
State: AR

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

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

Lab Data:

Allergies: NKA

Symptom List: Unevaluable event

Symptoms: Increased fatigue.

Other Meds: Isosorbide Mononitrate ER, Allopurinol, Carvedilol, Protonix, Novolin 70/30, Gabapentin, Zoloft, hydralazine, Bumetanide

Current Illness: Covid-19

ID: 0916827
Sex: F
Age: 35
State: CO

Vax Date: 12/23/2020
Onset Date: 12/24/2020
Rec V Date: 01/01/2021
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: allergy to penicillin - anaphylactic reaction

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

Symptoms: On 12/24/2020 around 7PM, I started my menstrual period. My menstrual period should not have started until 1/2/2021 and I am usually very regular with my menstrual periods. This menstrual bleeding lasted through 12/26/2020 and stopped on 12/27/2020 AM. I did not experience any abdominal cramping. The blood flow was normal for what I would consider my 'normal period.'

Other Meds: NA

Current Illness: NA

ID: 0916828
Sex: F
Age: 35
State: CO

Vax Date: 12/23/2020
Onset Date: 12/24/2020
Rec V Date: 01/01/2021
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: allergy to penicillin - anaphylactic reaction

Symptom List: Injection site pain, Pain

Symptoms: On 12/24/2020 around 7PM, I started my menstrual period. My menstrual period should not have started until 1/2/2021 and I am usually very regular with my menstrual periods. This menstrual bleeding lasted through 12/26/2020 and stopped on 12/27/2020 AM. I did not experience any abdominal cramping. The blood flow was normal for what I would consider my 'normal period.'

Other Meds: NA

Current Illness: NA

ID: 0916829
Sex: F
Age: 37
State: CA

Vax Date: 12/24/2020
Onset Date: 12/29/2020
Rec V Date: 01/01/2021
Hospital:

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

Lab Data:

Allergies: DayQuil, Hypercare, glycerin (in skin products and food), coconut oil (applied to skin)

Symptom List: Injection site pain, Menorrhagia

Symptoms: Tuesday 12/29 - Initially pruritis, erythema and unraised rash to L antecubital fossa. Wednesday 12/30 - Woke up with post nasal drip, congestion, scratchy throat, nausea. Pruritis, erythema and non raised rash to bilateral antecubital areas. Had intermittent chills without fever. Had muscle aching. Thursday 12/31 - Started to have pruritis to abdomen, no rash noted. Continue to have pruritis, erythema, non raised rash to bilateral antecubital areas. Continue to have post nasal drip, congestion, scratchy throat (none worse than the day before). No chills, only muscle aching. Friday 1/1 - Same as 12/31 so far.

Other Meds: Isibloom, Claritin, Prenatal vitamin, Folic acid, Vitamin D, probiotic

Current Illness: None

ID: 0916830
Sex: F
Age: 29
State: MT

Vax Date: 12/31/2020
Onset Date: 12/31/2020
Rec V Date: 01/01/2021
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: Had chills all night. Severe headache and body aches started around 10pm (vaccination was around 11am). I felt great for a few hours immediately following vaccination but developed severe light-headedness that evening. Passed out the following morning (01/01/2021) and my daughter called 911/ paramedics. I declined going to the hospital but I still feel horribly dizzy and ache.

Other Meds: Baby Aspirin

Current Illness:

ID: 0916831
Sex: F
Age: 50
State: AR

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 01/01/2021
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: red palms for 1st 30min, fever overnight

Other Meds:

Current Illness:

ID: 0916832
Sex: M
Age: 27
State:

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

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

Lab Data:

Allergies: None

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Day two: Injection site redness/swelling, Headache and nausea, full body-ache, joint pain, dry mouth, dehydration, chills/night sweats. Day three: Most symptoms resolved. Only injection site tenderness, redness, elevated reaction site bump, hot to touch and itchy.

Other Meds: None

Current Illness: None

ID: 0916833
Sex: F
Age: 35
State: MD

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

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

Symptoms: Mild headache starting about 4 hours after dose. Took Tylenol 500mg PO every 4 hours x three doses. Went away overnight. Came back in the afternoon again for 5-6 hours.

Other Meds: Vitamin D, Coq 10, magnesium oxide.

Current Illness: None

ID: 0916834
Sex: F
Age: 49
State: OK

Vax Date: 12/30/2020
Onset Date: 12/31/2020
Rec V Date: 01/01/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List: Nausea

Symptoms: Onset of moderate arthralgia, injection site pain, and mild myalgia within 9.5 hours of receiving vaccine injection. Onset of severe, activity-limiting arthralgia, myalgia, chills, nausea, and fatigue, as well as 102 F oral temperature, within 22 hours of receipt of vaccine. Symptoms progressively worsened to the point patient suspected influenza infection, so sought testing and evaluation at urgent care facility the evening of 12/31/2020.

Other Meds: Albuterol inhaler PRN, duloxetine 90mg QD, Adderall 90 mg QD, ibuprofen 600mg PRN, acetaminophen PRN (1,000mg PO dose taken 2 hours prior to urgent care visit)

Current Illness: None except history of mild asthma. Patient had positive COVID-19 PCR test on 11/15/2020.

ID: 0916835
Sex: F
Age: 30
State: NJ

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

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

Lab Data:

Allergies: None known

Symptom List: Injection site pain

Symptoms: Sudden onset cough, shortness of breath, and wheezing. A fever of 100.6 was noted but unsure as to when that occurred as I did not have chills. Feber has subsided. Cough, shortness of breath and intermittent wheezing remain as well as some chest pressure, sore throat, headache and chills. Coughing fits are bad enough to cause urinary incontinence but I did give birth 4 months ago so this may not be significant. No signs of allergic reactive such as redness, urticaria or swelling.

Other Meds: Paxil Vyvanse

Current Illness: None

ID: 0916836
Sex: M
Age: 55
State: MD

Vax Date: 12/24/2020
Onset Date: 12/30/2020
Rec V Date: 01/01/2021
Hospital: Y

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

Symptoms: Patient is a 55 year old male with no past medical history who presents with complaint of sudden onset of left-sided nonradiating chest discomfort of sudden onset approximately 1 hour prior to presentation while doing administrative work at rest. He describes the pain as a dull heaviness sensation and approximate 3/10 pain severity. Chest discomfort was associated with a feeling of flushing that was quite transient but chest discomfort was persistent. Patient immediately presented to the ED for further evaluation. He denies experiencing any chest pain upon waking up this morning. Does note that he did have a transient episode of epistaxis on his way to work for which he had to pull over and apply pressure to his nose but this subsequently subsided and he attributed this to dry air as he has experienced epistaxis in the past but with less severity previously. In the ER, vital signs noted for BP 133/76, pulse ranging 91-114, respiratory rate 16-20, 96% on room air. Initial laboratory parameters were completely normal including normal CBC, CMP, LFT, lipase, UA, and normal D-dimer. Initial troponin was negative x1. EKG with sinus tachycardia, heart rate of 115. Noted Q waves inferiorly. No acute ST or T wave changes appreciated. Chest x-ray with mild increased density in the left lower lobe. Given this, patient was tested for rapid Covid which was negative but PCR was positive for COVID. CT of the chest noted for focal subsegmental groundglass infiltrate at the superior segment of the LLL, likely infectious versus inflammatory. Also noted small nonspecific groundglass attenuation with focal septal thickening at the right upper lobe which could be infectious or inflammatory, bibasilar atelectasis. Patient was treated with aspirin 324 mg in the ED. Of note, patient actually just received the COVID-19 vaccination on 12/24/20. He denies any shortness of breath, no cough, denies any nausea or vomiting, denies any change in taste or smell nor change in appetite. Does note 1 single episode of loose stool but otherwise denies any diarrhea. Does report that he had approximate 48 to 72-hour period of fatigue and soreness at the site of the left deltoid injection following the vaccination but otherwise no further symptoms. It is also noted that he does have a positive family history of coronary artery disease as his dad had an MI at the age of 49. Patient has never undergone a cardiac catheterization in the past but does report having a negative stress test at the age of 42. He is being admitted under the hospitalist service for further management Patient was initially admitted under observation for chest pain obs. However patient's Covid test came back positive and patient also had dynamic EKG changes concerning for possible unstable angina. Patient was treated with aspirin Plavix full-strength Lovenox along with beta-blocker and a cardiology consult. Serial troponins were negative. Echocardiogram revealed normal EF of 55 to 60% with no hemodynamically significant valvular disease. Cardiology felt that patient likely has underlying coronary artery disease have recommended discharge home with aspirin and Plavix with outpatient stress testing given his positive Covid testing. At the time of discharge patient denied any chest pain or shortness of breath. Patient was borderline diabetic with a hemoglobin A1c of 6.1. Patient was discharged home with Metformin along with glucometer, glucose strip, lancets. Given patient's tachycardia patient's Metformin 25 mg twice daily was changed to Toprol 25 mg daily. (Please note clarification in comparison to discharge home med list. Toprol XL 25 mg daily was called to pharmacy in place of the metoprolol.)

Other Meds: No current medications

Current Illness: Pt reported frequent urination for several months

ID: 0916837
Sex: F
Age: 34
State:

Vax Date: 12/18/2020
Onset Date: 12/18/2020
Rec V Date: 01/01/2021
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: Latex - rash Amoxicillin - rash Bacitracin - rash Codeine - rash

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

Symptoms: I received the vaccine at 10:30 am. About two hours later I noticed a minor headache. By 4pm I had a moderate pounding headache. Around 4:30pm, I noticed minor unilateral scalp, facial and neck numbness on the left side. These symptoms lasted about a week, but slowly improved. Four days after the vaccine I had very tender lymph nodes on the left ear area. Today marks two weeks exactly since I received the vaccine and two days ago I noticed slight increase in numbness on the left cheek again which again, is slowly improving. However, I also wear Invisalign at sometimes notice that I bite my cheek while asleep. I also wear N95 masks four days of the week which are quite tight on the face. The injection site (Left deltoid) was moderately sore for the first few days and still two weeks later has minor soreness the comes and goes.

Other Meds: Nortiptyline 10 mg 3 capsules po daily Buspirone 5 mg po twice a day Magnesium Glycinate 400mg/day Plexus Nerve 2 capsules/day Plexus ProBio5 2 capsules /day Plexus Balance 2 capsules/day Plexus VitalBiome 1 capsule/day

Current Illness:

ID: 0916838
Sex: F
Age: 57
State: WI

Vax Date: 12/28/2020
Onset Date: 12/28/2020
Rec V Date: 01/01/2021
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: Naproxen, Tape

Symptom List: Tremor

Symptoms: sore arm started same day as vaccine 12/28/2020, then about 12 hours later-history of chronic cough but persistent cough, chills, headache, nausea and dry heaves,. Went to ED on 12/30/2020 at 5 am. given IV fluids, zofran, reglan, fentanyl, morphine. Sent home with prescription for Zofran

Other Meds: B12, Vit D, Calcium, Zinc. Atorvastatin, Valsartan, Prednisone, Metoprolol, Spironolactone, Folic Acid, Fosamax

Current Illness: none

ID: 0916839
Sex: F
Age: 44
State: NM

Vax Date: 12/21/2020
Onset Date: 12/29/2020
Rec V Date: 01/01/2021
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: None

Symptom List: Erythema, Pruritus

Symptoms: Pleuritic chest pain, seen in ED, 12/31/2020, had elevated ddimer, CT negative for PE, EKG and troponin normal, Covid swab negative, diagnosed with pleurisy

Other Meds: Topomax

Current Illness: None

ID: 0916840
Sex: F
Age: 32
State: TX

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

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

Symptoms: Fatigue, headaches, muscle aches with 12 hours. Low grade fever began 20 hours after vaccination. All symptoms subsided after 48 hours. Bruise-like tenderness at the injection site lasted >72 hours and burning sensation around the posterior of my left arm persisted for >72 hours.

Other Meds: Melatonin

Current Illness: None

ID: 0916841
Sex: M
Age: 42
State: TX

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

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

Symptoms: Palpitations increased drastically, I started increasing at 01:00 1/1/2021 and at it worse by 07:00 1/1/21 I was having about 1 very 3-5 seconds. I normally take metoprolol ER 50 to control them but I increased the dose to 75 mg and it helped where I was getting one per min or so. I did have a caffeinated drink at approximately 1800 12/31/20 but that?s not new for me.

Other Meds: Metoprolol, toperamate, ambien, omeprazole, Imitrex, melatonin, advair, albuterol

Current Illness: Palpitations nos well controlled for years, broncho-spasms recent, migraines

ID: 0916842
Sex: F
Age: 29
State: NJ

Vax Date: 12/30/2020
Onset Date: 12/31/2020
Rec V Date: 01/01/2021
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: ativan, ceftazidime

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Fever, chills, body aches. Swelling at site for 2+ days. Lymph node swelling

Other Meds: estrogen, progesterone, propranalol, protonix, zinc

Current Illness: n/a

ID: 0916844
Sex: F
Age: 55
State: FL

Vax Date: 12/29/2020
Onset Date: 12/30/2020
Rec V Date: 01/01/2021
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: Penicillin, sulfa, vancomycin, erythromycin, nickel

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

Symptoms: Apart from a very sore arm about 24 hours after the vaccine I developed a rash, small red dots. I felt itching all over my body and my face and neck felt like there were sunburnt. I did not lose any work time

Other Meds: Sertraline and Qvar inhayler

Current Illness: none

ID: 0916845
Sex: F
Age: 24
State: AR

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

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

Symptoms: dizzy / headache

Other Meds:

Current Illness:

ID: 0916846
Sex: F
Age: 36
State: AR

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

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

Lab Data:

Allergies: anesthesia

Symptom List: Pain in extremity

Symptoms: Red face and neck, itching, felt extreme heat sensation, nausea, high blood pressure, chills, muscle spasms to left leg, and headache. Took Benadyrl. Side effects have resolved.

Other Meds: None

Current Illness: None

ID: 0916847
Sex: F
Age: 50
State: CA

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

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

Lab Data:

Allergies: Shellfish

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

Symptoms: Fever and chills for 12 hours

Other Meds: D and multi

Current Illness: None

ID: 0916848
Sex: F
Age: 34
State: AR

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 01/01/2021
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: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: approx. 6 hours post shot felt like throat was tight, lips were numb and tingly and fingers numb. was given Benadryl orally and symptoms improved.

Other Meds:

Current Illness:

ID: 0916849
Sex: F
Age: 33
State: NC

Vax Date: 12/23/2020
Onset Date: 12/24/2020
Rec V Date: 01/01/2021
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: none

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

Symptoms: I received the vaccine in the left arm on 12/23 with no immediate symptoms. On 12/24 I had body aches mostly on my left side. On 12/25, I started having a strong headache, focused mostly on the left side. On 12/26 the headache continued and I also noticed swollen lymph nodes on both sides of my neck, and behind my ears. Also, it felt like someone had broken my nose and when I would try to bite down or chew I would have a sharp pain and pressure in my nose and sinuses. On 12/27, the headache continued, and I had severe left eye pain, as well as pain chewing and the swollen nodes, that became painful to touch. On 12/28, I went to my PCP and was tested for covid, which was negative. She diagnosed me with a sinus infection and prescribed amoxicillin. On 12/29, I noticed my scalp had lumps on it that were painful and I had a very itchy spot on my forehead, which became swollen as well to about a quarter size lump. I also had other painful spots on my scalp all over and a continued severe headache and left eye pain. I tried to follow up with my PCP on 12/31, but their office was closed, and the on call nurse referred me to urgent care. More painful, swollen lymph nodes have appeared on my face and neck. I wasn't able to be seen at urgent care until today (1/1), and was then diagnosed with Shingles. I was told to continue amoxicillin and to start taking Valtrex. I am very itchy, mostly on my face, scalp, and left side of my body.

Other Meds: mirena

Current Illness: none

ID: 0916850
Sex: F
Age: 20
State: TX

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

Symptom List: Vomiting

Symptoms: 20 year old female c/o possible adverse reaction to vaccine. States she received the 1st round of covid vaccine 2 days ago. Reports having increase difficulty swallowing, difficulty breathing, + diarrhea, chest tightness and increase difficulty ambulating ever since getting the vaccine. She is calling seeking guidance on what to do. She reports she had the pfizer vaccine.

Other Meds: Escitalopram 5 mg Venlafaxine 37.5 mg tablet ZyrTEC;

Current Illness:

ID: 0916851
Sex: F
Age: 41
State: IL

Vax Date: 12/22/2020
Onset Date: 12/26/2020
Rec V Date: 01/01/2021
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: No allergies to medications or food. Only perennial allergies related to Allergic Rhinitis.

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Moderate to severe nausea for the past 6 days.

Other Meds: Aplenzin 522mg, Flonase Sensimist, Clonazepam 0.5mg BID PRN, Melatonin SR 0.2mg, Ambien CR 12.5mg, Tretinoin cream, Elidel topical, Hydroquinone topical, Multivitamin and Krill oil supplements.

Current Illness: Allergic Rhinitis, Exercise-induced Asthma, Anxiety, Depression, Delayed Sleep Phase Disorder, Rosacea and Osteoporosis.

ID: 0916852
Sex: F
Age: 69
State: OH

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 01/01/2021
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: pencillin, garlic, aspertane products, root beer, red wine, shrimp

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

Symptoms: severe chills, headache, low grade fever, joint pain, nausea and vomiting, and injection site soreness Onset was within <5 hours of injection and lasted 60 hours. Took Tylenol for fever which helped control that symptom. It was like hospitalized COVIC all over again. Reluctant to receive 2nd dose if I have this same adverse reaction. I had donated my COVID convalescent plasma that morning for the 4th occasion but I was told it would not interfere with the vaccine.

Other Meds: Gemfibrosil, Excedrin extra strength, multivitamin

Current Illness: none

ID: 0916853
Sex: M
Age: 73
State:

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

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Moderna COVID-19 Vaccine EUA Lightheadedness, similar to effect of one or two alcoholic drinks. Systolic BP 180. No typical symptoms nor signs of allergy. No treatment except to watch and wait. Systolic BP returned to normal (<150) in 15 minutes. Lightheadedness fully resolved in less than 2 hours..

Other Meds: rosuvastatin, gabapentin, duloxetine, tamsulosin, baby aspirin (1/day), multivitamin; insulin to control diabetes (see item 12)

Current Illness: none

ID: 0916854
Sex: F
Age: 61
State: CA

Vax Date: 12/20/2020
Onset Date: 12/28/2020
Rec V Date: 01/01/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: 12/28 developed shingles for the first time. Started antivirals 12/31when vesicles appeared and I realized it was shingles.

Other Meds: none

Current Illness: none

ID: 0916855
Sex: F
Age: 61
State: TN

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

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

Symptoms: Severe injection site reaction, chills/fever, severe headache up back of the head, aches/pains, nausea, itching entire arm of injection. Unable to work for 2 days. The was the second injection.

Other Meds: Calcium, metoprolol, losartin, ASA

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm