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**
PLEASE CHECK BACK SOON
Download the files above while you wait.






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: 1167920
Sex: F
Age: 72
State: FL

Vax Date: 03/12/2021
Onset Date: 03/24/2021
Rec V Date: 04/05/2021
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: No

Symptom List: Dysphagia, Epiglottitis

Symptoms: Ache joints, no energy, sharp shocking pains intermittent in different areas, knees feel like kneeling on nails...general feeling ill

Other Meds: Oxbutynin B12 Krill oil D3 Calcium Omeprazole Atorvastatin

Current Illness: No

ID: 1167921
Sex: F
Age: 52
State: NJ

Vax Date: 04/01/2021
Onset Date: 04/02/2021
Rec V Date: 04/05/2021
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: n/a

Symptom List: Anxiety, Dyspnoea

Symptoms: severe itching in head, hands and lower stomach

Other Meds: Vitamin D Lamisil

Current Illness: n/a

ID: 1167922
Sex: F
Age: 47
State: MI

Vax Date: 03/30/2021
Onset Date: 04/01/2021
Rec V Date: 04/05/2021
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: iodine

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

Symptoms: Started with a body rash on Thursday 4/1/20. Rash is more on upper chest and Rt ear. "Big blotches" According to client. She went to the Urgent Care on 04/04/2021 and was giving medication..Steroid shot, Hydroxyeine HCL 50 mg at night for itching, Predisone 10 mg daily 3..2..1.. and Famotidine 20 mg 1 daily. Client states rash is still viable but not as itchy. It is lighter in color.

Other Meds: Humera Pen 40 mg every 2 weeks Blisovi -1.5/30 (BC) Cezimeline HCL 30 mg 3 x daily Omeprazole 20 mg 1 x daily Iron Supplement - 325 mg 3 x weekly Albuterol INH as needed

Current Illness: RA Sjogren's

ID: 1167923
Sex: F
Age: 32
State: PA

Vax Date: 02/19/2021
Onset Date: 03/07/2021
Rec V Date: 04/05/2021
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: 2 weeks after second COVID vaccine, immediately after taking polyethylene glycol (Miralax) had severe pruritis of bilateral hands and feet with redness of the skin. Followed shortly by nausea and 1 episode of vomiting, hypotension (70s/50s), and chills. This passed over the subsequent couple hours then about 6 hours later developed sudden onset severe bilateral conjunctivitis which was so painful I couldn't open my eyes or see very well and ended up going to the ED. Seen by ophthalmology there and told it was likely viral conjunctivitis. Over the next couple hours this passed but then started to develop severe diffuse arthralgias which lasted about 1 day. This then passed and I felt completely fine. About 2 weeks later I tried taking Miralax again and about 6 hours after taking the Miralax developed the same severe diffuse arthralgias as the prior episode, which again passed in about 1 day. I had taken Miralax several times before getting vaccinated without any issue.

Other Meds: Prenatal vitamins

Current Illness: Postpartum (delivered 1/25/21)

ID: 1167924
Sex: F
Age: 32
State: WI

Vax Date: 03/31/2021
Onset Date: 04/01/2021
Rec V Date: 04/05/2021
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: I take sertraline daily and the side effect is rolling nausea. Usually it occurs in the hour or two after taking my daily dose. After the vaccination, the nausea would roll over me in waves at various times all day for the first week. Nausea is a side effect I was warned about with the vaccine and wanted to report the perceived connection here between the sertraline, worsening nausea and the vaccine dose. Thank you. It didn't require special treatment or anything but I think people should be aware.

Other Meds: 125 mg Sertraline daily ... this was the adverse reaction.

Current Illness:

ID: 1167925
Sex: F
Age: 40
State: TN

Vax Date: 04/02/2021
Onset Date: 04/02/2021
Rec V Date: 04/05/2021
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: Sulfa antibiotics, seasonal allergies.

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

Symptoms: Headache started within a few hours of vaccine. Started feeling achy, fatigued, feverish by mid-afternoon. By evening, I had cold-chills, body aches. Saturday morning (4/3), my fever was 101.5. I took OTC cold/flu pills, which helped some with the body aches/chills/fever. My fever ended up spiking at 101.9 Saturday afternoon, and the fever broke Saturday night. Sunday I still had a slight headache, I took OTC Tylenol which eased the symptoms. As of Sunday, this was my only remaining symptom.

Other Meds: Generic Allegra and Flonase.

Current Illness: seasonal allergies.

ID: 1167926
Sex: F
Age: 32
State: IN

Vax Date: 04/02/2021
Onset Date: 04/03/2021
Rec V Date: 04/05/2021
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: sulfa

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Red, swollen ring around injection site for 4+ days. Knot underneath skin for 4+ days. Know/swelling is hot to touch for 4+ days.

Other Meds: NA

Current Illness: NA

ID: 1167927
Sex: F
Age: 49
State: NE

Vax Date: 03/27/2021
Onset Date: 03/28/2021
Rec V Date: 04/05/2021
Hospital:

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

Lab Data:

Allergies: na

Symptom List: Pharyngeal swelling

Symptoms: I ended up in the emergency room at 4am on 3/28. I had 103 temp, heart racing, headache, sore throat, body chills, joints muscles hurting couldn't walk. The ER did an EKG, chest xray, labs, respiratory swabs, and urine. Stated all was alright. This was an exaggerated response to the COVID vaccination. I have had an elevated temperature the entire week. Today my temp is 101.

Other Meds: Chemotherapy, Tylenol, daily vitamin, fish oil,

Current Illness: Breast Cancer

ID: 1167928
Sex: F
Age: 56
State:

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

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

Lab Data:

Allergies: IV contrast - Rash/itching Bactrim - hives/swelling of lips

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: During 15 minutes waiting period after second immunization, patient experienced metallic taste in their mouth. Metallic taste lasted during the entire monitoring period.

Other Meds:

Current Illness:

ID: 1167929
Sex: F
Age: 58
State: NY

Vax Date: 04/02/2021
Onset Date: 04/02/2021
Rec V Date: 04/05/2021
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: Ibuprofen: rash

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Tinnitus, has not resolved 4 days later.

Other Meds: Levothyroxine Wellbutrin Maxine Vit b Melatonin

Current Illness: No

Date Died: 03/25/2021

ID: 1167930
Sex: M
Age: 90
State: MN

Vax Date: 02/12/2021
Onset Date: 03/25/2021
Rec V Date: 04/05/2021
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: Patient death within 60 days of receiving the COVID vaccine series

Other Meds:

Current Illness:

ID: 1167932
Sex: F
Age: 50
State: NY

Vax Date: 04/03/2021
Onset Date: 04/03/2021
Rec V Date: 04/05/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Rash, Urticaria

Symptoms: Chills, feeling warm, headache, congestion, tired, achy, nauseous, loss of appetite. All symptoms except for slight congestion gone within 48 hours of shot.

Other Meds: Vitamin B12 1000mg; Birth control pill

Current Illness: None

ID: 1167933
Sex: F
Age: 21
State: IN

Vax Date: 04/02/2021
Onset Date: 04/02/2021
Rec V Date: 04/05/2021
Hospital:

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

Lab Data:

Allergies: Wheat allergy

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

Symptoms: 6 hours after vaccine: intense chills, 102? fever for 6 hours, muscle soreness, nausea Day after vaccine 4/3/21: nausea, loss of appetite, muscle soreness, blurry vision, headache 2 days after vaccine 4/4/21: headache, soreness- especially at injection site, loss of appetite 3 days after vaccine 4/5/22: nasal congestion, runny nose, headache, fatigue, dizziness

Other Meds:

Current Illness:

ID: 1167934
Sex: F
Age: 49
State: FL

Vax Date: 04/03/2021
Onset Date: 04/03/2021
Rec V Date: 04/05/2021
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: About 15 minutes after her second moderna covid19 vaccine patient had a reaction and was about to faint in her chair in the observation area. The MA noticed the patient about to faint and our Pharmacist and provider/APRN on duty, who also took the vitals, was able to quickly place the patient at our back clinic. Vitals were taken once she was taken to our clinic area around 10:30

Other Meds:

Current Illness:

ID: 1167935
Sex: M
Age: 28
State: IA

Vax Date: 04/02/2021
Onset Date: 04/04/2021
Rec V Date: 04/05/2021
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: Penicillin

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

Symptoms: Mother called to report information for son. All information documented was information obtained. Luanne counseled to have son contact PCP for further recommendation. 04/02/2021, symptom of nausea, headache and feeling flushed instantly after receiving the vaccine. Client did not report symptoms or wait 15 minutes prior to leaving mass clinic. Symptoms on 04/02/2021 were resolved by morning of 04/03/2021. On 04/04/2021, client woke with swollen eyes and red blotches to face. Client took 50mg of Benadryl, 3 times on 04/04/2021. Symptoms improved over the day, but did not resolve.

Other Meds: None

Current Illness: None

ID: 1167936
Sex: M
Age: 88
State: MO

Vax Date: 03/29/2021
Onset Date: 04/03/2021
Rec V Date: 04/05/2021
Hospital: Y

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

Lab Data:

Allergies: nka

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

Symptoms: This is a 88 yr old male pt with a hx significant for -stage renal disease on hemodialysis, hypertension hypertensive heart disease and kidney disease, CAD, history of acute MI, dementia, GERD, gout, prostate cancer who is admitted with complaints of chest reviewed and back pain. Pr records patient was noted to be grunting and hyperventilating while in the emergency department. Imaging done was negative for a pulmonary embolism, showed minimal interstitial upper lobe and peripheral lower lobe interstitial and groundglass lung opacities which are nonspecific. Patient was tested for COVID-19 and has tested positive.

Other Meds: Tylenol, tums, isosorbide mononitrate, xopenex, celexa, lipito

Current Illness:

ID: 1167937
Sex: F
Age:
State:

Vax Date: 03/25/2021
Onset Date: 04/02/2021
Rec V Date: 04/05/2021
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: She stated she had Moderna vaccine at Gillette on 3/25. She stated area has been itchy for a couple days and today she noticed a red rash near the injection site, that is warm, about 2-3 inches. She denies any other symptoms.

Other Meds:

Current Illness:

ID: 1167938
Sex: F
Age: 78
State: GA

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 04/05/2021
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: Pt received Pfizer dose #1 on 03/10/2021. Pt returned for 2nd dose on 03/31/2021 and received Moderna in error

Other Meds:

Current Illness:

ID: 1167939
Sex: M
Age: 39
State: KY

Vax Date: 04/02/2021
Onset Date: 04/04/2021
Rec V Date: 04/05/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: PATIENT REPORT MODERATE RASH AND SWOLLOWEN BUMP ON NECK. I ADVICED PATIENT TO TAKE IBUPROFEN AND BENADRYL. I RECHECKED AFTER 2 HOURS AND PATIENT HAD IMPROVED IN SYMPTOMS

Other Meds:

Current Illness: N/A

ID: 1167940
Sex: F
Age: 28
State: NC

Vax Date: 04/02/2021
Onset Date: 04/02/2021
Rec V Date: 04/05/2021
Hospital:

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

Lab Data:

Allergies: Septra Penicillin Percocet Shellfish

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

Symptoms: COVID-19 Moderna Arm - large tough red patch spreading over most of upper left arm, painful to the touch and swollen- ongoing at time of submission High Fever- April 3-4 high fevers all day ranging from 101-103 both days Severe headache- starting same afternoon of the shot, intense, light sensitive headache

Other Meds: Lexapro Buspirone Lamotrigine Estarylla

Current Illness: N/A

ID: 1167941
Sex: F
Age: 39
State: AZ

Vax Date: 03/28/2021
Onset Date: 04/05/2021
Rec V Date: 04/05/2021
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: Sulfa antibiotics

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

Symptoms: woke up 8 days later with itching, redness, soreness, and heat at the site of the injection on my left arm. Also experiencing intermittent pain in my left arm pit.

Other Meds: none

Current Illness: none

ID: 1167942
Sex: M
Age: 22
State: IN

Vax Date: 04/03/2021
Onset Date: 04/04/2021
Rec V Date: 04/05/2021
Hospital:

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

Lab Data:

Allergies: Dandruff and pollen

Symptom List: Unevaluable event

Symptoms: Sore arm, fever, congestion, headache, fatigue,

Other Meds: Allergy medicine and extra strength tylenol

Current Illness: N/A

ID: 1167943
Sex: F
Age: 24
State: NY

Vax Date: 03/23/2021
Onset Date: 03/23/2021
Rec V Date: 04/05/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Was fine for about 8 hours, outside of a little soreness in arm. Then I started feeling cold chills, and had to lie down in bed for the rest of the day. Slight fever also occured and intense body aches. However, these slowly subsided after taking tylenol at about 6PM. I slept through the night and outside of feeling a little lethargic the next day, I was back to normal.

Other Meds: Tylenol.

Current Illness: None

ID: 1167944
Sex: F
Age: 65
State: TN

Vax Date: 04/03/2021
Onset Date: 04/04/2021
Rec V Date: 04/05/2021
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: Benadryl

Symptom List: Injection site pain, Pain

Symptoms: Vomiting for 3 hours and shortness of breath for 24 hours

Other Meds: Lexapro and celebrex

Current Illness: Abcessed tooth

ID: 1167945
Sex: F
Age: 27
State: MI

Vax Date: 03/27/2021
Onset Date: 04/03/2021
Rec V Date: 04/05/2021
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: Day 1: headache, pain at injection site, lumps at injection site Day 2: pain at injection site, lumps at injection site Day 3: itchiness at injection site, lumps at injection site Day 4-6: minor itchiness, 2 dark spots Day 7: itchiness increases Day 8: very itchy, one large lump noticeably different from other arm - tennis ball sized in diameter with border Day 9: very itchy

Other Meds: levonorgestrel

Current Illness:

ID: 1167946
Sex: F
Age: 28
State: RI

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 04/05/2021
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: Patient received Pfizer first dose on 12/20/2020, lot # EH9899. Pfizer was the only manufacturer administered on 12/20. Patient was scheduled by the vaccinator for her second dose on 1/10 with an appt note "Pfizer 2nd dose." This appointment was subsequently cancelled and rescheduled to 1/11 with the same appt note. Patient no-showed for the 1/11 appt. On 1/12, the patient was scheduled for 1/26 with appt note "dose 2." 1/26 was a Moderna ONLY day. Moderna was documented as administered, lot # 032L20A. No adverse reaction, reporting as required by CDC.

Other Meds:

Current Illness:

ID: 1167947
Sex: F
Age: 64
State: FL

Vax Date: 04/04/2021
Onset Date: 04/04/2021
Rec V Date: 04/05/2021
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: Citrus; pineapple Trees, mold, grass, animal dander

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Raised hives on upper body (chest and under arms).

Other Meds: Armour Thyroid; Meloxicam; Gabapentin; Allegra; Vit ADK; Krill oil; CoQ10; Magnesium; Vit B complex; Selenium; Probiotic; Zinc; DHEA; DIM

Current Illness:

ID: 1167948
Sex: F
Age: 61
State: FL

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

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

Lab Data:

Allergies: betadine, amiodarone, levaquin, cipro, Bactrim, codeine, morphine, Demerol, lipitor

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Approximately 10 minutes after administration, patient stated her chest felt heavy and she was feeling sweaty/hot. Approximately 5 minutes later, patient went into a absence seizure for roughly 5 minutes.

Other Meds: Acyclovir, alprazolam, famotidine, levetiracetam, metoprolol tartrate, ondansetron, pravastatin, tacrolimus

Current Illness:

ID: 1167949
Sex: F
Age: 56
State: ME

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/05/2021
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: Penicillin

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

Symptoms: Headache, body aches, diarrhea

Other Meds: Zyrtec, HRT, Zoloft

Current Illness:

ID: 1167950
Sex: F
Age: 49
State: MI

Vax Date: 01/06/2021
Onset Date: 04/02/2021
Rec V Date: 04/05/2021
Hospital:

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

Lab Data:

Allergies: Clarithromycin, docusate sodium, erythromycin lactobionate

Symptom List: Nausea

Symptoms: Patient developed COVID. Not hospitalized at this time.

Other Meds: unknown

Current Illness: none noted

ID: 1167951
Sex: F
Age: 52
State: IN

Vax Date: 04/02/2021
Onset Date: 04/03/2021
Rec V Date: 04/05/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Injection site pain

Symptoms: swelling in face and hands--cannot make a fist without pain

Other Meds: heartburn medication and statin for cholesterol

Current Illness: none

ID: 1167952
Sex: F
Age: 60
State: IN

Vax Date: 03/26/2021
Onset Date: 04/03/2021
Rec V Date: 04/05/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

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

Symptoms: Left arm is itchy, swollen , red, hot to touch and sore

Other Meds: None

Current Illness: None

ID: 1167953
Sex: M
Age: 40
State: PA

Vax Date: 03/18/2021
Onset Date: 03/19/2021
Rec V Date: 04/05/2021
Hospital: Y

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

Lab Data:

Allergies: NA

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

Symptoms: Severe Vertigo

Other Meds: Effexor XR 150mg Clonazepam 1mg

Current Illness: NA

ID: 1167954
Sex: F
Age: 51
State: MI

Vax Date: 01/08/2021
Onset Date: 03/19/2021
Rec V Date: 04/05/2021
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: NA

Symptom List: Tremor

Symptoms: Patient tested positive for COVID-19 after completing the full Pfizer vaccine series, 70 days after 2nd dose. Patient received 2nd dose of COVID vaccine on 1/8/21 . Tested positive on 3/19/21. NOT hospitalized. reported being in contact with someone confirmed/suspected for COVID-19.

Other Meds: NA

Current Illness: NA

ID: 1167955
Sex: M
Age: 34
State: PA

Vax Date: 03/26/2021
Onset Date: 03/28/2021
Rec V Date: 04/05/2021
Hospital: Y

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

Lab Data:

Allergies: One time allergic reaction to penicillin

Symptom List: Erythema, Pruritus

Symptoms: Pfizer-BioNTech COVID-19 Vaccine EUA (administered on 03/26/21) Fever, chills, headache, general soreness all began on 03/27/2021. On 03/28/2021, I began to notice chest pain and simultaneous pain in my left arm on 03/28/2021. The fever, chills, headache, and general soreness subsided on 03/29/2021, but the periodic chest and arm pain persisted and continued to get worse. On 03/29/2021 I also had nausea/vomiting and sweating. On the morning of 03/30/2021 during an episode of chest and arm pain we went to the Emergency Department at. At the emergency department, they detected elevated troponin levels indicating damage to the heart muscle. I was rushed via ambulance for an emergency heart catheterization. I was admitted to the hospital and monitored while various other tests were performed. It was determined that there was inflammation of the heart muscle (myocarditis).

Other Meds: None

Current Illness: None

ID: 1167956
Sex: M
Age: 65
State: KY

Vax Date: 04/03/2021
Onset Date: 04/05/2021
Rec V Date: 04/05/2021
Hospital: Y

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: Imdur

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

Symptoms: The patient is a 65 yr/o male with a history of Afib on Xarelto and HTN presents via EMS for evaluation of AMS that was noted by wife this am. The wife states as soon as the pt woke up he was altered mainly acting confused and not speaking normally. She also states that his side of the bed was wet this am but is unsure if it was sweat or urine. LKW 2200 last night before the pt went to bed. Upon EMS arrival the pt was sitting on the floor, playing with a toilet brush, and speaking non-sense. While en route to the ED the pt reportedly had convulsive seizure like activity and was non-responsive 15-20min following the activity. He is now awake but not verbally responsive and still acting confused. No hx of seizures per wife. Hx otherwise limited as pt is non-verbal at this time

Other Meds: Lipitor, fiorinal, atarax, protonix, Zoloft, xarelto

Current Illness:

ID: 1167957
Sex: F
Age: 46
State: MI

Vax Date: 03/24/2021
Onset Date: 04/01/2021
Rec V Date: 04/05/2021
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: Sore and swollen arm at location of shot that occurred 7 days after shot. Starting with day 7 until now (day 12 as I type this) there has been a rash that is raised and itchy.

Other Meds: Plaquinil

Current Illness: None

ID: 1167958
Sex: F
Age: 59
State: IA

Vax Date: 02/02/2021
Onset Date: 02/04/2021
Rec V Date: 04/05/2021
Hospital: Y

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

Lab Data:

Allergies: penicillin, Levaquin gluten, dairy, eggs, dust, tree, mold

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: after 48 hours became very weak and fatigued. Became worse through the month of February. Had 2 doctor visits, blood tests, shot of steroids, prescription of steroids. 2 ER visits, 4 day hospitalization Low Cortisol now and have to see Endocrinologist missed lots of work and still cannot work my full 6 hours of work.

Other Meds: multi-vitamin, Vitamin D, Zinc, 180 mg Allegra 10mg Prednisone

Current Illness: none

ID: 1167959
Sex: F
Age: 38
State: NC

Vax Date: 04/05/2021
Onset Date: 04/05/2021
Rec V Date: 04/05/2021
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: NKA

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

Symptoms: C/o chest pain EMS took BP and first reading was 240/160, subsequent reading were in the same range. O2 stas were 97% HR 88. Continued to c/o of chest pain. Placed on monitor and ambulance called. Transported by 9:50 AM Had similar elevation of BP with first Moderna dose and was transported to hospital then as well per patient.

Other Meds: labetalol

Current Illness: unknown

ID: 1167960
Sex: F
Age: 58
State: NH

Vax Date: 04/02/2021
Onset Date: 04/04/2021
Rec V Date: 04/05/2021
Hospital:

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

Lab Data:

Allergies: None known.

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

Symptoms: Spotty red rash, not raised, not painful, not itchy. Across belly just below rib cage, above belly button. First noticed Sunday morning. Reported to primary care physician this morning. As of this morning, rash is fading (is less noticeable).

Other Meds: Phenobarbital, 120 mg./day Sertraline, 50 mg./day Flaxseed oil, 1200 mg./day Calcium 600 mg., Vitamin D 800 IU/day Glucosamine chondroitin, 1500 mg.day + Boswellia serrata, 100 mg.day Vitamin D., 50 mcg/day Folic acid, 800 mcg/day FiberCon,

Current Illness: None.

ID: 1167961
Sex: F
Age: 70
State: DE

Vax Date: 04/03/2021
Onset Date: 04/03/2021
Rec V Date: 04/05/2021
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: Patient potentially received more than the recommended dose of the Pfizer vaccine. As of Sunday 4/4, patient's only complaint is mild arm soreness at the injection site.

Other Meds:

Current Illness:

ID: 1167962
Sex: F
Age: 29
State: MO

Vax Date: 02/25/2021
Onset Date: 02/27/2021
Rec V Date: 04/05/2021
Hospital:

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

Lab Data:

Allergies: Family history of severe sulfa allergy. Soy products, almonds, apples

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

Symptoms: A few hours after the first dose: severe fatigue, sinus migraine and lack of appetite. Two days after first dose: I started mensturating heavily and suddenly with severe menstral symptoms. I continued to sporadically have light bleeding for 3 weeks. Prior to this event, I had not had a period in almost a year due to my birth control method. I have cramps, bloating, breast pain, irregular bleeding and weight gain. I received the second dose on 03/25/21 and by 03/30/21 I was experiencing yet another round of extreme PMS symptoms like severe breast pain, severe cramps that leave me bedridden, and intense food cravings. I have not had cyclic periods for several months prior to either of these events. It was jarring enough for me to start tracking my period symptoms because it was so out of the normal. I have been filtered into thinking any issues with my period are just something to deal with and to not seek medical attention, but I have missed approximately 6 days of work due to various symptoms after both of my doses.

Other Meds: Adderall XR 15MG, Adderall IR 10 MG, Euthyrox 25MCG, Nexplanon for 5 years, Aller-Flex

Current Illness: Seasonal allergies

ID: 1167963
Sex: M
Age: 56
State: MI

Vax Date: 04/03/2021
Onset Date: 04/04/2021
Rec V Date: 04/05/2021
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: codeine, hydrocodone

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

Symptoms: Body aches, headaches, tiredness, fatigue, injection site tenderness, lips/mouth swollen and very tender.

Other Meds: Diaovan hct, metformin, one a day multivitamin, urinozinc

Current Illness:

ID: 1167964
Sex: F
Age: 46
State: NC

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 04/05/2021
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: eggs, flu vaccine

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

Symptoms: 12/30 Vaccination The next day, started out with rash on neck and L arm. Took Benadryl. Lasted for 3 days. Spoke to pharmacist and PCM.

Other Meds: Tenex 2x day, Colace 100 mg 1xday,DHA Algal 900 mg, Adderall, multivitamin, Benadryl & Tagamet before 2nd vaccine

Current Illness: n/a

Date Died: 03/08/2021

ID: 1167965
Sex: F
Age: 75
State: IN

Vax Date: 03/04/2021
Onset Date: 03/08/2021
Rec V Date: 04/05/2021
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: dexamethasone, hydrocortisone, metronidazole, hydrochlorothiazide, sulfa, hydrococone

Symptom List: Vomiting

Symptoms: Patient called PCP office 3/5 w/ c/o N/V/D, weakness and lightheaded when she stood up. Was advised to hold blood pressure medication. On 3/8, was feeling much worse and called 911. Upon arrival (8:55), patient A&O x 4 with poor oxygen saturation (O2: 88%). Given nebulized albuterol/ipratropium. BG: 247mg/dl. Patient has episode of dry heaving after which she vagaled down with HR in the 40s. Recovered on her own. Once the nebulizer treatment ended, she was place on nasal O2 at 3 liters/minutes. Given 4mg ondansetron. Lost consciousness and respirations became agonal. Pt was bagged via BVM and noted to be in PEA. CPR initiated, including intubation. Given 1mg epinephrine. NSR obtained after two rounds of CPR. Pt arrested again shortly after arrival to ED. ACLS initiated once more. Patient expired at 10:40 am.

Other Meds: Amlodipine, Aspirin, carvedilol, lansoprazole, losartan, meclizine, questran

Current Illness: nausea, lightheadedness, diarrhea, vomiting, SOB

ID: 1167966
Sex: M
Age: 57
State: GA

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 04/05/2021
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: Pt received 1st dose of Pfizer on 03/10/2021, Pt returned for 2nd dose on 03/31/2021 and received moderna in error

Other Meds:

Current Illness:

ID: 1167967
Sex: F
Age: 63
State: NY

Vax Date: 04/02/2021
Onset Date: 04/04/2021
Rec V Date: 04/05/2021
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: Levaquin, apples, fish, seasonal allergies

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

Symptoms: Morning of day after shot woke with fever of 100.5, which went up to 100.7 and didn't break until 12:20 a.m. of following day. Some nausea late on second day. Headache and dizziness started evening of the shot and resolved sometime second day after shot.

Other Meds: Famotidine, Restasis, Yuvafem

Current Illness:

ID: 1167968
Sex: F
Age: 63
State: CA

Vax Date: 03/26/2021
Onset Date: 04/02/2021
Rec V Date: 04/05/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Itchy red circle developed at injection site. At its peak it was hot to the touch. Site felt itchy and sore 4/2 evening, was itchy and had a light vertical stripe by morning of 4/3, by evening it was a circle and hot to the touch. Took photo 4/4 when it continued to itch but was no longer hot.

Other Meds: Latanoprost topical eye drops

Current Illness: None

ID: 1167969
Sex: F
Age: 68
State: FL

Vax Date: 02/06/2021
Onset Date: 02/07/2021
Rec V Date: 04/05/2021
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: For 6 weeks I had significant high FBS levels. I increased my Tresiba 2 units every 2 days. I capped out at 16 units every night. My blood sugars then began to decrease as did my tresiba dosing.

Other Meds: Tresiba, metformin, carvedilol, jardiance, zetia, losartin, Prilosec , gabapentim Multi vit, cranberry

Current Illness: None

ID: 1167970
Sex: F
Age: 50
State: PA

Vax Date: 04/02/2021
Onset Date: 04/02/2021
Rec V Date: 04/05/2021
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: none

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

Symptoms: itching, hives on chest, flushed cheeks, thickness feeling in throat that began about 1.5 hrs after receiving second vaccination - relieved by 50mg of Benadryl. Itching persisted and controlled with Benadryl 25mg every 4-6 hours for the following two days. So far today, I have not taken any Benadryl, but am still feeling slightly itchy.

Other Meds: none

Current Illness: none

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm