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

Date Died: 04/04/2021

ID: 1180374
Sex: F
Age: 81
State: IL

Vax Date: 02/03/2021
Onset Date: 04/04/2021
Rec V Date: 04/08/2021
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: Sulfa

Symptom List: Dysphagia, Epiglottitis

Symptoms: Death within 60 days of vaccination. Unwitnessed cardiac arrest, CPR attempted and unsuccessful.

Other Meds: unknown

Current Illness: Unknown

ID: 1180375
Sex: F
Age: 40
State: IL

Vax Date: 03/27/2021
Onset Date: 03/27/2021
Rec V Date: 04/08/2021
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: Hydromorphone

Symptom List: Anxiety, Dyspnoea

Symptoms: Seven days after receiving the vaccine, the arm began to scratch, the next day it was red, a little swollen, itchy, about a size of 3.5 cm. To date, the outbreak has not disappeared but the swelling, itching and redness have decreased.

Other Meds: Vitamin C and D

Current Illness: None

ID: 1180376
Sex: F
Age: 62
State: WA

Vax Date: 03/26/2021
Onset Date: 03/01/2021
Rec V Date: 04/08/2021
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: pt was vaccinated 6 days early

Other Meds:

Current Illness:

ID: 1180378
Sex: F
Age: 65
State: FL

Vax Date: 04/06/2021
Onset Date: 04/07/2021
Rec V Date: 04/08/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Side effects: headache, low grade fever, body ache, burning sensation in the arm/shoulder, skin rush

Other Meds: Baby aspirin

Current Illness: None

ID: 1180379
Sex: F
Age: 85
State: ME

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/08/2021
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: Patient both verbally and on the form denied having had the COVID vaccine prior to 04/07/2021. However, when entered into Database it showed that the client had been fully vaccinated with Pfizer vaccine (12/28/2020 and 01/18/2021, by CVS 4158). Facility notified. I will notify client/guardian and PCP. PHN supervisor notified, as well.

Other Meds:

Current Illness:

ID: 1180380
Sex: F
Age: 57
State: WA

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/08/2021
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: Tetracycline

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

Symptoms: Patient already vaccinated. First dose of Moderna vaccine administered 03/16/2021, second dose administered 04/06/2021 (21 days after first dose). No adverse reaction or symptoms reported. Verified with MD that no other doses will be given.

Other Meds:

Current Illness:

ID: 1180381
Sex: F
Age: 27
State: TX

Vax Date: 04/06/2021
Onset Date: 04/07/2021
Rec V Date: 04/08/2021
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: Berries

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Very sore arm, major headaches, fever and body aches the next day after shot. The second day 4/8/21 after shot still had headache but felt dizzy and very nauseous couldn?t get out of bed without feeling the need to throw up or being dizzy to the point I couldn?t stand up.

Other Meds:

Current Illness:

ID: 1180382
Sex: M
Age: 27
State: TX

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 04/08/2021
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: Pharyngeal swelling

Symptoms: Patient experienced dizziness and fell out of chair during observation period after vaccination. Patient brought into triage area and examined by MD. Patient started feeling well shortly after laying down. Per MD, observe Patient for 30 minutes before sending home.

Other Meds: none

Current Illness: none

ID: 1180383
Sex: F
Age: 57
State: CO

Vax Date: 04/07/2021
Onset Date: 04/08/2021
Rec V Date: 04/08/2021
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, lidocaine

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Bad headache started middle of the night, body aches, unable to sleep, nausea 14 hours after vaccine.

Other Meds: Omperazole

Current Illness: Gastroparesis

ID: 1180384
Sex: F
Age: 24
State: CO

Vax Date: 03/27/2021
Onset Date: 04/01/2021
Rec V Date: 04/08/2021
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: None

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Delayed (5 days after shot) allergic reaction at the injection site- stiff, swollen arm, which was painful, itchy, red, and hard to the touch. This lasted for about 4 days

Other Meds: None

Current Illness: None

ID: 1180385
Sex: F
Age: 31
State: CT

Vax Date: 04/06/2021
Onset Date: 04/08/2021
Rec V Date: 04/08/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: Headache

Other Meds: Miralax

Current Illness: none

ID: 1180386
Sex: M
Age: 33
State: PA

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/08/2021
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: NKDA

Symptom List: Rash, Urticaria

Symptoms: PT c/o nausea and chills 5 minutes s/p injection. EMS onsite aware, PT initial VS BP 89/57, HR 85, Resp 20, 99% SaO2, Glucose 94 - PT stated nausea and chills resolved a few minutes later - EMS rechecked BP @ 1420 while sitting - 98/58, and while standing - 101/57 - PT states symptoms have resolved - has a history of feeling lightheaded after giving blood. PT declined further evaluation/intervention - EMS obtained signed release and PT left facility at approx 1430 in no apparent distress.

Other Meds: None

Current Illness: None

ID: 1180387
Sex: M
Age: 45
State: NJ

Vax Date: 03/30/2021
Onset Date: 03/30/2021
Rec V Date: 04/08/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: After first dose I experienced severe L shoulder pain for 2 days. Couldn't move it well, could not sleep on it. Pain started 4h after injection. After second dose I started experiencing L shoulder pain after 40 minutes. Pain was so severe I could not put my hand into the packet. In the evening the same day I started running temperature 101F that last 3 days non stop. I started experiencing severe chills, could not stop at times shaking! I was hot and cold every so often. I started experiencing same evening severe body ache which was constant and felt like I was squeezed by some machine. I could not sleep, I felt just terrible, couldn't find comfortable position. My heart beat resting was 110 per minute and it stayed like that first night. My normal resting pulse is 60-70 bps. I did not have headaches or nausea. At night everything felt worse. After 3 nights temperature subsided but I was exhausted and my temperature dropped 95.9F my normal temperature is 97.88F. ( 36.6C) . Since April 2nd I have been tired and I want to sleep all the time.

Other Meds:

Current Illness:

ID: 1180388
Sex: M
Age: 71
State:

Vax Date: 03/26/2021
Onset Date: 04/03/2021
Rec V Date: 04/08/2021
Hospital: Y

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: nkda

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

Symptoms: Suffered a mild stroke

Other Meds:

Current Illness:

ID: 1180389
Sex: F
Age: 34
State:

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 04/08/2021
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: 4/8/2021 Patient was observed post Covid-19 immunization for 15 minutes . During the observation period, she experienced an adverse reaction with the following symptoms: dizziness, nausea and weakness. Assessment : Time of assessment 0954 Alert and oriented, Anxious and Nausea. Actions taken: Vitals sign taken VAERS form obtained and completed by RN. 0954- BP- 134/99, P- 64, 98.2, Medications administered: No medication administered. Disposition: Reports no further symptoms of adverse reaction after observation for 30 minutes. Discharged home. The Patient was provided with Vaccine Information Sheet and instruction to access the V-Safe system. Immunizations Administered Name Date Dose VIS Date Route Pfizer COVID-19 Vaccine 4/8/2021 9:26 AM 0.3 mL 12/11/2020 Intramuscular Manufacturer: Pfizer, Inc Lot: ER8729

Other Meds:

Current Illness:

ID: 1180390
Sex: F
Age: 34
State: CA

Vax Date: 04/01/2021
Onset Date: 04/08/2021
Rec V Date: 04/08/2021
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: Bees

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

Symptoms: Red rash at injection site on arm

Other Meds: Sprintec (birth control), Venlaflaxine HCL ER 37.5 mg, Citakopram 40 mg, Kirkland Aller-Tec (allergies), My Kind Organics Women's Multi-Vitamin

Current Illness: None

ID: 1180391
Sex: F
Age: 34
State: MI

Vax Date: 01/19/2021
Onset Date: 01/20/2021
Rec V Date: 04/08/2021
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: I am allergic to sulpha and clendomycin.

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

Symptoms: I woke up Wednesday morning with awful diarrhrea and at about 3:30PM I developed terrible heartburn. The heartburn would come and leave. I finally called my doctor and went in for a visit. I was referred to a GI specialist and they added Pepcid to my medications to try and help control the heartburn.

Other Meds: I was taking Prilosec & Gavestron & Prozac.

Current Illness: No other illnesses at the time of vaccination or up to one month prior.

ID: 1180392
Sex: F
Age: 60
State: WA

Vax Date: 03/26/2021
Onset Date: 03/01/2021
Rec V Date: 04/08/2021
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 was vaccinated 6 days early

Other Meds:

Current Illness:

ID: 1180393
Sex: F
Age: 55
State:

Vax Date: 04/05/2021
Onset Date: 04/06/2021
Rec V Date: 04/08/2021
Hospital:

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

Lab Data:

Allergies: Flagyl

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Chest pain-mild to moderate. Intermittent pInching and tightness

Other Meds: Vitamin c, omega 3, vitamin D, multi vitamin, culturelle, aspirin (intermittent)

Current Illness: None

ID: 1180394
Sex: F
Age: 49
State: MN

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

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

Lab Data:

Allergies: Penicillin Victoria Wellbutrin Nortriptoline

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

Symptoms: Onset of headache and fatigue around 8pm 4am: woke up and has extreme headache, arm so sore unable to move it w/o pain, whole body aches, chills, low grade fever 8am: extreme fatigue, fever, chills, body aches, body so heavy feeling unable to leave bed for any extended amount of time Sat. 4/2 Headache still present but not as extreme, arm still very sore but able to move it, fever broke, fatigue Sun. 4/3 Slight headache, sore arm, minor cough, dry throat, tired but not fatigue Mon. 4/4 Headache upon waking, Headache subsided, arm sore, dry cough, heavy feeling in upper chest/throat Tues. 4/5 *same symptoms Monday Wed. 4/6 *same symptoms Thurs. 4/7 *same symptoms

Other Meds: 300mg lithium 30mg Ritalin 20mg Adderall Calcium 20mg Chantix

Current Illness:

ID: 1180395
Sex: U
Age: 29
State:

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/08/2021
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: episode of syncope. recovered immediately. pt evaluated and vitals were stable.

Other Meds:

Current Illness:

ID: 1180396
Sex: M
Age: 45
State: CA

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/08/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: Fever, chills, bad headache. Just rested, symptoms lasted about 24 hours. Was worse than any flu I can remember though.

Other Meds:

Current Illness:

ID: 1180397
Sex: F
Age: 65
State: PA

Vax Date: 04/02/2021
Onset Date: 04/03/2021
Rec V Date: 04/08/2021
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: No known

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

Symptoms: ACHES, HEADACHE, STIFF NECK, CHILLS/SWEATS, SORES THROUGHOUT MOUTH PATIENT STILL HAS MUSCLE ACHES, STIFF NECK, BAD HEADACHE (WORSE THAN MIGRAINE) SORES IN MOUTH LASTED 48 HOURS THEN RESOLVED

Other Meds: NORCO, SUMATRIPTAN, TEMAZEPAM, ALENDRONATE, METOPROLOL SUCCINATE, IBUPROFEN, TRAZODONE, VENLAFAXINE, ESTRADIOL, GABAEPNTIN, DEXTROAMPHETAMINE, b12 injection

Current Illness: No

ID: 1180398
Sex: F
Age: 53
State: MA

Vax Date: 03/08/2021
Onset Date: 03/27/2021
Rec V Date: 04/08/2021
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: no

Symptom List: Injection site pain, Pain

Symptoms: Several weeks after the vaccine on 3/27 I started experiencing cold symptoms, lost my sense of smell and taste and developed a cough so I reached out to my PCP who advised I take a COVID test and on 3/30 I tested positive for COVID-19 via the rapid test.

Other Meds: Vit D, Advare, Claritin, Losartan, sudafed, mucinex

Current Illness: no

ID: 1180399
Sex: F
Age: 22
State: PA

Vax Date: 04/06/2021
Onset Date: 04/07/2021
Rec V Date: 04/08/2021
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: Injection site pain, Menorrhagia

Symptoms: Low grade fever (99.5?), nausea, joint aches, lack of appetite, chills, moderately severe headache, fatigue

Other Meds: Amitriptyline, Wellbutrin, methylphenidate

Current Illness: N/A

ID: 1180400
Sex: F
Age: 42
State: VA

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 04/08/2021
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: C/O chest pressure, throat irritation, feeling like she "couldn't breathe". Pt expressed no difficulty speaking. No flushed skin, no perspiration, no swelling of lips or tongue. Vital Signs: 1045: 100% RA, PR 138 1052: 99% RA, PR 101 1057: 100% RA, PR 99 1131: 98% RA, PR 87, BP 135/64 Client stated she was feeling better and remained in observation area. Client was advised to have friend or family pick her up, but declined, and exited the facility to her own vehicle.

Other Meds:

Current Illness:

ID: 1180401
Sex: M
Age: 67
State: GA

Vax Date: 03/30/2021
Onset Date: 04/04/2021
Rec V Date: 04/08/2021
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: mold

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Swollen left knee - reduced range of motion - pain - unable to sleep because of pain. Steriod shot in knee joint resolved issue.

Other Meds: Omeprozole - metroprolol-sertraline-moloxicam

Current Illness: none

ID: 1180402
Sex: F
Age: 38
State:

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/08/2021
Hospital:

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

Lab Data:

Allergies: Sulfa

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Started with chills, then dizziness, nausea and passed out until was found by another person. Had ringing in ears either right before passing out or when coming to consciousness. Vomited after waking up. Chills returned, fever of 100.3, blue lips. Headache came later

Other Meds: Bcp

Current Illness: None

ID: 1180403
Sex: F
Age: 22
State: IN

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/08/2021
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: Icy hot substances

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

Symptoms: After 5 hours I began to get a headache. By the next morning I had a migraine and was nauseated all day. The next morning after I had a slight headache but the nausea has subsided

Other Meds: Humira injection Tylenol

Current Illness: N/A

ID: 1180404
Sex: M
Age: 72
State: MI

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/08/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: headache, chills, shoulder. lower backaches, nausea

Other Meds: pravastatin, atenolol 25mg, losartan 100 mg, hydrochlorothiazide 25mg

Current Illness:

ID: 1180405
Sex: F
Age: 58
State: ID

Vax Date: 03/29/2021
Onset Date: 03/29/2021
Rec V Date: 04/08/2021
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: My left arm started to sting immediately after getting the shot, then the stinging subsided. My left arm started to hurt later in the day and I had pain all the way down my left arm and left side of my chest. This pain throughout my left side was not helped by Ibuprofen and made sleep very hard. I had intermittent sharp pain in my neck, shoulder, and left arm for days. The injection site turned red, hot, and a raised area the size of a silver dollar appeared and was med-red in color for about 8 days. The color is better/ almost normal as of today, but still a hard lump under the skin and a bit itchy. This has caused pain throughout my back and shoulders since I got the shot....but it has not been activity limiting. I had a slight bit of nausea for a couple of days as well. My husband had his shot just after mine and experienced Chills , headache, and nausea at about 9:00 P.M. His chills subsided at about 3:00 A.M. He continued with the headache for another day/ fatigue for 2 days/ and nausea for about 5 days. He has also had tingling in his left arm (about 7 days) and a funny tingling on his tongue for about a week.

Other Meds: Vit D3 5000 IU;s; Vit C 1000; Vit D/Magnesium/Zinc combo; 81mg Apsrin; multi-vitamin; calcium supplement

Current Illness: none

ID: 1180406
Sex: M
Age: 26
State: WA

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/08/2021
Hospital:

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

Lab Data:

Allergies: No

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

Symptoms: I bin having pain on my left arm and I have a bump that causes pain it started to from on the day I got it .

Other Meds: No

Current Illness: i got my vaccine on Tuesday of April/6/21 the next day I bin having a bump on my left shoulder where I got the vaccine.

ID: 1180407
Sex: F
Age: 74
State: MS

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/08/2021
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: cycline drugs

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

Symptoms: very large lump next day, 1/2 baseball, red , tingling down arm after shot for 40 minutes.

Other Meds: tylenol, heart, BP, multi vitamins, synthroid, baby aspirin

Current Illness: cronic sinus symptoms

ID: 1180408
Sex: F
Age: 47
State: CA

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 04/08/2021
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: no known allergies

Symptom List: Tremor

Symptoms: Patient is a 47 y.o. female who received the Moderna Covid-19 Vaccine, mRNA-1273 (PF) 100 mcg/0.5 mL IM Susp, Lot 020321A on 4/8/2021. The patient experienced the following reaction(s) during the immediate of observation: 8:50am Patient vaccinated. 9:03am Patient c/o nausea during observation period. Patient was treated/managed as follows: 9:04am Patient taken to treatment area. Water and ice pack provided and applied. Patient c/o dizziness. 9:09am VS BP 140/70, HR 83, RR 20, O2 sat 99% on room air. Patient reports symptoms improving. Patient given educational material regarding vaccine and advised to continue to self-monitor per the CDC guidance. 9:19 VS BP 116/72, HR 62, RR 18, O2 sat 100% on room air. Patient reports symptoms improving. 9:25pm Patient escorted to car accompanied by significant other and RN.

Other Meds: none

Current Illness: none

ID: 1180409
Sex: F
Age: 16
State:

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/08/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: post vaccine syncope. did not fall. brought to observation tent. monitored for 25 minutes and sent home.

Other Meds:

Current Illness:

ID: 1180410
Sex: F
Age: 44
State: FL

Vax Date: 03/10/2021
Onset Date: 03/13/2021
Rec V Date: 04/08/2021
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: unknown

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

Symptoms: pt states that she developed a swollen arm and lymph nodes the Sat after the vaccination was given. This lasted several days. On advice of physician she took Benadryl. The problem was resolved

Other Meds: unknown

Current Illness: unknown

ID: 1180411
Sex: F
Age: 29
State: UT

Vax Date: 03/26/2021
Onset Date: 03/26/2021
Rec V Date: 04/08/2021
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 reported

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

Symptoms: Vaccine mixed with incorrect diluent (sterile water instead of normal saline). Pt informed of error and offered revaccination. Pt reports no adverse reactions.

Other Meds: none reported

Current Illness: none reported

ID: 1180412
Sex: F
Age: 24
State: KY

Vax Date: 04/01/2021
Onset Date: 04/02/2021
Rec V Date: 04/08/2021
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: Penicillin, Amoxicillin, Ampicillin, anything in that family. I had an allergic reaction to a tetanus shot before but it?s been around 12-13 years ago.

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Left arm at injection site is red, painful, radiating heat, raised and hard. The circular sprawling area itches, as well. A rash was also present the day before I went to the doctor. I was just given a non-steroidal cream and antibiotics. I haven?t started them yet because I haven?t got them from the pharmacy yet.

Other Meds: Keppra, Folic Acid, Sumatriptan, Naproxen, daily multi vitamin

Current Illness: None.

ID: 1180413
Sex: F
Age: 31
State: NC

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

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

Lab Data:

Allergies:

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

Symptoms: Patient developed lip tingling, tongue numbness and swelling, throat swelling. EMS was contacted. Patient chewed 50mg Benadryl and was given 3 doses of Epinephrine before EMS arrived. Patient was stable when transported to ER.

Other Meds:

Current Illness:

ID: 1180414
Sex: F
Age: 36
State:

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/08/2021
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: Guest complained of feeling "woozy" approximately 30 minutes following the administration of the first dose of the covid vaccine. The guest was given water and juice. Initially reported that she felt better afterwards but about 6 minutes following she requested to lay down on the cot. Patient reported that she has a history of PTSD. Guest also reported that she has had similar symptoms with other vaccines. The Medics were called to tend to the guest. Vitals were taken periodically over a 30 minute period. Blood pressure and pulse slowly decreased. Heart rate remined slightly elevated. O2 sats 98%. Guest was released to go home with her father who was driving. Guest reported that she felt quite a bit better. Ambulation was steady.

Other Meds:

Current Illness:

ID: 1180415
Sex: M
Age: 43
State: NY

Vax Date: 04/06/2021
Onset Date: 04/07/2021
Rec V Date: 04/08/2021
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: Pain in extremity

Symptoms: I woke up at 2am, with a fever, flu like symptoms, and a bad headache. I took a nap from 8-10am that morning and woke up at 10am with repeating, recurring chest pain every 2-3 minutes, the pain would only last a second then go away. My BP and pulse were very high. This all continued through out the day. I went to a walk-in urgent care clinic around 4PM, and then to the ER around 6PM.

Other Meds: Allopurinol Losartan Potassium

Current Illness: N/A

ID: 1180416
Sex: F
Age: 52
State: MN

Vax Date: 03/30/2021
Onset Date: 03/31/2021
Rec V Date: 04/08/2021
Hospital:

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

Lab Data:

Allergies: No Possible allergy to Zpak antibiotic - had itchy feeling over body

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

Symptoms: Sharp pains in left breast first 3 days after shot - This has gone away Tingling in left arm and hand - day 3 - this has subsided Tingling and itchy feeling of face, head, feet and sometimes lower legs. - this continues Knotted feeling in middle of chest - sometimes feel short of breath, but doesn't get worse with exertion - this continues General fatigue - first few days - this has subsided

Other Meds: 200 mg Hydroxychloroquine/day multivitamin

Current Illness: None

ID: 1180417
Sex: F
Age: 66
State: IL

Vax Date: 03/26/2021
Onset Date: 03/26/2021
Rec V Date: 04/08/2021
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: no

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

Symptoms: About 3/26 a rash started from my wrist going up to my shoulder and pretty much covers and it's still inflamed, it started going across my stomach and on both breast and now on right thigh. I was placed me on Zyrtec and Benadryl cream for itching, this week she added Pepcid and she put me on Hydroxyzine for the itch.

Other Meds: D3, Zetia, Lopressor, Crestor

Current Illness: no

ID: 1180418
Sex: M
Age: 31
State: KY

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/08/2021
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: Lethargic, muscle cramping, dizzy, temperature of 101.9 on 04/07/2021

Other Meds: None

Current Illness: None

ID: 1180419
Sex: F
Age: 35
State: WA

Vax Date: 03/18/2021
Onset Date: 03/22/2021
Rec V Date: 04/08/2021
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: sulpha drugs

Symptom List: Vomiting

Symptoms: I noticed I had a small rash - it was irregular circular shape. It was on my right side - non local to the injection site. Underneath my armpit slightly to the back (six inches below armpit). It was a little red; slightly bumpy; it felt tight. Overall, it was very mild discomfort. I don't usually get rashes like that. It was itching. My husband a primary care doctor and he looked at it. He said it looked unusual - not a usual rash. I gave it 24 hours and it did start receding a bit - it was still a bit itchy and tight the second day and it kind of faded away. It wasn't visual 3 days after the first onset of symptoms - it wasn't bumpy - I couldn't feel it. It is my first pregnancy. Estimated birth date - 9/10/2021

Other Meds: prenatal vitamin; Vit D/Fish oil - Omega; Zoloft

Current Illness: no

ID: 1180420
Sex: F
Age: 59
State: DE

Vax Date: 03/28/2021
Onset Date: 04/03/2021
Rec V Date: 04/08/2021
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 known allergies

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: No real issues it seemed until about 6-7 days later, Neck, shoulder, arm pain began. Noticed the next morning in addition to the pain, arm from shoulder to elbow was swollen, red and hot to the touch. Difficulty turning my head to the left for one day. Talked to pharmacist and was told to take benadryl and tylenol and contact my doctor regarding adverse effects to the vaccine. While they have improved since benadryl and tyenol, they have not completely subsided and today is day 5 since the reaction started.

Other Meds: Losartan, Metoprolol, Hydrochorothiazide, Synthroid, Magnesium glycinate, s-acetyl l- glutathione, krill oil, vitamin d3

Current Illness: none

ID: 1180421
Sex: F
Age: 47
State: FL

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/08/2021
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: None

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

Symptoms: 1 hour later - perception off driving 3 hours later - light headed/ soreness 7 hours later - Every joint ached painfully 8 hours later - fever (high of 103.2) before Tylenol & Advil 19 hours later - slight fever 100.4 before Advil 21 hours later - feeling off/confused 25 hours later - achy / tired

Other Meds: None

Current Illness: None

ID: 1180422
Sex: M
Age: 39
State: NV

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/08/2021
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: Penicilin

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Fever, chills, tiredness, headache, muscle pain, nausea.

Other Meds: None

Current Illness: None

ID: 1180423
Sex: F
Age: 48
State: GA

Vax Date: 02/26/2021
Onset Date: 02/26/2021
Rec V Date: 04/08/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Within 45 minutes of receiving vaccination I experienced severe tinnitus, headache at the top of my head, body aches, fatigue, and neck ache. All symptoms lasted about 2 days except severe tinnitus remains.

Other Meds: Venlafaxine Doxycycline

Current Illness:

ID: 1180424
Sex: F
Age: 61
State: CO

Vax Date: 04/06/2021
Onset Date: 04/07/2021
Rec V Date: 04/08/2021
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: Slept well the night of my vaccination, and woke up feeling okay. About an hour and a half later, I experienced severe chills, to the point of shaking. Half way through breakfast, I stopped eating as I no longer was hungry. I had to go back to bed. The chills subsided, but I ached all over, similar to having the flu. It is now day two, and I am still tiring easy. I did not report this to my physician, as I am doing much better.

Other Meds: Vitamin D Half gram Valacyclovir

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm