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: 0919547
Sex: M
Age: 50
State: CA

Vax Date: 12/29/2020
Onset Date: 12/30/2020
Rec V Date: 01/04/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: 12/30/2020, onset s/s runny nose, dry cough, itchy, watery eyes. Inner elbow flushing similar to taking niacin, Most notably headache and low back pain. Both knees hurt, tight stomach and malaise.

Other Meds:

Current Illness:

ID: 0919548
Sex: F
Age: 19
State: WA

Vax Date: 12/27/2020
Onset Date: 12/27/2020
Rec V Date: 01/04/2021
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: No

Symptom List: Anxiety, Dyspnoea

Symptoms: Day 1: pain/swelling at injection site with redness, muscle aches, joint pain Day 2: pain/swelling at injection site with redness, muscle aches, joint pain, headache; worked but with considerable discomfort/strain Day 3: pain at injection site, muscle aches, joint pain, headache, chills, fatigue, feeling unwell, insomnia; unable to work Day 4: extreme muscle aches, joint pain, headache, chills, fatigue, feeling unwell, insomnia, fever, sweating, sore throat, diarrhea; unable to work; attempted to see doctor but was refused care due to "CoVid-like symptoms" Day 5: extreme muscle aches, joint pain, headache, chills, fatigue, feeling unwell, insomnia, fever, sweating, sore throat, diarrhea; unable to work Day 6: extreme muscle aches, joint pain, headache, chills, fatigue, feeling unwell, insomnia, fever, sweating, sore throat, nausea; unable to work; attempted to see care at Urgent Care but was turned away for having "CoVid-like symptoms;" went to hospital per the recommendation of MD and urgent care Day 7: mild muscle aches, fatigue, feeling unwell, insomnia, sweating, sore throat; unable to work Day 8: sore throat, mild fatigue, sweating; unable to work

Other Meds: NO

Current Illness: None

ID: 0919549
Sex: F
Age: 74
State: WI

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 01/04/2021
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: MEPERIDINE, HYDROXYZINE

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

Symptoms: Redness itching inflammation at injection starting 1 day after vaccine and continuing for 2 days

Other Meds: LISINOPRIL, AMLODIPINE, SIMVASTATIN ,VITAMIN D, VITAMIN B 12

Current Illness: NO

ID: 0919550
Sex: M
Age: 6
State: CA

Vax Date: 11/02/2020
Onset Date: 11/03/2020
Rec V Date: 01/04/2021
Hospital:

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

Lab Data:

Allergies: none known

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: patient with mild fever earlier in the day, with redness and soreness at site of injection.. then went to bed. mom checked on him and saw him "vomiting on himself, but not fully on his side. I helped him get through that first vomiting session. Upon turning on the light, I saw him having a seizure. Mostly in his face... a big mouth twitch and chewing of the tongue. Unfocused eyes, limp-ish body. He kept vomiting and was having trouble getting it out. Once the twitching stopped 2-3 minutes later, he was very unresponsive and couldn?t speak, but was still breathing" in mom's words. They called 911, ER evaluated. no other cause of seizure found. no fever at that time noted.

Other Meds: none

Current Illness: none

ID: 0919551
Sex: F
Age: 60
State: WI

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 01/04/2021
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: Hives

Other Meds:

Current Illness: Sinusitis

ID: 0919552
Sex: F
Age: 36
State: VA

Vax Date: 01/02/2021
Onset Date: 01/02/2021
Rec V Date: 01/04/2021
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: N/A

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

Symptoms: - At time of vaccine (8:30am) no soreness or reaction. - Approximately 6pm injection site became sore and mild body aches and chills noted. Temperature 99.1; 2 Tylenol taken. - 1/3/2021 Approximately 12am woke up with severe chills and body aches. Temperature 101.5; 2 Advil taken. - Approximately 8am decreased body aches/chills. Temperature down to 98.8; 2 Advil taken. -Approximately 4pm mile-moderate body aches and chills. Temperature 101.8; 2 Advil taken. - Approximately 5:15pm Temperature 101.1 - Approximately 6:30pm Temperature 99.8; 1 Tylenol taken. - Approximately 7:30pm Temperature 98.6 - Approximately 8:30pm Temperature 97.8 - Approximately 10pm Temperature 96.6; 2 Advil taken. - 1/4/21 approximately 7:15am Temperature 96.6; no chills or body aches; injection sight remains slightly tender.

Other Meds: Nortriptyline HCL 10 MG

Current Illness: N/A

ID: 0919553
Sex: F
Age: 52
State: NC

Vax Date: 12/23/2020
Onset Date: 12/26/2020
Rec V Date: 01/04/2021
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: tramadol

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Initially I had sore arm and very tired , which all resolved with in 24 hours of the vaccine. The morning of the 26th (day 3 after vaccine) , I woke up and felt great.. I took my normal 4- 5 mile run. I felt a little dizzy , & hungry when I ran (not my normal) , got home had diarrhea 1 x , then for next two days very faint GI discomfort and I had fever for two days , temp range 99-100

Other Meds: Vit D, Vit C, psylium husk

Current Illness:

ID: 0919554
Sex: F
Age: 42
State: CA

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

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: stiffness in arm headache at the base of the skull tingly headache at the front of the skull feels heavy

Other Meds:

Current Illness:

ID: 0919555
Sex: F
Age: 64
State: WA

Vax Date: 12/24/2020
Onset Date: 12/24/2020
Rec V Date: 01/04/2021
Hospital:

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

Lab Data:

Allergies: Augmentin

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: The person who gave me the shot placed the injection too low on my arm. It should have been up near the shoulder, but instead the person gave it to me down toward the middle of my arm. I knew something was wrong immediately because it felt so warm and disruptive. The doctor on the scene said it was nothing. Nine days later I went to Urgent Care with swelling, hot-to-the-touch, itchy and a huge knot. The Urgent Care Dr. gave me a five-day prescription for Prednisone and also gave me a prescription for hydroXYzine pamoate, which is an antihistimine.

Other Meds: Hydrochlorothiazide, Vitamin B, Vitamin D, Calcium Supplement, Medical Cannabis

Current Illness: None

ID: 0919556
Sex: F
Age: 30
State: IN

Vax Date: 12/19/2020
Onset Date: 12/22/2020
Rec V Date: 01/04/2021
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: sulfa, erythromycin,

Symptom List: Diarrhoea, Nasal congestion

Symptoms: I had a sore arm the first couple of days, on the 22nd I had chills sore throat headache congestion sneezing sniffling and low grade fever 99.6. on the 23rd loose stools nasal drainage, I called the hospital hotline and I had to be off for ten days and went to Urgent care and took a rapid test and the test was positive. I have been quarantined for 14 days . The 25th was probably the worst day the 26th was a little better. the 27th symptoms were more mild and I also had diarrhea The 28th I woke up with a headache and light sniffles and the 27th I had no symptoms

Other Meds: buspar, lamictal, wellbutrin, metoprolol, L- methylfolate, synthroid. valboltoa birth control, allegra, zyrtec

Current Illness: no

ID: 0919557
Sex: F
Age: 86
State: NE

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/04/2021
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: Patient reported tightness in throat, lightheadedness, and cough after the 15 minute observation period. Patient was given Benadryl and symptoms improved in 15-20 minutes.

Other Meds:

Current Illness:

ID: 0919558
Sex: F
Age: 64
State:

Vax Date: 01/02/2021
Onset Date: 01/02/2021
Rec V Date: 01/04/2021
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: H/O side effects from centrally-acting and GI medications.

Symptom List: Rash, Urticaria

Symptoms: Developed dyspnea after vaccination.

Other Meds: oxycodone, estradiol, diclofenac, misc vitamins, some herbal products, whey powder

Current Illness:

ID: 0919559
Sex: F
Age: 40
State: OR

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

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

Lab Data:

Allergies: unknown

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

Symptoms: Pt experienced nausea, shortness of breath, chest tightness and anxiety and then lost consciousness. Vitals were obtained several times during the medical intervention. Respirations were within normal limits throughout, BP was 135/89 initially, then rose to 210/110, then declined to 180s/? prior to EMS assuming care. Heart rate was 47 initially, then rose to normal limits. Treated with epinephrine, Benadryl and ammonia smelling salts and transported by ambulance to hospital.

Other Meds: unknown

Current Illness: unknown

ID: 0919560
Sex: F
Age: 48
State: CA

Vax Date: 12/28/2020
Onset Date: 12/28/2020
Rec V Date: 01/04/2021
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: Hydromorphone, adhesive

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

Symptoms: Clinic staff was notified that a patient was having a reaction to the Moderna vaccine that was administered today at 843AM. Her reaction started around 855AM. She described her reaction to be tingling and numbing of her shoulders and described it as "it feel like it fell asleep" noted the injection site to be appropriate. The patient was asked to stay for additional 15 minutes. She didn't feel any difference after the additional 15-minute observation. The patient was able to tolerate the reaction and was asked to observe if it gets worse. Patient was also recommended to call Occ Health if it gets worse for proper triaging. Per reporter, resolved day following vaccination

Other Meds: Meloxicam

Current Illness:

ID: 0919561
Sex: F
Age: 22
State:

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 01/04/2021
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: Chills and headache. BP 107/67, 96 OSat, supine positioning. Resolved.

Other Meds:

Current Illness:

ID: 0919562
Sex: F
Age: 30
State: NY

Vax Date: 12/27/2020
Onset Date: 12/27/2020
Rec V Date: 01/04/2021
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: NKDA

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

Symptoms: 4 hours after fatigue and body aches 10 hours after fever, chills, arm pain, body aches, headache 1 week redness and rash at injection site

Other Meds: Multi vitamins Errin birth cjntrol

Current Illness:

ID: 0919563
Sex: F
Age: 43
State: NE

Vax Date: 12/28/2020
Onset Date: 12/28/2020
Rec V Date: 01/04/2021
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: no known allergies

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

Symptoms: None stated.

Other Meds: Oxtellar 600mg at 2:30pm Oxtellar 1200mg at 2:00am Lamictal 300mg at 2:30pm and 2:00am

Current Illness: seizures

ID: 0919564
Sex: F
Age: 47
State: CA

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

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

Lab Data:

Allergies: Mangoes and Ibuprofen

Symptom List: Ear pain, Hypoaesthesia

Symptoms: EE presented to EH with c/o hives to face and racing heart rate at 1445

Other Meds: Metoprolol 25 mg

Current Illness:

ID: 0919565
Sex: F
Age: 43
State: TX

Vax Date: 12/21/2020
Onset Date: 12/22/2020
Rec V Date: 01/04/2021
Hospital:

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

Lab Data:

Allergies: taxotere, cats

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: My arm was sore the 1st day, by noon the next day my HR was 160s, I was referred to go to the ER but I didnt and took benedryl went to sleep, woke up and I felt a little SOB but more like something was tied around my ribs preventing me from breathing. I saw the cardiologist who believed it to be sinus tackycardia as a result as an AE to vaccine. Felt as if my face and lips were swelling so I took benedry and laid down again and the next morning when I woke up and my face and lips were super swollen. But by the 3rd day the symptoms began to subside a little. By the 24th my HR had balanced out and I only had residual swelling around the eye area.

Other Meds: Vit D, B12, multivitamin

Current Illness: no

ID: 0919566
Sex: F
Age: 38
State: CO

Vax Date: 12/24/2020
Onset Date: 01/01/2021
Rec V Date: 01/04/2021
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: Injection site became red, very warm to the touch, and swollen. Lasted about 36 hours, then resolved. No other symptoms, only localized reaction.

Other Meds: none

Current Illness: none

ID: 0919567
Sex: F
Age: 65
State: MD

Vax Date: 12/29/2020
Onset Date: 01/02/2021
Rec V Date: 01/04/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Headache, Sore throat gradually increasing over the past 3 days

Other Meds: Premarin Synthroid

Current Illness:

ID: 0919568
Sex: F
Age: 33
State: DC

Vax Date: 12/28/2020
Onset Date: 01/03/2021
Rec V Date: 01/04/2021
Hospital:

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

Lab Data:

Allergies: PCN, amoxicillin, latex

Symptom List: Unevaluable event

Symptoms: Swelling at injection site, site is warm to the touch and began swelling/soreness at Day 6 post vaccine administration

Other Meds:

Current Illness:

ID: 0919569
Sex: F
Age: 44
State: CA

Vax Date: 12/20/2020
Onset Date: 01/03/2021
Rec V Date: 01/04/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Patient received the covid vaccine on 12/20/2020. She tolerated the vaccine without problem. c/o new onset of stomach pain, diarrhea, nausea, and bodyache starting on 1/3/2021. Symptoms persist today. No diarrhea today, 1/14/2021. LMP - 10/2020. Denies fever, cough, HA, any ocular symptom. Covid test on 12/28/2020 was negative.

Other Meds:

Current Illness:

ID: 0919570
Sex: F
Age: 41
State: WY

Vax Date: 12/18/2020
Onset Date: 12/19/2020
Rec V Date: 01/04/2021
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: MMR age 4 exp swelling

Symptom List: Injection site pain, Pain

Symptoms: The next day on 12/19 I was super sore. On 12/20 really bad joint pain and I had rash located on my face and chest. I went to PCP on 12/21 seen PCP given EpiPen.

Other Meds: No

Current Illness: No

ID: 0919571
Sex: F
Age: 35
State: IL

Vax Date: 01/04/2020
Onset Date: 01/04/2020
Rec V Date: 01/04/2021
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: Injection site pain, Menorrhagia

Symptoms: Individual received the vaccine at 3:57 pm and at 4:15 pm pt report she was hot, her heart was racing, she felt flushed. She was given Pepcid 20mg by mouth and Benadryl 25 mg by mouth and monitored at the hospital vaccination site. Vital signs remained stable throughout. By 4:54 pm patient's flushing had resolved and pt reported feeling back to base line.

Other Meds: None

Current Illness: None

ID: 0919572
Sex: F
Age: 31
State: OH

Vax Date: 12/23/2020
Onset Date: 12/25/2020
Rec V Date: 01/04/2021
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: Latex, cephalosporins

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

Symptoms: Large raised red circular welt that?s lasted two weeks from vaccination

Other Meds: Multivitamin

Current Illness: None

ID: 0919573
Sex: M
Age: 41
State: CA

Vax Date: 12/18/2020
Onset Date: 12/18/2020
Rec V Date: 01/04/2021
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: low class II IgE to peanuts and tree nuts. omnipaque (Iohexol)

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: itch, hard to swallow. throat tightness within few minutes of vaccination

Other Meds:

Current Illness:

ID: 0919574
Sex: F
Age: 47
State: IL

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

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Didn't feel "right", felt like her throat was closing, couldn't swallow, shortness of breathe, breathing got worse, called 911, 1 Epipen given, she started to cough and talk to us, then couldn't breathe again, couldn't talk, paramedics arrived.

Other Meds:

Current Illness:

ID: 0919575
Sex: F
Age: 67
State: WY

Vax Date: 12/28/2020
Onset Date: 12/29/2020
Rec V Date: 01/04/2021
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: No

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

Symptoms: Beginning the day after, pt had mild bruising over injection site. Over the next several days, bruising darkened and extended from superior L shoulder to elbow.

Other Meds: Metformin, insulin, Tylenol

Current Illness: Anemia

ID: 0919576
Sex: F
Age: 28
State: AZ

Vax Date: 12/18/2020
Onset Date: 12/21/2020
Rec V Date: 01/04/2021
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: Nausea

Symptoms: Patient developed asymptomatic COVID-19 infection approximately three days after first dose of vaccine. Detected on serial testing of nursing home staff.

Other Meds: None

Current Illness: None

ID: 0919577
Sex: M
Age: 60
State:

Vax Date: 12/24/2020
Onset Date: 12/31/2020
Rec V Date: 01/04/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: Patient reports Swelling of arm of injection site, induration, redness and itchiness at site.

Other Meds: Blood Pressure, Lipitor

Current Illness:

ID: 0919578
Sex: F
Age: 89
State: FL

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 01/04/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Swelling of eyes, lip numbness, tingling and dryness. Dizzy and weak. Client received Benadryl and was transported to hospital via EMS.

Other Meds:

Current Illness:

ID: 0919579
Sex: F
Age: 34
State:

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

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

Symptoms: light headedness

Other Meds:

Current Illness:

ID: 0919580
Sex: F
Age: 43
State: MI

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 01/04/2021
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: Cucumbers, contrast

Symptom List: Tremor

Symptoms: Headache, vomiting, diarrhea, body aches, sweating

Other Meds: Vitamin c

Current Illness: Sibo

ID: 0919581
Sex: M
Age: 88
State: VA

Vax Date: 09/21/2020
Onset Date: 09/25/2020
Rec V Date: 01/04/2021
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: lips swelled and itchy hands

Other Meds:

Current Illness:

ID: 0919582
Sex: M
Age: 78
State: CO

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

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

Lab Data:

Allergies:

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

Symptoms: Dry cough developed after about 10 hours after injection

Other Meds: Losartan; 50mg twice daily; Toprol: 12.5mg once daily; Levothyroxine: 50mcg once daily; 81mg aspirin once daily

Current Illness: Epidural in spine on Dec. 8, 2020 to relieve lumbar disc compression

ID: 0919583
Sex: F
Age: 76
State: CO

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/04/2021
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: Gluten....celiac disease/ Amoxicillin...diarrhea/Dorzolamide eye drops...tingling sensation of face/ lovastatin....muscle aches Morphine...rash

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

Symptoms: Tingling of tongue, lips, nose and cheeks lasted 5 hours . No swelling Unusual taste in mouth lasted only 5 hours

Other Meds: amlodipine 10 mg, Aspirin 81mg, atorvastatin 20mg, Vitamin D3 2000iu, CoQ-10 200mg, estradiol 0.5mg every other day, losartan 100mg, magnesium 200 mg, miralax q hs, timolol 0.5% OS bid, latanaprost 0.005% OS hs, vyzulta 0.024% OS hs.

Current Illness: High blood pressure/ Celiac Disease/Glaucoma OS/

ID: 0919584
Sex: F
Age: 48
State:

Vax Date: 01/03/2021
Onset Date: 01/03/2021
Rec V Date: 01/04/2021
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: azithromycin

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Lightheadedness, throat tightness. Increasing chest tightness. History of atrial fibrillation and bilateral breast implants. Received two doses of epinephrine and one dose of diphenhydramine.

Other Meds: none

Current Illness:

ID: 0919585
Sex: F
Age: 73
State: CA

Vax Date: 11/29/2020
Onset Date: 12/01/2020
Rec V Date: 01/04/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Severe muscle pain in torso and shooting pains in back of thighs lasting a week, vertigo lasting 2 days, and could not raise left arm over my head which lasted a week - with rest and exercise I have better movement of my arm however it has been over a month and my arm is still sore even with Tylenol

Other Meds: None

Current Illness: None

ID: 0919586
Sex: F
Age: 55
State: CA

Vax Date: 12/22/2020
Onset Date: 12/27/2020
Rec V Date: 01/04/2021
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: 5 days after 1st vaccine, experienced sync opal event at home. .Arrived at work 12/28/2020 feeling slightly lightheaded and tachy. went home.

Other Meds:

Current Illness:

ID: 0919587
Sex: F
Age: 39
State: TX

Vax Date: 12/24/2020
Onset Date: 12/24/2020
Rec V Date: 01/04/2021
Hospital:

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

Lab Data:

Allergies: Tetracycline

Symptom List: Pain in extremity

Symptoms: Body aches, chills and fever from around 8:30 pm 12/24/20 until around 10:00 am on 12/25/20. Injection site pain for 3 days. Fatigue for 48 hours after injection.

Other Meds: None

Current Illness: None

ID: 0919588
Sex: F
Age: 36
State: FL

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 01/04/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Chief complaint of dryness of her tongue. Felt better after drinking Gatorade. Observed for 30 Min, no issues.

Other Meds:

Current Illness:

ID: 0919589
Sex: F
Age: 62
State: AZ

Vax Date: 12/18/2020
Onset Date: 12/22/2020
Rec V Date: 01/04/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Developed symptomatic COVID+ infection approximately four days after vaccine dose. Had confirmed exposure to COVID+ individual prior to vaccination. Was administered IV Bamlanivimab on 12/22/2020 at Hospital. Stayed in an isolation facility at Center for 9 days.

Other Meds: Levothyroxine Metformin Amitryptiline Aspirin Atorvastatin Cholecalciferol Cetirizine Sumatriptan Lisinopril

Current Illness: None

ID: 0919590
Sex: M
Age: 58
State: CA

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 01/04/2021
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: unknown

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

Symptoms: About 2 minutes after receiving vaccine the individual reported feeling light headed. He also described an uncomfortable tingling sensation in his throat. Blood pressure had been normal prior to vaccination and became elevated. After about 30 minutes of persistent reaction, one dose of epi-pen (generic) was given. About 3 minutes after receiving the epinephrine he felt safe to stand up and more to a more comfortable chair. Lightheadedness, throat sensation, and elevated blood pressure resolved. He stayed another 15 minutes for observation and has no return of symptoms.

Other Meds: unknown

Current Illness: unknown

ID: 0919591
Sex: F
Age: 34
State: TX

Vax Date: 12/15/2020
Onset Date: 12/16/2020
Rec V Date: 01/04/2021
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: Sulfur, penicillin

Symptom List: Vomiting

Symptoms: On the 16 early in the morning I woke up with a circular, itchy, warm, red rash. I went to Employee Health and was prescribed a steroid but I didnt take it and benedryl and claritin. I took claritin and benedryl for about 2 days which began to make the rash subside on the 18 but on the 23rd the rash reappeared and went back to EH and was given another round of steroids which I did in fact take this time. And after the 6th day of the steroid pack the rash has mostly resolved

Other Meds: Birth Control Pill

Current Illness: no

ID: 0919592
Sex: M
Age: 28
State:

Vax Date: 01/02/2021
Onset Date: 01/02/2021
Rec V Date: 01/04/2021
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: Cats, pollen, hay fever, dust

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Puffy lips the night of injection went away after taking benadryl Sore throat which began a few hours after injection--still present Headache which began a few hours after injection--not sure if this is a migraine or side effect Soreness at injection site--stopped today (1/4/21)

Other Meds: Candesartan 4 mg tablet PO QHS Finasteride 1 mg tablet PO QAM Mirtazapine 15 mg tablet PO QHS Rizatriptan 10 mg tablet PO PRN Trazodone 200 mg PO QHS Omepreazone 40 mg capsule PO QAM Ajovy autoinjector every 30 days Gabapentin 100 mg caps

Current Illness:

ID: 0919593
Sex: M
Age: 64
State: IA

Vax Date: 12/30/2020
Onset Date: 01/02/2021
Rec V Date: 01/04/2021
Hospital: Y

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: opioids

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

Symptoms: Patient developed a septic knee (history of arthroplasty) need for immediate surgery, hospitalization and months to years of antibiotics in his future now.

Other Meds:

Current Illness: none

ID: 0919594
Sex: F
Age: 69
State: NY

Vax Date: 11/20/2020
Onset Date: 11/20/2020
Rec V Date: 01/04/2021
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: bacitracin, penicillin

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Entire left arm was swollen, red, and warm within 6 hours, MD gave a treatment of keflex 500 mg 2x a day in the event of a skin infection.

Other Meds: ramipril, rosuvastatin, desloratadine, therems, duloxetine, lorazepam, montelukast, metformin, carvedilol, gabapentin

Current Illness: none

ID: 0919596
Sex: F
Age: 68
State: CA

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/04/2021
Hospital:

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

Lab Data:

Allergies: Septra caused near Anaphylaxis Cipro causes tendinitis

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

Symptoms: Waves of quite severe malaise, abnormal neurological sensations in limbs, flushing, with start of rash versus hives, all starting 15minutes post infection. Relieved by Benadryl 50mg, which I brought with me. Took one hour to clear the initial wave of moderately severe malaise. Starting three hours later, extremely tired. Temperature 99 .5 my temperature runs low, went to bed. Next morning, temperature 100.5, didn?t feel well. Temperature rose to 102.5 in the afternoon. Regular Extra strength Tylenol brought it below 101. Extreme headache! interfered with function, lasted 3 days, severe day 1&2, milder day 3. Queasy with No appetite x 2 days. Day two after vaccine fever peaked at 101.5. Day three after vaccine, temperature peaked at 99.4 Day four very tired Day five entirely normal.

Other Meds: Atenolol 12.5mg

Current Illness: None

ID: 0919597
Sex: F
Age: 47
State: PA

Vax Date: 12/26/2020
Onset Date: 01/07/2021
Rec V Date: 01/04/2021
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: Sulfa

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

Symptoms: I felt like passing out tunnel vision . everything was black except center of vision. Unable to focus or stay attentive while driving "zoned out" multiple times. Felt like my head was detached from my body unable to shake it for 2 and a half days.

Other Meds: Lamictal

Current Illness: Na

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm