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: 1218665
Sex: F
Age: 48
State:

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 04/16/2021
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: 17:40 - female with history of hypertension presents to the emergency department with COVID-19 vaccine side effects. Per chart review, patient was evaluated here on 3/9/2021 after the first dose of the Pfizer COVID-19 vaccine. She had symptoms including dizziness, lightheadedness, intermittent headaches, neck pain, and chest tightness. She states her symptoms started 5 minutes after her first vaccine and lasted 48 hours. Prior to arrival, she had the second dose of the Pfizer COVID-19 vaccine and approximately 20 minutes after receiving the vaccine on her left arm, she had symptoms including right-sided chest pain, headache, neck pain, lightheadedness, and nausea. She describes her chest pain as squeezing, but denies similar chest pain as her last evaluation here due to its change in location. She states her symptoms have been constant since onset. She initially had shortness of breath, which subsided upon my evaluation. Her last stress test was in 2018, which was unremarkable.

Other Meds:

Current Illness:

ID: 1218666
Sex: F
Age: 32
State:

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 04/16/2021
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: None

Symptom List: Anxiety, Dyspnoea

Symptoms: Patient very anxious to receive vaccination as they are worried about side effects. After vaccine was given, patient sat in waiting room to be observed for 15 minutes. After around 5 minutes, patient noticed swelling of both hands at the thenar eminence. The swelling was more prominent on the left hand (vaccine arm). Patient did not have any shortness of breath and adverse effect was local at hands. Patient was given 50mg of diphenhydramine with resolution of signs within 10 minutes. The swelling had gone done and disappeared. Patient was observed for a total of 30 minutes. After 30 minutes, the patient returned to work.

Other Meds: N/A

Current Illness: None

ID: 1218667
Sex: F
Age: 87
State: NY

Vax Date: 04/16/2021
Onset Date: 04/16/2021
Rec V Date: 04/16/2021
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: Penicillin, Nitrofurantoin, Azithromycin

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

Symptoms: PT complained of excruciating headache on right side, advanced life support checked out, high BP, transported basic life support to Hospital

Other Meds: Eliquis, Ferrous sulfate, Lisinopril, Metoprolol, Omeprazole

Current Illness: Stroke & heart attack on 3/26/21

ID: 1218668
Sex: F
Age: 31
State: CA

Vax Date: 03/26/2021
Onset Date: 03/27/2021
Rec V Date: 04/16/2021
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: Per patient she developed a lump on her left shoulder that went away after 3 days. NP consulted and stated patient experienced Lymphedema and VAERS to be submitted.

Other Meds: None

Current Illness: Per pt no illness

ID: 1218669
Sex: M
Age: 16
State: IL

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 04/16/2021
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 erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Mass vaccine clinic. Both Moderna and Pfizer being offered. Nurse gave Moderna instead of Pfizer. Administration error

Other Meds: unk

Current Illness: No

ID: 1218670
Sex: F
Age: 37
State: PA

Vax Date: 04/14/2021
Onset Date: 04/14/2021
Rec V Date: 04/16/2021
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: Amoxocillin

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

Symptoms: 9 hours after recieving 2nd dose and lasted total 27 hrs: -fever 101 to 101.7 F -very swollen right armpit lymph node -stiff back -tingling and numbness in right hand fingers -swelling and pain in right breast -shooting constant pain from right shoulder to elbow 6/10 pain scale - required advil throughout day -sweating -chills -flush face -heart palpitations 5-10x/hr -sore arm and shoulder -swollen upper arm -bruising on upper right arm just below injection site following end of 27 hours of symptoms

Other Meds: Topcare brand one a day Women's multi vitamin Nature's Truth brand ultra collahen + c vitamin

Current Illness: None

ID: 1218671
Sex: F
Age: 57
State: AR

Vax Date: 03/13/2021
Onset Date: 03/13/2021
Rec V Date: 04/16/2021
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: NO ALLERGIES

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: 3:00 shot given 3:05 stomach pains and headache (for 16 hours) Monday 7am joint aches and pains Tuesday aches improved Next Tuesday March 23 bad headaches and calf cramps which has lasted for 3 weeks. She also has a pain up the left side of her neck that runs into the base of her brain. It is a daily problem. Currently still having problems.

Other Meds: TYLENOL AFTER THE VACCINATION

Current Illness: NONE

ID: 1218672
Sex: F
Age: 63
State: IL

Vax Date: 04/10/2021
Onset Date: 04/14/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies: CODINE

Symptom List: Pharyngeal swelling

Symptoms: ON WED APRIL 14 2021 , FELT OFF BALANCE AND DIZZY, NAUSEA , BLURRED VISION, HEADACHE / WENT TO URGENT CARE. BP WAS 180/90, I WAS TOLD TO GO TO HOSPITAL TO GET CHECK FOR SIGNS OF STROKE. WENT TO HOSPITAL , THEY RAN ALOT TEST - BLOOD WORK, CT-MRI TEST. EVERYTHING CAME BACK OK FOR NO SIGN OF STROKE.

Other Meds: FLONASE/ALBUTERAL

Current Illness: RHEUMATOID ARTHRITIES/ SEASONAL ALLERGIES

ID: 1218673
Sex: F
Age: 57
State: TX

Vax Date: 03/31/2021
Onset Date: 04/05/2021
Rec V Date: 04/16/2021
Hospital: Y

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

Lab Data:

Allergies: peanuts, avacado

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Wife found unconscious on kitchen floor.

Other Meds:

Current Illness: dehydration, UTI

ID: 1218674
Sex: M
Age: 62
State: MO

Vax Date: 04/08/2021
Onset Date: 04/09/2021
Rec V Date: 04/16/2021
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: Compazine - Itching

Symptom List: Diarrhoea, Nasal congestion

Symptoms: On 04/09/2021, day after 2nd Pfizer vaccine, woke up with stuffy head/chills. As day progressed towards work, changed to loss of hearing in right ear with phase shifting and ringing. Very disorienting and dangerous to work in busy kitchen. Made through weekend now little to no hearing in right ear with whirring, roaring, chirping. Saw Dr on 04/13 and started treatment for ear infection. Steroids and nasal spray for 3 days to no relief. Started antibiotics on 04/15. As of now at 10:36am on 04/16 no let up in all symptoms!

Other Meds: Cymbalta 120mg/day Norvasc 10mg/day

Current Illness:

ID: 1218675
Sex: M
Age: 23
State: CO

Vax Date: 04/12/2021
Onset Date: 04/12/2021
Rec V Date: 04/16/2021
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: Pt became nauseated following vaccination, patient vomited. Pt diaphoretic, face flushed, vitals checked, cool cloth placed on back of neck

Other Meds:

Current Illness:

ID: 1218676
Sex: M
Age: 56
State: NC

Vax Date: 04/06/2021
Onset Date: 04/09/2021
Rec V Date: 04/16/2021
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: Patient presents to clinic for swollen left axillary lymph nodes. Patient states he had his 2nd COVID-19 vaccine on 4/6/21 and he noticed the swelling on 4/9/21. Swelling is now staying the same. Denies pain but there is some discomfort. No change in deodorant. COVID vaccine received in left arm. Patient states intermittent pain of left forearm for the past two week. States an achy feeling. Pain will wake him up at night. States he normally has to turn or stretch arm to make it feel better. ED visit after 1st COVID vaccination- shortness of breath. He notices if he is taking a strenuous walk he will get short of breath. This has continued since his 1st COVID vaccination.

Other Meds:

Current Illness:

ID: 1218677
Sex: M
Age: 69
State: MS

Vax Date: 03/01/2021
Onset Date: 03/26/2021
Rec V Date: 04/16/2021
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: DVT left lower extremity treated with Xarelto. Symptoms have resolved. He also has a history of DVT 2003.

Other Meds:

Current Illness:

ID: 1218678
Sex: F
Age: 57
State: WV

Vax Date: 04/09/2021
Onset Date: 04/12/2021
Rec V Date: 04/16/2021
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: bee stings, peanut butter, several trees/grasses esp in fall/spring

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

Symptoms: Hives began on the right arm 3 days after vaccination. The next morning (day 4) the hives/welts had spread all over but would come and go mostly where her clothes would rub or where there was any kind of heat (like under arm area). The hives eventually moved down to her feet on day 7. The patient is still reporting hand sensitivity/itching if exposed to heat. The patient was prescribed pepcid, steroid shot, and prednisone taper. She is also using topical hydrocortisone cream. The steroid injection has helped with symptom management per the patient. (patient is also getting allergy injections and had received her allergy injection about 3 weeks before her covid vaccine)

Other Meds: miralax, zyrtec, singulair, asetlin nasal spray, hydrocortisone cream, wellbutrin, estradiol vaginal insert, levothyroxine, flonase

Current Illness: sinus infection (deemed viral)

ID: 1218679
Sex: F
Age: 64
State: SC

Vax Date: 04/13/2021
Onset Date: 04/13/2021
Rec V Date: 04/16/2021
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: About 3 hours after receiving injection I noticed swelling around the injection site as well as tenderness. Over the next few hours the tenderness became increasingly painful radiating between my shoulders to my elbow as well as numbness to my nose and cheeks. I also experienced fatigue. The pain in my arm interrupted my normal sleeping routine for a couple of nights. As of 04/16/2021 the swelling and pain in my arm has diminished to the point of being normal.

Other Meds: Glucosamine Chondrotin, Garcinia Cambogia, Centrum Silver Wome

Current Illness: None

ID: 1218680
Sex: F
Age: 45
State: IN

Vax Date: 04/14/2021
Onset Date: 04/15/2021
Rec V Date: 04/16/2021
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: allergic to Codeine

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

Symptoms: 100 to 101.3 temperature for more than 24 hours, body aches and severe headache. rotated Ibuprofen and acetaminophen.

Other Meds: Woman's One a Day, Vitamin Fish oil, Clariton, Vitamin C and Probiotic all daily

Current Illness: none

ID: 1218681
Sex: U
Age:
State: WA

Vax Date:
Onset Date:
Rec V Date: 04/16/2021
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: Woke up with headache and bloody nose on 4/6/2021 around 7 am. Around 9am started feeling flu like symptoms which morphed into weird and painful muscle cramps over my entire body including face and fingers. Cramps in my back were really bad. Felt like going into labor. The night of the vaccine around 8pm I had started coughing and it was severe. Took an antihistamine and it eased up around midnight.

Other Meds:

Current Illness:

ID: 1218682
Sex: F
Age: 44
State: WA

Vax Date: 04/14/2021
Onset Date: 04/15/2021
Rec V Date: 04/16/2021
Hospital: Y

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

Lab Data:

Allergies: NKDA

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Seizure on 4/15/21, 1-2 minutes, post-ictal for a few hours prior to return to baseline. No prior history of seizures.

Other Meds: Norco as needed for pain Synthroid Paxil

Current Illness: Right ankle surgery 4/13/21

ID: 1218683
Sex: M
Age: 37
State: NY

Vax Date: 03/30/2021
Onset Date: 03/30/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies: Cyclosporines, fish, penicillin

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Swelling lips, severe itching and hives on neck and face

Other Meds: Ceterezine, benedryl, stinging nettle, vitamin c

Current Illness: None

ID: 1218684
Sex: F
Age: 48
State: DC

Vax Date: 03/31/2021
Onset Date: 04/12/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies: NA

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

Symptoms: Itching, hives

Other Meds: NA

Current Illness: NA

ID: 1218685
Sex: F
Age: 30
State: IN

Vax Date: 04/14/2021
Onset Date: 04/16/2021
Rec V Date: 04/16/2021
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: Minocycline

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

Symptoms: Chills Sweating Body aches Vomiting Headache

Other Meds: Prenatal vitamin IB profun

Current Illness:

ID: 1218686
Sex: F
Age: 26
State:

Vax Date: 04/14/2021
Onset Date: 04/15/2021
Rec V Date: 04/16/2021
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: Chills, low grade fever, soreness throughout body.

Other Meds:

Current Illness:

ID: 1218687
Sex: U
Age:
State: TX

Vax Date: 04/10/2021
Onset Date: 04/10/2021
Rec V Date: 04/16/2021
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: bee venom

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

Symptoms: within 2-3 minutes, pt states felt dizzy, lip and cheeks "felt wierd" swelling on left side of cheek and lip; no SOB, no rash, no swelling of tongue; no reaction at site; laid down and APP evaluated; 50 mg Benadryl IM; VS WNL; monitored for 20-30 minutes; given dose of depomedrol; after 1.5 hours swelling subsided; lives 35-45 minutes from clinic; pt went home with pt employee/family for monitoring overnight and follow up with PCP

Other Meds: no

Current Illness: unknown/no

ID: 1218688
Sex: F
Age: 46
State: TX

Vax Date: 04/10/2021
Onset Date: 04/10/2021
Rec V Date: 04/16/2021
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: N/A

Symptom List: Injection site pain, Pain

Symptoms: FACE AND TONUGE NUMBNESS 15 MINUTES AFTER ADMINISTRATION, WAS ADMINISTERED 50 MG OF BENADRYL, PROCEEDED TO HOSPTIAL JUST IN CASE, COUGH AND HEADACHE THE FOLLOWING DAY

Other Meds: N/A

Current Illness: N/A

ID: 1218689
Sex: F
Age: 39
State: SC

Vax Date: 04/10/2021
Onset Date: 04/11/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies: No

Symptom List: Injection site pain, Menorrhagia

Symptoms: Headache, Nausea,

Other Meds: None

Current Illness: No

ID: 1218691
Sex: M
Age: 57
State: TX

Vax Date: 04/08/2021
Onset Date: 04/12/2021
Rec V Date: 04/16/2021
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: None reported

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

Symptoms: On 4/16/2021 patient reported left leg pain began on 4/12/2021. Pharmacist recommended the patient seek medical attention at the nearest emergency room.

Other Meds: None reported

Current Illness: None reported

ID: 1218692
Sex: U
Age:
State: TX

Vax Date: 04/10/2021
Onset Date: 04/10/2021
Rec V Date: 04/16/2021
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: bee venom

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: within 2-3 minutes, pt states felt dizzy, lip and cheeks "felt wierd" swelling on left side of cheek and lip; no SOB, no rash, no swelling of tongue; no reaction at site; laid down and APP evaluated; 50 mg Benadryl IM; VS WNL; monitored for 20-30 minutes; given dose of depomedrol; after 1.5 hours swelling subsided; lives 35-45 minutes from clinic; pt went home with pt employee/family for monitoring overnight and follow up with PCP

Other Meds: no

Current Illness: unknown/no

ID: 1218693
Sex: F
Age: 41
State: MA

Vax Date: 04/09/2021
Onset Date: 04/11/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies: Allergy to zucchini and yellow squash

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Diagnosed with livedo reticularis

Other Meds: Keppra XR, topiramate, magnesium, multivitamin, viactiv calcium supplement

Current Illness: N/A

ID: 1218694
Sex: F
Age: 36
State: WI

Vax Date: 04/15/2021
Onset Date: 04/16/2021
Rec V Date: 04/16/2021
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: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: high fever, aching muscles, fatigue, nausea, headache, early menstrual cycle, lymph node swelling in injection arm, pain at injection site

Other Meds: None

Current Illness: None

ID: 1218695
Sex: M
Age: 69
State: MD

Vax Date: 04/16/2021
Onset Date: 04/16/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List: Nausea

Symptoms: Palpitations

Other Meds: Amlodipine, Chlorthalidone, Losartan

Current Illness:

ID: 1218696
Sex: F
Age: 44
State: CA

Vax Date: 04/13/2021
Onset Date: 04/13/2021
Rec V Date: 04/16/2021
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: @ 13:50 Patient reported Dizziness and rapid heart rate, I called code assist, and took pt vital signs her readings were, BP: 147/89 o2:100%, PR: 114, code assist arrived and took patient into the clinic for further assistance.

Other Meds:

Current Illness:

ID: 1218697
Sex: F
Age: 44
State: WA

Vax Date: 03/22/2021
Onset Date: 03/26/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies: Medrol

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

Symptoms: About 4 days after the vaccination, I developed a rash, first a large patch on my lower back, followed by other areas, including another large one on my upper left arm (the injection site) and many other smaller ones on my fingers, abdomen, leg, and arms. The rash was initially made up of small clusters of intensely itchy bumps, which would eventually redden and join together. The worst areas also swelled a bit and the skin started to feel dry and began peeling in places. The rash drove me crazy all day and woke me at night. I treated myself at home with o/c antihistamines, anti-itch creams (hydrocortisone, etc.), and ice packs for a week and a half; but the rash did not subside and was continuing to pop up in new places. I had my appt with the doctor on 04/7/21. Due to my allergy to medrol, I was not prescribed oral steroids. I was prescribed doxepin for pm (sleep and itching), o/c Allegra for am, and a steroid cream. The treatment has been effective and the affected skin is healing.

Other Meds: Combipatch, dhea, Adhd stimulant medications, Flonase

Current Illness: None

ID: 1218698
Sex: F
Age: 57
State: MN

Vax Date: 04/14/2021
Onset Date: 04/15/2021
Rec V Date: 04/16/2021
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: no know allergies

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

Symptoms: Syncope event Vertigo

Other Meds: Vit D 2,000 unit daily Tums 500 mg TID PRN heartburn Excedrin extra strength 1 tab Q 8 hr PRN Ibuprofen 400 mg Q6 hrs PRN Advil Cold/Sinus 1 tab QD PRN

Current Illness: none

ID: 1218699
Sex: F
Age: 49
State: IN

Vax Date: 04/14/2021
Onset Date: 04/14/2021
Rec V Date: 04/16/2021
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: Latex

Symptom List: Tremor

Symptoms: Chills, fatigue, headache

Other Meds: Multivitamin, probiotic, allegra, calcium, vitamin d, vitamin c, magnesium, black cohosh

Current Illness: None

ID: 1218700
Sex: F
Age: 41
State: CO

Vax Date: 04/10/2021
Onset Date: 04/11/2021
Rec V Date: 04/16/2021
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: Lisinopril, doxycycline

Symptom List: Erythema, Pruritus

Symptoms: Extreme itching fill body above waist (back, front, arms, face, neck). No rash, just unquenchable itching.

Other Meds: Labetalol, Norco, Robaxin, wellbutrin, Latuda, lamotrigine, cyclobenzaprine, minocycline, hctz, atorvastatin, pregabilin, clonidine, norlyda

Current Illness: None

ID: 1218701
Sex: M
Age: 41
State: MO

Vax Date: 04/16/2021
Onset Date: 04/16/2021
Rec V Date: 04/16/2021
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: seafood and bactrim

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

Symptoms: Pt c/o chest tightness in middle are of chest Pt assessed: VS: 150/80 98HR 94% Rested for 10 min. After 10 min, VS: 142/80 O2Sat 95%, Denies chest tightness, pressure, heart palpitations.

Other Meds: metformine, ropinarole, alprzolam, sertraline, diphehydramine, cetrizine

Current Illness:

ID: 1218702
Sex: M
Age: 64
State: MO

Vax Date: 03/01/2021
Onset Date: 03/29/2021
Rec V Date: 04/16/2021
Hospital: Y

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

Lab Data:

Allergies: varenicline, venlafaxine, buprenorphine

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

Symptoms: 14 days after 2nd dose severe shortness of breath, fatigue, lightheaded, near syncope. Diagnosed with bilateral DVT and bilateral PE

Other Meds: albuterol, aspirin, tikosyn, Neurontin, Lidoderm, Mobic, midodrine, omeprazole, prednisone, Synthroid, anoro ellipta, vitamin b

Current Illness: chronic pain syndrome

ID: 1218703
Sex: F
Age: 66
State: TX

Vax Date: 03/07/2021
Onset Date: 03/08/2021
Rec V Date: 04/16/2021
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: Allergy to all metal including nickel, silver, gold, betadine, and mercury. Levaquin, Ceclor, Keflex, Codeine, and some others.

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Dull headache for several days. Excruciating abdominal cramping off and on for almost a week. Arm soreness appeared about a week later severe enough to keep me from sleeping on that side of my body. Lasted about a week. At the same time, large bruises appeared on the "shot arm" from the shoulder down almost to my elbow. Soreness in my right calf developed after four weeks and still comes at times.

Other Meds: Atenolol 25 mg Baby aspirin daily

Current Illness: None

ID: 1218704
Sex: F
Age: 75
State: NY

Vax Date: 04/09/2021
Onset Date: 04/12/2021
Rec V Date: 04/16/2021
Hospital: Y

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 was admitted due to feeling jittery, with history of seizure, possible non-compliance. Dose of Keppra increased, chest imaging negative for pneumonia.

Other Meds:

Current Illness:

ID: 1218705
Sex: F
Age: 64
State:

Vax Date: 04/07/2021
Onset Date: 04/14/2021
Rec V Date: 04/16/2021
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: Patient noted to have liver hematoma (post liver biopsy 4/02/2021) on 4/14/21 MRI (ordered to evaluate cancer bone metastatic lesions). Patient told to report to ER based on imaging findings. Patient clinically stable per ER note and discharged without intervention

Other Meds:

Current Illness:

ID: 1218706
Sex: F
Age: 29
State:

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 04/16/2021
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: Red rash on bilateral arms, no acute distress. Patient was given Zyrtec 10 mg PO. Watched for additional 15 minutes. Patient was discharged home.

Other Meds:

Current Illness:

ID: 1218707
Sex: F
Age:
State: FL

Vax Date: 04/12/2021
Onset Date: 04/13/2021
Rec V Date: 04/16/2021
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: Pt was given second dose of vaccine on 0412/2021. She developed severe pain of forearm and wrist. She had applied ice to site and today noticed a bruise on her inner wrist (4 x 2 inch). Denies taking any blood thinner and denied trauma. No warmth or pain at this time. She took 800 mg Ibuprofen night before vaccine for back injury. She applied ice to site. PCC: Advised to FU with pcp, urgent care or ED for cbc and coags. Although Pfizer vaccine has not been known to cause clotting issues and sx could be unrelated it is best to r/o. Caller will be going to home on Friday and said she might wait to fu with pcp there.

Other Meds: none

Current Illness:

ID: 1218708
Sex: F
Age: 33
State: MN

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Low grade fevers, hyperglycemia and ketonuria, headaches, L arm paresthesias and pain, and subsequent extremity weakness of arms and legs

Other Meds:

Current Illness:

ID: 1218709
Sex: F
Age: 49
State: OH

Vax Date: 04/14/2021
Onset Date: 04/15/2021
Rec V Date: 04/16/2021
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: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: The expected fever, aches, and joint pain started around 11pm on 4/14 and led to a very restless overnight. I got up around 5am on 4/15 feeling very thirsty and went to the bathroom to get a drink of water. I remember feeling extremely dizzy, nauseous, and lightheaded standing at the bathroom sink with a cup to fill with water. The next thing I remember is sitting on the bathroom floor with the bathroom cup next to me but I didn't know right away where I was (I hadn't turned on the bathroom light so it was dark) and I still don't know how I got there. I must've passed out. It was so difficult getting back to the bed that I had to ask my husband to help me. The fever, aches, and chills continued all day on 4/15 but the lightheadedness improved.

Other Meds:

Current Illness:

ID: 1218710
Sex: F
Age: 47
State: PA

Vax Date: 04/16/2021
Onset Date: 04/16/2021
Rec V Date: 04/16/2021
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: allergy to IV med in hospital unsure the med

Symptom List: Vomiting

Symptoms: pt states vision dark and dizzy, feeling racing HR, and feeling warm all over, staff lowered pt to floor pt assisted self to stretcher laying down and taken to OBS. pt given water feeling better once laying down, VS as noted pt evaluated and feeling better pt concerned due to 12 yr old daughter outside in car by herself pt requesting to leave as soon as she can due to feeling better and her daughter in car, pt sitting up and then dangling at side of bed then standing and denies feeling dizzy or other symptoms as previously stated. discharged from OBS area ambulated to car without diffiuclty at 1011. VS 0959 bp 122/84 hr 66 rr 18 o2 100, 1004 sitting bp 131/83 hr 72 rr 18 o2 100 1007 dangling bp123/84 hr 70 rr 18 o2 100 1010 standing bp 110/89 hr 71 rr 18 o2 100

Other Meds: none

Current Illness: none

ID: 1218711
Sex: F
Age: 16
State: MO

Vax Date: 04/02/2021
Onset Date: 04/02/2021
Rec V Date: 04/16/2021
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: lavender, latex, adhesive

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Inadvertently gave Moderna to 16 year old Mother relates had cold like symptoms, and fatigue but was well on day 3

Other Meds: Claritin, Flonase, Birth Control Pills, asthma inhaler, Zofran

Current Illness: none

ID: 1218712
Sex: F
Age: 63
State: PA

Vax Date: 04/03/2021
Onset Date: 04/03/2021
Rec V Date: 04/16/2021
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: NKA

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

Symptoms: Approximately two hours after receiving vaccine, the tip of my tongue went numb almost if I had eaten something bitter. The numbing sensation never progressed past the tip of my tongue but lasted up until I fell asleep. Next day, I was fine. Then Monday evening , I felt like I had a sty under my left eyelid. Tuesday morning, my daughter noticed my face was drooping a little, on the left side by the afternoon my other daughter called me and picked up on it. Called Drs office and was told to report to the Emergency Room .Arrived around 5:30 pm

Other Meds: Glimepiride, Metformin, Losartan/HCTZ, Vitamins, A , B, C ,D, E, Ginger, Cinnamon, Lutein, Fish Oil, Coconut, Magnesium,Turmeric. Garcinia Cambogia, GreenTea,

Current Illness: None

ID: 1218713
Sex: F
Age: 54
State: MI

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/16/2021
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: Allergy status to other anti-infective agents status

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Patient had generalized anxiety disorder. Onsite EMS was called vitals BP 138/96 HR 70. Patient refused evaluation or care without transport, released agianst medical advise.

Other Meds: Ativan Pill

Current Illness:

Date Died:

ID: 1218714
Sex: M
Age: 54
State: MI

Vax Date: 04/15/2021
Onset Date: 04/16/2021
Rec V Date: 04/16/2021
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: Patient was returning to unit. When patient reached unit doors, patient collapsed. Health Care called, 3 nurses and Mini Ambulance deployed. Upon the Staff's arrival CPR was in progress, AED in place, Narcan administered. Ambulance call, transported to Facility. Patient pronounced 0724 hours

Other Meds:

Current Illness:

ID: 1218715
Sex: F
Age: 50
State: LA

Vax Date: 03/29/2021
Onset Date: 03/01/2021
Rec V Date: 04/16/2021
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: Sulpha drugs Extended exposure to laytex

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

Symptoms: Arm soreness Swollen lymphnodes under arms Fibromyalgoa like symptoms that wrap around my chest and back.

Other Meds: Sertraline 100mg x 1, diazepam mg x3, oxycontin 15mg x 2,, Vitamin D

Current Illness: Managed chronic pain & neuropathy.

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm