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: 0944847
Sex: F
Age: 77
State: OR

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 01/14/2021
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: none

Symptom List: Dysphagia, Epiglottitis

Symptoms: Received the vaccination. Said immediately felt horrible pain like pharmacist hit a brick wall. There was bleeding which bandaid was applied to. Had to wipe off with tissue. Bruising started middle of night. Swelling has occurred. Pt has iced her arm. Pt has continued to use the arm, She is active with it. Ice helps, but if take ice away pain returns.

Other Meds: Prilosec

Current Illness: none

ID: 0944848
Sex: F
Age: 48
State: CO

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 01/14/2021
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: peas, pineapple, sulfa, watermelon PCN, Prednisone, Tetracycline Tuberculin PPD Influenza Virus vaccine

Symptom List: Anxiety, Dyspnoea

Symptoms: Pt states had sz at time of injection. Pt states after going home had numbness/tingling and facial droop as well as swelling to face/lips or tongue

Other Meds: albuterol, advair, mirena, epi pen prn

Current Illness: none reporter aware of

ID: 0944849
Sex: F
Age: 46
State: MO

Vax Date: 01/11/2021
Onset Date: 01/12/2021
Rec V Date: 01/14/2021
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: Sulfa and codine

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

Symptoms: Achy joints and bones, low grade fever 99.9, chills, feeling of needles pricking my skin- Tuesday around 1130am- went home from work and took ibuprofen. stayed home from work Wednesday- started to taper off pre immunization medication of benedryl, Pepcid, and prednisone on Wednesday afternoon. Wednesday night noticed using my inhaler. Little more- I took Half dose of prednisone. Had to do nebulizer treatment later that night. Thursday morning woke up wheezing took another prednisone and used rescue inhaler. Went to work and wheezing didn?t get any better, but didn?t get any worse. Took another prednisone and sent home to do nebulizer. Continued to rest and monitor asthma- Notified PCP of what was going on- advised to continue Pepcid, benedryl and prednisone for a few more days and advise of any issues.

Other Meds: Symbicort, albuteral, adderall, effexor, Pepcid, prednisone, benedryl

Current Illness:

ID: 0944850
Sex: M
Age: 88
State: WI

Vax Date: 01/06/2021
Onset Date: 01/07/2021
Rec V Date: 01/14/2021
Hospital:

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

Lab Data:

Allergies: aspirin, oxycodone HCl Pregabalin

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: fatigue, stayed in bed most of day after vaccination and during therapy oxygen sats dropped to 82 % on Room air, needed to start oxygen, HR 101, R 36, mild non productive cough, mild SOB, T 99.5 Oxygen administered at 2 liters from 1/7 at 220 pm til 1/8 0930 off oxygen sats 95%, guaifenisin 5 ml given 1/7/21 at bedtime _history of taking this in evening already GNP updated and ordered labs and CXR and oxygen via email/phone communication Back to baseline 1/8 by mid morning, oxygen off and performing in therapy per prior (1/6 level and has since shown steady improvement in therapy as expected with rehab stay.

Other Meds: tamsulosin, acetaminophen ES, atorvastatin, vitamin D3, vitamin B-12, finasteride, glipizide ER,isosorbide mononitrate ER, Vitamin E, Ascorbic acid, duloxetine, cranberry, aplha-lipoic acid, flonase, Nystantin powder, saw palmetto, gabapent

Current Illness: Hosp with severe sepsis with acute organ dysfunction, pneumonia, Covid + 12/8/20

ID: 0944851
Sex: F
Age: 39
State: FL

Vax Date: 12/31/2020
Onset Date: 01/08/2021
Rec V Date: 01/14/2021
Hospital:

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

Lab Data:

Allergies: Amoxicillin, Keflex, and Mango

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

Symptoms: I received my vaccine

Other Meds: Diamox 500mg PO BID Lasix 25mg PO BID Prozac 45mg PO QAM Synthroid 125mcg PO QAM Montelukast 10mg PO QAM Ajovy Subcutaneous Injection Q Month (on the 20th) Tylenol 1000mg PO PRN for Headache (I did pre-med with Tylenol just prior to receivi

Current Illness: None

ID: 0944852
Sex: F
Age: 61
State: NC

Vax Date: 01/13/2021
Onset Date: 01/14/2021
Rec V Date: 01/14/2021
Hospital:

Vax Type: FLUC4
Manufacturer: SEQIRUS, INC.
Vax Name: INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT)
Lot: 276563
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Sulfa drugs

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

Symptoms: Fever, muscle weakness, muscle pain

Other Meds: azelastine-fluticasone, diclofenac DR, levothyroxine, lansoprazole, vitamin E, vitamin D, vitamin b-12, trazodone, losartan-hydrochlorothiazide

Current Illness: None

ID: 0944853
Sex: M
Age: 34
State: OH

Vax Date: 11/30/2020
Onset Date: 11/30/2020
Rec V Date: 01/14/2021
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: Pyrexia, White blood cell count decreased

Symptoms: Lost mobility in arm. Still in physical therapy.

Other Meds:

Current Illness:

ID: 0944854
Sex: F
Age: 44
State: CO

Vax Date: 12/18/2020
Onset Date: 12/18/2020
Rec V Date: 01/14/2021
Hospital:

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

Lab Data:

Allergies: Shellfish

Symptom List: Pharyngeal swelling

Symptoms: Patient reported feeling dizzy and lightheaded. Vitals listed below: 1214 - 122/68; 97%; 74; 16 1219 - 110/66; 96%; 74; 18 1225 - 115/63; 96%; 75; 18 Patient was given water/juice and was discharged home in stable condition

Other Meds:

Current Illness:

ID: 0944855
Sex: M
Age: 29
State: ME

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 01/14/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: Dizziness (patient also reported intermittent dizziness prior to receiving the vaccine

Other Meds: Buprion

Current Illness:

ID: 0944856
Sex: F
Age: 39
State: WA

Vax Date: 01/01/2021
Onset Date: 01/09/2021
Rec V Date: 01/14/2021
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: Facial flushing occurred within 45 minutes of injection-resolved after about 12 hours. Dizziness, spinning and nausea occurred within 48 hours of injection-resolved within 5 hours Localized redness, warmth and itching noticed at injection site on 1/9/21-not resolved New area of redness and warmth on left arm noticed on 1/13/21-not resolved Additional new areas of redness and warmth on left arm noticed on 1/14/21-not resolved

Other Meds: spironolactone, propranolol, birth control

Current Illness: None

ID: 0944857
Sex: F
Age: 80
State: FL

Vax Date: 01/12/2021
Onset Date: 01/13/2021
Rec V Date: 01/14/2021
Hospital: Y

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

Lab Data:

Allergies: NKDA

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

Symptoms: Patient presented herself to LPN slurring words and 'not herself'. Upon evaluation, patient denied drinking alcohol, knew she was not able to speak correctly and visibly frustrated . With great difficulty she was able to communicate that she had a headache and was slightly dizzy. Failed FAST and does have a history of CVAs. EMS called and patient was taken to ER where they admitted her for observation post Stroke. Per the hosp nurse, patient received tPA treatment and will be moved to step-down unit when a bed is available.

Other Meds: Aspirin 81 MG, Famotidine 20 MG, Lasix 20MG, Levsin0.125 MG Potassium Chloride ER 10 MQ, Protonix 40 MG, Zoloft 50MG, Mutli 50+ for her, Nystatin cream, Tylenol 325MG (as needed), Zofran 4MG (as needed)

Current Illness:

ID: 0944858
Sex: F
Age: 90
State: FL

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 01/14/2021
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: PCN

Symptom List: Rash, Urticaria

Symptoms: 178/80 Dizziness

Other Meds: Hypertension

Current Illness:

ID: 0944859
Sex: F
Age: 33
State: MD

Vax Date: 12/21/2020
Onset Date: 12/21/2020
Rec V Date: 01/14/2021
Hospital:

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

Lab Data:

Allergies: Slagyl

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

Symptoms: I received my first dose on 12-21-2020 and at night I had a high fever, tachycardia, tremors. I also had joint pain, myalgia.

Other Meds: Wellbutrin, Zoloft , Acyclovir, Zonegran, Trazadone (taken everyday)

Current Illness: 11-25-2020 Hysterectomy 11-27-2020 Diagnosed with Covid-19

ID: 0944860
Sex: M
Age: 63
State: MA

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/14/2021
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: N/A

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

Symptoms: Headache Elevated temperature Chills Joint pain

Other Meds: Multi-Vitamin Eliquis Avapro Vitamin D Iron Supplement

Current Illness: Covid-19

ID: 0944861
Sex: F
Age: 58
State: CA

Vax Date: 01/11/2021
Onset Date: 01/12/2021
Rec V Date: 01/14/2021
Hospital:

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

Lab Data:

Allergies: Sulfa based medications, Levaquin, Zofran

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

Symptoms: Severe body shaking and jerking, uncontrollable teeth chattering, feeling of complete exhaustion and felt like I was freezing...I could not get warm. Lasted for 8 hours.

Other Meds: Vancomycin

Current Illness: Liver problems- stents in Common bile duct

ID: 0944862
Sex: F
Age: 45
State:

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 01/14/2021
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: NSAIDs = edema Hydrocodone = hives

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

Symptoms: shortness of breath, cough, sore throat, chest pain, myalgia, arm soreness, sweats, hot flashes, nausea, skin burning sensation, facial swelling

Other Meds:

Current Illness:

ID: 0944863
Sex: F
Age: 22
State: IN

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 01/14/2021
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: Zithromax Seafood Shellfish Hazlenuts

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

Symptoms: Headache- immediately after injection Nausea- 1pm Fatigue-1pm Injection site pain -9 am Dizziness-2pm Fever-2 pm

Other Meds: Prozac Albuterol Claritin Singular Breo elipta Magnesium Calcium Multi vitamin Probiotic

Current Illness:

ID: 0944864
Sex: F
Age: 38
State:

Vax Date: 12/24/2020
Onset Date: 12/24/2020
Rec V Date: 01/14/2021
Hospital:

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

Lab Data:

Allergies: cat dander

Symptom List: Ear pain, Hypoaesthesia

Symptoms: pain and swelling at injection site, muscle stiffness approximately 3 days

Other Meds: citalopram

Current Illness: none

ID: 0944865
Sex: F
Age: 43
State: NV

Vax Date: 01/07/2021
Onset Date: 01/13/2021
Rec V Date: 01/14/2021
Hospital:

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

Lab Data:

Allergies: Med allergies: Codeine & Sulfa Food allergy: honeydew melon

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Left upper arm became red, hard and tender to touch ~ 24 hours after vaccination

Other Meds: Omeprazole Metformin Singulair (generic) Lisinpril B-complex & Vit D

Current Illness: None at time of vaccination or in the month prior.

ID: 0944866
Sex: M
Age: 58
State: MD

Vax Date: 01/06/2021
Onset Date: 01/07/2021
Rec V Date: 01/14/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Starting the day after the vaccine he noticed tingling on the roof of his mouth and a lump.

Other Meds:

Current Illness:

ID: 0944867
Sex: F
Age: 79
State: VA

Vax Date: 01/13/2021
Onset Date: 01/14/2021
Rec V Date: 01/14/2021
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: diarrhea

Other Meds:

Current Illness:

ID: 0944868
Sex: F
Age: 23
State: IL

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 01/14/2021
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: Unevaluable event

Symptoms: Before injection patient was very nervous and did not eat breakfast. 3 minutes after injection patient complained of blurred vision and dizziness. BP 88/50, HR 54, O2 92%, pale in color, patient started to shake and have seizure activity only lasting a few seconds. 3 person assist to lie flat on the floor, rolled to left side. Patient was non-verbal at this time. 911 was called. At 9:11 AM EMS arrived and patient was responding at that time, patient transferred to the hospital. After hospital visit staff reported back the doctor felt it was an anxiety response rather than a vaccine reaction.

Other Meds: Depakote, Abilify

Current Illness:

ID: 0944869
Sex: F
Age: 46
State: MI

Vax Date: 01/02/2021
Onset Date: 01/10/2021
Rec V Date: 01/14/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: redness, swelling, pain at injection site

Other Meds: none

Current Illness: none

ID: 0944870
Sex: F
Age: 26
State: MD

Vax Date: 12/21/2020
Onset Date: 12/21/2020
Rec V Date: 01/14/2021
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:

Symptom List: Injection site pain, Pain

Symptoms: 15' after vaccine, developed " tingling in throat" and felt anxious : transferred to ED for E &M. sx resolved upon arrival, observed for 3 hrs and left AMA

Other Meds:

Current Illness:

ID: 0944871
Sex: F
Age: 48
State: MI

Vax Date: 01/04/2021
Onset Date: 01/11/2021
Rec V Date: 01/14/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: itching, swelling, pain, warm to the touch and expanding border. left arm -swollen lymph nodes under arm (painful) and at inside of elbow (just swelling)

Other Meds: Alavert, Vyvanse

Current Illness:

ID: 0944872
Sex: F
Age: 41
State:

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 01/14/2021
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: Pt Complained of numbness/tingling around the mouth . Red rash . Tenderness on the injection site/lower arm for 5 days.

Other Meds:

Current Illness:

ID: 0944873
Sex: F
Age: 52
State: AL

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 01/14/2021
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: UNKNOWN

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: FELT WEIRD, FELT "OUT OF BODY EXPER"

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 0944874
Sex: F
Age: 45
State: NJ

Vax Date: 01/05/2021
Onset Date: 01/10/2021
Rec V Date: 01/14/2021
Hospital:

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

Lab Data:

Allergies: no

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: My armpit had pain and swelling. I have hives on the R side of my body

Other Meds: citalopram, klonipin, multivitamins

Current Illness: no

ID: 0944875
Sex: F
Age: 36
State: NY

Vax Date: 01/05/2021
Onset Date: 01/10/2021
Rec V Date: 01/14/2021
Hospital:

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

Lab Data:

Allergies: NKDA

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

Symptoms: Left deltoid soreness day after and continuing for a couple days. Tiredness 24-48 post vaccine. Vaccine site started noticeably itchy about 5 to 6 days after. Site always had a smaller red elongated "stripe" at the site of injection. A couple days later it became more inflamed, red and larger, with distinct lines in the shape of an oval. Still very itchy and warm.

Other Meds: Venlafaxine, Loratadine

Current Illness: None

ID: 0944876
Sex: F
Age: 73
State: GA

Vax Date: 01/13/2021
Onset Date: 01/14/2021
Rec V Date: 01/14/2021
Hospital:

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

Lab Data:

Allergies: Factive

Symptom List: Nausea

Symptoms: pain tenderness at injection site; chills; muscle pain; sinus congestion and drainage causing a cough

Other Meds: Valacyclovir 1 gram; multivitamin: calcium chew; potassium citrate; magnesium citrate

Current Illness: Positive for COVID two weeks prior to vaccine

ID: 0944877
Sex: F
Age: 88
State: NE

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 01/14/2021
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: EVENING OF 1/13/21, DEVELOPED FEVER OF 100.2, THREW UP, AND WAS THIRSTY.

Other Meds:

Current Illness:

ID: 0944878
Sex: M
Age: 54
State: MI

Vax Date: 01/05/2021
Onset Date: 01/11/2021
Rec V Date: 01/14/2021
Hospital:

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

Lab Data:

Allergies: Cephalexin IV, uncontrolled diarrhea

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

Symptoms: Localized erythema to left deltoid. Size is irregular shape circle 3 inch diameter. No itching, and no other symptoms.

Other Meds: Omeprazole, Synthroid, loratadine

Current Illness: None noted

ID: 0944879
Sex: F
Age: 57
State: CA

Vax Date: 01/13/2021
Onset Date: 01/14/2021
Rec V Date: 01/14/2021
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: Bactrim

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

Symptoms: Had vaccine at Pharmacy yesterday, 01/13/21, felt fine. Next day, 01/14/21, woke up with headache, back pain. Called Doctor office, the doctor said go to Urgent Care if symptoms get worse.

Other Meds: Vitamin D 1000IU, Hydroclorothiazide 12.5 mg, Solifenacin 10mg, Flonase 50mcg, Loratadine 10mg

Current Illness: Tested positive for COVID-19 on 12/31/2020. Tested negative for COVID-19 on 01/08/2021.

ID: 0944880
Sex: F
Age: 37
State: NC

Vax Date: 01/12/2021
Onset Date: 01/13/2021
Rec V Date: 01/14/2021
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: Sulfa drugs

Symptom List: Tremor

Symptoms: Beginning 15 hours after vaccine: vomiting (multiple episodes over 6 hour period); fever 101F; chills; aches all over body; nausea; diarrhea (multiple episodes over 12 hour period); headache; sweating.

Other Meds: Vitamin D Iron Magnesium Melatonin

Current Illness: COVID-19 diagnosis on 12/8/2020

ID: 0944881
Sex: F
Age: 37
State: MA

Vax Date: 01/12/2021
Onset Date: 01/13/2021
Rec V Date: 01/14/2021
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: Sulfa

Symptom List: Erythema, Pruritus

Symptoms: 1/13-malaise, mild headache, chills, joint pain, body aches, low grade temp (99.7) 1/14 worsening exhaustion, body aches, head/neck pain, chills, afebrile.

Other Meds: Prilosec, multivitamins

Current Illness: None

ID: 0944882
Sex: F
Age: 56
State: GA

Vax Date: 01/11/2021
Onset Date: 01/11/2021
Rec V Date: 01/14/2021
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: N/A lactose intolerance

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

Symptoms: Severe cold chills

Other Meds: Estradiol

Current Illness: N/A

ID: 0944883
Sex: M
Age: 49
State: NC

Vax Date: 01/07/2021
Onset Date: 01/09/2021
Rec V Date: 01/14/2021
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: Penicillins

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

Symptoms: Diarrhea, bloating and severe abdominal tenderness that lasted one week

Other Meds: none

Current Illness: none

ID: 0944884
Sex: F
Age: 32
State: PR

Vax Date: 01/02/2021
Onset Date: 01/09/2021
Rec V Date: 01/14/2021
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: N/A

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Awoke with arm pain in AM and rash at injection site at 6PM, pt sought medical treatment at ER Health Service, Attending Dr stated allergic reaction to vaccine, topical cream prescribed, symptoms have resolved some redness still at injection site

Other Meds: N/A

Current Illness: N/A

ID: 0944885
Sex: F
Age: 52
State: CO

Vax Date: 01/11/2021
Onset Date: 01/12/2021
Rec V Date: 01/14/2021
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: Nausea, headache, body aches and pains, fever of 100.7 orally and chills, chest pain, feeling of burning at surgical scar site, malaise starting around 18 hours post injection and lasting about 14 hours. Minimal to zero relief with Ibuprophen, or Acetaminophen. No medical treatment required. Headache continues to persist but chronic headaches are part of normal history.

Other Meds: Atenolol, Excedrin, Ibuprophen Levothyroxine Omeprazole

Current Illness:

ID: 0944886
Sex: M
Age: 87
State: CA

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/14/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: Error: Booster Given Too Early

Other Meds:

Current Illness:

ID: 0944887
Sex: F
Age: 53
State: LA

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 01/14/2021
Hospital:

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

Lab Data:

Allergies: sulfa drugs

Symptom List: Pain in extremity

Symptoms: Within 5 minutes of shot, diarrhea and severe stomach cramps, sensitive to light and sound 5:30pm chills, temp 97.8 7:00pm warm shower 7:15pm diarrhea, shortness of breath, sweat dripping down body, dizzy, nauseated 7:45pm cool compresses on head and neck, clams, shortness of breath, still dizzy, weakened began shacking. 7:55pm. Dressed by husband and put in bed. Temperature 90.0 8:00pm 3 blankets on me, gloves on, socks and slippers on and heating pads to ankles and feet, still dizzy and shacking. no circulation to hand or feet. no capillary refill. 8:30pm Called nurse on Call who stayed on the phone with me for 45 minutes, two Advil taken. Trying to eat crackers and hydrate. 8:45pm. feeling blood flowing to hands but not feet. 9:45pm gloves off hands and heavy blanket off, toes still ice cold.10:15pm Up to bathroom with husbands help, no strength. Urinated, no more diarrhea. Stomach still making a lot of noise. Still sensitive to light and sound, feeling to toes, still dizzy.11:30pm Feeling more like myself. Just exhausted. Slept off and on throughout the night and hydrated and up to urinate on my own without assistance. Jan. 14, 2021 , 10:00am- Sitting up in bed. Very tired. Drinking water. 12:00 noon able to eat an egg and avocado sandwich

Other Meds: none

Current Illness: none

ID: 0944888
Sex: F
Age: 48
State: WI

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 01/14/2021
Hospital:

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

Lab Data:

Allergies: Food Allergies

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

Symptoms: Client reported to clinic staff at 12:20 that she wasn't feeling right. Client was placed supine on cot. Skin warm a nd dry , BP 140/? P 110-120. C/O itchiness on roof of mouth and tongue. No apparent respiratory distress. Pulse ox 98. C/O of some disorientation. No loss of consciousness. Patient monitored for 30 minutes, no worsening of symptoms. EMS called as symptoms still persisted, Client took Claritin at 11:30 as instructed by MD. Benadryl offered, client was refusing that as well.

Other Meds: Claritin

Current Illness: unknown

ID: 0944889
Sex: F
Age: 43
State: WI

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 01/14/2021
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: Two hours after being vaccinated I got a terrible headache and nose bleed

Other Meds: Seraquil, zoloft and high blood pressure

Current Illness: None

ID: 0944890
Sex: M
Age: 67
State: FL

Vax Date: 01/13/2021
Onset Date: 01/14/2021
Rec V Date: 01/14/2021
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: No known allergies

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

Symptoms: Patient has not had an adverse event; however he received 1.0ml instead of the 0.5ml dosage.

Other Meds: Benadryl, Keppra, Antivert, Zyprexa, Dilantin, Synthroid, Tylenol, Albuterol Aerosol, Lipitor, Vitamin B-12, Colace, Folic Acid, Zestril, Prilosec, Zoloft

Current Illness:

ID: 0944891
Sex: F
Age: 73
State: MD

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/14/2021
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:

Symptom List: Vomiting

Symptoms: Approximately 3 hours after the vaccination, she noticed her left eye was itching and swollen

Other Meds:

Current Illness:

ID: 0944892
Sex: F
Age: 30
State: NJ

Vax Date: 12/28/2020
Onset Date: 01/01/2021
Rec V Date: 01/14/2021
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: NONE

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Heather reports: "redness and bumps to my face, down my neck, and down my left arm (that is the arm that I got the vaccine). I took Claritan at facility and Benadryl at home. The rash burned badly and was extremely itchy." Heather stated that the symptoms resolved after taking the Benadryl.

Other Meds: NONE

Current Illness: NONE

ID: 0944893
Sex: F
Age: 35
State: MA

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/14/2021
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: Numbness, tingling in R arm distal to injection site. Swelling at injection site. Restricted movement due to pain.

Other Meds: motrin and tylenol

Current Illness: none

ID: 0944894
Sex: F
Age: 39
State: OH

Vax Date: 01/11/2021
Onset Date: 01/12/2021
Rec V Date: 01/14/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Injection site swelling, Limb discomfort

Symptoms: 9am 1/12/21 started low grade temp which lasted 24 hours. Late night 1/12/21 started with headache and body aches lasting through to 1/14/21. 1/14/21 nauseous and fatigue.

Other Meds: Pantoprazole

Current Illness: none

ID: 0944895
Sex: F
Age: 61
State: AK

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 01/14/2021
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: At time of shot, maybe 3 mins after, rush of hotness through entire body and severe nausea. Passed after about 4 mins then occurred a second time lasting for about 5 mins. Rested for about 45 mins before I felt well enough to drive. All better after about 2 hours.Next day, tired, sweaty, nauseous, lightheaded when standing.

Other Meds: Escitalopram 10 mg, 400 IU Vit D

Current Illness:

ID: 0944896
Sex: F
Age: 29
State: TX

Vax Date: 01/05/2021
Onset Date: 01/05/2021
Rec V Date: 01/14/2021
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:

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

Symptoms: 1/5/2021 @ 4:15 p.m. received vaccination. 1/5/2021 @ 6:30 p.m. had episode of dizziness, and nausea lasting 2 1/2 hours, then felt flushed. Was tired and fatigued for a day or so and her injection arm was sore for 2 days.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm