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: 0945302
Sex: F
Age: 39
State: AL

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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NKDA

Symptom List: Dysphagia, Epiglottitis

Symptoms: A few minutes into monitoring patient stated she was getting a migraine. Asked patient if she had her medication with her and she did not. Patient stated she did pre-medicate with Tylenol prior to coming to clinic. Patient was offered water and ibuprofen was offered and given - 800mg po. Patients lights were dimmed and we monitored for additional reactions. Patient was monitored a total of 53 minutes when she said she was feeling a little better and was ok to leave. Patient reported she would follow up with her physician if needed. Instructed to register with the v-safe website to report any additional reactions.

Other Meds: MIGRAINE MEDS PRN

Current Illness: UNKNOWN

ID: 0945303
Sex: M
Age: 60
State: VA

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: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: PPD-purified protein derivative- Inmate stated after the fact that he does react to PPD test. No other known allergies

Symptom List: Anxiety, Dyspnoea

Symptoms: Back and neck stiffness, trouble swallowing, tongue thickness, facial twitch, and shortness of breathe.

Other Meds: tylenol 500mg,ASA,lipitor,Coreg,motrin,flomax,xopenex,,buspar,

Current Illness: HTN,Asthma,Gerd,BPH, chronic back pain

ID: 0945304
Sex: U
Age:
State: TX

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: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: UNK

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

Symptoms: EMPLOYEE OBSERVED FOR 30 MINUTES, NO REACTION, CAME BACK NOT FEELING WELL EMPLOYEE DID NOT EAT TODAY, MAIN C/O IS BLURRED VISION. EMPLOYEE RECOMMENDED TO GO TO ER FOR EVALUATION.

Other Meds: UNK

Current Illness: UNK

ID: 0945305
Sex: M
Age: 22
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: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data:

Allergies: Unknown

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: 5 minutes after vaccine patient complained of dizziness and became diaphoretic, pale, and clammy. BP 74/48, HR 42 bpm, O2 92%. Water and snacks were given. At 10 minutes post vaccine HR was 52 bpm and O2 was 96%, patient is alert. At 15 minutes post vaccine BP was 90/50, O2 99%, HR 86 bpm and very talkative, states he is feeling better.

Other Meds:

Current Illness:

ID: 0945306
Sex: F
Age: 36
State: MO

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

Symptoms: Fever of 104.2 off and on, muscle aches, nausea, headache

Other Meds:

Current Illness: adhesive, amoxicillin, cefaclor,ciprofloxen, clavulanic acid

ID: 0945307
Sex: F
Age: 48
State: ME

Vax Date: 12/28/2020
Onset Date: 01/11/2021
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: Erythromycin

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

Symptoms: Bell?s palsy, treatment prednisone and acyclovir, outcome unknown

Other Meds: Levothyroxine Claritin D 24hr Celexa

Current Illness: None

ID: 0945308
Sex: F
Age: 52
State: CA

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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: IM given@ 9;00am and at 9;08 am pt. begin to c/o palpitaions. VS taken R 22 P70 BP 154/112 sats 99% pt. states has Hx . HTN and she says took her BP medication this morning. VS re-check at 9:15 am BP 153/102 HR 66 Sat 99% R20. Pt states feels better now , denies any more symptoms.

Other Meds:

Current Illness:

ID: 0945309
Sex: F
Age: 43
State: TN

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None known

Symptom List: Pharyngeal swelling

Symptoms: Low grade fever, chills, headache, muscle aches and dizzy

Other Meds: Dexilant, buspiroine, dicyclomine, lexapro, vitamin c, centrum, vesicare

Current Illness:

ID: 0945310
Sex: F
Age: 34
State: NY

Vax Date: 01/06/2021
Onset Date: 01/12/2021
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: None

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Productive cough, sore throat, myalgia, fatigue, hives at injection site

Other Meds: None

Current Illness: None

ID: 0945311
Sex: F
Age: 63
State: AZ

Vax Date: 12/23/2020
Onset Date: 12/24/2020
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: no

Symptom List: Diarrhoea, Nasal congestion

Symptoms: When I got home from my hike the next day of vaccination I felt my heart going crazy I had high blood pressure 160/100 it stayed like that for the next 3 days but the next day I felt my whole body pounding I was shaky I had to go to urgent care. Then for the next week I was feeling very fatigue & short of breath lasted for about a week.

Other Meds: none

Current Illness: no

ID: 0945312
Sex: F
Age: 43
State: MD

Vax Date: 01/08/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: PCN

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

Symptoms: I developed Hives all over my torso, legs, head, back and mouth

Other Meds: Symponi x 1 Injection due on 1/19/21 Vitamin C Paxil 20mg

Current Illness: none

ID: 0945313
Sex: F
Age: 55
State: MA

Vax Date: 01/04/2021
Onset Date: 01/04/2021
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: sulfa

Symptom List: Rash, Urticaria

Symptoms: Felt like vaccine was injected into subacromial space left arm/shoulder. Began having shoulder soreness and pain, progressing as afternoon and evening progressed 1/4/21. Had difficulty sleeping with frequent interruptions due to shoulder pain on 1/4/21 and 1/5/21. Unable to lift arm to shoulder height due to pain, difficulty and pain to reach faucet, get dressed, shower, overall functional use LUE with modifications required. Treated with over-the-counter ibuprofen 2-3x/day with temporary decrease in pain intensity. Iced shoulder twice. Symptoms began to improve during night 1/6/21 with improved sleeping tolerance. Steady decrease in symptoms 1/7/21 and 1/8/21 with pain with certain movements shoulder only.

Other Meds: levothyroxine 100mcg

Current Illness: none

ID: 0945314
Sex: F
Age: 36
State: CO

Vax Date: 01/07/2021
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:

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

Symptoms: Fatigue, GI upset, and Headache for 3-4 days post second vaccine

Other Meds:

Current Illness:

ID: 0945315
Sex: F
Age: 67
State: TX

Vax Date: 01/05/2021
Onset Date: 01/06/2021
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: No

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

Symptoms: Moderna COVID-19 Vaccine day after injection noticed some soreness and puffiness at the injection site and a red area right below the sight the size of a silver dollar that was warm to the touch. On 1/13/21 the red area was larger (2 1/2 inches by 2 1/2 inches) was still warm to the touch and felt hard.

Other Meds: synthroid, atorvastaatin, flonase, fish oil, Align, biotin, One A Day Vitamin, tumeric, Vitamin D3, calcium citrate, xyzal

Current Illness: Seasonal allergies

ID: 0945316
Sex: M
Age: 78
State: FL

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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: No Known Allergies

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

Symptoms: Patient has not had any adverse events. Patient was administered the wrong dose of medication (received 1ml instead of 0.5mg).

Other Meds: Flomax, Ensure, Colace, Lamictal, Abilify, Benadryl, Flomax, Miralax, Aspirin, Benadryl, Tylenol, Cymbalta, Milk of Magnesia,

Current Illness:

ID: 0945317
Sex: F
Age: 68
State: FL

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: 1) mycin family of antibiotics and Dioxin 2) Oak, Birch, Palm, Maple trees 3) sensitive to eggs 4) Nickle 5) horses, roaches, grasses, mold, dust, dust mites and other insects

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

Symptoms: 1) Ice cold toes & feet, sweat in toe area of socks 2) confusion, 3) chills

Other Meds: 1) Azelastine HCI Nasal Solution, Nasal Spray, .15 %, 205.5 mcg, (each nostril, once per day) 2) Mometasone Furoate Nasal Spray, 50 mcg, (each nostril, once per day) 3) Flovent Diskus 100 mcg, (once per day) 4)Synthroid, 25mcg, .025 mg, (on

Current Illness: Some gel in right eye came off; however retina remained.

ID: 0945318
Sex: F
Age: 89
State: FL

Vax Date: 01/11/2021
Onset Date: 01/11/2021
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:

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

Symptoms: BP down to 60/50

Other Meds: 5 m amlodipine Baby aspirin Ambien sometimes Fish oil B12

Current Illness: None

ID: 0945319
Sex: F
Age: 62
State: NC

Vax Date: 12/22/2020
Onset Date: 12/26/2020
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: No

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Soreness of the site then was sick 6 days later positive for COVID -19. Fatage

Other Meds: Zestortic 20/25 , Synthorid 75mg , Metformin 500 mg twice daily, Lexapro 10mg Vitamin D 1000, Vitamin B12, Fish Oil

Current Illness: No

ID: 0945320
Sex: M
Age: 56
State: OK

Vax Date: 12/31/2020
Onset Date: 12/31/2020
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: no

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: H/A chills, fever, malaise, then migraines. Then 1-2 migraine H/A every day. No H/A for the past 36 hours. Went to see pcp.

Other Meds: Valsartan 160mg, Acyclovir, Tylenol, Vitamin D, Zinc

Current Illness: no

ID: 0945321
Sex: F
Age: 58
State: HI

Vax Date: 12/30/2020
Onset Date: 12/31/2020
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: cats

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

Symptoms: Left arm still has red blotchy itchy patch at injection site. No other symptoms

Other Meds: levothyroxine

Current Illness: none

ID: 0945322
Sex: F
Age: 23
State: NJ

Vax Date: 01/07/2021
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: Sesame allergy

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

Symptoms: 7 days after vaccine, body ache and headache, temperature of 99.4 which is higher than my typical temp.

Other Meds: Lo lo estrin Fe, multivitamin

Current Illness: N/a

ID: 0945323
Sex: F
Age: 75
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Fish, shellfish, soy, latex, sulfa

Symptom List: Unevaluable event

Symptoms: Pain in arm and blurry eye vision

Other Meds: Advair, pantoprozle, verapamil 120 ER, hydrochlorithyazide 12.5 mg. , Mobic 7.5 mg

Current Illness: None

ID: 0945324
Sex: F
Age: 24
State: NJ

Vax Date: 01/05/2021
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: penicillin: rash

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

Symptoms: localized rash on left shoulder: no fluctuance, induration, tender to touch, measures 6x2.5cm, erythema with central 9 days after vaccination

Other Meds: tri-linah, oral contraceptive pill

Current Illness: none

ID: 0945325
Sex: F
Age: 25
State: MN

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: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Seasonal flu shot

Symptom List: Injection site pain, Pain

Symptoms: Patient felt warm. Patient's face + chest became pink and blotchy 15 minutes after administration. Patient received 2 25 mg oral capsules of Benadryl. Oxygen level 99.1. -Pulse 90. Monitored patient for 30 more minutes + she felt improved. She then discharged.

Other Meds: prenatal vitamin - 1 tablet daily

Current Illness: None

ID: 0945326
Sex: F
Age: 30
State: FL

Vax Date: 01/09/2021
Onset Date: 01/09/2021
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: Cats/Dogs/Pollen/shrimp - causes pruritus

Symptom List: Injection site pain, Menorrhagia

Symptoms: Fatigue/headache/body malaise one hour after 2nd dose of COVID 19 vaccine. Now c/o (L) arm pain radiating to (L) elbow/(L) leg pain/dizziness/diaphoresis weakness to (L) lower extremity.

Other Meds: Cranberry, Xigdou/ezetihab/pravastatin/flouxetin MVI / fish oil / osteo biflex / hg gluconate

Current Illness: DM/Hyperlipidemia/O/A/Headache/Depression/Anxiety

ID: 0945327
Sex: F
Age: 23
State: NY

Vax Date: 01/05/2021
Onset Date: 01/12/2021
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 has a rash (6x7cm oval area of erythema noted (R) deltoid no absEss or depot)

Other Meds: N/A

Current Illness: N/A

ID: 0945328
Sex: F
Age: 40
State: MO

Vax Date: 01/06/2021
Onset Date: 01/08/2021
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: Morphine, hydrcodone

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: My arm hurt after shot. Next day it still hurt. On Friday I had two red circle's on my arm. One where shot was given the other 1/2 inch below it. It was very red & had heat in it, and hurt to touch, move and swollen. 1/12 - (L) arm pain from shoulder to elbow felt "heavy" - (L) hand tingling 1/14 - redness continue to be present

Other Meds: Spirintec, Flonase, Venlafaxine Spironolactone, metformin, pantoprazole One daily women's vitamin, Vision formula (Ocuvite)

Current Illness: None

ID: 0945329
Sex: F
Age: 61
State: TN

Vax Date: 01/02/2021
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: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: pcn-hives

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Pt reports only soreness the day after receiving the Covid 19 vaccine, however reports on day 11 after receiving the vaccine redness to injection site with an area size of her palm, itching, and a rash at the injection site. Pt reports that her PCP gave her a steroid injection today.

Other Meds: venlafaxine, verapimil, hctz,pravastatin,metoprolol,abilify

Current Illness: none

ID: 0945330
Sex: F
Age: 44
State: MO

Vax Date: 01/06/2021
Onset Date: 01/07/2021
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: Claritin Sulfa drugs

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

Symptoms: Chills, Bodyaches fever 101.8, headaches, swollen aRm with redness and heat fRom 1-7-2021 - 1-8-2021 1-8-2021 to 1-13-2021 - headaches + swollen arm with Redness and heat. 1-12-2021 - Present itching at vaccine site headache

Other Meds: Zyrtec 1 daily 10 mg, Zinc 50 mg 1 daily, Lisinopril 5 mg 1 daily, Cranberry 500mg 1 daily, Prozac 40 mg 1 daily, Vitamin C 500 mg 1 daily, Prilosec 40 mg 1 daily, Vitamin D3 50 mcg 1 daily, Simvastatin 80 mg @ HS - HIgh chloesteal, Multivi

Current Illness: None

ID: 0945331
Sex: F
Age: 50
State: AK

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:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Pyridium, Macrobid; Flagyl, Sulfa, PCN, Cefzil, Guafinasine, Fire Ants, Demerol, Rocephin, Should NOT take ACE's

Symptom List: Nausea

Symptoms: Experciening Body Jerks, Fatigue, heahaches and chills. Sensativity at injection site in both left and right arm. Nausea < 15 minutes after injection - 1 hour later shaking & persistent jerks - Numbness both hands about 1 hour - EXTRAPARAMIDAL symptoms (EPS)

Other Meds: Lorazepam 1 Mg

Current Illness: None

ID: 0945332
Sex: F
Age: 59
State: NY

Vax Date: 01/05/2021
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: Penicillin, surgical tape

Symptom List: Injection site pain

Symptoms: Inflammatory response 8 days post injection

Other Meds: Zyrtec, lisinopril, chlorthalidone, Lipitor, propranolol, multivitamin, Vit D, calcium

Current Illness: None

ID: 0945333
Sex: F
Age: 42
State: CA

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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: n/a

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

Symptoms: On 01/13/2021 woke up feeling weak, chills and felt heat all over my body. On 01/14/2021 got an allergic reaction my whole body got a rash.

Other Meds: Emergency C , Women vitamins, Ibuprofen

Current Illness: n/a

ID: 0945334
Sex: F
Age: 42
State: TN

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: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

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

Symptoms: Exactly 15 hrs post injection I woke with uncontrollable shakes, fever 101.6, vomit x4, nausea, Bone pain especially neck, lower back and hips, headache and congestion.

Other Meds: Losartan, hydrochrothyzide, Wellbutrin

Current Illness: None

ID: 0945335
Sex: F
Age: 55
State: TN

Vax Date: 01/07/2021
Onset Date: 01/11/2021
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: Allergy to the Antibiotic Avelox

Symptom List: Tremor

Symptoms: Saturday 1/9/21: Saturday around noon I started having nausea and internal heat through out my body, sleep interruption and cold sweats during the night. Sunday 1/10/21: the same as Saturday. Sunday around noon I had internal heat through out my body, sleep interruption and cold sweats Monday 1/11/21 afternoon I developed a headache and pain in the left side of my neck around 5 pm I started dry heaving at work and on the drive home I started vomiting uncontrollably. The vomiting went on for quite some time after I got home, the vomit had a fowl taste and smell of sulfa. The Next morning Tuesday 1/12/21 : I still felt nauseous but no vomiting. I had fatigue, headache and lack of apatite, the same on Wednesday 1/13/21 and Thursday 1/14/21. Thursday 1/14/21 I have felt malaise and lack of energy still no appetite.

Other Meds: Vitamin C Tylenol

Current Illness: None

ID: 0945336
Sex: M
Age: 74
State: WI

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

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

Lab Data:

Allergies: no

Symptom List: Erythema, Pruritus

Symptoms: Staff reported that he wasn't being himself. He was leaning more towards the right. Had symptoms similar to Bell's Palsy, some right sided facial droop, right eyelid drooping. On CT right maxillary sinusitis, ventriculomegaly.

Other Meds: Vitamin D, Depacote, Fiber, Finasperide, Glucosamine Sulfate, Multivitamin, Terazesin., Ibuprofen

Current Illness: Chest pains, COVID 11/6/2020

ID: 0945337
Sex: U
Age: 57
State: NY

Vax Date: 01/10/2021
Onset Date: 01/10/2021
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: Arava, Avelox, Celebrex, Humira, Levaquin, Sulfa, Wellbutrin

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

Symptoms: 9 minutes post vaccination pt c/o scratchy throat feeling of Fullness in throat. She was given Benedryl 25mg po - 15 minutes later she still felt a lesser feeling of Fullness 3:59 she was given 25mg of Benedryl again by 4:15pm she felt better still scratchy. On 1/11/21 she reported to PCP - No symptoms

Other Meds:

Current Illness:

ID: 0945338
Sex: F
Age: 57
State: AL

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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: tingling to face, tongue and lips; lightheaded; no swelling; hr normal; observed extra 30 minutes; given water& crackers - lightheadedness subsided but states is itching all over; offered to call 911 - refused. stated is going to primary care physician. total observation 45 min

Other Meds:

Current Illness:

ID: 0945339
Sex: F
Age: 78
State: NY

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: IM
Vax Site: LA

Lab Data:

Allergies: No Known Drug Allergies

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: During 15 minutes post observation period, patient c/o mild posterior headache and neck pain. BP 166/103, HR 124, SaO2 99%. Pt taking HCTZ antihypertensive but missed medication today. Patient received IV hydration at treatment center.

Other Meds: Hydrochlorothiazide 12.5 mg daily, balsalazide 2250 mg BID, atorvastatin 10 mg qhs, tamoxifen 5 mg daily

Current Illness:

ID: 0945340
Sex: F
Age: 30
State: WA

Vax Date: 01/10/2021
Onset Date: 01/10/2021
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: UNKNOWN

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

Symptoms: THREE MINIUTES AFTER RECIVING THE VACCINE: RASH & TINGLING ON BACK 25 MINIUTES AFTER VACCINE: TOUNGE NUMBNESS IN THE MIDDLE SENT TO ED VIA EMS FOR TOUNGE NUMBNESS & SWELLING, PULSATING, HEADACHE, AND VERTIGO

Other Meds: UNKNWON

Current Illness: UNKNOWN

ID: 0945341
Sex: F
Age: 32
State: NY

Vax Date: 01/06/2021
Onset Date: 01/06/2021
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: Pine, Coconut, cannot use anything with a scent/fragrance

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

Symptoms: Lips tingling, throat swelling within 2-3 min of being administered

Other Meds: Effexor, Adderal, Wellbrutin, propananol, Larin-FE, B12 injection

Current Illness:

ID: 0945342
Sex: F
Age: 25
State: AZ

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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NKA/NKDA

Symptom List: Pain in extremity

Symptoms: DEVELOPED HIVES SEVERAL HOURS AFTER SECOND DOSE, SHE STATED SHE DEVELOPED HIVES AFTER SHE RECEIVED HER FIRST DOSE AS WELL. SHE SELF TREATED WITH ANTIHYSTAMINE. TO THE BEST OF MY KNOWLEDGE SHE DID NOT REQUIRE ANY FURTHER TREATMENT.

Other Meds: Birth control, Allegra PRN, Omeprazone PRN

Current Illness: unknown

ID: 0945343
Sex: F
Age: 94
State: AZ

Vax Date: 01/11/2021
Onset Date: 01/11/2021
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: ERYTHROMYICIN

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

Symptoms: Nurse: the resident received her vaccine at 09:25 am and immediately began to feel cold. This nurse was notified at 0945 at which time the resident complained of nausea and dizziness. The resident was also emotional, confused and experiencing high blood pressure (170/78) .

Other Meds: None

Current Illness:

ID: 0945344
Sex: F
Age: 19
State: WA

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: IM
Vax Site: LA

Lab Data:

Allergies: Unk

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

Symptoms: 19 year old female reaction to Covid 19 vac; she is alert and orientated; complaining of rash, difficulty breathing, dizzy, lump in throat, headache, nausea, cough. 1 dose of Benadryl 25 mg given at 1430. Patient states she is medical fragile and has a HX of epilepsy. EMS called at 1500 evaluation mild allergic rxn will transport to hospital for further evaluation.

Other Meds: Unk

Current Illness: Unk

ID: 0945345
Sex: F
Age:
State: AZ

Vax Date:
Onset Date:
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: Severe to epinephrine and reaction to monocycline

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

Symptoms: None stated.

Other Meds: Lisinopril 5 mg 1xday Progesterone micro 100mg 1xday Estriodiol 1 mg 1xday Vitamins d3 25mcg 1xday Allertec 10 mg 1x day

Current Illness: None

ID: 0945347
Sex: F
Age: 58
State: AR

Vax Date: 01/07/2021
Onset Date: 01/08/2021
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: sulfa drugs: rash

Symptom List: Vomiting

Symptoms: woke 15 hours after vaccine with temp 101.5 and body aches. symptom subsided in 8 hrs

Other Meds: emgality-- once monthly. multi-vits

Current Illness: none

ID: 0945348
Sex: F
Age: 37
State: MI

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: 037K20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: no

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Fever (100), body aches, headache, chills, fatigue

Other Meds: none

Current Illness: none

ID: 0945349
Sex: M
Age: 62
State: OH

Vax Date: 01/11/2021
Onset Date: 01/13/2021
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: Bactrim

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

Symptoms: Abdominal pain, Abdominal distention, severe acid reflux, awake until 4 am with severe abdominal pain,

Other Meds: Advair Simvastatin Avodart

Current Illness: None

ID: 0945350
Sex: F
Age: 24
State: WI

Vax Date: 01/07/2021
Onset Date: 01/07/2021
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:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Light arm pain began an hour and half after injection. The following day, arm pain was increased preventing movement of above shoulder, but not preventing daily actives and not pain medication used. Skin raised around injection sight. Throughout that day increased tiredness and fatigue was experienced but did not prevent from completing work at the office. Two days after injection, arm pain remained the same as the day before and some tiredness experienced. Skin red and raised in a 2in radius around injection site. Third day after injection, arm pain reduced, redness gone away. No pain by the fifth day. 7 days after injection, skin is still raised around injection site, redness returned and is now itchy, and increased tiredness.

Other Meds: Birth control pill

Current Illness:

ID: 0945351
Sex: F
Age: 59
State: OR

Vax Date: 01/02/2021
Onset Date: 01/07/2021
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: none

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

Symptoms: Fever to 104 from day 5 to day 14 and continuing after vaccination. No other symptoms other than mild fatigue

Other Meds: estradiol 1mg, levothyroxine 125mg, lisinopril 10mg,

Current Illness: febrile illness with neg COVID test in December 2020

ID: 0945352
Sex: F
Age: 71
State: TX

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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

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

Symptoms: Body aches, fever, nausea, chills, vomiting, join pain, fatigue

Other Meds: Folic Acid 1mg, Synthroid 150MCG, Losartan 50mg, Atorvastatin 20mg, OMEG 3 ETHY ESTE 1 GM CAP APO

Current Illness: High Blood Pressure

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm