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: 0946505
Sex: F
Age: 48
State:

Vax Date: 01/11/2021
Onset Date: 01/12/2021
Rec V Date: 01/15/2021
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: Within 24 hrs of injection, I had chills and headaches, no fever; these went away after 24 hrs, then my injection site on my L arm was swollen and red the following day after injection, my arm was sore. On the 13th of Jan, I was at work from 7am-7pm and my arm was even more swollen, sore, itchy and reddish, no fever, I was still able to work, but my L axillary area was sore the whole day. I went home and took a shower and noticed that my L armpit was swollen, like the size of a tennis ball! No redness, no fevers but sore and discomforting due to the swelling.

Other Meds:

Current Illness:

ID: 0946506
Sex: M
Age: 48
State: NY

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 01/15/2021
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: NKDA

Symptom List: Anxiety, Dyspnoea

Symptoms: Fatigue starting at 22:00 Impaired night vision starting at 0500 1/9/22 Rigors starting at 0500 1/9/21 Neuropathy in the hands starting at 0500 1/9/21

Other Meds: losartan amlodipine

Current Illness: None

ID: 0946507
Sex: M
Age: 11
State: IN

Vax Date: 01/11/2021
Onset Date: 01/12/2021
Rec V Date: 01/15/2021
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

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

Symptoms: PER MOM, PATIENT WITH AUTISM COMPLAINING OF ITCHING AND PAIN ON LEFT THIGH. MOTHER NOTICED A SMALL RED AREA 24HOURS AFTER VACCINE ON LEFT THIGH ONLY (MENVEO). DAY 2 HAS COMPLAINTS OF PAIN, INCREASED REDNESS, HARD AND WARM TO THE TOUCH. DENIES FEVER. THIS WAS THE FIRST TIME GETTING THE MENVEO. EXAMINED BY DR ON 1/13/21. AREA WARM TO THE TOUCH WITH SWELLING NOTED. CURRENT MEASUREMENTS 13 X 9 CM WITH INDURATION. TREATMENT PLAN: TOPICAL HYDROCORTISONE AND BENADRYL.

Other Meds: Clonidine Oral Suspension 0.1 mg/ml

Current Illness: None

ID: 0946508
Sex: M
Age: 69
State: NC

Vax Date: 01/06/2021
Onset Date: 01/12/2021
Rec V Date: 01/15/2021
Hospital:

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

Lab Data:

Allergies: IV contrast dye, Shellfish

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Mild disorientation, balance, impaired thought process.

Other Meds: Metoprolol .25 mg, Pravastatin 40.mg, magnesium 400 mg, Co Q 10 300mg.

Current Illness: none

ID: 0946509
Sex: F
Age: 56
State: IA

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/15/2021
Hospital:

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

Lab Data:

Allergies: latex and keflex

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

Symptoms: patient stated she had a red rash from her neck down her chest and a little on her stomach like what happens when she takes Keflex. She said it lasted 2 days. No treatment that I am aware.

Other Meds:

Current Illness:

ID: 0946510
Sex: M
Age: 29
State: PA

Vax Date: 01/06/2021
Onset Date: 01/11/2021
Rec V Date: 01/15/2021
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: Shellfish, Dairy

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

Symptoms: Mild redness and mild itchiness at injection site. Also, slight feeling of swelling/firmness compared to contra-lateral side.

Other Meds: None

Current Illness: None

ID: 0946511
Sex: F
Age: 49
State: PR

Vax Date: 01/05/2021
Onset Date: 01/05/2021
Rec V Date: 01/15/2021
Hospital:

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

Lab Data:

Allergies: NONE

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: FOUR DAYS OF SINTOMES, DIZZINESS,WEAK, PAIN INJECTION SITE,HEADACHE,TIRED,MUSCULAR PAIN, CHILLS, PAIN JOINTS,FEVER,NAUSEATE,FEELING BAD.

Other Meds: TYLENOL 500 MGS EVERY 6 HOURS FOR 24 HRS

Current Illness: NONE

ID: 0946512
Sex: F
Age: 41
State: WV

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 01/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: See Page 2 - all in 1 place

Other Meds:

Current Illness:

ID: 0946513
Sex: F
Age: 36
State: GA

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 01/15/2021
Hospital:

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

Lab Data:

Allergies: Nickel Meloxicam Topimax

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: 9:00pm at first my right arm started itching but then it spread to my whole body itching. No rash or hives. No closing of airway. Took 1 Benadryl at about 11:00pm. Woke up in the morning with sore arm but no more itching.

Other Meds: Norethindrone Tab 0.35MG A1 (1 tablet by mouth daily) Losartan/Hctz Tab 100-25 (1 tablet by mouth daily) Phentermine 35.5MG (1/2 tablet by mouth daily) Generic Allegra 180MG (1 tablet by mouth daily)

Current Illness:

ID: 0946514
Sex: F
Age: 34
State: MO

Vax Date: 01/13/2021
Onset Date: 01/14/2021
Rec V Date: 01/15/2021
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: Motrin, Penicillin, Sulfa, Macrobid

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Pfizer-BioNTech COVID-19 Vaccine EUA injection site pain, minor nausea, minor headache starting 4 hours after vaccine administration injection site pain, fatigue, worsening headache, body aches (muscle pain), chills, worsening nausea starting approximately 30 hours after vaccine administration

Other Meds: Hydroxychloroquine, Methotrexate, Multivitamin, Vitamin C, Naproxen, Zyrtec, Folic Acid, Nortrel

Current Illness: N/A

ID: 0946515
Sex: F
Age: 58
State: PA

Vax Date: 01/13/2021
Onset Date: 01/14/2021
Rec V Date: 01/15/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

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

Symptoms: Severe headache, nausea, fatigue, bodyaches. Unable to work that day after receiving vaccine

Other Meds: Metoprolol 50 mg qd Atorvastatin 40mg qd

Current Illness: N/a

ID: 0946516
Sex: F
Age: 69
State: GA

Vax Date: 01/06/2021
Onset Date: 01/15/2021
Rec V Date: 01/15/2021
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: Band Aids

Symptom List: Rash, Urticaria

Symptoms: Top of arm where shot waas administered has developed an itchy rash, is swollen, and hot to the touch.

Other Meds: Diovan Lexapro Lipitor Ativan Adipex Multi Vitamin

Current Illness:

ID: 0946517
Sex: F
Age: 17
State: TX

Vax Date: 01/12/2021
Onset Date: 01/13/2021
Rec V Date: 01/15/2021
Hospital:

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

Lab Data:

Allergies: UNKNOWN

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

Symptoms: (MODERNA COVID 19 VACCINE EUA) Unknown, tried contacting patient back multiple times but was unsuccessful

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 0946518
Sex: M
Age: 59
State: TX

Vax Date: 01/11/2021
Onset Date: 01/13/2021
Rec V Date: 01/15/2021
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: denies

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

Symptoms: Received 2nd COVID Pfizer vaccine on 1/11/21 and 2 days later noted rash to bilateral arms that progressed to entire body (not hands/feet) within 12 hours. Did itch. Denies fever, myalgia, arthralgia, headaches, sob, swelling or any other systemic symptom. Is self treating with oral benadryl - has not sought medical care with HCP.

Other Meds: daily baby ASA, MVI

Current Illness: denies

ID: 0946519
Sex: F
Age: 26
State: TX

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 01/15/2021
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: Allergies to environmental things such as grass, trees, pollen etc

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

Symptoms: Continual Elevated heart rate

Other Meds: Flonase

Current Illness:

ID: 0946520
Sex: F
Age: 56
State: IL

Vax Date: 12/18/2020
Onset Date: 12/18/2020
Rec V Date: 01/15/2021
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: "within 1 hour I was exhausted, Friday night and Saturday I had severe back aches, chills, fatigue. By Sunday I felt better"

Other Meds:

Current Illness:

ID: 0946521
Sex: F
Age: 37
State: NY

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 01/15/2021
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: cat dander, pineapple

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

Symptoms: patient had tingling in left injection site down to her leg.

Other Meds:

Current Illness:

ID: 0946522
Sex: F
Age: 25
State: IL

Vax Date: 01/13/2021
Onset Date: 01/14/2021
Rec V Date: 01/15/2021
Hospital:

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

Lab Data:

Allergies: Flexeril- adverse reaction not allergy

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Fever, chills, body aches, and arm soreness lasting a little over eighteen hours. Symptoms subsided with Tylenol within twenty four hours.

Other Meds: Camilla birth control daily

Current Illness: No recent new diagnoses. I did have some ear issues in November, but that has mostly resolved.

ID: 0946523
Sex: F
Age: 32
State: TX

Vax Date: 01/06/2021
Onset Date: 01/07/2021
Rec V Date: 01/15/2021
Hospital:

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

Lab Data:

Allergies: Vicodin

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Injection site has tenderness and a little swelling in the same arm of the injection, swelling and redness continuing a week after the shot has been given. It is super itchy around the injection site as well and I feel like my entire left side is swollen (arm and leg all the way to my ankle feels swollen)

Other Meds: B12 (2000mcg) D3 (125mcg) One a Day Women's Health Benadryl as needed for allergies Ondansetron 4mg as needed... usually once every few months when I have a flare up with my IBS Dicyclomine 10mg Capsule as neeeded... Usually once every fe

Current Illness: Seasonal Allergies. Mountain Cedar is really hard on me as well as ragweed

ID: 0946524
Sex: F
Age: 31
State: IL

Vax Date: 12/23/2020
Onset Date: 12/23/2020
Rec V Date: 01/15/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Body aches, chills, feverish, fatigue, sneezing started on evening of 12/23. 12/24 - loss of taste, body aches but improved, sneezing. 12/25-cough, severe nasal and sinus congestion, no smell or taste, sneezing. 12/26-congestion, no smell and improved taste, achy, scratchy throat. Sought medical advise on 12/26 primarily due to congestion and scratchy throat.

Other Meds: None

Current Illness: Congestion

ID: 0946525
Sex: F
Age: 45
State: AZ

Vax Date: 01/14/2021
Onset Date:
Rec V Date: 01/15/2021
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: Allergic to Penicillin

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

Symptoms: High Palpitations for the day.

Other Meds: Invokana Metformin Pravastatin Amlodipine Metoprolol Montelukast Benadyl Zrytec Prilosec Vitamin D Probiotics Multi Vitamin

Current Illness: N/A

ID: 0946526
Sex: F
Age: 34
State: GA

Vax Date: 01/12/2021
Onset Date: 01/13/2021
Rec V Date: 01/15/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List: Unevaluable event

Symptoms: Developed low grade fever (99.3F), fatigue, aches, headache around 6pm on 01/13/2020. Treated with OTC Aleve. All resolved within 12 hours except the fatigue. Also noticed painful axillary lymph node swelling on 01/13/2020 upon waking at 6:30am. Treating with OTC Aleve.

Other Meds: Elderberry-zinc gummies

Current Illness: None

ID: 0946527
Sex: F
Age: 56
State: IL

Vax Date: 01/08/2021
Onset Date: 01/10/2021
Rec V Date: 01/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: "Felt great until 36 hours after shot. It just hit suddenly, felt exhausted, chills and body aches. Very bad from midnight to 230am. Got up a 6am with a very bad headache, at 9am I took tylenol. I got up at noon and felt great until midnight that night, same symptoms but much less severe. had fever/chills, no body aches. when i got up at 7am i had a headache but not as bad as previous."

Other Meds:

Current Illness:

ID: 0946528
Sex: F
Age: 62
State: MI

Vax Date: 01/15/2021
Onset Date: 01/15/2021
Rec V Date: 01/15/2021
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: Vaccine administered at 8:43am; t 8:58, Associate complained that her lips felt tingly. Associate was provided Benedryl 25mg po at 9:05 am; associate verbalized relief of tingling symptoms at 9:30; Assoc was released to home; Vital signs were taken; BP 137/80, 97% Spo2, Heart rate 80; vital signs were obtained after Benedryl administered.

Other Meds:

Current Illness:

ID: 0946529
Sex: F
Age: 23
State: NC

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/15/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Injection site pain, Menorrhagia

Symptoms: She took the first dose today and apparently had a rapid heart beat after the vaccine (140 bpm).

Other Meds: Metoprolol Succinate ER 50 mg tablet, extended release, Junel Fe 1.5/30, Gabapentin

Current Illness:

ID: 0946530
Sex: F
Age: 62
State: MI

Vax Date: 01/15/2021
Onset Date: 01/15/2021
Rec V Date: 01/15/2021
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: Vaccine administered at 8:43am; t 8:58, Associate complained that her lips felt tingly. Associate was provided Benedryl 25mg po at 9:05 am; associate verbalized relief of tingling symptoms at 9:30; Assoc was released to home; Vital signs were taken; BP 137/80, 97% Spo2, Heart rate 80; vital signs were obtained after Benedryl administered.

Other Meds:

Current Illness:

ID: 0946531
Sex: F
Age: 57
State: NY

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 01/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Reported fever of 102F and shortness of breath on exertion

Other Meds:

Current Illness:

ID: 0946532
Sex: F
Age: 26
State: PR

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/15/2021
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: Symptoms starts 9am with headache. For 3 times panadol q 4 hours 500mg. At 8pm start fever (40.2 C), nauseas, dizzines, shaking chills and lost smell. Vomiting starts at 9:25 pm end 2:00 am. 01/08/2021 at 2:26 am visit Emergency Room, in clinic fainted and present high blood pressure 155/99. In hospital medication administred: Zofran, pepcid, .45 NSS and Phenergan IM at 01-08-2021.

Other Meds:

Current Illness: no

ID: 0946533
Sex: F
Age: 51
State: CT

Vax Date: 01/07/2021
Onset Date: 01/13/2021
Rec V Date: 01/15/2021
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: Latex

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

Symptoms: I had Maderna, At shot I got dizzy and sweaty, only lasted about 5 minutes, next day just itchy and soar, it gradually got more swollen, hard and red. Nurse at work told me to complete this form.

Other Meds: Prevastin, Vit D. Probiotic

Current Illness: None

ID: 0946534
Sex: F
Age: 26
State: NE

Vax Date: 01/12/2021
Onset Date: 01/14/2021
Rec V Date: 01/15/2021
Hospital:

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

Lab Data:

Allergies: no

Symptom List: Nausea

Symptoms: Redness, tender and warm to touch at injection site, redness streaking down to inner side of right arm. Noticed redness and tenderness on day 2. Day 3 has slightly more redness surrounding injection site, 2 inch in diameter circular redness, and increased redness down arm. On day 3, the red streak is approximately 1 inch in width and 3 inches in length.

Other Meds: 150mg spironolactone

Current Illness: no

ID: 0946535
Sex: F
Age: 39
State: PR

Vax Date: 01/05/2021
Onset Date: 01/06/2021
Rec V Date: 01/15/2021
Hospital:

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

Lab Data:

Allergies: NONE

Symptom List: Injection site pain

Symptoms: CHILLS,FEVER AND ANXIUS.

Other Meds: NONE

Current Illness: NONE

ID: 0946537
Sex: M
Age: 59
State: PA

Vax Date: 01/12/2021
Onset Date: 01/13/2021
Rec V Date: 01/15/2021
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: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Myalgias, fatigue, chills for 48 hours, left axillary lymphadenopathy unresolved at 72 hours

Other Meds: none

Current Illness: none

ID: 0946538
Sex: M
Age: 37
State: AR

Vax Date: 01/13/2021
Onset Date: 01/14/2021
Rec V Date: 01/15/2021
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:

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

Symptoms: Body aches and fatigue lasting approximately 24 hours

Other Meds:

Current Illness:

ID: 0946539
Sex: F
Age: 35
State: GA

Vax Date: 01/12/2021
Onset Date: 01/13/2021
Rec V Date: 01/15/2021
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, pennacilian

Symptom List: Tremor

Symptoms: Nausea, headache and congestion

Other Meds: Given Tylenol thru employee health

Current Illness: N/A

ID: 0946540
Sex: F
Age: 35
State:

Vax Date: 01/06/2021
Onset Date: 01/12/2021
Rec V Date: 01/15/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Erythema, Pruritus

Symptoms: Menstrual spotting and vaginal cramps, runny nose and mild sore throat one week after vaccination. I had common side effects (headache, backache, high body temperature and fatigue) for a couple of days right after injection.

Other Meds: Daily multivitamin

Current Illness: None

ID: 0946541
Sex: M
Age: 26
State: SC

Vax Date: 01/14/2021
Onset Date: 01/15/2021
Rec V Date: 01/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: I developed flu like symptoms the morning after receiving the first round of the moderna vaccine. I had chills, was weak, but did not show an elevated temperature. I felt like I had the flu until I took some I ibuprofen.

Other Meds:

Current Illness:

ID: 0946542
Sex: F
Age: 26
State: NY

Vax Date: 01/10/2021
Onset Date: 01/13/2021
Rec V Date: 01/15/2021
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: influenza vaccine caused facial rash

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

Symptoms: Patient developed angioedema of her eyelids after COVID-19 vaccination. She received her Covid vaccine on 1/10/2021 at 11:30 AM. She received the Pfizer vaccine. She works at a nursing home. She had some fatigue and tiredness during the day but woke up on the second day without any symptoms. On 1/30/2021, she developed bilateral eyelid swelling. The swelling is mild to moderate intensity involving the upper and lower eyelids bilaterally with a prickly burning sensation associated with pruritus. The reaction lasted less than a day and resolved without any skin desquamation, scarring or bruising. She denies any hives anywhere else. She does not have a large local reaction at the injection site. She denies respiratory complaints, GI symptoms, lightheadedness, loss of consciousness, wheezing, swelling of her throat or other symptoms consistent with anaphylaxis. She used Benadryl with significant improvement. She had a significant reaction after influenza vaccination consisting of swelling of her face and her eyelids with development of dry patches bilaterally within 2 days, resolving with skin desquamation. The reaction lasted for 1 week. She received her influenza vaccination in October 20, 2020. She was seen in our office in 2012 for bilateral eyelid angioedema with associated urticaria shortly after swimming in the pool. She was given oral antihistamines ?Zyrtec once daily? with significant improvement as well as prevention of this reaction. She has not had this reaction for more than 6 years.

Other Meds: none

Current Illness: none

ID: 0946543
Sex: F
Age: 59
State: CT

Vax Date: 12/28/2020
Onset Date: 12/28/2020
Rec V Date: 01/15/2021
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, adhesive, eggplant, lactose intolerance, codeine, Demerol, Sulfa drugs

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Approximately 5 hours after receiving the vaccine(2pm est) this writer noticed a slight cough, similar to post nasal drip and soreness at injection site. Approximately 3 hours later, injection site much more soreness, unusual for this writer comparing to previous vaccinations. When taking of the face mask, this writer experienced a feeling of "relief" in face, such as a removal of an "Ace" bandage from an ankle strain. Face was symmetrical, but felt swollen. At approx. 8pm, this writer felt "cold" unusual since this writer is going through menopause. This writer proceeded to add a sweatshirt to warm up, then added a jacket then a blanket and began to have noticeable chills, but didn't feel "sick" as one would with such pronounced trembling, chills. This writer had a low grade fever, abnormal. At approx. 9pm this writer noticed that left side of face was less swollen and now an asymmetrical appearance was evident in this writer's face. this writer decided to take Tylenol 1000mg po and Benadryl 25mg po. At approx. 10pm, all symptoms were gone, no swelling in face noted, no cough/post nasal drip , chills, with the ability to raise arm of injection site with little discomfort. *NOTE, this writer had facial fillers and Botox injections place 8/3/20 and swelling was noted at these areas. Next day, no side effects noted, arm tender at injection site if touched.

Other Meds: All Xymogen products: Liver protect, 5-MTHF plus B12, D3 5000

Current Illness: none

ID: 0946544
Sex: F
Age: 43
State: NH

Vax Date: 12/23/2020
Onset Date: 12/24/2020
Rec V Date: 01/15/2021
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: Augmentin

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

Symptoms: About 12 hrs after the vaccination I woke up with unbelieveable shakes and chills like tremors with a 102 temp which I could not get to break until about 12/27 with the use of tylenol. I had to change clothes several times because I kept sweating it out but it kept returning. I was extremely nauseous, fatigued and severly tired for about 2 weeks. And now neuropathy has developed in the bottom of my feet it feels as if prickles are at the bottom of my feet still to this day. I got tested for COVID-19 and was negative. I visited the Urgent Care is where I got the test performed at

Other Meds: no

Current Illness: no

ID: 0946545
Sex: F
Age: 51
State: PA

Vax Date: 01/13/2021
Onset Date: 01/14/2021
Rec V Date: 01/15/2021
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: Sulfa, Iron Dextran

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

Symptoms: Tiredness, Body aches, Headache, Chills started 1/14 at 1500 . I am still having symptoms today.

Other Meds: Effexor, Xarelto, Atorvastatin, Tramadol, Cimzia. Trazadone, Elderberry, Zinc, MultiVitamin

Current Illness: None

ID: 0946546
Sex: F
Age: 46
State: VA

Vax Date: 01/13/2021
Onset Date: 01/14/2021
Rec V Date: 01/15/2021
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: Pain in extremity

Symptoms: achy, chills, swollen lymph node, tired, headache

Other Meds: none

Current Illness: none

ID: 0946547
Sex: F
Age:
State: AZ

Vax Date:
Onset Date:
Rec V Date: 01/15/2021
Hospital:

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

Lab Data:

Allergies: Aluminum Walnuts

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

Symptoms: None stated.

Other Meds: Budesonide EC 4mg 1/day

Current Illness: none

ID: 0946548
Sex: F
Age: 35
State: PA

Vax Date: 12/01/2020
Onset Date: 12/01/2020
Rec V Date: 01/15/2021
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: This was the seasonal flu shot for the 2020 season. Muscle and arm pain at site of injection since December 1st, 2020. Still cannot place pressure on the site of injection, cannot lay on that arm (right arm). At times I struggle lifting my arm above my head due to sharp pain in the arm at injection site. Arm will have a slight pain at the injection site even as the arm is in a resting state.

Other Meds: Birth Control - Larissia

Current Illness: none

ID: 0946549
Sex: F
Age: 59
State: MA

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 01/15/2021
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: NKA

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

Symptoms: On 1/8 she took her 2nd dose of Pfizer vaccine around 3 PM. She went home in the evening and started sweating. She passed out. Her daughter was at home and she took her to the nearest hospital. Her BP was 60/34 and she had a temp of 100.3F on 1/8 during hospital admission. Her K was low. She received lot of fluids. She called our office on 1/10 and during the f/u she was still in the hospital. On 1/10 she has a temp of 98.4F and BP of 109/61. But she still has dizziness, nausea, anorexia and mild cough (Former smoker). COVID-19 test was done on 1/9, its negative. Dx was dehydration. Discharged from the hospital on 1/11, feels better but is tired. Will follow up with PCP on 1/16/21.

Other Meds:

Current Illness:

ID: 0946550
Sex: F
Age: 22
State: IN

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 01/15/2021
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: Penicillin, bactrim

Symptom List: Vomiting

Symptoms: Headache, nausea, increased HR and RR, vomiting, fever, chills, night sweats

Other Meds: Duloxetine (120 mg), ortho-tri-cyclin, trazodone (50 mg), chlorthalidone (25 mg)

Current Illness: N/A

ID: 0946551
Sex: F
Age: 34
State: TN

Vax Date: 01/13/2021
Onset Date: 01/14/2021
Rec V Date: 01/15/2021
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: Starting about 12 hours after vaccine I had the expected symptoms of body aches, chills, headache, nausea and low grade temps. At ~ 0500 on 1/14/21 (~18 hrs after vaccine), I woke up as I was in SVT. I was not able to convert myself and had to go to ED for treatment. HR was 232 upon arrival to ED. Prior to administering adenosine, SVT resolved on own. SVT episode lasted ~2hrs. I have not had a prolonged SVT episode since ablation in 2016. ER doc mentioned that perhaps fever/ illness from vaccine lowered my threshold for going into SVT.

Other Meds: None.

Current Illness: None

ID: 0946552
Sex: M
Age: 67
State: VA

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 01/15/2021
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: Patient reported a fever of 102.8 around 3 am after receiving the vaccine yesterday. Feeling overall badly.

Other Meds:

Current Illness: COVID positive in Dec 17

ID: 0946553
Sex: F
Age: 26
State: NM

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 01/15/2021
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: flu vaccine allergy

Symptom List: Injection site swelling, Limb discomfort

Symptoms: anaphylaxis by lethargy, nausea, vomiting, palpitations, funny feeling in chest, swollen lips

Other Meds: unknown

Current Illness: none

ID: 0946554
Sex: F
Age: 61
State: NV

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 01/15/2021
Hospital:

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

Lab Data:

Allergies: Latex

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

Symptoms: Started with a bad headache then got worse. I worked until 11:30pm the day of the vaccine. Woke up at 5:30 am with chills and body aches. Took off work. Fever spiked at about noon the day following the vaccine to 100.1 Tylenol then Ibuprofen was taken. By 6:30 am the next morning (today )all symptoms seem to be gone. I think it may be important to know that I was sick with covid 19 in April/May of 2020 for almost 3 weeks

Other Meds: None

Current Illness: None

ID: 0946555
Sex: M
Age: 37
State: KY

Vax Date: 01/07/2021
Onset Date: 01/15/2021
Rec V Date: 01/15/2021
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: Headache and dizziness began 1 hour after injection and lasted for 30 minutes. 8 days after injection, redness/swelling/itching/lumps developed at injection site. Axillary lymph node swelling in arm injection was given.

Other Meds: Vita fusion men?s daily vitamin Melatonin

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm