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: 0946760
Sex: F
Age: 69
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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: No known drug or food allergies

Symptom List: Dysphagia, Epiglottitis

Symptoms: The patient reports that the following morning, January 13th, after receiving the second dose of the vaccine, at the injection site, her arm was red, swollen, inflammed, and had peeling skin around it. Additionally, she reports that at the injection site, it was firm/hard, hot, painful, and itching. The patient saw FNP, on January 14th, and was administered an IM dose of cortisone, and prescriptions for Keflex and a Medrol dose pack. The patient was instructed to return to Doctor's office on January 15th to allow her to observe the site again.

Other Meds: Unknown

Current Illness: Unknown

ID: 0946761
Sex: F
Age: 31
State: FL

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: none

Symptom List: Anxiety, Dyspnoea

Symptoms: On the evening of her vaccination 1/8/21 she reports soreness at injection site. The following day 1/9/21 she reports experiencing headache, chills, body ache and a temperature of 100.0. She reports taking OTC Tylenol but no other treatment. As of date of reporting (1/13/21) she reports a headache remains but this is the only ongoing symptom.

Other Meds: none

Current Illness: none

ID: 0946762
Sex: F
Age: 38
State:

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

Lab Data:

Allergies:

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

Symptoms: I woke up 12 hours after vaccination with fever, chills, and body aches. This lasted approximately 36 hours with extreme fatigue and sweating over the course of 2 days.

Other Meds:

Current Illness:

ID: 0946763
Sex: F
Age: 99
State: MN

Vax Date: 01/05/2021
Onset Date: 01/14/2021
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: niacin, tramadol, sulfa, strawberries, adhesive tape, ciprofloxacin, grape, shellfish

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Starting the afternoon of 1/14/21 patient stated the injection site started to feel itchy. When she looked in the mirror, there was an area of bright pink surrounding injection site. She reports the site felt swollen and she could not tell if it was warmer than her other shoulder. Early on the morning of 1/15/21, patient reports the area around injection site was bright pink and remained swollen. At this time it is less itchy, but remains lightly itchy intermittently. At 9am on 1/15/21, RN visited patient and was informed of her reaction. RN observed her L upper arm and she has an oval-shaped light pink area with injection site at the center. Oval measures 8.8 cm x 6.1 cm. The site is warm, slightly swollen, and feels indurated from the swelling. Patient is afebrile at 97.4 orally. Patient reports the light pink coloring at this time is less bright than it was earlier in the morning. Report is being made at 10 am 1/15 so outcome of reaction unknown at this time.

Other Meds: fluticasone 50 mcg/act nasal spray twice daily as needed for allergies/sinusitis levothyroxine 75 mcg every morning atorvastatin 20 mg every evening metoprolol 12.5 mg twice daily Refresh Plus 0.5% eye drops 1 drop to each eye at least 6 ti

Current Illness: Had a flare of polymyalgia rheumatica on 1/3/21. Temp noted to be 99.7 the evening of 1/3. Fever broke overnight and she was afebrile the morning of 1/4. No other illnesses for the month prior to injection.

ID: 0946764
Sex: F
Age: 36
State: VT

Vax Date: 01/04/2021
Onset Date: 01/05/2021
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 reported

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

Symptoms: I had body aches, low grade fever and headaches.

Other Meds: Labetalol 200mg QD, Diclegis 10mgg OD, Zoloft 50mg QD, Levothyroxine 150mg QD

Current Illness: None reported

ID: 0946765
Sex: F
Age: 60
State: PA

Vax Date: 12/22/2020
Onset Date: 12/23/2020
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: KNA

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

Symptoms: fatigue muscle aches and stiffness

Other Meds: Calcium Vitamin D

Current Illness: NONE

ID: 0946766
Sex: F
Age: 40
State: IL

Vax Date: 01/08/2021
Onset Date: 01/09/2021
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: Bactrim

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: "after my 2nd shot i got a swollen area, with some redness which according the email was normal but what concerned me was alot of itching to the site which is still there along with the redness and swelling."

Other Meds:

Current Illness:

ID: 0946767
Sex: F
Age: 55
State: IA

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Vicodin

Symptom List: Pharyngeal swelling

Symptoms: Headache with sharp shooting pains in temples, chills, low grade fever 100.6, body aches especially knees

Other Meds: Ibuprofen Multi vitamin Folic acid Iron Vitamin D

Current Illness: Just headache and body aches from first vaccine

ID: 0946768
Sex: F
Age: 71
State: WA

Vax Date: 01/09/2021
Onset Date: 01/09/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: uncontrollable chills and fever, dizzy, no appetite, extreme headache, joint/muscle achiness. Took Tylenol for pain relief.

Other Meds: n/a

Current Illness: n/a

ID: 0946769
Sex: F
Age: 56
State: CO

Vax Date: 01/12/2021
Onset Date: 01/12/2021
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: No known allergies to food or medication. Seasonal allergies

Symptom List: Diarrhoea, Nasal congestion

Symptoms: 3 hours after vaccine was administered: PATIENT STATES SHE EXPERIENCES NAUSEA, VOMITTING, DIZZINESS,FATIGUE, WEAKNESS, ATAXIA RESULTING IN A FALL, PALLOR, AND FORGETFULNESS THE DAY AFTER THE VACCINE WAS ADMINESTERS SHE CONTINUED TO HAVE FATIGUE AND WEAKNESS. ADVISED TO CONTACT PCP TO HAVE SECOND DOSE ADMINSTERED Patient rested. No medical

Other Meds:

Current Illness: Patient stated she was feeling run down when she received the vaccine.

ID: 0946770
Sex: M
Age: 60
State:

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

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

Symptoms: The night of the vaccination I became ill with flu-like symptoms. I experienced muscle aches, chills, a fever, fatigue, and stomach cramping that lasted 3 days.

Other Meds:

Current Illness:

ID: 0946771
Sex: F
Age: 55
State: TX

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: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: Red raised bruise on left arm at injection site not improving since onset of symptoms following vaccination.

Other Meds:

Current Illness:

ID: 0946772
Sex: F
Age: 37
State: CO

Vax Date: 01/09/2021
Onset Date: 01/09/2021
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: amoxicillin (rash), penicillin (hives/rash), phenergan, promethazine (IV - hallucinations), vicodin

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

Symptoms: Patient left after 15 minute wait time after receiving second COVID-19 vaccine. Patient then returned at 0632 to vaccine clinic stating that she was having numbness and tingling to jaw and lips and left ear. Vitals were obtained: 115/73, HR, 74, O2 Sat: 97% on RA. Patient denies any SOB of difficulty breathing. Patient has no noted welts or redness noted. 0635: Patient was given 25 mg of Benadryl, PO and patient is drinking her coffee. 0640: patient sitting up in chair, patient denies any tingling and or numbness to jaw, lips, and left ear. Patient states " I can not believe I am feeling so much better. I have no numbness at all." 0702: patient feeling much better, and denies any SOB, edema, numbness and or tingling. Patient vitals: B/P: 113/58, HR: 76, O2 Stat: 97% on RA. Patient did ambulate out of clinic with out issues. Advised patient on signs and symptoms to look out for and when to seek medical attention. Patient verbalized understanding.

Other Meds:

Current Illness:

ID: 0946773
Sex: F
Age: 42
State: NC

Vax Date: 01/07/2021
Onset Date: 01/08/2021
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: Bactrim DS Eggs Peanuts

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

Symptoms: After normal soreness at the injection site, she started with tenderness under in the axillary area. States no change in skin; however, is tender to palpate or to have clothes rubbing

Other Meds: 200 mg Gabapentin 360 mg Valsartan 10 mg Loratadine Tumeric 2 Multi Vit Gummies 2 Vit C Gummes

Current Illness:

ID: 0946774
Sex: F
Age: 75
State: CO

Vax Date: 01/08/2021
Onset Date: 01/11/2021
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: shell fish, codeine

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

Symptoms: Site of injection started itching and getting red and hard third day after receiving vaccine. This continues and spreads a bit more by seventh day. Called clinic and they said this is normal and to put cold cloth on site but do not press. I will do that starting today (7th day).

Other Meds: Hydrochlorothiazide 12.5mg; vitamin K2, Strontium citrate; Plant Sterols; Vit. C; Vit. B12; vit. D3; fish oils;

Current Illness: none

ID: 0946775
Sex: F
Age: 63
State: OH

Vax Date: 01/14/2021
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: IM
Vax Site: LA

Lab Data:

Allergies: Gluten

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

Symptoms: numbness tingling in both arms into hands

Other Meds: Fluoxetine; Vitamin D; Levothyroxine; Naproxen; Ibuprofen; Acetaminophen

Current Illness: urinary tract infection

ID: 0946776
Sex: F
Age: 57
State: CA

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

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

Symptoms: Sore arm

Other Meds:

Current Illness:

ID: 0946777
Sex: F
Age: 47
State: MO

Vax Date: 12/22/2020
Onset Date: 12/23/2020
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:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: I initially developed soreness from the vaccine. Then on day 2-3 my arm became red in about a quarter size. That increased to golf-ball size. The pain went away and the redness stayed for a day or two more. It went away, then came back with itching and hives on around day 6. It cleared up again and came back a third time. This time baseball sized, measuring 6 cm x 7 cm in a circle with a dark red ring that was raised at times. It was itchy, warm and firm to the touch. I took Benadryl 25 mg on day 14, it started clearing up on day 15 and is totally gone at this time.

Other Meds:

Current Illness:

ID: 0946778
Sex: F
Age: 27
State: PA

Vax Date: 01/15/2021
Onset Date: 01/15/2021
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: Influenza vaccines, tree nuts such as cashews, bee stings, and now the Covid-19 Moderna vaccine.

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Patient experienced tightness to the left arm, felt the need to take deeper breaths, chest heaviness, nasal stuffiness, bilateral hands tight and swollen, redness/blotchiness to bilateral upper extremities, itchy skin, nausea.

Other Meds: Vitamin C, Vitamin D, Iron, Synthroid, Cytomel, Lisinopril.

Current Illness: None that we are aware of.

ID: 0946779
Sex: F
Age: 44
State: PA

Vax Date: 01/06/2021
Onset Date: 01/13/2021
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: 3" inch raised bump 7 days after injection

Other Meds: none

Current Illness: none

ID: 0946780
Sex: F
Age: 33
State: FL

Vax Date: 12/04/2020
Onset Date: 01/12/2021
Rec V Date: 01/15/2021
Hospital: Y

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: #Right parietal/temporal subarachnoid hemorrhage and right intra-axial hemorrhage CT brain (1/12/21): Right parietal intra-axial hemorrhage toward the convexity measuring 2.3 x 1.1 x 1.7 cm with decompression into the subarachnoid space, mild right predominantly temporal and parietal subarachnoid hemorrhage is seen with minimal associated hemorrhage along the tentorium. Mild diffuse right cerebral sulcal effacement with minimal leftward midline shift measuring 2.5 mm. #Dural sinus thrombosis CTA head (1/11/21): Increased density within the superior sagittal sinus, inferior sagittal sinus, and transverse sinuses on noncontrasted images with no flow seen on postcontrast sequences consistent with venous sinus thrombosis #Left sided weakness 2/2 above #Recent jaw alignment procedure

Other Meds:

Current Illness:

ID: 0946781
Sex: F
Age: 43
State: IN

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

Lab Data:

Allergies: Bee stings, Penicilin

Symptom List: Unevaluable event

Symptoms: Itching and redness at injection site developed within a minute of administration; ice was applied, and 50mg Benadryl IM was administered. Vitals pre-benadryl administration were 139/100; O2=99%; P=87. Patient was observed 45 min. Vitals 25 min after the vaccine administration and prior to leaving the clinic were 137/93; O2=99%; P77

Other Meds: Epi-Pen for bee stings, pepcid,

Current Illness: Unknown

ID: 0946782
Sex: F
Age: 70
State: FL

Vax Date: 01/04/2021
Onset Date: 01/04/2021
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: Sulfa, Medrol Pak, Levaquin

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

Symptoms: Evening of injection vaccine had an achy left arm. Took Tylenol. Next day noticed 1/2 inch welt next to injection site. Arm is very achy going into shoulder. Notice about two inch discoloration of left arm near injection site. Have been taking Motrin/Tylenol for achiness.

Other Meds: Vitamin D

Current Illness: N/A

ID: 0946783
Sex: F
Age: 72
State: FL

Vax Date: 01/11/2021
Onset Date: 01/11/2021
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: celebrex, tetanus, prolia, dye for eye exam

Symptom List: Injection site pain, Pain

Symptoms: in about 30 minutes after shot, hives began. They continue for 3 days - stopped now

Other Meds: klonopin, levothyroxine

Current Illness:

ID: 0946784
Sex: F
Age: 58
State: MI

Vax Date: 01/09/2021
Onset Date: 01/10/2021
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: sensitivities to egg, peanuts, avocados. Has tendency need to throw up with foods and not knowing what I am reacting too.

Symptom List: Injection site pain, Menorrhagia

Symptoms: After 15 minutes felt dizzy when got up to walk. Sat back down for about half hour. Still felt dizzy, but went home. Began to feel nauseated and headache which continued from Saturday through currently. On Wednesday 4:00 a.m woke up to feeling of itchyness in chest. It spread to stomach, then legs, arms, face, back head in about an hour and a half. Took a shower and then felt burning. called doctor next morning at 10:30 and told to start benadryl and allegra. Stared about 1:00 pm. very drowsy and increased headache and nausau. Could still feel burning. Continued with about 3 does. Work up 12:38 on Thursday morning with increased burning and itching and benadryl was last taken 7 and half hours before. Did not take benadryl on Thursday due to drowsyness. Did not work Wednesday or Thursday. Friday early morning hours, woke up several times with itchiness and burning. This is all over my body. No rash at any time. Continued headache and nausea.

Other Meds: Adderal

Current Illness: None

ID: 0946785
Sex: F
Age: 37
State: NC

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: 025J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Latex

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

Symptoms: Severe Migraine 10/10 lasting 24 hours (felt like my head was going to explode ice applied to my eyes and next), Nausea, Body aches lasting 24 hours ( could not move without help pain 8/10), congestion, fatigue.

Other Meds: Concerta, Prosac, Vit D, Womens Multivitamin, Zyrtec, Birth Control, IUD, Iron.

Current Illness: none

ID: 0946786
Sex: F
Age: 70
State: IL

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

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: 1/12 "Yesterday afternoon I was nauseous and cold. today I have been tired with a headache no appetite. It cannot compare to the severe symptoms of COVID"

Other Meds:

Current Illness:

ID: 0946787
Sex: F
Age: 51
State: MI

Vax Date: 01/12/2021
Onset Date: 01/12/2021
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: none

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Pain, swelling to injection site, pain, aches all over, fever and headache started approx 10 hours after injection, lasting approx 29 hours. Approx 48 hours after injection swollen, tender area approx size of golf ball under left arm ( injection arm) and conintues to be there on 3rd day

Other Meds: Blood pressure med (hyzaar) in am prior to injection

Current Illness: none

ID: 0946788
Sex: M
Age:
State: FL

Vax Date:
Onset Date: 01/15/2021
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: no

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

Symptoms: Diarrhear, Fever

Other Meds: no

Current Illness: no

ID: 0946789
Sex: M
Age: 54
State: MA

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: None

Symptom List: Nausea

Symptoms: Fever, Chills, Body aches Motrin and Tylenol uses alternately for 24hrs and symptoms improved

Other Meds: Omeprazole

Current Illness: None

ID: 0946790
Sex: F
Age: 23
State: WI

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: Bruising that extends down the arm and to the ribcage. In addition to fever, nausea, and body aches. No treatment other than monitor and rest at this time.

Other Meds:

Current Illness:

ID: 0946791
Sex: F
Age: 50
State: PA

Vax Date: 01/06/2021
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: 3" inch raised bump at site of injection 7 days later

Other Meds: none

Current Illness: none

ID: 0946792
Sex: F
Age: 54
State: WI

Vax Date: 01/04/2021
Onset Date: 01/12/2021
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: Sensitive to Codeine - Upset stomach. Nausea when taken.

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

Symptoms: At day 7 after receiving the vaccine, a rash developed on my entire body. Including the Hutchinson's sign found on the right side of nose, eye and ear. Immediately began treatment for shingles of 1 gram Valacyclovir prescribed by Urgent Care . Referred then for vision examine which found an eye complication including inflammation and zoster lesions on the right eye. Treatment of Zirgan 0.15% ophthamlic gel started. Rash around left eye began 01/15/2021.

Other Meds: None

Current Illness: None

ID: 0946793
Sex: F
Age: 71
State: CA

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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Tremor

Symptoms: Numbness in face, throat, tingling. It is 8:37 am next day, still continuing

Other Meds: Lipitor, lisinopril, metropol, choestoff, D3, Zinc, C, COQ10

Current Illness: None

ID: 0946794
Sex: F
Age: 31
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: IM
Vax Site: LA

Lab Data:

Allergies: pt denied, but chart indicated amox

Symptom List: Erythema, Pruritus

Symptoms: approx. 17 min after receiving vaccine, pt returned to desk to get the vaccine card that she had forgotten to take with her, She was handed the card, went to sit in the chair near her, asked if she was feeling ok, slumped to a sitting position, then passed out. Immediately regained consciousness, denied shortness of breath, no evidence of hitting head on ground during this episode

Other Meds: pt deniesany otc,any herbal tx, any vitamins,

Current Illness: pt denies

ID: 0946795
Sex: F
Age: 32
State: MN

Vax Date: 01/13/2021
Onset Date: 01/14/2021
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: Rifampin - hives, joint swelling Isoniazid - elevated LFTs

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

Symptoms: Fatigue and headache started about 12 hours after vaccine was given, lasted throughout the day on and off, fatigue and malaise progressed throughout the day. Nausea started about 24 hours after vaccination. Then overnight about 30 hours later developed chills and hot flashes alternating through the night, difficulty sleeping, headache and fatigue continued.

Other Meds: None

Current Illness: None

ID: 0946796
Sex: F
Age: 51
State:

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

Lab Data:

Allergies: none

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

Symptoms: "quasi-moto" type of lump on shoulder behind injection site

Other Meds:

Current Illness: none

ID: 0946797
Sex: F
Age: 35
State: VA

Vax Date: 01/07/2021
Onset Date: 01/14/2021
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: Blueberries

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Day 8 after receiving the vaccine a welt started growing on the employee's arm, then it progressed to swollen lymph nodes, a rash, chills and joint pain. No fever and no shortness of breath.

Other Meds: multivitamin and zoloft 150 mg every day.

Current Illness: None

ID: 0946798
Sex: F
Age: 43
State: ME

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: SYR
Vax Site: LA

Lab Data:

Allergies: OXYCODONE

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

Symptoms: Moderna COVID-19 Vaccine Severe dizziness for 10 seconds. Dizziness subsided on its own so I did not call my physician. No additional episodes experienced.

Other Meds: APRI, ZYRTEC

Current Illness: NONE

ID: 0946799
Sex: F
Age: 46
State: MA

Vax Date: 01/08/2021
Onset Date: 01/09/2021
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: Bactrim, Percocet, Cipro, Latex, IVP dye, Macrobid

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

Symptoms: Headaches, fevers of up to 102, nausea, chills, body aches, fatigue, palpitations upon standing with dizziness, feeling faint and nausea. Last fever episode was Monday night. Body aches, palpitations, nausea, dizziness and feeling faint were persistent until yesterday evening. Still having mid headaches and fatigue.

Other Meds: Multivitamin, Flovent, Albuterol, Loratadine, Levothyroxine

Current Illness: None

ID: 0946800
Sex: F
Age: 31
State: CA

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: Chocolate (anaphylaxis), peanuts (anaphylaxis)

Symptom List: Pain in extremity

Symptoms: Patient did not report an adverse reaction following dose #1. Within minutes of receiving vaccine dose #2, patient c/o flushing. VS 131/88, 100% RA, Hr 102, temp 97.5, RR 20, no SOB nor difficulty breathing. About 10 minutes post dose, patient reported feeling anxious, BP 130/87, HR 107, RR 20. Some swelling of lip on inner side. About 20 minutes post dose, patient started coughing and c/o itchy throat. Transported to ED where patient received epinephrine, Benadryl, solu-medrol, famotidine, NS 500mL bolus. Symptoms resolved and after 3.5 hours observation was discharged. After the patient was transported to the ED, a jar of nuts was found in the vicinity of where the patient was sitting post-vaccination.

Other Meds:

Current Illness:

ID: 0946801
Sex: M
Age: 32
State: NH

Vax Date: 01/14/2021
Onset Date: 01/15/2021
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:

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

Symptoms: Woke up just after midnight with chills, and a racing heart. Unable to sleep and symptoms progressed to headache, chills, fever, fatigue, weakness throughout the night and day, coming up to the 24 hour mark.

Other Meds:

Current Illness:

ID: 0946802
Sex: F
Age: 68
State: FL

Vax Date: 12/29/2020
Onset Date: 01/01/2021
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: codiene

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

Symptoms: 3 days after receiving her vaccination she noted redness and tenderness at and around the injection site. This lasted approximately 3 days.

Other Meds: none

Current Illness: none

ID: 0946803
Sex: F
Age: 38
State: MT

Vax Date: 12/23/2020
Onset Date: 12/23/2020
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: PCN-Hives Amoxicillin-Hives Grapefruit-angioedema

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

Symptoms: Received COVID -19 vaccine at approx 1800. 1845 - Extreme itching to sit and effected left arm, pain up into the shoulder and neck area. 1900 - Tingling to bottom lip with no facial swelling. Took 50 mg of Benadryl and tingling and itching resolved. Developed site reaction, redness at injection site. Extremely painful arm the next day 12/24/2020. Occasional itching 12/25/2020 - Chills / Body Aches / low grade temp / severe nausea and loss of appetite 12/27/2020 - ER with severe abdominal pain / flank pain / nausea. Dx UTI / Kidney infection. Unlikely related to vaccine per PCP. 1/1/2020 - 1/5/2020 - swollen lymph nodes. Continued to have random bouts of body aches and chills that seem to have resolved. Random itching of injection site. General fatigue. Have had previous reaction to flu shot, mainly 10+ years ago when shot was not preservative free. Headache, dizziness, had a syncopal episode after. Had not had an issue in recent years as a lot of them are preservative free now. Associate reported in casual conversation to Pharmacy Director Jan 5, 2021

Other Meds:

Current Illness:

ID: 0946804
Sex: F
Age: 30
State: VA

Vax Date: 01/14/2021
Onset Date: 01/15/2021
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: NKDA Peanuts

Symptom List: Vomiting

Symptoms: 20 hours after first dose of COVID19 vaccine arm was very sore (normal). Around 2:30am felt pressure and warmth (coming in waves) up towards my chest, lasting 1-2 seconds and occurring about every 5 minutes . Was able to withstand feeling until it became difficult to breath. Lips and face turned white and blue, fainted. Felt extremely nausea when awake. Called 911. Vitals were normal apart from BP was very high 130/100's. EKG was NSR. Blood sugar taken was normal around 113. After 1 hour of event, I took a shower and drank water. I felt the wave one more time before trying to fall asleep. Then stopped. Woke up fine.

Other Meds: Ibuprofen 400mg before vaccination and 600mg of Ibuprofen taken several hours after vaccination. Pre-natal B12 OTC Vit D3 OTC Melatonin

Current Illness: None

ID: 0946805
Sex: F
Age: 62
State: CA

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

Lab Data:

Allergies: sulfa

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Severe headache lasting over 34 hours

Other Meds: none

Current Illness: none

ID: 0946806
Sex: F
Age: 66
State: PA

Vax Date: 01/13/2021
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:

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

Symptoms: Periods of tachycardia and diaphoresis started 7 hours after vaccine Had 3 "spells" of it ending am of 1/14/21

Other Meds: lisinopril, fleicainide, Januvia, atorvstatin

Current Illness: none

ID: 0946807
Sex: M
Age: 25
State: FL

Vax Date: 01/06/2021
Onset Date: 01/06/2021
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: N/A

Symptom List: Injection site swelling, Limb discomfort

Symptoms: TENDER LAD LEFT AXILLA.

Other Meds: N/A

Current Illness: N/A

ID: 0946808
Sex: F
Age: 36
State: HI

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: RA

Lab Data:

Allergies: NKA

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

Symptoms: Nausea/vomiting and fatigue began at approx. 3pm the following day (about 30 hours following injection), treated with rest and Zofran, lasting about 24 hours. Also decreased appetite. Muscle aches and pains began morning of 14 Jan 2021, approx. 46 hours following injection, treated with extra strength Tylenol and rest, lasting about 24 hours. As of 15 Jan 2021, currently no more adverse reactions.

Other Meds: Birth control and Prozac (20mg daily)

Current Illness: none

ID: 0946809
Sex: M
Age: 44
State: LA

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: RA

Lab Data:

Allergies: no

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

Symptoms: aches started 24hrs after 2nd vaccination. Redness and tenderness about the size of a fist occurred @ 36hrs inferior to injection sight. Redness has doubled in size @ 96hrs with itching.

Other Meds: lisinopril, ambien, avorastatin

Current Illness: no

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm