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: 0946966
Sex: F
Age: 35
State: OH

Vax Date: 01/01/2021
Onset Date: 01/04/2021
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: N/A

Symptom List: Dysphagia, Epiglottitis

Symptoms: Swelling of left lymph node in armpit, dull pain radiating from upper left ribs to back. Redness/warmth/ occasional itching near injection site. Redness and warmth swelling 11x3inches around arm. Took Ibuprofen 800mg 3x daily. No relief. Prescribed Keflex 500 MG 3x daily with improvement.

Other Meds: Citalopram, Metformin

Current Illness: N/A

ID: 0946968
Sex: F
Age: 66
State: TX

Vax Date: 01/03/2021
Onset Date: 01/04/2021
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: Sore arm, loss of appetite, fatigue, extreme dizziness, drop in blood pressure

Other Meds: Metformin, Trulisty, Metoprolol, Lisinopril, Cyclophosphamide,Predsone, Rosuvastatin

Current Illness: None

ID: 0946969
Sex: F
Age: 31
State: NH

Vax Date: 01/12/2021
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: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NKA

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

Symptoms: At the time of the second vaccine I was 14 weeks and 5 days into my first pregnancy. The estimated date of delivery is July 08,2021. The only side effect I experienced was soreness at the site of injection.

Other Meds: Advair 2 puffs twice a day Prenatal vitamin daily Fluoxetine 40mg daily loratadine 10 mg daily synthroid 12.5 mg daily

Current Illness: none

ID: 0946970
Sex: F
Age: 45
State:

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: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Patient felt heart racing, shaky, and flushed a few minutes after COVID shot number 1. VS 186/98 HR 97 RR 16 Temp 36.5 No SOB or throat tightness. Patient sat for 15 minutes after vital signs. Given water. Felt much better. BP 145/94 HR 87 RR 14. No more shaking of hands. Discharged from clinic and recommend to report for next shot and let them know to monitor for 30 minutes.

Other Meds:

Current Illness:

ID: 0946971
Sex: F
Age: 24
State: NJ

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: no known drug allergies prior to administration

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

Symptoms: Systemic: Rash (other than injection site)-Mild; symptoms lasted 1 day

Other Meds:

Current Illness:

Date Died: 10/10/2020

ID: 0946972
Sex: M
Age: 93
State: MI

Vax Date: 10/08/2020
Onset Date: 10/09/2020
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: Mirtazapine, Myrbetriq, Penicillin

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

Symptoms: Patient received first dose of Shingrix and annual flu vaccine on 10/8/20. Patient's home care therapist called on 10/9/20 that patient developed nausea, vomiting, sweating, and cough after receiving the vaccines. Called patient later that day for follow-up and his wife reported he was feeling better, but was not planning to get the second dose of Shingrix in the future. Did not receive further communication regarding the patient, until on 12/24/20 spoke to patient's wife who reports the patient expired on 10/10/20. He went to bed the evening of 10/9/20, she woke up at 1:30AM on 10/10/20 and heard the patient take two deep breaths and then he stopped breathing. She called the funeral home who had her call the police and the medical examiner was notified.

Other Meds: Fluoxetine, Allopurinol, Omeprazole, Nadolol, Furosemide, Finasteride, Ramipril, Atorvastatin, Hydralazine, Metformin, Tamsulosin

Current Illness: None

ID: 0946973
Sex: F
Age: 41
State: CA

Vax Date: 12/19/2020
Onset Date: 12/19/2020
Rec V Date: 01/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: became anxious. c/o SOB, palpitations, dizziness, felt she was going to faint. Was evaluated in ED, discharged home

Other Meds:

Current Illness:

ID: 0946974
Sex: F
Age:
State: AZ

Vax Date:
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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: codine, sulfa and some beta blockers

Symptom List: Pharyngeal swelling

Symptoms: None stated.

Other Meds: Calcium with vitamin D ? 1200 once a day Vitamin D ? 5000 IU once a day Lisinopril 20 MG ? twice a day Verapamil 240MG ? once a day Fluticasone 50 mg nasal spray ? one each nostril daily Aspirin 81 mg ? one a day Atorvastatin 80 mg ? once

Current Illness: n/a

ID: 0946975
Sex: F
Age: 45
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:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: wheezing hot flush sensation had to use a breathing treatment arm is really sore headache chest feels tight, almost like she is congested

Other Meds:

Current Illness:

ID: 0946976
Sex: M
Age: 51
State: ND

Vax Date: 01/08/2021
Onset Date: 01/13/2021
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: nkda

Symptom List: Diarrhoea, Nasal congestion

Symptoms: cold urticaria touching cold object (eg. fridge temp Coke Can, holding onto room temperature metal door fram >2 min) results in itching, erythema, hives

Other Meds: losartan, lipitor

Current Illness:

ID: 0946977
Sex: M
Age: 88
State: PA

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

Lab Data:

Allergies: Cardura, Diltiazem , and Doxazosin

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

Symptoms: On 1/15/2021 at approx. 1115am, resident had an elevated temperature of 102.7 degrees F. Tylenol was given and the doctor ordered Ceftin 500mg BID for 7 days.

Other Meds: Aspirin 81 MG, Atorvastatin Calcium 40 MG QD, Cholecalciferol 400 unit QD, Ergocalciferol Capsule 1.25 MG (50000 UT) QD, MiraLax 17 gram QD, Norvasc 2.5 MG QD, Omeprazole Suspension 40 mg QD, Potassium Chloride Solution 20 MEQ/15ML (1

Current Illness: Hospitalized on 12/27/2020 with Multi focal Pneumonia. Returned to the facility on 1/5/2021.

ID: 0946978
Sex: M
Age: 49
State: FL

Vax Date: 12/29/2020
Onset Date: 01/03/2021
Rec V Date: 01/15/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies: NKDA

Symptom List: Rash, Urticaria

Symptoms: Onset of shortness of breath and cough on 1/3 that progressively got worse. Clinical diagnosis of pneumonia without fever was made, patient started azithromycin on 1/5 and albuterol treatments every 4-6 hrs. Initially he improved, but then worsened. chest xray on 1/6 was negative for pneumonia, PCR covid test was negative, albuterol treatment did not bring much relief. He started respiratory distress on 1/10 and was taken by car to the local ER where another covid test was negative and chest CT revealed multiple bilateral pulmonary emboli. The leg US revealed blood clots in both of his legs. He had an emergency catheter-delivered thrombolysis and was discharged home from the ICU on 1/12 on oral anticoagulants. He is gradually improving, but very weak. He tires easily and gets a drop in oxygen to 90- 93%, as well as an increase in the heart rate to 120 when walking less than half a mile. He runs out of breath with exertion.

Other Meds: lexothyroxine, vitamin D, montelukast, manesium citrate

Current Illness: Sinus infection at the beginning of December treated with augmentin

ID: 0946980
Sex: F
Age: 27
State: MN

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: shell fish

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

Symptoms: chills, headache, fatigue, generalized aches, intermittent nausea (no emesis) -all symptoms lasting around 24 hours at this time

Other Meds: Apri- birth control

Current Illness: n/a

ID: 0946981
Sex: F
Age: 32
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: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Macrobid

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

Symptoms: As I was awaiting my 30 minute monitoring I began to itch all over my body. I began to get hives on my face, arms, legs, and stomach. I felt ill and could not stop itching.

Other Meds: Escitalopram - 10mg Omeprazole - 40mg B12 - 2500mcg VitaFusion Women's Supercharged multi vitamin (gummy) VitaFusion Vitamin D3 gummy - 50mcg

Current Illness: none

ID: 0946982
Sex: F
Age: 36
State: TX

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

Lab Data:

Allergies: Barium

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

Symptoms: About 10 hours after my vaccine my arm was extremely sore, I vomited several times, and have the chills.

Other Meds: Levothyroxine 100 mcg Adderall 30mg

Current Illness: None

ID: 0946983
Sex: M
Age: 36
State: NY

Vax Date: 01/06/2020
Onset Date: 01/06/2020
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: None

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

Symptoms: An extreme headache began within 30 minutes. A few hours later I started a low grade fever and vomited. I slept most of the day. The extreme headaches kept me from working for a total of five days. When I went back to work, I struggled with painful headaches for the next week. It was over two weeks before the headaches regressed to a manageable state and about a month before I got back to normal.

Other Meds: None

Current Illness: None

ID: 0946984
Sex: F
Age: 62
State: GA

Vax Date: 01/15/2021
Onset Date: 01/15/2021
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: Pt reported no Allergies

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

Symptoms: Swelling at the injection site. Looked like a bubble and swelling was slowly spreading. Pt did not report dizziness or trouble breathing. Blood pressure machine was not accurate so bp not reported.

Other Meds: Nothing noted

Current Illness: No illness reported

ID: 0946985
Sex: M
Age: 69
State: PA

Vax Date: 01/15/2021
Onset Date: 01/15/2021
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: NKDA , no other known allergies

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Shot was given today, about 20 minutes after recieving #1 of covid19 vaccination patient experienced shaking and rigors and feeling "warm" and then chills, he denied chest pain sob muscle aches or pains or headaches or lightheadedness. Vitals were taken HR 105 pulse ox 99% normal S1S2 tachycardian lungs were clear We gave IM 25mg benadryl in right arm and 1000mg tylenol once we will monitor condition closely and re-assess, Dr was present for this assesssment and plan

Other Meds: Keppra, ASA, multivitamin

Current Illness: none

ID: 0946986
Sex: F
Age: 21
State: NY

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

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: tingling, chills, n/v, fever 101f, covid(-)

Other Meds:

Current Illness:

ID: 0946987
Sex: M
Age: 81
State: TX

Vax Date: 01/06/2021
Onset Date: 01/14/2021
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: Horse serum, propoxyphene

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

Symptoms: Delayed local reaction at injection site with pruritis, several cm area of erythema and swelling

Other Meds: Simvastatin, Hydrochlorthiazide, Losartan, Omperazole, Citirizine

Current Illness: Episodic urticaria

ID: 0946988
Sex: F
Age: 28
State: NY

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: 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: The unexpected reaction was localized constant left chest pain. It is believed to be due to swollen lymph nodes in the pectoral area (as all other testing at the ER was normal). Also sharp pain when breathing in deeply.

Other Meds:

Current Illness:

ID: 0946989
Sex: F
Age: 33
State: IA

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:

Symptom List: Unevaluable event

Symptoms: Systemic: Nausea, Systemic: Vomiting, Systemic: tongue/face swelling, shortness of breath; symptoms lasted 1 day

Other Meds:

Current Illness:

ID: 0946990
Sex: F
Age: 60
State: NY

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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Topical Bacitracin

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

Symptoms: Low grade fever, chills, headache, fatigue

Other Meds: Toprol, olmasarten, hctz,synthroid, baby Asa

Current Illness: HTN, Hypothyroidism, osteoarthritis

ID: 0946991
Sex: F
Age: 48
State: IL

Vax Date: 12/30/2020
Onset Date: 01/07/2021
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: Subject states she received the vaccine on 12/30/20 to her right arm. On 1/7/21 she noticed her arm was still sore and her lymph node in her armpit was swollen. As of 1/15/21 she stated the symptoms lasted about a week but have now just recently resolved

Other Meds:

Current Illness:

ID: 0946992
Sex: F
Age: 30
State: NY

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: N/A

Symptom List: Injection site pain, Menorrhagia

Symptoms: No reaction noted after first dose. Pt sts woke up on morning after first dose sweating, similarly profuse from past experiences as if he was sick and feverish. Also had "pain" in his throat, a tightness in his chest, and intermittent chills. 14JAN21, condition the same, with worsening in tightness in chest and throat pain. 15JAN21 chest tightness has subsided but throat pain worse, no trouble swallowing. PT sounds congested when speaking. DNS SOB.

Other Meds: Generic OTC anti-histamine, Nature's Bounty gummy men's multivitamin

Current Illness: N/A

ID: 0946993
Sex: F
Age: 24
State: CA

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: 5 min after vaccine admin pt had 5/10 Chest pain, Hypertensive 166/100, Tachycardia 135. Pt received 25 mg benadryl IM once at onset of symptoms. Resolved at arrival to ED.

Other Meds: Tylenol taken last night.

Current Illness: Covid positive 12/29/20. Pt states she was asymptomatic until 1/8/21, when she became hypertensive and tachycardic at 174/124 BP and 180HR, febrile at 99.7F.

ID: 0946994
Sex: M
Age: 79
State: TX

Vax Date: 01/13/2021
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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: L arm pain, fever, chills, muscle ache, weakness, No treatment other than Tylenol and bed rest. All symptoms began about 24 hrs after vaccine administered and less arm pain still exists 48 hrs later

Other Meds: amlodipine besylate, simvastin, allertec , tylenol, multivitamins,

Current Illness: none known

ID: 0946995
Sex: F
Age: 34
State: FL

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

Lab Data:

Allergies: Gluten Sensitivity

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Itchy swelling - bump - slight pain in arm all the way to fingers.

Other Meds: Synthroid 75 mcg; Vitamin B6; C; D3; Selenium; Meta?Stim Iodine; ADB5

Current Illness: None

ID: 0946996
Sex: F
Age: 36
State: AR

Vax Date: 01/07/2021
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: RA

Lab Data:

Allergies: None

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

Symptoms: 13 hours after the injection developed chills, myalgia, fever, rigors. Also local muscle pain at injection site. Systemic symptoms of fever (up to 101.4F), and myalgia resolved within 24 hours (about 36 hours since the injection). Also developed left axillary lymphadenopathy within 24 hours, which is improving but still some lymph node ttp present after 7 days

Other Meds: Melatonin, tylenol

Current Illness: None

ID: 0946997
Sex: F
Age: 26
State: NH

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: RA

Lab Data:

Allergies: Brazil Nuts

Symptom List: Nausea

Symptoms: Pt developed itching, mild rash around injection site several minutes after injection. She also reported some itching to face bilaterally. No evidence of anaphylaxis. Symptoms improved after 1/2 hour. She refused EMS services. Band-Aid was removed and new band aid was placed on other arm where the pt then developed mild rash there as well. Suspect new allergy to bandaid adhesive. Doubt this was a reaction to the vaccine. Pt was counseled to follow up with PCP for further guidance regarding 2nd dose.

Other Meds: Junel, omeprazole, sertraline, B12 injections

Current Illness: none

ID: 0946998
Sex: F
Age: 44
State: WI

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Injection site pain

Symptoms: Pt reported feeling itchy "all over" 19 minutes post vaccination. She denied any other sxs such as SOB, throat tightness, difficulty swelling, lightheadedness, nausea, vision change. I checked her BP and pulse @ 1117 and again @ 1122. Her BP and pulse remained stable and in normal range. Her lungs were clear, no wheezing. There was no visible rash. I administered 25 mg of benadryl @ 1125. She left the clinic 35 minutes post vaccine in good condition without evidence of significant reaction.

Other Meds: none

Current Illness: none

ID: 0946999
Sex: F
Age: 45
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:

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

Symptoms: wheezing tight chest headache had to use a breathing treatment hot flush sensation

Other Meds:

Current Illness:

ID: 0947000
Sex: M
Age: 48
State: OK

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: RA

Lab Data:

Allergies: Penicillins (rash)

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

Symptoms: 1/8/21, 1600: Received second dose of COVID-19 vaccine 1/9/21, 1800: Began to feel feverish and achy, and later identified some pruritic lesions beginning to emerge 1/10/21: Developed a crop of raised red pruritic lesions on distal extremities; later noticed visible swelling of the face. Patient did not experience swelling of tongue or respiratory compromise. Patient self-administered Benadryl and a Medrol Dosepak. The lesions expanded to involve torso. 1/11/21: Symptoms subsided, though there was a sensation of recrudescent pruritis at unspecified time. 1/11/21, 1631: Labs ordered; patient CBC and CMP were WNL. Noted that platelets were normal, no eosinophilia, and LFTs were WNL. Positive COVID-19 antibody test. The patient stated he had COVID-19 in November, but no positive test is noted in the patient chart.

Other Meds: Bystolic, 5 mg daily at bedtime

Current Illness: None reported

ID: 0947001
Sex: M
Age: 79
State: PA

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

Lab Data:

Allergies: n/a

Symptom List: Tremor

Symptoms: Pt did not experience an adverse reaction. I am reporting that He received his 2nd dose 45 days from the 1st dose instead of 60-180 days. I am not sure how this will affect the effectiveness of the vaccine. It was recommended that I do report through VAERS

Other Meds: n/a

Current Illness: n/a

ID: 0947002
Sex: F
Age: 22
State: MI

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

Lab Data:

Allergies: n/a

Symptom List: Erythema, Pruritus

Symptoms: Large, red, circular bump at the site of the injection. Was itchy when first notices but now feels fine; red circular bump is still visible though.

Other Meds: n/a

Current Illness: n/a

ID: 0947003
Sex: F
Age: 46
State: CA

Vax Date: 01/14/2021
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: Amoxicillin

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

Symptoms: Tight or swelling in her throat

Other Meds: none known

Current Illness: none known

ID: 0947004
Sex: M
Age: 17
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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: n/a

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

Symptoms: Pt developed a bilateral rashes on the arms 10 min s/p COVID vaccine administration. No other symptoms were experienced. Pt received 20 mg of Famotidine and 25 mg of Diphenhydramine. Rash improved. Pt was monitored for 30 minutes, and was able to return home with no issues

Other Meds: n/a

Current Illness: n/a

ID: 0947005
Sex: F
Age: 87
State: ND

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

Lab Data:

Allergies: several antibotics

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: after 30 minutes of vaccine resident started to get short of breath . Was monitored during the day and vitals normal was told to go to ER if symptoms got worse. Resident went to ER at 2000 with shortness of breath. Recommendation was to not get the second vaccination body has enough antibodies and getting the first dose was enough for her.

Other Meds: Unkown

Current Illness: Had Covid -19 on November 13th and was hospitalized

ID: 0947006
Sex: F
Age: 60
State: OK

Vax Date: 12/31/2020
Onset Date: 01/01/2021
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: No

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

Symptoms: Fever 38.8 Chills Muscle and joint pain

Other Meds: Excedrin, panteprazole

Current Illness: None

ID: 0947007
Sex: F
Age: 30
State: MI

Vax Date: 01/12/2021
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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: sensitivities to penicillin and flagyl, nickel, environmental

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

Symptoms: Wednesday 1/13/2021 I woke up feeling like nauseous, then later in the day I started to get itchy in my lower body that was coming and going (I believe I still had some allegra d in my system). On Thursday 01/14/2021 by noon time the itching had become extreme and unbearable all over my body and felt like my skin was crawling/burning, my chest and parts of my arms were really red . I also developed a lump in my throat that kept getting bigger and felt itchy and couldn't stop clearing my throat. Around 3pm I took 10ml of Claritin. The Claritin had not really helped however the redness had gone down a lot and by 4:30 I was miserable. Informed by a provider I work with to go to urgent care. I arrived at urgent care at about 5:10 where I was treated for an allergy reaction. I was given 0.9% sodium chloride IV bolus 500mL, Methylprednisolone sod suc(PF) (SOLU-Medrol) 125mg Intravenous, Famotidine (Pepcid) 20mg/2ml injection 20mg intravenous, diphenhydramine (Benadryl) 50mg/ml injection 25mg intravenous. The itching subsided within 30 minutes, the itchy throat/ lump was still present but was not getting worse and slowly improving. I was discharged home and was told to pick up famotidine 20mg, otc benadryl and prednisone 50mg to take for 5 days. got home a little after 7 and was able to eat dinner, let dog out, shower, rest before going to bed. I did take another 10 ml of Benadryl at 10:30. Woke up without any itchy skin at 5:45 and was able to return to work this morning. I still have a slight itchy throat but it is tolerable. I took allegra d and famotidine this morning. I am holding off on the prednisone because of the immune response to vaccines from steroids. I don't want to lessen the effectiveness of the vaccine.

Other Meds: Adderall 30mg XR, junel 1.5/30 (21) 1.5-30 mg-mcg tablet, Flonase 50mcg nasal spray, had allegra d in my system-last dose taken was Monday.

Current Illness: none

ID: 0947008
Sex: F
Age: 27
State: IL

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:

Symptom List: Pain in extremity

Symptoms: Systemic: shortness of breathe, 100-120 bpm,150/80bpm-Medium

Other Meds:

Current Illness:

ID: 0947009
Sex: F
Age: 70
State: FL

Vax Date: 01/15/2021
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: shellfish

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

Symptoms: hypertensive/tachycardic (possible vasovagal reaction) persisted > 1 hour post-dose and requiring antihypertensive medication be administered

Other Meds: atorvastatin, metoprolol, spironolactone

Current Illness: n/a

ID: 0947010
Sex: F
Age: 47
State: ME

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

Lab Data:

Allergies: CT Contrast Dye, Shellfish, penicillin, sulfa, aspirin.

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

Symptoms: Patient to be observed for 30 minutes beginning at 1050. Patient has a history of anaphylaxis to contrast dye for CT scans. 15 min into observation at 1105, patient reported feeling dizzy. Reported history of passing out but not associated with injections or labs. Denied blurry vision. Denied feeling SOB, throat tightening, nausea. No rash noted. Patient's VS were WNL. Laid patient flat. She reported her legs felt tingly and tight. Notified Dr. Patient reported persistent dizziness and new onset nausea. Patient then developed a splotchy red rash on chest. No itchiness. Pt treated with 0.3mg epi, 50mg benadryl, and 125mg solumedrol. VS monitored continuously and 911 was called.

Other Meds:

Current Illness:

ID: 0947011
Sex: M
Age: 69
State: CA

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

Lab Data:

Allergies:

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

Symptoms: My reaction occurred approximately 12 hrs. following the injection. I awoke on the night of Jan. 8 after rolling over on my right arm where the injection site was. I immediately awakened with sharp burning pain and as I became more awake, I realized that I was confused, slightly disoriented and very diapheretic. I alternated between having a chill to sweating profusely. My head was throbbing as in a migraine and the orbits around my eyes hurt as well. I was extremely nausea to the point of gagging but I had not eaten anything so I did not throw up. Later that night I also at watery diarrhea. All of my joints ached and my pelvic region seemed to hurt more than the rest of my body and joints. When I got up, I found that my equilibrium was off and that I was dizzy. My temperature 100.2 but over the next 2 days it went as high as 102, but continued around 100.8 for several hours. Early in the a.m. I called my PCP service and later spoke with the physician on call. We discussed in depth. At that point, my panic had subsided somewhat and he told me to take Tylenol for my fever and I also had Benadryl available and I took 50 mg. I hydrated myself (I did not have an appetite) but forced my to drink fluids and eat a serving of fresh fruit. By mid-day on 1/9 I was feeling less anxious and was able to sit and watch t.v. I continued to take Tylenol and Benadryl and slept for almost 16 hours. On Sunday I was more improved. Since then, I have continued to feel dizziness and tire very easily. Today, my equilibrium is still off and I have difficulty focusing. I have spoken with my PCP twice this week and I will be going into the Covid research clinic next week as they want to examine me and draw blood samples close to the two week period after the first injection.

Other Meds:

Current Illness: Unknown

ID: 0947013
Sex: F
Age: 57
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: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: NSAIDS

Symptom List: Vomiting

Symptoms: Severe abd pain with nausea-severe pain lasted 24 hrs then dull pain for 2 days after. Did also have pain, soreness at inj site, body aches and fatigue

Other Meds: Singular, tramadal

Current Illness:

ID: 0947014
Sex: F
Age: 46
State: TN

Vax Date: 12/22/2020
Onset Date: 12/29/2020
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: No

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: I had body aches, knee joints were hurting, temp 100F, chills, shaking, exhausted like I was hit by a truck. Later that evening my temp went to 102F, after that I was sleeping 10 hours a day, no appetite, nausea, vomiting, diarrhea, 9lbs in 9 days, back was killing me, alternated hot and cold compress. One morning I woke up and my tongue was like a rock, I was so dehydrated. Fever for 5 days, took Tylenol and it would just break it down to 100F. Went to COVID and flu on the 12/29 got positive for COVID on 12/31/20. Yesterday I felt hot and flushed and was sweating profusely, other than that no other symptoms. ( I received the second dose on 01/13/21)

Other Meds: Sertraline, Lovastatin, Anastrozole, Gabapentin, Tylenol as needed, Melatonin, letron shot once a month

Current Illness: No

ID: 0947015
Sex: F
Age: 32
State: MA

Vax Date: 01/12/2021
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: sulfa

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

Symptoms: Continued dizziness, dry mouth, sore throat, nausea, headache, vertigo, with intermittent sweating and hot flashes over 48 hrs after vaccination. Improvement with Tylenol 1000mg.

Other Meds: adult multivitamin, ativan

Current Illness: none

ID: 0947016
Sex: F
Age: 22
State:

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: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Shortly after receiving vaccine started feeling foggy. upper lip began to tingle, felt numb, and starting swelling. Started having palpitation and having shortness of breath.

Other Meds:

Current Illness:

ID: 0947017
Sex: F
Age: 43
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:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: HA, eye puffiness and redness, generalized body aches, malaise. Treatment - Ibuprofen. Outcome- does not interfere with ADL's continue to work. No improvement in symptoms will continue to monitor.

Other Meds:

Current Illness:

ID: 0947018
Sex: M
Age: 65
State: FL

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

Lab Data:

Allergies: None

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

Symptoms: Pain tenderness in the shoulder, fatigue, headache, muscle and joint pain, chills, Dizziness and weakness.

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm