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: 0949712
Sex: F
Age: 38
State: WI

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

Lab Data:

Allergies: Sulfa

Symptom List: Dysphagia, Epiglottitis

Symptoms: Mild upper arm pain within 3 hours of shot; extreme arm pain and stiffness following morning. 24 hours post shot, severe chills and low grade fever.

Other Meds: Omeprazole

Current Illness:

ID: 0949713
Sex: F
Age: 31
State: CA

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

Lab Data:

Allergies: Meloxicam, pineapples, kiwis, kiwiberries, certain lactose products (milk, cream).

Symptom List: Anxiety, Dyspnoea

Symptoms: 1/12 0715: Received Pfizer covid-19 vaccine dose 2 at end of shift. Went home to sleep after waiting 15 min. 1630: Woke up. Felt more tired than usual. 1900: Arrived at work. Felt fatigue and sore arm. 2000: Felt sore arm, fatigue, and mild HA. Drank coffee and this helped with fatigue and HA. 2100: Mild nausea starts. Still have sore arm. Less fatigue, no HA. Still able to eat with the nausea. 2200: Developed chills. I was putting up curtains in an isolation room and had to pause halfway through due to being short of breath as if I'd done something strenuous. I then was short of breath again walking specimens to lab, which is unusual for me. Walking samples to lab involves walking 400 ft and going up and down 1 flight of stairs. 2300: Coworkers keep asking me why I'm always out of breath. They are concerned. Chills are worse now and I go from feeling normal to feeling cold. My hands are like ice and I am gripping my arms to keep warm. I walk 2 samples to lab and each time I am dizzy on the way back. By the 2nd time I have to hold the wall to keep balance. I can no longer hide the side effects and a coworker offers me 650mg Tylenol. I gladly accept. I measure my spO2 and it is 97%. 1/13 0530: I am almost back to normal other than feeling fatigued. 0815: I get home and go to bed. My feet are ice cold so I have to wear socks, but my hands feel normal temperature. I feel like my blanket isn't warm enough. 1330: I wake up and feel absolutely miserable. I am going between having chills to having a hot flash. I can't seem to will myself to leave bed. I'm pretty sure I have a fever, which I haven't had in over 10 years. My mouth is completely dry. 1400: I manage to roll out of bed and take my temperature, which is 101.3F. I feel an overall malaise and keep getting periodic hot flashes, but manage to make it downstairs and I mix 1 liquid IV electrolyte packet w/ 24fl oz. water. I drank the whole thing. I also cooked myself some dumplings and 1 waffle w/ maple syrup due to feeling much hungrier than usual. 1430: I take 1000mg Extra Strength Tylenol after eating. 1830: I feel almost normal except for significant fatigue and go to bed. 1/14 0430: I wake up and feel completely normal. No fatigue. Go about my day as normal. 1545: Suddenly I feel lightheadedness and mild HA. Have trouble with inattention (ex. not following w/ conversation or forgetting what people just said, or listening but not registering, or can't find the words to respond or answers to a question.). I take my Vitals: 117/95, spO2 85%, HR 63. I then try taking a couple deep breaths and spO2 increases to 98% and lightheadedness and HA go away. Then a few minutes later lightheadedness and HA begin again and spO2 is 80-90%. Then I take 2 deep breaths and spO2 is 98% and HA and dizziness improves. This repeats several times and I grow concerned. My hands are cold and the pulse oximeter is $30 from Amazon. However, I used the pulse ox on my mother and she was 97% consistently every time without fail. I also used pulse ox on myself when perfectly healthy and same thing it was 98%+ every time. This is why I was now worried. 1630: I take Tylenol since this seems to have helped with any and every symptom I've had so far and book an Urgent Care appointment. 1700: I get up to take a shower and feel extremely dizzy to the point where I'm worried I might fall. I stumble into the bathroom holding the wall. I take spO2 and it is 87%. 1800: I show up to Urgent Care and after the shower I feel my hands are warm now. At Urgent Care they are using pulse oximeters and I am spO2 99% and HR 64. So they chalk it up to my crappy Amazon pulse ox and they tell me to hang in there. Perhaps if I had not taken a shower before going there it may have been a different story? Hard to say now. Also the Tylenol may have started to work by then. 2200: I am still inattentive, spacey, lightheaded, and fatigued. I then fell asleep on the couch without realizing. 1/15 0230: I wake up and feel fatigued with brain fog, but no more lightheadedness. 0630: I go back to bed because I'm too sleepy.

Other Meds: Mary Ruth's K2+D3 Calcium Gummies Vitafusion Women's Organic Multi Gummies Nature's Bounty Hair, Skin, and Nails Gummies Mary Ruth's Omega 3-6-7-9 Gummies Mary Ruth's Vitamin D3 Gummies Mary Ruth's Eye Care Gummies

Current Illness:

ID: 0949714
Sex: F
Age: 31
State: CA

Vax Date: 01/05/2021
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: None known

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

Symptoms: Swelling, itching, hot to the touch at left delt (injection site.) Delayed onset 10 days.

Other Meds: Just a more a IUD no other meds

Current Illness: No illnesses

ID: 0949715
Sex: F
Age: 31
State: NJ

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

Lab Data:

Allergies: DTap vaccine allergy

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Hive in area of the injection site. Itching, burning, redness.

Other Meds: Plaquenil 200 mg bid Topamax 100 mg once a day Multivitamin once a day

Current Illness: None

ID: 0949716
Sex: F
Age: 52
State: ID

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: none

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

Symptoms: 23 minutes after the patient receive the shot she complained of tingling at the site and down her arm. Provided patient with 2 25mg Benadryl to self administer. Upon checking at 1pm and 7:00pm patient was feeling better.

Other Meds: None listed

Current Illness: none

ID: 0949717
Sex: F
Age: 46
State: PA

Vax Date: 01/15/2021
Onset Date: 01/15/2021
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: Aspirin and Sulfar

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

Symptoms: Nausea and pain in the arm at location of injection

Other Meds:

Current Illness:

ID: 0949718
Sex: M
Age: 57
State:

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:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: severe reaction, severe sleepiness, received emergent care

Other Meds: This was second Shingrix vaccination. serious reaction to second and not to first.

Current Illness:

ID: 0949719
Sex: F
Age: 42
State: CA

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

Lab Data:

Allergies: Milk protein allergy, shellfish intolerance, fragrance, detergent, most lotions

Symptom List: Pharyngeal swelling

Symptoms: Maculopapular rash with pruritis from ears to calves covering entire body and only sparing the hands and feet. Especially dense rash in the antecubital fossa bilateral and symmetric.

Other Meds: Multivitamins, zinc, magnesium, acyclovir

Current Illness: None

ID: 0949720
Sex: F
Age: 65
State: FL

Vax Date: 11/23/2020
Onset Date: 11/24/2020
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: NKDA

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: itching and body rash

Other Meds:

Current Illness: Dermatitis body and scalp

ID: 0949721
Sex: F
Age: 42
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: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Patient felt like heart was racing 15 minutes after injection. Resolved spontaneously after a couple minutes. No interventions performed

Other Meds:

Current Illness:

ID: 0949722
Sex: F
Age: 54
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:
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: PCN and Ampicillan

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

Symptoms: Complained of Left arm tingling, and chest pressure 3:06 p.m. while under observation. PA assessed lungs and VS. Lungs clear. SpO2 98% on Room Air. 911 called at 3:14pm B/P 154/98 Pulse 88. At 3:20pm B/P 163/111 Pulse 88 spO2 98% Room Air 3:21pm Nitro 0.4 mg given x 1. 3:24 pm Paramedics arrived, shortly after administered Nitro paste patch due to Left arm tingling and chest pressure.

Other Meds: unknown

Current Illness: unknown

ID: 0949723
Sex: F
Age: 36
State: OR

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

Lab Data:

Allergies: Latex

Symptom List: Rash, Urticaria

Symptoms: Raised hot red rash started 1 week 1 day after injection.

Other Meds: Multi vitamin

Current Illness: None

ID: 0949724
Sex: F
Age: 62
State: WI

Vax Date: 01/08/2021
Onset Date: 01/09/2021
Rec V Date: 01/15/2021
Hospital: Y

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

Lab Data:

Allergies: morphine -GI nausea and vomiting; tetanus toxoid -arm swelled from shoulder down to hand

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

Symptoms: Pt had 3 vessel CABG on 1/14/21 after presenting to ED with chest pain on 1/9/21. Pt is critically ill following OR after cardiogenic shock, bleeding. Requiring inotropes and Impella.

Other Meds: Allopurinol 100mg BID; Adderall XR 30mg 1 capsule po BID is how pt takes--prescribed as 60mg po daily; Adderall 20mg po daily at noon; aspirin EC 81mg po daily; clopidogrel 75mg po daily; Lisinopril 20mg po BID; metoprolol XL 25mg po BID;

Current Illness: 12/1/20 head congestion, double ear aches, post nasal drip. SARS-CoV-2 NAAT test 12/3/20; result not detected.

ID: 0949725
Sex: F
Age: 35
State: CT

Vax Date: 01/12/2021
Onset Date: 01/15/2021
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: None

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

Symptoms: Headache, muscle ache in evening for few hours. Nausea And vomiting in the morning. Vomited 3-4 times in morning, then sore stomach rest of day( persistent after 14 hrs.). Able to eat light meals throughout day.

Other Meds: None

Current Illness: None

ID: 0949726
Sex: F
Age: 45
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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: latex

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

Symptoms: After 10 minutes of vaccine, patient started to have tight chest, and numbness on opposite arm. Then she couldn't remember her name and date of birth for 5 minutes. She then felt her throat was swelling. 911 was called and paramedics checked her blood pressure and vitals were within range. She was monitored at the hospital and was doing fine.

Other Meds: unknown

Current Illness: unknown

ID: 0949727
Sex: F
Age: 70
State: IL

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: sulfa drugs

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

Symptoms: I was awake in the night on 1/14/2021 with pain in my upper left arm. During the day on 1/15/2021, I've had muscle pain in both upper arms, back, lower back, and thighs. My temperature is 100.7 at 8:45 pm on 1/15/2021. I have a slight headache.

Other Meds: raloxophene, levothyroxine, Caltrate

Current Illness: I've been diagnosed positive with Covid on 12/31/2020. My symptoms had started 12/26/2020. My quarantine ended on 1/3/2021. My husband also tested positive for Covid and his quarantine ended on 1/1/2021.

ID: 0949728
Sex: F
Age: 52
State: MO

Vax Date: 12/22/2020
Onset Date: 12/22/2020
Rec V Date: 01/15/2021
Hospital: Y

Vax Type: DTAPHEPBIP
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: DTAP + HEPB + IPV (PEDIARIX)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies: Benedryl - Hallucinations

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

Symptoms: vertigo nausea / vomiting diarrhea low-grade fever pain at injection site

Other Meds: Meloxican Paxil Lansaprolozol Lisinopril / HCTZ Atenolol

Current Illness: Exposed to COVID Saturday, December 19th around 7 p.m.

ID: 0949729
Sex: F
Age: 29
State: NC

Vax Date: 12/23/2020
Onset Date: 01/01/2021
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:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Miscarriage. Expected due date in August 2021. No prior pregnancy history.

Other Meds: Prenatal vitamins

Current Illness:

ID: 0949730
Sex: F
Age: 32
State: MI

Vax Date: 01/05/2021
Onset Date: 01/12/2021
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: None.

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: 7 days after injection, site started itching and developing hive type bumps. Swelling started an hour or so later. The swelling started as a golf ball and swelled to the size of a softball and was hot. Went to the doctor Wednesday at 11 and was prescribed methylprednisolone tablet pack. Swelling is down and feeling much cooler.

Other Meds: Marijuana, ibuprofen.

Current Illness: None.

ID: 0949731
Sex: F
Age: 47
State: IL

Vax Date: 01/11/2021
Onset Date: 01/11/2021
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: N-A

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

Symptoms: GI issues, severe cramping, diarrhea >10/day , dehydration, headache, tired Normal activities affected

Other Meds: Topamax

Current Illness: None

ID: 0949732
Sex: F
Age: 63
State: RI

Vax Date: 12/20/2020
Onset Date: 12/20/2020
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: Compazine side effect anxious

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

Symptoms: Bells Palsy 1st injection on 12/20/21 symptoms started 1/7/21, 2nd dose on 1/10/21 immediate numbness in mouth and tightness in throat which triggered bells palsy symptoms immediately

Other Meds: Premarin .3 mg every other day multi vitamin

Current Illness: none

ID: 0949733
Sex: F
Age: 29
State: IN

Vax Date: 01/08/2021
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: Unevaluable event

Symptoms: Since receiving the shot I had a bump at the injection site. However, yesterday I started noticing that the bump was larger. Today I noticed that it's hot to touch and more like a welt that's larger than quarter size.

Other Meds: Estarylla

Current Illness: None

ID: 0949734
Sex: F
Age: 65
State: FL

Vax Date: 01/13/2021
Onset Date: 01/16/2021
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: Codeine, epinephrine, mango

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

Symptoms: Fatigue, joint pain, diarrhea

Other Meds: SMZ-TMP DS tab, Oxybutynin 5 mg tab, calcium plus D3, B12, women's sr multivitan plus minerals, Biotin plus Keratin.

Current Illness: None

ID: 0949735
Sex: F
Age: 21
State: NE

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

Lab Data:

Allergies: None

Symptom List: Injection site pain, Pain

Symptoms: I got up to use the bathroom at 4:30 this morning. I was extremely shaky but made it. I was using the bathroom and had the feeling that I was going to vomit. Next thing I know I was seeing stars and I fainted and fell off the toilet face forward and hit my head on my tile floor. I don't remember getting to the couch, but my dad was awake to let out the dogs and I couldn't really speak but he heard me and came downstairs and got me water and a cool rag. I was sweating but shivering. I am nauseous and have slept a total of 13 hours since 4:30am. I am pretty sure I have a concussion. I have a headache, on and off chills, muscle spasms beginning at 9:00PM on 1/14/21. I also have ringing in my ears. My resting heart rate is typically between 75-85 and I checked it at 7pm and it was 100. I have not sought out medical attention and have been debating it all day.

Other Meds: Prenatal vitamin

Current Illness: None

ID: 0949736
Sex: M
Age: 78
State: MN

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

Lab Data:

Allergies: neomycin topical

Symptom List: Injection site pain, Menorrhagia

Symptoms: Woke up early in the morning with 150 bpm pulse, endured for hour; underwent cardioversion; released from ER by 6:30 a.m.

Other Meds: Motoprolol; losarten

Current Illness: high blood pressure

ID: 0949737
Sex: F
Age: 42
State: CA

Vax Date: 12/23/2020
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: from patient: I got my 1st dose and waited the 15 minutes, feeling fine. When I got in the car and started driving home I began to notice that my face was slightly numb (Iike I'd had too much novicaine). This was maybe 20-25 minutes after the dose. When I was home I also noticed that the back of my throat felt a little swollen. This probably lasted for a couple hours.

Other Meds:

Current Illness:

ID: 0949738
Sex: F
Age: 66
State: CA

Vax Date: 09/16/2020
Onset Date: 09/17/2020
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: Patient reported that she has been having pain after receiving Pneumovax 23 on 9/16/20. She said the pain has gotten better, but wanted to notify us that she was having difficulty moving the arm for a few months since the injection. Patient stated that the pain has gotten better, but she still feels some discomfort. Pharmacy suggests patient to see her doctor for evaluation.

Other Meds: Liothyronine 5 mcg, Levothyroxine 25mcg, Rosuvastatin 10 mg

Current Illness:

ID: 0949739
Sex: M
Age: 23
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:
Dose Series: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: none

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Pt was accidently given two doses of the 1st dose, as the Patient thought he needed two doses and got in the second shot line. He was monitored for an hour and did not have any adverse reactions during that time.

Other Meds: None

Current Illness: none

ID: 0949740
Sex: F
Age: 22
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: None

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

Symptoms: Severe headache, fever, fatigue, body aches, injection site pain/ tenderness - all treated with NSAID and disappeared after 30hrs post injection

Other Meds: Spironolactone, tretinoin cream, multivitamin, collagen/biotin

Current Illness: None

ID: 0949741
Sex: F
Age: 21
State: MS

Vax Date: 01/06/2021
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: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Zoloft Propranolol

Symptom List: Nausea

Symptoms: Severe headaches, fatigue, fever and chills, moderate to severe and currently ongoing swelling, redness, itching, pain at injection site with the site continually getting larger, altered sense of smell, coughing, shortness of breath, moderate to severe heartburn, gi upset and diarrhea, altered taste. All currently ongoing

Other Meds: Effexor 150mg once daily Effexor 37.5 mg once daily 100 mg trazodone once daily 1/20 Aurovela Fe once daily

Current Illness: Migraines

ID: 0949742
Sex: F
Age: 26
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:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: no known allergies

Symptom List: Injection site pain

Symptoms: At approximately 17:15, time of discharge ,(15 minutes after vaccination) client stated that her left arm was itchy as well as both hands. Injection site area with pink hue but no hives. She also stated she felt a little something in her throat. Vital signs at this time were 143/85 BP, Heart rate 100 and O2 sat 96%. No sob. 17:19 she complained of a sensation of tongue swelling. VS 138/82, HR 90, O2 sat 96% and no SOB. Continued to monitor VS every 3 minutes. Pt offered IM Benadryl but refused. 17:22 132/87, HR 99, O2 sat 95%, 17:25 133/85 HR 90 O2 95% 17:29 132/82 HR 93, O2 sat 96%, denies any new symptoms at this time. 17:34 128/89 HR 88, O2 sat 96%, 17:38 134/85 HR 93 O2 sat 95%. States symptoms improving. 17:41 129/84 HR 93 and O2 sat95%, 17:73 133/83 HR 86 , O2 sat 96%. Pt. symptoms cont. to improve. 17:55 131/83 HR 86 O2 sat 95%. Pt states she feel better. Planes to take oral Benadryl as soon as she gets home. She was advised to consult with primary physician regarding this event and will follow up with physician if she chooses to receive a second dose of Moderna COVID 19 vaccine at her doctors office. She left at 17:56.

Other Meds: Levothyroxine

Current Illness: had a gallbladder attack 2 weeks ago

ID: 0949743
Sex: M
Age: 32
State: PA

Vax Date: 12/23/2020
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: Aspirin Ceclor Wasp

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

Symptoms: 1 week later I came down with COVID-19. I know they claim that you cannot catch covid from the vaccine but I had no other exposures so I think you should look into the data with it more. The nurse who gave me my second shot had a few other employees who caught it after the first shot.

Other Meds: Flecainade Metoprolol succinate Albuterol Symbicort

Current Illness:

ID: 0949744
Sex: F
Age: 63
State: WA

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

Lab Data:

Allergies: none

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

Symptoms: extremely dizzy, passed out, took blood pressure 3 times over 45 minutes, 56/34, 62/43, 81/56

Other Meds: levothyroxine

Current Illness: none

ID: 0949745
Sex: F
Age: 57
State: AZ

Vax Date: 01/05/2021
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: None

Symptom List: Tremor

Symptoms: Injection sight is red, swollen, itchy, and hot to the touch.

Other Meds: Hydroclorothyazide, B complex, multi vitamin

Current Illness: None

ID: 0949746
Sex: F
Age: 54
State: MA

Vax Date: 10/30/2020
Onset Date: 11/01/2020
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: erythromycin

Symptom List: Erythema, Pruritus

Symptoms: Approx two weeks after vaccine, I was diagnosed 11/24/2020 with an "id reaction". Rash all over my body. Allergy tested 12/15/2020, mold was only positive. Biopsy on left arm (1/5/2021). Pathology reported type of allergic reaction.

Other Meds: sunosi, fluoxetine

Current Illness: none

ID: 0949747
Sex: F
Age: 40
State: OH

Vax Date: 01/15/2021
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: Codeine Levaquin

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

Symptoms: Mild Lower lip and chin numbness for 30 mins

Other Meds: Wellbutrin xl Zyrtec Multivitamin Vitamin d-3

Current Illness: None

ID: 0949748
Sex: F
Age: 54
State: NY

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: None

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

Symptoms: Fever 101f Diarrhea Aches and pains Headache

Other Meds: MVI BIOTIN VITD3

Current Illness: Covid diagnosed 11/29/20

ID: 0949749
Sex: F
Age: 38
State: NY

Vax Date: 01/06/2021
Onset Date: 01/11/2021
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: Shellfish, cod, ciprofloxacin, latex, dust mites,environmental

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Initial symptoms right after vaccination: sore arm for the first 2-3 days - completely resolved. After 5 days?: Developed small red, slightly elevated dots on left hand. Also, developed white circular patch on left shoulder. The red dots on left hand are improving day by day. The white patch on shoulder is still there. Visited my doctor today (Jan 15). He discussed hypersensitivity on left hand, and vitiligo on left shoulder. I am concerned about getting 2nd dose of vaccine and possible reaction thereafter. Why did I get vitiligo? Will vitiligo worsen after 2nd dose? Will the hypersensitivy on hand translate to a stronger reaction/allergic reaction after 2nd dose? Thank you.

Other Meds: 2 Aleve 220mg & 2 Tylenol (500mg) 21 hours before vaccination

Current Illness: None (Started menstruation the day before vaccination)

ID: 0949750
Sex: F
Age: 93
State: WI

Vax Date: 01/11/2021
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:

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

Symptoms: On 1/14/2021 @ 0659, patient was noted to be weaker, arms were flaccid R>L. Unable to answer questions speech gargled. Unable to grasp hands. Pupils reactive, but sluggish. Probable CVA. Dr. and family were notified. Family wished to keep patient at hospital and provide comfort care rather than send to the hospital. MD was in agreement. APNP, assessed patient. Her tongue was red and swollen. Bite marks noted on right side of tongue likely d/t event. ST evaluation done to evaluate patient's ability to chew and swallow safely due to swelling of tongue. Hospice services were initiated. (Unsure if event was caused by vaccine administration)

Other Meds: Acetaminophen, Levothyroxine, Metoprolol Tartrate, Multivitamin, Norvasc, Seroquel, Vit D, Zoloft, Simethicone, Senna

Current Illness:

ID: 0949751
Sex: F
Age: 44
State: NY

Vax Date: 01/07/2020
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: None

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

Symptoms: Rash at injection site

Other Meds: VitC, VitD

Current Illness: None

ID: 0949752
Sex: F
Age: 68
State: OK

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: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Pain in extremity

Symptoms: Low fever 99.4. Joint aches. Chills. Red raised swelling at injection site.

Other Meds: None

Current Illness: None

ID: 0949753
Sex: F
Age: 55
State: IL

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: Sore at injection site. Low fever, chills, bone and muscle aches, mild headache.

Other Meds:

Current Illness:

ID: 0949754
Sex: F
Age: 45
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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Influenza vaccine, progesterone, wheat

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

Symptoms: Approx 10-12 hours after dose: injection site pain, swelling, headache, fever (temp max 99.5)

Other Meds: None

Current Illness: None

ID: 0949755
Sex: F
Age: 46
State: MS

Vax Date: 01/06/2021
Onset Date: 01/11/2021
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: morphine

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

Symptoms: Left side of entire body is swollen, Left neck, and left chest wall, left side, left thigh, leg and foot are swollen. Lymph nodes on side of left neck, left chest wall, left breast, under arm and side , left elbow, and lower arm are swollen and hurting to touch. area has been swollen all week. Still having headaches, pains in thigh and leg.

Other Meds: Multivitamin

Current Illness: hot flashes

ID: 0949756
Sex: F
Age: 41
State: NY

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: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Penicillin allergy

Symptom List: Vomiting

Symptoms: Day 8 post vaccine. Large Severe redness, swelling, hotness left arm. Day 8 post Moderna vaccine. Also had armpit pain on L. Severe itching L arm. Circular redness about 3 inches in diameter. Diagnosed with cellulitis. Put on Keflex.

Other Meds: Synthroid 125mg

Current Illness: None

ID: 0949757
Sex: F
Age: 36
State: CO

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

Lab Data:

Allergies: na

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: WARMTH BELOW INJECTION SITE

Other Meds: na

Current Illness: na

ID: 0949758
Sex: F
Age: 60
State: FL

Vax Date: 01/07/2021
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: RA

Lab Data:

Allergies: Latex, doxycycline, dairy products

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

Symptoms: Muscle spasms, fever, chills, rigors, rash, headache, joint swelling and pain

Other Meds: Progesterone 100mg 1 X daily; Estradiol Transdermal System, 0.1mg/day

Current Illness: none

ID: 0949759
Sex: F
Age: 59
State: TN

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

Lab Data:

Allergies: Sulfa Keflex Levaquin

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Tachycardia Hypertension (198/120) - no he of hypertension Lightheadedness

Other Meds: Vit D Vit E Glucosamine Immune supplements Turmeric

Current Illness: None

ID: 0949760
Sex: F
Age: 29
State: CA

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: IM
Vax Site: RA

Lab Data:

Allergies: shrimp and latex

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

Symptoms: After vaccine was administered, 4:40 pm, I was feeling my heart palpitating fast like an anxiety attack. I also experienced a headache, fatigue, body ache and arm pain that same day at 4:58 pm, and around 6:15 pm I my whole body was itchy. The next day January 12, 2021, I woke up with a fever of 100.2, still with body ache, headache, but no longer body itchiness. Yesterday January 14, 2021 and today January 15, 2021 still having headache, body ache pain did decrease.

Other Meds:

Current Illness:

ID: 0949761
Sex: F
Age: 49
State: NC

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Shellfish (Throat Swell Kid) 1/5/21 - Told Anaphylaxis by me

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

Symptoms: Patient information was reviewed. Patient was asked if they ever had any form of severe reaction to anything they had had in the past. Patient did not state yes to anything other than having a reaction that was managed at home to shellfish as a child. They stated their throat had swollen as a child during the event. Patient was told that it was an anaphylactic reaction and shouldn't have been managed at home as a child by nurse and should have been taken to the hospital. Patient was told they would be monitored for 30 minutes after receiving the vaccine. Within 2-3 minutes after receiving the vaccine the patient reported tingling or burning around the site of injections. Within 5 minutes they stated to be feeling tired and that their arm had felt numb. After this the patient began starring into the distance and was unresponsive. Called for help and advice by turning around as patient had syncoped. Got nurses and other team members attention and had an epi-pen ready just in case it was needed. Patient began having notable distress with respiration and administed an epi-pen. Advised for a nurse to call EMS for patient and crash cart/oxygen was also obtaine dby the facility. Oxygen was required. Patient was not responsive after the first dose and was given a second as they remained un-alert with notable distress. The patient became alert a while after receiving the second shot and not long after that the EMS arrived to the event.

Other Meds: None reported

Current Illness: None reported

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm