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: 0958747
Sex: M
Age:
State: MD

Vax Date:
Onset Date: 12/30/2020
Rec V Date: 01/17/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Follow up: Patient received casirivimab instead of intended COVID vaccine. At 48-hr follow up, patient reported arm soreness. Patient received COVID vaccine on December 31

Other Meds:

Current Illness:

ID: 0958756
Sex: F
Age:
State: MD

Vax Date:
Onset Date: 12/30/2020
Rec V Date: 01/17/2021
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:

Symptom List: Anxiety, Dyspnoea

Symptoms: Follow up: Patient received casirivimab instead of intended COVID vaccine. 48-hr follow revealed patient experienced little bit of arm soreness. Patient received COVID vaccine on December 31

Other Meds:

Current Illness:

ID: 0958759
Sex: F
Age:
State: MD

Vax Date:
Onset Date: 12/30/2020
Rec V Date: 01/17/2021
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: Follow up: Patient received casirivimab instead of intended COVID vaccine. 48-hr follow up didn't identify AEs. Patient received COVID vaccine on December 31

Other Meds:

Current Illness:

ID: 0958763
Sex: F
Age:
State: MD

Vax Date: 12/31/2020
Onset Date:
Rec V Date: 01/17/2021
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: Follow up to FAERS18694343: Patient received casirivimab instead of intended COVID vaccine. At 48-hr follow up. patient reported arm soreness. Patient received COVID vaccine on December 31.

Other Meds: casirivimab

Current Illness:

ID: 0958786
Sex: M
Age:
State: MD

Vax Date:
Onset Date: 12/30/2020
Rec V Date: 01/17/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Follow up: Patient received casirivimab instead of intended COVID vaccine. 48-hr follow up didn't identify AEs. Patient Patient received COVID vaccine on December 31

Other Meds:

Current Illness:

ID: 0958787
Sex: F
Age:
State: MD

Vax Date:
Onset Date: 12/30/2020
Rec V Date: 01/17/2021
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:

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

Symptoms: Patient received casirivimab instead of intended COVID vaccine. 48-hr follow up revealed arm soreness Patient received COVID vaccine on December 31

Other Meds: casirivimab

Current Illness:

ID: 0958788
Sex: M
Age:
State: MD

Vax Date:
Onset Date: 12/30/2020
Rec V Date: 01/17/2021
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: Follow up: Patient received casirivimab instead of intended COVID vaccine. 48-hr follow up didn't identify AEs. Patient Patient received COVID vaccine on December 31

Other Meds:

Current Illness:

ID: 0958789
Sex: M
Age:
State: MD

Vax Date:
Onset Date: 12/30/2020
Rec V Date: 01/17/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Patient received casirivimab instead of intended COVID vaccine. At 48-hour follow up, patient reported Soreness to arm, fever of 99.9 and high blood pressure. Wife thought he was anxious. Follow up 2 hrs later and next morning, he reported he was "fine". Received COVID vaccine on December 31

Other Meds: casirivimab

Current Illness:

ID: 0958790
Sex: F
Age:
State: MD

Vax Date:
Onset Date: 12/30/2020
Rec V Date: 01/17/2021
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: Follow up: Patient received casirivimab instead of intended COVID vaccine. 48-hr follow up didn't identify AEs. Patient Patient received COVID vaccine on December 31

Other Meds:

Current Illness:

ID: 0958791
Sex: M
Age:
State: MD

Vax Date:
Onset Date: 12/30/2020
Rec V Date: 01/17/2021
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: Follow up: Patient received casirivimab instead of intended COVID vaccine. 48-hr follow up revealed patient experienced arm soreness. Patient received COVID vaccine on December 31

Other Meds:

Current Illness:

ID: 0958792
Sex: F
Age:
State: MD

Vax Date:
Onset Date: 12/30/2020
Rec V Date: 01/17/2021
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: Follow up: Patient received casirivimab instead of intended COVID vaccine. 48-hr follow up didn't identify AEs. Patient Patient received COVID vaccine on December 31

Other Meds:

Current Illness:

ID: 0958793
Sex: F
Age:
State: MD

Vax Date:
Onset Date: 12/30/2020
Rec V Date: 01/17/2021
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: Follow up: Patient received casirivimab instead of intended COVID vaccine. 48-hr follow up didn't identify AEs. Patient Patient received COVID vaccine on December 31

Other Meds:

Current Illness:

ID: 0958794
Sex: F
Age:
State: MD

Vax Date:
Onset Date: 12/30/2020
Rec V Date: 01/17/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Follow up to FAERS18694343: Patient received casirivimab instead of intended COVID vaccine. 48-hr follow up didn't identify AEs. Patient received COVID vaccine December 31

Other Meds:

Current Illness:

ID: 0958795
Sex: M
Age:
State: MD

Vax Date:
Onset Date: 12/30/2020
Rec V Date: 01/17/2021
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:

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

Symptoms: Follow up: Patient received casirivimab instead of intended COVID vaccine. At 48-hr follow up, patient reported arm soreness. Patient received COVID vaccine on December 31

Other Meds:

Current Illness:

ID: 0958796
Sex: M
Age:
State: MD

Vax Date:
Onset Date: 12/30/2020
Rec V Date: 01/17/2021
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: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: Follow up to FAERS18694343: Patient received casirivimab instead of intended COVID vaccine. 48-hr follow up didn't identify AEs. Patient Patient received COVID vaccine on December 31

Other Meds: Casirivimab, EUA

Current Illness:

ID: 0958797
Sex: M
Age:
State: MD

Vax Date:
Onset Date: 12/30/2020
Rec V Date: 01/17/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Follow up to FAERS18694343: Patient received casirivimab instead of intended COVID vaccine. 48-hr follow up didn't identify AEs. Patient Patient received COVID vaccine on December 31

Other Meds: Casirivimab, EUA

Current Illness:

ID: 0958798
Sex: M
Age:
State: MD

Vax Date:
Onset Date: 12/30/2020
Rec V Date: 01/17/2021
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: Follow up to FAERS18694343: Patient received casirivimab instead of intended COVID vaccine. 48-hr follow up didn't identify AEs. Patient Patient received COVID vaccine on December 31

Other Meds: Casirivimab, EUA

Current Illness:

ID: 0958800
Sex: M
Age:
State: MD

Vax Date:
Onset Date: 12/30/2020
Rec V Date: 01/17/2021
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: Follow up to FAERS18694343: Patient received casirivimab instead of intended COVID vaccine. 48-hr follow up didn't identify AEs. Patient Patient received COVID vaccine on December 31

Other Meds: Casirivimab, EUA

Current Illness:

ID: 0958802
Sex: F
Age:
State: MD

Vax Date:
Onset Date: 12/30/2020
Rec V Date: 01/17/2021
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: Follow up to FAERS18694343: Patient received casirivimab instead of intended COVID vaccine. 48-hr follow up didn't identify AEs. Patient Patient received COVID vaccine on December 31

Other Meds: Casirivimab, EUA

Current Illness:

ID: 0958803
Sex: M
Age:
State: MD

Vax Date:
Onset Date: 12/30/2020
Rec V Date: 01/17/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Follow up to FAERS 18694343: Patient received casirivimab instead of intended COVID vaccine. 48-hr follow up didn't identify AEs. Patient received COVID vaccine on December 31

Other Meds: Casirivimab, EUA

Current Illness:

ID: 0960782
Sex: F
Age:
State: MD

Vax Date:
Onset Date: 12/30/2020
Rec V Date: 01/17/2021
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: Follow up to FAERS18694343: Patient received casirivimab instead of intended COVID vaccine. 48-hr follow up didn't identify AEs. Patient Patient received COVID vaccine on December 31

Other Meds: Casirivimab, EUA

Current Illness:

ID: 0960783
Sex: F
Age:
State: MD

Vax Date:
Onset Date: 12/30/2020
Rec V Date: 01/17/2021
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: Follow up to FAERS18694343: Patient received casirivimab instead of intended COVID vaccine. At 48-hr follow up, patient reported arm soreness. Patient received COVID vaccine on December 31

Other Meds: Casirivimab, EUA

Current Illness:

ID: 0960784
Sex: M
Age:
State: MD

Vax Date:
Onset Date: 12/30/2020
Rec V Date: 01/17/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Follow up to FAERS18694343: Patient received casirivimab instead of intended COVID vaccine. 48-hr follow up didn't identify AEs. Patient Patient received COVID vaccine on December 31

Other Meds: Casirivimab, EUA

Current Illness:

ID: 0960785
Sex: F
Age:
State: MD

Vax Date:
Onset Date: 12/30/2020
Rec V Date: 01/17/2021
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: Follow up to FAERS18694343: Patient received casirivimab instead of intended COVID vaccine. 48-hr follow up didn't identify AEs. Patient Patient received COVID vaccine on December 31

Other Meds: Casirivimab, EUA

Current Illness:

ID: 0960786
Sex: F
Age:
State: MD

Vax Date:
Onset Date: 12/30/2020
Rec V Date: 01/17/2021
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: Injection site pain, Menorrhagia

Symptoms: Follow up to FAERS18694343: Patient received casirivimab instead of intended COVID vaccine. 48-hr follow up didn't identify AEs. Patient Patient received COVID vaccine on December 31

Other Meds: Casirivimab, EUA

Current Illness:

ID: 0960787
Sex: M
Age:
State: MD

Vax Date:
Onset Date: 12/30/2020
Rec V Date: 01/17/2021
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: Follow up to FAERS18694343: Patient received casirivimab instead of intended COVID vaccine. 48-hr follow up didn't identify AEs. Patient Patient received COVID vaccine on December 31

Other Meds: Cisirivimab, EUA

Current Illness:

ID: 0960788
Sex: F
Age:
State: MD

Vax Date:
Onset Date: 12/30/2020
Rec V Date: 01/17/2021
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: Follow up to FAERS18694343: Patient received casirivimab instead of intended COVID vaccine. 48-hr follow up didn't identify AEs. Patient Patient received COVID vaccine on December 31

Other Meds: Casirivimab

Current Illness:

ID: 0960791
Sex: F
Age:
State: MD

Vax Date:
Onset Date: 12/30/2020
Rec V Date: 01/17/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Follow up to FAERS18694343: Patient received casirivimab instead of intended COVID vaccine. 48-hr follow up didn't identify AEs. Patient Patient received COVID vaccine on December 31.

Other Meds: Casirivimab, EUA

Current Illness:

ID: 0960798
Sex: M
Age:
State: MD

Vax Date:
Onset Date: 12/30/2020
Rec V Date: 01/17/2021
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: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: Follow up to FAERS18694343: Patient received casirivimab instead of intended COVID vaccine. 48-hr follow up didn't identify AEs. Patient Patient received COVID vaccine on December 31

Other Meds:

Current Illness:

ID: 0960800
Sex: M
Age:
State: MD

Vax Date:
Onset Date: 12/30/2020
Rec V Date: 01/17/2021
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: Nausea

Symptoms: Follow up to FAERS18694343: Patient received casirivimab instead of intended COVID vaccine. 48-hr follow up didn't identify AEs. Patient Patient received COVID vaccine on December 31

Other Meds: Casirivimab, EUA

Current Illness:

ID: 0960811
Sex: M
Age:
State: MD

Vax Date:
Onset Date: 12/30/2020
Rec V Date: 01/17/2021
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: Patient received casirivimab instead of intended COVID vaccine. 48-hr follow up didn't identify AEs. Patient received COVID vaccine on December 31

Other Meds: casirivimab

Current Illness:

ID: 1279625
Sex: U
Age: 70
State: FL

Vax Date: 01/08/2021
Onset Date: 01/10/2021
Rec V Date: 01/17/2021
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: Shingles in scalp, Forehead and upper eye

Other Meds: Baby aspirin 81 ROSUVASTATIN 10MG ARmOUR THYROID 75mg

Current Illness: NONE

ID: 0951799
Sex: F
Age: 56
State: MO

Vax Date: 12/29/2020
Onset Date: 01/01/2021
Rec V Date: 01/18/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Phenergan Dm

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

Symptoms: The patient received her first Moderna COVID-19 vaccination on 12/29/2020. However the patient was diagnosed with a positive COVID-19 test on January 4, 2021. Patient complained of nausea, vomiting, back pain, and sharp chest pain. On January 13, the patient presented to the emergency department again with shortness of breath and sharp, stabbing left-sided chest pain radiating to her back and right side. Initial work up ruled out cardiac etiologies. CTA chest demonstrated COVID-19 pneumonia. The patient complained of bilateral lower extremity weakness which had been progressing since her COVID-19 vaccination, per patient report. However, during her hospitalization the patient's bilateral lower extremity weakness began to accelerate. On the 13th, the patient was able to ambulate to and from the bathroom herself. Then on January 14 the patient required maximum assistance. Neurology was consulted and work up initiated for suspected possible Guillain-Barr? syndrome (GBS) secondary to recent COVID-19 infection. On January 15, 2021, the patient became obtunded and unable to protect airway. She was emergently intubated for acute hypercapnic respiratory failure secondary to GBS. Neurology started GBS treatment with IVIG. Patient also developed NSTEMI and Takotsubo cardiomyopathy. Patient remains critically ill requiring mechanical ventilation.

Other Meds: atorvastatin (LIPITOR) 10 MG tablet glipiZIDE (GLUCOTROL XL) 10 MG 24 hr tablet losartan (COZAAR) 25 MG tablet metformin (GLUCOPHAGE) 1000 mg tablet pantoprazole (PROTONIX) 40 mg tablets

Current Illness:

ID: 0951800
Sex: F
Age: 59
State: OR

Vax Date: 01/16/2021
Onset Date: 01/17/2021
Rec V Date: 01/18/2021
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: amoxicillin

Symptom List: Tremor

Symptoms: Premedicated with Ibuprofen 400mg about 2 hours before injection yesterday. Woke up this morning with chills, low grade fever, mild nausea, a headache, and a very sore arm. By late morning I had a fever of 100.9 and a severe headache. Early afternoon fever went up to 102.1. At this time I took ibuprofen 400mg and sumaptriptan 100mg. Fever came down and heaeache lessened.

Other Meds: ecitalipram, sumatriptan prn, ibuprofen prn

Current Illness: 0

ID: 0951801
Sex: F
Age: 26
State: AZ

Vax Date: 01/15/2021
Onset Date: 01/16/2021
Rec V Date: 01/18/2021
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: Any antibiotics ending in -icillin and beginning with sulfa (ie. penicillin, amoxicillin, sulfa meth etc.)

Symptom List: Erythema, Pruritus

Symptoms: I got the shot around 4:30PM on Friday and woke up in the middle of the night that night with a fever (100.5) and aches. I had both symptoms all through Saturday as well. I was also very tired and slept most of the day Saturday. When I woke up on Sunday I felt totally fine again.

Other Meds: None

Current Illness: None

ID: 0951802
Sex: F
Age: 35
State: VA

Vax Date: 01/11/2021
Onset Date: 01/11/2021
Rec V Date: 01/18/2021
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: None

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

Symptoms: Started feeling hot, redness all over body and itching that lasted 24 hours. Bilateral neck itching/redness and hives remain. Still occurring 1 week after vaccine. Worse at night.

Other Meds: Synthroid

Current Illness: None

ID: 0951803
Sex: M
Age: 51
State: CA

Vax Date: 01/05/2021
Onset Date: 01/14/2021
Rec V Date: 01/18/2021
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: NKDA mild dairy/lactose intolerance

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

Symptoms: Did not notice until January 13th, but there is about a one to one and half inch length strip by 1/2 inch wide of discoloration running anterior to the injection side of my arm, where it is slightly discolored. I would almost call it slightly jaundiced in color to a slight bruising in color. The area is not sore to the touch, nor warm nor itchy. I noticed it perhaps last week around January 13th, so it could have been there longer. No need for medical care nor intervention. Thought it might be worth reporting. I have had bruising before from a vaccine or blood draw, and this length of discoloration is too long to be bruising. I do not bruise easily nor have any type of coagulation disorder.

Other Meds:

Current Illness: none

ID: 0951804
Sex: F
Age: 40
State: NH

Vax Date: 01/17/2021
Onset Date: 01/17/2021
Rec V Date: 01/18/2021
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: Asthenia, Chills, Headache, Myalgia

Symptoms: Swollen arm Pain and tenderness at injection site

Other Meds: Zoloft Adderall Kevia

Current Illness: None

ID: 0951805
Sex: F
Age: 42
State: CA

Vax Date: 01/08/2021
Onset Date: 01/10/2021
Rec V Date: 01/18/2021
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: Penicillin, Bactrim, pollen

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

Symptoms: Infection in left eye, possibly resulting in cellulitis in surrounding area, treated with erythromycin ointment and keflex oral antibiotic. Eye tenderness began evening of 1/10/21 and became severe by 1/12/21. I have never experienced such a severe eye infection before.

Other Meds: Zoloft, Zyrtec, Flonase

Current Illness: None

ID: 0951806
Sex: F
Age: 42
State: KS

Vax Date: 01/15/2021
Onset Date: 01/15/2021
Rec V Date: 01/18/2021
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: penicillin

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

Symptoms: nausea, dizziness, pain at injection site, sleepy/lethargic

Other Meds:

Current Illness: none

ID: 0951807
Sex: F
Age: 45
State: CA

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 01/18/2021
Hospital:

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

Lab Data:

Allergies: Soy, amoxicillin, latex, Vicodin

Symptom List: Pain in extremity

Symptoms: Itching, rash, hives, difficulty breathing, difficulty swallowing, anaphylactic response. Treatment: epipen, IM Benedryl shot x2, ambulance transport to ER at Hospital for monitoring Outcome- deduced symptoms and eventual absence of symptoms 24 hours later

Other Meds: None

Current Illness: None

ID: 0951808
Sex: F
Age: 37
State: CT

Vax Date: 01/06/2021
Onset Date: 01/13/2021
Rec V Date: 01/18/2021
Hospital:

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

Lab Data:

Allergies: Amoxicillin, Shell fish, and environmental allergies

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

Symptoms: IM injection was given to my Left arm. Initial injection site was redden with small circular rash the size of a quarter. As the days progress the size of the rash has increased in size. Warm to touch, still red, itches and is still tender to touch.

Other Meds: Xyzal 5 mg, Singulair 10 mg, Lisinopril 10 mg.

Current Illness:

ID: 0951809
Sex: F
Age: 20
State: CA

Vax Date: 01/15/2021
Onset Date: 01/17/2021
Rec V Date: 01/18/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Unk

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

Symptoms: " Moderna Covid-19 Vaccine EUA" Headache and a rash with itchiness.

Other Meds: Unknown

Current Illness: Unk

ID: 0951810
Sex: F
Age: 48
State: CA

Vax Date: 01/13/2021
Onset Date: 01/14/2021
Rec V Date: 01/18/2021
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: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: Fever 99.7 Fast heart beat Body aches Chills For 24 hours Sore arm 4 days and counting

Other Meds: None

Current Illness: None

ID: 0951811
Sex: F
Age: 22
State:

Vax Date: 01/10/2021
Onset Date: 01/11/2021
Rec V Date: 01/18/2021
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:

Symptom List: Vomiting

Symptoms: episode of syncope ~15 hours after vaccine administration (next morning). sudden onset of lightheadedness which persisted for few minutes then lost consciousness. have never fainted before. tests in ER suggest low blood pressure but nothing else abnormal.

Other Meds:

Current Illness:

ID: 0951812
Sex: F
Age: 47
State: NY

Vax Date: 01/17/2021
Onset Date: 01/17/2021
Rec V Date: 01/18/2021
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: Adhesive on band aids

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: -About 5 minutes after receiving vaccine I began to cough continuously. At 15 minutes after receiving vaccine my tongue was tingling, my throat got tight, my mouth and jaw felt weird. - I took liquid Benadryl 10 ml. -About 50 minutes after receiving vaccine the tingling, and funny feeling in mouth began to subside. - my cough became less frequent. - it is 1:30 am on 1/18/21 and I cough often

Other Meds: None

Current Illness: Covid

ID: 0951813
Sex: F
Age: 93
State: CA

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/18/2021
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: lost of appetite

Other Meds:

Current Illness:

ID: 0951814
Sex: M
Age: 33
State: NV

Vax Date: 01/14/2021
Onset Date: 01/15/2021
Rec V Date: 01/18/2021
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: NKDA

Symptom List: Injection site swelling, Limb discomfort

Symptoms: I have had a constant pressure pain on my left eye which increases in pain when I close my eyes. It is only on my left eye. I had a continuous pressure headache two days post vaccine, but subsided on the third day. Injection side soreness for two days starting the day of administration.

Other Meds: None

Current Illness: None

ID: 0951815
Sex: F
Age: 93
State:

Vax Date: 01/12/2021
Onset Date: 01/13/2021
Rec V Date: 01/18/2021
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: Headache

Other Meds:

Current Illness:

ID: 0951816
Sex: F
Age: 25
State: NJ

Vax Date: 01/12/2021
Onset Date: 01/13/2021
Rec V Date: 01/18/2021
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: Latex Sugar alcohols/alternatives Sucralose Banana Pinapple Bactrim Hanes elastic underwear Adhesives

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

Symptoms: Aches, chills, loss of consious (passing out 1/13) lock jaw bilaterally, lumbar pain with swelling (unable to see spine anymore), body sweats, dizziness. Lasting 24 hours, 3 doses of benadryl

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm