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: 0953240
Sex: F
Age: 51
State: MA

Vax Date: 12/28/2020
Onset Date: 12/29/2020
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: LA

Lab Data:

Allergies: Nyquil, Sudafed - give me hyperactivity - tachycardia

Symptom List: Dysphagia, Epiglottitis

Symptoms: The moment I took the vaccine I felt a strange taste in my mouth, and the back of my tongue/throat felt scratchy. I also felt tired that day. The next day I woke up extremely tired, felt like I had dry eyes and some weird color/light coming out of them. I had fever (102F) that is when I called my PCP for a televisit consultation. They told me to take Tylenol. I took it and by night after taking 1000mg dose I started feeling better. I still felt extremely tired when I woke up the next day and that is why I did not go to work. I had covid in 05/2020 ( positive on 05/18/20).

Other Meds: multivitamins, Vitamin D

Current Illness: no

ID: 0953241
Sex: F
Age: 26
State: MA

Vax Date: 01/07/2021
Onset Date: 01/15/2021
Rec V Date: 01/18/2021
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: N/A

Symptom List: Anxiety, Dyspnoea

Symptoms: Development of cellulitis at the site of injection roughly 8 days following injection (no symptoms prior). Started as a small raised rash over the injection site, and spread to about a 6 inch radius, raised, red, hot to touch rash. Benadryl and cortisone cream did not work. Urgent care PA prescribed cephalexin 500 mg 4x/day for 1 week 2 days later. Seeing improvements (duller red color, not as raised, diameter remains same so far).

Other Meds: norethindrone (birth control)

Current Illness: N/A

ID: 0953242
Sex: F
Age: 34
State: NY

Vax Date: 01/10/2021
Onset Date: 01/17/2021
Rec V Date: 01/18/2021
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

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

Symptoms: Left arm pit pain with swollen lymph node

Other Meds: Lovonox 60 mg twice a day

Current Illness: None

ID: 0953243
Sex: M
Age:
State: AZ

Vax Date:
Onset Date:
Rec V Date: 01/18/2021
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: None stated.

Other Meds: none

Current Illness:

ID: 0953244
Sex: M
Age: 35
State: VA

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

Lab Data:

Allergies: Sulfa drugs

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

Symptoms: Developed mildly symptomatic COVID after vaccination. 05 Jan 2021: Dose #1 Pfizer vaccine 13 Jan 2021: Asymptomatic military screening performed. 14 Jan 2021: Test result positive with onset of mild symptoms reported. Managed with outpatient care and home isolation.

Other Meds: None reported

Current Illness: None reported

ID: 0953245
Sex: F
Age: 65
State: FL

Vax Date: 01/12/2021
Onset Date: 01/20/2021
Rec V Date: 01/18/2021
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: Sulfa drug

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

Symptoms: I have completely lost all taste and smell

Other Meds: Effexor losartan, toprol, doxycycline Synthroid Vitamin E,,D, potassium, cranberry, biotin

Current Illness: None

ID: 0953246
Sex: F
Age: 39
State: PA

Vax Date: 01/05/2021
Onset Date: 01/12/2021
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: Anaphylaxis to Hazelnut Oral allergy to melons

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Prolonged local reaction. 1 week after injection in left deltoid, there was still very mild induration, overlying erythema about 3cm in diameter, and pruritus at the site of injection.

Other Meds: Prenatal Vitamins PPI

Current Illness: None

ID: 0953247
Sex: F
Age: 37
State: TX

Vax Date: 12/30/2020
Onset Date: 01/07/2021
Rec V Date: 01/18/2021
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: 1/7 : 1 inch in diameter knot, very red, itched like crazy 1/12: 3 in diameter red spot, no knot, did not itch

Other Meds:

Current Illness:

ID: 0953248
Sex: M
Age: 69
State: FL

Vax Date: 01/04/2021
Onset Date: 01/04/2021
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: None

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Two weeks after vaccination still have a rash. The day of the vaccination had chills. Starting to use Hydrocortisone cream today

Other Meds: Potassium citrate, Ashwaganda , lactulose, vitamin D3

Current Illness: None

ID: 0953249
Sex: F
Age: 37
State: TN

Vax Date: 01/12/2021
Onset Date: 01/14/2021
Rec V Date: 01/18/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: unknown

Symptom List: Diarrhoea, Nasal congestion

Symptoms: injection site became red & swollen, the size of a softball. Employee started having seizure like symptoms on 1/14/21 and was admitted to hospital. DC from hospital on 1/16/21 and on 1/17/21 started having seizures again and readmitted back to hospital. Employee has no history of seizures.

Other Meds: unknown

Current Illness: unknown

ID: 0953250
Sex: F
Age: 31
State:

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

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

Lab Data:

Allergies: none

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

Symptoms: Fever, chills, body aches. Took Tylenol and Ibuprofen. Symptoms resolved at 9am 1/16/21.

Other Meds: Prenatal vitamin, singular and folic acid

Current Illness: none

ID: 0953251
Sex: F
Age: 33
State: NH

Vax Date: 01/05/2021
Onset Date: 01/12/2021
Rec V Date: 01/18/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Rash, Urticaria

Symptoms: I got my COVID Vaccine on 1/5/2021, I got the moderna vaccine in my L arm. I had a really sore L deltoid on the night of 1/5, took 500mg of Tylenol when I went to bed and my arm has felt fine since. On Tuesday or Wednesday night (1/12 or 1/13) I got a blotchy rash on the L side of my neck, I put hydrocortisone cream on it and it went away, about an hour later my L deltoid was really itchy and red. I again put hydrocortisone cream on it and it went away. I didn?t think much of it, but I developed a red ring on my L deltoid (1/16), and it is slightly inflamed/swollen inside the ring. Otherwise I feel normal, no fever, chills, other rashes, etc. The red ring has now (1/18) gone away. I spoke with my PCP's office who told me to report this.

Other Meds: mono-linyah 28 tablet

Current Illness: none

ID: 0953257
Sex: F
Age: 37
State: MT

Vax Date: 01/12/2021
Onset Date: 01/15/2021
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:

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

Symptoms: "On 1/15/21 my right forearm got a bit of a rash that was raised and red. Little island dots up my right arm, itching in my chest. My right knuckles were red, warm, swollen and sore as well as my left but to a lesser extent. Oddly enough I got all my vaccines in my left arm. On 1/15/21 I also noticed my knees were warm and sore but did not look at them. On 1/17/21...{knees and knuckles} Swelling, redness, hot to the touch, a little sore."

Other Meds:

Current Illness:

ID: 0953258
Sex: F
Age: 37
State: NJ

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: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: SEASONAL

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

Symptoms: AROUND 3PM: FATIGUED AND DIFFICULTY CONCENTRATING. AT 12MIDNIGHT: CHILLS, HEADACHE, JOINT PAIN, TEETH WERE CHATTERING, MUSCLES WERE SORE. STOMACH WAS QUEASY. NEXT DAY: FEELING EXHAUSTED AND "HUNG OVER." WEAK AND ACHY. TOOK IBUPROFEN, REST, AND FLUIDS.

Other Meds: PROZAC 20 MG DAILY

Current Illness: NONE

ID: 0953259
Sex: F
Age: 34
State: WA

Vax Date: 01/06/2021
Onset Date: 01/06/2021
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: penicillin : rash cephalosporin: swelling and rash

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

Symptoms: Head ache evening of vaccination. Lips numb up to nose on 1/6/2021,and intermittently on 1/7/2021. Severe head ache 1/6/2021 with nausea. Continued moderate to severe headache with intermittent nausea. Mild nasal congestion and sneezing.

Other Meds:

Current Illness:

ID: 0953260
Sex: F
Age: 44
State: VA

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: Bananas , kiwi, mushrooms, latex, augmentin.

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

Symptoms: Axilla on right side is swollen with enlarged lymph nodes, redness, warm to touch, and painful.

Other Meds: Celexa, Wellbutrin, Tylenol

Current Illness: None

ID: 0953261
Sex: F
Age: 38
State: MO

Vax Date: 01/09/2021
Onset Date: 01/09/2021
Rec V Date: 01/18/2021
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: Erythromycin, seasonal allergies

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

Symptoms: I received my second COVID-19 vaccine at 820 am on 1/9/2021. I was feeling well, no signs of illness prior to the injection. Around 6 pm I developed at headache, 7 pm developed fevers, chills, and a cough. The fevers, chills, headache, and cough were gone the next day by about 1 pm. The cough returned the following day and persisted getting worse each day leading to wheezing and shortness of breath. I had a negative COVID-19 test and negative chest x-ray. The PCP has diagnosed me with bronchospasms possibly associated with the vaccine as the cough came on following the vaccine. I have no know asthma, but they are also going to rule out an underlying asthma that could have been triggered by the vaccine. I have been taking oral prednisone and using steroid inhalers with significant improvement, but the symptoms have not completely resolved. I am still under the care of my PCP for ongoing management.

Other Meds: Loestrin FE

Current Illness: No illness at the time of or prior to the vaccination

ID: 0953262
Sex: M
Age: 34
State: NJ

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

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

Lab Data:

Allergies: gadolinium

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Pt had chest tightness, diaphoresis, and shortness of breath after receiving the Covid vaccine. Symptoms lasted about 15 minutes then completely resolved. He went to the ED for evaluation. He also had a mild headache, which was treated with Tylenol.

Other Meds: none

Current Illness:

ID: 0953263
Sex: F
Age: 75
State: TX

Vax Date: 01/12/2021
Onset Date: 01/13/2021
Rec V Date: 01/18/2021
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: Pt. states gradually experiencing severe nausea getting worse each day causing problem eating . Pt. concerned regarding symptom because they are prolonged and worsening. Pt. states due to ALS and other conditions needs to eat to to keep weight up .

Other Meds:

Current Illness:

ID: 0953264
Sex: F
Age: 27
State: MD

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

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

Lab Data:

Allergies: Morphine, codiene, polymyxin B, radio contrast dye, and medicine with alcohol

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

Symptoms: 1/15 12:15 pm covid vaccine with moderna 6:16pmtook singular 7:16 pm itchy and tingling of left side of tongue 8:05 Benadryl 50mg 11:00 Benadryl 50 mg 1/16 10am patient first still feeling itching and tingling of left side and tip of tongue with left side of throat. Given prednisone 60mg daily for 5-7 days 1/18 still feeling itching and tingling. Tongue still feels weird. Some dizziness

Other Meds: Montelukast 10mg (started that same day @6:15pm), multivitamin, vitamin D

Current Illness: Seasonal Allergies , tinnitus, lumbar sprain from mva

ID: 0953265
Sex: M
Age: 34
State: CA

Vax Date: 12/24/2020
Onset Date: 12/24/2020
Rec V Date: 01/18/2021
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: Minocycline, medical adhesive

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

Symptoms: Burning throat, ?fuzzy feeling? in throat, panic, hypertension

Other Meds: Atenolol 25mg daily

Current Illness:

ID: 0953266
Sex: F
Age: 36
State: WI

Vax Date: 01/05/2021
Onset Date: 01/06/2021
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: NKDA, allergy to mold and pollen

Symptom List: Unevaluable event

Symptoms: sore arm x 3 days. (starting on night of injection) Chills (starting night of injection) following injection for 24 hours: fever 100.8 F muscle aches extreme fatigue migraine mild shortness of breath

Other Meds: emgality injection once monthly desvenlafaxine 75mg QD vyvanse 30mg QD famotadine xarelto 20mg QD

Current Illness: COVID19 disease from 11/14-11/24

ID: 0953267
Sex: F
Age: 49
State: NH

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

Lab Data:

Allergies: Bactrim, Sulfa

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

Symptoms: Patient received vaccine 13:06, at 13:11 patient reporting some tingling to hands and feeling anxious. Observed for 5 minutes, patient then reports circumoral tingling, and throat tingling. 13:36: Patient reports burning to throat. Call for EMS assistance. HR 90. Color is pink, BP 130/80. No lip or tongue swelling, no urticaria, no chest pain or shortness of breathe. 13:38: Patient reports feeling better, tingling is improving. EMS arrived. Patient reports symptoms almost completely resolved. EMS Paramedic over to assess. Patient refuses EMS transport, states she feels completely recovered. 13:55: Patient discharged, daughter able to drive home.

Other Meds: HCT Singulair Zyrtec, Tramadol, Atorvastatin, Ozempic inject.

Current Illness: NONE

ID: 0953268
Sex: F
Age: 50
State: NC

Vax Date: 01/07/2021
Onset Date: 01/15/2021
Rec V Date: 01/18/2021
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: Penicillin

Symptom List: Injection site pain, Pain

Symptoms: On Friday, Jan. 15th, about a week after receiving the vaccine, the site around the injection became very red, swollen with a lot of heat. The reaction was not present after the vaccine was given (generalized pain in arm the day after vaccine was given but no redness or swelling or heat at injection site). Today is Monday, Jan 18th and the swelling, redness and heat are all still present but not as acute as Friday. Very visible on my arm.

Other Meds: None

Current Illness: None

ID: 0953269
Sex: F
Age: 33
State: CO

Vax Date: 12/23/2020
Onset Date: 12/23/2020
Rec V Date: 01/18/2021
Hospital:

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

Lab Data:

Allergies: Latex

Symptom List: Injection site pain, Menorrhagia

Symptoms: Arm soreness at vaccine site that night; moderate pain. Was exposed to COVID 20 hours after 1st vaccine. Developed symptoms of COVID that Monday - five days after vaccine. Tested COVID positive that same day. Started with headache, then I had a fever over 101. Chills - bad chills. Lost my taste and smell a couple days after that and that lasted a long time (about three days to get smell back and 10 days for taste). Just took Tylenol for the fever and headache. Also got leg pain - muscle type aches - painful - started on the 29th of December. Leg pain lingered and the pain went away by about the 7th of January. Took Tylenol as needed for that pain.

Other Meds: Prenatal Vitamin

Current Illness: no

ID: 0953270
Sex: M
Age: 41
State: CA

Vax Date: 01/09/2021
Onset Date: 01/11/2021
Rec V Date: 01/18/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Rash, swelling and tenderness at injection x 1 week

Other Meds: None

Current Illness: None

ID: 0953271
Sex: F
Age: 50
State: WA

Vax Date: 01/04/2021
Onset Date: 01/17/2021
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: LA

Lab Data:

Allergies: Clavulinic Acid, Adhesive Tape

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Nickel sized lump at injection site still very noticeable 12 days after injection. On Sunday evening around 7, started itching and turning red and the lump was no longer noticeable. By 9 there was a ring of welts around the injection site, with a pale area in the middle about 4 cm in diameter. Red, swollen area was 12x14 cm, extending downward from the site in an L shape. Mild pain and stiffness, very warm to the touch. Took 25 mg of Benadryl at 9 pm with minimal improvement to itching and no other changes to the site. Had been taking my normal meds throughout the day for a migraine that started 1/16, last dose being 600 mg Motrin just before 9 pm 1/17. Given 10 mg IV dexamethasone by mouth around 10:45 pm. At 8 am 1/18, the site was less swollen, had not extended past markings, and was less warm to the touch. Still some mild pain. Prescriptions for Prednisone 20 mg daily x 5 days and Keflex 500 mg QID x 10 days provided.

Other Meds: Fioricet, Excedrin, Motrin, Clonidine, Propranolol, Omeprazole

Current Illness: None

ID: 0953272
Sex: M
Age: 77
State: OR

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

Lab Data:

Allergies: None

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Flu-like symptoms, full body aches, short episodes of afib. I had a cardiac ablation over 10 years ago for afib and take flecainide as a prophylactic. Normally I don't not have any afib and haven't had an episode in several years.

Other Meds: Miripex, Flecaininde, Metroprolol Multi-vitamin

Current Illness: None

ID: 0953273
Sex: F
Age: 21
State: AR

Vax Date: 01/07/2021
Onset Date: 01/08/2021
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: no

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

Symptoms: The second day, headache and nausea but went away. A knot that went away also. Has a hive that's red and hot to the touch.

Other Meds: Tylenol, Meloxicam

Current Illness: no

ID: 0953274
Sex: U
Age:
State:

Vax Date:
Onset Date:
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: Nausea

Symptoms: Mild headache, mild nausea, chills, diarrhea and fatigue--lasted 1 day

Other Meds:

Current Illness:

ID: 0953275
Sex: F
Age: 48
State: NY

Vax Date: 01/06/2021
Onset Date: 01/14/2021
Rec V Date: 01/18/2021
Hospital:

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

Lab Data:

Allergies: shellfish (crab) kiwi latex bananas

Symptom List: Injection site pain

Symptoms: 9 days after vaccine large red, swollen and itchy are on left deltoid area. 10 days later red area much larger and itchy. 12 days later hives on left arm and back torso. Still itchy

Other Meds: Zyrtec

Current Illness: none

ID: 0953276
Sex: F
Age: 36
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: none

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

Symptoms: symptoms started 4-5 hours after the shot was given on Jan, 08 2021, were presented with rash, redness, swelling, pain, itchiness and warm to touch. symptoms are still presenting and not going away with increasing of itchiness, rudeness and swelling especially at night time. treatment: acetaminophen, ibuprofen and ice.

Other Meds: ibuprofen and acetaminophen

Current Illness: none

ID: 0953277
Sex: F
Age: 39
State: LA

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

Lab Data:

Allergies: n/a

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

Symptoms: the following day began running fever over 100; in the evening began having chills, at one point uncontrollable lasting for about 10 minutes. headache on and off x 3 days. severe tenderness and redness at the injection site. redness started out about 5X5, today it is about 10X8

Other Meds: n/a

Current Illness: n/a

ID: 0953278
Sex: M
Age: 34
State: CA

Vax Date: 12/24/2020
Onset Date: 12/24/2020
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: minocycline, medical tape

Symptom List: Tremor

Symptoms: Burning feeling in throat, "fuzzy feeling in throat," panic, hypertension

Other Meds: Atenolol 25mg / daily

Current Illness:

ID: 0953279
Sex: M
Age: 45
State: MI

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

Symptom List: Erythema, Pruritus

Symptoms: injection site itching

Other Meds: unknown

Current Illness: unknown

ID: 0953280
Sex: F
Age: 17
State: CA

Vax Date: 01/16/2021
Onset Date: 01/16/2021
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:

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

Symptoms: Vaccine given outside of indicated age range at community vaccine POD. Patient not displaying any adverse signs/symptoms.

Other Meds:

Current Illness:

ID: 0953281
Sex: F
Age: 54
State: VA

Vax Date: 01/11/2021
Onset Date: 01/12/2021
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:

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

Symptoms: Fever, chills, body aches, malaise, headache

Other Meds:

Current Illness:

ID: 0953282
Sex: F
Age: 17
State: CA

Vax Date: 01/16/2021
Onset Date: 01/16/2021
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:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Vaccine given outside of indicated age range at community vaccine POD. Patient not displaying any adverse signs/symptoms.

Other Meds:

Current Illness:

ID: 0953283
Sex: M
Age: 39
State: OR

Vax Date: 01/01/2021
Onset Date: 01/08/2021
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: PCN

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

Symptoms: 7 days after treatment, injection site became quite erythematous, indurated, and pruritic. resolved with a few antihistamines w/in 24 hours. possible delayed hypersensitivity reaction? i have prednisone and an Epi Pen on hand for shot #2 just in case

Other Meds: none

Current Illness: none

ID: 0953284
Sex: F
Age: 38
State: MT

Vax Date: 01/11/2021
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: Sulfa drugs (anaphylaxis)

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

Symptoms: Patient received first dose of Moderna Covid-19 Immunization vaccination 1/11/2021. Patient reports pruritic red rash that is hot to touch developed 1/15/2021 and has been moving from L. deltoid towards axillary area. Patient reported incident 1/18/2021 reports rash still present. Instructed patient to contact provider.

Other Meds: N/A

Current Illness: N/A

ID: 0953285
Sex: F
Age: 52
State: WA

Vax Date: 12/30/2020
Onset Date: 12/30/2020
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: Tea Tree oil

Symptom List: Pain in extremity

Symptoms: Malaise, headache, fever, chills, sweats x 48-72 hours

Other Meds: Anestrazole Synthroid 1 mcg QD Gabapentin 600 mg QD OsCal 2000U Vit D Doxylamine

Current Illness: N/A

ID: 0953286
Sex: F
Age: 72
State: FL

Vax Date: 01/06/2021
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: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: Penicillin Prilosec

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

Symptoms: Patient had vaccine on 1/6/21 and have three grand mal seizure on 1/12/21. She was hospitalized and return to facility on 1/15/21. Patient does has history of seizure but the last one was three years ago.

Other Meds: Atorvastatin Carvedilol Escitalopram Levetiracetam Sitagliptin Sucralfate

Current Illness: No Only chronic illness

ID: 0953287
Sex: F
Age: 57
State: CA

Vax Date: 01/07/2021
Onset Date: 01/14/2021
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: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: Initial expected side effects of hard mildly painful lump at injection site; mild elevated temp approx 1 degree 1st 24 hours; slight fatigue resolved in 48 hours. Noticed itching on day 8, by day 9 had 14cm warm to the touch red and painful swelling distal to injection site which grew to 21cm over next three days. No fever, headache, or joint pain. Saw urgent care physician on day 11, and am currently on a course of 500mg keflex for 7 days. Arm is still itchy, but less painful, and rednesss seems to be resolving medially. Entire site still warm, but less puffy and painful to pressure. Instructed to follow up with physician if not significantly improved in 48 hours.

Other Meds: none

Current Illness: none

ID: 0953288
Sex: F
Age: 67
State: NC

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

Lab Data:

Allergies:

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

Symptoms: During COVID vaccine observation period patient reported dizziness and light headness, no hives or rash noted. No SOB reported and no wheezing heard. Vitals checked WNL. Pt given juice and educated on reaction and reassurance provided. Pt offered and declines ED assessment.

Other Meds:

Current Illness:

ID: 0953289
Sex: M
Age: 16
State: CA

Vax Date: 01/15/2021
Onset Date: 01/15/2021
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: Vaccine given outside of indicated age range at community vaccine POD. Patient not displaying any adverse signs/symptoms.

Other Meds:

Current Illness:

ID: 0953290
Sex: F
Age: 60
State: NJ

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

Lab Data:

Allergies: Dairy; Iodine; Levaquin; yellowjacket stings

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: SORE ARM 8 HRS POST VACCINE. THEN, HEADACHES AND MALAISE. MINOR BODY ACHES UPON AWAKENING THE NEXT MORNING. ALL LASTED UNTIL ABOUT 28 HRS POST VACCINE.

Other Meds: Sertraline 50 Mg Daily; Probiotic, Multi-Vitamin and Calcium P.

Current Illness: None

ID: 0953291
Sex: F
Age: 52
State: MI

Vax Date: 01/13/2021
Onset Date: 01/14/2021
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: None known

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

Symptoms: Patient reports she had her vaccine on 1/13/21. On 1/14/21 at approximately 9 or 10 am she felt achy muscles, painful joints and all over pain. She reports the pain progressively worsened on Friday and Saturday and Sunday to the point where she was unable to sleep or move from the bed or sofa. She notes she ran a low grade fever up to 99.6 and she also had a headache throughout this time.

Other Meds: Unknown

Current Illness: Yes, Headache

ID: 0953292
Sex: F
Age: 35
State: CA

Vax Date: 01/07/2021
Onset Date: 01/17/2021
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: Benedryl, phenergan

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Rash at injection site started 1 1/2 weeks post injection. Has grown significantly after 1 day.

Other Meds: None

Current Illness: None

ID: 0953293
Sex: F
Age: 60
State: MA

Vax Date: 01/07/2021
Onset Date: 01/15/2021
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: Penicillins Bactrim Sulfa

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

Symptoms: I received the Pfizer COVID-19 vaccine on 1/7/21 which resulted in slight redness and soreness at the site. This gradually dissipated over a few days, but not completely. On Friday, 01/15/21 a couple hours after exercising (elliptical and hand weights) at the site of vaccination was redness, soreness, and heat. Upon waking up Saturday, 01/16/21, the redness, soreness, and heat had increased - area was 6cm x 7cm - contacted pcp and was advised to go to Urgent Care, which I did and was prescribed Doxycycline for possible cellulitis. Today, 01/18/21, sx's have much improved.

Other Meds: Losartan Citalopram Cetirizine

Current Illness: n/a

ID: 0953294
Sex: M
Age: 80
State: MD

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

Lab Data:

Allergies: none

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

Symptoms: pfizer-BioNTechCOVID-19 VaccineEUA daihrea 36 hours posst injection

Other Meds: sinemet gaabapentin

Current Illness: none

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm