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: 0920415
Sex: F
Age: 41
State: MA

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 01/05/2021
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: Recipient reported chest tightness, throat closing up, tachycardia, feeling flush approximately 2 minutes after vaccine administration. B/P- 162/76, HR- 124, O2 sat. 100%. She was taken to our outpatient clinic for close monitoring. Some symptoms were resolving. She reported right and then left arm numbness with a heavy feeling in her left eye. She remained in the outpatient department for monitoring until approximately 3p last set of vital signs B/P- 109/72, HR- 16, O2 sat. 100%

Other Meds:

Current Illness:

ID: 0920416
Sex: F
Age: 62
State: SD

Vax Date: 12/27/2020
Onset Date: 12/28/2020
Rec V Date: 01/05/2021
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: nka

Symptom List: Anxiety, Dyspnoea

Symptoms: chills, fever 101, sore swollen right arm at injection site, achy flu like symptoms, headache starting 12/28/20 in the morning until approximately 4:30 pm

Other Meds: crestor,asa,sertraline,omeprazole

Current Illness: Recovering from Covid November 4 2020

ID: 0920417
Sex: M
Age: 25
State: MA

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 01/05/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: I am experiencing Chills, Fatigue, Aches, soreness at injection site

Other Meds:

Current Illness:

ID: 0920418
Sex: F
Age: 27
State: WI

Vax Date: 12/26/2020
Onset Date: 12/30/2020
Rec V Date: 01/05/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Patient received a dose of vaccine that may be less than completely effective due to storage conditions. No adverse effects reported.

Other Meds:

Current Illness:

ID: 0920419
Sex: F
Age: 51
State: IL

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 01/05/2021
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: Sore at injection site, headache, dizziness

Other Meds: Metoprolol Tartate, Vitamin B complex, Zinc, Apple Cider Gummies

Current Illness:

ID: 0920420
Sex: F
Age: 33
State: NC

Vax Date: 12/22/2020
Onset Date: 12/29/2020
Rec V Date: 01/05/2021
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: NKA

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

Symptoms: Injection received in left upper arm. Injection site was quite low on the arm. Redness, swelling, and warm to touch.

Other Meds: None

Current Illness: NOne

ID: 0920421
Sex: F
Age: 46
State: NJ

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 01/05/2021
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: Pyrexia, White blood cell count decreased

Symptoms: fever, body aches, chills, fatigue

Other Meds: none

Current Illness: I had a runny nose

ID: 0920423
Sex: F
Age: 37
State: PA

Vax Date: 12/11/2020
Onset Date: 12/11/2020
Rec V Date: 01/05/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Pharyngeal swelling

Symptoms: Flu shot was administered, pain at injection site deep in the arm was immediate as soon as entire needle was inserted. Pain increased over the following weeks inside arm at injection site. No redness or swelling visible, not sore to the touch (outside). Pain prevented movement, cannot put weight on arm, difficulty sleeping due to pain and discomfort in arm, frequent numbness and tingling in right pinkie and ring finger. Seen by PCP at 24 days, PCP believes rotator cuff muscle was damaged during the injection, prescribed Meloxicam for two weeks to reduce inflammation, and patient was given exercises to start one week after start of medication.

Other Meds: Norethisterone

Current Illness: None

ID: 0920424
Sex: F
Age: 45
State: WI

Vax Date: 12/26/2020
Onset Date: 12/30/2020
Rec V Date: 01/05/2021
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: Patient received a dose of vaccine that may be less than completely effective due to storage conditions. No adverse effects reported.

Other Meds:

Current Illness:

ID: 0920425
Sex: F
Age: 51
State: PA

Vax Date: 09/11/2020
Onset Date: 09/11/2020
Rec V Date: 01/05/2021
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: Penicillin

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Patient states that they immediately had shoulder and neck pain. This has lasted for 3 months now.

Other Meds: N/A

Current Illness: None

ID: 0920426
Sex: M
Age: 26
State: FL

Vax Date: 12/30/2020
Onset Date: 01/05/2021
Rec V Date: 01/05/2021
Hospital:

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

Lab Data:

Allergies: NKDA

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

Symptoms: Big red circle around injection site occuring 6 days after vaccination.

Other Meds: Finasteride 1mg Albuterol PRN

Current Illness: N/A

ID: 0920427
Sex: F
Age: 57
State: OH

Vax Date: 12/26/2020
Onset Date: 01/04/2021
Rec V Date: 01/05/2021
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: Noticed some itching on my left arm at injection site and there was 3 large sized welts/hives on that area of my arm. They were itching, red, raised and slightly warm. Seen by CNP 1/4/21 Advised to take benedryl. Took some that night . This morning still have the 3 welts and still red but, the itching is not as bad as yesterday.

Other Meds: Gabapentin, Tramadol, Atenolo and Hydrochlorathiazide and Vitamin B

Current Illness: None

ID: 0920428
Sex: F
Age: 47
State: TX

Vax Date: 12/31/2020
Onset Date: 12/31/2020
Rec V Date: 01/05/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: Within 5 minutes of the vaccine given, tingling sensation down both arms, up the trunk to the back of the throat, metal taste in mouth, immediately started coughing, tickle at the back of the throat, pulse elevated at 110. O2 sats remained 95%-98%, monitored by paramedic for 20 minutes, 2 Benadryl (50mg), cough subsided, notified (primary doctor) started on Zyrtec 4x/day, Allegra 180 mg BID, Benadryl prn, continue this regimen for 3 days, ( improvement with cough when taking medication) Heart rate remains 80-90's, higher than baseline, instructed to start steroid dose pack on January 5th, pulse 100's, continued cough.

Other Meds: Vitamin C, Vitamin D, Probiotic, Viracid

Current Illness: none

ID: 0920429
Sex: F
Age: 57
State: NC

Vax Date: 01/03/2021
Onset Date: 01/04/2021
Rec V Date: 01/05/2021
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: Lisinopril, Darvocet

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

Symptoms: 01/04/2021 pt was feeling light headed and not "herself"' prior to 09:00PM pt fell and loss consciousness. Pt was aroused by Spouse to awake after fall and checked pt blood pressure 115/63 and sugar levels 93. Pt feeling weakness afterwards, pain in back and neck from fall. Awaiting calls from PCP and Neurologist for appointments.

Other Meds: levothyroxine, Fluoxetine HCL, Amlodipine 5 mg, Saxenda 3 mg, Mulitivitamin, B12

Current Illness: N/A

ID: 0920430
Sex: M
Age: 42
State: WI

Vax Date: 12/26/2020
Onset Date: 12/30/2020
Rec V Date: 01/05/2021
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: Patient received a dose of vaccine that may be less than completely effective due to storage conditions. No adverse effect reported.

Other Meds:

Current Illness:

ID: 0920431
Sex: F
Age: 42
State: KS

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 01/05/2021
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: Trees, wheat, yeast, corn, dogs, cats, feathers, horses,molds, grass, effexor, sulfa, erythromycin, PCN, nuts, hydroxyzine

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

Symptoms: Patient took ibuprofen, 2 zyrtec, 2 pepcid and ubrelvy that morningat 7am. Injection was administered at 9:30am, reaction started at 09:45am increased phelgm, severe migraine, tightness in chest, tongue swelling face swelling, patient took 4 zyrtec, 4 pepcid, ubrelvy. By 4pm tightness of chest and increased mucus subsides. That evening patient took 2 zyrtec 2 pepcid, 2 benadryl that evening, continued to have severe migraines, face and tongue swelling until 1/5/2021.

Other Meds: Zyrtec, pepcid, ubrelvy, ibuprofen

Current Illness: Flu A 12/17/2020

ID: 0920432
Sex: F
Age: 41
State: MA

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 01/05/2021
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: Recipient reported symptoms of chest tightness, throat closing up, tachycardia and feeling flush approximately 2 minutes after the vaccine administration. She was taken to our outpatient clinic for continued observation. Vital signs: B/P 162/76, HR-124, O2- 100% she had relief of some symptoms but also reported right then left arm numbness and heaviness of the left eye. She was monitored for until approximately 3p. Last set of vital signs: B/P 10/72, HR- 81, O2- 100%.

Other Meds:

Current Illness:

ID: 0920433
Sex: F
Age: 31
State: TN

Vax Date: 12/29/2020
Onset Date: 12/30/2020
Rec V Date: 01/05/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Solitary enlarged lymph node in left posterior cervical chain, approximately 2 cm in diameter, nontender. Enlargement initially felt the morning after receiving the vaccine. The lymph node continued to enlarge for several days and has remained 2 cm (visible bulge) at 7 days post-vaccination. No other cervical or axillary lymphadenopathy. Left arm sore for 24 hours post vaccination. No other swelling, redness, systemic or local reactions.

Other Meds: None

Current Illness: None

ID: 0920435
Sex: F
Age: 38
State: MO

Vax Date: 12/22/2020
Onset Date: 12/24/2020
Rec V Date: 01/05/2021
Hospital:

Vax Type: PNC13
Manufacturer: PFIZER\WYETH
Vax Name: PNEUMO (PREVNAR13)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies: Wellbutrin, Norco and Percocet

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Pt appears to suffer from a localized reaction that appears to be cellulitis nine days post injection. Per the patient she started having symptoms a few days post injection but did not have the pain, induration and warmth that she had when she made her appointment here at the clinic.

Other Meds:

Current Illness:

ID: 0920436
Sex: M
Age: 63
State: WI

Vax Date: 12/26/2020
Onset Date: 12/30/2020
Rec V Date: 01/05/2021
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: Patient received a dose of vaccine that may be less than completely effective due to storage conditions. No adverse effect reported.

Other Meds:

Current Illness:

ID: 0920437
Sex: F
Age: 23
State: MA

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/05/2021
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: NKA

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

Symptoms: Patient vaccinated at 1727 in COVID vaccine clinic, reported feeling like "my throat is closing" at 1739. This RN assessed for airway compromise and took VS (O2 sat: 98%, BP: 122/80 (RUA), RR: 16, HR:75 bpm). Patient observed for 30 min, patient received water and remained seated. No further reports of symptoms/adverse reactions prior to leaving clinic around 1800.

Other Meds: None

Current Illness: None

ID: 0920438
Sex: M
Age: 38
State: IL

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 01/05/2021
Hospital:

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

Lab Data:

Allergies: Ceftriaxone IV

Symptom List: Unevaluable event

Symptoms: Sore injection site, Dizziness, Headache, Body malaise

Other Meds: Vit C, Vit E, Vit D3, Antihistamine

Current Illness: None

ID: 0920439
Sex: F
Age: 37
State: VA

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 01/05/2021
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: Allergic to all cillins (penicillin, ampicillin, etc) and cyclosporine. Sensitive to sulfa drugs and bactrum,

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

Symptoms: Fever (up to 101.7), burning on skin throughout body (arms, legs and face), nausea, headache, chills, dizziness

Other Meds: None

Current Illness: None

ID: 0920440
Sex: F
Age: 31
State: KY

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 01/05/2021
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: Dopamine

Symptom List: Injection site pain, Pain

Symptoms: As entered by RN into Medical Record: Patient stated that she felt dizzy when she stood up. Patient's blood pressure elevated to 130's/100's, down at discharge to 126/92. Pulse rate was high at 132 about 10 minutes after injection. Patient stated that she had a cardiac ablation done in 2016 and currently takes propranolol BID. Last dose taken was 0800 with food. Per patients watch HR prior to vaccination was in the 60's. Patient was held for 45 minutes with no change in B/P or pulse rate. Family Provider notified, per PA have patient monitor for a couple of hours at home if able to drive and return to ER if not any better. Provider instructed patient not to take another dose of her beta blocker at this time. Patient was instructed to call clinic with any other issues. V/S at discharge 126/92 pulse 120. Called patient in the evening on 12/29/2020 at 7:30 pm. She stated she did feel better but still had a "jittery" feeling and HR was still in the 120's per her watch reading. No SOA reported. Did report some nausea. Patient did not feel in distress. Instructed in symptoms continued to visit the ER. 12/30/2020 at 0848 visited Medical Center for tachycardia and HTN. Prescribed steroids and metoprolol.

Other Meds: Xanax, Nortriptyline Hcl, Nexium, Keppra, Topiramate, Propranolol Hcl, Emgality, Abilify, Ondansentron, Rimegepant Sulfate

Current Illness: None known

ID: 0920441
Sex: F
Age: 47
State: NY

Vax Date: 12/27/2020
Onset Date: 01/04/2021
Rec V Date: 01/05/2021
Hospital:

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

Lab Data:

Allergies: Sulfa drugs

Symptom List: Injection site pain, Menorrhagia

Symptoms: Pruritus, redness, dermatographia, warmth, swelling, tenderness at injection site.

Other Meds: Microgestin Fe 1.5/30, Celexa 30mg daily, Iron supplement

Current Illness: none

ID: 0920442
Sex: F
Age: 51
State:

Vax Date: 01/04/2021
Onset Date: 01/05/2021
Rec V Date: 01/05/2021
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: Patient reports fever, body aches, headache, and small/mild amount of chest pain

Other Meds:

Current Illness:

ID: 0920443
Sex: F
Age: 34
State: FL

Vax Date: 12/26/2020
Onset Date: 12/26/2020
Rec V Date: 01/05/2021
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: Dust, cat dander, pollen and soy milk

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Moderna COVID?19 Vaccine EUA given on 12/26/2020 - No allergic reactions or any expected side effects , except for localized dull back pain in the lumbar region. Eleven days after vaccination (01/05/2021) the pain remains constant. Patient is certain no physical activity or unrelated event caused the back pain. Primary care physician is not knowledgeable if Covid 19 vaccine can cause such pain. Patient was referred to PT and/or acupuncture.

Other Meds: None

Current Illness: None

ID: 0920445
Sex: M
Age: 27
State:

Vax Date: 01/03/2021
Onset Date: 01/04/2021
Rec V Date: 01/05/2021
Hospital:

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

Lab Data:

Allergies: Augmentin

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Axillary swelling, severe pain at the site of injection, axillary lymphadenopathy

Other Meds: Humira, Mirtazapine

Current Illness:

ID: 0920446
Sex: F
Age: 61
State: WI

Vax Date: 12/26/2020
Onset Date: 12/30/2020
Rec V Date: 01/05/2021
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: Patient received a dose of vaccine that may be less than completely effective due to storage conditions. No adverse effects reported.

Other Meds:

Current Illness:

ID: 0920447
Sex: U
Age: 43
State: TX

Vax Date: 12/31/2020
Onset Date: 01/05/2021
Rec V Date: 01/05/2021
Hospital:

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

Lab Data:

Allergies: No known allergies.

Symptom List: Nausea

Symptoms: Swelling to left forearm, wrist, and hand.

Other Meds: Unknown.

Current Illness: Unknown.

ID: 0920448
Sex: F
Age: 39
State: NC

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

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

Lab Data:

Allergies: NKDA

Symptom List: Injection site pain

Symptoms: Slight numbness and swelling left side of upper lip half an hour after first injection. Patient observed for an additional 45 minutes after symptoms. Symptoms did not progress. Patient advised to continue to monitor symptoms and if swelling or numbness progress to seek medical attention immediately. Patient returned to work.

Other Meds:

Current Illness: none

ID: 0920449
Sex: F
Age: 24
State: WI

Vax Date: 01/04/2021
Onset Date: 01/05/2021
Rec V Date: 01/05/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Fever of 101 degrees and headache

Other Meds:

Current Illness:

ID: 0920450
Sex: F
Age: 91
State: TX

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 01/05/2021
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: No known allergies

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

Symptoms: Redness and irritation around the injection site, feels warm to the touch, is sore and aches a little bit.

Other Meds: amlodipine 10mg, meclizine 25mg

Current Illness: None

ID: 0920451
Sex: F
Age: 51
State: NJ

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 01/05/2021
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: achy, chills, fatigue, headache starting a few hours after vaccine. Resolved with sleep, tea and over the counter Sudafed 4 hour night time with ibuprofen.

Other Meds: Tylenol pm the night before - 24 hour, fish oil, vitamin d, magnesium, Colace and collagen

Current Illness: Was achy the night before the vaccine which is why I had taken Tylenol pm. I believed achiness was related to a yoga class I had taken

ID: 0920472
Sex: F
Age: 56
State: CA

Vax Date: 12/31/2020
Onset Date: 01/01/2021
Rec V Date: 01/05/2021
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: Erythema, Pruritus

Symptoms: Fatigue Weakness in left leg

Other Meds:

Current Illness:

ID: 0920473
Sex: F
Age: 0
State: CA

Vax Date: 06/17/1993
Onset Date: 01/11/2000
Rec V Date: 01/05/2021
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: Now dealing with fibromyalgia, anxiety, depression

Other Meds: None

Current Illness: None

ID: 0920474
Sex: F
Age: 30
State: IL

Vax Date: 01/04/2021
Onset Date: 01/05/2021
Rec V Date: 01/05/2021
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: NKA

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

Symptoms: Body ache, Chills, Headache, Nausea, Sore at Injection Site

Other Meds: depro provera

Current Illness:

ID: 0920475
Sex: F
Age: 46
State: GA

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 01/05/2021
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: nausea, numbness & tingling of mouth/tongue

Other Meds:

Current Illness:

ID: 0920477
Sex: F
Age: 32
State: MO

Vax Date: 12/23/2020
Onset Date: 12/23/2020
Rec V Date: 01/05/2021
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: CONTRAST DYE; ENVIRONMENTAL ALLERGIES

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

Symptoms: 12/23/2020 VACCINATION. 20 MINUTES LATER STARTED TO EXPERIENCE AE . MY FIRST REACTION WAS MY HEAD FELT HOT; WAS TOLD IT WAS NORMAL. 21 MINUTES; GOOSEBUMPS, SPREAD OVER ALL OVER BODY. DIDN'T GO AWAY FOR 3 HOURS. ABOUT 25 MINUTES AFTER, ON VITAL MACHINE. BP WAS 185/105 (HIGHEST EVER, ABNORMAL). FULL ALLERGIC REACTION. RUSHED TO ER. BENADRYL, PREDNISON. ITCHING STARTED, HIVES. STARTED TO GET SUPER ITCHY. HAS BEEN ON AND OFF FROM THEN TO PRESENT DAY. 12/24/2020 SENT HOME. ACHINESS AT SITE. WORST DAY OUT OF ALL OF THEM. I COULDN'T EVEN SIT UP; I FELT LIKE I HAD 'RIGAMORTOUS', COULDN'T EVEN MOVE MY PINKY. CALLED INTO WORK, LOST MY BONUS DUE TO THIS. 12/25/2020 - COULDNT MOVE. REGRET VACCINE MORE THEN ANYTHING 12/26/2020 CHILLS. NO FEVER. BODY ACHES. NAUSEA STARTED; SO BAD I DIDN'T EAT FROM DAY 3-DAY 6. LEFT ARM FELT 'DEAD'. 12/27/2020 - SYMPTOMS CONSISTED EACH DAY. SWELLING STARTED ON WHOLE LEFT SIDE OF MY BODY. TRIED TO GO TO WORK. MADE IT 2 HOURS BUT SWELLING WAS SO BAD. SENT TO ER. REFERRED TO DR IN HOSPITAL. PRESCRIBED 7 DAY PREDNISONE. FELT BETTER WITH THE STEROIDS. EVERYTING HAS SLOWLY TAPERED OFF REFERRED TO DR ARM STILL HURTING 11 DAYS LATER, LINGERING AFFECTS

Other Meds: N/A

Current Illness: N/A

ID: 0920478
Sex: F
Age: 54
State: LA

Vax Date: 12/16/2020
Onset Date: 12/22/2020
Rec V Date: 01/05/2021
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: When I first received shot my left arm start hurting. I was in contact with someone that had COVID-19 , which I was tested positive with COVID-19.

Other Meds: Norvasc, lipitor

Current Illness: None

ID: 0920479
Sex: F
Age: 52
State: VA

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 01/05/2021
Hospital:

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

Lab Data:

Allergies: Amoxicillin

Symptom List: Pain in extremity

Symptoms: Client reported developing a headache approximately 30 min. after receiving vaccine for which she took 2 Tylenol. At 2:20, B/P was 190/100, HR 84, and O2 sat 99%. At 2:28, B/P was 200/110, HR 86, and O2 sat was 99%. Client refused ambulance and her husband picked her up at 2:31. He reported that he would take her to the MD or ER.

Other Meds: Client states "I'm on a beta blocker."

Current Illness: None stated

ID: 0920480
Sex: F
Age: 28
State: OH

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

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

Lab Data:

Allergies: No

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

Symptoms: About 30-35 mins, after vax, I started noticing my eyes were itching, and I started scratching my face. I got in my car and realized it's not going away. I need advice on what to take for it to go away. I noticed a itchy throat. Not sure if it's something that's due to the vaccine.

Other Meds: No

Current Illness: No

ID: 0920481
Sex: F
Age: 34
State: IN

Vax Date: 01/05/2021
Onset Date: 01/05/2021
Rec V Date: 01/05/2021
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: Anxiety, clammy skin, minor throat swelling, tachycardia

Other Meds: Allegra Birth Control Pill

Current Illness: none

ID: 0920482
Sex: M
Age: 32
State: ME

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 01/05/2021
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: Dilaudid

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

Symptoms: Lips began to tingle and then went numb. Face became warm and itchy. Throat scratchy. First signs began about 40 minutes after vaccination and patient went to ER. Was given Slumedrol, Benedryl, & Famotidine in the ER and observed. Symptoms diminished and patient was released the same night.

Other Meds: Vyvanse

Current Illness: None

ID: 0920483
Sex: F
Age: 36
State: TX

Vax Date: 12/19/2020
Onset Date: 12/19/2020
Rec V Date: 01/05/2021
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: none

Symptom List: Vomiting

Symptoms: Begin with localized tenderness and pain at injection site. Progressed to joint pain in the arm, loss of strength, tenderness and inability to move arm.

Other Meds: Accutane 40 mg daily

Current Illness: acne

ID: 0920484
Sex: F
Age: 61
State: MO

Vax Date: 12/31/2020
Onset Date: 01/01/2021
Rec V Date: 01/05/2021
Hospital:

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

Lab Data:

Allergies: sulfa

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: severe vertigo could not lift head off pillow without retching lasted 12 hrs

Other Meds:

Current Illness:

ID: 0920487
Sex: M
Age: 59
State: PR

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 01/05/2021
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: Crab

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

Symptoms: Low grade fever , joint and muscular pain

Other Meds: None

Current Illness: Hypertension

ID: 0920488
Sex: F
Age: 65
State: MO

Vax Date: 12/23/2020
Onset Date: 12/23/2020
Rec V Date: 01/05/2021
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: No Know Allergies

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Red rash a little larger than Silver Dollar with a white ring around it.

Other Meds: Atenolol, Alosetron, Losartan, Mirtazapine, quetiapine, fluoxetine, pantoprazole, Meclizine, Melatonin, Atomoxetine

Current Illness: None known

ID: 0920489
Sex: F
Age: 31
State: PA

Vax Date: 12/29/2020
Onset Date: 12/30/2020
Rec V Date: 01/05/2021
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: Tenderness, warmth, redness and swelling at injection site starting 24 hours post vaccine and self-resolved within 5 days post vaccine. Did NOT require treatment.

Other Meds:

Current Illness:

ID: 0920490
Sex: F
Age: 30
State: MT

Vax Date: 12/30/2020
Onset Date: 12/31/2020
Rec V Date: 01/05/2021
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: knda

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

Symptoms: Very sore arm, swollen. No bruising or redness. Resolved in 2 days. In comparison received Boostrix and quad flu in the past with no soreness.

Other Meds: Nuvaring, escitalopram 10mg

Current Illness: na

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm