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: 0955041
Sex: F
Age: 52
State: NY

Vax Date: 01/18/2021
Onset Date: 01/18/2021
Rec V Date: 01/19/2021
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: Gluten

Symptom List: Dysphagia, Epiglottitis

Symptoms: Patient stated she had a weird feeling in throat and some resistance in swallowing and she had erythema on lower arm. On enhanced observation she became dyspneic and her throat was getting worse and she was having difficulty breathing. She was administered and EpiPen and brought to ED

Other Meds: Famotidine, folic acid, vitamin D, probiotics

Current Illness:

ID: 0955043
Sex: F
Age: 47
State: TX

Vax Date: 01/15/2021
Onset Date: 01/16/2021
Rec V Date: 01/19/2021
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: Severe headache the next day after vaccine, treatment included Aleve PM that evening post vaccine with second day residual headache and today completely resolved. Headache did not interfere with ADLs

Other Meds:

Current Illness:

ID: 0955044
Sex: F
Age: 39
State: UT

Vax Date: 01/12/2021
Onset Date: 01/18/2021
Rec V Date: 01/19/2021
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: Penicillin and amoxicillin Shellfish

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

Symptoms: I had the typical immune system response on Wednesday January 13th with a bump and soreness on the ejection sight, brief chills, slightly elevated temperature, and exhaustion which all lasted for only one day. It did not prevent me from going about my usual daily activities. I still had some soreness on my left arm on Thursday. After that, I have not noticed any other reactions to the vaccination until the evening of Monday January 18th at about 8:00 pm. My left arm started feeling itchy where the injection sight is. By this morning (Tuesday January 19th) the injection sight has become increasingly itchy, and is accompanied by a hard bump and a red spot that is about 3 inches wide and 2 inches tall.

Other Meds: Over-the-counter: Daily multivitamin gummies, daily dose of vitamin D (500 mg), daily Nature Valley blood pressure support Prescription: Twice daily Air duo

Current Illness: None

ID: 0955045
Sex: F
Age: 30
State: KS

Vax Date: 01/14/2021
Onset Date: 01/15/2021
Rec V Date: 01/19/2021
Hospital:

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

Lab Data:

Allergies: Nut allergy

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Localized pain, redness, and swelling at the injection site covering a 2x3 inch area of skin. Did not start until the next morning (1/15/21) and got progressively worse through that day/night. Pain started to subside Sunday morning (01/17/21) but site was still red and slightly swollen. Site is now pink in color and lessened in size (01/19/21) but still tender.

Other Meds: Ibuprofen 800mg, Montelukast, Diltiazem, Minocycline, Atorvastatin, BC pills, Allegra, Sudafed, Omeprazole, Levothyroxine, Multivitamins (gummy), Fish oil

Current Illness: None

ID: 0955047
Sex: F
Age: 43
State: IL

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 01/19/2021
Hospital:

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

Lab Data:

Allergies: milk, wheat, cottonseed, grapefruit, cinnamon, ginger, coffee, sesame, lemon, orange, mango, oysters, cats, penicillin, xopenex, some grasses, trees, flowers and weeds, scents and dust.

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

Symptoms: Approximately 15 minutes after injection I became itchy; the itchiness covered my body from the top of my head to just above my knees. About 5 minutes after that my face became tingly and my breathing became shallow. At this time my blood pressure, pulse ox and pulse were taken. They were all normal, however my breathing was still labored. I used my rescue inhaler, was given a double dose of allergy medicine and 800mg of ibuprofen. Within a couple of minutes my breathing had returned to normal. Approximately 20 hours after injection I suffered from a headache that lasted around 6 hours. I also became very tired; the day of the injection I slept 10 hours and the following day I slept 12 hours. On both occasions I woke up to an alarm, so I have no idea how long I would have slept on my own accord. Final thing to note which may not be related, but merely a coincidence: since receiving the vaccine, I have been unusually thirsty.

Other Meds: Montelukast

Current Illness: Had has an asthma attack on 1/4/21.

ID: 0955048
Sex: M
Age: 57
State: GA

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 01/19/2021
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: None

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

Symptoms: After pt's 15 min of monitoring was over and he was backing up in his vehicle, he became dizzy and pulled back in to see the nurse. States he didn't tell anyone, but immediately after receiving the shot, pt had dull headache, facial tingling and some dizziness. Upon notifying the nurse, he stated he felt like his heart was beating out of his chest, but pulse only 56 and regular (normal rate for him). BP was 180/90 O2 at 96%. (normal BP for pt was 130's/80's). Pt very chatty and nervous, which he said was not normal for him. Stated he felt almost intoxicated or drugged "out of body". Continued to monitor pt and BP trended down (last was 150/82 P56 R16 O2 sat 95-96%). Pt's facial tingling, dizziness resolved, headache improved. Pt stated he almost felt like it was a migraine coming on immediately after getting the shot. Pt refused transport or further evaluation. Pt phoned on 1/14 and he stated his s/s had completely resolved and no further complications.

Other Meds: None

Current Illness: None

ID: 0955049
Sex: F
Age: 59
State: IA

Vax Date: 01/18/2021
Onset Date: 01/19/2021
Rec V Date: 01/19/2021
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: sulfa

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: shortness of breath, chills, body aches

Other Meds: requip, multivitamin, vitamin c, venlafaxine,

Current Illness: none

ID: 0955050
Sex: F
Age: 32
State: ME

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 01/19/2021
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 reported

Symptom List: Pharyngeal swelling

Symptoms: Within moments felt lightheaded, within 10 minutes become tachycardic 120, feeling warm and developed hives.

Other Meds: none reported

Current Illness: none reported

ID: 0955051
Sex: F
Age: 58
State: CA

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 01/19/2021
Hospital:

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

Lab Data:

Allergies: TYLENOL

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: EXTREME TIREDNESS 3 1/2 HOURS AFTER 1ST SHOT. HEADACH 5 HOURS LATER AFTER 1ST SHOT (STILL HAVE HEADACH NOW DAY 6 TUESDAY) NEXT DAY SLEPT 23 HOURS (EXTREME TIREDNESS) JOINT PAIN IN WRISTS/ANKLES AND BACK ON DAY 3 LASTING 2 DAYS, SWOLLEN LYMPH NODE UNDER LEFT ARM FOR 1 1/2 DAYS, NAUSEA FOR 3 DAYS, VERY ITCHY BACK/WRISTS ON DAY 3 (LASTING 3 DAYS). ONE THING I DID NOTICE IS THAT MY BREATHING IS GREAT. NEVER FELT SO CLEAR. ANTIHISTAMINE 3 TIMES A DAY (ALLERGRA, BENADRYL)

Other Meds: NONE

Current Illness: NONE

ID: 0955052
Sex: F
Age: 85
State: MD

Vax Date: 12/31/2020
Onset Date: 01/05/2021
Rec V Date: 01/19/2021
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: amlodipine fluconazole macrolides paxil tetracycline erythropoietin analogues

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Patient tested positive for COVID 19 on Jan 5th 2021 Patient was admitted to the hospital January 9th for pneumonia due to COVID

Other Meds:

Current Illness:

ID: 0955053
Sex: M
Age: 32
State: MI

Vax Date: 01/18/2021
Onset Date: 01/18/2021
Rec V Date: 01/19/2021
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: Headache, Myalgia, significant fatigue, 24hrs

Other Meds: Propranolol, modafanil, synthroid, Vit D/k2

Current Illness: No

ID: 0955054
Sex: F
Age: 47
State: NY

Vax Date: 01/12/2021
Onset Date: 01/13/2021
Rec V Date: 01/19/2021
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: fever of 102 the morning after receiving the vaccine, severe headache, severe eye pain, diarrhea, weakness, bone pain, abdominal cramps, loose stool--that had mucous and blood in it. Also had a small amount of vaginal bleeding/spotting not associated with her period. Multiple days of these symptoms.

Other Meds:

Current Illness:

ID: 0955055
Sex: M
Age: 72
State: CO

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

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

Lab Data:

Allergies: Prednisone - Hive rash ACE Inhibitor - Cough Aspirin - SOB, asthma Percocet - Hive

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

Symptoms: Pt received dose #1 Moderna COVID Vaccine 1/12/21 Clinic. 1/15/21 presented to ED for left upper arm redness/swelling, fever, body aches, new cough, decreased appetite, and fatigue . Had been treating w/OTC Tylenol. Developed sepsis, leukocytosis from LUE cellulitis, currently admitted to hospital for treatment. Entered by PSS for tracking.

Other Meds:

Current Illness:

ID: 0955057
Sex: M
Age: 38
State: NY

Vax Date: 01/16/2021
Onset Date: 01/16/2021
Rec V Date: 01/19/2021
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: Patient complained of dizziness and was found to be hypotensive. He hadn't eaten anything. BP improved from 96/62 mm/Hg to 107/72 mm/Hg and he stated he felt better.

Other Meds:

Current Illness:

ID: 0955058
Sex: F
Age: 28
State: AZ

Vax Date: 01/18/2021
Onset Date: 01/18/2021
Rec V Date: 01/19/2021
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: Adhesive, nickel, pineapple, kiwi

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

Symptoms: Around 8:30 pm started having chills, 10:00 pm had a 101.4 fever, swollen arm, swollen lymph nodes. 8 am the next morning fever was at 99.9. Swelling, swollen lymph nodes, pain when using arm still persist.

Other Meds: N/A

Current Illness: UTI 2 weeks prior

ID: 0955059
Sex: F
Age: 51
State: RI

Vax Date: 01/15/2021
Onset Date: 01/15/2021
Rec V Date: 01/19/2021
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: Oxycodone,

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

Symptoms: Tingling of Lips and face

Other Meds: none

Current Illness:

ID: 0955060
Sex: F
Age: 35
State: IN

Vax Date: 01/04/2021
Onset Date: 01/01/2021
Rec V Date: 01/19/2021
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: None

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

Symptoms: Day 1 post dose body aches, chills, low grade temp. ( I wasn't sent a text this day to be able to report my symptoms. Left arm red near injection site and mild itching x 3 weeks.

Other Meds: Prenatal

Current Illness: None

ID: 0955062
Sex: M
Age: 73
State: FL

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/19/2021
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: after vaccine pt had pain in injection site X 1 day but was diagnosed w/ Pneumonia 5 days after vaccination.

Other Meds: omeprazole, Tamsulosin, losartan

Current Illness:

ID: 0955063
Sex: F
Age: 48
State: MN

Vax Date: 12/29/2020
Onset Date: 12/30/2020
Rec V Date: 01/19/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: reports the day after vaccination she had tenderness at site and a low grade fever. She developed a small rash (size of a quarter) at the injection site that was warm to the touch. The following days she developed swelling and enlargement of the lymph node above the clavicle, followed by swelling of additional lymph nodes. She did develop a lacy pink raised rash over the area, that burned.

Other Meds: N?A

Current Illness: None

ID: 0955064
Sex: F
Age: 43
State: NY

Vax Date: 01/05/2021
Onset Date: 01/15/2021
Rec V Date: 01/19/2021
Hospital:

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

Lab Data:

Allergies: Nkda

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

Symptoms: Palpitations and mild chest discomfort Palpitations have been intermittent throughout the day but occur all day long - few beats stop and then recur Some midsternal chest discomfort non radiating at rest The only change that would have occurred is the vaccine

Other Meds: Lamictal Vitamin d Ajovy Magnesium Trazadone

Current Illness: No

ID: 0955065
Sex: M
Age: 53
State:

Vax Date: 12/30/2020
Onset Date: 01/13/2021
Rec V Date: 01/19/2021
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: Small rash on arm that vaccine was administered

Other Meds:

Current Illness:

ID: 0955066
Sex: F
Age: 67
State:

Vax Date: 01/06/2021
Onset Date: 01/12/2021
Rec V Date: 01/19/2021
Hospital:

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

Lab Data:

Allergies: cephalexin

Symptom List: Unevaluable event

Symptoms: Itchy Rash at injection site, about 2-3 inches in diameter. Lasted 6 days.

Other Meds: Calcium/Vitamin D

Current Illness: none

ID: 0955067
Sex: F
Age: 72
State: FL

Vax Date: 01/09/2021
Onset Date: 01/16/2021
Rec V Date: 01/19/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Redness and swelling with itching at injection site for more than a week after injection.

Other Meds: Metoprolol, Simvastatin, Vitamin D3

Current Illness: None

ID: 0955068
Sex: F
Age: 38
State: VA

Vax Date: 01/15/2021
Onset Date: 01/15/2021
Rec V Date: 01/19/2021
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: turkey and celery

Symptom List: Injection site pain, Pain

Symptoms: Injection site pain for 2 days, dry cough for about 3 days following injection.

Other Meds: Multi-vitamin

Current Illness: None

ID: 0955069
Sex: F
Age: 31
State: MN

Vax Date: 01/11/2021
Onset Date: 01/18/2021
Rec V Date: 01/19/2021
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: Injection site pain, Menorrhagia

Symptoms: 7 days after receiving the vaccine I developed pain, redness, swelling, and heat around the site of my injection (left deltoid). Pain, red area and heat was increasing so I went to urgent care at 3 p.m. that day (symptoms started around 8 am). I was given optional antibiotics as it appeared similar to cellulitis but I did not end up taking them as it is resolving (still sore but not as red, not as warm, and less swollen) one day later.

Other Meds: Lexapro 10 mg, Vitamin D 2,000 IUs

Current Illness: none

ID: 0955070
Sex: F
Age: 31
State: WV

Vax Date: 12/23/2020
Onset Date: 12/28/2020
Rec V Date: 01/19/2021
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: midol

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

Symptoms: She began to have full body urticaria, facial and lip swelling, fever, diarrhea, nausea, and vomiting 5 days after receiving dose 1 of Moderna COVID vaccine. She reports at that time she was experiencing dizziness, but denies syncope. She was given Solu-Medrol 125mg IM and this helped.

Other Meds: Cymbalta, Levothyroxine, Buspirone, magnesium, cetirizine

Current Illness: none

ID: 0955071
Sex: F
Age: 29
State: ID

Vax Date: 01/16/2021
Onset Date: 01/16/2021
Rec V Date: 01/19/2021
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: sulfa based antibiotics, iodine, egg, dairy proteins, shellfish

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Moderna COVID-19 Vaccine Hives B LE and stomach, improved with bendryl w/in 24 hours

Other Meds: thyroxine

Current Illness: polycystic ovarian, interstitial cystitis

ID: 0955072
Sex: F
Age: 76
State: PA

Vax Date: 01/18/2021
Onset Date: 01/19/2021
Rec V Date: 01/19/2021
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: Fever the morning after the injection. Temperature was 100.2 and faster pulse (90).

Other Meds: pantoprazole, nifediprine, remeron, vitamins

Current Illness: Reflux

ID: 0955073
Sex: F
Age: 57
State: TX

Vax Date: 12/30/2020
Onset Date: 01/13/2021
Rec V Date: 01/19/2021
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: Penicillin demerol

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

Symptoms: Large welt at injection site very itchy about 3 cm

Other Meds: Multi vitamin calcium b12 rosuvastatin metformin

Current Illness: None

ID: 0955075
Sex: M
Age: 27
State: NJ

Vax Date: 01/18/2021
Onset Date: 01/19/2021
Rec V Date: 01/19/2021
Hospital:

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

Lab Data:

Allergies: Seasonal, dogs

Symptom List: Nausea

Symptoms: Symptoms began at 06:00 on 1/19/21 and included fever, chills, weakness, aches, injection site pain. Tylenol taken. Notified employee health at the facility.

Other Meds: Tylenol

Current Illness: None

ID: 0955076
Sex: F
Age: 54
State: NJ

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 01/19/2021
Hospital:

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

Lab Data:

Allergies: Singulair, Crabs, apples, cherries, peaches, dusts, molds, pollen, ragweed

Symptom List: Injection site pain

Symptoms: 1/14/2021Itching,rash on left arm, lightheaded,headache,chest heaviness. Benadryl 50 mgs and Solumedrol 125 mg . 1/18/2021 Severe headache, Bp high, numbness on left arm,neck and face, nausea. Tylenol 650 mgs and Zofran

Other Meds: Atorvastatin, Vitamin C, Vitamin D3 , Magnesium, Potassium, COQ 10, Vitamin B12,Biotin, Zinc, Calcium.

Current Illness: None

ID: 0955077
Sex: F
Age: 43
State: NY

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 01/19/2021
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 no food or environmental allergies

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

Symptoms: received injection before noon, by 1800 reported mild chills. After midnight, chills became worse, temp=101.6. Severe chills 0400, diaphoresis. 0900 body aches, especially back and legs. swollen axillary lymph node on arm of injection. Began vomiting intermittently until 1630. two days post injection awoke fully recovered with exception of tender, swollen axillary lymph node on arm of injection.

Other Meds: none

Current Illness: none

ID: 0955078
Sex: F
Age: 38
State:

Vax Date: 01/18/2021
Onset Date: 01/18/2021
Rec V Date: 01/19/2021
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: NKDA

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

Symptoms: flush "hot" body feeling, elevated BP, transient rash without itching, and throat discomfort

Other Meds: sertraline, magnesium, vitamin D

Current Illness: none

ID: 0955079
Sex: F
Age: 52
State: TX

Vax Date: 01/10/2021
Onset Date: 01/18/2021
Rec V Date: 01/19/2021
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: Moderna COVID 19 Vaccine Around noon on the 8th day after receiving my first dose of the vaccine I developed a large hive at the injection site. It?s approximately 3 inches long and 1 1/2 inches wide. The hive is itchy, bumpy, and raised and my arm is warm to the touch. I used a cold compress and took an antihistamine before bed but when I woke up the hive was still there.

Other Meds: None

Current Illness: None

ID: 0955080
Sex: F
Age: 40
State: IL

Vax Date: 01/18/2021
Onset Date: 01/18/2021
Rec V Date: 01/19/2021
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: Erythema, Pruritus

Symptoms: Aching Fever low grade Chills Muscle pain Headache Insomnia

Other Meds: None

Current Illness: None

ID: 0955081
Sex: F
Age:
State: AZ

Vax Date:
Onset Date:
Rec V Date: 01/19/2021
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: None stated.

Other Meds:

Current Illness:

ID: 0955082
Sex: M
Age: 56
State: MI

Vax Date: 01/16/2021
Onset Date: 01/25/2021
Rec V Date: 01/19/2021
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: betablockers latex milk asteline corgard

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

Symptoms: symptoms (increased heart rate, tiredness. weakness)

Other Meds: Norvasc hydralazine aldactone

Current Illness:

ID: 0955083
Sex: F
Age: 59
State: MI

Vax Date: 01/12/2021
Onset Date: 01/13/2021
Rec V Date: 01/19/2021
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: NKA

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: "Moderna COVID-19 Vaccine " approximately 30 hours after vaccine at injection site on right arm increased tenderness and very warm -hot at site. lasted most of the evening 3- hours with a cold pack applied and NSAID to reduce pain.

Other Meds: vitamin B COQ10 100 acidophilous aspirin 81mg x 2 cranberry

Current Illness:

ID: 0955084
Sex: F
Age: 57
State: NY

Vax Date: 12/29/2020
Onset Date: 01/05/2021
Rec V Date: 01/19/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: pruritic erythematous rash at injection site one week after injection. The involved area measured 7 cm x 10 cm. The rash resolved spontaneously after 72 hours.

Other Meds:

Current Illness:

ID: 0955085
Sex: F
Age: 40
State: PR

Vax Date: 01/15/2021
Onset Date: 01/15/2021
Rec V Date: 01/19/2021
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: Back pain, headache, joint pain, weakness, fever,

Other Meds: acetaminophen, baby asa, zinc 50mg,emergency, b12 complex, mtv, tums.

Current Illness: none

ID: 0955086
Sex: F
Age: 30
State: GA

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

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

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: extreme tenderness/pain in arm, shoulder, back on side vaccination was received.

Other Meds:

Current Illness:

ID: 0955088
Sex: F
Age: 52
State: NY

Vax Date: 12/23/2020
Onset Date: 12/30/2020
Rec V Date: 01/19/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Some pleuritic chest pain started the next day. Tachypnea 2 days after, then tachycardia. Chest pain on 12/30. continued on 12/ 31. was seen in ER. Was advised to increase prednisone, take NSAIDS. F/u with cardiology and rheumatology

Other Meds: Prednisone 5 mg daily. Methotrexate, pantoprazole, Allegra, Dulera, Vit D and ca supplement. Glucosamine, multivitamins.

Current Illness: Sjogren disease, Stress fracture

ID: 0955089
Sex: F
Age: 28
State: CA

Vax Date: 01/18/2021
Onset Date: 01/18/2021
Rec V Date: 01/19/2021
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: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: Fever, chills, vomiting, fatigue, body aches

Other Meds:

Current Illness:

ID: 0955090
Sex: F
Age: 64
State: TN

Vax Date: 01/07/2021
Onset Date: 01/15/2021
Rec V Date: 01/19/2021
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: allergy to morphine - migraines and vomiting

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

Symptoms: uticaria and pruritis with papules present, started day 8 after injection, and continues currently although uticaria are beginning to fade.

Other Meds: losartan, amlodipine, levothyroxine

Current Illness: no

ID: 0955092
Sex: F
Age: 46
State: MO

Vax Date: 01/14/2021
Onset Date: 01/15/2021
Rec V Date: 01/19/2021
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: Fever, Chills, Headache, Sinus Congestion, Sore Arm, Body Aches, Nausea All started Friday morning (1/15/21) after receiving the vaccine Thursday afternoon (1/14/21). Patient stated that the symptoms improved Saturday afternoon (1/16/21) and had completely stopped by Monday morning (1/18/21) when she woke up. Stated symptoms were not bad enough to seek medication attention.

Other Meds: trospium 20 mg, vitamin D2 50,000 units, bupropion xl 300 mg, pregabalin 75 mg, fluoxetine 40 mg

Current Illness:

ID: 0955094
Sex: M
Age: 84
State: NH

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 01/19/2021
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: Tolcapone

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Resident received vaccination on 12/29/2020. Records review shows that he had received monoclonal antibody therapy during hospital admission . Receipt of vaccination was contraindicated in this case.

Other Meds: SEROquel Tablet 25 MG (QUEtiapine Fumarate) Morphine Sulfate Solution 4 MG/ML Pramipexole Dihydrochloride Tablet 0.25 MG Mirtazapine Tablet 15 MG Atorvastatin Calcium Tablet 20 MG Acetaminophen Tablet 325 MG Ketoconazole Shampoo 2 % Folic A

Current Illness:

ID: 0955095
Sex: M
Age: 32
State: NJ

Vax Date: 01/18/2021
Onset Date: 01/18/2021
Rec V Date: 01/19/2021
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: Augmentin, Bactrum, Ceclor

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

Symptoms: 103.1 Fever, severe shakes from fever, headache, joint pain, nausea

Other Meds: None

Current Illness: None

ID: 0955096
Sex: F
Age: 50
State: KY

Vax Date: 01/01/2021
Onset Date: 01/16/2021
Rec V Date: 01/19/2021
Hospital: Y

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: None

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Acute liver injury requiring transplant evaluation and acute kidney injury

Other Meds: Bactrim Acetaminophen

Current Illness: None

ID: 0955098
Sex: F
Age: 45
State: AZ

Vax Date: 01/17/2021
Onset Date: 01/19/2021
Rec V Date: 01/19/2021
Hospital:

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

Lab Data:

Allergies: Erythromycin, Zithromax

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

Symptoms: Nausea, mild headache

Other Meds: Allegra, Pepcid, Paxil, Vit D

Current Illness: None

ID: 0955099
Sex: M
Age: 23
State: VA

Vax Date: 01/15/2021
Onset Date: 01/15/2021
Rec V Date: 01/19/2021
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: Cashews,tree nuts

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

Symptoms: Within 15 minutes of receiving vaccine patient was noted to have hives/redness to face, neck, chest, back and upper arms. He was given 25mg of liquid benadryl. BP was slightly elevated at 140s/90s with pulse between 100 and 110. He was observed for 2 hours and then driven home by family.

Other Meds: none

Current Illness: none

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm