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: 0956402
Sex: F
Age: 54
State:

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

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Body aches, Chills, fatigue, joint pain, arm tingling, sneezing. Took Tylenol and Claritin

Other Meds:

Current Illness:

ID: 0956403
Sex: F
Age: 43
State: WV

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

Lab Data:

Allergies: Amoxil

Symptom List: Anxiety, Dyspnoea

Symptoms: Hives, rash, itching, nausea, vomiting, headache, swollen lymph nodes

Other Meds: None

Current Illness: None

ID: 0956404
Sex: F
Age: 36
State:

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: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Started having irregular heart beat. Went to ER and monitored for 3hours PVC's dissipated and employee went home. Follow up with PCP on the 18th.

Other Meds:

Current Illness:

ID: 0956405
Sex: F
Age: 27
State: NJ

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: None

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: 01/15/21: I woke up feeling achy and very fatigued. The symptoms decreased throughout the day, but my shoulders and knees continued to hurt throughout the day. 01/16/21: I woke up with a headache, muscle aches, and feeling very fatigued again. My headache persisted until late afternoon, and the muscle aches persisted throughout the day. 01/17/20: I did not feel fatigued, but I had a mild headache and muscle aches persisted. 01/18/20: I did not feel fatigued, but my headache was worse than the day before and my muscle aches persisted. 01/19/20: My headache was more intense than the day before and my muscle aches persisted.

Other Meds: Vyvanse 50mg- every morning; Escitalopram 30mg- every night; Allegra every night.

Current Illness: None

ID: 0956406
Sex: F
Age: 43
State:

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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Penicillin, Benzoyl Peroxide, Paracetamol, milk, crab, lobster

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

Symptoms: Reports red rashes to bilateral upper extremities within developing 3 minutes post vaccination. Felt lump to throat developing, dizziness, warm flashes, felt like fainting, and shortness of breath. She was taken immediately to ED and was provided medications in the ED- IV benadryl and sodium medrol. Lump to throat relieved after medication IV administration. Was prescribed diphenhydramine and prednisone on discharge.

Other Meds: Vitamin D, Vitamin E, and Claritin

Current Illness: n/a

ID: 0956407
Sex: F
Age: 50
State: WA

Vax Date: 01/14/2021
Onset Date: 01/14/2021
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: NKA

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

Symptoms: Got vaccine at 11:30am. At 1:30p not feeling right, sweating, anxiousL hand swollen and tight, injection site looked normal. Assessed and was given Benadryl 50mg PO and lay down for an hour. Went home at 2:30p. Returned to work the next day and at noon felt feverish (100.0F), SOB, overall muscles ached and sore, injection site sore. My blood pressure was taken x 2 at 200/100 by nursing. I was driven to local ER and worked up. They could not determine if symptoms r/t to vaccine or not. My BP returned to normal. I was given a diagnosis of hypertension and a script for Lisinopril 5mg PO qd. I continue to have fluctuating high BP readings. My left hand swelling resolved. I plan to see my PCP as I have now s

Other Meds: Levothyroxine 25 mcg PO daily. First dose 1/14/21

Current Illness: none

ID: 0956408
Sex: F
Age: 50
State: TX

Vax Date: 12/21/2020
Onset Date: 12/22/2020
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: Allergies: bananas, pecans, mango, severely allergic to mold, OPIOD family

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Left side face and body numbness

Other Meds: I am on immunotherapy injections twice a week. I was due on date of vaccination but told to hold for 2 days before resuming my immunotherapy injections. I waited 3 days then resumed my immunotherapy injections.

Current Illness: Immunotherapy. have been injecting self for 9 months. Ongoing , long term treatment

ID: 0956409
Sex: F
Age: 74
State: FL

Vax Date: 01/11/2021
Onset Date: 01/11/2021
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: Penicillin, Sulfa

Symptom List: Pharyngeal swelling

Symptoms: Arm red swollen and itchy lasting more than one week.

Other Meds: Patel, Pepsi?s, Metaprolol

Current Illness: None

ID: 0956410
Sex: F
Age: 38
State: NH

Vax Date: 12/23/2020
Onset Date: 12/23/2020
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: latex

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Started with dull headache. Progressed to severe arm pain, radiating into neck and cramping in palm of hand. Unable to abduct arm. Symptoms lasted approx 36 hours. About 24 hours after administration, started with weakness, near syncope, and nausea with dry heaving. This lasted an additional 24 hours. There is persistent weakness in left arm compared to right when moving arm overhead. This weakness has persisted more than 3 weeks after injection.

Other Meds: Phendimetrazine 35mg by mouth once daily; multivitamin

Current Illness: None

ID: 0956411
Sex: F
Age: 62
State: ND

Vax Date: 01/06/2021
Onset Date: 01/07/2021
Rec V Date: 01/19/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Patient developed a fever starting 01/07/2021 and progressed to eventual decrease in condition overall. By 01/09/2021 she was bed bound, NPO, consistent fever, gurgling, hypoxic requiring 2-4 L of oxygen via nasal canula, and significant secretions requiring glycopyrrolate and suction. This progressed for the next days with decreasing condition and increase of above symptoms. Patient eventually could not swallow and developed rhonchi in lungs.

Other Meds:

Current Illness:

ID: 0956412
Sex: M
Age: 53
State: KS

Vax Date: 01/05/2021
Onset Date: 01/06/2021
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: no

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

Symptoms: Moderna COVID-19 vaccine 18 hours after vaccine administered starting on 1-6-2021 pt had fever of 100.1, chills and somewhat fatigued and then noticed his tongue slightly swollen. All symptoms subsided by 1-7-2021

Other Meds: Tylenol

Current Illness: no

ID: 0956413
Sex: F
Age: 34
State: LA

Vax Date: 01/12/2021
Onset Date: 01/12/2021
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: Paxil, wasps

Symptom List: Rash, Urticaria

Symptoms: The patient received the COVID-19 vaccine at 11:26. Within 15 minutes, the patient developed light-headedness, chills, shortness of breath, palpations, diaphoresis, and chest pain (described as "pressure on chest"). She was sent to the emergency department for observation/treatment. In the emergency department, she received diphenhydramine 25 mg IV push at 12:58. She was discharged to home at 1417 after it was determined she was stable.

Other Meds: None

Current Illness: None

ID: 0956414
Sex: F
Age: 29
State:

Vax Date: 01/08/2021
Onset Date: 01/11/2021
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:

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

Symptoms: chills, sore throat, dizziness, headache lasted for 7 days

Other Meds:

Current Illness:

ID: 0956415
Sex: F
Age: 28
State: NJ

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

Lab Data:

Allergies: n/a

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

Symptoms: I received the second shot of the Pfizer vaccine on 1/12/21 around 11am. By 5pm I felt very tire and during the night on 1/13/21 I developed a low-grade fever. On 1/13/21 when I woke up my entire body ached, and it felt like a truck ran over me. However, by 1/14 I felt much better and it seemed that I had fully recover. On 1/15/21 I had nausea and stomach ache, which got worst over time. On 1/16/21 I also developed a diarrhea that was ongoing until 1/19/21. From 1/15 to present (1/19) I had a stomach ache and it seemed that my stomach was not able to tolerate any food. Any time that I eat, I went to the bathroom with diarrhea.

Other Meds: n/a

Current Illness: n/a

ID: 0956416
Sex: M
Age: 75
State:

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: 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: ACHY, PAIN AT SITE, LETHARGY, TEMP, CHILLS

Other Meds:

Current Illness:

ID: 0956417
Sex: F
Age: 39
State: FL

Vax Date: 01/08/2021
Onset Date: 01/09/2021
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: Right upper eyelid spasm started next day after vaccine and continues until today, constant.

Other Meds: none

Current Illness: none

ID: 0956418
Sex: F
Age: 71
State: CA

Vax Date: 01/07/2021
Onset Date: 01/07/2021
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:

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

Symptoms: Dizzy 8 days later developed itching at the injection site, a raised area the size of a quarter that was red appeared

Other Meds:

Current Illness:

ID: 0956419
Sex: F
Age: 56
State: WI

Vax Date: 01/15/2021
Onset Date: 01/16/2021
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: none known

Symptom List: Ear pain, Hypoaesthesia

Symptoms: woke several times during the night with fever and chills in morning fever was 101.4 and strong headache, hips and back ache, fatigue

Other Meds: Claritin Possible a serving of Isagenics Ionix Supreme that morning (it is a herbal supplement) I do not remember if I had it that morning or not, I had it one day last week but do not recall the date.

Current Illness:

ID: 0956420
Sex: M
Age: 23
State:

Vax Date: 01/18/2021
Onset Date: 01/19/2021
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:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Body aches, Chills, Fever, Nausea Tylenol

Other Meds:

Current Illness:

ID: 0956421
Sex: F
Age: 51
State: MO

Vax Date: 01/17/2021
Onset Date: 01/18/2021
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: Keflex = nausea vomiting

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

Symptoms: Fatigue, headache, muscle pain, chills, joint pain lymphadenopathy dizziness, nausea

Other Meds: lexapro 20mg lisinopril 10mg

Current Illness: No

ID: 0956422
Sex: M
Age: 49
State: KS

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: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Penicillin, latex

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

Symptoms: Approximately 8 hours after the shot, I began to feel flu-like symptoms beginning with intestinal discomfort and incontinence. Shortly after, fever developed over 100 degrees F. By +9 hours, fever reached 102, and I became disoriented badly, to include loss of balance and some speech issues. Went to bed, waking every 1-2 hours to drink 20-30 ounces of water. Frequent urination throughout the next 48 hours. Fever peaked at 103.7 at about 36 hours after shot. After 48 hours from shot time, fever was gone with fatigue remaining. Low-grade fever returned at 60 hours, and fluctated continuously ever since between 98.4 and 99.6. All temps via temporal sensor thermometer.

Other Meds: Rosuvastatin 20 mg/1 a day; Losartan 50 mg/1 a day, Equate multivitamin for men

Current Illness: Regular cold two weeks prior (tested negative for COVID, test date 1-7-21)

ID: 0956423
Sex: F
Age: 47
State: KY

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: Tamiflu

Symptom List: Unevaluable event

Symptoms: Joint and muscle stiffness. Could barely walk. Had trouble lifting legs and arms. (5-6 hours) Hallucinations (1 hour) headache (2 hours) nausea (1 hour) chills (1 hour) fatigue (5-6 hours) Memory Loss. Could not remember the ride home or things I had said that afternoon (5-6 hours)

Other Meds: Fluoxetine HCL 20 MG

Current Illness:

ID: 0956424
Sex: F
Age: 56
State: NY

Vax Date: 01/19/2021
Onset Date: 01/19/2021
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: wine

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

Symptoms: red rash on chest

Other Meds: diphenhydramine 50 mg

Current Illness: none

ID: 0956425
Sex: F
Age: 49
State:

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

Symptom List: Injection site pain, Pain

Symptoms: Following my 2 dose of the Phizer Covid Vaccine I experienced a temperature of 101.0 spiking over the course of 2 days, sever body shaking, dizziness, weakness, and cold sweats. These symptoms lasted for approx. 2 1/2 days. 3-4 days following my severe symptoms I was extremely sore in my neck muscles and fatigued. My balance felt "off".

Other Meds:

Current Illness:

ID: 0956426
Sex: F
Age: 46
State: VA

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: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: None listed

Symptom List: Injection site pain, Menorrhagia

Symptoms: Patient received vaccine around 1pm and during the 15 minute observation period she became nonresponsive. She did not fall, but slumped in her chair and would not answer questions. Glazed look. Removal of mask showed swollen lips and neck and an epi-pen was administered at 1:14 and 911 called immediately. During the next 5 minutes the patient began to answer questions. EMTs arrived 1:25 and by then the patient was speaking, and did not want to go to the emergency room. EMTs loaded her onto the stretcher and transported her at 1:35.

Other Meds: None listed

Current Illness: None listed

ID: 0956427
Sex: F
Age: 86
State:

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

Lab Data:

Allergies:

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

Symptoms: ARM SORE

Other Meds:

Current Illness:

ID: 0956428
Sex: M
Age: 55
State: LA

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

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Patient noticed on day 7 following the vaccine administration: pain, redness, swelling of the area. On day 8, the redness and swelling of the area became larger. The area of erythema measured 21 cm X 22 cm respectively. There was also an area of induration. The patient contacted me and sent me a picture. I advised him to go to the nearest ER or urgent care for proper evaluation. Patient went to urgent care on 16 January 2021 and was seen by a physician assistant. No test were performed other than a physical exam. Patient was diagnosed with "Local infection of the skin and subcutaneous tissue (686.9)Patient was given an injection of 450 mg Clindamycin and given a prescription for Clindamycin.

Other Meds: Telmisartan, Chlorthalidone,

Current Illness: None

ID: 0956429
Sex: M
Age: 70
State:

Vax Date: 01/12/2021
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: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: vaccine given 1/12/2021 by covid clinic team. bells palsy diagnosed on 1/18/2021.

Other Meds:

Current Illness:

ID: 0956430
Sex: F
Age: 36
State: CA

Vax Date: 01/08/2021
Onset Date: 01/10/2021
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: NONE

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

Symptoms: MORNING OF 1-10-21 TO PAIN IN THE TONSIL AREA AROUND NECK AND FACE. AS THE DAY PROGRESSED THE SWELLING AROUND THAT AREA BECAME SWOLLEN. MOUTH BECAME DRY, THROAT WAS SORE. BY THE NEXT DAY, 1-11-21, MY FACE BECAME SO SWOLLEN THAT I DID NOT KNOW WHETHER THE SWELLING WAS GOING TO STOP BECAUSE MY FACE HAD JUST GOTTEN SO BIG. MY FACE LOOKED LIKE I WAS A 300LB WOMAN AND I AM ONLY 137LBS. I WENT TO THE ER. DR. GAVE ME A STEROID INJECTION AND PRESCRIBED ME AUGMENTIN AMOXICILLIN. HE DID A STREP THROAT TEST, MONO TEST AND COVID TEST. ALL CAME BACK NEGATIVE BY THE END OF THAT DAY, THE SWELLING WENT DOWN. OVER THE NEXT FIVE DAYS, THE SWELLING WENT DOWN AND WAS COMPLETELY GONE BY THE SIXTH DAY.

Other Meds: NONE

Current Illness: NONE

ID: 0956431
Sex: M
Age: 68
State: FL

Vax Date: 01/10/2021
Onset Date: 01/16/2021
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: none

Symptom List: Nausea

Symptoms: mild/moderate ache in right mid abdomen and mild ache in left upper abdomen

Other Meds:

Current Illness: none

ID: 0956432
Sex: M
Age: 42
State: CA

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: No.

Symptom List: Injection site pain

Symptoms: Pt reported extreme fatigue, evaluated by Paramedics on scene, declined (AMA) transport to hospital.

Other Meds: No.

Current Illness: No.

ID: 0956433
Sex: F
Age: 35
State: CO

Vax Date: 01/10/2021
Onset Date: 01/16/2021
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:

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

Symptoms: On 1/15/2021 patient presented at emergency department for evaluation of nausea, abdominal cramping, lightheadedness, diarrhea. Patient stated that two days after vaccination, she had myalgia, nausea, malaise. She started to feel better, but then developed nausea, abdominal cramping, and loose stool. It is nonbloody. She has not had a fever. She is able to tolerate fluid intake, but this triggers abdominal cramping and diarrhea. She has started to feel lightheaded. Patient was given supportive treatment and discharged home. On 1/16/2021, patient reported to emergency department again with significant abdominal pain, nausea, and diarrhea. Patient was diagnosed with pancolitis and given outpatient prescriptions for ciprofloxacin and metronidazole.

Other Meds:

Current Illness:

ID: 0956434
Sex: F
Age: 45
State:

Vax Date: 01/15/2021
Onset Date: 01/17/2021
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:

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

Symptoms: woke up Sunday morning with blurry vision (distance). Employee to let us know if did not improve in next 24hrs.

Other Meds:

Current Illness:

ID: 0956435
Sex: F
Age: 68
State: NV

Vax Date: 01/27/2020
Onset Date: 01/27/2020
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: Iodine

Symptom List: Tremor

Symptoms: Pain in Arm

Other Meds: Verapamil, Levothyroxine

Current Illness: None

ID: 0956436
Sex: F
Age: 24
State: IN

Vax Date: 01/06/2021
Onset Date: 01/07/2021
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: Apples

Symptom List: Erythema, Pruritus

Symptoms: Welt size of golf ball, painful to move or touch arm, bruising 24hours after vaccine. Cleared up in couple days. 9 days after vaccine arm became hot, softball size rash now spreading around arm of injection site. Itchy, hot, and red. Has not received medical attention yet.

Other Meds: Montelukast, Diltiazem, Multivitamin

Current Illness:

ID: 0956437
Sex: M
Age: 37
State:

Vax Date: 01/11/2021
Onset Date: 01/15/2021
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: I developed a sore throat after I got home from my shift (Finished at 8pm). Approx 815pm I noticed I had a sore throat. This continued into the next day with mild total body aches and fatigue. By Saturday 1/16/21 I felt 100% fine.

Other Meds:

Current Illness:

ID: 0956438
Sex: F
Age: 14
State: OH

Vax Date: 10/31/2020
Onset Date:
Rec V Date: 01/19/2021
Hospital: Y

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

Lab Data:

Allergies: NKDA

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

Symptoms: Flu vaccine. 10/31/20 - known Mast Cell Activation Syndrome Hives started later that evening. Over the course of the next week some difficulty breathing felt to be an issue with her vocal cords and/or throat. Admitted to hosp 11/6/20

Other Meds: Sertraline

Current Illness: None

ID: 0956439
Sex: F
Age: 55
State: WA

Vax Date: 01/14/2021
Onset Date: 01/17/2021
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: Gluten

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Started with stomach upset, headache and now have weakness, body aches, over all heaviness. No treatment at this time other than rest and fluids.

Other Meds: Vitamins B12, D, and C. Thyrocsin, Ashwagandha, curaMed, Maca

Current Illness: None

ID: 0956440
Sex: M
Age: 91
State:

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: 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: TEMP

Other Meds:

Current Illness:

ID: 0956441
Sex: M
Age: 29
State: PA

Vax Date: 01/18/2021
Onset Date: 01/19/2021
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: pain at injection site, headache, all over joint and muscle pain, slightly elevated heart rate

Other Meds: daily vitamin, duloxetine 30mg 1 a day, metformin twice daily 500mg

Current Illness: covid 19 returned to work after quarantine 1/8/2021

ID: 0956442
Sex: F
Age: 43
State: WA

Vax Date: 01/10/2021
Onset Date: 01/10/2021
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: gadobutrol latex

Symptom List: Pain in extremity

Symptoms: shortness of breath at the time of vaccine, petechiae appeared the next day

Other Meds: famotidine hydroxyzine losartan verapamil tretinoin

Current Illness: rhinitis reported 12/31/20

ID: 0956443
Sex: F
Age: 40
State: ME

Vax Date: 01/17/2021
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: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: none

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

Symptoms: I woke up at 2am (about 12 hrs after vaccine) with fever and sweats. Took acetaminophen and went back to bed. Up at 6am feeling very fatigued and exhausted. Fever again. Got a shower but couldn't stand up that long too exhausted, dizzy and naseau. Went back to bed and called in sick to work. Took IBU 800mg. Back to sleep. Up at 9m more Tylenol. This continued all day trying to keep fever down. 48hrs later still taking acetaminophen to manage symptoms (back to work) still feeling tried and low grade fever.

Other Meds: birth control, loratidine

Current Illness: none

ID: 0956444
Sex: F
Age: 42
State: GA

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: None

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

Symptoms: Body aches, headache, fever, chills, hallucinations

Other Meds:

Current Illness: None

ID: 0956445
Sex: F
Age: 42
State: FL

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

Lab Data:

Allergies: NKDA

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

Symptoms: This is a female with history of anemia who presents to the emergency department as a rapid response after feeling fatigued, nauseated and slightly lightheaded after receiving the first dose of the Covid vaccine. Patient is in no acute distress, non-toxic appearing. Vital signs stable, patient afebrile. No focal neuro deficits. Answering all questions appropriately.

Other Meds: none

Current Illness:

ID: 0956446
Sex: F
Age: 32
State: WA

Vax Date: 01/05/2021
Onset Date: 01/13/2021
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: latex, bees, clonazepam, passionfruits, ibuprofen.

Symptom List: Vomiting

Symptoms: red, hot, swollen arm, with a bump and with rash under spot where injection was given.

Other Meds: topiramate, verapamil, aimovig, rizatriptan, lyrica, omeprazole, litium, dulera, Flonase, loratadine, aripiprazole, Pristiq, EpiPen, albuterol, larin FE, Lunesta, clonidine, tizanidine, prenatal vitamin.

Current Illness: N/A

ID: 0956447
Sex: F
Age: 49
State:

Vax Date: 01/08/2021
Onset Date: 01/10/2021
Rec V Date: 01/19/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Day 1 after injection: injection site soreness Day 2-4 after injection; headache, sleepiness, low grade nausea - No relieved by IBU 600mg tid for 3 days, sleep. Low grade nausea remains today 9 days post injection.

Other Meds:

Current Illness:

ID: 0956448
Sex: F
Age: 31
State: NM

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

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

Symptoms: Day one I started to get a bump at injection site. Day 5 bump seemed nearly gone. Day 7 bump was back and itchy. Day 9, today, bump is bigger and itchy and red in two places.

Other Meds: None

Current Illness: None

ID: 0956449
Sex: F
Age: 91
State:

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

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: TEMP

Other Meds:

Current Illness:

ID: 0956450
Sex: M
Age: 32
State: IA

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

Lab Data:

Allergies: No known allergies

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

Symptoms: 1:12pm: Patient received vaccine 1:25pm: Patient reports throbbing headache. He has never experienced a migraine but thinks that is what he is feeling. Patient is asked to stay 30 minutes for observation. 1:40pm: Patient reports really tight chest and slightest improvement in headache. He is given diphenhydramine 50mg PO and moved to a recliner and put in reclining position. BP 150/94, pulse 76-106bpm, pulse ox 96%. No shortness of breath, no sore throat, no swelling of tongue. 2:05pm: Patient reports throbbing headache at 7 out of 10 on pain scale. Chest tightness has improved, but getting drowsy (likely due to diphenhydramine). BP 128/88, pulse 77bpm, Pulse Ox 97%. Patient refuses Tylenol at this time. 2:24pm: Patient accepts Tylenol 650mg PO, BP 130/82, pulse 74, pulse ox 97%, no longer has chest tightness, but headache is throbbing and remains unchanged. Patient has light sensitivity and the lights were dimmed. 2:35pm: BP 120/80, pulse 75, pulse ox 95%, no chest tightness and headache is still throbbing and unchanged. 3:30pm: BP 122/84, pulse 75, pulse ox 97%. Patient still has severe throbbing headache, but voices desire to go home and leaves facility. Upon follow up on 1/19/2021, patient reports headache lasted 3 days. Patient woke on 1/16/2021 with redness, swelling, heat, and itchiness at the injection site. This resolved on 1/19/2021.

Other Meds:

Current Illness: None Patient was diagnosed with Influenza A 10/2020

ID: 0956451
Sex: F
Age: 39
State: PR

Vax Date: 01/12/2021
Onset Date: 01/14/2021
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: N/A

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

Symptoms: Itch and severe rash on site of injection and on left side of neck and cheek

Other Meds: N/A

Current Illness: N/A

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm