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: 0956704
Sex: M
Age: 39
State: TX

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

Lab Data:

Allergies: NKDA or food

Symptom List: Dysphagia, Epiglottitis

Symptoms: Atypical ramsay hunt symdrome on right side. Vertigo started on 7JAN, tinnitus and hearing changes on 8 JAN, vertigo worsening 7-10 JAN, leading to significant headache, nausea and vomiting with complete PO intolerance, leading to ER visit on 13 JAN for fluid rehydration, medications (anti-vertigo, anti-nausea, steroids). CT Head unremarkable, CT soft tissue neck showed lymphadenopathy along with inflammation of right parotid consistent with acute parotitis. CXR normal. Labs relatively normal. Physical exam demonstrated vesicular lesions on right external ear and canal consistent with Ramsay Hunt syndrome. ENT evaluated and concurred. Audiology testing on 13 JAN demonstrated right mild-moderate sensorineural hearing loss. Patient discharged with Valtrex, PO prednisone, antivert.

Other Meds: Claritin, omeprazole, fluticasone nasal

Current Illness: None

ID: 0956705
Sex: F
Age: 58
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: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Finger tips on right hand tingling and painful. Slightly inflamed and swollen. Just monitored for improvement.

Other Meds:

Current Illness:

ID: 0956706
Sex: M
Age: 37
State: AZ

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

Lab Data:

Allergies: None

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

Symptoms: None

Other Meds: Tylenol

Current Illness: None

ID: 0956707
Sex: F
Age: 61
State: NJ

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: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: 1. SOB 2. Flushed 3. Tremble 4. Decrease in blood pressure EpiPen was administered. Attending physician was contacted and advised to send to ER for follow-up and monitoring.

Other Meds:

Current Illness:

ID: 0956708
Sex: U
Age: 42
State: MI

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

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

Symptoms: 5:15 pt complained of itchy and hot in the left arm. pt denied SOB and Difficulty breath Pt monitored and removed his sweatshirt and provided water. Pt. stated, "Left elbow was swelling and itching continued." Ice was applied. Patient denied allergies and does not received the flu shot. 5:20 Benadryl 25 mg P.O.. given . 5:35 pt stated, "Having discomfort in left shoulder." Vital sign B/P 210/115, HR-93, Pt was assisted to laying position. 5:38 B/P 190.105 HR 100 O2sat 96% EMS contacted Per EMS B/P 200/116, HR 100, transported to hospital via EMS

Other Meds: Unknown

Current Illness: Unknown

ID: 0956709
Sex: F
Age: 40
State: TX

Vax Date: 01/08/2021
Onset Date: 01/15/2021
Rec V Date: 01/19/2021
Hospital: Y

Vax Type: FLUC4
Manufacturer: SEQIRUS, INC.
Vax Name: INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT)
Lot: 276563
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Patient developed symptoms of Guillain-Barre syndrome on January 15, 2021 and was admitted the Hospital. She was diagnosed and eventually required ICU level care and has been treated with plasmapheresis. She is currently still in the ICU but is stable.

Other Meds:

Current Illness:

ID: 0956710
Sex: M
Age: 49
State: UT

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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Chills and fever for 2 days after shot. Swelling in arm where shot was for a couple days. Moderna Covid-19 vaccine EUA

Other Meds: Gout medication

Current Illness: Fever/Chills 3 weeks prior

ID: 0956711
Sex: F
Age: 41
State: KY

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: swollen arm, followed by headache and fatigue and low grade temperature. Symptoms resolved in 48 hours

Other Meds:

Current Illness:

ID: 0956712
Sex: F
Age: 72
State: MI

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: LA

Lab Data:

Allergies: Codeine, latex, SLS in toothpaste. Beer, blue cheese, Cats, Dogs, mold, grass, trees

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: I developed swollen glands on the right side of my face, in front of my ear and TMJ. I also developed swollen glands under my right ear and neck area. This occurred about 2 1/2 hours after my injection . I used hot compresses and took Benadryl tablet. The swelling went down thru the evening. In the morning , When I awoke, my glands were swollen again. In the afternoon, I went Urgent Care, The Nurse Practitioner to.d me it was a side effect and that there was nothing to do. Today, my glands are tender to the touch, but not swollen.

Other Meds: ZETIA, NIASPAN, MONTELUKAST, TRIMTERENE/HCT2, XYZAL Calcium, Multivitamin, Fish Oil, Glucosamine/ MSM, CO Q 10, Vitamin D

Current Illness: No illness in recent months

ID: 0956713
Sex: F
Age: 46
State: MI

Vax Date: 01/01/2021
Onset Date: 01/18/2021
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: None

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Fainted, chills sweating bodyaches and extremely bad headache

Other Meds: None

Current Illness: None

ID: 0956714
Sex: F
Age: 45
State: NE

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: SYR
Vax Site: LA

Lab Data:

Allergies: Motrin, augmentin, morphine, duracef, naproxen, grapes

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

Symptoms: Vomiting 12 hours post vaccine. 24 hours post vaccine temps 104+ to 106.8 temp orally 30 hours post vaccine. Red swollen eyes 24 hours post vaccine. Ringing in ears and temporary loss of hearing comes and goes.

Other Meds: None

Current Illness: None

ID: 0956715
Sex: F
Age: 34
State: MT

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: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: Patient was dx with COVID-19 on 1/14/2021. She received the vaccine on 1/12/2021.

Other Meds:

Current Illness:

ID: 0956717
Sex: F
Age: 65
State: MN

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:
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: Fever, chills, nausea, h/a, fatigue, vomiting lasting > 48*

Other Meds:

Current Illness:

ID: 0956718
Sex: F
Age: 50
State: CA

Vax Date: 01/05/2021
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: redness at the injection site swelling below injection site started to swell the size of a golf ball and turned red itchy

Other Meds:

Current Illness:

ID: 0956719
Sex: U
Age:
State:

Vax Date:
Onset Date:
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: While the vaccine was being administered the needle fell off the syringe with needle still in the patient's arm. Person giving the vaccine didn't feel the patient received any of the vaccine.

Other Meds:

Current Illness:

ID: 0956720
Sex: F
Age: 28
State: TX

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

Lab Data:

Allergies: NONE. Does state she had a reaction to some type of headache medication 2 years ago and had to take Benadryl but doesn't recall the name.

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

Symptoms: Patient c/o dry mouth and some shortness of breath with in 10 min of getting vaccinated. However states she can breath fine. EMT in attendance and evaluated. O2 sat 98% on room air. BP - 130/86; HR strong/regular at 88. EMT recommended ambulance and patient declined transport. Patient drove self and ambulated to personal vehicle. . No SOB noted.

Other Meds: NONE

Current Illness:

ID: 0956721
Sex: F
Age: 33
State: NM

Vax Date: 01/06/2021
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: NKA

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

Symptoms: Pain 7/10 in left arm for 36 hours following injection. Red discoloration of skin surrounding injection site progressively increasing in size, first noticed 24 hours after injection, circular area around 1 inch in diameter, now 13 days post injection around 4.5 to 5 inches in diameter. Area somewhat warmer than surrounding arm and occasionally is with mild itching. Suspicion of cellulitis.

Other Meds: Escitalopram 10 mg daily, bupropion 75 mg daily

Current Illness: None

ID: 0956722
Sex: F
Age: 55
State:

Vax Date: 01/13/2021
Onset Date: 01/17/2021
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: Slight soreness on injection site (left arm) -- lasted 3 days. Lethargic 1/17/21 Pain on left armpit since 1/17/21; pain worsened 1/18/21 (pain level 4 -- took aleve then tylenol); pain diminished today. Joint pain and rashes 1/18/21 (1 day)

Other Meds:

Current Illness:

ID: 0956723
Sex: U
Age:
State:

Vax Date:
Onset Date:
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: 20 minutes after injection, mild hives appeared on roof of mouth and lips. 4 hours after injection hives appeared on arms and chest, with general itching all over body. Moderate pain at injection site from 4-48 hours after injection, fatigue, and headache also present. 30 hours after injection redness and itching from elbow to shoulder on injected arm appeared and lasted approx 5 hours before subsiding. Hives flared up and went away throughout the last 48 hours after injection, both on body and in mouth and lips. Treated at home with benadryl and cortisone, cold compress at injection site.

Other Meds:

Current Illness:

ID: 0956724
Sex: M
Age: 94
State: NY

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

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

Symptoms: N/A. Patient received 2 doses of the second dose on the same day.

Other Meds:

Current Illness:

ID: 0956725
Sex: F
Age: 39
State: NY

Vax Date: 01/14/2021
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: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Sulfa

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

Symptoms: 24 hours after receiving the vaccine I experienced fever, chills, fatigue and headaches

Other Meds: Ortho Tri Cyclene birth control Metformin / Glucophage

Current Illness:

ID: 0956726
Sex: F
Age: 29
State: KY

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

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: None stated.

Other Meds:

Current Illness:

ID: 0956727
Sex: F
Age: 20
State: NJ

Vax Date: 01/13/2021
Onset Date: 01/14/2021
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:

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

Symptoms: Tongue and throat swelling

Other Meds:

Current Illness:

ID: 0956728
Sex: M
Age: 88
State: CA

Vax Date: 01/17/2021
Onset Date: 01/17/2021
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: None

Symptom List: Injection site pain, Pain

Symptoms: Extreme fatigue . Slept from Noon to 8pm.

Other Meds: Eliquis Atorvastatin Namenda Folic Acid Flomaz Calitriol Fosamax

Current Illness: None

ID: 0956729
Sex: F
Age: 56
State: TX

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: Sulfa, avelox

Symptom List: Injection site pain, Menorrhagia

Symptoms: Jan. 6, 7, & 8 - Had chills, fever, nausea, dizziness, headache, sore throat, ear pain, & fatigue

Other Meds: Plaquenil, urocitk, Vit. E, paxil, ropinirole,

Current Illness: None

ID: 0956730
Sex: F
Age: 71
State: IN

Vax Date: 01/16/2021
Onset Date: 01/17/2021
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: Lisinopril

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

Symptoms: Minor soreness in muscle of left calf

Other Meds: Bayer Low Dose 81 mg - 1 daily Centrum Silver Women 50+ - 1 daily Latanoprost 0.005% Eye Drops - 1 drop each eye at bedtime Levothyroxine 112 mcg - 1 daily Losartan Potassium 50 mg - 1 daily Metformin HCL ER 500 mg - 1 daily Pravastatin Sod

Current Illness: None

ID: 0956731
Sex: F
Age: 80
State:

Vax Date: 01/07/2021
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: LA

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: left upper arm cellulitis and tender lymphnodes

Other Meds:

Current Illness:

ID: 0956732
Sex: U
Age: 53
State: NH

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

Lab Data:

Allergies: none

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: right tongue swelling, difficulty swallowing, left lateral tongue sores approximately 1 hour after swelling started reported to employee health took Claritin which eventually resolved it

Other Meds: vitamins, fish oil, supplements

Current Illness: none

ID: 0956733
Sex: F
Age: 59
State: TX

Vax Date: 01/15/2021
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: RA

Lab Data:

Allergies:

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

Symptoms: Fever to 100.9 on Saturday 1/16/2021 and 100.3 on Sunday 1/17/2021. Right deltoid injection site swollen with a lump. Warmth and itching also noted at site. Motrin taken on Saturday and Sunday. Cold compress to injection site. Fever has resolved. Cold compress will relieve injection site itching while being applied.

Other Meds:

Current Illness:

ID: 0956734
Sex: F
Age: 66
State: FL

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

Lab Data:

Allergies: No allergies

Symptom List: Nausea

Symptoms: The day of vaccine in couple of hrs stared feeling dizziness,still on & off,Injection sight hurting,also started getting bad headaches.About third day I started getting weakness in my legs & it increase with numbness.I made an appointment with my Primary care doctor on 18th of Jan because the numbness still continues.Doctor order lab work which I did on Jan 19th morning & I have follow up virtual appointment with my doctor on 21st Jan @ 4:45 PM.

Other Meds: Levothyroxine Sodium,Probiotic,Methylprednisolone,Calcium with vitami D3,Fexofenadine Hydrochloride,Montelukast,Azythromycin,for dry eye Refresh,IPRATROPIUM/ALBUTRSOL.

Current Illness:

ID: 0956735
Sex: F
Age: 48
State: FL

Vax Date: 01/06/2021
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: Bactrim

Symptom List: Injection site pain

Symptoms: Diffuse hives on head, chest, abdomen, back, arms, hands?treated with antihistamine?Benadryl, Claritin and Zyrtec

Other Meds: Cymbalta, Xanax, plaquenil, colace, fluicasone, lorotadine

Current Illness: None

ID: 0956736
Sex: F
Age: 26
State: IN

Vax Date: 01/08/2021
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: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Red patch appeared on right arm directly over the injection site 10 days post-dose. No other systemic symptoms, no arm pain, no swelling.

Other Meds:

Current Illness:

ID: 0956737
Sex: F
Age: 47
State: TX

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

Lab Data:

Allergies: shellfish, iodine, Bactrim, Flagyl,

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

Symptoms: nervousness, nerve twitching, right side facial numbness and tingling, tingling in hands, hands cold, bells palsy, "pins and needles" feeling all over

Other Meds: none

Current Illness: none

ID: 0956738
Sex: F
Age: 31
State: MN

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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Penicillins/ Amoxicillin-- Anaphylaxis Zosyn- Shortness of Breath Tetracycline- GI Upset/Nausea/Vomiting

Symptom List: Tremor

Symptoms: Approximately 15-20 minutes post-injection I started to feel lightheaded, dizzy, shaky and increased heart rate. This was swiftly followed by a feeling of tightness in my throat, shortness of breath, and coughing. In addition I had a moderate to severe headache. The hospitals rapid response team was called and I was brought to the emergency department on-site. I was given a racemic epinephrine and albuterol neb treatment which resolved upper airway stridor and cough. I received PO Benadryl, Pepcid, and Prednisone. A EKG was completed. I was observed in the emergency department for about 2 hours until discharge. I was discharged with prescriptions for an Epi-Pen, Prednisone, and Pepcid. The diagnosis on my after visit summary was: Allergic Reaction. I was unable to finish my scheduled shift as an RN.

Other Meds: omeprazole 20 mg Delayed-Release capsule BID buPROPion 300 mg Extended-Release tablet Daily EPINEPHrine 0.3 mg/0.3 mL injection PRN Breo Ellipta 200mcg/25mcg inhaler 1 puff Daily clonazePAM 1 mg tablet Daily tamsulosin 0.4 mg capsule Daily

Current Illness: None at the time of injection. 3 weeks prior I had a reaction to my first vaccine with sudden onset of tachycardia, lightheadedness, dizziness, nausea (see prior VAERS report if available)

ID: 0956739
Sex: F
Age: 39
State: MI

Vax Date: 12/28/2020
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: IM
Vax Site: LA

Lab Data:

Allergies: Bactrim

Symptom List: Erythema, Pruritus

Symptoms: About five-ten minutes after the injection, tinnitus began ( both ears)... Immediately, I notified the nurse overseeing the vaccination event, Then next day, I notified my primary. The tinnitus started to subside a little after about two weeks, but still there as of 1/19/2021. I have my second dose tomorrow...

Other Meds: Lyrica, Tramadol, Trazadone

Current Illness:

ID: 0956740
Sex: F
Age: 76
State: FL

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

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

Symptoms: Fever, sore muscles, sore joints, headache, fatique, nausea & chills. I had a positive Covid 19 test on September 9th. The symptoms I've had from the shot are pretty much the same as when I was sick. I was fortunate not to have any respiratory symptoms either time as confirmed by my oximeter. I had two Antibody tests. One on Nov. 23rd, which was positive for both IgG and IgM. I had my second anti-body test on 1/17/2021, the day of my injection which was positive for IgG and negative for IgM. I have not contacted my doctor concerning this and I am taking Advil for the fever and ached and pains. Today i feel better than yesterday.

Other Meds: Venlaflaxine HCR ER 75 mg, multi-vitamin, Vitamin D3 - 2000 IU, Calcium 1200 mg

Current Illness: None

ID: 0956741
Sex: F
Age: 25
State: DE

Vax Date: 12/30/2020
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: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Lymphadenopathy secondary to Pfizer covid vaccine. Has not resolved

Other Meds:

Current Illness:

ID: 0956742
Sex: F
Age: 54
State: LA

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: Flu vaccine, eggs

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: The injection site became swollen, tender and developed a knot that was feverish. An icepack was applied to the area. By 4PM, the site was softer with decreased swelling and pain. She went home. One day later, the site continues to be swollen.

Other Meds: None

Current Illness: None

ID: 0956743
Sex: F
Age: 44
State: TX

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: 011J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: no

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

Symptoms: Rapid heart beat for three weeks. Takes medicine for anxiety.

Other Meds: no

Current Illness: no

ID: 0956744
Sex: F
Age: 51
State: GA

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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Latex

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

Symptoms: Patient received Covid vaccine ?around 3:45?. Patient?s initial complaint was feeling ?alittle bit itchy? and her ?nose was closing up?. Vitals taken at 3:48- 129/75 BP, 98 HR, 98% O2. Continuing complaint of ?itching?. 1 mL of Benadryl (Lot #080010, Exp 08/22) given at 3:52. Vitals taken again at 3:54- 150/84 BP, 92 HR, 97% O2. Patient sipped water and speaking with responding nurses at 3:55. At 4:00, reported ?throat itching? and had hoarseness, coughing, and congestion. 4:01, 0.3 mg Epi given via autoinjector (Lot #0GM147, Exp 11/21). 4:06 patient reported her tongue was less ?itchy? and decreased congestion. 4:14 vitals were 123/72 BP, 106 HR, 98% O2 & patient reported no improvement of symptoms. 4:15, Dr. was called at which time recommended to call EMS. 4:16, RN called EMS. 4:18 patient reports ?someone is pushing on my throat?. 4:20 a 0.3 mg Epi given via autoinjector (Lot #0GM147, Exp 11/21). 4:22 vitals were 126/81 BP, 107 HR, 96% O2. 4:26 EMS arrived at clinic and left via stretcher. EMS provided with medications given to patient.

Other Meds:

Current Illness:

ID: 0956745
Sex: F
Age: 27
State: TX

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

Lab Data:

Allergies: Amoxicillin

Symptom List: Pain in extremity

Symptoms: Redness, swelling (hardness), itchiness, and sensitivity at the injection site. This has been ongoing for over a week and I am starting to get concerned.

Other Meds: Melatonin

Current Illness: Sinus infection 12/18-1/1

ID: 0956746
Sex: M
Age: 68
State: OR

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: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: unknown

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

Symptoms: Patient has been observed in the waiting area for 15 minutes per protocol and suffered no adverse reactions during that time. He was released from the waiting area and walked out independently. He was found appearing to be in some distress in the parking lot by a nurse leaving the vaccination observation area after her COVID 19 injection. This nurse escorted the patient back into the vaccine clinic at which time he was seated in a wheel chair and wheeled directly to the emergency room for evaluation.

Other Meds: unknown

Current Illness: unknown

ID: 0956747
Sex: F
Age: 34
State: CA

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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Zophran and Morphine

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

Symptoms: Injection side became very red and swollen, hot to the touch within the first 4 hours. Continued to get red and swollen. Managed with Tylenol. swelling reduced on day 5 however on day 7 the site is now red again and hot to the touch. other side effects during the first 4-5 days included SEVERE headache, SEVERE fatigue, foggy thoughts and cognitive issues.

Other Meds: None.

Current Illness: None

ID: 0956748
Sex: F
Age: 71
State: NJ

Vax Date: 01/13/2021
Onset Date: 01/14/2021
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:

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

Symptoms: 1. Tongue and throat swelling 2. Difficulty breathing

Other Meds:

Current Illness:

ID: 0956749
Sex: F
Age: 56
State: NY

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

Symptom List: Vomiting

Symptoms: 1st vaccine: spontaneous tachycardia (HR 110 initially) and elevated BP (160/100) at 10 minutes mark which subsequently resolved spontaneously at 30 mins (closely monitored by MD, NP) 2nd vaccine: spontaneous tachycardia, and elevated BP (160/100) at 10 minutes mark (monitored by MD and NP), normalized after 1 hour of observation. On 1/8/2020 I developed severe fatigue, fever, numbness on lower lip, bitter taste in my mouth, fever, chills, headache until Sunday 1/10/2021. Went to work on 1/11/2021 with worsening symptoms. Ended up in ER on 1/12/2021 due to weakness, high BP, numbness on lower lip, difficulty focusing. BP is normalizing as of 1/19/2021 but still have weakness, equilibrium is off and difficulty in focusing

Other Meds: Tamoxifen

Current Illness: no

ID: 0956750
Sex: F
Age: 37
State: TN

Vax Date: 01/07/2021
Onset Date: 01/08/2021
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: Amoxicillin/Augmentin, azithromycin, sulfa, tramadol

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: erythema, edema, tenderness, itching at injection site-post injection day 12 continues to worsen. Pt questions if she should receive 2nd dose.

Other Meds: Clonazepam, famotidine, reglan, flonase, protonix, sumatriptan, pramipexole

Current Illness:

ID: 0956751
Sex: F
Age: 39
State:

Vax Date: 01/13/2021
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: RA

Lab Data:

Allergies: metamizol sodico

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

Symptoms: upper limb rash itch neck rash

Other Meds: matoprolol, levotiroxina , metformina

Current Illness: ninguna

ID: 0956752
Sex: F
Age: 55
State: TX

Vax Date: 12/31/2020
Onset Date: 01/01/2021
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: NKDA

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Severe HA that began on right side with tightening of the right jaw. Started at 0200 1/1/21. Lasted for more than 48 hours. Then went away. Returned 2 days after that for 4 days. Then went away for 2 days then returned for 1 day. Then came back say 1/17/21 and has persisted through today. Accompanied by dizziness at various times not with ha

Other Meds: Progesterone. Armour Thyroid Lasix. Vitamin D. Bcomplex Estrogen.

Current Illness: N/A

ID: 0956753
Sex: M
Age: 80
State: CA

Vax Date: 10/22/2020
Onset Date: 10/25/2020
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: RA

Lab Data:

Allergies:

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

Symptoms: Patient called to report an adverse reaction he had almost 3 months ago. Patient stated he started to develop an elevated bump ( 1/4 inch raised) which was 3 inches in diameter a few days after receiving a flu shot. The area was not red, painful or itchy and he did not seek medical attention. Only after a couple of months did he see a medical doctor. According to the patient, the doctor believed he had a hematoma and gave him instructions to treat. Even after following the doctor's directions he did not see any improvement and contacted the pharmacy to report and find more information.

Other Meds:

Current Illness:

ID: 0956754
Sex: F
Age: 30
State: CA

Vax Date: 01/05/2021
Onset Date: 01/12/2021
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:

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

Symptoms: Patient describes left shoulder where the injection site was along with itchiness, big red rash but has not spread or gotten larger

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm