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: 0960660
Sex: F
Age: 51
State: NY

Vax Date: 01/12/2021
Onset Date: 01/20/2021
Rec V Date: 01/21/2021
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: No

Symptom List: Dysphagia, Epiglottitis

Symptoms: In the first 36 hours site of injection very sore, red, and swollen. Noticed 8 days after vaccine that at the injection site a 3 inch by 3 inch area is red, swollen, hard if you touch area, warm, and a little itchy. No pain. NO other symptoms have occurred.

Other Meds: Vitalo pray and levothroxine

Current Illness: None

ID: 0960661
Sex: M
Age: 59
State: NJ

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 01/21/2021
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: none

Symptom List: Anxiety, Dyspnoea

Symptoms: hot and sweaty lasting two minutes after rash

Other Meds: phenobarbital

Current Illness:

ID: 0960662
Sex: M
Age: 36
State: CA

Vax Date: 01/13/2021
Onset Date: 01/19/2021
Rec V Date: 01/21/2021
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: Rash to arms, legs, and trunk

Other Meds:

Current Illness:

ID: 0960663
Sex: F
Age: 37
State: OH

Vax Date: 01/13/2021
Onset Date: 01/18/2021
Rec V Date: 01/21/2021
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: Redness and itchy at injection site 6 days after vaccine. then it is just getting redder and larger of an area that is red/swollen/itchy. about 2 cennimeters below the injection site. Progressively getting worse. No onther symptoms

Other Meds: daily viatmin

Current Illness: none

ID: 0960664
Sex: F
Age: 29
State: PA

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 01/21/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: High fever, chills, severe body aches. Loss of appetite, nausea and diarrhea

Other Meds: Lexapro 10mg

Current Illness:

ID: 0960665
Sex: F
Age: 73
State: AR

Vax Date: 12/29/2020
Onset Date: 12/31/2020
Rec V Date: 01/21/2021
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: approximately 48 hours after receiving the first Pfizer Covid vaccine I noticed a small area of redness on my left clavicle near my shoulder, it was red and itchy. Just thought it was dry skin and used some Eucerin lotion. Over the next 3-4 days this redness spread across my chest and down toward my breast. It became more red, itchy and irritated and started spreading up my neck. This went on for a few weeks and just thought it was dry skin irritation. When the rash became more raised and looked almost like hives I checked in with our clinic Family Practice doctor as my regular provider was out of the office. It was about time for my second Pfizer Covid vaccine and I hesitated to get another shot with this rash getting worse. Dr. has started me on Mometasone Cream twice daily along with Benadryl and or Zyrtec for the itching. The rash is fading and tolerable as of 1/21/21 but still remains.

Other Meds: Atorvastatin 10 mg Losartan 25 mg Centrum Silver Multivitamin Vitamin D3 2000IU Biotin

Current Illness: None

ID: 0960666
Sex: F
Age: 53
State: OH

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 01/21/2021
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: Pyrexia, White blood cell count decreased

Symptoms: mild headache began within hours of vaccination. injection site pain, agitation, body aches/myalgias overnight, woke up morning after with fairly severe chills, nausea, weakness/dizziness, severe headache (like an ice pick stabbing between my ears), neck stiffness/inflammation, upper body on both sides painful, lower back pain, injection site pain, sore throat. Went to doctor thinking I had the flu, 102.8 temperature recorded, elevated blood pressure, throat redness, "classis covid presentation" per provider. Negative rapid flu test, negative rapid covid test, negative pcr covid test. Combo of tylenol/ibuprofen was advised, so I have taken the max allowable and slept nearly all day and most of the night. second morning after 1/21/2021, still feeling ill, but not as bad as the day before, continuing to take combo of tylenol and ibuprofen as directed.

Other Meds:

Current Illness:

ID: 0960667
Sex: M
Age: 50
State: PR

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 01/21/2021
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: Pharyngeal swelling

Symptoms: DOLOR DE CABEZA ARDOR EN AMBOS OJOS DOLOR EN EL CUERPO INAPETENTE FIEBRE

Other Meds: NO

Current Illness: NO

ID: 0960668
Sex: M
Age: 74
State:

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 01/21/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: left arm muscle pain

Other Meds:

Current Illness:

ID: 0960669
Sex: F
Age: 82
State: IN

Vax Date: 01/11/2021
Onset Date: 01/13/2021
Rec V Date: 01/21/2021
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: Narcotics

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Red arm

Other Meds: Vit B, E,D, krill

Current Illness: None

ID: 0960670
Sex: F
Age: 42
State: IN

Vax Date: 01/18/2021
Onset Date: 01/19/2021
Rec V Date: 01/21/2021
Hospital:

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

Lab Data:

Allergies: Codeine

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

Symptoms: 14 hours later I woke up seeing black spots and felt trembly. My BP was 187/92 and my pulse was 120. I went home from work and became itchy to my neck and arms . At about 20 hours later I became short of breathe and pulse standing would go up to 140. I rested and continued taking Motrin and Tylenol as suggested . I ate minimally despite nausea . I messaged my Dr the next AM. By that time my glucose was settling down to normal and my Bp and pulse . The headache got worse and I had a pain in my axilla on the same arm I received the vaccine. I developed ?lymphadema? in that area which is sore to touch or move my arm. I reached out to infectious disease Dr at the hospital I work at and he suggested to continue Tylenol and Motrin and wait a week as this is due to vaccine. It is now Day 3 following vaccine and I am yet unable to work. My arm and axilla area is sore and I can?t lift my arm without pain, I have headaches and nausea as well.

Other Meds: 1 gm tylenol

Current Illness:

ID: 0960671
Sex: F
Age: 47
State: ME

Vax Date: 01/20/2021
Onset Date: 01/21/2021
Rec V Date: 01/21/2021
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: n/a

Symptom List: Rash, Urticaria

Symptoms: headache, Body aches , fever , arm hurt

Other Meds: metoprolol, metformin, amlodipine, levothyroxine, cytomel , glaxambi

Current Illness: none

ID: 0960672
Sex: M
Age: 50
State: WA

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 01/21/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: fever,chills,headache for 24 hours

Other Meds: amlodipine

Current Illness: covid infection diagnosed dec2,2020

ID: 0960673
Sex: F
Age: 28
State: PA

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 01/21/2021
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: nka

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

Symptoms: Muscle aches and headache 12 hours post. Fever and chills 18 hours post that resolved with tylenol. Muscle aches, headache and fatigue 24 hours post.

Other Meds: prenatal vitamin

Current Illness: n/a

ID: 0960674
Sex: F
Age: 23
State: MA

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 01/21/2021
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: N/a

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

Symptoms: Fever, chills, aches, fatigue

Other Meds: Citalopram 25 mg Vitamin b complex Magnesium 250 mg

Current Illness: N/a

ID: 0960675
Sex: M
Age: 74
State: FL

Vax Date: 12/29/2020
Onset Date: 01/20/2021
Rec V Date: 01/21/2021
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: Cipro Flagyl Avodart Griseofulvin

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

Symptoms: Acute left knee arthritis with pain and seelling

Other Meds: Bystolic 5 mg 1/day Coumadin 3.5 mg 1 per day Flecainide 50 mg 2 BID Augmentin 875 bid (started 2 days prior) Hizentra 8 gm sc once per week

Current Illness: Chronic inflammatory demyelinating polyneuropathy On Hizentra 8 gm sc once per week. Left lower quadrant oak and presumed diverticulitis started on augmentin on the evening of 1/18/2021

ID: 0960676
Sex: F
Age: 28
State: OH

Vax Date: 01/13/2021
Onset Date: 01/14/2021
Rec V Date: 01/21/2021
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: No

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

Symptoms: Moderna COVID-19 Vaccine EUA chills, sore arm, aches

Other Meds: Multi-vitamin

Current Illness: No

ID: 0960677
Sex: F
Age: 71
State: FL

Vax Date: 01/17/2021
Onset Date: 01/18/2021
Rec V Date: 01/21/2021
Hospital:

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

Lab Data:

Allergies: Aleve, Naprosyn, Quaternium, Sulfa

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Head, body aches and fever on day 1-2, then itchy red rash on back

Other Meds: Aspirin, Calcium, Cyclobenzaprine, gabapentine, Hydroxychloroquine, levothyroxine, Myrbetriq, premarin, trazadone, probiotic, multivitamin, trazadone, vitamin D3, Tylenol

Current Illness: None

ID: 0960678
Sex: F
Age: 32
State: PA

Vax Date: 01/15/2021
Onset Date: 01/16/2021
Rec V Date: 01/21/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Dizziness and nausea on day 5 of symptoms

Other Meds: Lexapro

Current Illness: Anxiety

ID: 0960679
Sex: F
Age: 51
State: GA

Vax Date: 01/08/2021
Onset Date: 01/14/2021
Rec V Date: 01/21/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

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

Symptoms: Fever, chills, severe headache, vomiting, diarrhea for 2 days

Other Meds: Atenolol, Losartin, Paxil, Metformin

Current Illness: none

ID: 0960680
Sex: M
Age: 39
State: FL

Vax Date: 01/15/2021
Onset Date: 01/15/2021
Rec V Date: 01/21/2021
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: Pistachio

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

Symptoms: Patient reported lethargy, hives, flushing and pain at injection site starting in the evening of 1/15/2021. Symptoms continued 1/16 and 1/17/21. On 1/18/21 in the morning patient noted lymph node swelling in the groins and still continued with intermittent flushing. Dr. made aware on Monday morning. On 1/19/2021 patient reported no further lethargy, site pain, or flushing but lymph node swelling persisted in bilateral groins.

Other Meds: Anastrozole 1mg, losartan 50 mg, multiviamin, quercetin, tumer

Current Illness:

ID: 0960681
Sex: F
Age: 24
State:

Vax Date: 12/23/2020
Onset Date: 12/28/2020
Rec V Date: 01/21/2021
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: Inflammation of lymph node in arm pit of injected arm.

Other Meds:

Current Illness:

ID: 0960682
Sex: F
Age: 29
State: NY

Vax Date: 01/12/2021
Onset Date: 01/18/2021
Rec V Date: 01/21/2021
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: Penicillin

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

Symptoms: Localized redness, swelling, and pain on the right arm, not located at the injection sight. The location is approximately two inches below the injection site.

Other Meds: Tri-lo-marzia (birth control)

Current Illness: None

ID: 0960683
Sex: F
Age: 46
State: MI

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 01/21/2021
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: Augmentin

Symptom List: Injection site pain, Pain

Symptoms: Hives on left hand itchy skin, within an hour. Cough, fatigue, headache, upset stomach sore arm (hard to move) fever 99.9. Hives went away after a few hours.

Other Meds: Wellbutrin, melatonin, mirtrazapine

Current Illness: No

ID: 0960684
Sex: F
Age: 63
State: NJ

Vax Date: 01/19/2021
Onset Date: 01/20/2021
Rec V Date: 01/21/2021
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 known

Symptom List: Injection site pain, Menorrhagia

Symptoms: Arm pain, fever, chills, headache, body aches, hard to concentrate

Other Meds: amlodipine hydroxyurea levothyroxine atrovent low dose aspirin Calcium supplement Vitamin D supplement

Current Illness: No

ID: 0960685
Sex: F
Age: 25
State: GA

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 01/21/2021
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: NKA

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

Symptoms: ?Moderna COVID-19 Vaccine EUA?. Received vaccine on 1/20 at 1030. Noted arm soreness later that afternoon around 1430. Had really bad chills, goosebumps, and shivering around 2230 (temp 98.1). Spiked a fever (temp 103.2) and had nausea around 0340 on 1/21. Took 2 tablets of 500mg Tylenol for fever. Only side effect noted after first dose of vaccine on 12/23 was arm soreness and fatigue.

Other Meds: Junel Fe birth control

Current Illness: None

ID: 0960686
Sex: F
Age: 71
State:

Vax Date: 01/20/2021
Onset Date: 01/21/2021
Rec V Date: 01/21/2021
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: slight left arm tenderness the day after vaccine

Other Meds:

Current Illness:

ID: 0960687
Sex: F
Age: 59
State: FL

Vax Date: 12/30/2020
Onset Date: 01/15/2021
Rec V Date: 01/21/2021
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: swelling on sites of intradermal fillers on face injected in 2018 - ongoing shortness of breath - ongoing joint pains Above are currently being treated with prednisone and daily Allegra. Both medicines were started on 01/15/2021. Joint pains have resolved. Other symptoms are improving. I am an internist. I self-medicated.

Other Meds: Singulair

Current Illness: Pretracheal/mediastinal lympadenopathy ( total of two lymph nodes) of indeterminate etiology on CT chest in 10/2020. Repeat CT chest in 12/2020 showed decrease in size of the lymph nodes.

ID: 0960688
Sex: F
Age: 46
State: AR

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 01/21/2021
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: Fever, HA, & Body aches

Other Meds: Synthroid, BP med

Current Illness: None

ID: 0960689
Sex: F
Age: 48
State: NY

Vax Date: 01/04/2021
Onset Date: 01/05/2021
Rec V Date: 01/21/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: temp 100.9-101.5 took tylenol last night temp 101.8 down to 99.9 chills body malaise, running nose

Other Meds:

Current Illness:

ID: 0960690
Sex: F
Age: 30
State: GA

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/21/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Injection site pain

Symptoms: I received the vaccine at 8:00am, and at approximately 7:00pm the same day, I developed a headache. About an hour later, I developed generalized muscle aches and subjective fever/chills. The symptoms did not interfere with my sleep, and when I woke up the next morning, the fever/chills had resolved. The myalgia and headache resolved by approximately 11:00am the day after I received the vaccine. I also had arm soreness from approximately 12 hours to about 72 hours after the vaccine.

Other Meds: None

Current Illness: None

ID: 0960691
Sex: F
Age: 60
State: GA

Vax Date: 01/19/2021
Onset Date: 01/20/2021
Rec V Date: 01/21/2021
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: Patient reported having severe chills and uncontrollable shaking for 2-3 hours about 24 hours after receiving her first dose. Symptoms resolved on their own and patient is no longer experiencing this issue.

Other Meds:

Current Illness:

ID: 0960692
Sex: F
Age: 31
State: NY

Vax Date: 01/13/2021
Onset Date: 01/19/2021
Rec V Date: 01/21/2021
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: Hardened swelling and redness at injection shot several days after injection Lymph nodes in left armpit in pain several days after injection

Other Meds: Mesalamine tablets

Current Illness:

ID: 0960693
Sex: F
Age: 38
State: MO

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 01/21/2021
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: Metronidazole Topamax Hydrocodone Clindamycin

Symptom List: Tremor

Symptoms: Reported tingling in face and "inside" while indicating her chest. Symptoms remained steady for 30 minutes and vital signs were stable.

Other Meds:

Current Illness:

ID: 0960694
Sex: M
Age: 64
State: NC

Vax Date: 01/07/2021
Onset Date: 01/16/2021
Rec V Date: 01/21/2021
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: Flexeril

Symptom List: Erythema, Pruritus

Symptoms: Tested positive for Covid -19 by PCR after second vaccination

Other Meds: Nexium

Current Illness:

ID: 0960695
Sex: F
Age: 37
State: AR

Vax Date: 01/19/2021
Onset Date: 01/20/2021
Rec V Date: 01/21/2021
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: no

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

Symptoms: Began to have chills, fatigue, sore throat and low grade fever at 0130 1/20.

Other Meds: Zoloft and ADHD medication

Current Illness: Had Covid-19 1 month prior

ID: 0960696
Sex: F
Age: 58
State: MO

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 01/21/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Fever, chills, body aches, headaches

Other Meds:

Current Illness:

ID: 0960697
Sex: F
Age: 67
State: ME

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 01/21/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Patient broke out in hives on arms and chest. Was given Benadryl and observed. Was sent home after improvement. Counselled on pre-medication with Benadryl prior to dose #2.

Other Meds:

Current Illness:

ID: 0960698
Sex: F
Age: 49
State:

Vax Date: 01/20/2021
Onset Date: 01/21/2021
Rec V Date: 01/21/2021
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: Employee received her #2 COVID vaccine at 0930. At 0300 on 1/21/2021 she woke up with temp of 101, chills, bodyaches and pain in the neck and lower back. Diarrhea starting at 0730.

Other Meds:

Current Illness:

ID: 0960699
Sex: M
Age: 54
State: VA

Vax Date: 01/14/2021
Onset Date: 01/17/2021
Rec V Date: 01/21/2021
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: Inflammation, erythema, pain, stiffness starting in right elbow, persisted for approx 5 days and then began in left elbow.

Other Meds: Losartan, amlodipine, HCTZ

Current Illness: None

ID: 0960700
Sex: F
Age: 40
State: MO

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/21/2021
Hospital:

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

Lab Data:

Allergies: Seasonal/Environmental

Symptom List: Pain in extremity

Symptoms: Tongue tingling and throbbing Immediate headache Hives on back of neck at hairline and a small patch on upper chest that persisted for weeks following initial vaccine. First day hive free was January 19th.

Other Meds:

Current Illness:

ID: 0960701
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 01/21/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: None stated.

Other Meds:

Current Illness:

ID: 0960702
Sex: F
Age: 52
State: PA

Vax Date: 01/11/2021
Onset Date: 01/14/2021
Rec V Date: 01/21/2021
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: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: After 4 days begun to get headaches that are increasingly worse as the days pass. After a week have noticed bouts of vertigo that are getting increasingly worse. The vertigo and headaches have made me nauseous at times.

Other Meds: None

Current Illness: None

ID: 0960703
Sex: F
Age: 24
State: MN

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 01/21/2021
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: seafood

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

Symptoms: Client reported severe allergy to seafood and some medications, but did not list them. Denied allergies to vaccine ingredients. Reports she spoke with her healthcare provider and was told there was no concern about this vaccine. Received vaccine and within a few minutes red blotchy hives spread up her arms, neck and torso. EMS responded. Client reported this was a common response for her and stated she has had about 8 similar episodes over the last several months. After about 20 minutes the rash continued. No difficulty breathing had occurred, however the client then reported that occasionally some tightness in her breathing occurred after about 45 minutes. After initially declining to be transported to the ER, she agreed to be transported to be monitored. Client declined the use of the stretcher and walked out with EMS to be transported to the ER for observation.

Other Meds:

Current Illness: none

ID: 0960704
Sex: M
Age: 31
State: GA

Vax Date: 01/18/2021
Onset Date:
Rec V Date: 01/21/2021
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: Melons

Symptom List: Vomiting

Symptoms: began severe muscle aches, nausea and vomiting and itching. We went to grady clinic today 1/21/21 and was evaluated/treated. He is feeling a little better today - was given several prescriptions.

Other Meds: triumeq, quetiapine, fumarate, carbacepine, amitriptyline, hydroxyzin

Current Illness: none

ID: 0960705
Sex: F
Age: 43
State: NY

Vax Date: 01/19/2021
Onset Date: 01/20/2021
Rec V Date: 01/21/2021
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: fever 101.3, body aches, headache, tired

Other Meds:

Current Illness:

ID: 0960706
Sex: F
Age: 33
State: IN

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 01/21/2021
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: Back pain, Cold sweat, Headache, Nausea, Vomiting

Symptoms: itchy left eye beginning one hour after vaccination chills the day after vaccination mild cough the day after vaccination extreme fatigue for 36 hours swollen puffy left eye the day after vaccination, still currently experiencing more that 40hrs after vaccination

Other Meds:

Current Illness:

ID: 0960707
Sex: F
Age: 20
State: OH

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 01/21/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: no allergies; but patient reports nausea with flu shot when gets it every year

Symptom List: Injection site swelling, Limb discomfort

Symptoms: patient states feeling nausea (same as whenever she gets flu shot)

Other Meds: citalopram

Current Illness: n/a

ID: 0960708
Sex: F
Age: 50
State: AR

Vax Date: 01/14/2021
Onset Date: 01/17/2021
Rec V Date: 01/21/2021
Hospital:

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

Lab Data:

Allergies: nka

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

Symptoms: began to have periorbital edema with skin sloughing around eyes

Other Meds: Ibuprofen

Current Illness: none

ID: 0960709
Sex: F
Age: 33
State: IN

Vax Date: 01/06/2021
Onset Date: 01/13/2021
Rec V Date: 01/21/2021
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: Toradol

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

Symptoms: Shingles. I was prescribed Valtrex.

Other Meds: Adderall, Buspar, Pristiq, Spironolactone, Noreth/Ethin-FE (Birth control), Metformin, Trazadone

Current Illness: none

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm