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: 0965783
Sex: F
Age: 28
State: NJ

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 01/22/2021
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: I just wanted to report an incident that occurred after receieving the first dose of the covid vaccine. It was not one of the possible reaction from covid vaccine but rather administrator error in injecting the vaccine. The symptoms appeared about 3 hours after receiving the vaccine, now have numbness, tingling, pain and burning sensation on my left pam in the arm of given vaccine. Obviously, the person giving the vaccine, hit the nerve.

Other Meds: no

Current Illness: no

ID: 0965784
Sex: F
Age: 45
State: KS

Vax Date: 01/14/2021
Onset Date: 01/15/2021
Rec V Date: 01/22/2021
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: Fever Headache fatigue started 1/15/2021 at 7:30am

Other Meds: None

Current Illness: None

ID: 0965785
Sex: F
Age: 49
State: CO

Vax Date: 01/08/2021
Onset Date: 01/16/2021
Rec V Date: 01/22/2021
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: bacitracin . She has had 2 episodes of anaphylaxis after bacitracin that has been documented in record.

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

Symptoms: Only sore arm initially. 1/16/21 she developed redness heat and swelling at site. no fever. treated with ice and ibuprofen. she takes zyrtec daily for allergies. condition improved by time of evaluation 1/22/2021- fading redness, no heat

Other Meds: none. sometimes takes allergy medications

Current Illness: no ne

ID: 0965786
Sex: F
Age: 32
State: NE

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 01/22/2021
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: DAVELOPED BODY ACHES, FEVER, AND CHILLES THAT LASTED UNTIL 1/21/21 @6AM.

Other Meds:

Current Illness:

ID: 0965787
Sex: M
Age: 65
State: OK

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 01/22/2021
Hospital:

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

Lab Data:

Allergies: Statins= headaches

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

Symptoms: 10 minutes after leaving driving home, sudden rush feeling and dizziness, feeling warmth in my chest, up my neck and into head. 2 hours later still feel light heated.

Other Meds: Vitamins C, D, B12 , 81mg aspirin, Coreg6.25

Current Illness:

ID: 0965788
Sex: F
Age: 22
State: MN

Vax Date: 01/12/2021
Onset Date: 01/19/2021
Rec V Date: 01/22/2021
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: N/A

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

Symptoms: Moderna COVID-19 Vaccine EUA I had gotten the these three red, circle marks on my left arm, below and diagonal from the injection site on Wednesday, 01/20/2021. On the 21st I noticed these three red circles grew to where they merged into one large spot. I drew a pen line around the spot to monitor the growth. Today, 22nd, I noticed it grew past the pen line. I have drawn another pen line around the new growth and will continue to supervise it. No itching, pain. A little heat from it.

Other Meds: N/A

Current Illness: N/A

ID: 0965789
Sex: M
Age: 30
State: OR

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/22/2021
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: amoxicillin

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Hot flashes, itching/tickling sensation in throat, coughing, facial flushing. Resolved within minutes. Throat tickle returned a few hours later.

Other Meds: pantoprazole, atenolol

Current Illness: palpitations, anxiety

ID: 0965790
Sex: M
Age: 15
State: OR

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/22/2021
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: minor age 15 received COVID vaccine. no adverse reaction

Other Meds:

Current Illness:

ID: 0965791
Sex: F
Age: 41
State: CO

Vax Date: 01/21/2021
Onset Date: 01/22/2021
Rec V Date: 01/22/2021
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, cyphalosporins, benadryl

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Malaise, severe generalized body aches especially around knees hips, jaw,ankles, headache, nausea, chills, fever up to 101.4. Severe heartburn. Taking dayquil 30 ml q4 hrs with 2 ibuprofen tablets q6 hrs with famotadine in AM.

Other Meds: None

Current Illness: None

ID: 0965792
Sex: F
Age: 44
State: IL

Vax Date: 01/21/2021
Onset Date: 01/22/2021
Rec V Date: 01/22/2021
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: Shellfish.

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Blotchy skin, cold and clammy, fatigue, vomiting.

Other Meds: 15. Former Brain cancer patient. on standard dosages for seziures, steriods, graves, and addisons disease.

Current Illness: No.

ID: 0965793
Sex: F
Age: 38
State: NY

Vax Date: 01/18/2021
Onset Date: 01/21/2021
Rec V Date: 01/22/2021
Hospital:

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

Lab Data:

Allergies: Penicillin, Aleve/NSAIDs, dust, cats

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

Symptoms: Soreness in arm for 4 days following the injection (beginning within a few hours of the injection), headache for one day, fatigue for four days (through the present), brain fogginess, and starting three days after, hives and throat tightness. Still going on.

Other Meds: prozac (10mg), hydroxychloroquine (400mg), vitamin D, multivitamin, resveratrol, biotin, injection of ketamine for depression

Current Illness: n/a

ID: 0965794
Sex: F
Age: 62
State: WI

Vax Date: 10/16/2020
Onset Date: 10/16/2020
Rec V Date: 01/22/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Rash, Urticaria

Symptoms: On 01/21/21, patient was in the next booth over and she stated the shot got her really sick. She stated she went to work and was extremely dizzy that night, and the next day she stated she felt even more dizzy, shaky, nauseated, and ended up vomiting a small amount that was all acid she stated. She fell asleep after vomiting, and stated she felt back to normal the next day.

Other Meds: None

Current Illness: None

ID: 0965795
Sex: F
Age: 26
State:

Vax Date: 01/15/2021
Onset Date: 01/18/2021
Rec V Date: 01/22/2021
Hospital:

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

Lab Data:

Allergies: Dairy, fructose

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

Symptoms: Fever, chills, cough, shortness of breath, HA, nasal congestion. Started about 2 days after immunization and lasted about one week.

Other Meds: Wellbutrin, methylphenidate, valacyclovir

Current Illness: Viral pharyngitis in Dec 2020

ID: 0965796
Sex: F
Age: 37
State:

Vax Date: 01/16/2021
Onset Date: 01/16/2021
Rec V Date: 01/22/2021
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: shellfish, strawberry, tomato

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

Symptoms: itchy scalp, back, neck; palpitations; lightheaded

Other Meds: oral contraceptive

Current Illness:

ID: 0965797
Sex: F
Age: 46
State: WI

Vax Date: 01/16/2021
Onset Date: 01/16/2021
Rec V Date: 01/22/2021
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: NA

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

Symptoms: 8 1/2 hrs. after receiving 2nd dose, right arm became very painful, right axillary lymph nodes enlarged, and right breast pain and swelling started. Symptoms impeded function of arm. Seen by a provider on 1/19/2021

Other Meds: NA

Current Illness: NA

ID: 0965798
Sex: F
Age: 84
State: OH

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 01/22/2021
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: NKA

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

Symptoms: throat felt funny, she said it felt strange to swallow and that her head felt funny. Administered 25mg Benadryl and gave patient water.

Other Meds: Benadryl 25mg 1 tab

Current Illness:

ID: 0965799
Sex: F
Age: 67
State: NJ

Vax Date: 01/14/2021
Onset Date: 01/22/2021
Rec V Date: 01/22/2021
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: Only formaldehyde

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

Symptoms: I woke up today, 1/22/2021, with an extremely itchy left arm. I also woke up 1 hour after the alarm went off, and was still lethargic. The source of the itch is a 1.5" rash just below the vaccination site on my left arm. The rash appears over a hard or swollen bump that is the same size as the rash. I may also have a rash on my left neck because it itches, but I can't see or feel it.

Other Meds: Asacol, fenofibrate; calcium, probiotic (Culturelle), iron (Feosol)

Current Illness: NONE

ID: 0965800
Sex: M
Age: 45
State: MA

Vax Date: 12/22/2020
Onset Date: 12/23/2020
Rec V Date: 01/22/2021
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: Adverse reaction on the same day

Other Meds:

Current Illness:

ID: 0965801
Sex: M
Age: 62
State: FL

Vax Date: 01/14/2021
Onset Date: 01/15/2021
Rec V Date: 01/22/2021
Hospital: Y

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: 1/14 vaccine, code blue in hospital 1/15, discharged 1/20

Other Meds:

Current Illness:

ID: 0965802
Sex: M
Age: 62
State: NE

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 01/22/2021
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: DAVELOPED HEADACHE, BODY ACHES, FEVER, BACK ACHE, EXTREME CHILLS, NIGHT SWEATS, EXTREME FATIGUE

Other Meds:

Current Illness:

ID: 0965803
Sex: F
Age: 81
State: IL

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 01/22/2021
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: Most pain meds- morphine, pollen, opioids of any kind

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

Symptoms: the night of vaccine Started feeling bad all over about 7 pm aching and chills all over. went to bed early because i felt so bad a little nauseous. about an hr later i got up and threw up. i took 1 tsp of pepto, before i threw up and after. I only weight 89 pounds so i feel like it affected me differently. the next day (today) had nausea when i woke up but am starting to feel a little better. able to keep down a little yogart.

Other Meds: Calcuim, before vaccine CBD that night before bed Tylenol yesterday afternoon

Current Illness:

ID: 0965804
Sex: F
Age: 33
State: WI

Vax Date: 01/11/2021
Onset Date: 01/12/2021
Rec V Date: 01/22/2021
Hospital:

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

Lab Data:

Allergies: Bactrim

Symptom List: Unevaluable event

Symptoms: Day after vaccine I began to have tachycardia upon standing and walking. Heart rates are in the 140-170s when walking a normal pace. Resting heart rate is much higher than normal at around 100. When climbing stairs, heart rate gets into the high 170s. Shortness of breath and dizziness accompany standing, walking and climbing stairs. These symptoms still persist - have been ongoing from 11/12/21 - 11/22/21.

Other Meds: Tramadol, Clonazepam, Lyrica

Current Illness: None

ID: 0965805
Sex: M
Age: 73
State: TX

Vax Date: 01/07/2021
Onset Date: 01/11/2021
Rec V Date: 01/22/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: soreness more than normal and a slight rash about 2 inches in diameter

Other Meds: Atorvastatin 80mg metformin 500 mg allopurinol 300 mg eliquis 5 mg 2x day Solatik 40mg 2xday

Current Illness: none

ID: 0965806
Sex: F
Age: 72
State: FL

Vax Date: 01/09/2021
Onset Date: 01/21/2021
Rec V Date: 01/22/2021
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 known

Symptom List: Injection site pain, Pain

Symptoms: Two areas of Redness, Swellling and slight heat but no pain or itching. One of 1/2" on injection site and another of 1 1/2" @ 2" below. No systemic symptoms

Other Meds: Levothyroxine (88 mcg). IBGuard. Calcium. Vit E. Vit D. Magnesium. Miralax. Glucosamine. GasX. Lactase. Glutten Cutter. Biotin. Restasis eye drops. Celuvisc eye drops.

Current Illness: None

Date Died: 01/16/2021

ID: 0965807
Sex: F
Age: 90
State: GA

Vax Date: 01/08/2021
Onset Date: 01/09/2021
Rec V Date: 01/22/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List: Injection site pain, Menorrhagia

Symptoms: began itching within 24 hours, within 5 days couldn't move on her own, by 6th day was having respiratory issues, by day 7 unresponsive, by day 8 dead

Other Meds: metoprolol, methotrexate, calcitrol, digoxin, calcium prednisone, clopidogrel, levothyroxine, folic acid, pantoprazole, eliquis, atorvastatin, latanoprost, melatonin

Current Illness: nose bleeds

ID: 0965808
Sex: F
Age: 42
State: OK

Vax Date: 01/19/2021
Onset Date: 01/20/2021
Rec V Date: 01/22/2021
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: Ibuprofen Rabbits Eggs Latex

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

Symptoms: Body aches, chills, headache, dizziness, ringing in the ears, nausea, vomiting, and fatigue

Other Meds: Levothyroxine Wellbutrin Protonix Claritin Vitamin d Vitamin b12 Iron Vitamin c

Current Illness: None

ID: 0965809
Sex: F
Age: 59
State: IL

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 01/22/2021
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: patient reports being ill and having an arm reaction

Other Meds:

Current Illness:

ID: 0965810
Sex: F
Age: 56
State: PA

Vax Date: 01/10/2021
Onset Date: 01/11/2021
Rec V Date: 01/22/2021
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: received vaccination on 1/10/21 on 1/11/21 developed bright red rash with swelling and arm soreness. All symptoms started to go away on 1/13/21. On 1/16/21 injection site on left arm became very itchy and bright red rash appeared again. Site was swollen and arm pain was worse than first time. Not debilitating but my shoulder and elbow were sore this time. On 1/22 rash is not as red but still there. Arm soreness is still there also

Other Meds: Lisonopril 40 mg Omeprazole 20 mg HCTZ 25 mg Amiodipine 5mg Ropinorole 0.5mg Fluoxetine 10 mg

Current Illness: none

ID: 0965811
Sex: F
Age: 44
State: MD

Vax Date: 01/12/2021
Onset Date: 01/13/2021
Rec V Date: 01/22/2021
Hospital:

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

Lab Data:

Allergies: penicillin

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

Symptoms: initial red swelling around injection site, about 2" diameter . Went away in about 5 days return about a week later. Warm to the touch but no longer raised

Other Meds: vitamin d, zyrtec, zinc, vitamin a, vitamin b12

Current Illness: Sinus infection month prior

ID: 0965812
Sex: F
Age: 86
State: MN

Vax Date: 01/20/2021
Onset Date: 01/21/2021
Rec V Date: 01/22/2021
Hospital: Y

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

Lab Data:

Allergies: Penicillin (rash) Cat dander/hair

Symptom List: Nausea

Symptoms: Tenant developed nausea/vomiting in the middle of the night after vaccination. The next day she continued with GI upset, fever, and body aches. Toward the afternoon with Tylenol she appeared to be feeling better. At around 6pm she had sudden onset shortness of breath and respiratory distress. Nebulizer was given without improvement, O2 sats were in the 70's and 80's. Tenant was transported to the hospital via ambulance

Other Meds:

Current Illness: None

ID: 0965813
Sex: F
Age: 29
State: CA

Vax Date: 01/12/2021
Onset Date: 01/21/2021
Rec V Date: 01/22/2021
Hospital:

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

Lab Data:

Allergies: Shellfish, dust

Symptom List: Injection site pain

Symptoms: Itching since the vaccination day and rash appeared 9 days after the vaccine (1/21/2021) and getting bigger.

Other Meds: Desogestrel/Ethinyl Estradiol, Vitamin C, Vitamin E, Multi-vitamins

Current Illness:

ID: 0965814
Sex: F
Age: 55
State: NV

Vax Date: 01/04/2021
Onset Date: 01/18/2021
Rec V Date: 01/22/2021
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: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Rash at vaccination site appeared on 01/18/21

Other Meds: Losartan, hydrochlororthiazide

Current Illness: None

ID: 0965815
Sex: F
Age: 49
State: CA

Vax Date: 01/15/2021
Onset Date: 01/19/2021
Rec V Date: 01/22/2021
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: Imetrex

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

Symptoms: Repeated Headaches treated with tylenol. Began 4 days post shot and continues. Shortness of breath (not explained by other activity) upon waking each morning. Also began 4 days post injection. Use of albuterol inhaler provides little relief. Symptom comes and goes

Other Meds: Daily vitamin Vit D

Current Illness: None

ID: 0965816
Sex: F
Age: 50
State: CT

Vax Date: 01/11/2021
Onset Date: 01/19/2021
Rec V Date: 01/22/2021
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: Soy intolerance

Symptom List: Tremor

Symptoms: Beginning the evening of the 8th day after receiving the vaccine my arm began to feel sore and tender in the area of the injection. Upon waking on the 9th day after the vaccination, the arm was red, warm, tender to touch, sore and itchy in a roundish area at the injection site. This has now continued for two days without resolving.

Other Meds: Glucosamine/Chondritin/MSM blend, Women's multivitamin (Centrum equivalent), Zyrtec

Current Illness: none

ID: 0965817
Sex: F
Age: 28
State: PA

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 01/22/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: Lightheadiness, facial flushing, heaviness of head, tired.

Other Meds:

Current Illness:

ID: 0965818
Sex: F
Age: 37
State: IL

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 01/22/2021
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: Penicillin

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

Symptoms: Fatigue, achiness, headache, sore arm for about 24 hours

Other Meds: Lamictal, NPThyroid, Xyzal

Current Illness:

ID: 0965819
Sex: F
Age: 39
State: WA

Vax Date: 01/13/2021
Onset Date: 01/19/2021
Rec V Date: 01/22/2021
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: Reglan (medication), environmental allergies (cats, pollen, mold)

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

Symptoms: Red solid rash around injection site that is growing over time. Current size 4.5inches x 5.5inches. Itchy, swollen, hot skin. Headache lasting from 1/13 to present time. Urgent care appintment on 1/21 prescribed 50mg benadryl and triamcinolone acetonide 0.1% ointment twice daily. Follow up appointment 1/23 by 3pm.

Other Meds: Zyrtec

Current Illness: None

ID: 0965820
Sex: F
Age: 25
State: IN

Vax Date: 01/20/2021
Onset Date: 01/21/2021
Rec V Date: 01/22/2021
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: Environmental and animal allergies only

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Lightheaded, fever (reached 102 degrees before taking Tylenol), extremely thirsty, fatigue, body aches. Very similar to the flu.

Other Meds: Allergy shots every month, flu shot received on 1/9

Current Illness: N/A

ID: 0965821
Sex: M
Age: 43
State: IN

Vax Date: 01/20/2021
Onset Date: 01/21/2021
Rec V Date: 01/22/2021
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: Body aches, tired, hard time catching my breath, mind foggy

Other Meds:

Current Illness:

ID: 0965822
Sex: F
Age: 48
State: TX

Vax Date: 01/08/2021
Onset Date: 01/19/2021
Rec V Date: 01/22/2021
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 reported

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

Symptoms: . On Friday 1/8/21, Pt was vaccinated with Moderna first dose in the left deltoid muscle. No immediate issues/complications. Beginning Tuesday 1/19/21 (eleven days post-vaccine), she reports noticing itching in the injection site; no rash or other symptoms (e.g. temperature elevation, shortness of breath, wheezing, swelling, hives). Today 1/20/21 her arm has a noticeable ?rash? type reaction. She reports continued itching but no particular pain or tenderness. No visible pustules but the area is reddened and very slightly warm but not ?hot-to-touch?. At about 4:15 pm, the affected area measured approximately 2 ? inches (5.5 cm) wide by 2 ? inches (6.5 cm) long. 1/21/20, Pt reported taking oral diphenhydramine overnight /1/20/21) with reduced itching/swelling but again today notes return of redness, swelling and warm to touch. Pt reports about 3 years ago having a "tetanus" booster ? had a reaction of the entire upper arm with swelling, redness and hot-to touch. No reported anaphylaxis. Based on consultation with the regional medical director, and the Infectious Disease Specialist, they will defer providing the second dose of Moderna. Pt has been referred to her private health care provider with a recommendation to consider referral to an infectious disease practitioner for any future COVID-19 vaccine administration.

Other Meds: occasional acetaminophen and ibuprophen only

Current Illness: none reported

ID: 0965823
Sex: F
Age: 50
State: WA

Vax Date: 01/13/2021
Onset Date: 01/14/2021
Rec V Date: 01/22/2021
Hospital:

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

Lab Data:

Allergies: amlodipine, amoxicillin, penicillin, sulfa antibiotic

Symptom List: Pain in extremity

Symptoms: Patient called the pharmacy to report adverse events a week after it started. She stated the normal possible listed side effects of diarrhea/headache for 72 hours but said he redness, swelling tender at the injection site seemed pretty extreme and lasted 6 days. On day 7 it actually came back worse than the first time so she went into her doctors office. Her doctor was thinking that she was having a delayed reaction response and they marked the area and was told to come back if it got any worse. Last note I heard from the patient is that it did get worse and she was going back in to possibly get antibiotics. The doctor was thinking possible cellulitis due to the injection site. The injection site was very far back on the deltoid and the MD stated she thought the vaccine was in the soft tissue vs being in the muscle.

Other Meds:

Current Illness:

ID: 0965824
Sex: F
Age: 46
State: IL

Vax Date: 01/16/2021
Onset Date: 01/16/2021
Rec V Date: 01/22/2021
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: RN administered 0.5mL dose of the COVID-19 vaccine instead of 0.3mL. No adverse reactions were documented.

Other Meds: allopurinol, metformin, liraglutide, montelukast, levocetirizine

Current Illness: none

ID: 0965825
Sex: M
Age: 39
State: NY

Vax Date: 01/12/2021
Onset Date: 01/18/2021
Rec V Date: 01/22/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: ON 01/18/2021, 6 DAYS AFTER INJECTION ON 01/12/2021, I BEGAN TO DEVELOPE AN ITCHY, RED RASH AROUND THE INJECTION SITE ON MY LEFT ARM. AS OF THIS DAY IT CONTINUES TO GAIN IN SIZE, ALTHOUGH BECOMING LESS RED IN COLOR TOWARDS THE CENTER. AS OF THIS DATE, IT MEASURES APPROX. 5" L X 3"W. DOCTORS PRESCRIBED Z-PACK IN CASE OF INFECTION, PREDNISONE, DESOXIMETASONE USP CREAM, AND BENADRYL REGIMENT.

Other Meds:

Current Illness:

ID: 0965826
Sex: F
Age: 34
State: CA

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 01/22/2021
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: Headache Fever

Other Meds:

Current Illness:

ID: 0965827
Sex: F
Age: 50
State: CA

Vax Date: 01/13/2021
Onset Date: 01/18/2021
Rec V Date: 01/22/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: Headache, diarrhea, body aches

Other Meds:

Current Illness:

ID: 0965828
Sex: F
Age: 61
State: KS

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 01/22/2021
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: previous reaction (hives) to an antibiotic she doesn't recall the name of.

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Pt reported previous adverse reaction to an antibiotic that she recalls giving her hives. Due to this we observed her for 30 minutes following administration of vaccine. About 25 minutes into her observation period she began developing hives on her forearms and wasn't feeling her normal self. She denied any respiratory symptoms but was continuously clearing her throat and when asked if she normally did that, she stated that she did not. Decision was made to take vital signs and administer 50mg of IM Diphenhydramine. She was agreeable to this plan . After administering Diphenhydramine, we continued to monitor her vitals and had her stay another 45 minutes for observation. Hives resolved and vital signs remained within normal limits. Patient was education on allergic reactions and she to seek medical care. Patient verbalized understanding and felt back to her normal self.

Other Meds: none reported

Current Illness: None reported

ID: 0965829
Sex: F
Age: 51
State: MD

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 01/22/2021
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: no

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

Symptoms: Received the Pfizer COVID-19 vaccine this morning and, while walking back to work, experienced hypertension, tachycardia, diaphoresis, shortness of breath, anxiety and chest discomfort. Code Blue was called; she received supplemental oxygen and was given Aspirin 81 mg. Emergency Medical Services (911) were contacted and arrived at 11:45 AM. She was assessed and an intravenous line was inserted. She was transported to an emergency room and left this facility at 12:20 PM. Update: The employee was assessed and treated at Hospital. She was not admitted; she was directed to follow up with her primary care provider and to seek a referral to a cardiologist.

Other Meds: none

Current Illness: no

ID: 0965830
Sex: F
Age: 42
State:

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 01/22/2021
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: Shellfish Latex Phenergan Sulfa

Symptom List: Injection site swelling, Limb discomfort

Symptoms: stomach cramps and bloating

Other Meds: Buspar Paroxetine Zyrtec Singular Pantoprazol Magnesium B complex Cranberry

Current Illness: None

Date Died: 01/20/2021

ID: 0965831
Sex: F
Age: 74
State: MI

Vax Date: 01/18/2021
Onset Date: 01/20/2021
Rec V Date: 01/22/2021
Hospital:

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

Lab Data:

Allergies: Allergies: Brilinta, ACE Inhibitors, Bactrim, Cipro, Codeine Derivatives, Penicillins, Statins, sulfa

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

Symptoms: Patient received her first dose of vaccine on Monday, January 18th. Two days later on Wednesday, January 18th, she retired to bed early. Later that night when her husband went to bed, he found her in the bed deceased. No other details of the event are know.

Other Meds: Albuterol Sulfate HFA 108 MCG/ACT AERS Allopurinol 300 MG Oral Tablet Aspirin Low Dose 81 MG TABS Baclofen 10 MG Oral Tablet Bystolic 10 MG Oral Tablet Clobetasol Propionate 0.05 % External Cream Cyanocobalamin 1000 MCG TABS Fish Oil

Current Illness: Emergency Room Visit 1/7/2021 complaining of shortness of breath and swelling. She and elevated D-dimer with no evidence of a Pulmonary Embolus. Persantine Myoview showed small mild area of reversible ischemia to the inferolateral apical wall. Mild symptoms of vague discomfort in her chest, but nothing that has been reproducible with activity. She is chronically short of breath with limited activities because of problems with her hip

ID: 0965832
Sex: F
Age: 28
State: CA

Vax Date: 01/21/2021
Onset Date: 01/22/2021
Rec V Date: 01/22/2021
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: Fever, headache. Improved.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm