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: 0967011
Sex: M
Age: 60
State: NV

Vax Date: 12/02/2020
Onset Date: 12/03/2020
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:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Felt dizzy and nauseas for 2 days after the vaccine

Other Meds:

Current Illness:

ID: 0967012
Sex: F
Age: 32
State: CA

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

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Pt reported nausea at 10:34am. Vitals were evaluated. b/p 102/78 p 111 o2 99%. Pt reassessed at 10:37am. cont to c/o nausea. pulse 105 o2 99%. Pt reassessed at 10:40. Deneid nausea. Pulse 108, o2 99. Pt released by MD.

Other Meds:

Current Illness:

ID: 0967013
Sex: F
Age: 77
State: CA

Vax Date: 01/22/2021
Onset Date: 01/22/2021
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: Sulfa

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

Symptoms: 20 minutes after injection my heart started beating rapidly and then it went into Atrial Fibulation. This irregular rhythm lasted for about 45 minutes and then converted back to sinus rhythm.

Other Meds: DILTIAZEMCD,FLECAINIDE, ELIQUIS, ROSUVASTATIN, GABAPENTIN MAXI TEARS, MAGNESIUM, CITRICAL, MULTI VITAMIN, VITAMIN D3, CO Q 10, SUPER B COMPLEX

Current Illness: Multiple Sclerosis, High Blood pressure, Artial Fibrulation (controlled by medication) High Cholesterol

ID: 0967014
Sex: F
Age: 34
State: TX

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

Lab Data:

Allergies: Penicillin, codine

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Small headache, fatigue, fever,

Other Meds: None

Current Illness: None

ID: 0967015
Sex: F
Age: 19
State: AZ

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: prevenar vaccine

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

Symptoms: rash, itchy skin, itchy throat

Other Meds: advair/levalbuteral

Current Illness: no

ID: 0967016
Sex: F
Age: 36
State: WA

Vax Date: 01/22/2021
Onset Date: 01/22/2021
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:

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

Symptoms: Tingling in had on side of injection site.

Other Meds:

Current Illness:

ID: 0967017
Sex: F
Age: 75
State:

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

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Minor headache, stomachache, resolved in less than 30 minutes. Vital signs measured, blood pressure 163/117, repeat in 15 minutes without intervention on a different blood pressure measuring device was 150/87.

Other Meds:

Current Illness:

ID: 0967018
Sex: F
Age: 65
State: FL

Vax Date: 01/05/2021
Onset Date: 01/13/2021
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: None

Symptom List: Pharyngeal swelling

Symptoms: On day 8 hard lump the size of palm developed over vaccine site as well as a red spotty rash on top of lump. The next day the hard lump turned into the size of a hand and there was a red circle fully red inside with a defined edge over this lump. Went to doctor was told they don?t know what it was maybe to be safe gave her antibiotics in case it was cellulitis and that is all she was given. Seems to be going down but still a small lump

Other Meds: Xarelto, trazadone, bumetadine, potassium, cholesterol medication

Current Illness: Congestive heart failure

ID: 0967019
Sex: F
Age: 31
State: KS

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:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Patient started to show signs of hives 30 mins after vaccination. Her symptomps started as mild hive and persist and worsen. Advise patient to call PCP for treatment guidance and also advise to go to urgent care if her sympstoms keeps escalating.

Other Meds:

Current Illness:

ID: 0967020
Sex: F
Age: 44
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: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Fever almost fainted feels BP dropped. left work

Other Meds:

Current Illness:

ID: 0967021
Sex: F
Age: 28
State: CO

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

Lab Data:

Allergies: Penicillin

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

Symptoms: Swelling and redness at injection site, dizziness, fatigue, body aches, chest pressure, difficulty breathing, nausea- currently lasting almost 2 days

Other Meds: Levothyroxine, phentermine, probiotic, estradiol, amino acid supplement, albuterol inhaler

Current Illness: None

ID: 0967022
Sex: F
Age: 67
State: CA

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

Lab Data:

Allergies: penicillian, valproic, sulfa antibiotics, iodine, shell fish

Symptom List: Rash, Urticaria

Symptoms: Patient complained of Itchy eyes and tightness in her chest.

Other Meds: unknown

Current Illness: N/A

ID: 0967023
Sex: F
Age: 36
State: CA

Vax Date: 01/15/2021
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: LA

Lab Data:

Allergies:

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

Symptoms: Injection site reactions: itchiness spreading like a rash swollen

Other Meds:

Current Illness:

ID: 0967024
Sex: F
Age: 78
State: MO

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

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

Symptoms: Patient reports that she had severe swelling at injection site.

Other Meds:

Current Illness:

ID: 0967025
Sex: F
Age: 78
State: MO

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

Lab Data:

Allergies: Erythromycin, Codeine, Macadamia Nuts

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

Symptoms: When I awoke this morning and was getting dressed, I noticed a soreness in the back of my left leg (on the right side of the left leg). I felt a lump, It was about 2-3 inches above the knee. It was what I would describe as a medium-sized lump. I called my doctor to leave a message about my symptoms. My doctor called a few minutes after 11 am and asked me to immediately come in so he could see the lump. He thought I might have a blood clot. This lump was not present late last night because when I put lotion on my legs after my shower, I felt no lump or soreness. I worked out this morning and by 11:00, it seemed to me the lump was not as big as it was when I was getting dressed earlier this morning.

Other Meds: Metoprolol, Calcium, Fish Oil, Vitamin D3, Omeprazole, Furosemide, Potassium, Forteo Injections, Restasis, Daily probiotic

Current Illness: None

ID: 0967026
Sex: F
Age: 35
State: LA

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: IM
Vax Site: LA

Lab Data:

Allergies: Kiwi, Bactrim

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

Symptoms: Body aches leading into flushing and nausea. Then vasovagal event. Unconscious for an unknown period of time. Symptoms occurred at approximately 02:30am, no treatment sought at time of event. Dizziness and weakness continued for about another hour. No further episodes of fainting. Body aches and fatigue continued into the next day for approximately 24 hours in total, pain managed with Motrin. All symptoms then resolved.

Other Meds: None

Current Illness: None

ID: 0967027
Sex: F
Age: 81
State:

Vax Date: 01/22/2021
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:

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

Symptoms: Patient felt faint, hot, weak, had to sit down upon trying to leave the facility after observation period. Vital signs stable, blood glucose measured = 89 Orthostatics conducted, negative for orthostatic hypotension Patient given crackers, water. Evaluated by nurse practitioner, advised to take deep breathes, patient felt better and left facility with daughter

Other Meds:

Current Illness:

ID: 0967029
Sex: F
Age: 38
State: TN

Vax Date: 01/01/2021
Onset Date: 01/22/2021
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: None

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Headache

Other Meds:

Current Illness:

ID: 0967030
Sex: F
Age: 57
State: AZ

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

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

Lab Data:

Allergies: Heparin IV, sulfa

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: 8 hours post - fever, severe chills - stink have 24 hours later

Other Meds: Amlopidine Besylate, triamterene hctz, vitamin d2, eye vitamin AREDS

Current Illness: Bronchitis

ID: 0967031
Sex: F
Age: 48
State: PA

Vax Date: 01/22/2021
Onset Date: 01/22/2021
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: sulfa, erythromycin

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

Symptoms: Injection site swollen, hot, and very tender

Other Meds: Warfarin 2mg/day; Gabapentin 300mg 3x/day; buspirone 1/day, ClaritinD 24 hour 1/day; Centrum daily vitamin

Current Illness: None

ID: 0967032
Sex: F
Age: 81
State: AZ

Vax Date: 01/15/2021
Onset Date: 01/18/2021
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: PCN, Codeine, Ambien, Tizanidine

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

Symptoms: pt. has had 4 days of nausea with vomiting, fatigue, change in stool consistency.

Other Meds: Multiple medications

Current Illness: none

ID: 0967035
Sex: F
Age: 35
State: TN

Vax Date: 01/20/2021
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:

Symptom List: Unevaluable event

Symptoms: After receiving the second shot on 01/20/2021 the shot site has raised and I have a red hot rash that keeps getting bigger.

Other Meds:

Current Illness:

ID: 0967036
Sex: F
Age: 46
State: CA

Vax Date: 01/22/2021
Onset Date: 01/22/2021
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: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

Symptoms: Pt c.o anxious and dry mouth. B/p was assessed and elevated. Pt advised to f/u w PCP. b/p 148/90, p 81 o2 97%.

Other Meds: b/p meds

Current Illness:

ID: 0967037
Sex: M
Age:
State: CT

Vax Date: 01/15/2021
Onset Date: 01/22/2021
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

Symptom List: Injection site pain, Pain

Symptoms: Lightheaded

Other Meds: Alot

Current Illness: None

ID: 0967038
Sex: F
Age: 67
State:

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: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Patient felt light headed around 1 hour after receiving vaccination. Nurse practitioner evaluated patient and took vital signs: BP 132/86, repeat 15 minutes later after patient given crackers and water was 115/57. Patient felt better and left facility.

Other Meds:

Current Illness:

ID: 0967039
Sex: F
Age: 47
State: MD

Vax Date: 01/14/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Itchy rash around injection site

Other Meds: Birth control pill

Current Illness: None

ID: 0967040
Sex: F
Age: 44
State: FL

Vax Date: 01/20/2021
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: LA

Lab Data:

Allergies: None

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Severe arm and full body pain, 102 fever, headache, tremors, shaking, fatigue

Other Meds: Venlafaxine

Current Illness: None

ID: 0967041
Sex: F
Age: 49
State: TX

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: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Left arm has redness, swelling , itching at sight and feels hot - symptoms have also travelled beyond the injection site - new swelling and redness and itching is now 3 inches around and appears to be spreading. I have had these symptoms for 9 days now and they do not appear to be getting better.

Other Meds:

Current Illness:

ID: 0967042
Sex: M
Age: 59
State: CO

Vax Date: 01/20/2021
Onset Date: 01/20/2021
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: None

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

Symptoms: Shivering, chills, headache, body ache for two days after second injection. Know at least three other associates who experienced the same condition day after their second injection. Responsive to acetaminophen and ibuprofen.

Other Meds: Multivitamin, glucosamine, fish oil, ibuprofen, acetaminophen, lisinopril

Current Illness: None

ID: 0967044
Sex: F
Age: 70
State: NJ

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: RA

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Patient is known to faint after receiving vaccinations. Also endorsed being very anxious being around people. Patient felt hot and dizzy. EMT's evaluated, moved patient to separate and quiet room where she rested on stretcher. Increased wait time, patient felt better at 1155 and left on her own accord.

Other Meds:

Current Illness:

ID: 0967045
Sex: F
Age: 39
State: CA

Vax Date: 01/13/2021
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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: amoxicillin, penicillin, Vicodin, percocet

Symptom List: Injection site pain

Symptoms: ITCHINESS, SWOLLEN AND RED

Other Meds: none

Current Illness: none

ID: 0967046
Sex: F
Age: 52
State: IL

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:
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: Sore arm started on evening of January 20th (date of injection), 2:00 p.m. January 21st severe body aches, chills and extremely tired. Around 3 a.m. of January 22nd those symptoms where getting better but just below the injection site there is a large red area that is hot and swollen and that is still continuing as of 7:08 p.m. January 22nd

Other Meds: Ibuprofen

Current Illness: none

ID: 0967047
Sex: F
Age: 30
State: ME

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: IM
Vax Site: RA

Lab Data:

Allergies: N/A

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

Symptoms: Nausea, fever, chills, body aches, headache 12 hours after injection for about 24 hours. Headache currently.

Other Meds: Minocycline, multi vitamin with folic acid, elderberry, b2, coQ10, d3

Current Illness: N/A

ID: 0967048
Sex: F
Age: 57
State: NC

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

Lab Data:

Allergies: None

Symptom List: Tremor

Symptoms: Received vaccine at 13:45 on 1/19. Awoke around 04:00 on 1/20 with loud ringing/buzzing in ears. The intensity continued until approximately 07:00 1/21. I still have low buzzing sound/ tinnitus. I had the day off work but probably could not have worked (as a pharmacist) if I hadn?t. I returned to work on 1/21 though. I have a hearing test on 1/28.

Other Meds: None

Current Illness: None

ID: 0967049
Sex: F
Age: 74
State: TX

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

Symptom List: Erythema, Pruritus

Symptoms: Redness, blistering and itching of 7 of my 10 toes. Symptoms began on 2 bd toe of left foot late evening of Monday, January 18; involved 2 more left toes by Tuesday evening; Wednesday morning (January 20) involved 3 toes on right foot. Benadryl seems to help the itching. Could not comfortably wear shoes. Friday afternoon, January 22, symptoms appear to be easing a little. No visible signs of pus or infection. Reported this to my physician.

Other Meds: Ezetimebe Lisinopril Alive vitamin supplement Vitamin B-12 Vitamin D3 Calcium/Magnesium/Zinc supplement

Current Illness: None

ID: 0967050
Sex: F
Age: 76
State: CA

Vax Date: 01/21/2021
Onset Date: 01/21/2021
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, zestril, codeine

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

Symptoms: Within minutes I felt dizzy and then my heart started beating rapidly. Nurse took my blood pressure, pulse, respirations. I was held at clinic for 30 minutes. Symptoms subsided gradually and were gone in 15 minutes.

Other Meds: Nifedipine, Hydrochlorothiazide, Fenofibrate, K-lor, Gabapentin, carbamazepine, baclofen, buproprion, vitamin D, Zinc

Current Illness: Trigeminal neuralgia

ID: 0967051
Sex: M
Age: 31
State: AK

Vax Date: 01/13/2021
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:

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

Symptoms: 3 days post vaccination Pt reported red, hot itchy rash developed on left abdomen, still present post vaccination day 5 redness almost gone but itchiness still present.

Other Meds: OTC hydrocortisone used for Rash

Current Illness:

ID: 0967052
Sex: M
Age: 74
State: FL

Vax Date: 01/08/2021
Onset Date: 01/10/2021
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: Tetanus Toxoid, Morphine

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Nausea, dizziness, headache, dehydration (sickest I have ever been)

Other Meds: Hydroxyzine HCL 25MG (as needed), Fish Oil 2000MG, 1 daily, Red Yeast Rice CoQ-10 , Aspirin 81 MG, 2 daily, Vitamin D3 50 mcg (2000IU) 1 daily.

Current Illness: None

ID: 0967053
Sex: M
Age: 29
State: OR

Vax Date: 01/14/2021
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: Pruritic and erythematous rash at the injection site about 2 inches in diameter.

Other Meds:

Current Illness:

ID: 0967054
Sex: F
Age: 47
State: WV

Vax Date: 01/14/2021
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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: latex shellfish

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

Symptoms: After injection, I had a 2 inch bruise around the injection site and my arm was sore. Six days after vaccine, I developed an itchy rash near the injection site. It spread approximately 4 inches down my arm. It was hot to the touch, and sometimes it would burn. I contacted my PCP and she told me to take Benadryl, apply a cold compress, and she called in some antibiotics.

Other Meds: Topamax 100 mg 1x day Welbutrin 300mg 1xday Acyclovir 400 mg 2x day

Current Illness: HSV 2 breakout

ID: 0967055
Sex: F
Age: 50
State: NY

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

Lab Data:

Allergies: None

Symptom List: Pain in extremity

Symptoms: About a half hour after the dose, the area around my mouth went numb. It spread to the area under my left eye. It lasted a few hours and went away. It recurred twice that day and was accompanied by decrease in taste.

Other Meds: Vitamin D/calcium Baby aspirin Tecfidera Dexilant Unisom

Current Illness:

ID: 0967056
Sex: F
Age: 41
State: WI

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

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

Symptoms: Patient become dizzy and overall not feeling well, patient was placed supine and hooked up to a pulse oximetry. Oxygen saturations were WNL but heart rate tachy, was placed on telemetry which showed tachycardia 160-180, blood pressure elevated, patient was anxious and to note was also nervous/anxious about receiving vaccination prior to injection. Patient was then transferred to the ER to be evaluated by MD. At that time EKG completed with NSR 94, BP 133/85, 100 % oxygen on room air, respirations - 20. Dizziness and tachycardia subsided within 20 minutes without intervention, patient continued to be anxious regarding event.

Other Meds: multivitamin

Current Illness:

ID: 0967057
Sex: M
Age: 76
State:

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

Lab Data:

Allergies: NKA

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

Symptoms: Patient c/o light headedness/dizziness during post - vaccine monitoring. BP: 89/56 P: 72 SpO2: 96% on RA. Patient monitored for extended time. 2:50pm Patient verbalized resolved symptoms, BP: 114/70 P: 75 Sp)2 100% RA. Patient assisted to vehicle and d/c home.

Other Meds: Not known

Current Illness:

ID: 0967058
Sex: F
Age: 41
State: WA

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: Gabapentin, Nitroglycerin

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

Symptoms: Immediate nausea and dizziness followed by increasing fatigue, brain fog and cognitive difficulties (I.e. driving and returning to work after) especially involving quick movements, tracking and concentrating. Moderate Arm soreness increased from the time of shot continuing beyond 24 hours and making it difficult to lift or move the arm

Other Meds: Vitamin D Kava root Probiotics

Current Illness: None

ID: 0967059
Sex: F
Age: 26
State: WA

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: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Vomiting

Symptoms: 1-21-21 @ 11 pm - chills started,with 98.7 F fever. Body aches and headache. They continued all night and still going today 1-22-21 @ 5:08pm. Temperature continues to go up it has not gone down from 102.5 F. In the past 2 hours after taking Tylenol at 3:30pm. feels very thirsty, have drank 4- 24oz of water, a bottle of 28oz Gatorade. Shortness of breath started 8:45 am 1-22-21 Fast heart rate and feels heart skip started around 3:30pm 1-22-21 took 500mg Tylenol at 3 am Took 1000mg Tylenol at 7:30 am Took 420 mg Naproxen @ 9:30 am Took 1000 mg Tylenol @ 3:30pm

Other Meds: Layolis Fe (birth control)

Current Illness: None

ID: 0967060
Sex: M
Age: 67
State: MA

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

Lab Data:

Allergies: Nabutnome

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Weakness, slight fever, pain at injection site.

Other Meds: Levothyroxin, Simvastatin, Omega-3, Vitamin D3, Muilti-vitamin

Current Illness: None

ID: 0967061
Sex: F
Age: 35
State: CT

Vax Date: 01/13/2021
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: Topical salicylic acid

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

Symptoms: Reddened hard\lumpy area approx 4 inches below injection site; painful to palpation; achiness with all ROM; intermitten itch; burning hot sensation; intermitten sharp stabbing sensation; moderate swelling Started at approx 4pm on 1/21 with same symptoms persisting to current time--- area increasing in size

Other Meds: Tri-Sprintec

Current Illness: N/A

ID: 0967062
Sex: F
Age: 85
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: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: nka

Symptom List: Injection site swelling, Limb discomfort

Symptoms: After 15 minutes of observation and no adverse reactions, patient went to the restroom, and went shopping. 30 minutes after administration, patient was extremely fatigued, unresponsive, unable to be aroused. Called 911. Blood pressure was 60/Error or blood pressure machine was not working properly. Began to gasp and vomit. Epinephrine was administered at that time. 45 minutes after administration, EMS arrived. Patient was discharged from hospital around 3pm and her diagnosis was syncope.

Other Meds: docusate sodium 100mg bid, pantoprazole 40mg qd, ozempic 0.5mg q week, metoprolol succ 100mg qd, losartan 50mg qd, hctz 12.5mg qd, allopurinol 100mg qd, triamcinolone 0.1% aaa bid, spironolactone 25mg qd, warfarin 1mg

Current Illness: diabetes

ID: 0967063
Sex: F
Age: 43
State: IN

Vax Date: 01/08/2021
Onset Date: 01/08/2021
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: Penicillin morphine sulfa

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

Symptoms: About 40 mins after the injection, I was beyond extremely tired. Extreme body aches, nausea, dizziness and migraine followed shortly after. I felt to have more of an agitated PVC, PAC and tachycardia activity than usual. This lasted Friday 1/8 through all day Sunday 1/10. On 1/11 I only suffered from the migraine. A very sore arm was only during the first night and alleviated on Saturday afternoon.

Other Meds: AleveD

Current Illness: Everyday allergies

ID: 0967064
Sex: F
Age: 39
State: MO

Vax Date: 01/13/2021
Onset Date: 01/21/2021
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: Wellbutrin

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

Symptoms: Right supraclavicular lymphadenopathy that started on 1/21/21. 2 mobile, firm, tender lymph nodes noted on exam.

Other Meds: Relpax

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm