VAERS 2021 Database www.vaers.hhs.gov

Main Page | All 2021 Deaths | Videos
VAERS Updated: 11/12/2021
** VAERS DATABASE Last updated: November 12, 2021**
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Manufacturers

Total Manufacturer
199,106MODERNA
36,710JANSSEN
5,381PFIZER\BIONTECH
2,555GLAXOSMITHKLINE BIOLOGICALS
1,469UNKNOWN MANUFACTURER
897MERCK & CO. INC.
627SEQIRUS, INC.
112DYNAVAX TECHNOLOGIES CORPORATION
91SANOFI PASTEUR
75NOVARTIS VACCINES AND DIAGNOSTICS
40EMERGENT BIOSOLUTIONS
14PAXVAX
12TEVA PHARMACEUTICALS
12PROTEIN SCIENCES CORPORATION
9PFIZER\WYETH
4BERNA BIOTECH, LTD.
4SMITHKLINE BEECHAM
3INTERCELL AG
1MEDIMMUNE VACCINES, INC.
1CSL LIMITED

COVID19 Lot Number

VAX LOT Total
2S9CL7,949
7,473
2,547
1,506
1,187
1,051
1,049
s0294561,043
866
IMM209861
816
UT7065MA766
657
579
U62828AA563
557
538
U6737AA516
515
S034636506
4F472471
458
P100253275449
444
276563436
429
418
4BH32414
MENVEO404
PP9L5362
UJ446AA337
319
306
290
271
49TM3270
R1B252M253
4F472179
933622147
C5763AA144
CW3116134
3Y7NL126
UNK114
113
ARBA141A105
104
103
96
300057A90
79
1F4EB73
R1B743M62
56
UJ090AA55
51
UH894AB46
45
UNK44
UNK42
42
EJ168638
Unknown36
35
34
32
32
26
el128424
24
A115A22
22
EN620222
21
UNK20
20
19
Z127A19
19
17
JEV18K95E15
12
111798PI12
10
A739088
No batch number8
3333324181078
6
6
TAR356
5
5
U6935AA5
UNK5
4
unknown4
3
2
55RB72
2
2
2
2
2
U7124AA2
JEV18A68E2
2
ABYB05BA1
1
1
1
1
AMVA436A1
1
1
TJ3521
A130A; VIS give1
1
U7140BB1
1
1
SP UP016AA1
1
1808P08802/ESV01
037K20A300,947
EL1284288,578
57,766
1,432

Incidents per State

State Total
82,750
CA62,821
FL38,209
TX36,512
NY34,921
PA23,646
IN23,622
IL20,597
MI19,590
OH19,426
NJ18,413
NC16,769
GA15,932
WA15,351
VA15,234
MA14,876
AZ14,206
MN12,940
MD12,656
CO11,908
WI11,425
MO10,240
TN9,685
OR8,768
KY8,437
CT8,300
SC6,700
OK6,293
AL5,692
LA5,025
IA4,825
KS4,821
UT4,637
NV4,374
NM3,967
AR3,807
ME3,161
NH3,096
NE2,918
MS2,859
ID2,785
WV2,469
HI2,459
PR2,417
MT2,414
RI2,076
DE1,868
AK1,830
VT1,734
DC1,715
ND1,388
SD1,269
WY866
GU118
VI69
AS47
MP29
MH8
XB6
FM4
QM3
XV2
XL1

ID: 1628405
Sex: F
Age: 79
State: ME

Vax Date: 08/16/2021
Onset Date: 08/16/2021
Rec V Date: 08/24/2021
Hospital:

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

Lab Data: none

Allergies: ACE inhibitors

Symptom List: Dysphagia, Epiglottitis

Symptoms: Covid rash. turned into swelling. patient wanted us to report for her. no other symptoms

Other Meds: loratadine 10mg, diazepam 5mg, losartan 50mg, armour thyroid 30mg, estradiol 1mg

Current Illness:

ID: 1628406
Sex: F
Age: 44
State: AZ

Vax Date: 08/17/2021
Onset Date: 08/17/2021
Rec V Date: 08/24/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data: Emergency dental appointment

Allergies: N/A

Symptom List: Anxiety, Dyspnoea

Symptoms: Two hours after the vaccine my left jaw locks up Throbbing tooth pain face droopy

Other Meds: N/A

Current Illness: N/A

ID: 1628407
Sex: F
Age: 73
State: CO

Vax Date: 02/11/2021
Onset Date: 03/15/2021
Rec V Date: 08/24/2021
Hospital: Y

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: MRI/A of head, neck, orbits CT/A. with and without contrast Echocardiogram EKG Multiple lab tests while inpatient for CVA. Inpatient stay in hospital

Allergies: NKDA and no food allergies

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

Symptoms: Appox. 35 days after receiving second Moderna vaccine I developed severe headaches. No hx of headaches in the past. The headaches continued every day. I was seen multiple times by urgent care and my doctor and treated for various things as they didn't know what was causing the headaches. Then on June 1 I lost sudden onset of vision on the bottom of my right eye. Then one week later lost vision in my left eye. I was seen by retinol specialist and dx with new onset NAION in both eyes. TIA July 11, and full CVA on July 12th admitted to hospital with confirmed CVA. I now have left sided weakness and my vision will never return according to my retinal specialist. I am having to do physical, speech, and occupational therapy multiple times per week. Multiple visits with neurologists/retinal specialists/primary care.

Other Meds: citalopram levothyroxine simvastatin aspirin Calcium D3 B12

Current Illness: none

ID: 1628408
Sex: M
Age: 13
State: KS

Vax Date: 05/14/2021
Onset Date: 08/10/2021
Rec V Date: 08/24/2021
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: Fully vaccinated. Congestion noted 8/10/21, tested positive on 8/13/21

Other Meds:

Current Illness:

ID: 1628409
Sex: F
Age: 10
State: IA

Vax Date: 08/22/2021
Onset Date: 08/22/2021
Rec V Date: 08/24/2021
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: Patient came in for a flu vaccine, but received a Pfizer COVID vaccine by mistake. Patient parent notified and recommended to be observed for 30 minutes. Patient doctor notified. Next day, pharmacy followed up with parents where patient had no ill feeling and just a sore arm.

Other Meds:

Current Illness:

ID: 1628410
Sex: F
Age: 25
State: IL

Vax Date: 01/11/2021
Onset Date: 02/09/2021
Rec V Date: 08/24/2021
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: CAT scan 3/12/21 9:30 AM - found kidney stones in both kidneys as well as liver cysts Met with urologist. Ultrasound done for liver cysts. Ultrasound for kidney stones scheduled for 9/7/21.

Allergies: Amoxicillin

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

Symptoms: Kidney stones began approximately 1 month after first vaccine dosage received. Liver cysts discovered in a CAT scan along with kidney stones. Follow-up ultrasound scheduled for 9/7/21. Menstrual cycle was also inconsistent for 6 months after first injection, although I did not seek medical treatment for this.

Other Meds: Sertraline (150 mg. daily), Nexplanon (implant every 3 years)

Current Illness:

ID: 1628411
Sex: F
Age: 59
State: PA

Vax Date: 01/12/2021
Onset Date: 02/13/2021
Rec V Date: 08/24/2021
Hospital: Y

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

Lab Data: MRI, CT head, hospitalization, many doctor visits including to specialist.

Allergies: None

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Stroke twice within 3 weeks of vaccine. Now using a cane to walk. Dizziness that is all the time. Vision problems. Now on new medications. I was on aspirin prior to events.

Other Meds: Aspirin; Humalog;

Current Illness: None

ID: 1628412
Sex: M
Age: 54
State: NJ

Vax Date: 06/03/2021
Onset Date: 06/03/2021
Rec V Date: 08/24/2021
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: sharp pain in left side of chest, comes and goes, right eye gets unfunctional

Other Meds: soniodine, levatroxin, hydrocodone,

Current Illness:

ID: 1628413
Sex: F
Age: 63
State: FL

Vax Date: 04/07/2021
Onset Date: 04/28/2021
Rec V Date: 08/24/2021
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: AFTER THREE WEEKS PATIENT STARTED TO COMPLAIN ABOUT ITCHY SCALP AND RASH ON THE LOWER BACK NECK.

Other Meds:

Current Illness:

ID: 1628414
Sex: M
Age: 39
State: OH

Vax Date: 08/18/2021
Onset Date: 08/19/2021
Rec V Date: 08/24/2021
Hospital:

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

Lab Data: Echocardiogram- 8/24/2021 Bloodwork - 8/24/2021 Chest X-ray - 8/24/2021

Allergies: None

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Heart discomfort/pressure that comes and goes in waves with varying intensity and duration.

Other Meds: None

Current Illness: None

ID: 1628415
Sex: F
Age: 47
State: OK

Vax Date: 01/20/2021
Onset Date: 08/24/2021
Rec V Date: 08/24/2021
Hospital:

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

Lab Data:

Allergies: Patient is not here to provide this information

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

Symptoms: This person has been fully vaccinated and had a break-through positive case with symptoms. She has congestion and headache. She has had symptoms for one week and tested negative on 08/16/21 and 08/18/2021. She tested positive on 08/23/2021

Other Meds: Patient is not here to provide this information

Current Illness: The person is not here to provide this information

ID: 1628416
Sex: F
Age: 55
State: CA

Vax Date: 02/20/2021
Onset Date: 03/26/2021
Rec V Date: 08/24/2021
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: breast cancer dx

Other Meds: lisinopril, crestor, estrace, multi vitamin, aspirin,

Current Illness: N/A

ID: 1628417
Sex: M
Age: 76
State: PA

Vax Date: 02/22/2021
Onset Date: 02/24/2021
Rec V Date: 08/24/2021
Hospital: Y

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

Lab Data: Covid test- negative, Sputum culture, Blood culture, Urine culture, Basic metabolic, CBC, Hepatitis C, C reactive protein, I do not know the results

Allergies: None

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

Symptoms: I got the second shot and I was feeling good. I was actually in a walking contest and I walked 18 miles the day I got the shot and 18 miles the day after. The third day I walked several miles but after that I kept sleeping. I lost my smell and taste. On Wednesday, Thursday and Friday I slept pretty much all day, like 20 hours a day. I got like a tickle on my throat type of thing. When I would go to sleep I would get a bad cough. Then I went to sleeping from 20 hours a day to not being able to sleep at all. On Sunday I called my son who is a doctor and he said he would like to take my vitals so I did. He got concerned and he told me to go to the hospital right away. They did a Covid test and I do not remember what other tests because I was pretty far gone. Looking at my paperwork it says they did Sputum culture, Blood culture, Urine culture, Basic metabolic, CBC, Hepatitis C, C reactive protein. I was admitted with pneumonia. I think I had Covid or a reaction to a reaction, but they told me it was just pneumonia. I recovered from the pneumonia but I still have acute diarrhea since February but I blame the antibiotics.

Other Meds: Tamsulosin .4 mg, Finasteride 5 mg, baby Aspirin not regularly, injection for cholesterol Repatha

Current Illness: None

ID: 1628418
Sex: M
Age: 70
State: FL

Vax Date: 08/23/2021
Onset Date: 08/23/2021
Rec V Date: 08/24/2021
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: n/a

Allergies: none

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

Symptoms: Patient injection site would not stop bleeding over night. Patient came to pharmacy I applied pressure with a cotton ball and changed the Band-Aid bleeding stopped.

Other Meds: crestor 20mg, enalapril 5mg, brilinta 90mg, felodipine er 10mg, isosorbid din 5mg, metoprolol xl 25mg

Current Illness: hypertension

ID: 1628419
Sex: M
Age: 65
State: CA

Vax Date: 03/04/2021
Onset Date: 03/09/2021
Rec V Date: 08/24/2021
Hospital:

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

Lab Data: Doctor prescribed oral steroid . Triamcinolone acetonide cream was also given.

Allergies: no

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

Symptoms: 5 days after vaccine. Went to walk in clinic with hives on back and armpits down to waist . Also upper groan area. spread from armpit to elbows. Patient also was really fatigue. Heart rate was dropping in the 40's at rest.

Other Meds: no

Current Illness: no

ID: 1628420
Sex: F
Age: 49
State: IN

Vax Date: 08/16/2021
Onset Date: 08/16/2021
Rec V Date: 08/24/2021
Hospital:

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

Lab Data: N/A

Allergies: Latex

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

Symptoms: Headache, body aches, fatigue starting evening after receiving shot, peak for 24 hours (8/17/2021) then gradually better over 4 days.

Other Meds: Stelara, methotrexate, naproxen, cymbalta

Current Illness: N/a

ID: 1628421
Sex: F
Age: 58
State: PA

Vax Date: 08/23/2021
Onset Date: 08/23/2021
Rec V Date: 08/24/2021
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: Systemic: Allergic: Anaphylaxis-Medium, Systemic: Allergic: Difficulty Breathing-Medium, Systemic: Allergic: Difficulty Swallowing, Throat Tightness-Medium, Additional Details: taken to ER by paramedics, treated with 3-4 more doses of epi. discharged several hours later

Other Meds:

Current Illness:

ID: 1628422
Sex: F
Age: 11
State: IL

Vax Date: 08/23/2021
Onset Date: 08/23/2021
Rec V Date: 08/24/2021
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: Vaccine given on 8/23/21. Vaccine expiration date was 8/21/21.

Other Meds:

Current Illness:

ID: 1628423
Sex: M
Age: 40
State: NY

Vax Date: 02/18/2021
Onset Date: 05/10/2021
Rec V Date: 08/24/2021
Hospital:

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

Lab Data: Ana titer and dx of auto immune disorder. Lab test in June and dx in June.

Allergies: Bone

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Positive Ana titer and a dx of an auto immune disease. No family history, no problems before the vaccine. Pain, fatigue and all symptoms of an auto immune disorder.

Other Meds: None

Current Illness: None

ID: 1628424
Sex: F
Age: 16
State: FL

Vax Date: 08/24/2021
Onset Date: 08/24/2021
Rec V Date: 08/24/2021
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: Site: Redness at Injection Site-Mild, Systemic: Dizziness / Lightheadness-Severe, Systemic: Flushed / Sweating-Medium

Other Meds:

Current Illness:

ID: 1628425
Sex: F
Age: 77
State: UT

Vax Date: 02/19/2021
Onset Date: 02/25/2021
Rec V Date: 08/24/2021
Hospital: Y

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: MRI 03/11/2021 Ultrasound 03/11/2021 EKG 03/11/2021

Allergies: Iodine

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

Symptoms: Pt. states that after receiving the 2nd dose of Phizer 02/19/2021, started experiencing symptoms 02/25/2021 of chest pain. Hospitalized (Internal Bleeding) 03/11/2021-03/18/2021 diagnosed with Pulmonary Embolism, located in Lung.

Other Meds: N/A

Current Illness: N/A

ID: 1628426
Sex: F
Age: 37
State: MI

Vax Date: 08/11/2021
Onset Date: 08/12/2021
Rec V Date: 08/24/2021
Hospital:

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

Lab Data: Liver labs, Mildly elevated

Allergies: Latex, adhesive tape, propoxyphene, gabapentin, herbal Drugs, Thimerosal, Covid 19 vaccine.

Symptom List: Unevaluable event

Symptoms: 8/12-Fever 100.6, body aches, chills x1 day 8/13 itchiness day 2 to current VA RX'd hydroxyzine 25mg PRN and Chlorpheniramine 4mg PRN

Other Meds: acyclovir, aripiprazole, buspirone, vitamin D3, cyclobenzaprine, dicyclomine, duloxetine, hydroxyzine, lactobacillus, levocetirizine, levonorgestrel, meclizine, methylprednisolone, nortriptyline HCI, ondansetron, simethicone, ursodiol

Current Illness: None

ID: 1628427
Sex: F
Age: 54
State:

Vax Date: 08/23/2021
Onset Date: 08/24/2021
Rec V Date: 08/24/2021
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, Sulfa, Levaquin.

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

Symptoms: Swollen lymph nodes.

Other Meds: None.

Current Illness:

ID: 1628428
Sex: F
Age: 78
State: TX

Vax Date: 02/14/2021
Onset Date: 03/29/2021
Rec V Date: 08/24/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: Mammogram 3/29/2021, ultrasound 4/21/2021, needle biopsy 5/18/2021, lumpectomy 7/29/2021

Allergies: None

Symptom List: Injection site pain, Pain

Symptoms: Diagnosis of Breast cancer

Other Meds: Losartan, Ibanderate, Rouvestatin, COQ10, Vitamin D3, Vitamin E, Tumeric

Current Illness:

ID: 1628429
Sex: M
Age: 33
State: FL

Vax Date: 08/24/2021
Onset Date: 08/24/2021
Rec V Date: 08/24/2021
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: 9 minutes after receiving Janseen vaccine pt reported feeling lightheaded. He was asked to lay down on exam table for 10 minutes and this feeling resolved.

Other Meds:

Current Illness:

ID: 1628430
Sex: F
Age: 51
State: TX

Vax Date: 08/24/2021
Onset Date: 08/24/2021
Rec V Date: 08/24/2021
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: yes

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

Symptoms: Anxiety

Other Meds: yes

Current Illness:

ID: 1628431
Sex: F
Age: 23
State: IL

Vax Date: 08/13/2021
Onset Date: 08/13/2021
Rec V Date: 08/24/2021
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: Systemic: Allergic: Rash (specify: facial area, extremeties)-Mild

Other Meds:

Current Illness:

ID: 1628432
Sex: M
Age: 54
State: OH

Vax Date: 06/22/2021
Onset Date: 07/15/2021
Rec V Date: 08/24/2021
Hospital:

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

Lab Data:

Allergies: Zanamivir, Mefloquine

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Tinnitus, Left ear greater than Right, first noted on date above. No history of similar symptoms in the past. Has progressed bilaterally but is still mild. Worse in the early morning, and in evening as well as when attempting to sleep.

Other Meds: Timolol

Current Illness: None

ID: 1628433
Sex: F
Age: 27
State: PA

Vax Date: 08/17/2021
Onset Date: 08/17/2021
Rec V Date: 08/24/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Severe itching all over body, vomiting , body aches, feeling weak sleeping all day

Other Meds:

Current Illness:

ID: 1628434
Sex: M
Age: 60
State: FL

Vax Date: 04/13/2021
Onset Date: 05/30/2021
Rec V Date: 08/24/2021
Hospital:

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

Lab Data: fluids, some antibiotics, CT scans, bloodwork

Allergies: none - ever

Symptom List: Nausea

Symptoms: 6 weeks after the vaccine, I began to shiver out of the blue. I could not shivering no matter how many blankets I put on. I was also dizzy when walking. I went to the emergency room. They were not sure if I had an infection and could never articulate where or what may have caused my low grade fever. They treated me with antibiotics and I felt better but even my primary care doctor claimed she did not know what caused my issue and questioned if I even had an infection. This sort of event has never occurred unless I was actually sick or had the flu. I had no other symptoms....no headaches, no breathing issues, no congestion, no sore throat, no body aches. After 4 days I was released. After personally hearing of people with chills in various body parts, arms and hands, it did not seem so unreasonable that this may have been MY reaction to the vaccine. My only immediate reaction to the shot was a flushing feeling in my chest as if it were dry and tight but that passed in about 15 minutes or so. But ending up in the hospital for no apparent reason makes me wonder? They tested me for Covid and I did not test positive.

Other Meds: Gabapentin, Metformin, Tresiba, Humulin R, Atorvastatin, Irbesartan, Hydalazine, Vescepa

Current Illness: None

ID: 1628435
Sex: F
Age: 29
State: MN

Vax Date: 08/24/2021
Onset Date: 08/24/2021
Rec V Date: 08/24/2021
Hospital:

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

Lab Data:

Allergies: na

Symptom List: Injection site pain

Symptoms: Pt received pfizer as her 1st covid-19 vaccine dose. She was given moderna in our clinic as her 2nd dose.

Other Meds: prozac, baby aspirin, multivitamin, tylenol

Current Illness: na

ID: 1628436
Sex: F
Age: 56
State: CA

Vax Date: 08/24/2021
Onset Date: 08/24/2021
Rec V Date: 08/24/2021
Hospital:

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

Lab Data:

Allergies: artificial sweetener, cipro, clavulanic acid, doxycycline, iodine, keflex, notriptyline Hcl, pneumococcal 23-val p-sac vaccine, shellfish derived products, spironolactone, sulfa (sulfonomide antibiotics), sulfasalazine, sulfa (not sulfonomides)

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

Symptoms: 5 minutes post vaccination, pt reported the roof of her mouth swelling and then swelling to her throat and tightness to her face and neck. Benadryl 50mg IM given to R arm.

Other Meds: unknown

Current Illness: none

ID: 1628437
Sex: F
Age: 33
State: VA

Vax Date: 05/02/2021
Onset Date: 08/20/2021
Rec V Date: 08/24/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data: n/a

Allergies: wheat, gluten chicken, eggs, turkey, banana, pineapple, eggs, cows milk, bakers yeast, brewers yeast, oats, rye, barley, bran, mushroom, bell peppers, squash, black tea, coffee, garlic, ginger, sesame , oregano

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

Symptoms: My left eye twitches open and closes on its own, changes focus on its own, sometimes my eyes cross and uncross too. almost like a tick. But almost like a Robot too, my left eye wandered to a dog and lady walking past my house and I was trying to watch tv. I felt as if someone else was controlling my eye remotely.

Other Meds: adderall, venlaflaxine, omperazole, i dont remeber th name but its a medicine to helo me sleep.

Current Illness: none

ID: 1628438
Sex: F
Age: 30
State: MA

Vax Date: 06/14/2021
Onset Date: 06/14/2021
Rec V Date: 08/24/2021
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: Latex : Rash Grass

Symptom List: Tremor

Symptoms: 30F w/ PMHx of seizure disorder and asthma who reported after receiving 2nd COVID vaccine to be nauseous. Upon assessment, pt vital signs 125/83, P84, SaO2 100%. Pt stated that throat began to itch. after further assessment, pt reporting worsening of throat itching and "chest tightening". vitals reassessed SaO2 80%. decision to call ER proceed out made. ER team arrived, and transfered patient to ER for treatment and observation . ER Course: Exam remarkable for bilateral expiratory wheezes and uvular edema. Treated with epi, benadryl, famotidine, albuterol and steroids. EKG nonischemic. Bedside scope shows mild swelling to the larynx without evidence of airway compromise. Patient was observed for 4-6 hours and discharged once all symptoms resolved.

Other Meds: No

Current Illness:

ID: 1628439
Sex: M
Age: 31
State: NC

Vax Date: 08/23/2021
Onset Date: 08/23/2021
Rec V Date: 08/24/2021
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: Error: Booster Given Too Early-

Other Meds:

Current Illness:

ID: 1628440
Sex: M
Age: 25
State: IN

Vax Date: 08/24/2021
Onset Date: 08/24/2021
Rec V Date: 08/24/2021
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: N/A

Allergies: none reported

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

Symptoms: Patient came into the pharmacy for the Johnson and Johnson covid-19 vaccine. Patient filled out the registration and consent form. This form has a question asking if the patient has received any of the covid-19 vaccines to date. The patient checked "no." After the clinic the vaccinator (RN) went to document vaccination in system and noticed that the patient has a documented vaccination of Moderna from the health department 4 days prior to receiving the Johnson and Johnson vaccine. Pharmacy unable to reach patient at provided phone number.

Other Meds: unknown

Current Illness: unknown

ID: 1628441
Sex: F
Age: 2
State: NE

Vax Date: 08/19/2021
Onset Date: 08/19/2021
Rec V Date: 08/24/2021
Hospital: Y

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

Lab Data:

Allergies: Propanolol

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

Symptoms: swelling, tenderness of L thigh. Febrile Xray--showed soft tissue swelling labs showed elevated WBC & CRP hip MRI showed myositis ABT for treatment. IV Ancef and Augmentin per GTube.

Other Meds:

Current Illness:

ID: 1628442
Sex: F
Age: 82
State: MI

Vax Date: 03/25/2021
Onset Date: 08/20/2021
Rec V Date: 08/24/2021
Hospital: Y

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

Lab Data:

Allergies: Cipro, codeine, Macrodantin, sulfa drugs

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Malaise, decreased appetite, cough, hospitalization.

Other Meds:

Current Illness: Unknown

ID: 1628443
Sex: F
Age: 13
State: NY

Vax Date: 08/20/2021
Onset Date: 08/20/2021
Rec V Date: 08/24/2021
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: Systemic: Allergic: Rash (specify: facial area, extremeties)-Medium, Additional Details: patient received vaccine with mother - no issue at first but according to RPh, they returned and she had hives all over her hands. no sequelae known to have occur since as of today 8/24/21

Other Meds:

Current Illness:

ID: 1628444
Sex: F
Age: 31
State: MD

Vax Date: 08/19/2021
Onset Date: 08/20/2021
Rec V Date: 08/24/2021
Hospital: Y

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: CAT scan with inflamed appendex showing appendicitis. Appendex was removed in appendectomy.

Allergies: None

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

Symptoms: I got severe abdominal pain which turned out to be appendicitis. I've never had any pain or symptoms before it. Pain started the next day after getting vaccine. Appendex was inflamed. Happened rapidly and with no prior pain before taking the vaccine.

Other Meds: None

Current Illness: None at all

ID: 1628445
Sex: F
Age: 55
State: OH

Vax Date: 08/17/2021
Onset Date: 08/17/2021
Rec V Date: 08/24/2021
Hospital:

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

Lab Data:

Allergies: PCN

Symptom List: Pain in extremity

Symptoms: Pain in arm for 7 days with knot like bump, nausea, headache chills, extreme tiredness for 7 days

Other Meds:

Current Illness:

ID: 1628446
Sex: F
Age: 24
State: AZ

Vax Date: 05/18/2021
Onset Date: 06/25/2021
Rec V Date: 08/24/2021
Hospital:

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

Lab Data: N/a

Allergies: None

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

Symptoms: I have experienced changes in my menstrual cycle. My sister and I have both went from very regular cycles to having 2 periods a month. I bleed for an average amount of time, stop for 2-3 days, and then restart for about 3 more. I'm concerned as this is now the 3rd month with the same situation.

Other Meds: None

Current Illness: Ear infection 6/1/2021

ID: 1628447
Sex: M
Age: 25
State: GA

Vax Date: 08/24/2021
Onset Date: 08/24/2021
Rec V Date: 08/24/2021
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: Error: Booster Given Too Early-

Other Meds:

Current Illness:

ID: 1628448
Sex: F
Age: 31
State: VA

Vax Date: 08/23/2021
Onset Date: 08/24/2021
Rec V Date: 08/24/2021
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: No

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

Symptoms: Heart palpitations within 12 hours of vaccine

Other Meds: No

Current Illness: Postpartum anxiety

ID: 1628449
Sex: M
Age: 42
State: TX

Vax Date: 08/13/2021
Onset Date: 08/17/2021
Rec V Date: 08/24/2021
Hospital:

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

Lab Data: full set of labs and I was sent to the ER and they did another whole set of labs

Allergies: no

Symptom List: Vomiting

Symptoms: On 08/17/2021 I had major heart palpitations throughout the day and night. Increased blood pressure and chest pain. I saw a Doctor on the morning of 08/19/2021-the doctor did a whole set of labs and I was sent to the ER and they did another whole set of labs. I have been ongoing with doctors and cardiologist, and everyone is coming to the conclusion that it was an adverse effect of the second dose of Pfizer. Treatments : hydroxychloroquine 200 mg at first it was 4 /bd and now I take 2/bd; baby aspirin 4/81 mg od; Prednisone. I would say unknown to recovering from the AEs. Its' not as bad, but I'm still having heart palpitations and high blood pressure. I am also up to $5,000 of medical bills so far. Prior to the vaccination I did not have any heart palpitations and high blood pressure.

Other Meds: none

Current Illness: no

ID: 1628451
Sex: F
Age: 25
State: VA

Vax Date: 08/20/2021
Onset Date: 08/20/2021
Rec V Date: 08/24/2021
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: Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium, Systemic: Joint Pain-Medium, Systemic: Lymph Node Swelling-Medium

Other Meds:

Current Illness:

ID: 1628452
Sex: M
Age: 45
State: TN

Vax Date: 08/02/2021
Onset Date: 08/03/2021
Rec V Date: 08/24/2021
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: The morning after vaccination, on moving arm, patient reached to touch his injection site because it was sore. He noted there was some milky gelatinous fluid at the site and on trying to remove it, some extruded 'in a string' from the injection site. The site was surrounded by an area of redness about the size of a dime that layered peeled Patient was not I'll and experienced no other problems.

Other Meds:

Current Illness:

ID: 1628453
Sex: F
Age: 62
State: GA

Vax Date: 04/02/2021
Onset Date: 04/03/2021
Rec V Date: 08/24/2021
Hospital: Y

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

Lab Data: I have none. Medical personnel at the hospital did not think it was adverse reaction to the vaccine.

Allergies: None

Symptom List: Injection site swelling, Limb discomfort

Symptoms: 1st dose: I was lethargic, confusion, weakness, tiredness, wanted to sleep 2nd dose: Same as above but it lasted longer, all the above symptoms were getting worse. I was confused, felt fearful to drive or to go anywhere. Developed 2 UTI's (not sure if related) but I have not had a UTI since I was a child. Ended up in the hospital due to weakness in my legs, depression (which I do not or ever had) They treated me with IV antibiotics and ran every test they could and could not find anything. They had no answers as to if I had an allergic reaction to the vaccine, nor did they want to talk about that. I was in for 4 days.

Other Meds: Synthroid, Fish Oil, Multi-Vitamin, Vit C, Tramadol as needed, Soma as needed and clonazepam as needed.

Current Illness: None

ID: 1628454
Sex: F
Age: 75
State: FL

Vax Date: 08/24/2021
Onset Date: 08/24/2021
Rec V Date: 08/24/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Error: Booster Given Too Early-

Other Meds:

Current Illness:

ID: 1628455
Sex: F
Age: 65
State: PA

Vax Date: 08/13/2021
Onset Date: 08/15/2021
Rec V Date: 08/24/2021
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: 2 days after the vaccine was administered, patient reports she had a noticeable in pain in her joints, particular her knes and her lower back. She also reports getting a headache. Now, 11 days post vaccination she reports that she has the headache "off and on". Instead of getting better, the joint pain has gotten gradually worse each day is now making it difficult for her to walk.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am