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**
PLEASE CHECK BACK SOON
Download the files above while you wait.







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: 1632352
Sex: M
Age: 67
State: NJ

Vax Date: 01/01/2021
Onset Date: 07/01/2021
Rec V Date: 08/25/2021
Hospital: Y

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: Anemia, Periannal Abcess, Bakers Cyst both knees, Gout both knees

Other Meds: Amlodipine,Atorvistan,Carvedilol,VitaminD3,Fluoxetine, Gabapentin, Glimepride,Hydrochlorothiazide, levothyroxine, Quetiapine

Current Illness: Depression. Heart Disease. Kidney Disease. Anemia. High Chlorestorol, Obesity

ID: 1632354
Sex: F
Age: 40
State: FL

Vax Date: 08/21/2021
Onset Date: 08/24/2021
Rec V Date: 08/25/2021
Hospital:

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

Lab Data: I have an appointment to see my primary care physician on 8/30/2021

Allergies: parabens

Symptom List: Anxiety, Dyspnoea

Symptoms: On the 3rd day experienced sudden dizziness episode while standing followed by nausea which required me to sit down. On the morning of the 4th day (today) while sitting experienced another dizziness episode which incapacitated me, following by nausea. I have made an appointment with my primary care physician.

Other Meds: Thyroid mediations synthroid and cytomel

Current Illness: hypothyroidism

ID: 1632355
Sex: F
Age: 57
State: NJ

Vax Date: 08/19/2021
Onset Date: 08/19/2021
Rec V Date: 08/25/2021
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: Just a doctors visit next day. Given steroids.

Allergies: All fruit, blue fish, eggs, chicken, rag weed, mold, dogs, cats, grass, trees, Amoxicilin, Tetricycline

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

Symptoms: Itching throughout body inside & out. Throat tightening, coughing, tiredness. Eppi pin, allergy meds, steroids asthma pump. Hasn't stopped.

Other Meds: Verapamil 180, Valsartin 120 hydrochilodizide 25, avorsartin 40, c, d 3, tuneric,

Current Illness: Asthma

ID: 1632356
Sex: M
Age: 32
State: CA

Vax Date: 06/11/2021
Onset Date: 06/22/2021
Rec V Date: 08/25/2021
Hospital: Y

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

Lab Data:

Allergies: None

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: DVT and PE diagnosed a month after. Currently on blood thinners

Other Meds: None

Current Illness: None

ID: 1632357
Sex: M
Age: 53
State: OH

Vax Date: 08/24/2021
Onset Date: 08/24/2021
Rec V Date: 08/25/2021
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 erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Arm hurts, I feel drained and tired, a little cold. Same things happened when I got the first dose 3 months ago.

Other Meds: Pantoptazole SOD 20 mg Flovent HFA 220 mcg

Current Illness: None

ID: 1632358
Sex: M
Age: 48
State:

Vax Date: 04/05/2021
Onset Date: 08/24/2021
Rec V Date: 08/25/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: Tested COVID + on 8/24/21 at nursing home facility, sent to hospital since nursing home does not keep covid + patients. Hospitalized with no COVID symptoms

Other Meds:

Current Illness:

ID: 1632359
Sex: F
Age: 40
State: KY

Vax Date: 04/02/2021
Onset Date: 08/21/2021
Rec V Date: 08/25/2021
Hospital:

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

Lab Data: COVID-19 Positive on 08/21/2021

Allergies: penicillin

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: ? Tenderness at injection site ? Fatigue ? Anxiety ? Headaches

Other Meds: ? Once Daily Vitamin ? 800mg Prescribed Motrin

Current Illness: None

ID: 1632360
Sex: F
Age: 15
State: MI

Vax Date: 08/11/2021
Onset Date: 08/11/2021
Rec V Date: 08/25/2021
Hospital:

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

Lab Data: none

Allergies: none noted

Symptom List: Pharyngeal swelling

Symptoms: Moderna Covid 19 Vaccine was administered to an underage person. No adverse reactions.

Other Meds: unknown

Current Illness: none

ID: 1632361
Sex: F
Age: 55
State: AL

Vax Date: 08/03/2021
Onset Date: 08/06/2021
Rec V Date: 08/25/2021
Hospital:

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

Lab Data: none

Allergies: sulfa drugs, sometimes banana and watermelon makes my mouth itch but not always

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: All the joints in both of my hands hurt. They were sensitive to touch. This was not extremely painful but lasted for days then got better and then came back. It has been off and on.

Other Meds: nature made omega 3, monolaurin, vitamin d, some days I take a multiple vitamin

Current Illness: none

ID: 1632362
Sex: F
Age: 64
State: HI

Vax Date: 03/27/2021
Onset Date: 07/21/2021
Rec V Date: 08/25/2021
Hospital:

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

Lab Data: Blood test on 7/21/2021 showed potassium low at 2.5 and red blood cell count, hemoglobin and hematocrit all low.

Allergies: scopolamine

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Day after shot - extreme weakness, dizziness, nausea. Following months increasing fatigue. Sleeping over 12 hours a day and still fatigued. Finally contacted PCP and given blood test which showed hypokalemia and anemia. (An earlier blood test showed potassium levels were normal 4 days before first covid shot on 3/5/21) Currently taking potassium pills prescribed by doctor.

Other Meds: Warfarin calcitriol statins leothyroxine lutein vitamin bs, c,

Current Illness: none

ID: 1632363
Sex: F
Age: 40
State: MO

Vax Date: 04/15/2021
Onset Date: 04/18/2021
Rec V Date: 08/25/2021
Hospital:

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

Lab Data: Ultrasound, uterine biopsy, PAP, all done at hospital the first week of August, 2021.

Allergies: Sulfu

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

Symptoms: Menstrual bleeding, 12 to 14 ounces per day. Had to go on medical leave due to non-stop gushing blood and decreasing hemoglobin count. Now I am getting fired.

Other Meds: Cymbalta and Hydrocodone

Current Illness: None

ID: 1632364
Sex: F
Age: 63
State: KS

Vax Date: 01/28/2021
Onset Date: 05/07/2021
Rec V Date: 08/25/2021
Hospital: Y

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

Lab Data: Multiple MRIs, Lumbar puncture, blood tests- all at the Medical Center

Allergies: compazine

Symptom List: Rash, Urticaria

Symptoms: Transverse Myelitis developed 4 months s/p second shot

Other Meds: atenolol 50 mg, sumatriptan, ubrevly, multivitamin, calcium

Current Illness: none

ID: 1632365
Sex: M
Age: 13
State: OK

Vax Date: 08/11/2021
Onset Date: 08/11/2021
Rec V Date: 08/25/2021
Hospital:

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

Lab Data: none

Allergies: none

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

Symptoms: near syncope. Vasovagal symptoms with pallor, diaphoresis, weakness. Patient was laid flat (supine) and rested for 15min and symptoms resolved except for a little fatigue. He was able to stand then walk out of clinic. States he felt a little tired but otherwise felt fine. He did not lose consciousness, did not vomit.

Other Meds: none

Current Illness: none

ID: 1632367
Sex: M
Age: 69
State: MO

Vax Date: 07/26/2021
Onset Date: 07/28/2021
Rec V Date: 08/25/2021
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: Blood Work 08/23/2021

Allergies: N/A

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

Symptoms: Pt. states that after receiving the 1st dose of Phizer 07/26/2021, started experiencing symptoms 07/28/2021 of muscle aches, bone aches, joint pain, right side of the head pain, right knee pain, and weakness throughout the body. Primary visit 08/23/2021 recommended self reporting to VAERS. Blood work orders (antibodies).

Other Meds: Ativan, Multi-Vitamin

Current Illness: N/A

ID: 1632368
Sex: F
Age: 78
State: KY

Vax Date: 03/26/2021
Onset Date: 08/22/2021
Rec V Date: 08/25/2021
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:

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

Symptoms: COVID + test on 8/24/21. admitted with shortness of breath, weaness, and heart palpitations. required 2L oxygen, started on steroids and remdesivir

Other Meds: Zyrtec, lasix, irbesartan/HCTZ, mobic, metformin, omeprazole, zocor, diclofenac gel

Current Illness:

ID: 1632369
Sex: M
Age: 56
State: VA

Vax Date: 03/23/2021
Onset Date: 08/09/2021
Rec V Date: 08/25/2021
Hospital:

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

Lab Data: None

Allergies: Cats Dogs Trees

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

Symptoms: Vaccine 1: dizziness, foggy, tiredness and sore arm Vaccine 2: sore arm During the process of both vaccines pts level rose up significantly February before vaccine was .65 . August after both vaccines psa went up to 2.67.

Other Meds: Bicalutamide 50mg (once daily) Turmeric 2250mg (once- daily)

Current Illness: Cancer

ID: 1632370
Sex: F
Age: 47
State: OR

Vax Date: 06/05/2021
Onset Date: 08/16/2021
Rec V Date: 08/25/2021
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: Sulpha Latex

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

Symptoms: Extremely Painful menses Heavy bleeding 10 days and I?m still bleeding

Other Meds: Wellbutrin xl

Current Illness:

ID: 1632371
Sex: M
Age: 22
State: WA

Vax Date: 07/26/2021
Onset Date: 08/23/2021
Rec V Date: 08/25/2021
Hospital:

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

Lab Data: None

Allergies: No

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Client was asked if interested in being vaccinated for COVID while our team was on outreach. Reported never being vaccinated before and wanted to receive vaccine today. Team was unable to find client on Immunisation Registry so vaccine was administered. After the fact, it was discovered client had previously been vaccinated on 4/26 and 6/7 with Moderna.

Other Meds: No

Current Illness: No

ID: 1632372
Sex: F
Age: 63
State: NC

Vax Date: 02/14/2021
Onset Date: 07/29/2021
Rec V Date: 08/25/2021
Hospital:

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

Lab Data:

Allergies: penicillin, rochepin, jelly beans, mangos

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: developed itchy rash under left lip about the size of a nickel. Treated with steroid cream with helped to alleviate the itching. Painful blisters occurred 4 days later. Lymph nodes under chin on left side became very tender all the way to my ear. This caused ear pain that required use of heating pad to alleviate some of the discomfort. On day 5, lymph nodes in neck also became tender. Decided to go the urgent care on Aug 2. He treated me with Valacyclovir 1000mg twice a day for 7 days. He thought it could be herpes labialis even though I have never had this previously. I completed this treatment but I still have a red bumpy spot where the original rash was.

Other Meds: bupropion, Vit D3, diazepam, gabapentin, hydrocone with APAP, estradiol vag tab, lisinopril, pantoprazole, ubrelvy, hair, and nails vitamins, cyanocobalamin inj,

Current Illness:

ID: 1632373
Sex: F
Age: 55
State: OR

Vax Date: 08/23/2021
Onset Date: 08/23/2021
Rec V Date: 08/25/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Temperature of 104.8 degrees for 8 full hours. Unable to get temperature to lower.

Other Meds: Lisinopril

Current Illness: None

ID: 1632374
Sex: F
Age: 58
State: NY

Vax Date: 03/30/2021
Onset Date: 08/16/2021
Rec V Date: 08/25/2021
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: Bloodwork was taken 8/16/21..

Allergies: Penicillin Bananas Bee venom Laytex

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

Symptoms: Was recently diagnosed with Rheumatoid Arthritis..never had that diagnosis prior to my covid shot yet had tons of blood tests a year ago and tests came up negative for RA.

Other Meds: Eliquis 2x day Baby asprin 81 mg 1x daily Norvasc 5mg 1x daily Crestor 5 mg 1x daily

Current Illness: None

ID: 1632375
Sex: F
Age: 29
State: TX

Vax Date: 08/23/2021
Onset Date: 08/24/2021
Rec V Date: 08/25/2021
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: Heart beating off/ fluttering and shortness of breath

Other Meds:

Current Illness:

ID: 1632376
Sex: M
Age: 14
State: AZ

Vax Date: 08/06/2021
Onset Date: 08/13/2021
Rec V Date: 08/25/2021
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: Trying to get help now.

Allergies: peanuts, fish, beans

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

Symptoms: Severe Tics resembling Tourettes. He 10-30 tics per minute. He did not have these symptoms at all before the vaccine.

Other Meds: none

Current Illness: none

ID: 1632377
Sex: F
Age: 51
State: AL

Vax Date: 02/17/2021
Onset Date: 07/27/2021
Rec V Date: 08/25/2021
Hospital: Y

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

Lab Data: MRI on 7/27/2021 and 7/28/2021 Blood work and I am not sure what kinds EKG monitoring CAT Scan 7/27/2021

Allergies: Sulfa, Penicillin

Symptom List: Injection site pain, Pain

Symptoms: I did not have risk associated with the possibility of a stroke. However, I experienced and was treated for a stroke on 07/27/2021. I was taken by ambulance when I could not speak and remember words that normally came naturally to me. According to the Emergency room doctors, I experienced a blockage in the language area, 3 blockages, according to the neurologist in the emergency room. I was given medication to dissolve the clots in the brain and admitted for 2 days afterward. I was given medications to take going home and have continued to do so. I have also been wearing a cardiac monitor for 30 days per cardiologist orders. Slowly, I have been regaining the ability to speak and recall words.

Other Meds: Estrogen

Current Illness: None

ID: 1632378
Sex: F
Age: 29
State: NJ

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

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

Lab Data: 6/8 went to emergency room. Was put on fluids with an antibiotic. Was given ultrasound of arm to determine if an abscess had occurred. Operation not necessary

Allergies: Allergic to tree nuts

Symptom List: Injection site pain, Menorrhagia

Symptoms: Almost immediate fever (about an hour after injection). High to the point of melting the ice pack I used to help cool down. Injection site swelled to the size of a grapefruit. Dehydration. Severe headache. Chills and sweats

Other Meds: IUD birth control

Current Illness:

ID: 1632379
Sex: M
Age: 24
State: TX

Vax Date: 04/30/2021
Onset Date: 08/08/2021
Rec V Date: 08/25/2021
Hospital: Y

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

Lab Data: COVID vaccine is listed in patient's history but he did not receive the vaccine where this reporter works.

Allergies: None listed in medical record

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

Symptoms: This 24 year-old patient was transferred to our hospital, from a separate nearby hospital on 8/9/21. He had presented on 8/8/21 with acute respiratory failure requiring intubation, and pneumonia. He was admitted to Hospital on 8/9/21 and discharged home on 8/20/21. Treatment at transferring hospital on 8/8/21 included Remdesivir, dexamethasone, azithromycin, rocephin, cefapime, vancomycin, and 3L NS. H & P at receiving hospital, says: Reportedly multiple COVID 19 testing negative, however elevated inflammatory markers concerning for possible COVID, for this reason placed on isolation. Diagnosed with respiratory failure, sepsis, MSSA pneumonia POA, infective endocarditis, acute normocytic anemia, and others.

Other Meds: unknown--vaccine not given at this hospital

Current Illness: unknown

ID: 1632380
Sex: F
Age: 63
State: FL

Vax Date: 08/06/2021
Onset Date: 08/07/2021
Rec V Date: 08/25/2021
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: Following with psychiatry.

Allergies: reglan

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Patient states increased anxiety associated with vaccine.

Other Meds: levothyroxine, glimperide, HCTZ, Januvia, creon, lipitor, ambien, prevacis, potassium chloride, buspirone, Klonopin

Current Illness: DM, HTN, chronic pancreatites, GERD, OSA, COPD

ID: 1632381
Sex: F
Age: 83
State:

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 08/25/2021
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: Swollen, hot, and red around the injection site. Arm is sore, oozing clear fluid from injection site.

Other Meds: None.

Current Illness:

ID: 1632382
Sex: M
Age: 49
State: WA

Vax Date: 07/28/2021
Onset Date: 08/23/2021
Rec V Date: 08/25/2021
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: None

Allergies: No

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

Symptoms: Client was asked if interested in being vaccinated for COVID while our team was on outreach. Reported never being vaccinated before and wanted to receive vaccine today. Team was unable to find client on Immunisation Registry so vaccine was administered. After the fact, it was discovered client had previously been vaccinated on 4/26 and 6/7 with Moderna.

Other Meds: No

Current Illness: No

ID: 1632383
Sex: F
Age: 43
State: KY

Vax Date: 08/10/2021
Onset Date: 08/20/2021
Rec V Date: 08/25/2021
Hospital:

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

Lab Data: Dr appt took place on Tuesday Aug 24th at 10:50 am, prescribed Bactrim twice a day for 7 days and also Kenalog cream to apply twice a day to affected arm.

Allergies: Penicillin

Symptom List: Nausea

Symptoms: First vaccine administered August 10, August 20th around 530 PM a half inch red line showed up under my left arm along with fever to the touch. By Saturday morning Aug 21st I developed a severe rash, blisters, redness all over my arm from 2 inches above elbow up to about an inch above the injection site. Swollen, red and very itchy. Blisters and terrible, painful rash. The redness and puffiness spread all over the top of my arm to both sides. The sleeve of my shirt hurt to touch it. Extreme sensitivity. I called my doctor on Monday Aug 23 and they wanted to see me on Tuesday Aug 24th. Dr stated that this was COVID Arm and she said there could potentially be a secondary infection at the injection site due to how how severe my arm was. I was prescribed antibiotics to take for one week as well as a steroid topical ointment. I do recall while at Walgreens the staff member took the needle cap off and then dropped the vaccine on her work station table needle side down then administered.

Other Meds: Zanax, Ambien and Zoloft

Current Illness: None

ID: 1632384
Sex: F
Age: 29
State: PA

Vax Date: 02/28/2021
Onset Date: 02/28/2021
Rec V Date: 08/25/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List: Injection site pain

Symptoms: Shingles.

Other Meds: N/A

Current Illness: N\A

ID: 1632385
Sex: F
Age: 59
State: PA

Vax Date: 01/25/2021
Onset Date: 08/17/2021
Rec V Date: 08/25/2021
Hospital:

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

Lab Data: Updated Procedure 08/21/21 0909 POCT COVID-19 PCR Collected: 08/21/21 0908 | Final result | Specimen: Swab from Nares POC COVID-19 PCR DetectedAbnormal Lot # 1000270419 Point of Care COVID-19 PCR Testing Method Cepheid Lot Expiration Date 06/12/2022

Allergies: NKA

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

Symptoms: Patient with head congestion, cough, fever, fatigue, works at the hospital with COVID-19 patients, she has had the vaccine.

Other Meds: ACETAMINOPHEN ORAL amoxicillin (AMOXIL) 500 mg capsule cholecalciferol, vitamin D3, 10 mcg (400 unit) tablet diclofenac sodium (VOLTAREN GEL) 1 % gel levothyroxine (SYNTHROID) 100 mcg tablet

Current Illness:

ID: 1632386
Sex: F
Age: 67
State: NC

Vax Date: 08/25/2021
Onset Date: 08/25/2021
Rec V Date: 08/25/2021
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: none

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

Symptoms: Patient received full series of Pfizer COVID vaccine in 2/2021. Came into pharmacy asking for Moderna COVID shot. Asked patient if they had ever received a COVID shot to which she replied no. Administered Moderna COVID shot on 8/25/2021. When entering shot into system saw they had previously received Pfizer series and our policy is not to mix manufacturer's unless it is absolutely necessary.

Other Meds: Unknown

Current Illness: unknown

ID: 1632387
Sex: M
Age: 92
State: MI

Vax Date: 02/24/2021
Onset Date: 08/22/2021
Rec V Date: 08/25/2021
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: Amiodarone, penicillin

Symptom List: Tremor

Symptoms: Fever, Weakness, fatigue, decreased appetite.

Other Meds: Unknown

Current Illness: Unknown

ID: 1632388
Sex: M
Age: 58
State: NJ

Vax Date: 07/26/2021
Onset Date: 08/21/2021
Rec V Date: 08/25/2021
Hospital:

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

Lab Data: PHYSICIAN EXAM 08/24/2021

Allergies: none

Symptom List: Erythema, Pruritus

Symptoms: BELLS PALSY DIAGNOSIS

Other Meds: multivitamin, d3, baby aspirin

Current Illness: none

ID: 1632389
Sex: M
Age: 65
State: NJ

Vax Date: 04/11/2021
Onset Date: 07/12/2021
Rec V Date: 08/25/2021
Hospital: Y

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: Blood test at hospital and EKG at doctor office after incident

Allergies: none

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

Symptoms: As soon as I woke up I felt very dizzy almost passed out. Called 911 when I went to hospital my blood pressure was high. First time I saw high blood pressure. Always perfect at doctor visits. I was told Potassium was low, Never happened before. few weeks later same happened and drove to hospital. again high blood pressure. I followed up with my doctor. Gave me medicine for high blood pressure and dizziness. **Most importantly he told me I have irregular heart beat. ** All my life I exercised , never had this issue. There is nothing in my life to think why this happened.

Other Meds: nona

Current Illness: none

ID: 1632390
Sex: F
Age: 61
State: NC

Vax Date: 02/03/2021
Onset Date: 03/01/2021
Rec V Date: 08/25/2021
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: Cipro, codeine

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

Symptoms: Beginning in March began having more severe arthritis flare ups than usual (pain, swelling, hot joints) may have no connection to vaccine. Maybe it's an age thing. Usually have minor flareups that do not affect working however have had 3+ since March. I plan to get the booster as soon as possible

Other Meds: Tylenol, ibuprofen, vitamin d, aspirin, Allegra

Current Illness: none

ID: 1632391
Sex: F
Age: 74
State: OH

Vax Date: 03/16/2021
Onset Date: 03/16/2021
Rec V Date: 08/25/2021
Hospital:

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

Lab Data: I did not have any medical tests completed.

Allergies: Sulfa; cipro.

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Immediately after receiving the vaccine, I experienced chills and fatigue. The symptoms lasted about 24-48 hours. Five months later, I started feeling like I had water in my ears and they were popping. I went to see my doctor and she said that there was not an infection. She had me take Flonase nasal spray twice a day. My doctor said the sound had to do with eustachian tubes. I am still hearing the popping in my ears, but it seems to have reduced.

Other Meds: Lisinopril; atorvastatin; CL-210; cilostazol; vitamin D3; multivitamin; omeprazole; vitamin B12.

Current Illness: I was not experiencing any illness.

ID: 1632392
Sex: M
Age: 42
State: TX

Vax Date: 08/03/2021
Onset Date: 08/04/2021
Rec V Date: 08/25/2021
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: Patient had numbness on right side of body, slurred speech, right side aches, dizziness, head fullness

Other Meds:

Current Illness:

ID: 1632393
Sex: M
Age: 33
State: GA

Vax Date: 03/15/2020
Onset Date: 05/04/2020
Rec V Date: 08/25/2021
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:

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

Symptoms: persistent sinus trouble causing dizziness

Other Meds:

Current Illness:

ID: 1632394
Sex: F
Age: 40
State: NH

Vax Date: 05/17/2021
Onset Date: 05/25/2021
Rec V Date: 08/25/2021
Hospital:

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

Lab Data: Echogram. Nuclear imaging, Stress test. Normal results 7/9, 8/17

Allergies: None

Symptom List: Pain in extremity

Symptoms: Chest pain after one week of injection from vaccine. Patient has had continuous chest pain since vaccine. Patient was admitted to emergency room on 7/9 for chest pain. Examination came back normal. Stress test was conducted 8/17. Stress test showed normal results. Doctors are unsure of what is causing chest discomfort. No shortness of breath. Just a constant pain in center of chest, sometimes migrating to left or right side. No history of acid reflux. Patient has a family history of heart disease. Patient is not overweight and lives an active, relatively healthy lifestyle.

Other Meds: Topomax, Atorvastatin

Current Illness: None

ID: 1632395
Sex: F
Age: 55
State: NY

Vax Date: 02/01/2021
Onset Date: 02/11/2021
Rec V Date: 08/25/2021
Hospital:

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

Lab Data: Blood work, ultrasound, MRI.

Allergies: Sulfa drugs

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

Symptoms: Around 2 weeks after the 2nd dose vaccine, I had severe sharp abdominal pain following by vomiting. I consulted with the doctor the following morning. I had to get blood work and the blood work showed elevated lipase levels, which can be indicative of pancreatitis. I went in for an ultrasound which showed a cyst on my pancreas. I also did an MRI which showed a cyst/lesion on my liver. The acute pain did resolve within 24 hours and I had residual cramping which resolved in a day or 2.

Other Meds: None

Current Illness: None

ID: 1632396
Sex: M
Age: 75
State: PA

Vax Date: 01/26/2021
Onset Date: 08/17/2021
Rec V Date: 08/25/2021
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: Updated Procedure 08/18/21 1438 POCT COVID-19 PCR Collected: 08/18/21 1438 | Final result | Specimen: Swab from Nares POC COVID-19 PCR DetectedAbnormal Lot # 1000270419 Point of Care COVID-19 PCR Testing Method Cepheid Lot Expiration Date 6/12/22

Allergies: NKA

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

Symptoms: cough, diarrhea, low-grade fever and shortness of breath Admission: Current 8/20/2021 - present (5 days) COVID-19 Principal problem History of Present Illness Patient is an 75 y.o. male. Pt presents via community referral for MAB infusion for recent COVID infection. Pt is fully vaccinated and doing well. Pt states that earlier in week he was outside leaf blowing and kicked up some dust and started coughing, he initially thought that this was the cause of his symptoms but by the next day he was feeling very poorly and was seen in the urgent care. Urgent care did COVID swab and his swab resulted as positive on 8/18. Pt was notified and d/t his hx of bone marrow transplant, obesity, T2DM, and age he was a candidate for MAB infusion. Pt agreed and was placed on list for infusion. Facility was consulted to help facilitate infusion. Pt was screened at home via telephone and notes that he has a niece that lives nearby and helps him, as well as family and many friends that are willing to help him if needed. Pt denies recent falls and states that he bowls on a league and is always active. Pt will be enrolled in facility for MAB infusion and continued following for several days to ensure improvement in symptoms. Pt was agreeable. Currently endorsing fatigue, loss of taste/smell, cough, SOB, chest tightness, mild nausea, lack of appetite, fevers, and body aches.

Other Meds: acyclovir (ZOVIRAX) 800 mg tablet albuterol HFA (PROVENTIL;VENTOLIN) 90 mcg/actuation inhaler amLODIPine (NORVASC) 5 mg tablet aspirin 81 mg tablet atorvastatin (LIPITOR) 80 mg tablet azithromycin 500 mg in sodium chloride 0.9 % 250 mL

Current Illness:

ID: 1632397
Sex: F
Age: 65
State: SC

Vax Date: 08/03/2021
Onset Date: 08/19/2021
Rec V Date: 08/25/2021
Hospital:

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

Lab Data: None offered or given

Allergies: None known

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

Symptoms: Muscle pain in left arm, chest and left back at shoulder blade. Tingling in left arm. Started on 8/19/2021 and continues, as of 8/25/2021. Had ultrasound and EKG, both negative.

Other Meds: Probotics, Omega 3

Current Illness: Inflamation of intestines

ID: 1632398
Sex: F
Age: 67
State: UT

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

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

Lab Data: None

Allergies: none

Symptom List: Vomiting

Symptoms: First bowel movement 17 hours after the vaccine-heavy rectal bleeding. This have never happened to me before. Assume it is related to the vaccine. I don't know if this will be a one-time thing, but it is certainly the first time I have bled from the rectal area.

Other Meds: 2 Tablets of Acetaminophen

Current Illness: none

ID: 1632399
Sex: F
Age: 36
State: MN

Vax Date: 08/10/2021
Onset Date: 08/18/2021
Rec V Date: 08/25/2021
Hospital: Y

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

Lab Data: MRI, MRV, TEE, Lower extremity ultrasound, and labs all done between 8/18/2021-8/20/2021

Allergies: N/A

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Patient had a Left ischemic cerebellar stroke on 08/18/2021. Pt started having L sided weakness and clumsiness at 7 pm. Went to the ER at 9 pm. Pt was discharged the next morning and then asked to come back in for an MRI, which confirmed the stroke. Pt is currently on blood thinners and a cardiac monitor for the next 30 days to determine what long term treatment will be.

Other Meds: Larissia, pre natal vitamin, vitamin D

Current Illness: N/A

ID: 1632400
Sex: F
Age: 85
State: CT

Vax Date: 01/08/2021
Onset Date: 08/24/2021
Rec V Date: 08/25/2021
Hospital: Y

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

Lab Data: rapid test

Allergies: Iodinated Contrast Media, Hydrocodone, Acetaminophen, Lisinopril, Sulfa, Codeine

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

Symptoms: Cough

Other Meds: Certavite-Antioxidant, Culturelle, Vitamin D2

Current Illness: None

ID: 1632401
Sex: M
Age: 70
State: TX

Vax Date: 02/09/2021
Onset Date: 07/30/2021
Rec V Date: 08/25/2021
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: Deep Vein Doppler

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: In the evening of Friday July 30th and I looked down at my ankle, which it has happened to before and has happened with an overseas flight. I sent a picture to my doctors. They scheduled a deep vein doppler and they concluded I had a deep vein thrombosis about a foot long clot in my lower leg. They put me on XARELTO to treat it. I have another ultrasound for it next week to see what it has done. I had only flown a domestic flight. They only have concerns when you make a longer flight.

Other Meds:

Current Illness:

ID: 1632402
Sex: F
Age: 61
State: IL

Vax Date: 03/26/2021
Onset Date: 06/24/2021
Rec V Date: 08/25/2021
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: sulfa drugs and clarithromycin,

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

Symptoms: severe pain started on 6/24/21 and she went to the emergency room on 6/26/21 and they ran a CAT scan and it was determined it was her appendix, on 6/26/2021 they transported her to the hospital because they couldn't get to her appendix, at the hospital she was on heavy doses of antibotics, after a few days they did another CAT SCAN and it now was worse, the doctor was unable to get to her appendix because it was surrounded like a wall.. on 7/1/21 she came home and stayed on antibiotics, on 7/14/21 she is at the hospital and her appendix was removed and 6 inches of her intestine was removed after that she stayed in the hospital 6 more days.

Other Meds: Synthroid, Irbesartan, hydrochlorothiazide, clonazepam, trazadone, simvastatin, pantobrazed, amitriptyline,

Current Illness:

ID: 1632403
Sex: M
Age: 72
State: FL

Vax Date: 08/20/2021
Onset Date: 08/23/2021
Rec V Date: 08/25/2021
Hospital:

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

Lab Data: None at this time.

Allergies: NKA

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

Symptoms: 08/23/2021 about 8:30 PM observed round/oval red rash 2 inches in diameter between left ankle and heel on outside of left leg. Saw doctor 08/24/2021 who prescribed DOXYCYCLINE HYC 100 mg twice a day if rash a bacterial infection and KETOCONAZOLE 2% Cream twice a day if rash a fungal infection. Advised to go to the ER if the rash gets worse and fever develops. Pharmacy counselled that there were no adverse drug interactions expected.

Other Meds: Remicade 100 mg/8 weeks; Lialda 2.4 grams/day; Lipitor 10 mg/day; fish oil 1,000 mg/day; B6 100 mg/day; B12 1,000mcg/day; Folic Acid 400mcg/day; Benadryl 25 mg/prn; Tylenol 325 mg/prn

Current Illness: Ulcerative Colitis; high cholesterol and non-alcoholic fatty liver

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am