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: 1632455
Sex: F
Age: 58
State:

Vax Date: 02/01/2021
Onset Date: 02/01/2021
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: LA

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: States felt like mini COVID. Had vomiting, body aches, and headache for 3-4 days.

Other Meds:

Current Illness:

ID: 1632456
Sex: F
Age: 45
State: IN

Vax Date: 08/06/2021
Onset Date: 08/06/2021
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: None reported

Allergies: None

Symptom List: Anxiety, Dyspnoea

Symptoms: Client states she started her menstrual cycle on Tuesday 8/3/2021 and received her vaccine on 8/6/2021. She states she has not stopped menstruating since receiving her vaccine. She states the discharge is a light amount and brown with clots. She described it as "when her period is almost over, but it just never stopped" She states she took her first pill of her new pack on 8/7/21. States she has not been evaluated by a medical professional or her OBGYN. Advised her that she should contact her medical professional or OBGYN.

Other Meds: Sprintec birth control

Current Illness: None reported

ID: 1632457
Sex: F
Age: 57
State:

Vax Date: 03/29/2021
Onset Date: 04/12/2021
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:

Allergies: ASA

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

Symptoms: Non-itchy scaly patch (~1/4 inch in diameter) above clitoris. Diagnosed as post-menopausal lichen sclerosis. Gradually sloughed-off over a two-week period of gentle scrubbing with water, followed by tearing of the vulva and white spots on labia. Doctor prescribed treatment of cortisone cream cleared up spots and healed tearing over several weeks.

Other Meds:

Current Illness:

ID: 1632458
Sex: M
Age: 46
State: PA

Vax Date: 07/01/2021
Onset Date: 07/15/2021
Rec V Date: 08/25/2021
Hospital:

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

Lab Data: None.

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Two weeks after getting the vaccine, I had 2 days where I was extremely "out of it" with some balance issues, lack of energy, and minor headaches. I had been surfing and thought that I had a concussion. I did not recall any specific event while surfing that would have caused the concussion but i had bumped my head a few times. I am reporting this now because two weeks after my second dose, I had the same reaction except it was much worse and I was not surfing, so I now thing the original side effect was from the vaccine.

Other Meds:

Current Illness:

ID: 1632459
Sex: F
Age: 33
State: TX

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: BP: 100/62 , HR: 99 , SO2: 100 , Resp.: 16 BS: 117

Allergies: NONE

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

Symptoms: 12 weeks pregnant, last meal was 4 hours prior to vaccination. Patient started panting, says to have lost eyesight for a couple of minutes, eyes rolling in back of head.

Other Meds: NONE

Current Illness: NONE

ID: 1632460
Sex: F
Age: 16
State: AZ

Vax Date: 08/06/2021
Onset Date: 08/08/2021
Rec V Date: 08/25/2021
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: None

Allergies: NKDA

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

Symptoms: Patient came in and received the vaccine before her age was verified. Patient was instructed to wait the 30 minutes o make sure that there was no adverse reaction. Patient had no reaction to the vaccine and left the facility. Staff was retrained on verifying the age before any vaccine is given in the facility.

Other Meds: Depo-Provera

Current Illness: None

ID: 1632461
Sex: F
Age: 57
State: GA

Vax Date: 08/20/2021
Onset Date: 08/20/2021
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: Had a Covid test done to make sure I didn't have Covid at the same time of getting the vaccine and it was negative. I was also negative for the flu.

Allergies: Penicillin, sulfa and beans

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Severe nausea, diarrhea, headache, fatigue, weakness and neurological issues. The headache has subsided, but the other symptoms continue. Biggest issue is the neurological. Arms, hands, legs and feet feel like pens and needles. When air blows on me it feels like its burning. My right hand hurts to use.

Other Meds: None.

Current Illness: None. Healthy

ID: 1632462
Sex: F
Age: 12
State: NJ

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Allergies to various substances, but I was not given a list

Symptom List: Pharyngeal swelling

Symptoms: Patient experienced hives, I recommended to use Benadryl and call her PCP

Other Meds:

Current Illness:

ID: 1632463
Sex: M
Age: 75
State: PA

Vax Date: 02/03/2021
Onset Date: 08/13/2021
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: 08/21/21 1658 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 08/21/21 0722 | Final result | Specimen: Swab from Nares COVID-19 SARS-CoV-2 Overall Result DetectedCritical 08/21/21 1658 COVID-19 PCR Collected: 08/21/21 0722 | Final result | Specimen: Swab from Nares

Allergies: NKA

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: exposed to a COVID congestion

Other Meds: aspirin 81 mg tablet sildenafiL (VIAGRA) 50 mg tablet

Current Illness:

ID: 1632464
Sex: F
Age: 16
State: IA

Vax Date: 08/23/2021
Onset Date: 08/23/2021
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: none

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Moderna Vaccine mistakenly given to a 16 y/o patient. No adverse effects, hospital pharmacist called patient and her parent to discuss the off label use of the vaccine.

Other Meds:

Current Illness:

ID: 1632465
Sex: F
Age: 56
State: FL

Vax Date: 08/19/2021
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: SYR
Vax Site: LA

Lab Data: no

Allergies: codeine

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

Symptoms: Patient report that she has muscle pain on her left side all the way down to her feet... also reported that she had a fever and numbness in her leg.

Other Meds: no

Current Illness: no

ID: 1632466
Sex: F
Age: 44
State: CA

Vax Date: 05/14/2021
Onset Date: 06/15/2021
Rec V Date: 08/25/2021
Hospital:

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

Lab Data:

Allergies: Coconuts; walnuts; bitter leaves; fish; soy; soy lecithin; penicillin

Symptom List: Rash, Urticaria

Symptoms: I have been very sensitive to the heat since my second dose and I experience some swelling in my hands and feet. Within three weeks of the second dose of the vaccine I became very sensitive to shampoo. After I shampooed my hair it would make me itch where my hair touched. My scalp is very itchy and a little red. The doctor prescribed ketoconazole shampoo but it did not work because I still needed to use regular shampoo. It is impossible to find shampoo with no coconut ingredients. I have had food allergies to coconut, but it has never been a topical sensitivity before. I had Covid-19 in early January of 2021. My hair was falling out for a while, and I still have fatigue, headaches and other symptoms of Long Haul Covid-19.

Other Meds: Vitamin B12; vitamin D; probiotics.

Current Illness:

ID: 1632467
Sex: M
Age: 19
State: UT

Vax Date: 03/01/2021
Onset Date: 05/10/2021
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: Skin biopsy / Emergency room and urgent care visits

Allergies: none that we know of

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

Symptoms: Severe edema, rash, hives, agitation, etc.

Other Meds: Valproic acid (depakote)

Current Illness: None

ID: 1632469
Sex: F
Age: 76
State: PA

Vax Date: 02/03/2021
Onset Date: 08/13/2021
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: Updated Procedure 08/21/21 1658 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 08/21/21 0732 | Final result | Specimen: Swab from Nares COVID-19 SARS-CoV-2 Overall Result DetectedCritical 08/21/21 1658 COVID-19 PCR Collected: 08/21/21 0732 | Final result | Specimen: Swab from Nares

Allergies: LatexOther (document details in comments) PenicillinsOther (document details in comments)

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

Symptoms: close exposure to COVID-19 virus ASYMPTOMATIC

Other Meds: levothyroxine (SYNTHROID) 50 mcg tablet triamcinolone (KENALOG) 0.5 % ointment

Current Illness:

ID: 1632470
Sex: F
Age: 56
State: PA

Vax Date: 08/15/2021
Onset Date: 08/16/2021
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: None

Allergies: None

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

Symptoms: Extreme vertigo; unable to walk with any steadiness. Dizziness has continued for the 10 days since.

Other Meds: Omeprazole, Probiotic, Liver MD, Zinc

Current Illness: Barrett's Syndrome, fatty liver

ID: 1632471
Sex: F
Age: 61
State: VA

Vax Date: 01/27/2021
Onset Date: 03/03/2021
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: I had practical exam to diagnose Bell's Palsy.

Allergies: NSAIDS; seasonal allergies; cat dander.

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

Symptoms: I developed Bell's Palsy. The right side of my face went completely limp. My eye would not close. I went to the ER at first, and they ruled out a stroke. My doctor put me on medication and eye drops to help my eye with closing. My mouth was drooping and I had problems with eating. My face looks like I had a face lift. My mouth is not exactly even, but I don't notice any other lingering issues. I would say that it took about 2 weeks for my eye to close. Getting my face back to normal was closer to 4 weeks time.

Other Meds: Lexapro; lorazepam; vitamin D3; omeprazole; montelukast; probiotic.

Current Illness: I was not experiencing any illness.

ID: 1632472
Sex: M
Age: 51
State: PR

Vax Date: 07/08/2021
Onset Date: 07/09/2021
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: none so far.

Allergies: Shrimp, seafood.

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

Symptoms: Bandlike headache and anxiety. Headache is persistent since then. Blood pressure is on normal parameters.

Other Meds: None

Current Illness: NONE

ID: 1632473
Sex: F
Age: 61
State: TX

Vax Date: 08/17/2021
Onset Date: 08/18/2021
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: No

Allergies: Penicillin

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Temperature of 105.

Other Meds: Lazorton

Current Illness: No

ID: 1632474
Sex: M
Age: 92
State: FL

Vax Date: 04/23/2021
Onset Date: 08/25/2021
Rec V Date: 08/25/2021
Hospital: Y

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

Lab Data: POSITIVE COIVD TEST 08/23

Allergies: SULFA DRUGS, CONTRAST DYE

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: brought into the emergency department after having a fall while he was trying to get out of bed, patient reports feeling lightheaded. Denies loss of consciousness or hitting his head. Patient had fever, sore throat dry cough for a week, he tested positive for COVID on 08/23

Other Meds: Alphagan, 2 drops, Each Affected Eye, Daily amlodipine 5 mg oral tablet, 5 mg, PO, BID (2 times a day) aspirin 81 mg oral tablet, 81 mg= 1 TAB, PO, Daily cloNIDine 0.1 mg/24 hr transdermal film, extended release, 2 Patch, Transdermal, Q

Current Illness:

ID: 1632475
Sex: F
Age: 33
State: VA

Vax Date: 08/12/2021
Onset Date: 08/20/2021
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: Unknown.

Allergies: No

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

Symptoms: Patient reported feeling extremely lethargic and severe back pain that is affecting everyday activities. Back pain did not start until a few days after vaccination.

Other Meds: Unknown

Current Illness: Unknown

ID: 1632476
Sex: F
Age: 36
State: NY

Vax Date: 03/17/2021
Onset Date: 03/18/2021
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: None.

Allergies: Topical fragrances on skin.

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

Symptoms: Extreme mental distress. Thoughts of self harm including suicide. Anxiety and Depression. Began 24 hours after injection and subsided 24 hours later, with negative effects lingering for several weeks.

Other Meds: Advil. Mirena IUD.

Current Illness: None.

ID: 1632477
Sex: M
Age: 17
State: WA

Vax Date: 04/16/2021
Onset Date: 05/14/2021
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: n/a

Allergies: None

Symptom List: Unevaluable event

Symptoms: n/a

Other Meds: None

Current Illness: None

ID: 1632478
Sex: F
Age: 65
State: IN

Vax Date: 08/24/2021
Onset Date: 08/24/2021
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: None

Allergies:

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

Symptoms: No evident adverse events at this time. Patient received Moderna COVID19 vaccination on 07/08/2021, and the Pfizer COVID19 vaccine was mistakenly administered as her second dose.

Other Meds:

Current Illness:

ID: 1632479
Sex: F
Age: 25
State: PA

Vax Date: 02/03/2021
Onset Date: 08/20/2021
Rec V Date: 08/25/2021
Hospital:

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

Lab Data: 08/22/21 1903 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 08/22/21 0926 | Final result | Specimen: Swab from Nares COVID-19 SARS-CoV-2 Overall Result DetectedCritical 08/22/21 1903 COVID-19 PCR Collected: 08/22/21 0926 | Final result | Specimen: Swab from Nares

Allergies: NKA

Symptom List: Injection site pain, Pain

Symptoms: Nausea ? Generalized Body Aches ? Cough ? Headache ? Excessive Sweating

Other Meds: albuterol HFA (PROVENTIL;VENTOLIN) 90 mcg/actuation inhaler cetirizine (ZyrTEC) 10 mg tablet escitalopram (LEXAPRO) 10 mg tablet levonorgestrel (KYLEENA) 17.5 mcg/24 hrs (5 yrs) 19.5 mg IUD OCREVUS 30 mg/mL solution topiramate (TOPAMAX

Current Illness:

ID: 1632480
Sex: F
Age: 41
State: IA

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

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

Lab Data: None

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Redness appeared near injection site approximately 1 week after vaccine

Other Meds:

Current Illness:

ID: 1632481
Sex: F
Age: 45
State: TN

Vax Date: 05/18/2021
Onset Date: 08/10/2021
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: chest xray 8/16/21: Multifocal scattered areas of moderate groundglass consolidation throughout both lungs, predominantly in a peripheral distribution. This is compatible multifocal pneumonia, and is favored to represent an atypical viral pneumonia in this patient with known Covid. 8/16:21: covid positive test

Allergies: penicillins, tramadol

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

Symptoms: hospitalized for covid 19 pna. - She feels terrible. She is complaining of shortness of the breath and muscle pains and aches. Her oxygen saturation is low and now she is requiring oxygen supplementation. Needing 4L of O2. smoker.

Other Meds: unknown

Current Illness: unknown

ID: 1632482
Sex: M
Age: 52
State: OH

Vax Date: 08/13/2021
Onset Date: 08/14/2021
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:

Allergies: penicillin

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Patient called complaining about a severely sore arm that start a day after his 2nd Covid shot and the soreness has continued to the current date of 8/25/21. The soreness prevents the patient from using his left arm and he has to rest his arm continually due to the soreness. The soreness has not gone away.

Other Meds: no medications

Current Illness: none

ID: 1632483
Sex: F
Age: 83
State: OH

Vax Date: 02/17/2021
Onset Date: 03/17/2021
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: SEE ABOVE----- MANY OTHER LABS

Allergies: NONE

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: PATIENT DESCRIBES: 1 MONTH FOLLOWING 2ND DOSE MODERNA- PLATELET COUNT 625 AFTER A BASELINE OF 236 IN 11/2020. FOLLOWUP PLATELET COUNTS- 6/30/2021- 1684: 7/9/2021- 1566: SEPT/ 2021- 1900. DENIES ALL SYMPTOMS EXCEPT UNUSUAL TIREDNESS. EVALUATED BY HEMATOLOGIST- DR. AND DX GIVEN: CHRONIC MYELOCYTIC LEUKEMIA.

Other Meds: NONE- DID NOT TAKE ROUTINE MEDICATIONS ON DAY OF VACCINES - CELECOXIB -LAZARTAN -CLOPIDOGREL -OSTEOBIFLEX -OMEGA Q PLUS -VITAMIN C - MULTI VIT - CALCIUM

Current Illness: NO ACUTE ILLNESSES

ID: 1632484
Sex: F
Age: 71
State: ME

Vax Date: 08/18/2021
Onset Date: 08/18/2021
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:

Allergies:

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

Symptoms: After two hours arm started to hurt as with first injection. About 6-8 hours after shot, pain continued up into my neck and head, then proceeded to go down my left side and sciatic nerve. Then I started to feel really bad all over. Ears plugged, equilibrium off. Every joint and muscle in my body ached. Could not get out of bed for about 24 hours, drinking only water and no food. Second day started to feel better and ate a small meal of eggs for dinner. Continued to feel better but still very tired and worn out from the ordeal. Felt like the worst flu I've ever had but my husband had the same shot with the same results.

Other Meds: Gabapentin Omeprazole Tikosyn Eliquis

Current Illness: none

ID: 1632485
Sex: F
Age: 26
State: TX

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: RA

Lab Data: BP: 114/69 HR: 107

Allergies: NONE

Symptom List: Nausea

Symptoms: 36 weeks pregnant; patient complained of pain in right arm (opposite from injection site) and right leg.

Other Meds: NONE

Current Illness: NONE

ID: 1632486
Sex: F
Age: 50
State: FL

Vax Date: 08/23/2021
Onset Date: 08/23/2021
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: lactose intolerant

Symptom List: Injection site pain

Symptoms: Chills the night of, skin very sensitive all over my body, very tired and nauseous, Very dizzy and skin sensitivity the next day. injection sight very swollen , red and painful to touch.

Other Meds: Tylenol

Current Illness: none

ID: 1632487
Sex: M
Age: 41
State: CO

Vax Date: 05/03/2021
Onset Date: 05/06/2021
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: Extensive lab work, CT scans, UA, bone marrow biopsy

Allergies: None reported

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

Symptoms: I had four anaphylactic episode with SOB and rash and hives and stomach and digestive issues after my second vaccine. Three of those four events I went to the ER. I felt the vaccine pushed me over the edge. I do have auto immune issue, celiac disease. I have had extensive lab work, CT scans and all exams were normal. I have also seen a specialist who performed UA tests and bone marrow biopsy trying to figure out if I have mass cell disease.

Other Meds: None reported

Current Illness: None reported

ID: 1632488
Sex: M
Age: 65
State: PA

Vax Date: 02/03/2021
Onset Date: 08/20/2021
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: Updated Procedure 08/21/21 1241 POCT COVID-19 PCR Collected: 08/21/21 1241 | Final result | Specimen: Swab from Nares POC COVID-19 PCR DetectedAbnormal Lot # 1032625 Point of Care COVID-19 PCR Testing Method Abbott ID NOW Lot Expiration Date 10/23/2021

Allergies: SpironolactoneOther (document details in comments)

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

Symptoms: Exposure to COVID-19 virus Lab test positive for detection of COVID-19 virus Cough Other fatigue

Other Meds: aspirin 81 mg tablet blood pressure test kit-large kit buPROPion XL (WELLBUTRIN XL) 150 mg 24 hr tablet dilTIAZem SR (CARDIZEM SR) 120 mg 12 hr capsule ergocalciferol, vitamin D2, 400 unit tablet hydroCHLOROthiazide (HYDRODIURIL) 12.5

Current Illness:

ID: 1632489
Sex: F
Age: 17
State: KS

Vax Date: 08/20/2021
Onset Date: 08/20/2021
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:

Allergies:

Symptom List: Tremor

Symptoms: Right after patient received the COVID vaccine, patient became limp and passed out. She was unconscious for about 30 seconds. When patient came back and was conscious, she was not aware of what happened and did not know that she passed out. After about a minute and a half, patient was aware of what happened and was laying down on the couch for 20 minutes. After about 20 minutes, patient stated she was feeling good and not lightheaded or dizzy. Patient walked around the library with her friend to make sure she would be doing okay with being up and walking.

Other Meds:

Current Illness:

ID: 1632490
Sex: M
Age: 66
State: MI

Vax Date: 04/01/2021
Onset Date: 08/18/2021
Rec V Date: 08/25/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: Break through COVID case

Other Meds:

Current Illness:

ID: 1632491
Sex: F
Age: 39
State: NV

Vax Date: 08/03/2021
Onset Date: 08/05/2021
Rec V Date: 08/25/2021
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: went to urgent care on 8/7 and received antibiotics and nose spray

Allergies: Amoxicillan doxyclycline

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

Symptoms: lost smell/taste, dizziness, nausea, sinus pain/pressure, body aches, extreme tiredeness, unable to focus, migraines, unable to eat/keep food down

Other Meds:

Current Illness:

ID: 1632492
Sex: F
Age: 53
State: MN

Vax Date: 03/12/2021
Onset Date: 08/22/2021
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 PCR nasopharyngeal swab

Allergies: Advil [ibuprofen] Not Specified 01/22/2021 Itching Amoxicillin Not Specified 10/29/2015 Itching

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

Symptoms: Patient contracted Covid

Other Meds: citalopram (CELEXA) 20 mg tablet Take 1.5 tablets (30 mg) by mouth 1 time per day furosemide (LASIX) 20 mg tablet Take 1 tablet (20 mg) by mouth 1 time per day potassium chloride (KLOR-CON M20) 20 MEQ CR tablet Take 1 tablet by mouth twice

Current Illness: N/A

ID: 1632493
Sex: M
Age: 83
State: MN

Vax Date: 08/02/2021
Onset Date: 08/07/2021
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: none

Allergies: none known

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Headache, full body aches, upset stomach

Other Meds: Blood Pressure, Oxy for pain, flow max

Current Illness: none

ID: 1632494
Sex: F
Age: 53
State: AR

Vax Date: 08/20/2021
Onset Date: 08/20/2021
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: penicillin

Symptom List: Injection site erythema, Injection site pain, Injection site swelling

Symptoms: Patient received the second dose 1 week early.

Other Meds:

Current Illness:

ID: 1632495
Sex: F
Age: 35
State: CA

Vax Date: 08/18/2021
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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Penecillin

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

Symptoms: Started getting sharp pain in upper right chest around 230PM that worsened with activity, got better with resting. Around 9P started severe nose bleed and coughing spitting blood, continued chest pains. Never had a nose bleed of cough blood before. Bleeding stopped around 15 minutes later but chest pains continued for 3 days.

Other Meds: None

Current Illness: None

ID: 1632496
Sex: F
Age: 26
State:

Vax Date: 08/23/2021
Onset Date: 08/23/2021
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: Pain in extremity

Symptoms: Body aches and fatigue for 12 hours. Injection site soreness for 3 days.

Other Meds: None

Current Illness: None

ID: 1632498
Sex: M
Age: 39
State:

Vax Date: 05/14/2021
Onset Date: 05/15/2021
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:

Allergies:

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

Symptoms: I got a bloody nose the day after the vaccine, which lasted for two days. I also got a strong headache on the right side of my head, just above the ear, which I never had before. When I get tired or stressed out, a headache in the same location still comes back, over three months later. I had pain whenever I moved my eyes, lasting for about three days after the vaccine. I had a fever, muscle aches, and fatigue for two days after the vaccine.

Other Meds:

Current Illness:

ID: 1632499
Sex: M
Age: 27
State: CA

Vax Date: 06/25/2021
Onset Date: 06/28/2021
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:

Allergies: Amoxicillin, Penicillin, Alcohol and Lactose.

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

Symptoms: I had fever, swollen lymph nodes, congestion and 'covid arm' aka a large round red rash on my right arm where I got the first dose of moderna. The red rash was itchy and sore. It was about the size of an apple.

Other Meds: None.

Current Illness: None.

ID: 1632500
Sex: M
Age: 24
State: VA

Vax Date: 02/04/2021
Onset Date: 07/03/2021
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: 07/09/2021 EKG, normal, X-ray normal, CT Plural effusion in left lung, blood work, normal.

Allergies: Pollen; dogs; cats

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

Symptoms: 07/03/2021 chest pain for several days, got better after a few days, and then got worse. As of 07/10/2021 I have not had any more chest pains.

Other Meds: Zyrtec; Flonase

Current Illness: No

ID: 1632501
Sex: M
Age: 64
State: AZ

Vax Date: 08/20/2021
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:

Allergies: nka

Symptom List: Vomiting

Symptoms: difficulty breathing, double pneumonia, vent 100% o2

Other Meds: metformin, atorvastatin calcium, jardiance, metoprolol

Current Illness: nka

ID: 1632502
Sex: M
Age: 55
State: CA

Vax Date: 06/26/2021
Onset Date: 06/26/2021
Rec V Date: 08/25/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: On 8/23/21 Patient said he had skin reaction (itching) after first shot of Pfizer COVID vaccine on 6/26/21. After the second vaccine on 8/6/21, he continued to have skin reaction. In addition he passed out at night time. He also hears noise in his ears. He will see his family doctor shortly.

Other Meds:

Current Illness:

ID: 1632503
Sex: F
Age: 14
State:

Vax Date: 06/06/2021
Onset Date: 06/29/2021
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:

Allergies: None

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

Symptoms: Menstrual cycle irregularity - increased frequency and prolonged menses. Pt received COVID-19 #2 on 6/6/21,. Pt had menstrual period on 6/8/21 for 10 days, then again on 6/29/21 for 14 days, then again on 7/22/21 that lasted 1 month until 8/20/21. OCPs started to help regulate her period.

Other Meds: Allegra and multivitamins

Current Illness: None

ID: 1632504
Sex: F
Age: 25
State: OH

Vax Date: 08/19/2021
Onset Date: 08/19/2021
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: unknown

Allergies: unknown

Symptom List: Injection site swelling, Limb discomfort

Symptoms: patient developed hives and itching the evening of receiving the dose. she followed up with a dr that told her to take an antihistamine. patient said she was stilling having some hives and itching and asked what else she could do to the pharmacy. suggested that she follow up with dr and continue to take antihistamine. if getting worse see ER

Other Meds: medrodroxyprogesterone 10mg tabs

Current Illness: unknown

ID: 1632505
Sex: F
Age: 59
State: RI

Vax Date: 07/30/2021
Onset Date: 07/30/2021
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:

Allergies: Shellfish, iodine, rocephine, sulphur, thimerisal, latex, something in the Covid 19 vaccine

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

Symptoms: Waited a half hour in waiting area, no one came to check on me (after I had indicated my allergy concerns and history), left pharmacy and went directly home (less than 5 minutes from pharmacy), upon arrival at home, felt weird, looked in mirror and face was swollen, red patch across cheeks/nose area, chin and red patchy look to forehead, tiny hives appearing just below cheeks and on upper chest, just below neck. Took some Tylenol, sat in a chair with fan blowing on me and slowly drank 2 large glasses of iced water. After about 2 hours (this includes the 1/2 hour in the waiting room) of monitoring myself, swelling started to go down and redness had turned pinkish. Went to bed and took a nap for 3 hours, woke up and felt fine. On Sunday, right arm where shot had been given felt like a wide elastic band was wrapped around my arm. Feeling slowly diminished over the next two days. No other symptoms since. Very concerned about having the next shot because of inflammation concerns. I had breast cancer in my left breast and have inflammation issues due to lymphedema on that side. Know that radiation can cause inflammation issues with lung and heart. Know concerned about inflammation issues with heart from vaccine. Very nervous to get second shot, contacted PCP and breast surgeon, both said to contact pharmacy with my concerns and one said to contact CDC to find out where I could go to have the vaccine administered at a facility that had a Physician or Nurse present to monitor me. Can anyone give me feedback on my concerns and inform me where I can get a supervised shot, if I should get the shot at all?

Other Meds: None

Current Illness: past 6 months, have been having random problems swallowing food, cause has not been determined yet, appointment with GI Specialist has been made.

ID: 1632506
Sex: F
Age: 37
State: NE

Vax Date: 03/17/2021
Onset Date: 07/29/2021
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: CT scan showing blood clots.

Allergies: Outdoor allergies to trees, weed, grasses.

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

Symptoms: I was diagnosed with Pulmonary Embolism in the Emergency Room on 7/31/21 (blood clots in my lungs)

Other Meds: Levocetrizine 5mg, Montelukast 10mg, Pantoprazole 40mg, Trokendi XR 125 mg, Ubrelvy (only at onset of migranes) 50mg, Naproxen at onset of migranes 500 mg, flonase nasal spray, multi vitamin, immunotherapy allergy injections every other day

Current Illness: allergies are the only known.

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am