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: 1633065
Sex: F
Age: 20
State: NY

Vax Date: 02/17/2021
Onset Date: 05/26/2021
Rec V Date: 08/25/2021
Hospital:

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

Lab Data: (07/14/2021) Halter test, ECG, confirmed only leaky valve.

Allergies: Amoxicillin

Symptom List: Dysphagia, Epiglottitis

Symptoms: During a physical EKG found a leaky valve with no treatment. Ongoing.

Other Meds: None

Current Illness: None

ID: 1633066
Sex: F
Age: 36
State: CA

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

Lab Data: n/a

Allergies: n/a

Symptom List: Anxiety, Dyspnoea

Symptoms: Patient experienced red, bumpy, hot, blistered skin where the shot/bandage was the day after. Right after the vaccination, patient experienced pressure from left collar bone to right collar bone instantly.

Other Meds: n/a

Current Illness: n/a

ID: 1633067
Sex: M
Age: 26
State: CA

Vax Date: 04/05/2021
Onset Date: 04/22/2021
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: PCP, April 22 - Daily migraines. Prescribed Triptans Ophthalmologist, April 27 - Nearsightedness, already wearing contacts and glasses for it MRI, May 22 - No abnormalities Neuro-Ophthalmologist, June 14 - No abnormalities Neurologist, June 24 - EEG requested EEG, July 27 - Test Neurologist, August 16 - No abnormalities

Allergies: Penicillin

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

Symptoms: Daily debilitating migraines paired with photosensitivity and vertigo. They are now less frequent, occurring once a week, whereas they were first happening every day. Migraines start with aura symptoms - visual distortions, feeling dizzy and nauseous - and then progress into a piercing pain in the upper left side of my head. Every since they have started, I have been sensitive to light and patterns in my vision (blinds, stripes, flashing lights, light in between tree branches, etc.) That hasn't gone away. I first saw my Primary Care physician, who prescribed me different Triptan medications. Those didn't help, so he referred me to an Ophthalmologist who saw nothing unusual, only that I was nearsighted (which I wear glasses and contacts for.) My Primary Care physician then referred me for an MRI, which showed everything was normal. I then went to an Ophthalmologist who checked my vision, and everything was fine there. I then went to a Neuro-Ophthalmologist, who also said everything was fine. I then saw a Neurologist, who suggested I may be having seizures. I conducted an EEG, which showed no unusual brain activity.

Other Meds: Supplements: Men's Daily, Fish Oil 1000MG, Vitamin C 1000MG, Quercetin 500MG, Zinc 50MG, Resveratol 1200MG, NMN 500MG

Current Illness:

ID: 1633068
Sex: F
Age: 42
State:

Vax Date: 08/22/2021
Onset Date: 08/25/2021
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:

Allergies: macrolide/ketolide

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Patient called to state she had itching beginning a few days after her COVID vaccination

Other Meds:

Current Illness:

ID: 1633069
Sex: F
Age: 47
State: MN

Vax Date: 04/14/2021
Onset Date: 08/22/2021
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: 8/22-8/24 the following tests were performed: CBCwith differential, CRP, Herpes, Varicella antibody test HERPES SIMPLEX VIRUS NUCLEIC ACID DETECTION, NON-CSF, xray, incision and drainage

Allergies:

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

Symptoms: Dx: Rash/skin eruption; Formation of vesicles

Other Meds:

Current Illness:

ID: 1633070
Sex: F
Age: 40
State: CA

Vax Date: 04/13/2021
Onset Date: 04/21/2021
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: (for the process of elimination) Pelvic ultrasound Blood panel (showed low B12 and low vitamin D)

Allergies: codeine penicillin Percocet shellfish anchovies

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

Symptoms: I have been menstruating (spotting to heavy flow) since about a week after my second shot. As of today, August 25th, I have had only 6 days interspersed where I was not on my period. At about 6 weeks of being spotting/on my period, I contacted my primary physician. I had a full panel of blood work and internal ultrasound performed and found nothing indicating a problem. Upon visiting the OB/GYN NP, we narrowed it down to starting after my second vaccine. She advised that I report it here (sorry that it took me a couple of weeks.) We tried an elevated hormone (Medroxyprogesterone) for 10 days. The menstruation stopped for 2 days, then bled through that as well.

Other Meds: Bupropian (Wellbutrin) XL 300mg Hailey (Birth Control Pill) 11.5mg Zyrtec

Current Illness:

ID: 1633071
Sex: M
Age: 15
State: CA

Vax Date: 07/11/2021
Onset Date: 07/13/2021
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: Initial ECG with possible diffuse ST elevations and PR depression consistent with pericarditis. No blood testing was done (was seen at another ED). Current echo, ECG, troponin, BNP, ESR, CRP are all normal today 8/25/21

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Patient developed chest pain on 7/13, 2 days after 1st vaccine dose.

Other Meds:

Current Illness:

ID: 1633072
Sex: F
Age: 47
State: MO

Vax Date: 03/11/2021
Onset Date: 05/01/2021
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. Have notified Primary Physician about adverse event.

Allergies: Famciclovir

Symptom List: Pharyngeal swelling

Symptoms: Reddish, hard bump at location of both injection sites. Not painful but feels like small bee-bee in arm at both sites. Neither have changed shape, size or color since being discovered after second vaccine dose.

Other Meds: Escitalopram, Naproxen, Omeprazole, Methocarbamol, Furosemide, Potassium Chloride, Magnesium Oxide

Current Illness: None

ID: 1633073
Sex: F
Age: 53
State: NM

Vax Date: 03/24/2021
Onset Date: 03/25/2021
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: Blood work, pap smear and ultra sound - which all came back normal and clean with no issues noted.

Allergies: Penicillin

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: 24 hours after the vaccine had red spots on both legs and leg/abdomen cramping started. 48 hours after vaccine started a menstrual cycle after being in menopause for 19 months. Extremely heavy bleeding with severe leg and abdomen cramps lasted 4 days. Once the bleeding stopped, abdomen cramps continued but slowly subsided after a couple of weeks. Leg pain and red spots continued. I contacted my health insurance , but they weren't able to provide any good information. My primary physician retired, so the only doctor appt I was able to get was my OB/GYN on April 26th. On approx April 11/12th I noticed a large bruise on the back of my right calf, but had not hit it on anything . I also felt a large lump under where the bruise was. A few days later, on April 24th my calf was extremely swollen, and was still experiencing pain in both legs. This was Saturday evening so I reached out again to the ask a nurse and the reply was "this should not be vaccine related, it's been too many weeks". I had my OB/GYN appt the following Monday, and she took pictures of my leg and also measured my calf, but the swelling had gone down quite a bit. Bruise and leg pain eventually went away within a few weeks. No confirmation but suspicions of a blood clot

Other Meds: Claritin, Benadryl

Current Illness: No illness, only seasonal allergies to pollen

ID: 1633074
Sex: F
Age: 47
State: PA

Vax Date: 08/04/2021
Onset Date: 08/04/2021
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: Klonopin, novacain

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Headache, nausea, fatigue, arm soreness, Lightheadedness

Other Meds: Atenolol, amlodipine, benazepril, protonix, alprazolam, vitamin d, vitamin c

Current Illness: Fibromyalgia, ibs, reflux

ID: 1633075
Sex: F
Age: 61
State: TN

Vax Date: 08/23/2021
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: Pharmacy suggested benadryl

Allergies: no

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

Symptoms: Woke up to itching and hives and really bad headache

Other Meds: lisinopril, sequel , levaproxin

Current Illness: no

ID: 1633076
Sex: F
Age: 37
State: AR

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

Lab Data:

Allergies: 0

Symptom List: Rash, Urticaria

Symptoms: vial from this lot number was punctured on 08/16/2021. 9 days since puncture

Other Meds: 0

Current Illness: 0

ID: 1633077
Sex: F
Age: 42
State: CA

Vax Date: 08/22/2021
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: None

Allergies: None

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

Symptoms: Constant twitching in the left side of my face for the last two days. I also have blurred vision and my eyes hurt and feel sensitive to the touch.

Other Meds: None

Current Illness: None

ID: 1633078
Sex: F
Age: 42
State: NY

Vax Date: 08/15/2021
Onset Date: 08/15/2021
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:

Allergies: Stone fruits. Most nuts EXCEPT pistachio and cashews. Seasonal allergies.

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

Symptoms: Heaviness while walking, Fatigue, Headache, Low Grade Fever, Chills, Muscle Pain, Body Aches, Loss of Apetite, Nausea, Odd symptom on day 2 and 3 was heaviness in chest and urge to cough 1-2x after taking a deep breath. On 8/23 around 11pm, had tenderness at 2 precise spots on right forearm; sensation like bruising but no discoloration. Felt like 2 tiny rice grains were in my vein. I had anxiety and couldn't sleep, thinking they were blood clots. Will visit doctor to do ultrasound to rule out blood clot

Other Meds: Junel FE 1/20 (oral contraceptive), multi vitamin, zinc, vitamin c.

Current Illness:

ID: 1633079
Sex: F
Age: 71
State: MN

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

Lab Data: 8/23 tests ran: blood alcohol, CMP, CBC with diff, lipase, magnesium, PT/INR, PTT, Sars/flu/rsv, troponin, CT abdomen, EKG, chest xray

Allergies:

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

Symptoms: back/chest/epigastric pain

Other Meds:

Current Illness:

ID: 1633080
Sex: M
Age: 59
State: MA

Vax Date: 08/21/2021
Onset Date: 08/22/2021
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: Scallops

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

Symptoms: Vomiting (1 time) in morning, fever, chills and low temperature for 18 hours, very drowsy, slept a lot.

Other Meds: Methotrexate Atorastatin

Current Illness:

ID: 1633081
Sex: F
Age: 60
State: CA

Vax Date: 08/21/2021
Onset Date: 08/23/2021
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: CBC, normal except the palette count was 18,000, WBC differential, normal.

Allergies: Shellfish

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

Symptoms: I experienced a low CBC and called my Hematologist and ordered some labs of a CBC with a white blood cell differential on 08/23/2021and 08/24/2021. I'm scheduled to have another CBC done on 08/26/2021 to find out if my palette count went back to normal.

Other Meds: Mycophenolate sodium; multivitamin; calcium; vitamin D-3

Current Illness: No

ID: 1633082
Sex: F
Age: 37
State: WA

Vax Date: 08/04/2021
Onset Date: 08/04/2021
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:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Pt says her menstrual cycle has been off from her daughters since getting the vaccine when they have been perfectly synced up to this point

Other Meds:

Current Illness:

ID: 1633083
Sex: F
Age: 18
State: LA

Vax Date: 05/13/2021
Onset Date: 08/20/2021
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: COBAS-SARS-CoV-2 PCR

Allergies: NKDA

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Breakthrough COVID19 infection

Other Meds: birth control

Current Illness:

ID: 1633084
Sex: F
Age: 70
State: ME

Vax Date: 01/21/2021
Onset Date: 05/01/2021
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: OxyContin; Percocet; nickel

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

Symptoms: I started to get headaches and my blood pressure was elevated. I just monitor it for a couple days and my blood pressure was still elevated. I started blood pressure medication in June.

Other Meds:

Current Illness:

ID: 1633085
Sex: F
Age: 46
State: FL

Vax Date: 07/30/2021
Onset Date: 08/03/2021
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: I currently started a new job in August and won't have health insurance until September but will go see a doctor if it is still going on then

Allergies: erythromycin bee stings shell fish

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

Symptoms: I have been having regular nose bleeds that are hard to stop and my right ankle has been swollen for the past week.

Other Meds: levothyroxine montelukast metoprolol loratadine aspirin b12 d3

Current Illness: none at the time of the vaccination but had a sinus infection a month earlier in which I took a z-pack

ID: 1633086
Sex: F
Age: 25
State: CA

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

Lab Data:

Allergies: N/A

Symptom List: Unevaluable event

Symptoms: Pt stated her hand felt numb, she was sitting up and her face went pale then she folded forward passing out. We sat her up and she convulsed slightly and turned red before stating she was very confused and became pale again. We had her sit for 15 minutes, gave her water and snacks (chips and candy for salt and sugar). She stated she was feeling better after sitting and the color returned to her face.

Other Meds: N/A

Current Illness: N/A

ID: 1633087
Sex: F
Age: 49
State: AZ

Vax Date: 07/19/2021
Onset Date: 07/20/2021
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: LA

Lab Data: Ct scan with dye. Urine tests.

Allergies:

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

Symptoms: Heart was racing terribly for a week. Recently spent a couple days in the hospital with complicated diverticulitis with an abscess. No issues before with health ever. Think I may have had something brewing but vaccine possibly attacked it more. Not 100% sure as no one seems to be sure about anything anymore.

Other Meds: Cephalexin

Current Illness: Not sure. Was on cephalexin for a bladder infection presumably

ID: 1633088
Sex: F
Age: 59
State: TX

Vax Date: 12/30/2020
Onset Date: 02/02/2021
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: Ekg chest xray,blood test

Allergies: None

Symptom List: Injection site pain, Pain

Symptoms: Heavy pressure on my chest with shortness of breath. Acid reflux, headache, body pain

Other Meds: Advil occasionally back pain

Current Illness: None

ID: 1633089
Sex: F
Age: 28
State: AR

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

Lab Data:

Allergies: 0

Symptom List: Injection site pain, Menorrhagia

Symptoms: Vial was punctured on 8/16/21 and administered 8/25/21

Other Meds: 0

Current Illness: 0

ID: 1633090
Sex: F
Age: 61
State: VA

Vax Date: 08/13/2021
Onset Date: 08/13/2021
Rec V Date: 08/25/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Hives and itching worse after time

Other Meds:

Current Illness: Bronchitis

ID: 1633091
Sex: F
Age: 43
State: ME

Vax Date: 08/19/2021
Onset Date: 08/20/2021
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: My hands and feet are on and off tingly and it?s not going away. No treatment sought yet.

Other Meds: Protein powder

Current Illness: None

ID: 1633092
Sex: F
Age: 70
State: ME

Vax Date: 02/18/2021
Onset Date: 05/01/2021
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: OxyContin; Percocet; nickel

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: I started to get headaches and my blood pressure was elevated. I just monitor it for a couple days and my blood pressure was still elevated. I started blood pressure medication in June.

Other Meds:

Current Illness:

ID: 1633093
Sex: F
Age: 39
State: TN

Vax Date: 08/25/2021
Onset Date: 08/25/2021
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: Patient give Pfizer Covid 19. Patient reported issues breathing. Patient given benadryl. 911 called and instructed to administer epipen. Patient had multiple seizures. Patient transported to hospital by ambulance.

Other Meds: topamax

Current Illness: seizure

ID: 1633094
Sex: M
Age: 26
State:

Vax Date: 08/21/2021
Onset Date: 08/24/2021
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: troponin elevation

Allergies: None

Symptom List: Nausea

Symptoms: Patient developed acute chest pain consistent with myopericarditis requiring hospitalization 72 hours post 2nd dose of Moderna vaccination. COVID testing negative.

Other Meds: Vitamin D, Fish oil

Current Illness: None prior; URI symptoms/achiness after 2nd dose

ID: 1633095
Sex: M
Age: 38
State: FL

Vax Date: 08/22/2021
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: None

Symptom List: Injection site pain

Symptoms: Ringing and warmness in left ear. Tinnitus like symptoms

Other Meds: Claratin

Current Illness: Covid 2 weeks prior

ID: 1633096
Sex: F
Age: 26
State: CA

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

Lab Data:

Allergies:

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

Symptoms: Brief LOC with nausea, feeling warm, tingling to hands, dizzy, Resolved with rest and po fluids

Other Meds:

Current Illness:

ID: 1633097
Sex: F
Age: 62
State: IN

Vax Date: 07/30/2021
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: none

Allergies: unknown

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

Symptoms: Patient has 3 profiles in system with 2 different phone numbers. Patient presented to clinic on 8/20/21 to get second dose of Pfizer vaccine. When she presented her card she gave a card with her name and a Janssen lot number. Patient was asked by clinic nurse, if she had told the previous nurse about this dose and she stated no she had not. Vaccinator spoke with clinic manager who called clinic doctor and 2nd dose of Pfizer was NOT give. On 3/5/2021 patient was given Janssen lot number 1802068. Then on 7/30/21 the 1st dose of Pfizer vaccine was given (see lot number above).

Other Meds: unknown

Current Illness: unknown

ID: 1633098
Sex: U
Age:
State: CA

Vax Date:
Onset Date:
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: Refrigerator excursion, temperature dropped to 33.8 for approximately 10-15 mins on 8/25/2021 between 1:44pm- 2:04pm.

Other Meds:

Current Illness:

ID: 1633099
Sex: F
Age: 51
State: OR

Vax Date: 08/12/2021
Onset Date: 08/12/2021
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:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: The patient reported feeling numbness and tingling that radiated from her right arm to the right side (cheek area) of her face. She also experienced swelling from the arm to the face. She stated that the symptoms resolved about a day later.

Other Meds:

Current Illness:

ID: 1633100
Sex: F
Age: 66
State: WI

Vax Date: 02/01/2021
Onset Date: 02/01/2021
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: CT scan of my jaw

Allergies: Sulfa; penicillin

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

Symptoms: I continued to experience the left upper jaw pain I was having from the first vaccine. My symptoms developed into something, I had pain in my left upper jaw, and I thought it was tooth so I went to dentist. I even got a CT scan of my jaw and it was not my tooth. As the days went by, the pain radiated to the top of my head and shoulder. This pain I experienced came and went. I ended up calling my doctor and he gave me treatment for the pain. I have never experienced this kind of pain before, it was a neurological pain. My symptoms have resolved today and I have no pain today.

Other Meds: Urso; Pepcid; Crestor; flaxseed oil

Current Illness:

ID: 1633101
Sex: F
Age: 28
State: IL

Vax Date: 01/12/2021
Onset Date: 01/21/2021
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:

Allergies: None

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

Symptoms: Breakthrough bleeding/spotting a week or so after vaccine. Saw gynecologist two weeks after onset, dismissed as stress, spotting/breakthrough bleeding continued for several weeks until end of February with period.

Other Meds: Daily women's multivitamin, hormonal birth control pills

Current Illness: None

ID: 1633102
Sex: F
Age: 74
State: CO

Vax Date: 05/05/2021
Onset Date: 05/07/2021
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: Don?t have any

Allergies: None

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: I had the 2nd Moderna Vaccine on 5/7/2021. On 5/7/2021, I had my RA infusion, Actemra. The evening of 5/7/2021, I broke out in severe hives. I contacted the Dr in June when we got back from vacation. I suffered with hives and a lot of body pain as the Actemradid not work. Took a lot of ibuprofen. He had me contact my primary dr. I saw her nurse practitioner. They did not know what to do. Dr prescribed a regiment of Prednisone. This helped relieve the hives and pain somewhat. July 6th, I had another Actemra infusion. I broke out with hives again, just not as severe. I saw Dr and he believes the Moderna created an allergic reaction to something in Actemra. He said the Moderna should not be active by then and my body is allergic now to Actemra

Other Meds: RA infusion - Actemra

Current Illness: None

ID: 1633103
Sex: F
Age:
State: VA

Vax Date:
Onset Date: 02/27/2021
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: blood work which show I was very anemic and my inflammation was high

Allergies: Aspirin; sulfa drugs

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

Symptoms: I started breaking up into hives. Little red dots that itch from the inside like I was on fire. It kept getting worse and spreading all over. It was in my hands, chest, arms, down my back, legs, ankles. I went to several doctors and they said I had bed bugs but I did not think I had that. I did all the stuff to get rid of bed bugs but that did not seem to get rid of the hives. I finally went to a doctor that I could trust and they referred me to a dermatologist. All of my doctors did blood work which show I was very anemic and my inflammation was high. I did a short run of prednisone and that did not help. The dermatologist gave me some topical cream and if that did not work to call him to give me a heavier dose of prednisone. He gave me that heavy dose prednisone and most of them went away but I still have to use that cream every day on my back.

Other Meds: None

Current Illness: None

ID: 1633104
Sex: M
Age: 52
State: FL

Vax Date: 08/24/2021
Onset Date: 08/25/2021
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: None

Allergies: IV iodine dye

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

Symptoms: Received the COVID vaccine yesterday; fever, chills, body aches, lethargy, nausea/vomitting? feels just like COVID all over again

Other Meds: Levothyroxine, Rozerem, Mirtazipine, Cymbalta, Lamotrigine, Testosterone cypionate

Current Illness: None

ID: 1633105
Sex: F
Age: 46
State: PA

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: None

Allergies: No known allergies

Symptom List: Pain in extremity

Symptoms: Patient presents for covid vaccination. Vaccination administered, and patient was observed after 15 minutes for reaction. Felt lightheaded and diaphoretic 15 minutes after vaccine administration- did not lose consciousness; thinks it is anxiety related. Complete resolution of symptoms with supine positioning with slow elevation of head of bed over 15 minutes.

Other Meds: Cholecalciferol (VITAMIN D) 1000 UNITS capsule Multiple Vitamins-Minerals (MULTIVITAMIN ORAL)

Current Illness: No known illnesses

ID: 1633106
Sex: F
Age: 25
State: AR

Vax Date: 08/25/2021
Onset Date: 08/25/2021
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: None

Allergies: None

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

Symptoms: Vial was punctured on 8/16/21 and dose was administered 8/25/21

Other Meds: None

Current Illness: None

ID: 1633107
Sex: U
Age: 63
State: CA

Vax Date: 08/13/2021
Onset Date: 08/15/2021
Rec V Date: 08/25/2021
Hospital:

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

Lab Data: No

Allergies: No

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

Symptoms: My muscles in my legs were weak.

Other Meds: Naproxen

Current Illness: No

ID: 1633108
Sex: M
Age: 56
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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: NA

Allergies:

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

Symptoms: Patient was given undiluted Pfizer Covid 19 vaccine

Other Meds:

Current Illness:

ID: 1633109
Sex: F
Age: 68
State: IL

Vax Date: 02/15/2021
Onset Date: 08/14/2021
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: CPT test Saturday, 8/14 was negative; follow-up rapid test Wednesday 8/18 was negative.

Allergies: cow milk, fragrances, e.mycin, penicillin, trees & ragweed

Symptom List: Vomiting

Symptoms: On the morning of Saturday, August 14, 2021, I lost my sense of taste and smell, was tired and had a headache. I went to the walk-in clinic and saw a Dr, who believed I probably had COVID-19. He called later that afternoon with a negative CPT test result but prescribed azithromycin anyway which I took for 10 days as directed. He also told me to get a follow-up test. My symptoms gradually went away and were gone by Friday, August 20.

Other Meds: Pulmicort, diltiazemCD,Prilosec,topiramate,furosemide,potassiu

Current Illness: none

ID: 1633110
Sex: F
Age: 40
State: CA

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

Lab Data: patient was sent to the ED.

Allergies: Tramadol. Mentioned she was allergic to some ingredients on the Jansen and Jansen, doctor prescribed Epipen.

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Blurry Vision, Weakness, Twitching, Numbness on the cheeks, Shakiness. patient was sent to the ED.

Other Meds: unknown

Current Illness: none

ID: 1633111
Sex: F
Age: 43
State: FL

Vax Date: 07/17/2021
Onset Date: 08/11/2021
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: Back pain, Cold sweat, Headache, Nausea, Vomiting

Symptoms: I took the first dose of Phizer vaccine and I had symptoms of getting hotness and being more tired than normally. After the second dose with the recommended wait time, I have pain in the legs, stomach, and arms. The beginning phase I also had hot and cold feeling where I could not sleep. I feel very weak with a headache. Additionally, I just felt my throat to bother me. Now, my son has similar symptoms a week after I experienced mine.

Other Meds:

Current Illness:

ID: 1633112
Sex: F
Age: 66
State: WI

Vax Date: 01/28/2021
Onset Date: 02/01/2021
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: CT scan of the jaw

Allergies: Sulfa; penicillin

Symptom List: Injection site swelling, Limb discomfort

Symptoms: I started to have symptoms on my first dose to my left upper jaw and tooth but I did not think anything at first. I went to the dentist to check out my tooth. I even got a CT scan of my jaw and it was not my tooth. I got then my second dose vaccine and my symptoms persisted. As the days went by, the pain radiated to the top of my head and shoulder. This pain I experienced came and went. I ended up calling my doctor and he gave me treatment for the pain. I have never experienced this kind of pain before, it was a neurological pain. My symptoms have resolved today and I have no pain today.

Other Meds: Urso; Pepcid; Crestor; flaxseed oil

Current Illness:

ID: 1633113
Sex: M
Age: 13
State: CA

Vax Date: 08/10/2021
Onset Date: 08/10/2021
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: RA

Lab Data: He went to the doctor and tested positive for Covid-19. He took a Strep test and Covid-19 test. He is currently dealing with some coughing from the Covid-19.

Allergies:

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

Symptoms: Soreness of the arm. This went away after a day. He tested positive for Covid-19 on August 19, 2021. He experienced a fever, coughing, muscle soreness, tightness in his chest, loss of taste, and sore throat.

Other Meds:

Current Illness:

ID: 1633114
Sex: F
Age: 18
State: TX

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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data: NONE

Allergies: NO

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

Symptoms: ONE 18 YEAR OLD FEMALE THAT ONLY HAD A 15 MINUTE WAIT THAT STATED HAVING ISSUES. WITH CONTROLING HER BREATHING, HER MOTHER STATED SHE HAD BAD ANXIETY ATTACK, AFTER A FWE MOMENT THE YOUNG LADY SHE WAS NAUSEOUS. SHE WAS GIVEN A EMISES BAG AND TRIED TO DO BREATHING EXERCISE THEN SHE STATED SHE HAD TO THROW UP AND SHE DID.

Other Meds: BIRTH CONTROL

Current Illness: NO

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am