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: 1633782
Sex: F
Age: 26
State: CA

Vax Date: 03/12/2019
Onset Date: 03/15/2019
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: Cefzil and Erythromycin

Symptom List: Dysphagia, Epiglottitis

Symptoms: Normal pregnancy, due date was June 1, 2019. Shortly after being vaccinated I experienced premature rupture of membranes resulting in the pre-mature deliver of my child. My water broke on 4/19/2019. My child was born weighing only 4lbs 4oz even though he was originally thought to be 34 weeks gestation. After an evaluation they realized he?d stopped growing around the time of my injection.

Other Meds: None

Current Illness: None

ID: 1633783
Sex: M
Age: 42
State:

Vax Date: 08/17/2021
Onset Date: 08/18/2021
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:

Allergies: None

Symptom List: Anxiety, Dyspnoea

Symptoms: Soreness, swelling

Other Meds: None

Current Illness: None

ID: 1633784
Sex: M
Age: 37
State: AL

Vax Date: 12/14/2020
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: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: PCR positive

Allergies: NKA

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

Symptoms: Breakthrough infection

Other Meds: Omeprazole, famotidine

Current Illness: None

ID: 1633785
Sex: F
Age: 55
State: UT

Vax Date: 01/22/2021
Onset Date: 06/25/2021
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: Doppler u/s done to diagnose on June 25,2021

Allergies: Levaquin

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: 2 DVT?s in left leg ; presented with slight leg edema; Ultrasound was used for diagnosis;Treatment was Eliquis 10mg BID x 7 days, followed by 5mg BID currently; probably for 6-12 months; Dr will monitor and decide in 6 months; no family hx of clots.

Other Meds: Nadalol, lyrica, Prevacid, Lipitor, zetia, depakote, Claritin, vitamin D, CoQ10, centrum, biotin, Ca, Mg, tylenol, baby aspirin, ibuprofen, osteobiflex

Current Illness: Sinus infection

ID: 1633786
Sex: M
Age: 33
State: CA

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: no known allergies

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

Symptoms: Client complained of feeling lightheaded and dizzy while sitting in the observation unit. RN moved client to lay down on a cot. Client stated had not eaten since noon. Client's skin pale and moist, vitals taken: at 1913: BP 103/70, HR 93 bpm, SpO2 97% RR: 20. Client stated dizziness gone while lying down, denies itchiness or SOB. At 1917 RN sat client up and he was able to eat food and drink water. Vitals taken: 912/50, HR 111 bpm, SpO2 99%, RR 19. At 1920 client c/o dizziness returned while sitting, still pale and skin moist, PHN instructed client to lie back down. Denied nausea. Client AxO x4. At 1923 client stated dizziness is gone. Vitals taken" BP 98/57, HR 93 bpm, SpO2 100%, RR 21. At 1935 client was sat up, vitals taken: BP 106/72, HR 111, RR 18. Skin dry and appropriate color for Ethnicity. Client stated symptoms resolved, stated "feeling better." RN educated client to f/u with PMD. Client stood up at 1943 and walked off with a steady gait unassisted.

Other Meds: none

Current Illness: none

ID: 1633787
Sex: F
Age: 53
State: MI

Vax Date: 04/30/2021
Onset Date: 08/04/2021
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: Patient admitted for pneumonia, Negative COVID.

Other Meds:

Current Illness:

ID: 1633788
Sex: M
Age: 38
State: LA

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:

Allergies: NKDA

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Constant tinnitus in both hears. Loud, high-pitched ringing. Begin after first dose, intensified after 2nd dose.

Other Meds: Omeprazole

Current Illness: None

ID: 1633789
Sex: M
Age: 66
State: WY

Vax Date: 02/20/2021
Onset Date: 02/20/2021
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:

Symptom List: Pharyngeal swelling

Symptoms: After getting the vaccine I started to have a high-pitched ringing in my ears, more strongly in the left.

Other Meds:

Current Illness:

ID: 1633790
Sex: F
Age: 56
State: MI

Vax Date: 08/12/2021
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: I am seeing employee health nurse practitioner tomorrow. The orthopedic doctor is going to run a complete rhuematoid panel to see if I have this.

Allergies: Black Pepper, Red Snapper - Dairy must be Lactose Free, Amoxicillin, Cephalexin, Nystatin, Naproxen, Nickel, Clindamycin, Latex

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: I developed a rash under my chin and noticed it the next morning when I went to work - Friday Aug 13, 2021. I felt sick all weekend and noticed this rash was now going into my ear and on Sunday it was very painful - somewhat itchy, but very painful. Noticed it on my right side of face. I called my doctor Monday morning immediately and they wanted me to come into the office. She stated the rash looked like shingles and started me on valacyclovir 1000mg tablet and hydrocortisone cream 2.5 % cream. The rash finally went down towards the end of the week -friday, Saturday. I did notice a couple little spots show up on my right arm on Friday - but not sure it was related. My doctor said if it was to get worse to go to Urgent Care. I did also speak to a doctor from employee health today from the hospital and he said that my primary care doctor needs to send in a form stating I had an adverse reaction from the vaccination. My doctor is on a leave of absence right now so I am scheduled to see the Nurse Practitioner from Employee Health tomorrow - Aug 26. I figured this should be reported as I read an article from April 21, 2021 and the title was "Rash Horror Shingles could be new but rare side effect of Covid vaccine, docs discover."

Other Meds: spironolactone 100mg, Allopurinol 100mg, Metformin 1000mg, levothyroxine 100 mcg, Calcium Citrate, Vitamin D3, Multivitamin with minerals tablet

Current Illness: Knee replacement Oct 2020- still having pain post replacement with swelling and inflammation. The physician removed some fluid from the knee and sent it in to see if there is an infection. On Aug 12 he said there is no infection - I may have other issues like rheumatoid arthritis and he might need to remove the synovial fluid or synovium around the knee joint - So when he said I did not have an infection I went and got the vaccine as it is being mandated and I don't want to lose my job. I also have thyroid issue, I have gout issues,, I have PCOS, I am borderline diabetic and I have gout

ID: 1633791
Sex: F
Age: 24
State: TN

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: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: No

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Herpes zoster on top of nose

Other Meds: Doxycycline

Current Illness: No

ID: 1633792
Sex: M
Age: 52
State: NY

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: None

Allergies: No allergies to anything

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

Symptoms: 24-36 hrs fever/ cold sweats , closed soaked, body/ legs aches , headache 2 extra strength Tylenol seemed to help with symptoms . Was a able to go to work . I am a lineman for power company. Systems started 18-24 hrs after second shot 6 days after I still have muscle twitching in my left arm at/ around injection site

Other Meds: Brilinta 90 mg x2 a day Baby aspirin 81 mg Atrovastin 80 mg 1 x day Citalopram 20 mg x1 Metoprolol 25 mg x1 Ezetimibe 10 mg x1 All meds prescribed from a heart attack December 4, 2020

Current Illness: None

ID: 1633793
Sex: M
Age: 62
State: CO

Vax Date: 02/24/2021
Onset Date: 02/26/2021
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: MRI -- no nerve impigment Nerve conductiont tests -- diagnosed as brachial plexitits

Allergies: none

Symptom List: Rash, Urticaria

Symptoms: Stated with severe pain in left shoulder, back and neck a couple days after 2nd shot. One week after 2nd shot, parasthesia & weakness in left arm. Pain resolved in about a month. Parasthesia and weakness did not resolve for about 2 1/2 months.

Other Meds: Vitamin D

Current Illness: none

ID: 1633794
Sex: M
Age: 69
State: MI

Vax Date: 04/14/2021
Onset Date: 08/05/2021
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: LA

Lab Data:

Allergies:

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

Symptoms: Patient admitted to hospital for altered mental status

Other Meds:

Current Illness:

ID: 1633795
Sex: M
Age: 31
State: AL

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: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data: unknown

Allergies: NKDA

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

Symptoms: Pt presented 08/25/2021 to the pharmacy complaining of feeling as if something was stuck in his throat. He was referred to see a physician. Pt returned about 2 hours later with his hand turning a bluish color. Advised pt go to the ER to be examined. No further follow up available at this time.

Other Meds: protonix

Current Illness: unknown

ID: 1633796
Sex: F
Age: 11
State: OR

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: LA

Lab Data: N/a

Allergies: none

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

Symptoms: Mom lied to us about daughters age. Pfizer covid is only approved for 12 and older. Mom lied saying daughter was 12, but we figured out daughter was only 11 years old.

Other Meds: unknown

Current Illness: none

ID: 1633797
Sex: F
Age: 40
State: AL

Vax Date: 02/04/2021
Onset Date: 03/10/2021
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: Rheumatology autoimmune workup, ophthalmologist evaluation and treatment with steroids by drops/ injection

Allergies: None

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

Symptoms: Uveitis about a month after 2nd dose. Saw ophthalmology.

Other Meds: Nuvaring

Current Illness: None

ID: 1633798
Sex: F
Age: 83
State: MI

Vax Date: 02/23/2021
Onset Date: 08/11/2021
Rec V Date: 08/25/2021
Hospital: Y

Vax Type: DTAPHEPBIP
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: DTAP + HEPB + IPV (PEDIARIX)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies:

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

Symptoms: Positive COVID result on hospital admission despite fully vaccination Feb 2021

Other Meds:

Current Illness:

ID: 1633799
Sex: M
Age: 20
State: TN

Vax Date: 08/25/2021
Onset Date: 08/25/2021
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: N/A

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Medication was expired - expired on 8/1/21 - and administered on 8/25/21

Other Meds: N/A

Current Illness: N/A

ID: 1633800
Sex: F
Age: 98
State:

Vax Date: 02/17/2021
Onset Date: 07/14/2021
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:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: After receiving both doses of Moderna COVID vaccine in January 2021 and February 2021, my mother started becoming ill. Previous to this she was active, could drive, go to the store, the hair salon and family functions. She started not feeling well in March 2021 and May 2021. In July 2021 she was admitted to the hospital for 3 days having trouble breathing. August 2021 she was admitted again for 5 days with the same breathing issues. She was released and taken to the Emergency room again within 36 hours. She was admitted to hospital for 3 days and released to a nursing home August 25,2021. Her prognosis is not good and she will probably die soon. These COVID shots have seriously injured my mother.

Other Meds:

Current Illness:

ID: 1633801
Sex: F
Age: 60
State: NY

Vax Date: 08/17/2021
Onset Date: 08/24/2021
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: no

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

Symptoms: One week later exactly, developed stomach pains, achiness, weakness and malaise

Other Meds: Paxil, Neurontin, Klonopin, Breo, Singulair and Albuteral

Current Illness: no

ID: 1633802
Sex: M
Age: 97
State: MI

Vax Date: 03/11/2021
Onset Date: 08/12/2021
Rec V Date: 08/25/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Patient with positive COVID result despite full vaccination in March 2021

Other Meds:

Current Illness:

ID: 1633803
Sex: F
Age: 45
State: CO

Vax Date: 07/27/2021
Onset Date: 08/05/2021
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: EKG and D-dimer, 8/18/21, chest CT and blood work 8/19/21, EKG 8/24/21. All negative. Pending echocardiogram and 14-day heart event monitor.

Allergies: anit-emetics

Symptom List: Unevaluable event

Symptoms: Moderate to severe shortness of breath. Was seen by PCP, ER, and cardiologist. Also several days of bradycardia/tachycardia. Heart rate fluctuated from 36-202.

Other Meds: multi-vitamin, vitamin D, zinc

Current Illness: none

ID: 1633804
Sex: M
Age: 47
State: AZ

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: LA

Lab Data: none

Allergies: none noted

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

Symptoms: Patient passed out after vaccination. Blacked out for a moment and very sweaty then came back to consciousness. They had stated that they have passed out before when donating blood and that they had not eaten anything for breakfast today before hand.

Other Meds: unknown

Current Illness: none noted

ID: 1633805
Sex: F
Age: 39
State: MN

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: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Golf ball size rash around the point of injection. Lots of pain at the area of the rash. Also it is hot to the touch, itches, and tingles. Rash has gotten bigger and spread over more of my upper arm. Stool looks like coffee grounds.

Other Meds:

Current Illness:

ID: 1633806
Sex: M
Age: 13
State: TX

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

Symptom List: Injection site pain, Menorrhagia

Symptoms: Both patient and guardian came in to get vaccine. Asked age, guardian said 30 years instead of 13 years. Didn't show card and patient was given moderna vaccine. Upon preparing passport card, we realized patiend has Pfizer as first shot and age not applicable to the Moderna vaccine. On questioning guardian, he said that "my English not good"

Other Meds:

Current Illness:

ID: 1633807
Sex: F
Age: 13
State: CA

Vax Date: 06/05/2021
Onset Date: 07/19/2021
Rec V Date: 08/25/2021
Hospital:

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

Lab Data: None

Allergies: Penicillin

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

Symptoms: She was having regular menstrual periods every 28 days (first menstrual period approximately 8-12 months before). Shortly after the second Covid vaccine, she had her period approximately 1-2 weeks later and then has not had menstrual period since then (approximately 2.5 months since LMP). She has no medical issues, no stress, no excessive exercise, no change in diet. Taking no medications. Otherwise completely healthy.

Other Meds: None

Current Illness: None

ID: 1633808
Sex: F
Age: 23
State: AL

Vax Date: 03/03/2021
Onset Date: 03/06/2021
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: Bunch biopsy

Allergies: NKDA

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Full body rash lasted x 5 weeks

Other Meds: Birth control

Current Illness:

ID: 1633809
Sex: F
Age: 20
State: AZ

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:
Dose Series: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: PATIENT CAME IN TO RECEIVE 3RD COVID VACCINE AND FILL OUT PAPERWORK. REGISTRATION DESK ENSURED THAT MODERNA WAS WRITTEN ON THE PAPERWORK AND VACCINE CARD WAS GIVEN. VERBAL COMMUNICATION WAS ALSO ALERTED WHEN PAPERWORK WAS HANDED OFF TO PHARMACIST THAT IT WAS A MODERNA DOSE. PHARMACIST VERBALLY VERIFIED MODERNA DOSE WITH PATIENT BUT ACCIDENTLY GAVE PFIZER. DRAWN MODERNA DOSES ARE KEPT IN THE COOLER SEPARATE FROM THE PFIZER DOSES TO AVOID VACCINATION ERRORS. PATIENT WAS OKAY AFTER MONITORING PERIOD AND LEFT.

Other Meds:

Current Illness:

ID: 1633810
Sex: F
Age: 88
State: MI

Vax Date: 02/06/2021
Onset Date: 08/14/2021
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:

Allergies:

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

Symptoms: Positive COVID result on admission despite full vaccination Feb 2021

Other Meds:

Current Illness:

ID: 1633811
Sex: M
Age: 43
State: WI

Vax Date: 08/05/2021
Onset Date: 08/05/2021
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: None.

Allergies: Unknown

Symptom List: Nausea

Symptoms: Pt had previously received Janssen COVID-19 vaccine. Pt reported on consent form that he had no previous COVID-19 vaccines. The Immunization Registry reports a Janssen vaccine on 3/14/21.

Other Meds: Unknown

Current Illness: Unknown

ID: 1633812
Sex: F
Age: 53
State: ME

Vax Date: 08/01/2021
Onset Date: 08/01/2021
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: no

Allergies: PCN

Symptom List: Injection site pain

Symptoms: Nausea, vomiting, dizzy, diaphoretic, fever, chills, abdominal pain, diarrehea , hot burning in left arm, redness left arm, severe headache pain, shakey , felt like I was going to pass out. sick 4 days missed one night of work . I felt severely ill and in pain.

Other Meds: No

Current Illness: no

ID: 1633973
Sex: F
Age: 56
State: GA

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: 1
Vax Route: IM
Vax Site: LA

Lab Data: EKG. - Abnormal- Sinus tachycardia with frequent ectopic beats. Incomplete right bundle branch block Labs cbc, cmp, PT, PTT, Troponin, CKMB, Magnesium- all normal. Chest xray- negative EKG- abnormal- Sinus tachycardia, Ventricular premature complex LAD, consider left anterior fasicular block.

Allergies: Iodinated contrast. latex

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

Symptoms: Upon awakening the morning after receiving the 2nd dose of Moderna Covid vaccine, I was slightly short of breath and my heart was racing. Heart rate sustained most all day between 120-130s, with increasing palpitations. (I was experiencing a headache and low grade fever also). This continued all day. Went to local Urgent Care, there were 28 patients ahead of me so I left. Went home and called cardiology office to ask for appt. Was told to go to the ER, that a heartrate that high and lasting over 20 minutes is an emergency and put me at rick for stroke. My husband drove me to the ER, where there was a 5 hour wait. I then left there and went to my PCP urgent care office. Was seen by NP. An ekg was done and I was told it was abnormal and to go back to the ER. My heartrate at that time had slowed down some- to the 110s. I returned to the ER and was seen soon after. Labs, EKG, and a chest xray was done. Labs and chest xray were all okay. EKG was abnormal so was monitored for a short while. Still having palpitations at that time but less frequently. Was told by the ER physician that the increased heartrate and irregular beats/incomplete beats/ palpitations were a reaction to the vaccine. This started at 0700am on August 23. I returned home from the ER at around 1100pm.

Other Meds: None.

Current Illness: Runny nose

ID: 1633974
Sex: M
Age: 79
State: MI

Vax Date: 03/11/2021
Onset Date: 06/17/2021
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: RA

Lab Data:

Allergies:

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

Symptoms: Patient admitted to hospital with DVT

Other Meds:

Current Illness:

ID: 1633975
Sex: F
Age: 72
State: OR

Vax Date: 04/24/2021
Onset Date: 04/29/2021
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: morphine

Symptom List: Tremor

Symptoms: Five days after the 2nd vaccination at 11:15 AM I lost sight in my right eye due to a central retinal vein occlusion. Went to a Retina Specialist at 1:00 PM the same day and received the first of so far four monthly injections to the eyeball to help with the hemorrhaging. My vision improved after two months however am unable to read or drive currently.

Other Meds: Multiple Vitamin ,81 mg aspirin

Current Illness: None

ID: 1633976
Sex: M
Age: 68
State: MI

Vax Date: 03/30/2021
Onset Date: 08/17/2021
Rec V Date: 08/25/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: Patient hospitalized for ventricular tachyarrhythmia

Other Meds:

Current Illness:

ID: 1633977
Sex: F
Age: 23
State: CA

Vax Date: 05/20/2021
Onset Date: 05/23/2021
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:

Allergies: No

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

Symptoms: First started out as what felt like a sore throat but over the course of the next few days it was obvious the left side of my neck in the lymph node area was swollen which was causing the sore throat. It felt like I had a giant lump in my throat but only on the left side of my throat. It made it very painful to swallow anything, even my own saliva. The right side of my neck and throat were completely fine, which luckily allowed me to eat and drink because the left side felt almost completely closed at one point during the worst of it. Over the next few days it was kind of going away, not so swollen or painful but still there and hard to swallow. During this time it was hard to sleep on my left side as well because the pressure of the pillow on my neck made it uncomfortable. Pressing on the area in general was painful because it was so tender. It lasted overall for about a week and a half to 2 weeks, which went beyond the initial first two weeks after getting the second dose of the covid 19 vaccine. If it had lasted longer I would've gone to the doctor since most side effects shouldn't last more than 2 weeks after getting vaccinated. There wasn't much I could do to help with the swelling, sometimes I took ibuprofen for the pain and it would help a little temporarily. I had heard of people getting swollen lymph nodes on the side they got the shot, but I only found reports of it being in the armpit/breast area, so I thought it was strange yet maybe made sense that I had experienced it in my neck on the left side where I got my shot. Although searching I couldn't find anywhere that people were experiencing it in their neck. Overall this was the worst sore throat I've ever had and I hope to never experience the severity of it again.

Other Meds: Oral birth control, levothyroxine

Current Illness: No

ID: 1633978
Sex: M
Age: 57
State: GA

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

Lab Data:

Allergies: Aspirin

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

Symptoms: None stated.

Other Meds: ELIQUIS, amLODIPine, Ferrus Sulf, ROSUVASTATIN,

Current Illness: N/A

ID: 1633979
Sex: M
Age: 13
State: FL

Vax Date: 08/03/2021
Onset Date: 08/03/2021
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: None

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: After administrating vaccine PFIZER. We sat down to wait 15 minutes in the chairs located next to the place where the vaccine was administer. 10 minutes after, a red spot appeared on his neck, immediately I notified the nurses who were in charge, they took his temperature, pulse, oxygen, and checked his heart and everything came out with normal range. He was itchy on his face, and his eyes became small and itchy, they administered two tablets of BENADRYL in 15 to 20 minutes later the itching went away he had water and GATORADE we waited about 40.

Other Meds: None

Current Illness: None

ID: 1633980
Sex: M
Age: 61
State: MI

Vax Date: 04/01/2021
Onset Date: 08/21/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Patient admitted to hospital with PE

Other Meds:

Current Illness:

ID: 1633981
Sex: F
Age: 45
State: OH

Vax Date: 08/17/2021
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:

Allergies: None

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

Symptoms: Swelling and itching and a hard knot at injection site. 7days after shot

Other Meds: Mortrin

Current Illness: None

ID: 1633982
Sex: F
Age: 67
State: PA

Vax Date: 04/13/2021
Onset Date: 04/13/2021
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: I am dealing with it myself.

Allergies: allergic to Penicillin and bee bites

Symptom List: Pain in extremity

Symptoms: After the first shot, within 1/2 hour, my legs felt weak. Within 2 hours, I did not feel myself. I took my pulse with my pulse-ox and my pulse was dropping and went in the low 50's. It was like this for 4-5 days. My pulse never goes below 70, usually always afg. between 70-80. After the 2nd shot, same thing-my legs felt weak and my pulse using my pulse-ox showed dropping down in the low 50's again and lasted for 1 1/2 days. Then my left arm with the 2nd dose (half way up my arm) was always itchy. It got a scab several times and left a noticeable scar. Also, I developed weird small white bumps on my body, some itchy and has left scars. Most importantly, after the 2nd shot, my hands became very sore-unable to open and close and they has been going numb ever since the 2nd shot. I have never had any issues with my hands going numb. Its mainly the right hand. Everyday its my right hand. I ahve been doing exercises and trying different therapy for my hands. It is causing me some disability to not be able to use my hands.

Other Meds: verapimil for blood pressure (180mg.-1 pill)

Current Illness: none

ID: 1633983
Sex: F
Age: 64
State: MI

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

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: Patient received once dose of Moderna. Developed pneumonia (non-COIVD)

Other Meds:

Current Illness:

ID: 1633984
Sex: F
Age: 40
State: IL

Vax Date: 05/24/2021
Onset Date: 06/12/2021
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

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

Symptoms: My first shot was on May 3rd, I got my period on May 12th, but after my second shot on May 24th, I have missed three menstrual cycles and counting. Please note that I have always been on time like clockwork my entire life, and I have not been sexually active during this timeframe.

Other Meds: none

Current Illness: none

ID: 1633985
Sex: F
Age: 35
State: NC

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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: N/A

Allergies: Slight allergy to shrimp.

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

Symptoms: On 08/24/2021 I felt bad within the hour after getting the COVID-19 1st dose at 3:45 pm; very fatigued and cold. On 08/25/2021 I woke up at 6:30 am and felt bad; nausea, fatigue, and weakness. On 08/25/2021 at 10:00 pm, I started feeling light-headed. I brushed it off and started to get hot, dizzy, at moments I could not hear. I sat there for about 10 minutes and got up to go to bed took about 5 steps, and had to immediately sit back down. After that, I do not remember anything but waking up on the floor and jerking and could not hear anything my fiance was in front of me crying and histairicle. I had no recollection of what just happen. When I came completely too my fiance preceded to tell me what happen he said, "I sat back down and was looking down and suddenly raised my head up and gave him a blank stare and jumped up out of the chair, locked up and started to convulse and fell over and continued to convulse and kick my legs vigorously. I suspect I had a seizure.

Other Meds: I took the following medications at 06:00 AM on 08/24/2021; Xyzol 10mg, Prenatal Vitamins, AMOX-CLAV 875-125 MG TABL, and Mucinex-D 600 mg tablet.

Current Illness: N/A

ID: 1633986
Sex: M
Age:
State: CA

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

Symptom List: Vomiting

Symptoms: Patient came to the pharmacy after 4 days of receiving the vaccine and said that the vaccination caused an infection per his Doctor.

Other Meds:

Current Illness:

ID: 1633987
Sex: F
Age: 14
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: NA

Allergies: na

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Patient got dizziness and sweating and headache while sitting at the waiting after the shot. Pharmacy staff gave her gatorate to drink. Pharmacist and walked by OB doctor helped her laying down on the floor and gave her one chewable benadryl. Paramedics team arrived check her pulse and pressure.

Other Meds: na

Current Illness: na

ID: 1633988
Sex: F
Age: 75
State: CA

Vax Date: 08/23/2021
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: RA

Lab Data: None

Allergies: Penicillin Vicodin

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

Symptoms: Severe diarherra starting 18 hours post 3rd vaccine dose

Other Meds: Metropolol

Current Illness: None

ID: 1633989
Sex: F
Age: 55
State: PA

Vax Date: 03/18/2021
Onset Date: 03/18/2021
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:

Allergies: Sulfa . PCN. Bee stings. Berries. Honey.

Symptom List: Injection site swelling, Limb discomfort

Symptoms: I took benadryl the night before and day of vaccine. 7 mins after receiving vaccine, started feeling severely hot. Then Swelling of lips mouth tongue. Became dizzy. Ringing of ears.itchy. unable to clearly focus. Self administration of Epipen. After 1.5hrs. Went home. Temp 103.severe body aches. Moderate swelling. Fatigued. Needed assist to get OOB lasted 4 days. On 5th day fever down to 99. Improved but continued with body aches and hives . Throat itchy still felt slightly swollen. Saw CRNP .spoke with allergy MD.

Other Meds: Plavix. ASA. Trulicity.Toprol XL. Miralax. Tylenol.Vita D. MVI. Singular. Zyrtec. Xyzal.pepcid.Tadalafil.

Current Illness: Severe Hives for 6 months w/Treatment from Allergest

ID: 1633990
Sex: F
Age: 35
State: WI

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: RA

Lab Data: Unknown

Allergies: No known allergies

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

Symptoms: Immunizing pharmacist spoke with patient prior to vaccine. Patient said after her first dose, she did experience chest palpitations for a few seconds, 12 hours after her first dose on 7/29/21. The patient said the palpitations did not occur again - it was just that one time. Pharmacist told her there have been reports of myocarditis/pericarditis after the vaccines, but nothing that Pharmacist could see relating to palpitations. Pharmacist did tell her it's her body, so it's up to her if she wants to receive the vaccine - there are always risks. She confirmed that she did want the second dose. After administering the second dose, Pharmacist told her to wait in the pharmacy for 15 minutes after the dose like last time. Pharmacist believes she only waited 5 minutes, then proceeded up to health and beauty to shop. About 10 minutes post vaccine, she came right back stating she felt like she was going to faint and was having heart palpitations. We sat her down and took her blood pressure and heartrate. 5:14pm it was 153/97 and HR 129, at 5:17pm it was 126/93 HR 95, at 5:21pm it was 121/91 HR 85. We told her to stay sitting for a while because she said she still felt dizzy, like she could faint. at 5:30pm she grabbed our attention again and said her palpitations were back. I asked if she wanted us to call an ambulance and she said yes. I called an ambulance and relayed all of the information to the paramedics. Patient did receive about 3-4 ounces of water at 5:15ish. Paramedics arrived at 5:38 pm and the patient's vitals were taken, prior to being escorted out by them to where they were awaiting the arrival of the ambulance. She was able to walk out of the store with the paramedics on her own. I tried calling the patient at 8:44pm on 8/25/21 to check on her and see how she is doing, but there was no answer and I had to leave a voicemail.

Other Meds: melatonin at bedtime for sleep, no other meds

Current Illness: None were reported by the patient

ID: 1633991
Sex: F
Age: 70
State: MI

Vax Date: 03/04/2021
Onset Date: 08/14/2021
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: RA

Lab Data:

Allergies:

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

Symptoms: Patient admitted for CVA/pneumonia

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am