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: 1636871
Sex: F
Age: 63
State: MI

Vax Date: 08/26/2021
Onset Date: 08/26/2021
Rec V Date: 08/26/2021
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: codeine, tramadol, vicodin, sulfa

Symptom List: Dysphagia, Epiglottitis

Symptoms: 10 days after her shot, patient had a hard spot at the injection site that got bigger, red, warm to the touch, itchy and had welts lower down her arm. She did go to the ER and they did an ultrasound which was normal. They said it was a reaction they have seen from the moderna vaccine.

Other Meds: zolpidem, estradiol, lamotrigine, pantoprazole, atorvastatin

Current Illness:

ID: 1636872
Sex: F
Age: 44
State: PR

Vax Date: 08/02/2021
Onset Date: 08/04/2021
Rec V Date: 08/26/2021
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: unknown

Symptom List: Anxiety, Dyspnoea

Symptoms: Female patient age 44, comes to the clinic after 2 days of getting second vaccine Pfizer. Reports 24 hours later she got nauseated, vomit, myalgia. We explained the effects expected to get after getting vaccinated. The effect of concern for the patient are angiodema in the ears and urticaria in bilateral extremities. She was treated with Benadryl by mouth and it was recommended if the symptoms did not improve or if they worsened, she should visit her primary doctor.

Other Meds: Unknown if patient was taking any medications at time of vaccine.

Current Illness:

ID: 1636873
Sex: M
Age: 30
State: CA

Vax Date: 08/25/2021
Onset Date: 08/25/2021
Rec V Date: 08/26/2021
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: None

Allergies: None

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

Symptoms: received his first dose of Pfizer on 8/11/21 and was schedule for his second dose on 8/25/21. arrived to the clinical on 8/25/21, and was administered the second dose of Pfizer. The medication administration error occurred as the patient received his second dose 14 days apart instead of 21 days. The patient remained asymptomatic during is observation. Patient informed of the mistake and advised to monitor for signs and symptoms. Patient denies any symptoms and stated he "felt fine". Provided patient with the Pfizer fact sheet and a contact number.

Other Meds: None

Current Illness: None

ID: 1636874
Sex: M
Age: 64
State: PA

Vax Date: 08/16/2021
Onset Date: 08/17/2021
Rec V Date: 08/26/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Systemic: Chills-Medium, Systemic: Cold Sweats-Medium

Other Meds:

Current Illness:

ID: 1636875
Sex: M
Age: 13
State: LA

Vax Date: 08/19/2021
Onset Date: 08/19/2021
Rec V Date: 08/26/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: child 13 received vaccine, age not approved at present.

Other Meds:

Current Illness:

ID: 1636876
Sex: F
Age: 68
State: FL

Vax Date: 08/21/2021
Onset Date: 08/22/2021
Rec V Date: 08/26/2021
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: na

Allergies: erythromycin, latex, pineapples

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

Symptoms: Erythema, tenderness, edema to right upper arm. No drainage. Blanching skin

Other Meds: Altace 5mg bid, Crestor 5mg qhs, Multivitamins, aspirin 81mg qhs

Current Illness: na

ID: 1636877
Sex: F
Age: 20
State: CA

Vax Date: 08/12/2021
Onset Date: 08/13/2021
Rec V Date: 08/26/2021
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:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Mild facial swelling, rash on chest/face and weakness

Other Meds:

Current Illness:

ID: 1636878
Sex: M
Age: 25
State: FL

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

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

Lab Data: BP 116/67, HR 67

Allergies: NKDA

Symptom List: Pharyngeal swelling

Symptoms: After vaccination administration client returned to the waiting area for prescribed 15 minute observation. After 5 minutes client had complaint of feeling faint,, sweating and tingling in hands, feet and lips. Client walked into clinic exam room to lay down for 15 minutes. BP initially was 106/67, HR 67. After 15 minutes and dringking water the client felt better and left the building.

Other Meds: Advil ocassionally

Current Illness: None

ID: 1636879
Sex: M
Age: 24
State:

Vax Date: 04/05/2021
Onset Date: 04/07/2021
Rec V Date: 08/26/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Patient experience a seizure less than 48 hours after dose 1 of Moderna COVID19 vaccine. Patient was stable on medications and had no history of seizures in the previous 3+ months.

Other Meds:

Current Illness: Epilepsy - stable and no history of seizures in 3+ months.

ID: 1636880
Sex: M
Age: 60
State: WA

Vax Date: 03/24/2021
Onset Date: 07/23/2021
Rec V Date: 08/26/2021
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: none

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Got COVID Delta On July 23rd. Started as a head cold, fever of 100 a couple days, body aches, headache, congestion, cough. DId not lose smell or taste-more fatigued than usual, but continued to have an appetite and was able to do household chores. I just retired but would have found it hard to work especially the first week. Tylenol helped and naps.

Other Meds: none

Current Illness: none

ID: 1636881
Sex: F
Age: 54
State: NJ

Vax Date: 04/20/2021
Onset Date: 04/21/2021
Rec V Date: 08/26/2021
Hospital:

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

Lab Data:

Allergies: Sulfa, Macrobid, Flagyl, Urontin, Seroquel.

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

Symptoms: Suicidal thoughts, chills, nausea, pain at injection site.

Other Meds: Abilify 20mg, Atenolol 25mg, Depakote 500mg, Metformin 500mg, Primidone 50mg, Trazodone 100mg.

Current Illness:

ID: 1636882
Sex: M
Age: 78
State: CA

Vax Date: 02/20/2021
Onset Date: 03/01/2021
Rec V Date: 08/26/2021
Hospital:

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

Lab Data: Biopsy

Allergies: None

Symptom List: Rash, Urticaria

Symptoms: Bullous Pemphigoid diagnosis six months and three biopsies later.

Other Meds: Xarelto, Carvedilol, Lisinopril, Rosuvastatin, Furosemide, Sulfasalazine, Levothyroxine

Current Illness: None

ID: 1636883
Sex: M
Age: 42
State: KY

Vax Date: 07/09/2021
Onset Date: 07/09/2021
Rec V Date: 08/26/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: Error: Improper Storage (temperature).

Other Meds:

Current Illness:

ID: 1636884
Sex: M
Age: 19
State: NY

Vax Date: 08/23/2021
Onset Date: 08/24/2021
Rec V Date: 08/26/2021
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: Various Tests Ran

Allergies: None

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

Symptoms: Difficulty breathing, heart racing, legs and hands were shaking, and he felt chills.

Other Meds: None

Current Illness: None

ID: 1636885
Sex: F
Age: 28
State: FL

Vax Date: 08/24/2021
Onset Date: 08/26/2021
Rec V Date: 08/26/2021
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 fb

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

Symptoms: Mastitis in right breast onset 48 hours after injection.

Other Meds: Prenatal

Current Illness:

ID: 1636886
Sex: F
Age: 61
State: VA

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

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

Lab Data: blood work EKG chest Xray CT scan of lungs

Allergies:

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

Symptoms: I had a bad reaction to my first dose of this shot (a separate report has been filed on that) that caused a severe flare up of long dormant Lupus symptoms. On day one after the 2nd shot I got light headed and had tingling in my arms and legs. On day 3 after the shot I developed chest pain and shortness of breath along with light headedness. On day 6 I developed severe stomach pain in addition to other symptoms. I thought it was all from the shot so kept waiting thinking I was ok and it would get better. By day 7 I had severe chest pain and shortness of breath and severe stomach pain that made me think I was having a heart attack or had a blood clot in my lungs. I went to the Emergency Room at this point. The doctors ruled out heart attack and blood clot via blood tests and CT scan. They also did a Covid test which was Negative. They sent me home after 6 hours of testing with no explanation of what was wrong with me. The next day I did a follow up visit with an Internist who did more blood work and told me the symptoms I was having was from a reaction to the vaccine. That the vaccine causes inflammation and that it went after my weak and already inflamed areas such as lungs from Asthma, and stomach from Reflux GERD. My ANA also had remained elevated since a reaction to the first shot.

Other Meds:

Current Illness:

ID: 1636887
Sex: M
Age: 0
State: WI

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

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

Lab Data:

Allergies: NONE

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

Symptoms: The patient choked on the Rotarix liquid. He then turned cyanotic and stopped breathing. Patient then took several attempt of patting and rubbing his back to get him breathing comfortably on his own again.

Other Meds: POLY-VI-SOL, timolol (TIMOPTIC) 0.5 % ophthalmic solution

Current Illness: NONE

ID: 1636888
Sex: F
Age: 57
State: SC

Vax Date: 04/22/2021
Onset Date: 04/22/2021
Rec V Date: 08/26/2021
Hospital:

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

Lab Data: Biopsy of my tongue

Allergies: Codeine Bee stings Fentanyl Latex

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Began itching that evening, running fever 103.6, coughing, worse than original case of Covid. Breaking out included sores in my mouth and head, still short of breath Biopsy on sore on my tongue?..returning to see what will be done about the enlarged lymph node on my tongue?I anticipate the oncologist cutting it off Miracle mouthwash Steroids

Other Meds: Cymbalta Lisonopril hctz Doxepin Wellbutrin Prilosec B12 shot. Vitamin D. Botox for migraines every 84 days. Nurtec

Current Illness: None Covid 12/2021-1/2021

ID: 1636889
Sex: M
Age: 50
State: IN

Vax Date: 07/15/2021
Onset Date: 07/15/2021
Rec V Date: 08/26/2021
Hospital:

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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1636890
Sex: F
Age: 54
State: AL

Vax Date: 08/21/2021
Onset Date: 08/24/2021
Rec V Date: 08/26/2021
Hospital:

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

Lab Data:

Allergies: Zyrtec

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

Symptoms: Fever blisters

Other Meds: Simvastatin Immune support vitamin C, D and Zinc Allegra Flonase

Current Illness: Sinuses Plantar fasciitis

ID: 1636891
Sex: M
Age: 15
State: WA

Vax Date: 04/28/2021
Onset Date: 04/28/2021
Rec V Date: 08/26/2021
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:

Allergies:

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

Symptoms: PATIENT 15 AT TIME OF IMMUNIZATION - EUA FOR 16 AND OLDER

Other Meds:

Current Illness:

ID: 1636892
Sex: F
Age: 49
State: AR

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

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

Lab Data:

Allergies: Keflex

Symptom List: Unevaluable event

Symptoms: Moderna vaccine used past the 12 hour window of use time once vial was punctured. Stored in fridge the entire time of use and cleaned between use with alcohol. Patient was contacted and no adverse reaction reported.

Other Meds:

Current Illness:

ID: 1636893
Sex: M
Age: 47
State: KY

Vax Date: 07/16/2021
Onset Date: 07/16/2021
Rec V Date: 08/26/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Error: Improper Storage (temperature)-.

Other Meds:

Current Illness:

ID: 1636894
Sex: F
Age: 36
State: IN

Vax Date: 08/24/2021
Onset Date: 08/24/2021
Rec V Date: 08/26/2021
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: I had pain in neck almost after the shot, and pain in my arm where it hurt to move it. The next day I was nauseous on and off, had a extremely bad migraine.

Other Meds:

Current Illness:

ID: 1636895
Sex: F
Age: 49
State:

Vax Date: 02/12/2021
Onset Date: 07/22/2021
Rec V Date: 08/26/2021
Hospital:

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

Lab Data: Abdominal CT positive only for uterine fibroids, blood work negative, ultrasound of gallbladder negative, HIDA scan with slightly decreased gallbladder function.

Allergies: PCN/Sulfa

Symptom List: Injection site pain, Menorrhagia

Symptoms: Symptoms started 7/22/21: constant nausea, frequent burping, can only eat very small meals, feel full fast, reflux (burning back of throat), mid epigastric pain with intermittent pain left upper abdomen, occasionally right upper abdomen, diarrhea/loose stool. All symptoms persist to the date of this submission. Daily prilosec and tums with varied relief.

Other Meds: Avonex, Celexa, Provigil, Viorelle, Metroprolol, Vit B, Vit D, Fish Oil

Current Illness: none

ID: 1636896
Sex: M
Age: 35
State: KY

Vax Date: 07/16/2021
Onset Date: 07/16/2021
Rec V Date: 08/26/2021
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: None stated.

Other Meds:

Current Illness:

ID: 1636897
Sex: F
Age: 75
State: LA

Vax Date: 04/01/2021
Onset Date: 05/01/2021
Rec V Date: 08/26/2021
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: She had bloodwork one the beginning of May and the beginning of August along with a urine test showing high white blood cell count indicative of a bladder infection

Allergies: Penicillin

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Early May diagnosed with a bladder infection, beginning of June a slight case of the shingles, end of June a cold lasted 2 to 3 weeks, end of July a mini stroke, and early August another bladder infection From early May to early August she lost almost 12 pounds

Other Meds: - [ ] Amlodipine 10mg blood pressure 1 a day - LADERER / morning - [ ] Hydralazine 25mg blood pressure ** 75mg 3times - LADERER /morning /lunch/dinner - [ ] Trazodone 50mg sleep aid 1 a day - LADERER / bedtime - [ ] Rosuvastatin (Creator)

Current Illness: None

ID: 1636898
Sex: F
Age: 60
State: NE

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

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

Lab Data: Called Pfizer medical information number and Drug safety.

Allergies: Shellfish

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Had first COVID-19 Pfizer vaccine on 8-14-21 and second COVID-19 Pfizer vaccine on 8-25-21, this is 11 days too soon. Client still cannot smell, taste, ears itch, has visual changes and brain fog, all of this is from having COVID in Oct 2020.

Other Meds: None

Current Illness: COVID Oct 2020

ID: 1636899
Sex: F
Age: 42
State: AZ

Vax Date: 08/23/2021
Onset Date: 08/26/2021
Rec V Date: 08/26/2021
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: cycle came very early

Other Meds: lexiproyl

Current Illness:

ID: 1636900
Sex: M
Age: 42
State: AR

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

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Moderna vaccine used past the 12 hour window of use time once vial was punctured. Stored in fridge the entire time of use and cleaned between use with alcohol. Patient was contacted and no adverse reaction reported.

Other Meds:

Current Illness:

ID: 1636901
Sex: M
Age: 42
State: KY

Vax Date: 07/14/2021
Onset Date: 07/14/2021
Rec V Date: 08/26/2021
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: Injection site pain

Symptoms: Error: Improper Storage (temperature)-.

Other Meds:

Current Illness:

ID: 1636902
Sex: F
Age: 57
State:

Vax Date: 12/29/2020
Onset Date: 08/24/2021
Rec V Date: 08/26/2021
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: PATIENT TESTED POSITIVE TO COVID-19 ON 8/24/21. PATIENT HAD RECEIVED PFIZER COVID-19 VACCINE AS FOLLOWS, Dose 1 date: 12/29/20 and Dose 2 date: 1/19/21.

Other Meds:

Current Illness:

ID: 1636903
Sex: M
Age: 30
State: MD

Vax Date: 01/11/2021
Onset Date: 08/16/2021
Rec V Date: 08/26/2021
Hospital:

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

Lab Data: Ultrasound Blood work (Comprehensive metabolic panel, hepatic function, cbc differential auto)

Allergies: N/a

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

Symptoms: Superficial Thrombophlebitis.

Other Meds: N/a

Current Illness: N/a

ID: 1636904
Sex: M
Age: 20
State: TX

Vax Date: 03/22/2021
Onset Date: 04/09/2021
Rec V Date: 08/26/2021
Hospital: Y

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

Lab Data: ER visits on 4/10/2021 and 4/30/2021, Hospitalizations on the following dates: 4/12/2021 - 4/16/2021, 5/1/2021 - 5/5/2021, 6/19/2021 - 6/26/2021, 7/11/2021 - 7/22/2021 with increase in seizure activity, elevated heart rate, abnormal EKG, Multiple MRIs, CT scans, elevated troponin levels, abnormal liver enzymes etc.

Allergies: Phenobarbital Megace Vimpat Keppra

Symptom List: Tremor

Symptoms: Left occipital brain swelling, myocarditis

Other Meds: Megace Clobazam Lamictal Magnesium

Current Illness: Seizures Migraines Dandy-Walker Malformation

ID: 1636905
Sex: M
Age: 64
State: IN

Vax Date: 02/17/2021
Onset Date: 07/15/2021
Rec V Date: 08/26/2021
Hospital:

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

Lab Data: ECG, Echo 08/10/2021

Allergies: NA

Symptom List: Erythema, Pruritus

Symptoms: Experienced typical atrial flutter during colonoscopy on 07/15/2021. It was verified on 08/10/2021 at hospital.

Other Meds: Diltiazem, , for PSVT; Cetirizine, ; CBD Oil, ; Standard Process Catalyn 2160, ; Vitamin C,

Current Illness: NA

ID: 1636906
Sex: M
Age: 18
State: KY

Vax Date: 07/12/2021
Onset Date: 07/12/2021
Rec V Date: 08/26/2021
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:

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

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1636907
Sex: F
Age: 80
State: FL

Vax Date: 03/23/2021
Onset Date: 08/01/2021
Rec V Date: 08/26/2021
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 test

Allergies: Aspirin, plavix

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

Symptoms: Rhinorrhea, covid exposure.

Other Meds:

Current Illness:

ID: 1636908
Sex: F
Age: 36
State: AZ

Vax Date: 08/25/2021
Onset Date: 08/25/2021
Rec V Date: 08/26/2021
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: Asthenia, Chills, Headache, Myalgia

Symptoms: Body aches and pains, chills and sweating, vaccination site soreness

Other Meds: Prenatal vitamins Calcium supplement

Current Illness:

ID: 1636909
Sex: F
Age: 65
State: PA

Vax Date: 02/25/2021
Onset Date: 03/01/2021
Rec V Date: 08/26/2021
Hospital:

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

Lab Data: EKG

Allergies: Mycins, scallops

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

Symptoms: I had rapid heartbeat for about 2 weeks. Them I had an irregular heartbeat for about 2 months, so I went to the doctor. The heartbeats went like this: boom...boom...boom. BOOM. I have no history of heart problems at all. My Blood pressure is usually 110/70, within normal range.

Other Meds: Metformin, Align

Current Illness: none

ID: 1636910
Sex: F
Age: 20
State: NE

Vax Date: 02/23/2021
Onset Date: 02/23/2021
Rec V Date: 08/26/2021
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: Covid-19 rapid test & Covid-19 home test.

Allergies: Benzoyl peroxide, seasonal allergies

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

Symptoms: Sinusitis Sore throat, nasal congestion lasting several days, mild cough, headache 2 doctors visits No test administered during first visit, Rapid Covid test on second. Home tested too. Both negative. Had prior exposure to strep.

Other Meds: Ferrous sulfate, vitamin D

Current Illness:

ID: 1636911
Sex: F
Age: 57
State: MA

Vax Date: 03/05/2021
Onset Date: 03/09/2021
Rec V Date: 08/26/2021
Hospital:

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

Lab Data: Had a hearing test completed and an MRI to see if there was anything causing my hearing issues

Allergies: None

Symptom List: Pain in extremity

Symptoms: Tinnitus in my left ear. Started a few days after receiving the 2nd shot of Moderna Vaccine. Continues to this day

Other Meds: Lisinopril

Current Illness: None

ID: 1636912
Sex: F
Age: 27
State: KY

Vax Date: 07/21/2021
Onset Date: 07/21/2021
Rec V Date: 08/26/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1636913
Sex: F
Age: 69
State: GA

Vax Date: 08/22/2021
Onset Date: 08/22/2021
Rec V Date: 08/26/2021
Hospital:

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

Lab Data: EKG, Chest X Ray, Labs

Allergies: Augmentin, Bactrim

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

Symptoms: GI upset, headache, chills, muscle aches, neck pain, back pain, breast pain, arm pain, shoulder pain, myalgias.

Other Meds: Trelegy Ellipta 200mg/inhalation one puff daily, Tramadol 50mg tab as needed for pain, Dupixent as directed, Ambien 10mg at bedtime, Amitriptyline 50mg once per day, Pantoprazole 40mg once a day as needed, Hyzaar 100-12.5mg tab one daily

Current Illness: none-

ID: 1636914
Sex: F
Age: 26
State: FL

Vax Date: 07/06/2021
Onset Date: 07/06/2021
Rec V Date: 08/26/2021
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: many food allergies adverse reaction to prednisone

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

Symptoms: Began with upset stomach, nausea, shortly after shot. Then developed difficulty breathing, shortness of breath. To2 puffs of Primatene mist inhaler (contains epi), with slight improvement. Repeated zyrtec and inhaler, and finally symptoms subsided.

Other Meds: Lamotrigine, zyrtec

Current Illness: none

ID: 1636915
Sex: F
Age: 36
State: AR

Vax Date: 07/23/2021
Onset Date: 07/23/2021
Rec V Date: 08/26/2021
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: Moderna vaccine used past the 12 hour window of use time once vial was punctured. Stored in fridge the entire time of use and cleaned between use with alcohol. Patient was contacted and no adverse reaction reported.

Other Meds:

Current Illness:

ID: 1636916
Sex: F
Age: 34
State: MN

Vax Date: 06/24/2021
Onset Date: 06/25/2021
Rec V Date: 08/26/2021
Hospital:

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

Lab Data: Unknown

Allergies: Wheat & dairy sensitivity. Cephalosporin allergy. Latex allergy.

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Had weird tingling on RIGHT side of body evening of 1st shot. Had a strangle pounding heart episode in the middle of the night, lasted maybe 2-minutes. Woke up morning after with shingles on RIGHT side of body, increasing pain. Called Hospital (where my 1st dose was given) and they referred me to their urgent care (facility listed in this report). I went, was diagnosed with shingles & put on antivirals & a nerve blocker. Went away pretty quick with antivirals, never took the nerve blocker. Continued to have occasional pounding heart episodes. Seems to occur when I am resting/sleeping. After a rather intense/longer lasting one, I went to the ER to see what was going on. No episode occurred while I was there. The episodes started being further & further apart. Continued to have a

Other Meds: None.

Current Illness: None

ID: 1636917
Sex: F
Age: 44
State: FL

Vax Date: 08/23/2021
Onset Date: 08/24/2021
Rec V Date: 08/26/2021
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: Swollen Lymph Node under arm

Other Meds: None

Current Illness: None

ID: 1636918
Sex: F
Age: 60
State: KY

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

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1636919
Sex: M
Age: 56
State: IN

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 08/26/2021
Hospital:

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

Lab Data: EKG

Allergies: NKDA

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

Symptoms: Subclinical Myocarditis

Other Meds: ASA 81 mg daily, turmeric 2000mg daily, Multiple Vitamin Daily, Tramadol 50mg as needed

Current Illness: Back Pain

ID: 1636920
Sex: M
Age: 54
State: NY

Vax Date: 08/25/2021
Onset Date: 08/25/2021
Rec V Date: 08/26/2021
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: NKDA

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

Symptoms: Resident noted unresponsive, unable to open eyes when repeatedly called; noted lethargy and unresponsive to stimulation. Upon assessment, no labor breathing noted and VS: BP 163/101 P 74 T 98.4 R 18 O2sat 99% FS 148mg/dL. Resident unable to open eyes independently/move his limbs. In acute care - ddx includes seizure vs syncopal episode.

Other Meds: Levemir insulin, Coreg, Procardia XL, Keppra, Clonidine, Hyzaar, Novolog insulin, Bisacodyl EC, aspirin, sitagliptin-metformin, lipitor

Current Illness: Patient is a resident at facility. He was admitted from acute care after being unable to manage his type II Diabetes at home.

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am