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: 1636921
Sex: F
Age: 56
State: CO

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: bp 140/100 p 100 rr 22 02 sat 92% on ra

Allergies: nkda

Symptom List: Dysphagia, Epiglottitis

Symptoms: anxiety attack, tingling in body

Other Meds: thyroxine,celexa

Current Illness:

Date Died: 08/12/2021

ID: 1636922
Sex: M
Age: 61
State: OH

Vax Date: 07/27/2021
Onset Date: 08/12/2021
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: An autopsy was preformed by Medical Center per the family's request.

Allergies: No known allergies.

Symptom List: Anxiety, Dyspnoea

Symptoms: The decedent was a 61 year-old male who passed away suddenly at home. No complaints of well-being were reported the evening before. No resuscitative measures were attempted as the patient was already dead by the time EMS arrived (EMS incident time, 0932-0954).The patient was pronounced dead on 8/12/2021 at 09:38.

Other Meds: No known medications.

Current Illness: No known illnesses.

ID: 1636923
Sex: F
Age: 70
State: KY

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

Allergies:

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

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1636924
Sex: F
Age: 45
State: CA

Vax Date: 05/25/2021
Onset Date: 05/25/2021
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: Went to the hospital on May 28 They ran tests and found nothing wrong It the numbness is still persistent

Allergies: N/A

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Sharp pain in vein in the neck, about 5pm left side pain all the way down my left side. The neck swelled up and under arm. Then numbness started on left side and continues off and on

Other Meds: N/a

Current Illness: None

ID: 1636925
Sex: M
Age: 16
State: WA

Vax Date: 05/20/2021
Onset Date: 05/20/2021
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: Moderna dose given to under 18 years old. Patient stayed for 15 min observation. No adverse events observed.

Other Meds:

Current Illness:

ID: 1636926
Sex: F
Age: 52
State: KY

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

Allergies:

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

Symptoms: Patient received Pfizer-BioNTech as the 3rd dose in a series due to being immunocompromised. It was after the dose was administered that it was identified that the patient had received MODERNA for dose 1 and dose 2.

Other Meds:

Current Illness:

ID: 1636927
Sex: F
Age: 57
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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1636928
Sex: F
Age: 64
State: TX

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Bactrim, PCN, Gluten

Symptom List: Pharyngeal swelling

Symptoms: 103 fever, nausea, chills, headache, abdominal cramps, diarrhea, bone aches, lethargy and dizziness. The fever lasted 4 days, at day 8 now and still experiencing abdominal cramps and some nausea and lethargy.

Other Meds: Exemastrane, Pepcid AC, Melatonin, D3, Calcium

Current Illness:

ID: 1636929
Sex: M
Age: 66
State: FL

Vax Date: 07/27/2021
Onset Date: 08/03/2021
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: Covid test, CXR

Allergies: Sulfa

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Cough.

Other Meds:

Current Illness:

ID: 1636930
Sex: M
Age: 47
State: HI

Vax Date: 01/19/2021
Onset Date: 08/25/2021
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:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: positive for covid-19. EE stated coughing, running nose on 8/24/21 and lost of smell 8/25/21

Other Meds:

Current Illness:

ID: 1636931
Sex: M
Age: 60
State: TN

Vax Date: 05/03/2021
Onset Date: 08/22/2021
Rec V Date: 08/26/2021
Hospital: Y

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

Lab Data: CT, Angiogram, MRI, echocardiogram, lab tests. Two day stay in ICU. tPA administered. Outcome recovering and prognosis from stroke good as he reached emergency care within one hour of the onset of symptoms.

Allergies: None

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

Symptoms: After second injection, fever, muscle aches, fatigue followed by a large inflamed lymph node under left arm. Enlarged lymph node lasted ~2 weeks. Otherwise healthy yet had an ischemic stroke on 22Aug2021.

Other Meds: doTERRA, Lifelong Vitality vitamins, OnGuard supplement Meloxicam

Current Illness: Orthopedic hand surgery in Dec 2020 - follow up

ID: 1636932
Sex: M
Age: 63
State: KY

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

Allergies:

Symptom List: Rash, Urticaria

Symptoms: Error: Improper Storage (temperature).

Other Meds:

Current Illness:

ID: 1636933
Sex: F
Age:
State: AZ

Vax Date:
Onset Date: 03/24/2021
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: checked cbc, comp, tsh. rf, ana, sed rate, vitamin D sent to rheumatology only abn lab was vitamin D 15.7

Allergies: none

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

Symptoms: pt states she started with severe pain in hands and could not move her hands- progressed into arms o the point she could not bath herself. Symptoms started the night she was give the vaccine within hours. Then for 3 mos she had severe muscle pains t/o body and joints.

Other Meds: mutivitamin calcium fish oil vitamin d

Current Illness: none

ID: 1636934
Sex: F
Age: 58
State:

Vax Date: 08/21/2021
Onset Date: 08/23/2021
Rec V Date: 08/26/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data: CT head 8/24; MRI brain 8/25; carotid ultrasound doppler 8/25; EKG 8/24

Allergies: iodine medium contrast

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

Symptoms: Patient had received 2 doses of vaccine in home country in Spring 2021. On a visit in August 2021, received a Pfizer booster on 8/21. Felt well for about 60 hours, travelled back to home country. The evening (local time) of 8/23, patient developed some dizziness. The next morning 8/24, noted worsening dizziness, headache, dysarthria. Presented to ED and was admitted to the hospital. Diagnosed with Transient Ischemic Attack of posterior circulation. Discharged from hospital after 24h admission to stroke ward.

Other Meds: Lisinopril 10mg QD, bupropion 150mg QD, quetiapine 150mg, estrogen hormone replacement daily, fluconazole 150mg weekly

Current Illness: none

ID: 1636935
Sex: F
Age: 16
State: AL

Vax Date: 06/03/2021
Onset Date: 06/03/2021
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: NKA

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

Symptoms: Patient was given vaccine dose outside of the EUA authorized age range (16yo and time of vaccination). Mild flu like symptoms (headache/achy the day following shot) but no other adverse events reported.

Other Meds: none known

Current Illness: None

ID: 1636936
Sex: M
Age: 35
State: PR

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

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

Symptoms: Patient reports after administration of first vaccine dose, got rash in a period time of 7 hours and itchiness in cheeks area. Third day bleeding in stool for 3 days.

Other Meds: Folic acid

Current Illness:

ID: 1636937
Sex: F
Age: 40
State: KY

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

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

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1636938
Sex: F
Age: 45
State: OH

Vax Date: 08/12/2021
Onset Date: 08/20/2021
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: None

Allergies: Sensitivity to farxiga no other known allergies besides seasonal

Symptom List: Ear pain, Hypoaesthesia

Symptoms: 10th day after vaccine was itching with a large gumball size not right at injection site 11th day more itching not had spread out not was from elbow to shoulder with shoulder discomfort 13th day I am formed facility where vaccine was given and left a message with the nurse at my doctor's office doctor recommended ice and Benadryl

Other Meds: Metformin, glipizide, Lisinopril, low dose aspirin, atenolol, super B-Complex, cranberry capsule, ibuprofen, Tylenol

Current Illness: No other known illnesses

ID: 1636939
Sex: M
Age: 68
State: MN

Vax Date: 03/17/2021
Onset Date: 08/25/2021
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: positive covid PCR 8/26/21

Allergies: NKA

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: patient developed covid-19 infection on 8/25/21

Other Meds: atorvaSTATin (LIPITOR) 10 mg tablet Take 10 mg by mouth 1 time per day tamsulosin (FLOMAX) 0.4 mg capsule Take 0.4 mg by mouth 1 time per day omega-3 fatty acids (FISH OIL) 1000 mg capsule Take 2 g by mouth 1 time per day sildenafil 20 mg t

Current Illness: none

ID: 1636940
Sex: M
Age: 32
State: MD

Vax Date: 08/26/2021
Onset Date: 08/26/2021
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: none

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

Symptoms: Patient complained of dizziness, shortness of breath and chest heaviness about 5 minutes after receiving second dose. Diaphoretic. BP 120/80. Heart Rate 88, resp. 32, and pulse ox 99%. Pt. experienced a small bit of emesis from nausea. RN notified and came to talk to patient. 911 called and transferred patient to the hospital for evaluation at 1:55pm. Pt. remained conscious and alert and oriented throughout.

Other Meds:

Current Illness: none

ID: 1636941
Sex: F
Age: 51
State: AK

Vax Date: 08/24/2021
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: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none known

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

Symptoms: minor burning/stinging rash on shoulder-duration 12 hours enlarged lymph nodes around collar bone and neck on the left side. Painful to touch, warm and swollen. Started after rash subsided. pain in shoulder that radiates down arm and around to the shoulder blade.

Other Meds: venlafaxine (effexor)

Current Illness: None

ID: 1636942
Sex: F
Age: 36
State: MO

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

Lab Data: None

Allergies: Lamictal

Symptom List: Unevaluable event

Symptoms: 10 hours after receiving the covid 19 injection, my arm started to hurt at the injection site, I got a 101.4 degree fever. 14 hours after receiving it my heart began to flutter and I immediately vomited and started sweating perfusely but also got cold chills at the same time. I felt like death was upon me. I could not even hold water down in my stomach. I couldn't sleep that night either. The whole next day I had fever and chills and all my joints ached and were painful. I felt dizzy every time I stood up. 2 days after the injection, I have a very swollen lymph node under my right arm pit and my fingers hurt in my right hand really bad. I have messaged my physician regarding these symptoms and they said those are common. I just wanted you guys to have my information so that you can add it to your studies.

Other Meds: Triamcinolone .1% topical cream for poison ivy rash, multivitamin, 81 mg aspirin, 5,000 iu vitamin d, Flonase, 10 mg zyrtec, 40 mg adderall, calamine lotion was taken in the morning prior to vaccine

Current Illness: Poison ivy rash on arms.

ID: 1636943
Sex: M
Age: 34
State: NY

Vax Date: 08/04/2021
Onset Date: 08/04/2021
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: 1636944
Sex: M
Age: 13
State: KY

Vax Date: 08/25/2021
Onset Date: 08/26/2021
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: Temperature and symptoms recorded by school nurse.

Allergies: None

Symptom List: Injection site pain, Pain

Symptoms: Consistently High fever of around 102.5, headache, body/joint pain and fatigue, chills and stomach cramps.

Other Meds: None

Current Illness: None

ID: 1636945
Sex: F
Age: 57
State: FL

Vax Date: 07/19/2021
Onset Date: 08/03/2021
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: Covid test.

Allergies: NKA

Symptom List: Injection site pain, Menorrhagia

Symptoms: Cough, body aches, diarrhea, loss of smell.

Other Meds:

Current Illness:

ID: 1636946
Sex: M
Age: 62
State: KY

Vax Date: 07/20/2021
Onset Date: 07/20/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1636947
Sex: F
Age: 53
State: MI

Vax Date: 08/26/2021
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: LA

Lab Data: None

Allergies: Seasonial allergies, cats

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Vaccine was given without being diluted.

Other Meds: Allergy Medications OTC

Current Illness: NA

ID: 1636948
Sex: F
Age: 75
State:

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

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Patient presented to facility today for her appointment and noted that she received her booster shot at location on Monday. She presented today with significant swelling, redness, and heat at the site of injection. She denies pain in the area and can palpate it without discomfort. She did note that it occasionally feels itchy.

Other Meds:

Current Illness:

ID: 1636949
Sex: M
Age: 36
State: CA

Vax Date: 08/24/2021
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:
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: Body ache, fatigue, chills

Other Meds:

Current Illness:

ID: 1636950
Sex: M
Age: 67
State: MI

Vax Date: 08/16/2021
Onset Date: 08/24/2021
Rec V Date: 08/26/2021
Hospital: Y

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

Lab Data: Rapid COVID antigen, CBC W Diff, BMP,

Allergies: Bees

Symptom List: Nausea

Symptoms: lethargic, change in baseline

Other Meds: Melatonin, busPIRone, Atrovastatin, Cholecalciferol, Asorbic Acid, amLODIPine Besylate, Cardura tablet, Multivitamin, Atenolol, Acetaminophen, Cymbalta, Isosorbide Dinitrate, Trazodone, HumaLOG

Current Illness: UTI

ID: 1636951
Sex: M
Age: 39
State: KY

Vax Date: 07/12/2021
Onset Date: 07/12/2021
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: 1636952
Sex: F
Age: 50
State: IL

Vax Date: 02/13/2021
Onset Date: 02/13/2021
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: blood work, EKG

Allergies: None

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

Symptoms: About 45 minutes after the 2nd dose vaccine, I noticed a fullness feeling in my chest and head then it went away. That evening around 8PM, my resting heart rate was 94. Then 11 days later 2/24/21 at 3:15PM, my heart started racing, it felt about 160 BPM. I waited it out and after 45 seconds it resolved. I felt tired afterwards. The following day, I felt very anxious and nervous and my heart rate was 110. I decided to go to the ER. They did blood work and EKG and everything came back normal so I was discharged. I did follow up with my cardiologist. The doctor recommended doing an ablation to correct the problem. On 4/28/2021, I did the ablation procedure and have not had any cardiac symptoms since.

Other Meds: None

Current Illness: None

ID: 1636953
Sex: M
Age: 38
State: NY

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

Allergies: unkown

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

Symptoms: Pt. developed seizure like activity for 1-2 minutes 10 minutes after vaccination. Pt. had convulsions, pallor and some diaphoresis. Was transported to Emergency room via ambulance.

Other Meds: unknown

Current Illness: unkown

ID: 1636954
Sex: M
Age: 50
State: KY

Vax Date: 07/31/2021
Onset Date: 07/31/2021
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: Tremor

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

Date Died: 08/13/2021

ID: 1636955
Sex: F
Age: 72
State: GA

Vax Date: 04/22/2021
Onset Date: 08/08/2021
Rec V Date: 08/26/2021
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: Hospitalization, On supplemental O2, Remdesivir, Decadron, Death

Other Meds:

Current Illness:

Date Died: 08/22/2021

ID: 1636956
Sex: M
Age: 54
State: TN

Vax Date: 04/28/2021
Onset Date: 08/22/2021
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: Pt. given dose. NO lot number in our vaccination system, pt. passed from COVID19 on 8/22/2021.

Other Meds:

Current Illness:

ID: 1636957
Sex: F
Age: 49
State: FL

Vax Date: 04/02/2021
Onset Date: 08/03/2021
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, chest xray.

Allergies: NKA

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

Symptoms: Cough, congestion, fever.

Other Meds:

Current Illness:

ID: 1636958
Sex: F
Age: 62
State: WI

Vax Date: 06/09/2021
Onset Date: 06/21/2021
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: No testing for vertigo. 7/13/21 SARS-VOV-2 (COVID-19) RAPID - POSITIVE

Allergies: none

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: 6/21/21 Vertigo - lightheaded, dizziness that lasted 36 hours and continued with milder symptoms coming and going until 7/5/2021. 7/11/21 deep cough, 7/12/21 severe headache and fatigue and muscle aches...diagnosed Covid-19 on 7/13/21 at ER.

Other Meds: Amlodipine Besylate 6 mg, Hydrochlorothiazide 25mg, Losartan Potassium 100mg, Sertraline HCI 50mg, Multi vitamin, probiotic, anti-inflammatory

Current Illness: Granuloma Annular, Lichen Sclerosis, and joint pain

ID: 1636959
Sex: M
Age: 44
State: KY

Vax Date: 07/22/2021
Onset Date: 07/22/2021
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:

Allergies:

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

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1636960
Sex: F
Age: 63
State: IL

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

Allergies:

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

Symptoms: Throat swelling Syncopal episode Fever Shaking chills Wheezing Muscle cramps Skin red/hot Joint pain

Other Meds:

Current Illness:

Date Died: 08/16/2021

ID: 1636961
Sex: F
Age: 89
State: GA

Vax Date: 01/05/2021
Onset Date: 08/03/2021
Rec V Date: 08/26/2021
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: Pain in extremity

Symptoms: Patient main reason for hospitalization was for hypoxic respiratory stress secondary to covid pneumonia. Pt had two separate hospitalizations, but the hospitalization at time of positive test was admit on 8/8 and discharged to hospice on 8/12. Death: ACUTE RESPIRATORY FAILURE WITH HYPOXIA, PNEUMONIA DUE TO COVID-19

Other Meds:

Current Illness:

ID: 1636962
Sex: M
Age: 32
State: KY

Vax Date: 07/17/2021
Onset Date: 07/17/2021
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: 1636963
Sex: F
Age: 19
State: KY

Vax Date: 07/28/2021
Onset Date: 07/28/2021
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: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1636964
Sex: F
Age: 36
State: PR

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

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

Symptoms: Patient female 36 years of age, oriented in time, place, date. Reports that after getting the second vaccine dose MODERNA "felt rush" (accelerated). Patient reports that it could be anxiety and that her last meal was at 2pm (a snack) and also started her period today. She has Uterine fibroid. 4:09 pm verbalizes feeling better. Patient is moved to take vitals B/P: 130/90, pulse 93, O2 99%, glucose 99%. Patient is recommended to monitor symptoms, and to visit her doctor if they worsen.

Other Meds:

Current Illness:

ID: 1636965
Sex: M
Age: 23
State:

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: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: Patient received first dose of Pfizer vaccine on 8/5/21 and second dose of Pfizer vaccine today 8/26/21. It is later discovered in database on 8/26/21 that patient received a dose of J&J vaccine months ago on 3/12/21.

Other Meds:

Current Illness:

ID: 1636966
Sex: F
Age: 84
State: KY

Vax Date: 07/28/2021
Onset Date: 07/28/2021
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:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

Date Died: 08/26/2021

ID: 1636967
Sex: M
Age: 21
State: OK

Vax Date: 07/29/2021
Onset Date: 08/23/2021
Rec V Date: 08/26/2021
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: 8/25: HIT antibody (P4F) negative 8/25: platelets 227 8/25 CT Head: 1. Abnormal low density compatible with infarcts throughout the cerebellum, pons and brainstem, and both of the posterior cerebral artery territories including the bilateral thalami. 2. Mass effect within the posterior fossa results in distortion of the fourth ventricles with what appears to be early developing lateral and third ventricular hydrocephalus. There is marked effacement of the basilar cisterns. 3. Residual intracranial contrast limits assessment but there are no current findings of hemorrhagic conversion or acute intracranial hemorrhage. 4. Paranasal sinus disease.

Allergies: no known allergies

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

Symptoms: Patient woke up 8/23 morning c/o dizziness, slurred speech and with ringing in his left ear. Shortly afterwards pt exhibited seizure-like activity. Family called 911. EMS witnessed seizure at home and was actively seizing on arrival of EMS. Pt was administered 5mg Versed w/o relief then was given Ketamine and intubated. After airway was secured pt was transported to the ED. Pt was admitted for treatment for status epilepticus. Pt sedated on Propofol gtt, Keppra and placed on cEEG. Initial CT Head w/o contrast negative for any acute findings. cEEG was negative for seizures. Pt treated prophylactically with Rocephin and Vancomycin for suspected aspiration. MRI brain w/o contrast obtained early today at the outside hospital and showed Bilateral cerebellar and thalamic AIS with possible basilar occlusion. Dr was contacted and accepted for transfer for acute stroke evaluation and treatment. Prior to transfer obtained CTA head/neck. Pt transported via helicopter. Upon arrival pt was met in ED CT for stat CT cerebral perfusion and CT Head w/o contrast. Pt arrived 8/24/2021 16:08. NIH 36 and GCS 3T. Pt arrived on Propofol and was stopped. Scans showed a large infarction and no intervention recommended. Of note: pt had just received this Johnson and Johnson COVID vaccination 2 weeks ago.

Other Meds: acetaminophen 650 mg as needed for headache/pain

Current Illness: none

ID: 1636968
Sex: F
Age: 27
State: FL

Vax Date: 04/07/2021
Onset Date: 08/03/2021
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: CXR, covid test.

Allergies: NKA

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Cough, SOB, fever.

Other Meds:

Current Illness:

ID: 1636969
Sex: F
Age: 46
State: PA

Vax Date: 07/12/2021
Onset Date: 08/17/2021
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: Trip to the emergency room on August 17th 2021. CT scans, blood work and MRI to rule out stroke and diagnosed with Bell's palsy

Allergies: Penicillin and Ambien

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

Symptoms: Stroke symptoms with a diagnosis of Bell's Palsy with right side face paralysis

Other Meds: Mirtazapine, clonazepam, colestipol, Gabapentin

Current Illness: None

ID: 1636970
Sex: M
Age: 20
State: KY

Vax Date: 07/29/2021
Onset Date: 07/29/2021
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: RA

Lab Data:

Allergies:

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

Symptoms: Error: Improper Storage (temperature).

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am