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: 1637021
Sex: M
Age: 57
State: TN

Vax Date: 04/09/2021
Onset Date: 04/09/2021
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: none

Symptom List: Dysphagia, Epiglottitis

Symptoms: It has been over 5 months since I recieved this injection and the area the shot was given is still tender to the touch and will wake me up at night when I roll over on that area on my right arm.

Other Meds: Multivitamin, AREDS 2, D3 1000 IU

Current Illness: none

ID: 1637022
Sex: F
Age: 58
State: PA

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

Lab Data: N/A

Allergies: Penicillin Ceclor Nexium Prilosec Percocet Darboset

Symptom List: Anxiety, Dyspnoea

Symptoms: Uncontrollable chills - couldn't hold a bottle of water or other Sever Throwing Up Sharp Stabing Pain in upper stomach area to my back - so sever was doubled over for some time Sever Aches Migraine

Other Meds: Prescriptions - Sertraline 100 mg (Night time) - Famotidine 40 MG (2x a day) - Bupropion HCL XL 150 MG (1 x a day) Vitamins - Natures Made D3 Gummies 2000 UI - Natures Made Multi Vitamin for Women + Omega - 3s Gummies

Current Illness: Gastroenteritis Sinusitus

ID: 1637023
Sex: M
Age: 20
State: IL

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: IV was started by APN and fluids were started, EMS called.

Allergies: NKA

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

Symptoms: event occurred at 10:40am. Pt approached the front desk and told them he didn't feel well. Pt had what appeared to be a vaso vagal response.

Other Meds: none

Current Illness: none

ID: 1637024
Sex: M
Age: 59
State: IN

Vax Date: 08/02/2021
Onset Date: 08/02/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1637025
Sex: M
Age: 60
State: OH

Vax Date: 04/01/2021
Onset Date: 08/20/2021
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: POC test done on 8-26-2021, resulted as positive.

Allergies:

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

Symptoms: fever, muscle aches, sore throat, cough, headache, fatigue, nasal congestion

Other Meds:

Current Illness:

ID: 1637026
Sex: F
Age: 92
State: WI

Vax Date: 08/20/2021
Onset Date: 08/20/2021
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: NONE REPORTED

Allergies: NONE REPORTED

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

Symptoms: BRUISING AND SORENESS AT INJECTION SITE NOTED 6 DAYS AFTER VACCINATION

Other Meds: NONE REPORTED

Current Illness: NONE REPORTED

ID: 1637027
Sex: F
Age: 57
State: FL

Vax Date: 03/01/2021
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: None

Allergies: None

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Post menopausal bleeding . I've not had a period in 5 years. Now I'm bleeding again.

Other Meds: High blood pressure medication

Current Illness: None

ID: 1637028
Sex: F
Age: 58
State: KY

Vax Date: 03/08/2021
Onset Date: 08/22/2021
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: Pharyngeal swelling

Symptoms: PT. was vaccinated on 3/08/2021, tested + 08/24/2021.

Other Meds:

Current Illness:

ID: 1637029
Sex: F
Age: 30
State: NY

Vax Date: 07/07/2021
Onset Date: 08/03/2021
Rec V Date: 08/26/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Decreased breastmilk supply in left breast the side of the vaccine occurred 3 days after each vaccine and is still on going

Other Meds: Pepcid

Current Illness: none

ID: 1637030
Sex: F
Age: 63
State: MT

Vax Date: 04/08/2021
Onset Date: 04/08/2021
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: EKG was normal (4/8/21) Labs showed elevated BUN and WBC (4/8/21)

Allergies: Intolerance to Oxycodone, Hydrocodone.

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Within 4 hours of injection, rapid pulse, elevating blood pressures which peaked at over 200/100. This was verified by nursing staff as I had a podiatry appointment the same day as the injection. Eight hours after injection blood pressures lowering to 174/90. Took several days to get all the way back to normal range. No headaches, no dizziness. I was monitored in ER for several hours before being released. I was told by the Pharmacist not to repeat (with booster) the Moderna or Pfizer covid vaccine due to adverse reaction. I might possible be able to do a booster with J&J as this is a different type of vaccine.

Other Meds: Levothyroxine Calcitonin Salmon Calcium Magnesium Vitamin D3

Current Illness: none

ID: 1637031
Sex: M
Age: 42
State: KY

Vax Date: 03/04/2021
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: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Tested positive for COVID19 on 8/23/2021

Other Meds:

Current Illness:

ID: 1637032
Sex: F
Age: 69
State: CA

Vax Date: 02/03/2021
Onset Date: 02/09/2021
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: On 2/15/21 had video conference with PA.

Allergies: Verapamil Neomycin-Bacitracin

Symptom List: Rash, Urticaria

Symptoms: itchy and painful rash on upper arm around injection side. Spread all down upper inner and outer arm and anteriorly to the chest with some pain.

Other Meds: sertraline - 25mg/day amitryiptyline - 10mg/day vitamen D

Current Illness: none

ID: 1637033
Sex: F
Age: 18
State: FL

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

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

Lab Data: CXR, covid test.

Allergies: NKA

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

Symptoms: Cough, rhinorrhea, sore throat, abd pain.

Other Meds:

Current Illness:

ID: 1637034
Sex: M
Age: 55
State: KY

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

Lab Data:

Allergies: Penicillin

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

Symptoms: At approx 1025 pt complained of dizziness, to another patient in waiting area who notified staff. On assessment, pt appeared to be holding his breath, and staring straight ahead. He was shaking mildly, VSS-BP 120/90, P-76, R-22, Sat 97%. Gluc 135. EMS was called. Pt began to come back to baseline, reported seizures as a child, but none since. Reported had "odd" feeling, headache, and feeling faint. Patient taken to Medical Center for further eval and treatment.

Other Meds: Unknown

Current Illness: Unknown

ID: 1637035
Sex: F
Age: 71
State: CA

Vax Date: 08/24/2021
Onset Date: 08/25/2021
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

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

Symptoms: pt states abnormal red spots that appear on both her feet following the 3rd dose of the covid vaccine (moderna). no other issues at this time.

Other Meds:

Current Illness:

ID: 1637036
Sex: F
Age: 68
State: KY

Vax Date: 04/13/2021
Onset Date: 08/21/2021
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: Tested PCR Covid-19 positive 8/23/21 with onset 8/21/21

Other Meds:

Current Illness:

ID: 1637037
Sex: M
Age: 69
State: KY

Vax Date: 08/02/2021
Onset Date: 08/02/2021
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: 1637038
Sex: F
Age: 24
State: NY

Vax Date: 01/11/2021
Onset Date: 08/15/2021
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:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose12/23/21 2nd dose01/11/21 Diagnosed covid positive:08/18/21 Symptom onset:08/15/21 Exposure:Travel Symptoms:cough, fatigue,loss of smell/taste, sorethroat,HA

Other Meds:

Current Illness:

Date Died: 08/13/2021

ID: 1637039
Sex: F
Age: 67
State: GA

Vax Date: 02/19/2021
Onset Date: 08/08/2021
Rec V Date: 08/26/2021
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: ACUTE RESPIRATORY FAILURE WITH HYPOXIA, COVID-19 Hospitalization and Death

Other Meds:

Current Illness:

ID: 1637040
Sex: F
Age: 26
State: NY

Vax Date: 02/08/2021
Onset Date: 08/13/2021
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:

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

Symptoms: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose01/11/21 2nd dose02/08/21 Diagnosed covid positive:08/17/21 Symptom onset:08/13/21 Exposure: Symptoms:oss of smell/taste, runny nose,

Other Meds:

Current Illness:

ID: 1637041
Sex: F
Age: 59
State: WI

Vax Date: 02/26/2021
Onset Date: 03/08/2021
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: Blood test & BP 190.

Allergies: None

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

Symptoms: A lot of head issues with first vaccine, tenderness, sharp pain in calf muscle went around leg and then down to foot and back up leg. Little spots of pain in leg.

Other Meds: V12 Vitamin, D3 Vitamin

Current Illness: None

ID: 1637042
Sex: F
Age: 31
State: NY

Vax Date: 02/08/2021
Onset Date: 08/15/2021
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: Unevaluable event

Symptoms: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose01/11/21 2nd dose02/08/21 Diagnosed covid positive:08/17/21 Symptom onset:08/15/21 Exposure:community Symptoms:cough, fatigue,muscle aches,sore Throat,chills, HA

Other Meds:

Current Illness:

ID: 1637043
Sex: F
Age: 11
State: MO

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: N/A

Allergies: N/A

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

Symptoms: Patient was administered the adult Hep B vaccine dose instead of the pediatric Hep B vaccine. Once error was discovered, nursing supervisor, health director, and oversight physician made aware of the error. Patient guardian made aware of the error and as of today 8/26/21, patient is feeling well. No adverse outcome noted. Patient guardian advised to please contact us with any change in the patient so will can assist them with obtaining the appropriate follow-up.

Other Meds: N/A

Current Illness: N/A

ID: 1637044
Sex: F
Age: 46
State: SC

Vax Date: 08/10/2021
Onset Date: 08/18/2021
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: Neosporin

Symptom List: Injection site pain, Pain

Symptoms: Injection site skin reactions - Red, itchy, swollen, and painful rash at injection site

Other Meds: None

Current Illness: None

ID: 1637045
Sex: F
Age: 28
State: PR

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: 1
Vax Route: SYR
Vax Site: LA

Lab Data: The patient blood pressure was measured with a result of 103/55mmHg with 65bpm

Allergies: seafood

Symptom List: Injection site pain, Menorrhagia

Symptoms: fainting, dizziness, anxious, shaky, itching on hands, heavy breathing

Other Meds: none

Current Illness: none

ID: 1637046
Sex: F
Age: 61
State: NY

Vax Date: 02/09/2021
Onset Date: 08/14/2021
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: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose01/09/21 2nd dose02/09/21 Diagnosed covid positive:08/17/21 Symptom onset:08/14/21 Exposure:Home Symptoms:fever, HA, muscle aches, sorethroat

Other Meds:

Current Illness:

ID: 1637047
Sex: F
Age: 36
State: HI

Vax Date: 01/27/2021
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: LA

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: symptoms started 8/13, tested Covid positive 8/24

Other Meds:

Current Illness:

ID: 1637048
Sex: M
Age: 50
State: NJ

Vax Date: 04/14/2021
Onset Date: 08/11/2021
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: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose 03/24/21 2nd dose 04/14/21 Diagnosed covid positive:08/17/21 Symptom onset:08/11/21 Exposure:community Symptoms:cough, fatigue,loss of smell/taste, runny nose.

Other Meds:

Current Illness:

ID: 1637049
Sex: F
Age: 36
State: LA

Vax Date: 07/28/2021
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: Vaccine was beyond the Use By Date, not beyond the expiration date.

Other Meds:

Current Illness:

ID: 1637050
Sex: M
Age: 8
State: NC

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: 1
Vax Route: IM
Vax Site: RA

Lab Data: N/A

Allergies: N/A

Symptom List: Nausea

Symptoms: Patient was administered the adult Hep B vaccine dose instead of the pediatric Hep B vaccine. Once error was discovered, nursing supervisor, health director, and oversight physician made aware of the error. Patient guardian made aware of the error and as of today 8/26/21, patient is feeling well. No adverse outcome noted. Patient guardian advised to please contact us with any change in the patient so will can assist them with obtaining the appropriate follow-up.

Other Meds: N/A

Current Illness: N/A

ID: 1637051
Sex: F
Age: 72
State: NV

Vax Date: 02/14/2021
Onset Date: 02/15/2021
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: X-ray - Normal

Allergies: I allergic to pain pills.

Symptom List: Injection site pain

Symptoms: I experienced dizziness, fainted, and hit my head which caused a visit to Urgent Care who sent me to the ER. The doctor did an X-ray on my head and was referred to a Neurologist; however, the Neurologist failed to submit the paperwork to perform an MRI to my insurance company. I decided not to reschedule because my appointment would have taken place 3 months later.

Other Meds: No.

Current Illness: No.

ID: 1637052
Sex: M
Age: 14
State: WA

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: 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 was in office to see provider, patient requesting Pfizer vaccine I had drawn up 0.7mL of diluent for Pfizer, and mixed it with pfizer , our COVID RN nurse brought it to my attention that I had drawn too little of the diluent, patient still got 0.3mL of it wrong dosage amount was given to patient.

Other Meds:

Current Illness:

ID: 1637053
Sex: F
Age: 30
State: NY

Vax Date: 02/05/2021
Onset Date: 08/17/2021
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:

Allergies:

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

Symptoms: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose01/12/21 2nd dose02/05/21 Diagnosed covid positive:08/17/21 Symptom onset:08/16/21 Exposure: Symptoms:Muscle aches, fatigue, runny nose,HA, sorethroat.

Other Meds:

Current Illness:

ID: 1637054
Sex: F
Age: 77
State:

Vax Date: 02/23/2021
Onset Date: 08/23/2021
Rec V Date: 08/26/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: COVID +

Other Meds:

Current Illness:

ID: 1637055
Sex: F
Age: 33
State: CO

Vax Date: 08/03/2021
Onset Date: 08/03/2021
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: n/a

Allergies: none

Symptom List: Erythema, Pruritus

Symptoms: I had COVID in October 2020. My repeat antibody testing for spike and nucleocapsid remained high q2months with testing. I had 1st Pfizer 7/15/21. Second dose 8/3/21. First dose I had fatigue, arm soreness, mild headache, mild total body myalgias. Second dose, around 12-13 hours after the injection I had severe myalgias, rigors, headache, insomnia. It lasted until around 8am then started to wane until 2pm the next day. I took 1000mg tylenol around midnight and then again at 8am. It was like mini early COVID again for me. I expected this type of reaction but just reporting since it was severe. I also developed a rash on my neck the AM after the injection. It resolved over 1 week and I used hydrocortisone cream sparingly on it after day 3 until day 7.

Other Meds: flonase daily

Current Illness: none

ID: 1637056
Sex: M
Age: 65
State: CA

Vax Date: 12/11/2020
Onset Date: 12/15/2020
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: None known

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

Symptoms: 3 or 4 days after my first dose, I starting having random small stinging pustules on my chest and abdomen continuing 1 or 2 per day. This continued for many weeks so I waited 20 weeks for the frequency to lessen to about 1 per 4 days before having my second Shingrix dose on April 30, 2021. After the second dose, the pustules seemed to increase in frequency again and now after 17 weeks they appear to be diminishing at this point to 1 per week. Basically I viewed this as an inconvenience and no big deal so I never sought any medical attention, but wanted to report it in case others have the same issue.

Other Meds: Lisinopril 10 mg daily

Current Illness: None

ID: 1637057
Sex: F
Age: 42
State: NY

Vax Date: 02/10/2021
Onset Date: 08/14/2021
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: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose01/20/21 2nd dose02/10/21 Diagnosed covid positive:08/17/21 Symptom onset:08/14/21 Exposure:Home Symptoms:loss of smell/taste,HA, congestion, cough

Other Meds:

Current Illness:

ID: 1637058
Sex: F
Age: 41
State: ID

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

Allergies: sulfa antibiotics

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: 3 hours after shot I felt like I couldn't breathe. I had to use my asthma inhaler a lot from 830pm to the next morning. I got a 101 fever about 8pm that has lasted for 14 days now. It still hasn't gone away. I've been getting severe headaches every day since. My bloodsugar has been really really high and I've had to increase my insulin amounts. 3 days after vaccine I started getting random hives all over my body. It was one or 2 raised red itchy bumps at a time in random places, like on my leg, chest, arm, face, back. Those lasted for 5 days.

Other Meds: Insulin, bupropion, duloxetine, valium, tizanadine, coQ10

Current Illness:

ID: 1637059
Sex: F
Age: 30
State: NY

Vax Date: 01/13/2021
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: SYR
Vax Site: LA

Lab Data: h

Allergies:

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

Symptoms: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose12/23/20 2nd dose01/13/21 Diagnosed covid positive:08/16/21 Symptom onset:08/16/21 Exposure:work Symptoms HA, sinus pressure.

Other Meds:

Current Illness:

ID: 1637060
Sex: F
Age: 38
State: PR

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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Patient reports having headache and dizziness. Vitals are taken pulse 65, BP 80/40 at obscuration clear lungs were heard, equal and reactive pupils were observed. She reports having an upset stomach. Observation and monitoring of vitals continues for approximately 45 minutes. Doctor indicates discharging patient.

Other Meds:

Current Illness:

ID: 1637061
Sex: F
Age: 29
State: TX

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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: sulfur based antibiotic

Symptom List: Pain in extremity

Symptoms: Ice Pack and cold water

Other Meds: Birth Control

Current Illness: non

ID: 1637062
Sex: M
Age: 41
State: NY

Vax Date: 01/28/2021
Onset Date: 08/16/2021
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: Home

Allergies:

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

Symptoms: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose01/7/21 2nd dose01/28/21 Diagnosed covid positive:08/16/21 Symptom onset:08/16/21 Exposure:Home Symptoms:fever, fatigue,muscle aches,loss of smell/taste, nausea, HA

Other Meds:

Current Illness:

ID: 1637063
Sex: M
Age: 19
State: KY

Vax Date: 08/02/2021
Onset Date: 08/02/2021
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: 1637064
Sex: F
Age: 62
State: CA

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

Lab Data: NONE

Allergies: NONE

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

Symptoms: DIZZINESS WITHIN THE FIRST 10 MINUTES OF INJECTION FOLLOWED BY NAUSEA AND VOMITING.

Other Meds: I DONT KNOW

Current Illness: I DONT KNOW

ID: 1637065
Sex: F
Age: 27
State: NJ

Vax Date: 01/29/2021
Onset Date: 08/15/2021
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: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose01/8/21 2nd dose01/29/21 Diagnosed covid positive:08/16/21 Symptom onset:08/15/21 Exposure:community Symptoms: fatigue,loss of smell/taste, runny nose,HA, cough, sorethroat, muscle aches

Other Meds:

Current Illness:

ID: 1637066
Sex: F
Age: 42
State: AL

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

Lab Data: None. Stayed home.

Allergies: None

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Fever 103.4 for 12 hours. Headache for 8 hours Fainting 2 times approximately 40 hours after shot. Chest pain 28 hours after shot, lasted for 12 hours, intermittently. Rapid heart rate for last 3 days since shot. Body aches and fatigue for 6-48 post shot.

Other Meds: Levothyroxine 50mcg

Current Illness: None

ID: 1637067
Sex: F
Age: 59
State:

Vax Date: 03/27/2021
Onset Date: 03/27/2021
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: Back pain, Cold sweat, Headache, Nausea, Vomiting

Symptoms: Patient had a rash develop after covid vaccination. Per doctor notes 4/5/21; Rash was red, raised, small dots over abdomen, torso, back, and axilla. Not pruritic or painful. Not similar to hives. No sors in her mouth. Rash is now completely resolved

Other Meds:

Current Illness:

ID: 1637068
Sex: F
Age: 27
State: NJ

Vax Date: 01/10/2021
Onset Date: 08/16/2021
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: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose12/2020 2nd dose01/10/21 Diagnosed covid positive:08/16/21 Symptom onset:08/16/21 Exposure:work Symptoms:loss of smell/taste, runny nose,congestion

Other Meds:

Current Illness:

ID: 1637069
Sex: F
Age: 66
State: PA

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: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: Patient requested flu vaccine, completed flu vaccine admin form, technician verified flu vaccine with patient and pharmacist verified flu vaccine with patient. After administration, patient inquired about Covid vaccine and thought that she was getting Covid vaccine.

Other Meds:

Current Illness:

ID: 1637070
Sex: F
Age: 63
State: KY

Vax Date: 03/01/2021
Onset Date: 08/22/2021
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: Patient tested positive for covid

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am