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: 1637172
Sex: F
Age: 58
State: NY

Vax Date: 08/20/2021
Onset Date: 08/20/2021
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: penicilin sulfur drugs

Symptom List: Dysphagia, Epiglottitis

Symptoms: low grade fever of 99 headache Vomiting the runs

Other Meds: multi vitamin Rinvoq- stopped day before vaccine hydroxychloroquine Atorvastatin

Current Illness: none

ID: 1637173
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: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data: none

Allergies: n/a

Symptom List: Anxiety, Dyspnoea

Symptoms: patient given third dose of Pfizer when intended dose was to be anthrax. patient second dose was may 19, 2021. patient left stable from site with no adverse reaction noted at time of discharge? patient advised to seek guidance from PCM if anything arises.

Other Meds: n/a

Current Illness: n/a

ID: 1637174
Sex: F
Age: 57
State: NV

Vax Date: 02/20/2021
Onset Date: 07/30/2021
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: eye exams, MRI scans

Allergies: Sulfa drugs, Latex, Seasonal allergies, Cats

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

Symptoms: I am struggling with double vision, currently my eye exam, went to two doctors for second opinion. My retina, optical nerve is healthy. All MRI scans performed are unremarkable. I will see a eye specialist on Monday 08-30-2021. I have been struggling with double vision for the past 4 weeks. I have not recovered from the double vision.

Other Meds: Metformin, Atorvastatin, Acetamide.

Current Illness:

ID: 1637175
Sex: M
Age: 53
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: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data:

Allergies: No

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Client was vaccinated 1st dose Pfizer at 1108, 2-3 minutes later, he stated felt his heart rate increasing. His BP 143/97 @1111, 126/88 @ 1125. He seemed calm. Released at 1145. H=

Other Meds: For Afib,, blood thinners, and for BP. Client couldn't think of the names.

Current Illness: Hypertension, Afib, and cancer survivor

ID: 1637176
Sex: F
Age: 36
State: TX

Vax Date: 07/30/2021
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: None.

Allergies: Poison oak

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

Symptoms: Cough, sore throat, sinus congestion, voice stopped working, rash all over body, itchiness. The rash and itchiness started about one week after receiving vaccine. Cough, sore throat, congestion, and loss of voice happened about one week ago. Rash has gone away, but other symptoms still persist.

Other Meds: Prenatal vitamin, vitamin D, monolukast, fluticazone.

Current Illness: Cystic fibrosis

ID: 1637177
Sex: M
Age: 38
State: TX

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

Vax Type: FLUC4
Manufacturer: SEQIRUS, INC.
Vax Name: INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT)
Lot: 276563
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data: Troponin I <0.015 on 8/25 @ 2106, at 1005 on 8/26 = 25.3 Serum Potassium of 3.1 on 8/25 @ 2106, and 4.3 on 8/26 @ 0248 Serum Magnesium = 4.1 on 8/26 @ 0248

Allergies: NKDA

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

Symptoms: Moderna COVID-19 Vaccine EUA: Patient received Moderna vaccine on 8/25/2021. Later on 8/25/2021 patient presented to ED complaining of chest pain. Chest pain started just prior to arrival, sternal pressure, non-radiating. Symptoms are associated with multiple episodes of nausea, vomiting. Patient denies fever, cough, shortness of breath. On arrival to the ED, 12 lead showed STEMi and cath lab was activated. While awaiting cath lab patient suffered a VFib arrest and was shocked and never lost pulse. He was taken to cath lab where he yet again suffered VF/VT multiple times and shocked each time with success. Patient was intubated

Other Meds:

Current Illness:

ID: 1637178
Sex: M
Age: 84
State: GA

Vax Date: 02/26/2021
Onset Date: 08/09/2021
Rec V Date: 08/26/2021
Hospital: Y

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: Patient tested positive for COVID-19 and is fully vaccinated. Patient is hospitalized due to COVID.

Other Meds:

Current Illness:

ID: 1637179
Sex: M
Age: 80
State: CA

Vax Date: 02/10/2021
Onset Date: 08/25/2021
Rec V Date: 08/26/2021
Hospital: Y

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

Lab Data: 8/25 covid pcr+ 8/25 cxr: New lingular airspace opacity suggestive of pneumonia. Recommend follow-up two-view chest radiograph in 6 weeks after appropriate therapy.

Allergies: amlodipine

Symptom List: Pharyngeal swelling

Symptoms: Admitted to hospital with COVID-19

Other Meds: flomax, norco, remeron, senna, colace, symmetrel, atropine, lipitor, proscar, metoprolol, allopurinol, aspirin

Current Illness: NA

ID: 1637180
Sex: M
Age: 55
State: FL

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: LA

Lab Data:

Allergies: Penicillin

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Minor discomfort near injection site within first thirty minutes. Discomfort increased the following morning: arm pit area, general body achiness, elevated heart rate during much of the day.

Other Meds:

Current Illness:

ID: 1637181
Sex: M
Age: 61
State: WY

Vax Date: 03/26/2021
Onset Date: 03/28/2021
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: D- Dimer 4.18 Lower leg US positive for DVT

Allergies: wasps

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Pt was seen in the office on 3/29/21 with lower leg edema . Positive D-Dimer of 4.18 and positive US for DVT

Other Meds: Losartan

Current Illness: None

ID: 1637182
Sex: M
Age: 80
State: KY

Vax Date: 03/15/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: PT. FULLY VACCINATED 2/22/21 LOT EM9810; 3/15/2021 LOT EN6198. TESTED + 8/22/2021

Other Meds:

Current Illness:

ID: 1637183
Sex: F
Age: 38
State: IL

Vax Date: 03/24/2021
Onset Date: 03/26/2021
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: Asprin, Epinephrine,

Symptom List: Rash, Urticaria

Symptoms: Two days after first covid vaccine had four days of vertigo attacks she said they started in the evening and lasted four hours.

Other Meds: Annovera, Sertraline, Triamterene-HCTZ

Current Illness: none

ID: 1637184
Sex: F
Age: 30
State: LA

Vax Date: 03/20/2021
Onset Date: 03/21/2021
Rec V Date: 08/26/2021
Hospital:

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

Lab Data: 4/26/21: Anti Sm/RNP-2.9 (standard range <1 AI) ANA- borderline

Allergies: none

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

Symptoms: The day after my second covid vaccination I had the expected body aches, neck stiffness, and joint pain. The following day, when I expected to feel better, I noticed I still had neck stiffness as well as joint pain in my fingers and wrists. I've also had fatigue since the vaccine. The neck stiffness has continued since the day after I received the vaccine. The joint pain in my hands has also continued and has spread to my elbows, shoulders, hips, knees, ankles, and toes. It is worse with increased physical activity and at night. Symptoms improve temporarily with naproxen and steroid injections. I have never previously had joint pain in my hands or neck stiffness for any other reason until March 21, 2021.

Other Meds: multi-vitamin, tylenol

Current Illness: none

ID: 1637185
Sex: F
Age: 52
State: IL

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

Lab Data:

Allergies: none

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

Symptoms: pain at injection site

Other Meds:

Current Illness: none

ID: 1637186
Sex: M
Age: 76
State: FL

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

Lab Data: None

Allergies: None

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

Symptoms: I received the Pneumonia 23 vaccine about 1 PM on 8/25/2021, and that night my arm was sore (expected), but around midnight, I had severe chills, and fever for about 8 hours, to the point that my entire body was shaking. Twenty four hours after the injection, I feel abouit 80% normal, and continuing to get better.

Other Meds: diclofenac 50 mg

Current Illness: None

ID: 1637187
Sex: F
Age: 41
State: IL

Vax Date: 07/28/2021
Onset Date: 07/29/2021
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: My doctor ran routine bloodwork and didn?t find anything abnormal. She also sent me to the eye doctor who also didn?t find anything abnormal.

Allergies: Penicillin

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

Symptoms: I have had a persistent headache for the duration of time since my first Covid shoot. I also experience nausea. I previously has Covid in March. I also am experiencing tingling of the tongue since the shot.

Other Meds: Multivitamin

Current Illness: None

ID: 1637188
Sex: F
Age: 60
State: CA

Vax Date: 01/21/2021
Onset Date: 02/18/2021
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: None

Allergies: Penicillin, Latex

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

Symptoms: 6 days after 1st dose on 1/21/21, I came down with full C-19. I was ill for 1 week and found a doctor who prescribed Ivermectin and within 2 days was nearly symptom free. I was advised to follow through with the next dose on 2/18/21 after more than 14 days symptom free. Within 6 hours of the second dose I developed a high fever and flu-like symptoms that were even worse than the C19 itself. These symptoms cleared within 36 hours. In early May I lost my sense of taste and smell, which returned quickly but was drastically distorted. Many foods taste and smell like gasoline, especially dairy and milk products. Coffee, chocolate, bread and some meats are intolerable. This has only worsened in the last few months. My doctor prescribed Flonase, but it has done nothing to help.

Other Meds: Zinc, D3, Vitamin C, Losartan 7.5mg

Current Illness: None

ID: 1637189
Sex: F
Age: 18
State: MI

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

Symptom List: Ear pain, Hypoaesthesia

Symptoms: PATIENT HAD ALREADY COMPLETED THIS SERIES, HAD VACCINE OUT OF STATE, AND I WAS UNAWARE. PATIENT HAD NO ADVERSE REACTIONS.

Other Meds: None

Current Illness: None

ID: 1637190
Sex: F
Age: 42
State: AL

Vax Date: 03/02/2021
Onset Date: 03/03/2021
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: Diagnosed in office based on symptoms and visual appearance of rash

Allergies: PCN

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: rash on left side of forehead, extending to my left eyelid and on the left side of scalp....diagnosed with Shingles

Other Meds: Zoloft 200mg 1xdaily Protonics 40 mg 1xdaily Bisoprolol 2.5 mg 2xdaily

Current Illness: None

ID: 1637191
Sex: F
Age: 43
State: FL

Vax Date: 04/01/2021
Onset Date: 06/10/2021
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: Labs and urinalysis done on 6/17/2021 at Hospital.

Allergies: Paxil Cats Grass Cockroaches

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

Symptoms: Started with dizziness and then facial drooping. Hospital was unable to identify so they sent me home. I saw my neurologist, but by then the facial drooping healed. However, I am still dizzy and experiencing nystagmus. My neurologist believes it may be some sort of palsy like Bell's, but it is unknown and we are treating it like it is with steroids. I am unsure if this is related to the vaccine, but thought I should report it anyway.

Other Meds: Plavix 75mg 1 daily Inderal ER 60mg 1 daily Prilosec 40mg daily Nystatin 100000UNT Suspension started 6/13/21 5ml 4 times daily Xanax .50mg 1 daily as needed for anxiety Tylenol#4 1 as needed for migraines Super B Complex 1 daily Biotin 100

Current Illness: None

ID: 1637192
Sex: F
Age: 41
State: HI

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

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

Symptoms: Rash, believed to be Shingles Rash, flared up two weeks after vaccination. This also occurred when I had Covid infection last year; shingles flared up two weeks after onset of illness.

Other Meds: Oral birth control pill

Current Illness: none

ID: 1637193
Sex: F
Age: 80
State: CT

Vax Date: 01/08/2021
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: Sulfa Drugs

Symptom List: Unevaluable event

Symptoms: Pt was having a headache and some throat pain and upper airway congestion.

Other Meds: Melatonin, Vitamin B-12, Vitamin B1

Current Illness: N/A

ID: 1637194
Sex: F
Age: 1
State: IA

Vax Date: 08/24/2021
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:

Allergies: none

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

Symptoms: Redness and swelling the size of patient's fist, red and painful to the touch

Other Meds: none

Current Illness: None

ID: 1637195
Sex: F
Age: 29
State: NC

Vax Date: 05/06/2021
Onset Date: 08/16/2021
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: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose04/15/21 2nd dose05/06/21 Diagnosed covid positive:08/16/21 Symptom onset:08/18/21 Exposure: Symptoms:Cough, fatigue,runny nose,HA, sore throat.

Other Meds:

Current Illness:

ID: 1637196
Sex: M
Age: 30
State: NJ

Vax Date: 01/28/2021
Onset Date: 08/18/2021
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: Injection site pain, Menorrhagia

Symptoms: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose01/07/2021 2nd dose01/28/21 Diagnosed covid positive:08/18/21 Symptom onset: Exposure: Symptoms:Asymptomatic

Other Meds:

Current Illness:

ID: 1637197
Sex: F
Age: 36
State: CO

Vax Date: 12/16/2020
Onset Date: 12/17/2020
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: na

Allergies: na

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

Symptoms: V-trac representive called me and told me to report on here. I have had a significant increase in migraine headache, 2-4 x month since my first vaccine. I have a history of chronic headache but it has gotten much worse since December. My second dose was on Jan 7, 2021 lot number EL0142. I did receive a booster shot on 8/23/2021 lot # EW0187

Other Meds: levothryoxin 100mcg tab daily

Current Illness: na

ID: 1637198
Sex: F
Age: 34
State: NY

Vax Date: 01/27/2021
Onset Date: 08/17/2021
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: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose01/07/21 2nd dose01/27/21 Diagnosed covid positive:08/19/21 Symptom onset:08/17/21 Exposure:Travel Symptoms:fever, cough,fatigue,muscle aches, sore hroat,loss of smell/taste, chills,runny nose,HA

Other Meds:

Current Illness:

ID: 1637199
Sex: F
Age: 46
State: NJ

Vax Date: 01/08/2021
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: 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 12/21/21 2nd dose01/08/21 Diagnosed covid positive:08/19/21 Symptom onset:08/17/21 Exposure: Symptoms:sneezing.

Other Meds:

Current Illness:

ID: 1637200
Sex: M
Age: 86
State: MN

Vax Date: 02/25/2021
Onset Date: 08/25/2021
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:

Allergies:

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

Symptoms: Received Moderna vaccines on 1/28/21, 2/25/21 Tested positive for COVID on 8/25/21. Admitted toHospital on 8/25/21, to ICU for 1 day, transferred to floor 8/26. 3 day h/o DOE, orthopnea, mild cough, mild fever

Other Meds:

Current Illness:

ID: 1637201
Sex: F
Age: 28
State: NY

Vax Date: 01/20/2021
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: RA

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose12/30/20 2nd dose01/20/21 Diagnosed covid positive:08/19/21 Symptom onset:08/17/21 Exposure:travel Symptoms:fever, cough, muscle aches,diarrhea, chills HA

Other Meds:

Current Illness:

ID: 1637202
Sex: F
Age: 28
State: MN

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: vitals taken

Allergies: none on file

Symptom List: Injection site pain

Symptoms: The patient received her 2nd Pfizer dose. Approximately 10 mins after administration, she started to feel dizzy. She came to the pharmacy window and told one of the technicians that she is feeling dizzy. She was helped to sit down in the chair. She passed out for a moment. When I came up to her, she seemed a little pale but said that she was feeling better. She was given water to drink. 911 was called and EMT team took her vitals. She felt much better and refuzed to go to the hospital. Her husband arrived to give her a ride home.

Other Meds:

Current Illness:

ID: 1637203
Sex: F
Age: 29
State: NY

Vax Date: 01/08/2021
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:

Allergies:

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

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

Other Meds:

Current Illness:

ID: 1637204
Sex: F
Age: 31
State: AK

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: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Amoxicillin

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

Symptoms: Perceived right side facial numbness directly after vaccination. No apparent facial weakness/asymmetry. No signs of anaphylaxis. spO2 99% on room air, pulse 52 bpm, BP 108/72, resp 12 bpm. Monitored for extended period, symptoms improved. Allowed to leave with ER precautions and to call if symptoms persist.

Other Meds:

Current Illness:

ID: 1637205
Sex: F
Age: 43
State: IL

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: none

Allergies: Aspirin

Symptom List: Tremor

Symptoms: Patient was administered her Pfizer Covid 19 vaccination and waited 30 mins after dosage. Patient phoned the facility nurse describing left side throat swelling and nasal discomfort 15 mins after leaving the facility and headed home. Nurse then told patient to a Benadryl for the reaction. The follow up with the Physician patient denied any continued swelling or discomfort 30mins after; she was advised to take another Benadryl if it returned and to contact the Emergency Department.

Other Meds: Levothyroxine MiraLax TriLoEstarylla

Current Illness: none

ID: 1637206
Sex: M
Age: 49
State: NY

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

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose02/15/21 2nd dose03/08/21 Diagnosed covid positive:08/20/21 Symptom onset: Exposure: Symptoms:Asymptomatic

Other Meds:

Current Illness:

ID: 1637207
Sex: F
Age: 33
State: NY

Vax Date: 01/27/2021
Onset Date: 08/13/2021
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: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose01/06/21 2nd dose01/27/21 Diagnosed covid positive:08/20/21 Symptom onset:08/13/21 Exposure: Symptoms:SOB,fatigue,COUGH, loss of smell/taste, runny nose,HA

Other Meds:

Current Illness:

ID: 1637208
Sex: M
Age: 12
State:

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

Lab Data:

Allergies: None

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

Symptoms: Erythema and pain to the right arm

Other Meds: None

Current Illness:

ID: 1637209
Sex: F
Age: 45
State: GA

Vax Date: 05/14/2021
Onset Date: 06/01/2021
Rec V Date: 08/26/2021
Hospital:

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

Lab Data: Visit on 07/12/21. X-Rays taken, came normal.

Allergies: None

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Severe Back pain after 2 weeks of first dose of Vaccination.Took Ibuprofen for 3 days.

Other Meds: None. Vitamin Supplements B-12

Current Illness: None

ID: 1637210
Sex: F
Age: 31
State: NY

Vax Date: 02/22/2021
Onset Date: 08/20/2021
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: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose02/01/21 2nd dose02/22/21 Diagnosed covid positive:08/20/21 Symptom onset:08/20/21 Exposure: Symptoms:sorethroat

Other Meds:

Current Illness:

ID: 1637211
Sex: M
Age: 44
State: WA

Vax Date: 03/21/2021
Onset Date: 03/30/2021
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: Pain in abdomen, Lipase levels around 1300. No CT scan and ultrasound couldn't see pancreas. 2 CT scans since (May and July) and both show pancreas to be unremarkable.

Allergies: Allergic to gold

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

Symptoms: Acute Pancreatitis.

Other Meds: Had been taking metoprolol succinate on a daily basis but stopped taking it couple weeks prior to vaccine.

Current Illness: Still have lingering smell issues confirmed COVID on 02/22/2020

ID: 1637212
Sex: M
Age: 42
State: NY

Vax Date: 04/14/2021
Onset Date: 08/14/2021
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: Pain in extremity

Symptoms: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose03/24/21 2nd dose04/14/21 Diagnosed covid positive:08/20/21 Symptom onset:08/14/21 Exposure:community Symptoms: fatigue,loss of smell/taste, sore throat.

Other Meds:

Current Illness:

ID: 1637213
Sex: F
Age: 56
State: NV

Vax Date: 01/08/2021
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: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: Keflex Latex

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

Symptoms: Circular rash

Other Meds:

Current Illness: Somatatostatinoma

ID: 1637214
Sex: M
Age: 34
State: NY

Vax Date: 01/27/2021
Onset Date: 08/18/2021
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: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose01/06/21 2nd dose01/27/21 Diagnosed covid positive:09/20/21community Symptom onset:08/18/21 Exposure:community Symptoms:fever, fatigue,muscle aches, loss of smell/taste, chills, runny nose

Other Meds:

Current Illness:

ID: 1637215
Sex: F
Age: 40
State: WA

Vax Date: 02/24/2021
Onset Date: 02/01/2021
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: NKDA

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

Symptoms: Extreme swelling of upper arm, Fever, Body aches, headache (resolved) FATIGUE is the most concerning - has become chronic now -it is overwhelming and never went away!

Other Meds: Loryna OCP

Current Illness: None

ID: 1637216
Sex: F
Age: 38
State: NY

Vax Date: 01/13/2021
Onset Date: 08/19/2021
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 dose12/23/21 2nd dose01/13/21 Diagnosed covid positive:08/21/21 Symptom onset:09/19/21 Exposure: Symptoms:fever, cough, muscle aches,diarrhea,fatigue, chills,runny nose,HA

Other Meds:

Current Illness:

ID: 1637218
Sex: F
Age: 44
State: NC

Vax Date: 08/17/2021
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:

Allergies: N/A

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Covid Arm. It began itching the evening of 8/24 and when I woke up the AM of the 25th, I had a medium sized rash surrounding my injection site. It is puffy, slightly itchy and red. I also have pain in my left elbow, which I believe is related to this.

Other Meds: Daily Women's Vitamin

Current Illness: N/A

ID: 1637219
Sex: F
Age: 25
State: NJ

Vax Date: 03/05/2021
Onset Date: 08/19/2021
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: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose02/12/2021 2nd dose03/05/2021 Diagnosed covid positive:08/19/21 Symptom onset:08/21/21 Exposure:Home Symptoms:Cough, muscle aches, sore throat,runny nose, HA.

Other Meds:

Current Illness:

ID: 1637220
Sex: M
Age: 52
State: NV

Vax Date: 06/12/2021
Onset Date: 06/15/2021
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: Blood Test: 6/17/2021, 6/24/2021, 7/8/2021, Vitamin D Deficient, negative for Covid 19 x-ray: 7/8/2021 non conclusive MRI: 8/12/2021 of Brain, results - 8/16/2021 negative

Allergies: None

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Entire Joint Pain 6/15/2021 throughout physical body, achy, stiffness, sore, feeling very arthritic Seen at Urgent Care on the following dates: 6/17/2021, 06/24/2021 and 6/30/2021 Upon Completion of consecutive Steroid treatment soreness on the left side of extremities subside to more dull pain, but right side still exert stiffness, soreness. NO SWELLING of Joints apparent. Blood Work ordered and completed on the following dates: 6/18/2021, 6/24/2021 and 7/8/2021 Seen by Primary Care Physician on 7/8/21, 7/16/21 and 8/16/21 X ray taken of Lower extremities on 7/8/21 Prescribed: Ibuprofen 800 mg, Hydrocodone, and 1x a week dose of Vitamin D Referred to Rheumatologist, appointment not scheduled until 10/08/2021 is earliest appointment set

Other Meds: Vitamin C 2000 mg.

Current Illness: None

ID: 1637221
Sex: F
Age: 32
State: IN

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: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None.

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

Symptoms: Rash. Hives over the entire body, healthcare provider told patient it was an allergic reaction. Takes Benadryl.

Other Meds: None.

Current Illness:

ID: 1637222
Sex: M
Age: 34
State: WI

Vax Date: 04/20/2021
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:

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

Symptoms: Received Moderna vaccines on 3/13/21, 4/10/21 Tested positive for COVID by PCR on 8/25/21 Admitted to ICU on 8/25/21, intubated. Medical comorbidities include alcoholic liver cirrhosis a/p TIPS (2020), Type 2 Diabetes COVID pneumonia, liver failure.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am