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: 1651224
Sex: M
Age: 15
State: KY

Vax Date: 08/28/2021
Onset Date: 08/28/2021
Rec V Date: 08/28/2021
Hospital:

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

Lab Data: n/a

Allergies: none

Symptom List: Dysphagia, Epiglottitis

Symptoms: Patient was kind of nervous before receiving the vaccine. He felt lightheaded while waiting his 15 minutes after receiving the vaccine. He began to feel nauseous and then vomited once. Blood pressure was 106/61, heart rate was 87, O2 was 99. Patient was cooled with an ice pack and give water to sip. After 30 minutes he began to cool down and the nausea went away. He was also given 1 25 mg tablet of diphenhydramine.

Other Meds: 50 mg zinc daily

Current Illness: none

ID: 1651225
Sex: F
Age: 41
State: NJ

Vax Date: 08/27/2021
Onset Date: 08/27/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Anxiety, Dyspnoea

Symptoms: Severe nausea and migraine type headache, OTC acetaminophen and ibuprofen not helping.

Other Meds: None

Current Illness: None

ID: 1651226
Sex: F
Age: 36
State: WI

Vax Date: 08/01/2021
Onset Date: 08/01/2021
Rec V Date: 08/28/2021
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: Doxycycline Penicillin Bactrim

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

Symptoms: Body aches/pains for two and a half days Nausea for one day

Other Meds: Nuvaring Lamictal Wellbutrin Xanax Herbs Advil

Current Illness:

ID: 1651227
Sex: F
Age: 43
State: MD

Vax Date: 03/16/2021
Onset Date: 03/23/2021
Rec V Date: 08/28/2021
Hospital:

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

Lab Data:

Allergies: Never had any allergies in my life.

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: I have been bleeding every day since right after I received the vaccine. There has not been a day since march that I do not have to wear a tampon or pad to protect my clothing. It is ridiculous and I just want it to stop. How long is this going to last?

Other Meds: I only take vitamins.

Current Illness: I am overall very healthy, rarely am sick. I may have been sick 5 times in my life.

ID: 1651228
Sex: F
Age: 85
State:

Vax Date: 08/24/2021
Onset Date: 08/24/2021
Rec V Date: 08/28/2021
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: pt had rash around injection site and itched for 24 hours, then redness remained.. no swelling, or warm to the touch

Other Meds:

Current Illness:

ID: 1651229
Sex: F
Age: 48
State: MD

Vax Date: 08/27/2021
Onset Date: 08/27/2021
Rec V Date: 08/28/2021
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: Antibiotics, some kind of rubberized material

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

Symptoms: Chills, too much dizziness that I can hardly get up, nausea, fatigue

Other Meds: None

Current Illness: None

ID: 1651231
Sex: F
Age: 42
State: FL

Vax Date: 08/14/2021
Onset Date: 08/26/2021
Rec V Date: 08/28/2021
Hospital:

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

Lab Data: Regular examination of ears and throat and vitals at minute clinic on 8/27/21 referred to er for ct scan

Allergies: None

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: After third shot have severe pain behind left ear in head. Intermittently. Pain at injection site 12 days after injection

Other Meds: Cimzia, arava, Celebrex, prednisolone ophthalmic, tomolol, multivitamin

Current Illness: Rheumatoid arthritis, sarcoidosis, glaucoma, fibromyalgia, others

ID: 1651232
Sex: F
Age: 81
State: GA

Vax Date: 08/17/2021
Onset Date: 08/18/2021
Rec V Date: 08/28/2021
Hospital: Y

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

Lab Data: ECG, ct, mri echocardiogram, blood tests, urine tests

Allergies: Pi

Symptom List: Pharyngeal swelling

Symptoms: Fever 104.7, loss of consciousness, high heart rate, low sodium, cardiac ischemia

Other Meds: Pyridostigmine, lamotrigine, prednisone, memantine, mirabegron, losartan, amlodipine, potassium, D-3, B complex, aspirin 81, calcium

Current Illness:

ID: 1651233
Sex: F
Age: 54
State: NC

Vax Date: 08/20/2021
Onset Date: 08/28/2021
Rec V Date: 08/28/2021
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: Red rash on my upper right arm near where shot was administered. Swollen as well. Feels hot, slightly itchy, and sore. Rash measures about one inch by one inch.

Other Meds: Vitamin D, Lipitor, Fenofibrate

Current Illness: None

ID: 1651234
Sex: F
Age: 67
State: MI

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: none

Allergies: Versed, TB. Skin test serum, flu vaccine, strawberries(calf.) walnuts, latex, nitrile gloves, environmental, mulberry trees, almonds, over ripe bannas

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Started to have extra oral secretions under my tongue followed by sides of mouth followed by a metal taste which lasted about 25 minutes. The next day I could not taste anything. This lasted about 48 hours.

Other Meds: Singular, Zoloft, Mult. Vitamins, magnisium, prilosec,Advair, xopenex

Current Illness: none

ID: 1651235
Sex: F
Age: 64
State: TX

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 08/28/2021
Hospital:

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

Lab Data:

Allergies: Succinylcholine dilaudid tetanus toxoid

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

Symptoms: ICU nurse appointed to me form 1 hour due to adverse reaction on 1st dose. 15 minutes post injection, she noticed my voice changing, asked to take drink some water. Unable to completely swallow without choking. All within the next 30 minutes, diaphoretic, unable to clearly compose thoughts, somewhat lethargic, itching and linear hives on arms .Slight increased pulse normal respirations. Within 2 hours of shot, headache and fever. followed by exhaustion, extreme vertigo with unsteady gait, severe chills and fever reached 101. that lasted close to 12 hours.

Other Meds: 10 mg Benadryl 30 minutes prior to vaccine Routine meds - Climara patch, Singular ,Synthroid

Current Illness: Adverse reaction to dose 1 Moderna 12/31/2020 VAERS ID: 931917 E-Report Number: 230174

ID: 1651236
Sex: F
Age: 80
State: IN

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

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

Lab Data: none

Allergies: None

Symptom List: Rash, Urticaria

Symptoms: Chills and Fever 100.1 lasting 9 or 10 hours the evening of shot. Headache and joint pain. Tiredness lasting next day & day after. Took Tylenol every 6 hours.

Other Meds: Amiodipine,Atorvastatin,Bisoprol , Pantoprazole, Ciphalexin, Brudesonide/Formoterol Fumarate Dihydrate inhaler, ProAir HFA, vitamin D-3, Ecotrin 81 MG, Folic Acid, Centrum silver for women.

Current Illness:

ID: 1651237
Sex: F
Age: 41
State: TN

Vax Date: 08/25/2021
Onset Date: 08/26/2021
Rec V Date: 08/28/2021
Hospital:

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

Lab Data: No

Allergies: Ibu and Latex

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

Symptoms: Arm sore for one day, for three days I have ran a temperature (101) every six to eight hours I've had to take tylenol, I'm weak, my body aches, I've had a severe headache, a slight runny nose, a slight cough, and a runny nose, and my hands have a tingling feeling.

Other Meds: No

Current Illness: No

ID: 1651238
Sex: F
Age: 36
State: FL

Vax Date: 08/27/2021
Onset Date: 08/27/2021
Rec V Date: 08/28/2021
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: NKA

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

Symptoms: Metallic taste in mouth, tiredness, muscle fatigue.

Other Meds: Ibuprofen for body aches, but it was taken after metallic taste.

Current Illness: Covid

ID: 1651239
Sex: F
Age: 38
State: IL

Vax Date: 08/27/2021
Onset Date: 08/28/2021
Rec V Date: 08/28/2021
Hospital:

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

Lab Data:

Allergies: Aspirin

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

Symptoms: Sever stomach pain began 9 am

Other Meds: Xyzal flonase

Current Illness:

ID: 1651240
Sex: F
Age: 39
State: PR

Vax Date: 04/05/2021
Onset Date: 04/05/2021
Rec V Date: 08/28/2021
Hospital:

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

Lab Data: GYNECOLOGY EVALUATION AND LABS DONE

Allergies:

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

Symptoms: INCREASED MENSTRUAL BLEEDING

Other Meds:

Current Illness:

ID: 1651241
Sex: F
Age: 40
State: CA

Vax Date: 07/13/2021
Onset Date: 07/15/2021
Rec V Date: 08/28/2021
Hospital:

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

Lab Data: Had labs done Aug 3, 26, and 27. High in Eosinophils.

Allergies: Acetominophin

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

Symptoms: 2 days after receiving the vaccine, my left side of my chest started hurting with pain, pressure, and I went in to the ER thinking I was having a heart attack. The doctor said that I was having inflammation in my chest wall from the vaccine and to get rest. Periocardidis? For two months now I have had constant pain on my left side of my chest that won't go away.

Other Meds: None

Current Illness: None

ID: 1651242
Sex: F
Age: 65
State: OH

Vax Date: 08/27/2021
Onset Date: 08/28/2021
Rec V Date: 08/28/2021
Hospital:

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

Lab Data:

Allergies: shrimp, seafood

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Patient reports pain in entire left arm, not just at the injection site. Difficult to move arm.

Other Meds: unknown

Current Illness: not known

ID: 1651243
Sex: F
Age: 86
State: GA

Vax Date: 01/24/2021
Onset Date:
Rec V Date: 08/28/2021
Hospital:

Vax Type: PNC13
Manufacturer: PFIZER\WYETH
Vax Name: PNEUMO (PREVNAR13)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies: Codeine, Morphine

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: 1st injection, patient felt what she thought was the needle hitting her bone. 2 days later, deep pain, no skin reaction. Sore at injection site. Pain lasted about 2 weeks. 2nd injection, pain worse, and has continued with progressive swelling of anterior upper arm and shoulder. Swelling is tender, not hot, feels firm, no evidence of fluid. This has continued from February until now, Aug. 28, 2021. Pain has gotten so bad it is interfering with sleep. Would a course of prednisone help? Your questionsire does not fit our problem. This was not an acute obvious allergic reaction. I am her husband, and a retired M.D. (pediatrician). We need your advice and help. Thanks.

Other Meds: Ibuprofen, Lidocaine Skin Patches

Current Illness: None

ID: 1651244
Sex: M
Age: 35
State: FL

Vax Date: 08/23/2021
Onset Date: 08/24/2021
Rec V Date: 08/28/2021
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: Brain Fog, persistent difficulty concentrating/focusing even after sleep within 16 hours of vaccination. Dizziness, Lasting fatigue, burning/dry eyes, strange seemingly random body cramps even with high fluid intake and rest.

Other Meds: none

Current Illness: none

ID: 1651245
Sex: F
Age: 40
State: TX

Vax Date: 08/10/2021
Onset Date: 08/16/2021
Rec V Date: 08/28/2021
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: none

Allergies: None that I am aware of

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

Symptoms: Normal side effects immediately after injection. From 8/10 to 8/16 weight loss of 17 lbs with no changes to diet or activity level. On 8/16 started spotting, which lasted 7 days, then after starting, 1 day of clotty heavy flow, 2 days of abnormal light flow and still spotting as of today 8/28. I normally have EXTREMELY HEAVY periods that are painful. I normally have to wear adult diapers due to how heavy they are. It definitely changed my cycle, honestly for the better.

Other Meds: None

Current Illness: None

ID: 1651246
Sex: F
Age: 37
State: IL

Vax Date: 08/28/2021
Onset Date: 08/28/2021
Rec V Date: 08/28/2021
Hospital:

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

Lab Data: N/A

Allergies: Sulfa

Symptom List: Unevaluable event

Symptoms: Patient fainted, was out for about 10-15 seconds. When she came to she knew where she was as well as the day. She appeared sweating and pale at first, a few minutes later after have some water and gatorade her appearance was back to normal

Other Meds:

Current Illness: No

ID: 1651247
Sex: F
Age: 38
State: FL

Vax Date: 08/26/2021
Onset Date: 08/26/2021
Rec V Date: 08/28/2021
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: Rapid beating heart, shortness of breath, chest pain

Other Meds: Estradiol

Current Illness: None

ID: 1651248
Sex: M
Age: 52
State: AR

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

Symptom List: Injection site pain, Pain

Symptoms: 1. Severe pain at injection site radiating to right fingers 2. Prostatitis flared up within 24 hours of receiving vaccine 3. General malaise 4. Elevated temperature of under 100 degrees F

Other Meds:

Current Illness: none

ID: 1651249
Sex: F
Age: 36
State: MO

Vax Date: 08/02/2021
Onset Date: 08/04/2021
Rec V Date: 08/28/2021
Hospital:

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

Lab Data: 8/17: X-Ray on right knee. My doctor indicated that it showed there was fluid build-up above the kneecap.

Allergies: None

Symptom List: Injection site pain, Menorrhagia

Symptoms: I received my 2nd dose of Pfizer COVID-19 on Monday, 8/2. When I woke up on Wednesday, 8/4, my right knee was very, very stiff - I couldn't bend it past 90 degrees. For the next week, I experienced stiffness, but by Saturday, 8/14, I felt that the knee was better. However, I woke up on Monday, 8/16 and could barely move my leg due to the extreme stiffness - and this time, the knee was visibly swollen as well. I went to my primary care physician on 8/17 and got an X-Ray the same day. I saw an orthopedist on 8/18. There was liquid pooled above the kneecap. The orthopedist recommended compression, icing, and anti-inflammatory meds. Within a few days, the swelling and stiffness had improved, although as of today (8/28) I am still experiencing some swelling and stiffness. After the first COVID-19 vaccine (administered 7/12) I also experienced knee stiffness, although not to the same degree. I also didn't correlate it with the COVID-19 vaccine so I did not note the exact date the knee stiffness started - however, I am confident that it began after the first dose of the vaccine. I have never had knee stiffness/swelling like this before.

Other Meds: Levothyroxine 50 mcg

Current Illness: None

ID: 1651250
Sex: F
Age: 12
State: AL

Vax Date: 08/22/2021
Onset Date: 08/22/2021
Rec V Date: 08/28/2021
Hospital:

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

Lab Data: Doctor did not take any samples.

Allergies: Latex avoidance due to Spina Bifida

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

Symptoms: Triggered Chicken Pox. Doctor said it is not the first case he has seen triggered after a child received their Covid vaccine. Currently the chicken pox are mild. Will miss school due to them.

Other Meds: None

Current Illness: None

ID: 1651251
Sex: F
Age: 32
State: CA

Vax Date: 08/25/2021
Onset Date: 08/26/2021
Rec V Date: 08/28/2021
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: N/A

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Chilies

Other Meds: Keppra Vimpact

Current Illness: Seizure

ID: 1651252
Sex: M
Age: 22
State: MD

Vax Date: 05/09/2021
Onset Date: 08/08/2021
Rec V Date: 08/28/2021
Hospital: Y

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

Lab Data: Hospitalized from Aug 16, 2021 - Aug 18, 2021 with stomach pains that lead to diagnosis

Allergies: none

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: 3 months after 2nd vaccination of COVID-19 Pfizer diagnosed with Type 1 Diabetes

Other Meds: none

Current Illness: none

ID: 1651253
Sex: M
Age: 39
State: SC

Vax Date: 08/27/2021
Onset Date: 08/27/2021
Rec V Date: 08/28/2021
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: no adverse even, but the dose was give at 21 days interval instead of 28 days interval as recommended by cdc. pt is in good health and condition

Other Meds:

Current Illness:

ID: 1651254
Sex: F
Age: 54
State: CO

Vax Date: 04/13/2021
Onset Date: 04/13/2021
Rec V Date: 08/28/2021
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: Nausea

Symptoms: Fever, chills, nausea, ringing in my ears, and injection site sore for weeks

Other Meds:

Current Illness: None

ID: 1651255
Sex: F
Age: 62
State: SC

Vax Date: 04/12/2021
Onset Date: 04/12/2021
Rec V Date: 08/28/2021
Hospital:

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

Lab Data: None

Allergies: Red and yellow food dyes, artificial sweetener, dairy

Symptom List: Injection site pain

Symptoms: Swollen and painful injection site, fever 100 , dizziness, fatigue , lethargy, ,sharp back pain

Other Meds: Lisinopril, Amlodipine, Duloxetine, flexeril, probiotic, baby aspirin

Current Illness:

ID: 1651256
Sex: M
Age: 12
State: UT

Vax Date: 08/24/2021
Onset Date: 08/25/2021
Rec V Date: 08/28/2021
Hospital:

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

Lab Data:

Allergies: amoxicillin; sulfa drugs

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

Symptoms: fever, aches, headache, fatigue

Other Meds:

Current Illness:

ID: 1651257
Sex: F
Age: 58
State: WI

Vax Date: 06/08/2021
Onset Date: 06/09/2021
Rec V Date: 08/28/2021
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: gluten, wheat, shellfish, cleosin,

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

Symptoms: Extreme chills, broke out in hives on arms and legs, vertigo, ringing in ears, blurred vision.

Other Meds: Vitamins, minerals

Current Illness:

ID: 1651258
Sex: F
Age: 31
State:

Vax Date: 12/29/2020
Onset Date: 08/24/2021
Rec V Date: 08/28/2021
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: Positive for covid 19

Other Meds:

Current Illness:

ID: 1651259
Sex: F
Age: 51
State: WA

Vax Date: 08/01/2021
Onset Date: 08/28/2021
Rec V Date: 08/28/2021
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: Erythema, Pruritus

Symptoms: Severe tinnitus in right ear. I have no history of this. It occurred three days after my second Pfizer shot.

Other Meds: None

Current Illness: None

ID: 1651260
Sex: F
Age: 38
State: FL

Vax Date: 08/27/2021
Onset Date: 08/28/2021
Rec V Date: 08/28/2021
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

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

Symptoms: Chills, muscle aches, bone pain, headache

Other Meds: Busiperone 10mg

Current Illness: None

ID: 1651261
Sex: M
Age: 68
State: NC

Vax Date: 08/16/2021
Onset Date: 08/25/2021
Rec V Date: 08/28/2021
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 yet except home pulse oximeter results crosschecked with a second pulse oximeter.

Allergies: PCN

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

Symptoms: Don't know when it actually started but.. used my wife's pulse oximeter on Wednesday evening on date previously given (she has Hypoxemia and a number of other health problems and also may have had a more dramatic adverse event after her third shot). I was feeling very slightly short of breath. My oxygen saturation was 75. We monitored it the rest of the evening and I used some of her supplemental oxygen to get it back up. This is Saturday and I have been checking my oxygen saturation periodically since Wednesday. Though I don't feel symptomatic, my O2 levels are routinely 90-93. They have been as low as 75-85. I had no problems with the first two shots except a sore arm and brief flu-like aches. I had that with shot #3 for only about maybe 5 hours. I got all three shots in the left arm. The first two were from my local Health Dept. I have a Primary Care Physician appointment in about 10 days and plan to mention it then unless I have to address it elsewhere first.

Other Meds: (This was third Pfizer injection. #1 was 02/08/21 and #2 was 03/01/21.) Levothyroxine 0.125mcg a day. Plaquinil/Hydroxychloroquine (for Rheumatoid Arthritis) 200mg twice a day. Prescribed Vitamins: D3 4000U, B12 1000U & K 100mcg daily. OTC

Current Illness: None

ID: 1651262
Sex: F
Age: 32
State: CA

Vax Date: 08/23/2021
Onset Date: 08/23/2021
Rec V Date: 08/28/2021
Hospital:

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

Lab Data: Ultrasound. 08/27/21 - no abnormalities

Allergies: None known

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Extreme dizziness, mental fog, and abnormal heavy uterine bleeding and shedding of clots, began to notice spotting 30-60 minutes post-vaccine, bleeding has grown progressively worse. 5 weeks postpartum, exclusively breastfeeding, no menstruation should be happening at this time. Arm became very itchy 5 hours post-vaccine, itching improved but continues to be mildly itchy.

Other Meds: None

Current Illness: None

ID: 1651263
Sex: M
Age: 36
State: VA

Vax Date: 08/26/2021
Onset Date: 08/27/2021
Rec V Date: 08/28/2021
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: None

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

Symptoms: Fever, chills, muscle aches, nausea, vomiting, constipation, mood swings, depression, suicidal thoughts

Other Meds: Cymbalta, 30 mg

Current Illness: Major Depression

ID: 1651264
Sex: F
Age: 59
State: OR

Vax Date: 08/27/2021
Onset Date: 08/27/2021
Rec V Date: 08/28/2021
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: Fever of 99.4 the evening of the vaccine; and a fever of 101.2 the next morning. Nausea

Other Meds: Dentist prescribed Ibuprofen for a toothache (600 mg) three times a day on 8/26, I took it at lunch and dinne8/26 and breakfast the day of the 3rd vaccine. I completely forgot that it was a bad idea.

Current Illness:

ID: 1651265
Sex: F
Age: 49
State: IN

Vax Date: 08/13/2021
Onset Date: 08/21/2021
Rec V Date: 08/28/2021
Hospital:

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

Lab Data:

Allergies: n/a

Symptom List: Pain in extremity

Symptoms: Swollen, hot vaccination site. Rash, numbness in arm. Heart palpitations.

Other Meds: n/a

Current Illness: n/a

ID: 1651266
Sex: F
Age: 48
State: ME

Vax Date: 08/27/2021
Onset Date: 08/27/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: None

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

Symptoms: The second she injected the vaccine I got a sting metal taste in my mouth. This is day number 2 and I still have the metal taste.

Other Meds: Ms contin

Current Illness: None

ID: 1651267
Sex: F
Age: 38
State: MT

Vax Date: 08/25/2021
Onset Date: 08/27/2021
Rec V Date: 08/28/2021
Hospital:

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

Lab Data: EKG - SINUS RYTHMN BLOOD GLUCOSE - LOW NORMAL

Allergies: DARVON

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

Symptoms: 9:00 AM - TOUNGE STARTED FEELING NUMB 10:00 AM - TOUNGE CONTINUED TO FEEL NUMB AND A SWELLING FEELING STARTED 11:00 AM - TOUNGE CONTINUED TO FEEL NUMB AND STARTED FEELING SIGNIFICANTLY LARGER 11:30 - FAINTING OCCURED WHILE PATIENT WAS LAYING FLAT ON FLOOR NOON - TRANSPORTED TO HOSPITAL 1PM - EKG, BLOOD GLUCOSE PERFORMED - PATIENT RECIEVED BENEDRYL AND ORAL HYDRATION 1:30 PM - PATIENT FELT SWELLING WAS SUBSIDING BUT NUMBNESS STILL OCCURING 2PM - PATIENT STATED SWELLING AND NUMBNESS WAS GONE REMAINED IN OBSERVATION 5PM - DISCHARGED FROM ER

Other Meds: YAZ

Current Illness: NONE

ID: 1651268
Sex: M
Age: 42
State: MA

Vax Date: 08/27/2021
Onset Date: 08/27/2021
Rec V Date: 08/28/2021
Hospital:

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

Lab Data: Blood pressure taken twice- normal

Allergies:

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

Symptoms: Pt said that sometimes he faints after vaccine. He was instructed to wait an extra 15 min in addition to the already 15 min required. After about 5 min he felt sick. We gave him water and asked if he would like us to call 911. He declined. He was given water multiple times and his blood pressure was taken twice and came amount normal. Pt was still feeling sick after some time so we called 911 and ems arrived. He was alert and talking on his phone the entire time.

Other Meds:

Current Illness:

ID: 1651269
Sex: F
Age: 37
State: AR

Vax Date: 08/16/2021
Onset Date: 08/27/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data: none at this point

Allergies: none

Symptom List: Vomiting

Symptoms: Red raised area below injection site, no itching, no evidence of bug bite, not warm or painful. Located in the exact same place as primary post-injection pain was located. No treatment given 8/27/21 was about 1 inch diameter, 8/28/21 is 2 inches by 1 inch Currently 32 weeks pregnant, due 10/21/21, no complications with pregnancy

Other Meds: Prenatal vitamin Probiotic Elderberry syrup Magnesium supplement

Current Illness: none

ID: 1651270
Sex: M
Age: 56
State: VA

Vax Date: 05/14/2021
Onset Date: 05/17/2021
Rec V Date: 08/28/2021
Hospital: Y

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

Lab Data: Ultrasound confirmation. Surgical intervention needed.

Allergies: NKDA

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Arterial and Venous blood clots7.29.2021

Other Meds: None

Current Illness: None

ID: 1651271
Sex: F
Age: 55
State: IL

Vax Date: 08/13/2021
Onset Date: 08/28/2021
Rec V Date: 08/28/2021
Hospital:

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

Lab Data: None at this time

Allergies: None

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

Symptoms: Dizziness 15 minutes post vaccination, soreness & swelling at site for 2 hours, severe exhaustion after 3 hours, achiness all over body after 4 hours, chills after 8 hours, leg & back pain between shoulder blades as well as ankles and right wrist for 48 hours with continued exhaustion. Intermittent hand numbness for 72 hours. 15 days post vaccine new spider veins in legs as well as worsening pre existing spider veins with moderate leg pain.

Other Meds: Vitamin D, Vitamin C, Vitamin B12, Zinc

Current Illness: None

ID: 1651273
Sex: F
Age: 22
State: TX

Vax Date: 08/27/2021
Onset Date: 08/27/2021
Rec V Date: 08/28/2021
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: 128/80, BP, 97 , HR 100% , Respiration 18

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Patient claims to feel light headed , shaking, and body feels hot. Patient mentioned she hasn't ate or drank anything since last night. Vitals where taken see below. Patient declined transport to hospital.

Other Meds:

Current Illness:

ID: 1651274
Sex: F
Age: 63
State: FL

Vax Date: 03/23/2021
Onset Date: 04/30/2021
Rec V Date: 08/28/2021
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: A red rash developed across my eyes. It had swelling and itching, a type of eczema that lasted about 10 days and would return in about 10 days.

Other Meds: ibuprofen 200mg, Atorvastatin 20mg, Calcium with Vit. D3 600 mg (2 times a day)

Current Illness: none

ID: 1651275
Sex: F
Age: 24
State:

Vax Date: 02/17/2021
Onset Date:
Rec V Date: 08/28/2021
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: None stated.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am