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: 1651326
Sex: M
Age: 34
State: PR

Vax Date: 08/06/2021
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: NKA

Symptom List: Dysphagia, Epiglottitis

Symptoms: Paramedic reports patient feeling dizzy and sweaty. VS are manually taken with values BP 97/70, P-62 and o2-99. Patient lies down and legs are raised. Doctor R. is notified. He's left in observation. Patient responds to treatment, VS are retaken BP 112/80, P-75, o2-99. Patient leaves the clinic with his wife oriented X3.

Other Meds: N/A

Current Illness: N/A

ID: 1651327
Sex: F
Age: 55
State: MI

Vax Date: 02/08/2021
Onset Date: 02/09/2021
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: Bloodwork just happened to take place 7 days after I received the injection . My liver function was way off, compared to my normal. My ATL value and Albumin levels were both way off. So, a few blood test were repeated on day 9 and my results were farther off! So, my doctor ordered ultrasound imaging of my liver, spleen, and pancreas, which all looked normal. My blood work was repeated about 6 weeks after the injection and everything was back to normal.

Allergies: Tamoxifen, codeine

Symptom List: Anxiety, Dyspnoea

Symptoms: Major muscle aches the next morning and throughout that first day. Days 3 -10 Swollen Face, yellowing of eyes, blurred vision, watery/goopy eyes in the morning, metallic taste for most of these days, and really bad, smelly gas for over 2 weeks! To this day, I still have yellowing in my left eye and it is watery/sticky and goopy every day when I wake.

Other Meds: Gabapentin, daily vitamin, Vitamin C, Vitamin D, Calcium, probiotics,

Current Illness: none

ID: 1651328
Sex: F
Age: 17
State: MI

Vax Date: 08/28/2021
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: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: None

Allergies: unknown

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

Symptoms: Patient started to feel light headed and hot 3-5min after vaccination. She was in transition from consult room to waiting room for 15m waiting period. Patient was observed starting to look pale so was asked to be seated. Upon sitting she stated she was very anxious from the vaccine and starting to feel 'sick'. Patient was upset and crying also stated her hearing seemed muted-she continued to say she was over heated and was visibly sweating. I attempted to get cool cloths for her-while mom stood in front of her chair in case she lost consciousness. Within the next 5min period patient vomited 1-2 x and had increased pulse rate. She was given cool cloths and ice pack and water over the next 15minutes. Her pulse began to normalize and she stopped crying and sweating. Her color returned to normal and she stated she was feeling better after getting sick and did not feel light headed any longer. We had her wait for another 15minutes until she stated she was feeling more normal, she had no signs of reaction on her arm or other symptoms. She did state that she had not ate or drank anything prior to the vaccine and had a big fear of needles. Patient went home with both parents, will follow up later today to ensure no issues.

Other Meds: unknown

Current Illness: none indicated

ID: 1651329
Sex: F
Age: 29
State: WA

Vax Date: 05/03/2021
Onset Date: 05/04/2021
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: My doctor has a copy of these. She did a physical exam and we did x rays. I am going to meet with the rheumatology department soon as I am unable to even open doors or type on my laptop or dress myself when my arthritis flares.

Allergies: Allegra D

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Persistent Arthritis in hands

Other Meds: Vitamin D, citalopram, buproprion

Current Illness: None

ID: 1651330
Sex: M
Age: 26
State: FL

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:
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: Extreme facial flushing / face felt "on fire" for hours

Other Meds:

Current Illness:

ID: 1651331
Sex: F
Age: 59
State: PA

Vax Date: 07/24/2021
Onset Date: 07/26/2021
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:

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

Symptoms: Patient reported flat, red rash at injection site approx 2 days after receiving vaccination, lasting for approx 1 week.

Other Meds:

Current Illness:

ID: 1651332
Sex: F
Age: 72
State: DE

Vax Date: 01/18/2021
Onset Date: 02/08/2021
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

Allergies: none

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: I felt no major discomfort immediately after my first Covid-19 Vaccine injection. I did notice some soreness in left arm about a month after first shot but decided to get the second shot in same arm anyway. I had little arm pain and no other side effects following this second shot. After about another month I began noticing increasing pain upon certain movements like reaching behind my back while dressing. This pain increased quite slowly and I finally saw the doctor in mid July. He recommended a Physical Therapy evaluation. The PT diagnosed left shoulder impingement syndrome which he thought was likely related to the vaccine injection in January. This would have been a reaction to the injection itself, not a reaction to the vaccine. I have completed a course of 12 PT sessions with some pain relief and some increased range of motion. I still have quite a bit of pain upon certain movements and often am unable to sleep through the night due to pain in my left arm. I will begin a second course of PT next week.

Other Meds: Simvastatin 40mg Levothyroxin .88mmg Vitamin D3 Calcium Multivitamin

Current Illness: none

ID: 1651333
Sex: F
Age: 14
State: MI

Vax Date: 06/10/2021
Onset Date: 06/10/2021
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: Labwork completed on 7/16/21 showed TSH level had dropped to .21 after being normal in previous years. She repeated the labwork on 8/13/21 and her TSH had dropped even further to .01. When she tried to take her concerta she became very nauseous and had to stop taking it. She is off all medications but feels fid fidgety and more anxious than normal. met with an endocrinologist on August 18th and he ordered more labwork. The results showed she does not have the antibodies indicating an auto immune disease and does in fact have inflammation in her thyroid. The doctor instructed to stop all medications and exercise. She will repeat the labwork again mid September.

Allergies: Food allergy to eggs, peanuts, tree nuts and shellfish

Symptom List: Pharyngeal swelling

Symptoms: Labwork completed on 7/16/21 showed TSH level had dropped to .21 after being normal in previous years. She repeated the labwork on 8/13/21 and her TSH had dropped even further to .01. When she tried to take her concerta she became very nauseous and had to stop taking it. She is off all medications but feels fid fidgety and more anxious than normal.

Other Meds: Concerta Citalopram

Current Illness: celiac disease-diagnosed at 2

ID: 1651334
Sex: M
Age: 42
State: NY

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

Lab Data: None yet

Allergies: Shellfish, Insects, Dust, Dander

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: there were a few adverse reactions that I received when i got the vaccine. When I got home from work I noticed that I had a fever. The fever ranged from 101 to 103 and lasted 3.5 days. I also had bone and muscle pain, soreness, tightness, and numbness especially in the chest, shoulder and arm areas and lasted 4 days. My skin had this weird pins and needles effect as well as a red rash on my left arm and I felt a swelling all over that seemed to come and go and lasted 4 days. My hair felt electric when I rubbed it and my eyes were unfocused and lasted 4 days. Now Today I notice a swelling under my left arm and my left arm is numb and occasionally looses some motor function and I think i can feel my heart in my chest and the pins and needles are back. this is ongoing.

Other Meds: Multivitimans

Current Illness: Unknown

ID: 1651335
Sex: F
Age: 49
State: VA

Vax Date: 06/06/2021
Onset Date: 06/08/2021
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: medical examination 6/11/21

Allergies: penicillin amoxicillin doxycycline

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Itching and rash that began two days after injection. By day five, the rash spread to arms, hands, legs, trunk, neck. Doctor prescribed prednisone 20mg twice daily for seven days.

Other Meds: wellbutrin sunosi

Current Illness: none

ID: 1651336
Sex: M
Age: 55
State: TX

Vax Date: 05/14/2021
Onset Date: 05/14/2021
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: none so far

Allergies: none

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

Symptoms: lost my hearing first in my right ear then in my left hear, my hearing constantly cuts off then slowly returns with a following persistent loud ringing in my ears.

Other Meds: guanfacine

Current Illness: none

ID: 1651337
Sex: F
Age: 50
State: NC

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: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data: Allergic reactions to vaccines in the past

Allergies: Magnesium. Allergic reactions to vaccines in the past.

Symptom List: Rash, Urticaria

Symptoms: Vaccine was administered and within 2 minutes the patient was having a anaphylactic reaction. Unable to breath and red on the trunk. Epipen was administered at 1:15 and 911 was called.

Other Meds: Unknown

Current Illness: Unknown

ID: 1651338
Sex: F
Age: 60
State: VA

Vax Date: 12/30/2020
Onset Date: 01/01/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: I was sitting at rest in the am and I suddenly felt my heart begin to race. I called to my husband and we checked my pulse and it was up to 224 beats/minute. I was able to get up and then rest for awhile, but my heart began beating excessively fast again a few minutes later. The only change to my body was having the Pfizer- vaccine.

Other Meds:

Current Illness:

ID: 1651339
Sex: F
Age: 39
State: MO

Vax Date: 03/04/2021
Onset Date: 03/04/2021
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: blood work

Allergies: n/a

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

Symptoms: 1st injection, within hours my right arm started burning. after a few days my arm started to tingle down to my pinky finger. i've also started experiencing seeing shadows and bugs. I feel like my mind is foggy. Also, magnets and coins will stick to both arms. not little magnets like big fishing magnets . I've never been diagnosed with Covid I went to the doctor 8/24 for the numbness and the doctor said it was a side effect and it will eventually go away. Friday 8/27 I saw a different doctor for a 2nd opinion . i was told this is not normal and was given a list of supplements to take

Other Meds: n/a

Current Illness: n/a

ID: 1651340
Sex: M
Age: 60
State: OR

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

Lab Data:

Allergies:

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

Symptoms: Patient was given an expired vaccine which expired at 2:45pm--there was no date just a time left in the basket they were stored in. Patient was still in the store when we discovered the dose was expired and we asked him to remain in the store while we called Pfizer to determine how to proceed. Per Pfizer, there medical department was not open to advise on what procedure to follow until the following Monday 8-30-2021 8am-8pm Eastern. Patient was notified we would contact him Monday after contacting Pfizer's medical team.

Other Meds:

Current Illness:

ID: 1651341
Sex: F
Age: 46
State: TX

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

Lab Data:

Allergies: Cipro

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

Symptoms: Nausea chills bodyaches headache swollen lymph nodes

Other Meds: Zinc vitamin D probiotic

Current Illness: None

ID: 1651342
Sex: F
Age: 22
State: WI

Vax Date: 08/26/2021
Onset Date: 08/28/2021
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: No

Allergies: Not that I know of

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

Symptoms: Today on 8/28 I woke up to a swollen face on my right side. It hurt to touch and to even blink or squint. I had to call into work due to the circumstances. I couldn?t sleep very well because even the ear in that side of the face felt swollen as well. I put a cold compress on it twice then went to sleep and woke up to the swelling going down. Then I took Tylenol to help with the pain which hasn?t fully worked. My face is still swollen.

Other Meds: No

Current Illness: Had covid around 7/28-8-6

ID: 1651343
Sex: U
Age:
State: IN

Vax Date:
Onset Date:
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:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: None stated.

Other Meds:

Current Illness:

ID: 1651344
Sex: M
Age: 68
State: NV

Vax Date: 04/06/2021
Onset Date: 04/01/2021
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: none

Allergies: none

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Edema in both hands on April 10, 2021 which continues Edema in both ankles in late April 2021. May 9, 2021 spontaneous bruise and swelling on bottom of right foot immediately behind the little toe. This has resolved. May 27, 2021 spontaneous bruise on right forearm, inside. This has resolved. July 4, 2021 spontaneous bruise and swelling on the bottom of left foot, immediately behind the little toe. Bruise has resolved. However, site is still tender to the touch. I first reported this issue to my urologist , then my dermatoligist, then my PA at my GP. NO ONE knew what to do or how to report.

Other Meds: multiple vitamin

Current Illness: none

ID: 1651345
Sex: M
Age: 66
State: ID

Vax Date: 08/28/2021
Onset Date: 08/28/2021
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: Severe lower back pain for over 24 hours

Other Meds: None

Current Illness: None

ID: 1651346
Sex: M
Age: 16
State: NC

Vax Date: 08/28/2021
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: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Systemic: Fainting / Unresponsive-Medium

Other Meds:

Current Illness:

ID: 1651347
Sex: F
Age: 49
State:

Vax Date: 08/18/2021
Onset Date: 08/18/2021
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: Unevaluable event

Symptoms: Peripheral Neuropathy. Numbness, burning, pins and needles in arms, hands and one leg.

Other Meds:

Current Illness:

ID: 1651348
Sex: F
Age: 70
State: AL

Vax Date: 03/21/2020
Onset Date: 03/31/2020
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: adverse reaction to Ephinephrine, Bactrim, Propofol, Prozac, Pseudoephedrine. Cannot tolerate sugar. Sensitivity to caffeine and citrus, and alcohol.

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

Symptoms: Difficulty walking began within 10 days of the immunization with leg weakness making walking difficult. Slowly began having signs of arm weakness, slurred speech and difficulty swallowing, vision problems. Symptoms intensified over the course of the next 15 months, in June 2021 diagnosis of ALS.

Other Meds: Vitamin A B C D E & K, Omega 3, Amoxicillin & Pot Clavulanate (875 MG PO Bid)

Current Illness: Psoriasis on face and neck

ID: 1651349
Sex: F
Age: 24
State: CA

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: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Systemic: Tingling (specify: facial area, extemities)-Mild, Error: Improper Storage (temperature)-, Additional Details: Tingling in back and arm.

Other Meds:

Current Illness:

ID: 1651350
Sex: M
Age: 23
State: MN

Vax Date: 05/05/2021
Onset Date: 05/06/2021
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: None

Allergies: None

Symptom List: Injection site pain, Menorrhagia

Symptoms: Heavy chest pain. Difficulty breathing. I couldn?t move. I just laid on the ground to release the pressure on my chest. The heavy pain was for a few hours. Had to focus on every breath. Then it took a few days for the full chest to feel normal again.

Other Meds: None

Current Illness: None

ID: 1651351
Sex: F
Age: 70
State: SC

Vax Date: 02/14/2021
Onset Date: 07/17/2021
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: 7/20/2021

Allergies: Bactrim Augmentum Celexa

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

Symptoms: RSV/pneumonia 5 months later Sore arm for 1-2 days initially

Other Meds: Multi Vitamin Berberine Caltrate+D Zyrtec L-Methylfolate Levothyroxine Metformin Atorvastatin Glyxambi Carvedilol Temazepan Pioglitazone Setraline Lisinopril Latanoprost drops

Current Illness:

ID: 1651352
Sex: F
Age: 27
State: IN

Vax Date: 08/15/2021
Onset Date: 08/22/2021
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:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Site: Itching at Injection Site-Medium, Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium, Additional Details: She said she got red, swollen arm from elbow up that started a week after injection. It was hot and itchy to touch. She took benadryl and iced area and went to immediate care. If improved daily and she said that it is still a little red.

Other Meds:

Current Illness:

ID: 1651353
Sex: M
Age: 57
State: MI

Vax Date: 07/31/2021
Onset Date: 08/28/2021
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: MRI ordered 8/25/21, Consult to neurology includes impression of transverse myelitis with etiology yet to be determined.

Allergies: NKDA

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Patient now admitted to Hospital. At direction of the Provider currently taking care of patient I am entering this report. Per providers note and conversation - patient is experiencing facial droop, numbness and migrating neurologic symptoms severe enough to present to emergency room and then be admitted to Hospital floor for further monitor and testing. Demyelinating disease with possible transverse myelitis is suspected.

Other Meds:

Current Illness: none

ID: 1651354
Sex: F
Age: 27
State: OH

Vax Date: 08/28/2021
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:

Allergies:

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

Symptoms: Error: Wrong Dose of Vaccine - Too Low-

Other Meds:

Current Illness:

ID: 1651355
Sex: M
Age: 50
State: IA

Vax Date: 08/07/2021
Onset Date: 08/07/2021
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:

Symptom List: Nausea

Symptoms: PATIENT STATES THAT HE BECAME VERY TIRED AND LIGHTHEADED FOLLOWING VACCINATION. HE STATES HE WOKE UP IN THE MIDDLE OF THE NIGHT AT SOME POINT, BECAME LIGHTHEADED AND LOST CONSCIOUSNESS/PASSED OUT AND SUFFERED A FALL AS A RESULT OF THIS.

Other Meds:

Current Illness:

ID: 1651356
Sex: M
Age: 31
State: IA

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: Systemic: Fainting / Unresponsive-Medium, Systemic: Flushed / Sweating-Medium, Systemic: Hypertension-Medium, Systemic: Tachycardia-Medium, Additional Details: Patient fainted after receiving 1st Pfizer COVID 19 vaccine. Paramedics were called and patient came to fairly quickly. He did bite his tongue and had some bleeding. Heart rate and pulse were elevated.

Other Meds:

Current Illness:

ID: 1651357
Sex: F
Age: 34
State: NC

Vax Date: 08/22/2021
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: Amoxicillan

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

Symptoms: Approximately one week after receiving my first shot I woke up with vertigo. I have never had a bought of vertigo in my life. The dizziness and spinning room sensation has been happening for about 8 hours now.

Other Meds: Celexa 20mg, bupropion 150mg sr,

Current Illness:

ID: 1651358
Sex: M
Age: 57
State: NY

Vax Date: 04/23/2021
Onset Date: 06/25/2021
Rec V Date: 08/28/2021
Hospital: Y

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

Lab Data: MRIs, CTIs, blood tests, and others on date of event or within 3 days.

Allergies: None

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

Symptoms: Exactly two weeks before the event, was given the first dose of a shingles vaccine. On June 25th suffered a moderately severe stroke.

Other Meds: Allegra, Simvestatin

Current Illness: None

ID: 1651359
Sex: M
Age: 27
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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NKA

Symptom List: Tremor

Symptoms: Patient became anxious after receiving the dose. He stated he has a hx of anxiety and takes medication. He said he had taken his medication this am but had not eaten. He then complained of racing heart, arm tingling, heart palpitations. and became shaky. BP 180/90 and HR= 90. Patient was given water and a protein bar. He still complained of not feeling well and at that time EMS was alerted. They arrived within 15min. and took over this patient.

Other Meds: Anti-Anxiety meds, no other information

Current Illness: Hx of Anxiety

ID: 1651360
Sex: M
Age: 53
State: NY

Vax Date: 04/30/2021
Onset Date: 05/08/2021
Rec V Date: 08/28/2021
Hospital: Y

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

Lab Data: blood work and MRI lower back 7/30

Allergies: n/a

Symptom List: Erythema, Pruritus

Symptoms: After one week, pain in left ankle. Within a month pain spread up leg through hip, swelling in knee. Suffered with discomfort for a couple weeks before seeing doctor 7/16. Went to two prescribed physical therapy sessions but pain had spread to right leg and through shoulders with hand swelling. Xrays taken of ankle and lower back; MRI of ankle. With lower back xray, doctor sent me to emergency room for back MRI. That showed bulging but not on nerve to cause pain. Many blood draws and tests run for tick borne illness, all negative. ER took fluid from knee, found crystals, diagnosed psuedogout. I was admitted to hospital for pain management. Saw my primary after release, he referred me to spine specialist who determined that bulging was not causing pain; referral to rheumatologist for possible PMR (no appointments until Jan). Still swollen hands and limited shoulder mobility. In my most severe time I was unable to move my legs, needed assistance with every motion. Pseudo gout medicine (colchicine); pain relievers celecobrix and tramadol.

Other Meds: Tums

Current Illness: n/a

ID: 1651361
Sex: M
Age: 30
State: UT

Vax Date: 03/11/2021
Onset Date: 08/01/2021
Rec V Date: 08/28/2021
Hospital: Y

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: MRI 08/01/21 PET Scan

Allergies:

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

Symptoms: 2 strokes Enlarged lymph nodes

Other Meds: Finastride

Current Illness:

ID: 1651362
Sex: M
Age: 12
State: NC

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: 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: Approximately 5 minutes post administration, patient came back and reported throwing up one time and feeling short of breath. He did not report any itching or show any signs of generalized allergic reaction. I had him sit down and focus on slow, deep breathing. I had him put a cold, wet cloth on his head and gave him some water. I observed him for about 10 minutes. I asked if he felt any itching or tingling or had trouble breathing. He denied any of these symptoms. He said he was feeling better and left the store.

Other Meds:

Current Illness:

ID: 1651363
Sex: F
Age: 60
State: CA

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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: rash on hands, swollen, itchy, painful

Other Meds: MULTIVIT

Current Illness: none

ID: 1651364
Sex: F
Age: 38
State: PA

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

Lab Data:

Allergies: NKA

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

Symptoms: Debilitating fatigue, muscle weakness, muscle shaking, pressure and ringing in ears, vertigo, dizziness, nausea, increased heart rate, increased orthostatic intolerance, exercise intolerance, headache, cognitive impairment

Other Meds:

Current Illness:

ID: 1651365
Sex: F
Age: 34
State: MN

Vax Date: 08/03/2021
Onset Date: 08/04/2021
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: NSAIDS

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

Symptoms: Fever, chills, fainted and headache

Other Meds: None

Current Illness: No

ID: 1651366
Sex: F
Age: 44
State: NY

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:

Allergies:

Symptom List: Pain in extremity

Symptoms: NAUSEA, HEAVINESS IN TONGUE. GIVEN MECLIZINE FELT BETTER AFTER.

Other Meds:

Current Illness:

ID: 1651367
Sex: F
Age: 46
State: FL

Vax Date: 08/23/2021
Onset Date: 08/25/2021
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: Levaquin

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

Symptoms: Left arm - large circular site reaction. Painful, raised, hot, itchy, red. Started day 2 following injection at injection site. Arm throbs and hurts to touch. Excessive thirst since night of vaccine. Have awoken every night at least 2 times to get a large glass of water (I never do this). I have also been craving water during waking hours since the day after vaccine.

Other Meds: Multivitamin, Effexor xr, Topamax, Aimovig, Nurtec ODT, vitamin d

Current Illness: No

ID: 1651368
Sex: F
Age: 12
State: VA

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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: none

Allergies: none

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

Symptoms: Sweating, loss of color in skin, nausea, light-headedness, dizziness.

Other Meds: none

Current Illness: none

ID: 1651369
Sex: F
Age: 46
State: CO

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

Lab Data: 8/27/21 - blood drawn for metabolic panel, CBC, d dimmer, vital signs

Allergies: Latex Lactose Eggs

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

Symptoms: At midnight It felt like my brain was going to explode like a had a brick being dropped on my head MUCH different than my typical migraines. I had so much muscle and nerve tension in my jaw and neck radiating down into my spine and body aches everywhere! Called my family dr and they recommended me going to the ER. At the ER one liter of IV fluid , IV Benadryl, IV toradol, IV raglan , Tylenol , ibuprofen ,

Other Meds: Gabapentin Cyclobenzaprine Elatriptan Daily vitamin Magnesium glyphosate Complex b vitamin Fish oil Bone maximizer Probiotics

Current Illness:

ID: 1651370
Sex: F
Age: 65
State: WA

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

Lab Data: none

Allergies: ether, peppers

Symptom List: Vomiting

Symptoms: itchy rash over torso, especially chest and lower middle of back

Other Meds: l-lysine, vitamins e & d, potassium, antihistamine

Current Illness: none

ID: 1651371
Sex: M
Age: 76
State: WV

Vax Date: 04/09/2021
Onset Date: 08/18/2021
Rec V Date: 08/28/2021
Hospital: Y

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

Lab Data: xrays

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Patient admitted with Covid Pneumonia lots of oxygen steroids etc Not much info from the facility

Other Meds: none

Current Illness:

ID: 1651372
Sex: F
Age: 54
State: VA

Vax Date: 08/28/2021
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

Allergies: grass, pollen, sulfur

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

Symptoms: itching throat immediately after vaccination

Other Meds: none

Current Illness: none

ID: 1651373
Sex: M
Age: 26
State: TX

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: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: nka

Symptom List: Injection site swelling, Limb discomfort

Symptoms: he had a seizure 5 minutes after shot and frozed up in chair. Called EMS and ambulance came and vitals good but when he got up from lying down, he had another seizure so he went to the hospital.

Other Meds:

Current Illness: none

ID: 1651374
Sex: F
Age: 30
State:

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

Lab Data:

Allergies:

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

Symptoms: Period came early, a very strong blood flow, a lot of clots, different colour and consistency.

Other Meds:

Current Illness:

ID: 1651375
Sex: M
Age: 38
State: HI

Vax Date: 08/18/2021
Onset Date: 08/25/2021
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: RA

Lab Data:

Allergies:

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

Symptoms: reports possible community exposure 8/22/21. Onset of symptoms (pounding headache) 8/25. Called in sick for work 8/26. Covid test collected 8/26. 8/27 resulted positive. confirms remains in quarantine and able to isolate from household/roommate(s) per CDC guidelines.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am