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: 1653990
Sex: M
Age: 59
State: MO

Vax Date: 07/21/2021
Onset Date: 07/21/2021
Rec V Date: 08/29/2021
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: Augmentin (Hives: reaction to clauvinate vehicle only, amoxicillin well tolerated)

Symptom List: Dysphagia, Epiglottitis

Symptoms: Blurred Vision (Persistent/Undiminished), Intense Headaches(Subsided), Chronic Fatigue, Tingling of extremities (Feet/Hands), Body Aches including Joints (Ankles/Knees/Shoulders/Elbows), Muscle Cramps.

Other Meds: Nexium 20-40mg. daily

Current Illness: Circulatory issues in legs, skin lesions(known and unknown) including Melanoma identified by prior Medical Doctor in 2018,

ID: 1653991
Sex: F
Age: 38
State:

Vax Date: 08/29/2021
Onset Date: 08/29/2021
Rec V Date: 08/29/2021
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: Latex

Symptom List: Anxiety, Dyspnoea

Symptoms: Patient received Pfizer vaccine and started feeling dizzy and nauseous. We had patient lay down on the floor and gave her water and felt better afterwards. Patient also started to have some numbness in the lips.

Other Meds: No

Current Illness: No

ID: 1653992
Sex: F
Age: 55
State: MS

Vax Date: 08/27/2021
Onset Date: 08/27/2021
Rec V Date: 08/29/2021
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: NA

Allergies: Eggs, certain fish - halibut, whiting, shrimp, certain nuts - legumes I.e. peanuts, certain melons - I.e. - cantaloupe, honey news, certain root vegetables - white potatoes, certain berries - strawberries, raspberries, etc., multiple outdoor - dust, pollen, grasses, trees, sumac, Ivy, oak, algae, latex, mold - penicillin, certain insects - bees, wasp, spiders, mites, fleas, etc, certain chemicals

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

Symptoms: Mild headache, sudden chills, fatigue, body aches, pain in injected arm - took 1000 mg of Tylenol Rapid Relief, rested the remainder of night and next day and symptoms passed

Other Meds: Vitamin B-12, Symbicort, Atrovent Nasal Spray, Atrovent Inhaler, Lipitor, Aspirin 81 mg, Flonase Inhaler, Zyrtec, Torsemide, Losartan, Singular

Current Illness: NA

ID: 1653993
Sex: M
Age: 54
State: TX

Vax Date: 05/12/2021
Onset Date: 05/13/2021
Rec V Date: 08/29/2021
Hospital:

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

Lab Data: Going to doctor and having blood work

Allergies: None

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Joint pain for 2 weeks then intermittent. Joint pain, tiredness since injection and muscle aches of right arm since injection

Other Meds: Gummy multi vitamin and gummy fiber, low dose baby aspirin

Current Illness: None

ID: 1653994
Sex: F
Age: 47
State: MI

Vax Date: 08/26/2021
Onset Date: 08/27/2021
Rec V Date: 08/29/2021
Hospital:

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

Lab Data: None at this time

Allergies: Cecolr

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

Symptoms: 8/26 Got shot in left upper arm @ 5:40 8/27 Started getting slight chills in PM. Those went away after taking Tylenol. 8/28 Noticed a rash developing all over my back. Went to pharmacy to see if a rash is a side effect and ask if it was contagious. Advised by pharmacist to take Benedryl and monitor. Planning on going to regular doctor if rash is still there on 8/30. or first available appointment.

Other Meds: Nature Made multi vitamin taken in AM

Current Illness: None

ID: 1653995
Sex: F
Age: 60
State: TN

Vax Date: 08/23/2021
Onset Date: 08/24/2021
Rec V Date: 08/29/2021
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: No w

Allergies:

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

Symptoms: A two to three inch diameter circular red rash at the injection site for over a week post 3rd booster shot. Pt reported having similar side affects with the 3rd shot as the other two, but the severity of symptoms has been getting worse. Red rash is very warm to the touch

Other Meds:

Current Illness:

ID: 1653996
Sex: F
Age: 27
State: MN

Vax Date: 01/28/2021
Onset Date: 08/27/2021
Rec V Date: 08/29/2021
Hospital:

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

Lab Data: Covid-19 test

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Employee tested positive for Covid-19 after being fully vaccinated

Other Meds:

Current Illness:

ID: 1653997
Sex: M
Age: 18
State: KY

Vax Date: 08/14/2021
Onset Date: 08/14/2021
Rec V Date: 08/29/2021
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: None

Symptom List: Pharyngeal swelling

Symptoms: 2nd dose was give at day 14 (7 days early)

Other Meds: None

Current Illness: None

ID: 1653998
Sex: F
Age: 55
State: MD

Vax Date: 08/26/2021
Onset Date: 08/27/2021
Rec V Date: 08/29/2021
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: None that I'm aware

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: SWOLLEN AREA OF VACCINE SITE - ONGOING- ITCHING OF VACCINE SIGHT--USE OF ANTI-ITCH CREAM PAINFUL TO TOUCH VACCINE SITE- TYLENOL FOR PAIN SEVERE HEADACHE- TYLENOL FOR PAIN STOMACH PAIN- DIARRHEA- DRANK LOTS OF WATER & OTHER FLUIDS

Other Meds: Lunesta, Zytek-D, Daily Vitamins, Tylenol

Current Illness: Minor Sinus issues

ID: 1653999
Sex: F
Age: 82
State: NY

Vax Date: 04/07/2021
Onset Date: 08/12/2021
Rec V Date: 08/29/2021
Hospital: Y

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

Lab Data: Cxr 8/24/21 There is patchy interstitial infiltrate involving both lungs diffusely with sparing only of the apices. This is similar appearance to previous. The heart appears normal. IMPRESSION: Diffuse bilateral pulmonary infiltrates similar to prior study of August 16, 2021. Results (MRN 6574907) as of 8/29/2021 15:26. 8/12/2021 20:17 SARS-CoV2 BY REAL TIME-PCR: Detected (A) SOURCE: Nasopharyngeal. Results (MRN 6574907) as of 8/29/2021 15:26. 8/14/2021 08:57 SARS-CoV2 BY REAL TIME-PCR: Detected (A) SOURCE: Nasopharyngeal. Results (MRN 6574907) as of 8/29/2021 15:26. Results (RN 6574907) as of 8/29/2021 15:26. 8/12/2021 20:17 SARS-CoV2 BY REAL TIME-PCR: Detected (A SOURCE: Nasopharyngeal. 8/14/2021 08:57. SARS-CoV2 BY REAL TIME-PCR: Detected .SOURCE: Nasopharyngeal. 8/27/2021 10:08. SARS-CoV2 BY REAL TIME-PCR: Detected (A). SOURCE: Nasal d dimer 926.

Allergies: pcn, Keflex, niacin, lipitor

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Pt was admitted on 8/12/21 unresponsive with altered mental status and a possible seizure. She tested positive for covid- 19. chest x ray showed b/l infiltrates. she was started on remdesivir, oxygen and dexamethasone on day #3. Her condition worsened requiring heated high flow for respiratory failure requiring 45L of high flow oxygen at 45% fio2. pt had a protracted hospital course and became deconditioned requiring rehab on discharge. She continues to require 3L oxygen on discharge

Other Meds: Albuterol; Vit D; levothyroxine, Lisinopril, metoprolol, nitro prn, Prilosec, Advair, insulin, potassium

Current Illness: None

ID: 1654000
Sex: F
Age: 33
State: TN

Vax Date: 08/24/2021
Onset Date: 08/25/2021
Rec V Date: 08/29/2021
Hospital:

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

Lab Data:

Allergies: minocycline

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

Symptoms: Numbness in left and face progressed to numbness in right arm and face by day 3 after vaccine.

Other Meds: levothyroxine, metformin, spironolactone, Vitmains B-C-D, Coq-10, zinc

Current Illness: none

ID: 1654001
Sex: F
Age: 30
State: OH

Vax Date: 08/29/2021
Onset Date: 08/29/2021
Rec V Date: 08/29/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: Patient passed out shortly after receiving vaccination.

Other Meds:

Current Illness:

ID: 1654002
Sex: F
Age: 37
State: NC

Vax Date: 08/09/2021
Onset Date: 08/10/2021
Rec V Date: 08/29/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Severe headache (light and sound sensitivity), lasted almost 48 hours, took over the counter ibuprofen and Tylenol.

Other Meds: Depo Provera

Current Illness: None

ID: 1654003
Sex: F
Age: 45
State: CT

Vax Date: 05/08/2021
Onset Date: 05/08/2021
Rec V Date: 08/29/2021
Hospital: Y

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

Lab Data: CT Scan -- July 4, 2021 MRI -- July 8, 2021 Neuroendoscopic Colloid Cyst Removal -- July 13, 2021

Allergies: Amoxicillan

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

Symptoms: The evening after I had my vaccination, the lymph nodes in my armpits swelled up quite a bit; the following day, the nodes behind my knees and in my neck also became swollen. This swelling lasted two weeks. I also began experiencing really debilitating head pains the following day that would come and go every day for two weeks. I was extremely fatigued for a few weeks and found it hard to work. Additionally, my hair started falling out in handfuls after vaccination and this is still an issue. I also had a rash starting in my armpits and going down my arms and sides. My menstrual cycle was interrupted (I stopped ovulating and had bleeding every day) and this is just now getting back to normal three months later. Six weeks after vaccination, my head pains returned and were very extreme. I went to the ER where I was diagnosed with a colloid cyst in my brain. I had urgent surgery the following week to remove as it was preventing spinal fluid from exiting my brain; my endocrinologist believes the incident could be related to the inflammation caused when I was vaccinated.

Other Meds: Armour thyroid 90mg, Cytomel 25mcg

Current Illness:

ID: 1654004
Sex: M
Age: 73
State: GA

Vax Date: 08/20/2021
Onset Date: 08/21/2021
Rec V Date: 08/29/2021
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: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: Fever. Chills headaches stomach pain

Other Meds: Finafribrate. Nexium

Current Illness: None

ID: 1654005
Sex: F
Age: 36
State: NC

Vax Date: 08/28/2021
Onset Date: 08/28/2021
Rec V Date: 08/29/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: The patient received her vaccine at approximately 10:30am on 8/28/21. Roughly 15 minutes later, the patient began vomiting and sweating. About 15 minutes after that, the patient reported difficulty breathing. The pharmacist who administered the vaccination the instructed a pharmacy technician to call 911 and the pharmacist administered one 0.3mg epinephrine auto-injector at 11:02am into the patient's right anterolateral thigh. EMS arrived and took the patient. The patient was discharged at approximately 4:00pm.

Other Meds: Benadryl

Current Illness:

ID: 1654006
Sex: F
Age: 38
State: AZ

Vax Date: 08/01/2021
Onset Date: 08/01/2021
Rec V Date: 08/29/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Have very very STRONG reason to believe that I have undiagnosed MCAS and each dose has triggered a flare. 4 hours after first dose - severe nausea, diarrhoea, fainting: episode lasted about 15 to 20 minutes. 24 hours after second dose - headache, chest tightness, dizziness, stuffy ears, inflammation, throat tightness, lasting about one hour or less. Possible mild lingering symptoms.

Other Meds:

Current Illness:

ID: 1654007
Sex: M
Age: 29
State: TX

Vax Date: 08/29/2021
Onset Date: 08/29/2021
Rec V Date: 08/29/2021
Hospital:

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

Lab Data: EKG (sinus tachycardia) CBC, Troponin, CMP, all WNL

Allergies: None

Symptom List: Ear pain, Hypoaesthesia

Symptoms: 15 minutes after shot, pt reportedly had muscle stiffening in both arms, became diaphoretic, and was unable to actively contorl his arms. Had mild shortness of breath, did not lose consciousness, symptoms resolved after 15 minutes.

Other Meds: None

Current Illness: None reported

ID: 1654008
Sex: M
Age: 43
State: TX

Vax Date: 08/25/2021
Onset Date: 08/26/2021
Rec V Date: 08/29/2021
Hospital:

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

Lab Data: None

Allergies: Zithromax

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Onset of high fever - 103.3. Lasted about 24 hours. Severe shaking/shivering. Body aches in lower back and base of head/neck

Other Meds: None

Current Illness: None

ID: 1654009
Sex: M
Age: 39
State: TN

Vax Date: 08/28/2021
Onset Date: 08/28/2021
Rec V Date: 08/29/2021
Hospital:

Vax Type: RV1
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: ROTAVIRUS (ROTARIX)
Lot:
Dose Series: 1
Vax Route: PO
Vax Site: MO

Lab Data: nothing at this time.

Allergies: nothing on file

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

Symptoms: Patient's wife said that he had chest pain shortly after receiving the vaccine, but did not mention it to any of the staff. The next morning, the patient went to the bathroom to throw up, but blacked out/ passed out and doesn't remember what happened. When the wife called approximately 11:00 am, patient was resting . I suggested that he go to the emergency room, but he refused because he was too worried that he would catch COVID while he was there. I told him that if he had any further symptoms, ex. light headed, to go anyway.

Other Meds: unknown

Current Illness: unknown

ID: 1654010
Sex: F
Age: 19
State: IL

Vax Date: 07/02/2021
Onset Date: 07/04/2021
Rec V Date: 08/29/2021
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: EKG - 07/05/2021 Echocardiogram - 07/12/2021 EKG, repeat - 08/04/2021

Allergies: None known

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

Symptoms: Developed chest pain, neck pain, shortness of breath

Other Meds: None

Current Illness: None

ID: 1654011
Sex: F
Age: 44
State: TX

Vax Date: 08/29/2021
Onset Date: 08/29/2021
Rec V Date: 08/29/2021
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: Penicillin and morphine

Symptom List: Unevaluable event

Symptoms: Client received 1st dose of Pfizer vaccine @ 11:47. Around 1150, she stated feeling nauseated and needing to throw up. She was walked to the bathroom in accompany of 2 medical staff members. Vitals @ 11:57, O2-99, BP 138/74, Pulse 78. She returned to her seated family and remained under supervision until 12:17P

Other Meds: Biotin

Current Illness:

ID: 1654012
Sex: M
Age: 59
State: CO

Vax Date: 08/23/2021
Onset Date: 08/28/2021
Rec V Date: 08/29/2021
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: Yes 8/28/2021 Blood test, ekg and CT and MRI

Allergies: Na

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

Symptoms: 3 days after 3rd shot started feeling a little dizzy. 5 days after got extremely dizzy and fatigued and could not see due to eye balls ?moving up and down extremely fast?. Could not see at all as everything was ?jumping with eyes open. ? went to ER, thought maybe mini stroke. Next day, same thing happened. Couldn?t walk, no balance, super dizzy

Other Meds: Seizure meds-Lamotrogine 200mg, clonazapan 10mg, Transplqnt Rejection meds Tacrolimus, Imuran and Prednisone. Blood pressure Atenolol and Azothioprine

Current Illness: Na

ID: 1654013
Sex: M
Age: 46
State: CA

Vax Date: 07/25/2021
Onset Date: 08/01/2021
Rec V Date: 08/29/2021
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: None.

Symptom List: Injection site pain, Pain

Symptoms: Feeling of pins and needles that started around week 2. Now is 8/29/2021 and hasn't gone away after about 5 weeks.

Other Meds: None.

Current Illness: None.

ID: 1654014
Sex: F
Age: 34
State: NC

Vax Date: 08/07/2021
Onset Date: 08/17/2021
Rec V Date: 08/29/2021
Hospital:

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

Lab Data: I went to my doctor on 8/20/2021 and she examined my legs. She was not able to tell what was going on and asked me to follow up if it does not improve which I will do.

Allergies: Acyclovir

Symptom List: Injection site pain, Menorrhagia

Symptoms: 10 days after I received the vaccine, I began experiencing leg pain in both legs. I first experienced what felt like muscle cramps and they progressively got worse throughout the day and week. I also began experiencing what feels like pins and needles on the back of my legs from my upper thighs, calves and into my ankles at times. The pain continued so I went to my doctor 3 days after first symptoms appeared. I also began my menstrual cycle 3 days after the onset of the leg pain and had a tremendous amount of pain (cramps and sharp knife like pains) in my abdomen and pelvis for 3 days during my menstrual cycle. I also discussed this with my doctor. While pain and cramps are typical with my periods, this was nothing like I have experienced before. I also passed many clots both small and large (larger than a 50 cent piece) the entirety of my menstrual cycle. While a few clots are normal for me, the amount I was passing the entire time has never happened to me before. I am still experiencing the leg pain and pins and needles sensations in my calves. I also have experienced weakness in my left arm from time to time since receiving the vaccine.

Other Meds: Vitamin D3, B-12, Magnesium Glycinate, Vitamin C

Current Illness:

ID: 1654015
Sex: F
Age: 65
State: FL

Vax Date: 07/31/2021
Onset Date: 08/01/2021
Rec V Date: 08/29/2021
Hospital:

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

Lab Data: N/A

Allergies: Sulfa

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

Symptoms: Patient explained itching up until today after receiving vaccine. Arm was red and had a rash.

Other Meds: Norvasc, Irbesartan, Rosuvastatin

Current Illness: No

ID: 1654016
Sex: F
Age: 47
State: TX

Vax Date: 08/29/2021
Onset Date: 08/29/2021
Rec V Date: 08/29/2021
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: Pt became lightheaded after receiving COVID vaccine. He was provided 2 bottles of cold water and monitored vital signs. pt felt better.

Other Meds:

Current Illness:

ID: 1654017
Sex: F
Age: 24
State: FL

Vax Date: 08/27/2021
Onset Date: 08/28/2021
Rec V Date: 08/29/2021
Hospital:

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

Lab Data: none

Allergies: na

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: lymphadenopathy on the left side, left deltoid vaccine was given

Other Meds: ibuprofen

Current Illness: na

ID: 1654018
Sex: F
Age: 39
State: IN

Vax Date: 08/25/2021
Onset Date: 08/26/2021
Rec V Date: 08/29/2021
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: N/A

Allergies: Latex, benedryl, buspar, penicillin

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

Symptoms: A little over 24 hours I started vomiting uncontrollably, having clear stool/foam, 102? fever for 2 days, body aches, no appetite, couldn?t stay awake, was unable to take any medication to help because I just kept throwing up.

Other Meds: Mirena IUD, Sudafed, Singular, Pepcid AC, klonopin, tramadol, phenergan, compazine, zofran, bentyl, robinul, Transdermal Scopalimine patch, Celexa, lomotil

Current Illness: Nothing out of the ordinary considering I have Crohn?s disease.

ID: 1654019
Sex: M
Age: 28
State:

Vax Date: 08/29/2021
Onset Date: 08/29/2021
Rec V Date: 08/29/2021
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: Pt received covid vaccine. Pt felt dizzy he was seeing black and white spots and dizzy. EMS provided 2 bottles of water and he instantly felt better. Vitals monitored.

Other Meds:

Current Illness:

ID: 1654020
Sex: M
Age: 16
State: RI

Vax Date: 08/29/2021
Onset Date: 08/29/2021
Rec V Date: 08/29/2021
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: shortly after vaccine patient felt light headed and fainted

Other Meds:

Current Illness:

ID: 1654021
Sex: M
Age: 72
State: AZ

Vax Date: 01/29/2021
Onset Date: 02/03/2021
Rec V Date: 08/29/2021
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: None

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

Symptoms: Diarrhea

Other Meds: Flomax 0.4 mg, Carvedilol 25mg, Flecainide Acetate 100mg x2, Spironolactone 25 mg, Pantoprazole Sod 40mg, Lasix 20 x 2, Lisinopril 20mg x 2, Amlodipine 5mg, Melatonin 3mg, Centrum, Citracal, and Triple Flex.

Current Illness: None

ID: 1654022
Sex: M
Age: 40
State: WA

Vax Date: 06/12/2021
Onset Date: 08/09/2021
Rec V Date: 08/29/2021
Hospital:

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

Lab Data: Aug 12th. Went to urgent care they drew blood. But didn't test me for covid or any other lung test etc. Blood came bqck ok. It got real bad Aug 9th. And I'm still sick it's been 25days feeling terrible so far.

Allergies: Sulfa

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

Symptoms: Been sick ever since I've got the shot. Upper respitory effects. Coughing up phlegm. Sore throat . Low grade fever. Fatigue. Dizzyness.

Other Meds: Metoprolol, methadone,gabapentin eliquis. High cholesterol pill

Current Illness: Pulmonary embolism

ID: 1654023
Sex: F
Age: 24
State: KY

Vax Date: 08/24/2021
Onset Date: 08/25/2021
Rec V Date: 08/29/2021
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: Severe headache Extreme ongoing fatigue starting the day after vaccination and ongoing Chest discomfort, ongoing

Other Meds: Doxycycline, cefepime, Vitamin D3, Magnesium

Current Illness: Bacterial upper respiratory infection

ID: 1654024
Sex: F
Age: 27
State: MO

Vax Date: 08/24/2021
Onset Date: 08/29/2021
Rec V Date: 08/29/2021
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: Extremely heavy period ? not supposed to have period right now and never have heavy period

Other Meds:

Current Illness:

Date Died: 08/07/2021

ID: 1654025
Sex: F
Age: 64
State: TX

Vax Date: 01/10/2021
Onset Date: 01/10/2021
Rec V Date: 08/29/2021
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: No treatments were ever done as follow ups from my conversations with personnel at the facility. They never even responded to my overwhelming evidence of how she changed.

Allergies: I do not know of any.

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

Symptoms: Injection was given with no immediate outward sign of an adverse affect. I, as her sister, noticed an affect when I tried to talk to her on the phone calling from California. She hardly talked which was unusual since we talked or texted everyday. She said she did not feel like texting. From that Sunday (1/10/21) through Thursday (1/14/21), she only texted one time. On Thursday, she said it hurt to text, that her mind could not figure out how to text. From that time on, she had many, many times when she could or would not text. She could not figure out how to operate her phone. She got more and more UTI infections and was hospitalized in acute facilities from then on, numerous times. She even said people were trying to kill her. She went downhill cognitively as well as physically until she passed on 8/07/21.

Other Meds: Prescriptions for high blood pressure and antibiotics due to a surgery. Garden of Life Meal Replacement vitamin supplements.

Current Illness: Patient had had a colostomy surgery within 2 weeks prior to the injection.

ID: 1654026
Sex: F
Age: 41
State: CA

Vax Date: 08/27/2021
Onset Date: 08/28/2021
Rec V Date: 08/29/2021
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: N/A

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

Symptoms: Body aches, headache, shivering, fever, vomiting, nose bleed, and nausea.

Other Meds: None prior to vaccine. Tylenol the following day after vaccine administered.

Current Illness: N/A

ID: 1654027
Sex: F
Age: 49
State: GA

Vax Date: 08/24/2021
Onset Date: 08/24/2021
Rec V Date: 08/29/2021
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: Left hospital after the 15 minute wait time. About 5 minutes later as I was driving talking with my husband by I give I began feeling strange. My head began to fell numb and tingle. I began to feel as if I was going to black out? tunnel vision, shaking, difficult breathing. I kept talking and pulled over. I never passed out. But felt the same sensation a few minutes later. Took about 20 minutes to feel like I could drive again.

Other Meds: Pepcid, protonix, low dose aspirin, metoprolol, provera, estrace

Current Illness:

ID: 1654028
Sex: F
Age: 71
State: IL

Vax Date: 08/26/2021
Onset Date: 08/28/2021
Rec V Date: 08/29/2021
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: 2 days post vaccine patient developed swelling on her neck (right side)

Other Meds: unknown

Current Illness: none

ID: 1654029
Sex: M
Age: 61
State: CA

Vax Date: 07/30/2021
Onset Date: 07/31/2021
Rec V Date: 08/29/2021
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: none

Allergies: none

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

Symptoms: Covid Arm. Infection at site of injection. Red, itchy swollen rash.

Other Meds: none

Current Illness: Grover's disease

ID: 1654030
Sex: M
Age: 51
State: UT

Vax Date: 08/27/2021
Onset Date: 08/28/2021
Rec V Date: 08/29/2021
Hospital:

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

Lab Data: It is the weekend. Where would I get lab tests done?

Allergies: N2O2, Broccoli, Amoxicillin has done different averse things over the years including hallucinations and stomach ache.

Symptom List: Pain in extremity

Symptoms: At noon the following day, the expected soreness of the injection site started spreading throughout my body just like the first shot did. Tired, sore, could barely shuffle feet. Took long nap, or at least laid down but could not sleep. By midnight felt like death was creeping in and injection site was size of two golf balls and site was 101 degrees and my body temp was 101. Extreme pain in my left arm with tingling all up and down the arm. Some small jolts into my chest. Entire body sore and difficult to walk. Finally able to go to bed about 1:30am. Tylenol and Iboprophen had no noticeable effect. Slept to 6 am woke up soaking from sweat in bed (not typical) and fever was 101 at both the site and forehead. Stayed up for about an hour and fever broke on forehead. As of 2:45 this afternoon (Sunday) fever at injection site is 101 and the swelling has increased about ? inch from last night. Site is primary pain now. Body still sore, been napping all day. A little wobbly.

Other Meds: Omnoprozlone, Hydrochloroquine, Metamucil,

Current Illness: None

ID: 1654031
Sex: M
Age: 22
State: FL

Vax Date: 07/12/2021
Onset Date: 07/31/2021
Rec V Date: 08/29/2021
Hospital:

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

Lab Data: Blood test on 8/12/21. high thyroglobulin antibodies and high thyroid peroxidase antibodies

Allergies: None

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

Symptoms: A few weeks after getting the vaccine had symptoms of hashimotos thyroiditis (hashitoxicosis). Found high thyroglobulin antibodies and high thyroid peroxidase antibodies from bloodtest. Symptoms include weight loss, anxiety, fatigue, hyperactivity, irritability, polyura, polydipsia, depression.

Other Meds: None

Current Illness: None

ID: 1654032
Sex: M
Age: 54
State: PA

Vax Date: 07/27/2021
Onset Date: 07/28/2021
Rec V Date: 08/29/2021
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: Patient reported rash on both arms and across abdomen 1 to 2 days after administration and lasted about 1 week.

Other Meds:

Current Illness:

ID: 1654033
Sex: F
Age: 63
State: NC

Vax Date: 08/22/2021
Onset Date: 08/23/2021
Rec V Date: 08/29/2021
Hospital:

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

Lab Data: Doctor visit. Labs Done,EKG shows left atrial enlargement. Echocardiogram ordered

Allergies: Sulfur

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

Symptoms: Palpatations, abnormal heart rhythm.

Other Meds: Vitamin D 2000 mg daily

Current Illness: None

ID: 1654034
Sex: F
Age: 38
State:

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 08/29/2021
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: None

Symptom List: Vomiting

Symptoms: 24-48 hours after vaccination Numbness and tingling 24-48 hours after vaccination Followed by internal tremors, paresthesias, loss of smell and taste, electrical shock sensations, dizziness, orthostatic intolerance, fatigue, myalgias, lower extremity paralysis and upper and lower limb weakness, cognitive fatigue, inability to concentrate, headaches, exercise intolerance, temperature dysregulation and heat intolerance, sudomotr dysfunction consistent with autonomic dysfunction/dysautonomia and small fiber neuropathy

Other Meds: Vitamin b12

Current Illness: None

ID: 1654035
Sex: M
Age: 46
State: TX

Vax Date: 07/26/2021
Onset Date: 07/26/2021
Rec V Date: 08/29/2021
Hospital:

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

Lab Data: N/A

Allergies: No known allergies

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Awkward headaches- fuzzy/ foggy sensation lasting minutes to an hour- comes and goes, abdominal pain like cramps- not stomach cramps but all the muscles around the stomach- lasts a few hours, comes and goes. Pharmacist said would disappear after 24 hrs but it hasn?t. Both symptoms have been recurring since I received my first dose 4 1/2 weeks ago.

Other Meds: Naproxen

Current Illness: N/A

ID: 1654036
Sex: F
Age: 68
State: UT

Vax Date: 08/18/2021
Onset Date: 08/29/2021
Rec V Date: 08/29/2021
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: Latex

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

Symptoms: Nausea, fevers, headache and neck aches. Mild fatigue.

Other Meds: None

Current Illness: None

ID: 1654037
Sex: M
Age: 11
State: IL

Vax Date: 08/02/2021
Onset Date: 08/09/2021
Rec V Date: 08/29/2021
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: Many blood tests were done on August 15th all of which returned normal results except for his white blood count was high. They also tested his urine on both August 11th and 15th and again everything returned normal.

Allergies: None

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Diagnosis: HSP Henoch-Schonlein purpura; Symptoms started August 9 with extreme abdominal pain that persisted for 2 days. He was taken to the Emergency room on August 11th by suggestion from the nurse at our pediatrician's office. An abdominal CT scan was done and revealed no cause other than inflammation. We went home without answers and luckily abdominal pain subsided August 13th. During that time, patient could barely eat anything due to extreme pain. August 14th patient was finally feeling well when he began to display a rash on his lower legs that looked like hives at first and then flattened out. Throughout the day the rash spread up his legs to the bottom of his belly and to his upper arms. The rash was accompanied by extreme pain in his legs, especially his knees and ankles. We brought patient to the walk in clinic on August 15th where they advised we go to the emergency room. At the emergency room the doctor ran blood tests that confirmed a diagnosis of HSP( Henoch-Schonlein purpura). The emergency room was very traumatic on both occasions, as patient is very afraid of having his blood drawn, which caused a stress response. We have to continue to monitor patient's kidney function and he continues to have rash flair ups.

Other Meds: Probiotic; MultiVitamin; Fish Oil; Methelphenidate CD 20mg; Desmopressin Acitate 0.2mg

Current Illness: None

ID: 1654038
Sex: F
Age: 63
State: NC

Vax Date: 04/29/2021
Onset Date: 08/29/2021
Rec V Date: 08/29/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Patient experienced swelling in her lower left extremity for a week after vaccination, beginning the same evening as vaccination. She also claims that her chronic migraines have ended since her vaccination. She also claims that she has not had a herpes outbreak since the vaccination and she would normally have one at least once a month.

Other Meds:

Current Illness:

ID: 1654039
Sex: F
Age: 57
State: FL

Vax Date: 08/10/2021
Onset Date: 08/11/2021
Rec V Date: 08/29/2021
Hospital:

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

Lab Data: none

Allergies: penicillin. erythromycin. sudafed

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

Symptoms: Next day head ache. left arm pain. as of 8/29 my injection site is tender And i have shooting pain in my left upper arm near the shoulder. I have a nagging head ache in the frontal lobe and on the r side of my head. this pain in my arm wakes me at night. I have trouble sleeping on my left side due to the pain. I am reporting this because It has lingered on. I visited the CDC web site that gave thus site for ongoing symptoms

Other Meds: anastrozole, Lexapro. vit d. b-complex. magnesium. calcium, ferrous gluconate.

Current Illness: none

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am