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: 1658421
Sex: M
Age: 41
State: TX

Vax Date: 08/27/2021
Onset Date: 08/27/2021
Rec V Date: 08/31/2021
Hospital:

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

Lab Data: labs

Allergies: None

Symptom List: Dysphagia, Epiglottitis

Symptoms: Urticardia over chest and neck

Other Meds: None

Current Illness: None

ID: 1658422
Sex: M
Age: 38
State:

Vax Date: 05/03/2021
Onset Date: 08/28/2021
Rec V Date: 08/31/2021
Hospital: Y

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

Lab Data: COVID test + 8/28/2021

Allergies: mild products, penicillins

Symptom List: Anxiety, Dyspnoea

Symptoms: COVID Breakthrough. First vax 4/5/2021. 38 y/o male presents to the ED with the CC of LLQ abdominal pain x1 day. Patient described abdominal pain as sharp, 7/10, constant pain, localized to LLQ. Patient admits to fever, chills, headache but denies nausea, vomiting, diarrhea, chest pain, dysuria, dizziness, or any other symptoms at this time. discharged 8/30/2021

Other Meds:

Current Illness:

ID: 1658423
Sex: M
Age: 32
State: OK

Vax Date: 03/20/2021
Onset Date: 08/20/2021
Rec V Date: 08/31/2021
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:

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

Symptoms: Breakthrough case of COVID. Symptoms: Headache

Other Meds:

Current Illness:

ID: 1658424
Sex: F
Age: 15
State: PR

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

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

Lab Data: N/A

Allergies: no

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Mom called the following day to report vomiting, fever, lack of air, body pain and headache. Mom gave her acetaminophen and the girl improved.

Other Meds: no

Current Illness: no

ID: 1658425
Sex: F
Age: 47
State: CA

Vax Date: 05/14/2021
Onset Date: 05/14/2021
Rec V Date: 08/31/2021
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: Ongoing symptoms : shortness of breathe, nausea, no appetite, no taste or smell, joint Pain, exhaustion, mental confusion

Other Meds:

Current Illness:

ID: 1658426
Sex: F
Age: 88
State: NJ

Vax Date: 04/05/2021
Onset Date: 08/26/2021
Rec V Date: 08/31/2021
Hospital: Y

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

Lab Data: Timeline 1.) SARS-CoV-2 PCR (-) on 8/5/21 2.) SARS-CoV-2 Antigen (-) on 8/24/21 3.) SARS-CoV-2 PCR (+) on 8/30/21 4.) SARS-CoV-2 IgG 2.05; IgM 6.25 on 8/30/21

Allergies: Biaxin; codeine; penicillin

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

Symptoms: Admitted to hospital with Altered Mental Status Pneumonia vs UTI - CXR Showed new/increasing infiltrates in the Right Upper and Mid Lung that are consistent with pneumonia - WBC count of 12.4

Other Meds: acidophilus-pectin, citrus (Acidophilus Probiotic) 100 million cell-10 mg Capsule Directions: 1 capsule oral daily (Active) aspirin 81 mg tablet,chewable Directions: 1 tablet oral daily (Active) atorvastatin 80 mg Tablet Directions: 1

Current Illness:

ID: 1658427
Sex: M
Age: 20
State:

Vax Date: 06/07/2021
Onset Date: 06/07/2021
Rec V Date: 08/31/2021
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: Pyrexia, White blood cell count decreased

Symptoms: vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1658429
Sex: F
Age: 54
State:

Vax Date: 06/07/2021
Onset Date: 06/07/2021
Rec V Date: 08/31/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1658430
Sex: F
Age: 56
State:

Vax Date: 04/09/2021
Onset Date: 08/30/2021
Rec V Date: 08/31/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: Breakthrough case Positive covid test by PCR on 8/30/2021

Other Meds:

Current Illness:

ID: 1658431
Sex: F
Age: 50
State: NV

Vax Date: 08/24/2021
Onset Date: 08/27/2021
Rec V Date: 08/31/2021
Hospital:

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

Lab Data: 8/30/21 blood work should elevated heart enzymes. Physical exam should knot still in left arm muscle. XRAY negative for pneumonia.

Allergies: Penicillin, Coconut, Iodine Dye, Morphine, Red meat, citrus, latex

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Day 3 after shot-Large knot in upper left arm and pain under armpit, and forearm. Day 6-Chest pain and sweating, nauseous, dizzy. Went to er Day 7, with chest pains and was told after blood work that I had a negative reaction to the covid vaccine.

Other Meds: Metoprolol, Triamterene-Hctz, Amlodipine Besylate, Elderberry

Current Illness: High blood pressure, asthma, obesity

ID: 1658432
Sex: M
Age: 33
State:

Vax Date: 06/07/2021
Onset Date: 06/07/2021
Rec V Date: 08/31/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1658433
Sex: M
Age: 87
State: FL

Vax Date: 02/17/2021
Onset Date: 07/26/2021
Rec V Date: 08/31/2021
Hospital: Y

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

Lab Data: CXR, covid test-positive.

Allergies: PCN, sulfa.

Symptom List: Rash, Urticaria

Symptoms: Pt came to ER with fever.

Other Meds:

Current Illness:

ID: 1658434
Sex: M
Age: 28
State: TX

Vax Date: 08/27/2021
Onset Date: 08/28/2021
Rec V Date: 08/31/2021
Hospital:

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

Lab Data: general physician looked at me listened to my breathing inspected remannits of rash prescribed azithromycin 250mg 6 tablets methyiprednisolone 4mg 21 tablets triamcinolone acetonide cream

Allergies: not any known

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

Symptoms: hives aross arms and body within 24 hours headache fatigue chest pain rapid heart beat pain in left side of abdoamin wheezing/cough 32-48 hours after injection went to urgent care facility on the monday after reciving my shot on friday

Other Meds: none

Current Illness: strep

ID: 1658435
Sex: F
Age: 37
State: NC

Vax Date: 07/27/2021
Onset Date: 08/10/2021
Rec V Date: 08/31/2021
Hospital:

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

Lab Data:

Allergies: None on file

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

Symptoms: Patient experienced localized reaction. Area is red and swollen x2 weeks accompanied by pain. Hyperpigmentation is currently present.

Other Meds: Unknown

Current Illness: None on file

ID: 1658436
Sex: F
Age: 42
State: NY

Vax Date: 04/01/2021
Onset Date: 04/20/2021
Rec V Date: 08/31/2021
Hospital:

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

Lab Data: Fibrogenin, PT, INR, cbc, cmp, tsh, ana, rf, sed rate, crp, haptoglobin, vitamin d, MRI of brain with and without contrast

Allergies: NKFA Penicillin

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

Symptoms: Pt with diarrhea initally, progressed to systemic rash that continues and has had some shortness of breatht that is not otherwise explained.

Other Meds: norethindrone AC-Eth-estradiol 1-20

Current Illness: None

ID: 1658437
Sex: M
Age: 52
State: CA

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

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

Lab Data: hyponatremia (131), hypokalemia (6.5), Creat 2.24, BUN 60, D-Dimer 2.90, CRP 10.6, Lactate 2.1, Neutrophils 81%, and Lymphocytes 8%, O2 sats 85%

Allergies: Insulin, labetalol, lantus, lisinopril, metoprolol, tolinase

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

Symptoms: Patient with DM, HTN and history of renal transplant with recent diagnosis of COVID who presents complaining of abdominal discomfort, nausea, vomiting and shortness of breath found to be hypoxic to mid to high 80s by paramedics. Nausea with nonbloody emesis x2, and generalized abdominal pain aching in nature and worse throughout upper abdomen. Took his own zofran at home about 30 minutes prior to arrival. Patient tested positive for COVID on 8/14/21, also with multiple risk factors including DM, HTN, and transplant patient

Other Meds:

Current Illness:

ID: 1658438
Sex: M
Age: 16
State: VA

Vax Date: 08/30/2021
Onset Date: 08/31/2021
Rec V Date: 08/31/2021
Hospital:

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

Lab Data: None

Allergies: None known

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

Symptoms: Heart racing, chills with uncontrollable shaking, headache and stomach ache

Other Meds: None

Current Illness: None

ID: 1658440
Sex: M
Age: 18
State:

Vax Date: 08/26/2021
Onset Date: 08/27/2021
Rec V Date: 08/31/2021
Hospital:

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

Lab Data: N/A

Allergies: None

Symptom List: Ear pain, Hypoaesthesia

Symptoms: left armpit mild lymphadenopathy (pea-sized), fatigue, malaise, chills x 24 hours. Bed rest and full recovery.

Other Meds: None

Current Illness: None

ID: 1658441
Sex: M
Age: 52
State: KY

Vax Date: 08/18/2021
Onset Date: 08/18/2021
Rec V Date: 08/31/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Patient developed nerve pain in his left arm around the site of the vaccination, which he believes is due to improper administration "too close to the triceps."

Other Meds:

Current Illness:

ID: 1658442
Sex: F
Age: 41
State: NE

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 08/31/2021
Hospital:

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

Lab Data:

Allergies: Fluoxetine

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

Symptoms: Instant swelling of tongue and tightening of throat

Other Meds:

Current Illness:

Date Died: 08/27/2021

ID: 1658443
Sex: M
Age: 81
State:

Vax Date: 02/11/2021
Onset Date: 08/17/2021
Rec V Date: 08/31/2021
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: Cycle threshold 8/16/21 = 26.4

Allergies:

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

Symptoms: Hospitalization with COVID-19 Reported per vaccine EUA

Other Meds:

Current Illness:

ID: 1658444
Sex: F
Age: 51
State: IL

Vax Date: 04/28/2021
Onset Date: 04/30/2021
Rec V Date: 08/31/2021
Hospital:

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

Lab Data:

Allergies: amoxycillin, demerol, chlorohexidine

Symptom List: Unevaluable event

Symptoms: Resulted in much shorter menstrual cycle than normal.

Other Meds: Vitamin D supplements

Current Illness: none

ID: 1658445
Sex: F
Age: 48
State: FL

Vax Date: 04/05/2021
Onset Date: 08/13/2021
Rec V Date: 08/31/2021
Hospital: Y

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

Lab Data: COVID-19 PCR positive on 8/13/21

Allergies: nka

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

Symptoms: 8/13/2021: The patient reports that she is feeling lethargic with a low-grade temperature. Because of that and her immunosuppressive status, the patient went to the hospital for evaluation on 8/13 and was admitted. Test was positive for COVID-19 on 8/13/21. Diagnosed with acute covid 19 infection, hypoxic respiratory failure secondary to viral pneumonia. Note: previously received the Pfizer COVID-19 vaccine; First Dose: 03/11/21 Lot Number EN6208;Second Dose: 04/05/21 Lot Number EP6955 8/17/21: Discharged to home.

Other Meds: cinacalcet, diltiazem, hydralazine, losartan, magnesium oxide, pantoprazole, potassium/phosphorus/sodium (K-Phos Neutral), prednisone, tacrolimus

Current Illness:

ID: 1658446
Sex: M
Age: 62
State: IN

Vax Date: 02/28/2021
Onset Date: 03/07/2021
Rec V Date: 08/31/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: EKG, XRAY, BLOOD TEST

Allergies: Penicillin

Symptom List: Injection site pain, Pain

Symptoms: I started having heart palpitations. My blood pressure went up. That lasted a couple days. I was also having cramps in my hands like arthritis. I went to my family Dr. who couldn't diagnose me with anything. I went to the ER in April. They suggested I go to a cardiologist. Before vaccination, heart rate was in the 60's. I was very active prior to the vaccine. My heart rate is gradually returning to normal. The palpitations have lessened. I was on beta blockers for tests. I was also on another medication, but it did not agree with me. At the ER, they did blood tests, EKG, chest X-rays. I honestly felt like I was having a heart attack. The doctors did confirm I was not having a heart attack, but my heart rate was elevated. As of current, I do feel I am better. I am definitely doing better than I was initially.

Other Meds: No

Current Illness: No

ID: 1658447
Sex: M
Age: 59
State: TX

Vax Date: 04/01/2021
Onset Date: 05/13/2021
Rec V Date: 08/31/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Shingles

Other Meds:

Current Illness:

ID: 1658448
Sex: F
Age: 46
State: DE

Vax Date: 08/23/2021
Onset Date: 08/25/2021
Rec V Date: 08/31/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: swelling and pain in lymph nodes under armpit and down to breast, some swelling still present a week later generalized aching in joints discomfort weakness lethargy, headache discomfort in left shoulder area down the full extremity

Other Meds: none

Current Illness: none

ID: 1658449
Sex: F
Age: 25
State:

Vax Date: 08/27/2021
Onset Date: 08/28/2021
Rec V Date: 08/31/2021
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: Patient received COVID vaccine on 08/27/21. On 08/28/21 patient started to experience chest pain, headache, shortness of breath and blurred vision. Also had some weakness. She was taken to ED and assessed. Symptoms have slightly improved but continues to have headache and chest pain several days later.

Other Meds:

Current Illness:

ID: 1658450
Sex: F
Age: 57
State: NE

Vax Date: 08/20/2021
Onset Date: 08/21/2021
Rec V Date: 08/31/2021
Hospital:

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

Lab Data:

Allergies: Eggs. Lactose

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Patient reports not feeling well after the shot, states it caused shingles

Other Meds: N/a

Current Illness: N/A

ID: 1658451
Sex: F
Age: 36
State: NY

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 08/31/2021
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: CT SCANS AT AND ER VISITS/ MULTIPLES DONE OF BOTH FROM JANUARY 2021 GOING FOWARD

Allergies: Amoxicillin

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

Symptoms: SOB ABOUT ONE WEEK AFTER AND WAS REOCCURING / FACE NUMBNESS 2 HOURS AFTER INJECTION AND WAS NUMB FOR ABOUT 30MINUTES TO A HALF HOUR/ SWOLLEN GLANDS AND LYMPHNODES / ASTHMA SYMPTOMS ONGOING

Other Meds: NONE

Current Illness: NONE

ID: 1658452
Sex: M
Age: 28
State: SC

Vax Date: 08/27/2021
Onset Date: 08/29/2021
Rec V Date: 08/31/2021
Hospital:

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

Lab Data:

Allergies: n/a

Symptom List: Nausea

Symptoms: On 8/28 patient experienced muscle aches/pains which he associated as a potential side effect from the vaccination. On 8/29 patient began developing a rash consisting of large whelps all over his entire body. These itched and caused discomfort which he managed with OTC Benadryl. After approximately 6 doses he was able to gain some relief. On 8/30 the rash still persists and he has taken OTC Zyrtec as well to manage the rash.

Other Meds: n/a

Current Illness: n/a

ID: 1658453
Sex: M
Age: 28
State: NE

Vax Date: 08/27/2021
Onset Date: 08/31/2021
Rec V Date: 08/31/2021
Hospital:

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

Lab Data: No tests have been performed

Allergies: no known allergies

Symptom List: Injection site pain

Symptoms: Experience a swollen bulge next to clavicle bone. Patient noticed the swollen area 4 days after vaccination

Other Meds: nothing.

Current Illness: no other illnesses

ID: 1658454
Sex: F
Age: 45
State:

Vax Date: 07/15/2021
Onset Date: 08/03/2021
Rec V Date: 08/31/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: Hospitalization with COVID-19 Reported per vaccine EUA

Other Meds:

Current Illness:

ID: 1658455
Sex: F
Age: 35
State: FL

Vax Date: 04/01/2021
Onset Date: 05/01/2021
Rec V Date: 08/31/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: NUMBNESS AND RADIATING PAIN (RIGHT ARM) AFTER SECOND DOSE, NUMBNESS AND TINGLING AROUND LIPS, NUMBNESS ON RIGHT SIDE OF TONGUE, FOGGY BRAIN, CHRONIC FATIGUE. THESE SYMPTOMS ARE STILL ONGOING.

Other Meds:

Current Illness:

ID: 1658457
Sex: F
Age: 69
State: PR

Vax Date: 07/13/2021
Onset Date: 08/04/2021
Rec V Date: 08/31/2021
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: Crustacean; Penicillin

Symptom List: Tremor

Symptoms: In the morning I have a lot of cramps in my legs and the pain is mostly in my right leg. Second week 08/09/2021 bleeding in the urine with clots. The week of 08/23/2021 I had a manifestation in the eye, with bruises and broken capillaries in the LF eye.

Other Meds: n/a

Current Illness: Lupus; Fibromyalgia; Rheumatoid Arthritis; Osteoporosis; COPD patient; Pulmonary Fibrosis; Fibrosis pulmonary

ID: 1658458
Sex: F
Age: 36
State: NY

Vax Date: 08/30/2021
Onset Date: 08/30/2021
Rec V Date: 08/31/2021
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: Systemic: Chills-Mild, Systemic: Dizziness / Lightheadness-Mild, Systemic: Hypertension-Mild, Systemic: Tingling (specify: facial area, extemities)-Mild, Systemic: Weakness-Mild, Additional Details: WITHIN 5 MINUTES OF FIRST PFIZER COVID INJECTION PATIENT COMPLAINED OF RACING HEART RATE/PALPITATIONS, TINGLING SENSATION OF ROOF OF MOUTH AND CHIN, DIZZINESS AND LIGHT HEADEDNESS, FAINTNESS. PATIENT SHOWED SIGNS OF ANXIETY AND HIGH PULSE RATE - EMS CAME - PATIENT HAD ELEVATED BLOOD PRESSURE AND WAS TRANSPORTED TO HOSPITAL FOR FURTHER EVALUATION. PATIENT NEVER LOST CONCIOUSNESS.

Other Meds:

Current Illness:

Date Died: 05/02/2021

ID: 1658459
Sex: M
Age: 21
State: HI

Vax Date: 04/13/2021
Onset Date: 05/01/2021
Rec V Date: 08/31/2021
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: Autopsy shows previously unidentified/ undiagnosed heart issues.

Allergies: None

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

Symptoms: Specifically unknown, but patient (he's now deceased) was concerned about throwing up so much that he'd lose his stomach lining.

Other Meds: None

Current Illness: None

ID: 1658460
Sex: F
Age: 35
State: KY

Vax Date: 08/23/2021
Onset Date: 08/23/2021
Rec V Date: 08/31/2021
Hospital:

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

Lab Data: Negative covid x2,neg flu, neg strep

Allergies: Minocycline

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

Symptoms: Arm numbness and pain, fever 100.6-103.2, headache, fatigue, all over aching, sore throat, cough

Other Meds: Levothyroxine, trazodone, fluoxetine, vit d, multivitamin, vit cyclobenzaprine

Current Illness:

ID: 1658461
Sex: F
Age: 33
State: MA

Vax Date: 02/10/2021
Onset Date: 02/24/2021
Rec V Date: 08/31/2021
Hospital:

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

Lab Data: Office visit with PCP.

Allergies: Sulfa drugs, Augmentin

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Roughly 2 weeks after my first vaccine, I noticed a lump on the side of my right breast, underarm area. It only lasted a couple days, but since then has come back randomly.

Other Meds: NO

Current Illness: None known

ID: 1658462
Sex: F
Age: 43
State: VA

Vax Date: 02/20/2021
Onset Date: 02/21/2021
Rec V Date: 08/31/2021
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: Aspartame

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

Symptoms: On 02-21-2021 I experienced itchiness on my skin and had a rash and I also got hives on my legs. I had a little bit of throat scratchiness but no anaphylactic. I went to see my PCP on 02-23-2021 and was prescribed antihistamine. I also saw an allergist doctor who gave me stronger medication which helped my symptoms cleared up. My symptoms lasted 5 days only.

Other Meds: Benadryl; Pepcid; OTC Allegra; Jardiance

Current Illness:

ID: 1658463
Sex: M
Age: 64
State: TN

Vax Date: 05/03/2021
Onset Date: 05/03/2021
Rec V Date: 08/31/2021
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: shellfish

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

Symptoms: squamous cell carcinoma 8 days after 3 inches below site. Required surgery to remove but did not require MOHS

Other Meds: zortress prednisone nifedipine zetia zoloft abilify veltassa aspirin 81 flomax cardelvilol

Current Illness:

ID: 1658464
Sex: M
Age: 62
State:

Vax Date: 07/24/2021
Onset Date: 08/05/2021
Rec V Date: 08/31/2021
Hospital: Y

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

Lab Data: Cycle threshold 8/5/21 = 20.1

Allergies:

Symptom List: Pain in extremity

Symptoms: Hospitalization with COVID-19 Reported per vaccine EUA

Other Meds:

Current Illness:

ID: 1658465
Sex: F
Age: 53
State: NC

Vax Date: 08/23/2021
Onset Date: 08/29/2021
Rec V Date: 08/31/2021
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: site of shot still hot, inflamed, itchy and red over a week later

Other Meds: Hydrocholorthiazide; Atorvastatin; Linsopril

Current Illness: none

ID: 1658467
Sex: M
Age: 44
State: MA

Vax Date: 05/24/2021
Onset Date: 05/24/2021
Rec V Date: 08/31/2021
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: Prednisone, Percocet; gluten; bee sting

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

Symptoms: I developed all over body hives approximately 45 minutes after receiving the J&J covid 19 vaccine. The hives were on my legs, back, arms, and chest and lasted over an hour. I continued to get the hives over my entire body for the next four days, often several times a day that lasted approximately one hour.

Other Meds: None

Current Illness: None

ID: 1658468
Sex: F
Age: 67
State: FL

Vax Date: 02/01/2021
Onset Date: 07/20/2021
Rec V Date: 08/31/2021
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: 7/20/20: CXR, 7/6/20: Covid test positive.

Allergies: Levaquin

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

Symptoms: Pt came to ER c/o weakness and fatigue, lack of strength, chest pain, nausea, SOB, fever, chills, and achy. Onset 1 week prior was recently diagnosed with Covid.

Other Meds:

Current Illness:

ID: 1658469
Sex: M
Age: 18
State: FL

Vax Date: 08/29/2021
Onset Date: 08/30/2021
Rec V Date: 08/31/2021
Hospital:

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

Lab Data: PATIENT OUTCOME IS NOT KNOW A CALLED WAS MADE TO THE FAMILY AND THE PHONE WAS NOT ANSWERED

Allergies: NON

Symptom List: Vomiting

Symptoms: PATIENT'S MOTHER CALLED IN TO PHARMACY TO INFORM US THAT THE PATIENT WENT TO BED THE NIGHT OF GETTING VANCCINATED AND WOKE UP THE NEXT MORNING 8/30/2021 WITH SWOLLEN LIPS, FACE AND CHEEKS. PATIENT TOOK SOME BENADRYL AND IT SWELLING WENT SUBSIDED SOME WHAT. MOTHER WAS ADVISED TO TAKE PATIENT TO THE E.R.

Other Meds: NON

Current Illness: NON

ID: 1658470
Sex: M
Age: 43
State: FL

Vax Date: 08/27/2021
Onset Date: 08/27/2021
Rec V Date: 08/31/2021
Hospital:

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

Lab Data: None

Allergies: PCN

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Pain and burning at injection site (didn't happen the first time). Total body joint pain and lethargy, general malaise, headache, light headed, weakness. Intermittent chest pains, kidney pains. Lasted until Monday at 1300 when I went into a full sweat. Only symptom remaining is soreness and tightness at base of skull/neck.

Other Meds: Tizanidine; vivance

Current Illness: None

ID: 1658471
Sex: F
Age: 47
State: VA

Vax Date: 08/02/2021
Onset Date: 08/02/2021
Rec V Date: 08/31/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Muscle pain. Joint pain. Nausea. Dizzy. High fever. Sweat. Chills. Fatigue.

Other Meds:

Current Illness:

ID: 1658472
Sex: F
Age: 47
State: KY

Vax Date: 01/21/2021
Onset Date: 08/28/2021
Rec V Date: 08/31/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Tested positive for Covid 19

Other Meds:

Current Illness:

ID: 1658473
Sex: F
Age: 84
State: NJ

Vax Date: 08/27/2021
Onset Date: 08/28/2021
Rec V Date: 08/31/2021
Hospital:

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

Lab Data: I called my primary doctor, and based on the questions that I answered, he ruled out a heart attack. I was instructed to take a couple of Tylenol. and if I got worse to go to the ER.

Allergies: Sulfate

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

Symptoms: Excruciating chest pains

Other Meds: N/A

Current Illness: None

ID: 1658475
Sex: M
Age: 59
State: TX

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 08/31/2021
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: pain in arm, shoulder and neck. still going on at this time

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am