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: 1658833
Sex: F
Age: 63
State:

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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: Objective:11 am BP 132/83 HR 82/mt RR 14 O2sat 100% RA 11:21 AM BP: 125/74 Pulse: 81/mt Spo2: 99% in RA Exam: Physical Exam General alert, cooperative, in NAD HENT moist mucous membranes, no swelling of lips or tongue CV regular rate and rhythm, without murmurs, Resp clear to auscultation, good air exchange Skin no diaphoresis noted, no rash or hives

Allergies: Influenza virus vaccine - anaphylaxis Propofol - anaphylaxis, seizures Shellfish - anapphylaxis Beef containing products - hives Egg - hives Latex - itching, swelling, rash Adhesive tape/silicones - rash

Symptom List: Dysphagia, Epiglottitis

Symptoms: Patient is 63 y.o. year-old female status post receipt of first dose of Pfizer Covid vaccine. Patient walked into triage area at the vaccine clinic 30 minutes after receipt of vaccine. Pt stated she felt itching on the arm she received the vaccine( left) immediately after receiving the vaccine which is resolved soon. Then while sitting in the observation area she felt warm in chest, then tightness. After coming to triage area vital signs were checked which is wnl and given below. She reported of ER visit 3 weeks ago for anaphylaxis after kissing her granddaughter who had consumed shrimp.She was evaluated in allergy clinic after her ER visit. She also reported about an asthma attack a week later the ER visit which is resolved by using albuterol inhaler at home, not evaluated by healthcare provider at that time. While in triage room patient she took two puffs of her albuterol inhaler and she her chest tightness resolved after some time. Then she felt something in her throat as if she can feel more when she swallows, also started feeling tip of tongue numb/tingling. Then she started feeling congestion in head/nose and voice becomes husky. Patient has similar symptoms with her previous anaphylaxis. Due to persistence of feeling congested and feeling of tongue swelling and previous hx of anaphylaxis patient sent to hospital via EMS personnel for further observation. Patient also preferred to be observed longer given her persistence of sx Pt is instructed to check with ER physician or allergy specialist regarding the safety of second dose of the Covid vaccine before coming for the second dose.

Other Meds:

Current Illness:

ID: 1658834
Sex: F
Age: 25
State: FL

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

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

Lab Data: n/a

Allergies: None

Symptom List: Anxiety, Dyspnoea

Symptoms: After the vaccine Saturday at 11am I felt good until early Sunday when I had a lot of chills and woke up Sunday morning with no appetite and with a headache. Monday midnight I felt tachycardia and a little shortness of breath until today. Tuesday, the tachycardia is mild and intermittent but every time I have tachycardia, I feel short of breath and my chest feels a little tight and uncomfortable.

Other Meds: Sronyx

Current Illness: None

ID: 1658836
Sex: M
Age: 79
State: FL

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

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: 7/19/21: CXR

Allergies: Invokana

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

Symptoms: Pt came to ER with fever, chills, fatigue, hypoglycemia, and vomiting. Covid positive.

Other Meds:

Current Illness:

Date Died: 08/19/2021

ID: 1658837
Sex: M
Age: 67
State:

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

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Hospitalization with COVID-19 Reported per vaccine EUA

Other Meds: mycophenolate

Current Illness:

ID: 1658838
Sex: F
Age: 46
State: NJ

Vax Date: 02/10/2021
Onset Date: 08/29/2021
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: 8/29/2021 - SARS-CoV-2 Antigen and PCR both (++) 8/30/2021 SARS-CoV-2 IgG - 5.75; IgM 0.56 8/30/2021 SARS-CoV IgI2 QT-SPIKE< ++++ >50,000

Allergies: Penicillins

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

Symptoms: Hospitalized on 8/29/2021 with COVID19+, viral pneumonia and leukocytosis.

Other Meds: atorvastatin 40 mg Tablet Directions: 1 tablet oral daily at bedtime (Active) cefdinir 300 mg Capsule Directions: 1 capsule oral twice a day (Active) cyproheptadine 4 mg Tablet Directions: 1 tablet oral three times a day (Active) doxy

Current Illness:

ID: 1658839
Sex: M
Age: 59
State: FL

Vax Date: 06/16/2021
Onset Date: 08/23/2021
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:

Allergies: Lidocaine

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

Symptoms: Vaccinated patient hospitalized with COVID-19.

Other Meds:

Current Illness:

ID: 1658840
Sex: F
Age: 65
State: TX

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

Lab Data:

Allergies: 1. Codeine - reaction not specified since 12/09/2010 2. Macrolide Antibiotics - reaction not specified since 12/09/2008 3. Morphine (bulk) - reaction not specified since 12/09/2008 4. Tramadol - reaction not specified since 10/16/2019 5. Zithromax ( Azithromycin) - reaction not specified since 12/20/2010 6. Strawberry - reaction : Hives since 07/09/2020

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: At 1552 Patient given Pfizer covid vaccine first dose lot#EW0178 0+3 ml to Left deltoid. Patient awake alert oriented x 3, with even and unlabored breathing , with clear speech, able to finish sentences without difficulty and ambulatory using a cane. At 1618 Patient stated " I feel that my tongue is swollen and when I bite I do not feel anything. I can breathe very well. " At 1620 Dr. notified and evaluated patient and with verbal order to bring patient to emergency center. At 1625 Patient brought to emergency center via wheelchair awake, alert, oriented x 3, with even and unlabored breathing, speech clear, able to finish sentences without difficulty and ambulatory using cane . Patient report given to RN-Triage.

Other Meds:

Current Illness: No complaints at the time of vaccination and a month prior. History of COVID-19 infection last April 18, 2021

ID: 1658841
Sex: M
Age: 12
State: NJ

Vax Date: 08/31/2021
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:

Allergies: None known

Symptom List: Pharyngeal swelling

Symptoms: Patient received 2nd dose 10 days after administration of the 1st dose, not 21 days as recommended. Patient observed 15 minutes after injection- No adverse reaction reported

Other Meds: unknown

Current Illness:

ID: 1658842
Sex: M
Age: 73
State: GA

Vax Date: 02/24/2021
Onset Date: 07/23/2021
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: COVID test 07/26/2021

Allergies: No

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: I contracted the COVID virus after being fully vaccinated. With the symptoms of diarrhea, fever, massive fatigue, coughing and squeezing. I had to get an infusion 07/29/2021.

Other Meds: Blood Pressure and Cholesterol medication

Current Illness: No

ID: 1658843
Sex: M
Age: 71
State:

Vax Date: 02/25/2021
Onset Date: 08/07/2021
Rec V Date: 08/31/2021
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: Cycle threshold 8/8/21 = 19.7

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Hospitalization with COVID-19 Reported per vaccine EUA

Other Meds:

Current Illness:

ID: 1658844
Sex: M
Age: 18
State: NY

Vax Date: 08/26/2021
Onset Date: 08/27/2021
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: None - symptoms resolved at time of visit

Allergies: None

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

Symptoms: Pt developed hive-like itchy rash to forehead, hands, and feet/ankles. Had joint pain at same time. All symptoms resolved 48 hrs after symptoms started. Pt took an antihistamine which helped.

Other Meds: None

Current Illness: None

ID: 1658845
Sex: F
Age: 75
State: PR

Vax Date: 02/26/2021
Onset Date: 05/12/2021
Rec V Date: 08/31/2021
Hospital:

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

Lab Data: 05/26/2021 EKG Normal.

Allergies: I don't have any allergies

Symptom List: Rash, Urticaria

Symptoms: 05/12/2021 Felt sick walking into Cardiologist. Checked blood pressure and it was very high and was prescribed high blood pressure medication. 05/26/2021 Went to see primary care physician changed blood pressure medicine.

Other Meds: Venlafaxine; black elderberry; Metformin; Rosuvastatin

Current Illness: No other illnesses at the time of vaccination

ID: 1658846
Sex: F
Age: 29
State: RI

Vax Date: 08/25/2021
Onset Date: 08/25/2021
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: Lab tests order by doctor office for today.

Allergies: Amoxicillin/penicillin

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

Symptoms: Immediate severe pain at site, whole left arm feeling heavy and noticed numbness and tingling in my left hand same day, following day entire arm swelling including forearm bulging up. I am having numbness & tingling in both hands as well as muscle weakness (grip strength reduced) numbness in lower extremities and intermittent tingling in feet and legs as well. Fingers were pruning and swelling up and down visibly for several days, I still feel I am retaining fluid but visible swelling reduced. Overall severe exhaustion 6 days post injection, my blood pressure is up which is not typical.

Other Meds: None

Current Illness: None

ID: 1658847
Sex: F
Age: 31
State: MN

Vax Date: 08/23/2021
Onset Date: 08/24/2021
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: Patient plans to see her adult provider for recommendation.

Allergies: No known allergies

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

Symptoms: Patient states she has an itchy rash on both her lower legs since the day after receiving the Pfizer vaccine. It was advised she take Benadryl and to see her adult provider to assess if this could be related to the vaccine and/or if she needs any further treatment for the rash.

Other Meds: None known

Current Illness: none

Date Died: 07/21/2021

ID: 1658848
Sex: M
Age: 79
State: WA

Vax Date: 03/16/2021
Onset Date: 07/21/2021
Rec V Date: 08/31/2021
Hospital: Y

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

Lab Data: Positive COVID-19 test on 07/18/2021

Allergies: Unknown

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

Symptoms: Patient died of COVID-19 on 07/21/2021

Other Meds: Unknown

Current Illness: Unknown

ID: 1658849
Sex: F
Age: 39
State: FL

Vax Date: 04/02/2021
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: 7/20/21: Covid test Positive, CXR.

Allergies: Amoxicillin, PCN

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

Symptoms: Pt came to ER c/o sinus pressure, headache, cough, diarrhea, fever.

Other Meds:

Current Illness:

ID: 1658850
Sex: F
Age: 62
State: OH

Vax Date: 08/23/2021
Onset Date: 08/24/2021
Rec V Date: 08/31/2021
Hospital: Y

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

Lab Data:

Allergies: clindamycin, adhesive tape, amoxicillin, azithromycin, Biaxin, pantoprazole, penicillins, vancomycin

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

Symptoms: Patient presented to hospital from her PCP office for worsening bilateral buttock pain with noted erythema and tenderness with some blistering with the left buttock area more tender and indurated than the right side. Patient noted that no trauma was involved to the areas. She noted tat she had the initial tenderness to both buttocks since the previous day but since that time they have progressively gotten worse and she feels as though the left buttock has been developing a blistering appearance to the rash. She denied any other recent symptoms of fever, chills, dizziness, syncope, blood in urine/stool/sputum, dysuria, abdominal pain/nausea/vomiting/diarrhea. She also noted that she had been having increasing amounts of leg swelling but is uncertain as to how long it had been worsening.

Other Meds: metoprolol, hydralazine, Symbicort, calcitriol, probiotic product, calcium citrate-vitamin D, amiloride, omeprazole, magnesium, albuterol

Current Illness:

ID: 1658851
Sex: M
Age: 87
State:

Vax Date: 01/12/2021
Onset Date: 08/30/2021
Rec V Date: 08/31/2021
Hospital: Y

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

Lab Data:

Allergies: penicillin, levaquin

Symptom List: Ear pain, Hypoaesthesia

Symptoms: This is a 86-year-old male with past medical history of hypertension, hyperlipidemia, type 2 diabetes, peripheral vascular disease status post left forefoot amputation, dementia, anxiety, depression, BPH, myelodysplastic syndrome, diabetic neuropathy. He came to the hospital with a chief complaint of altered mental status. Patient unable to provide detailed history due to metabolic encephalopathy. Currently no family members at the bedside. Was reported that the patient has been positive for COVID-19 and under isolation. Tested positive on 8/30/2021

Other Meds:

Current Illness:

ID: 1658852
Sex: F
Age: 46
State: WI

Vax Date: 01/19/2021
Onset Date: 01/20/2021
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: None

Allergies: CT Scan dye

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Migraine headaches lasting at least 2 days and recurring once a week.

Other Meds: Losartan, simvastatin, Enskyce, omeprazole, Paroxetine, biotin, MSM, Iron, Vitamin C, Super B Complex

Current Illness: None

ID: 1658853
Sex: F
Age: 32
State: TX

Vax Date: 08/24/2021
Onset Date: 08/24/2021
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: None

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

Symptoms: Facial twitching to left side of face

Other Meds: Vitamin C, multivitamin, vitamin D, Zinc, Melatonin

Current Illness: None

ID: 1658854
Sex: F
Age: 53
State: KY

Vax Date: 08/09/2021
Onset Date: 08/10/2021
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:

Allergies: none

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

Symptoms: fever, aches, chills, headache

Other Meds: Sertraline, calcium, vit D, Zinc, Vit C

Current Illness: none

ID: 1658855
Sex: M
Age: 68
State: NJ

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

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

Lab Data: SARS-CoV-2 Antigen ++ 8/28 SARS-CoV-2 IgM 0.015; IgG 0.10 SARS-CoV-2 IgG2 QT-SPIKE - 7055

Allergies: NKDA

Symptom List: Unevaluable event

Symptoms: admitted 8/28, Went to urgent care and dx with COVID 3 days ago. Was prescribed Medrol by urgent care. Had low grade fever previously but today went up to 102. +cough. +SOB.

Other Meds: Unknown, not listed in H and P

Current Illness:

ID: 1658856
Sex: F
Age: 41
State: CO

Vax Date: 04/23/2021
Onset Date: 04/29/2021
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: N/A. None of my health care providers knows anything about the duration, cause, etc., and it appears that no serious study effort is being directed towards this issue.

Allergies: N/A

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

Symptoms: My menstrual cycle severely impacted. I have had my period no less than twice per month since the 2nd Vaccine, with no more than 21 days in between cycles; Generally there have been 10 days in between periods. The uterine lining is thick, clotty, and the flow is heavy, with significant cramping. None of these are the norm for me, I usually have lighter periods with no cramping.

Other Meds: Daily Multi Vitamin

Current Illness: N/A

ID: 1658857
Sex: F
Age: 58
State: TN

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

Allergies: Not Applicable

Symptom List: Injection site pain, Pain

Symptoms: The patient deliberately checked that she had not received a prior vaccine- she checked "no" on the question, " have you received previous Covid 19 vaccine". She received 2 doses of Pfizer vaccine on 12/18/2020 and 01/11/2021. On 08/25/2021 she requested Janssen vaccine as her one and only vaccine.

Other Meds: Not Applicable

Current Illness: Not Applicable

ID: 1658858
Sex: F
Age: 56
State: FL

Vax Date: 08/19/2021
Onset Date: 08/19/2021
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: no

Symptom List: Injection site pain, Menorrhagia

Symptoms: severe crippling headache, high heart rate, arm completely went red and she couldn't move it and it was painful, have a hurtful cough cant take deep breaths

Other Meds: cellcept

Current Illness: autoimmune disease, cardiomyopathy, scleroderma raynauds

ID: 1658859
Sex: M
Age: 62
State: NC

Vax Date: 08/11/2021
Onset Date: 08/15/2021
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: Dr visit . Hospital for ultrasound.

Allergies: None

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

Symptoms: Blood clots in left leg. Ultrasound results Femoral Vein Thrombus present in femoral vein in distal thigh. Popliteal Vein Occlusive thrombus present. Calf Veins Visualized tibial veins demonstrate thrombus.

Other Meds: Telmisartan, Fenofibrate, Actos, Janumet, Tresiba, Omeprazole

Current Illness: None

ID: 1658860
Sex: F
Age: 68
State: FL

Vax Date: 02/24/2021
Onset Date: 08/25/2021
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:

Allergies: Sulfa Drugs

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Vaccinated patient admitted to the hospital for COVID-19.

Other Meds:

Current Illness:

ID: 1658861
Sex: F
Age: 62
State: CO

Vax Date: 08/01/2021
Onset Date: 08/26/2021
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: N/A

Allergies: penicillin

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: This events started right away the same day I was administered the vaccine. I experienced all as follows: Nausea, Vomiting, Headache, Severe body ache, Fatigue and No appetite

Other Meds: None

Current Illness: None

ID: 1658862
Sex: F
Age: 29
State: TX

Vax Date: 08/18/2021
Onset Date: 08/23/2021
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: None reported or disclosed

Allergies: None reported or disclosed

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

Symptoms: Patient received flu vaccine on 8/18/21 in the morning around 10 AM. Patient reported pain and discomfort in arm/shoulder on 8/23. Patient shared with pharmacist a picture of her injection site which included the location as evident on the upper deltoid and without apparent redness or swelling. Patient was counseled to use over-the-counter NSAID's such as ibuprofen, icing, and light stretching. Patient stated that she has felt improvement in her arm discomfort and pain, but not full relief. Patient returned to her normal physical activity including hot yoga. On 8/30, patient still reported sharp pains recurring especially at night still.

Other Meds: None reported or disclosed

Current Illness: None reported or disclosed

ID: 1658863
Sex: M
Age: 64
State: MT

Vax Date: 05/06/2021
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:

Symptom List: Nausea

Symptoms: Covid infection despite vaccination Admitted 8/29. SARS-CoV-2+ on admit. Pt has received 2 doses of Pfizer 3/17/21, 5/3/21.

Other Meds:

Current Illness:

ID: 1658864
Sex: F
Age: 75
State: FL

Vax Date: 03/12/2021
Onset Date: 07/27/2021
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: CXR, covid test.

Allergies: Sulfa drugs.

Symptom List: Injection site pain

Symptoms: Pt came to ER c/o SOB x 5 days.

Other Meds:

Current Illness:

ID: 1658865
Sex: F
Age: 53
State: GA

Vax Date: 08/10/2021
Onset Date: 08/11/2021
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: COVID test- negative

Allergies: Seasonal allergies

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

Symptoms: It swelled all around the vaccine site. The size of a soft ball. I could hardly move my arm at all. The doctor drew a circle around where it appeared to be infected to make sure it did not go outside that area. They were not able to do anything about it. They asked me to take Benadryl, iced it, and continue to watch it. They did a COVID test and it was negative. After that I continued to keep a headache and I was really sick. I felt like I had COVID for about 4 days. The injection site is much better. Since then I have been keeping a really bad headache, nasal drip, and cough.

Other Meds: None

Current Illness: None

ID: 1658866
Sex: F
Age: 44
State: MI

Vax Date: 08/30/2021
Onset Date: 08/31/2021
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: n/a

Allergies: Morphine - Resp Arrest Dilantin - Resp Arrest

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

Symptoms: swelling, redness, warm to touch, right upper arm, motrin as needed

Other Meds: Motrin

Current Illness: no

ID: 1658867
Sex: M
Age: 53
State: TX

Vax Date: 08/13/2021
Onset Date: 08/13/2021
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: NA

Allergies: NA

Symptom List: Tremor

Symptoms: Patient had a Pfizer vaccine back on March 9, 2021 and after receiving the vaccine had chest palpitations and never received the second dose. His doctor advised him that he should get the Jansen Covid vaccine and not to complete the Pfizer series based on the adverse reaction he had with the first dose. So patient received two different vaccines 5 months apart, 1 pfizer and 1 jansen.

Other Meds: NA

Current Illness: NA

ID: 1658868
Sex: F
Age: 38
State: OR

Vax Date: 01/26/2020
Onset Date: 02/01/2020
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: Penicillin

Symptom List: Erythema, Pruritus

Symptoms: Abnormal menstruation and vaginal bleeding 5 months straight of bleeding and or spotting

Other Meds: Albuterol

Current Illness:

ID: 1658869
Sex: F
Age: 90
State: KY

Vax Date: 02/27/2021
Onset Date: 08/27/2021
Rec V Date: 08/31/2021
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: 2019-CoV rRT-PCR positive on 8/28/2021

Allergies:

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

Symptoms: Patient was diagnosed with COVID-19 breakthrough infection on 8/27/2021 with positive PCR test

Other Meds:

Current Illness:

ID: 1658870
Sex: F
Age: 65
State: CT

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

Lab Data: leukocytosis of 11k

Allergies: Biaxin, clarithromycin, codeine, hydromorphone, paclitaxel

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

Symptoms: chills, rigors, fever, rash at vaccine site

Other Meds: Albuterol, alpha lipoic acid, azithromycin, bupropion, calcium, carbamazepine, ergocalciferol, fluoxetine, fluticasone salmeterol, gabapentin, Neurontin, tiotropium, diazepam, prednisone

Current Illness:

ID: 1658871
Sex: M
Age: 93
State: FL

Vax Date: 01/25/2021
Onset Date: 08/13/2021
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: IM
Vax Site: LA

Lab Data: 8/14/2021 SARS CoV 2 PCR COVID19 detected

Allergies: Avandia, Januvia

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: 8/14/2021 Admitted. Sick at home x 7-10 days. He was found to have severe hypoglycemia by ambulance. He was screened with COVID testing, which turned out to be positive. Hypoxic, Admitted to COVID unit. Diagnosed with: Coronavirus pneumonitis Note: previously received COVID-19 Pfizer Vaccine: First dose: 01/04/21 Lot Number EL1284; Second dose: 01/25/21 Lot Number EL3247 8/17/21: patient discharged

Other Meds: Doxycycline, hydrocortisone, synthroid, metoprolol, prilosec,

Current Illness:

ID: 1658872
Sex: M
Age: 19
State: ME

Vax Date: 08/31/2021
Onset Date: 08/31/2021
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: n/a

Allergies: unknown

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

Symptoms: patient received 1 shot, he passed out 5 minutes later, he woke up and passed out again briefly, ambulance called,

Other Meds: unknown

Current Illness: unknown

ID: 1658873
Sex: M
Age: 51
State: NY

Vax Date: 08/30/2021
Onset Date: 08/31/2021
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:

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

Symptoms: very high fever 40.5 C, fatigue, weakness, whole body pain, muscle pain , nausea, vomiting x2 , headache, blurry vision in the morning on 08/31/21. I received second dose of covid Pfizer vaccine on 08/30/21 and developed this significant side effects . Even by taking advil every 7 hours, drinking fluids when I can still I have this symptoms . It should be further investigation and evaluation. And who is responsible for forcing this vaccine in healthy adults ?

Other Meds:

Current Illness:

ID: 1658874
Sex: F
Age: 40
State: CA

Vax Date: 08/14/2021
Onset Date: 08/27/2021
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: Pain in extremity

Symptoms: Red rashes on the right leg ( lower extremity), and one red rash on the right forearm have appeared since 8/27/2021 midnight. today 3 spots have added on my right leg. I used hydrocortisone 1% cream on it twice but it wasn't effective. It doesn't have itching but it has a little induration.

Other Meds:

Current Illness:

ID: 1658875
Sex: M
Age: 56
State: MO

Vax Date: 07/13/2021
Onset Date: 07/15/2021
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: None

Allergies: Penicillin - shortness of breath

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

Symptoms: Normal vaccine side effects of fatigue, cold symptoms, and muscle soreness/body aches for the first 36-48 hours post vaccination. Uncommon side effects that developed after the first 48 hours and continued for the next 6-8 days were vertigo/dizziness/light-headedness similar to feeling mildly to extremely intoxicated and unable to walk steady at times. Only other common side effects during this time were pronounced fatigue and soreness at the injection site for 5-6 days. An appointment was made to seek treatment after 5-6 days of these side effects, but side effects cleared up before the date of the appointment (9-10 days post vaccination). No other side effects appear to be present at this time other than new joint pains that may or may not be related to physical exertion or exercise.

Other Meds: Mirtazapine 7.5mg x 1 daily at night before bedtime. Alprazolam 0.5mg x 1 daily at night before bedtime as needed for insomnia. Patient has taken both does for over 5 years

Current Illness: None

ID: 1658876
Sex: F
Age: 90
State: PA

Vax Date: 01/15/2021
Onset Date: 07/28/2021
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: CXR, covid test.

Allergies: NKA

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

Symptoms: Pt came to ER c/o weakness.

Other Meds:

Current Illness:

ID: 1658877
Sex: M
Age: 70
State: TN

Vax Date: 03/31/2021
Onset Date: 04/04/2021
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: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: tiredness, fatigue, loss of weight, cant sleep

Other Meds: blood pressure meds, vitamins

Current Illness:

ID: 1658878
Sex: F
Age: 11
State: OK

Vax Date: 08/19/2021
Onset Date: 08/19/2021
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: none noted in medical record

Allergies: NKDA

Symptom List: Vomiting

Symptoms: none noted at time of injection, kept for 15min without any reaction noted

Other Meds: none noted in medical record

Current Illness: none noted in medical record

ID: 1658879
Sex: F
Age: 63
State: VA

Vax Date: 06/02/2021
Onset Date: 06/02/2021
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:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Horribe headache starting at 1150 pm. Headache lasted until aug 21. Felt sick and tired...Nonstop post nasal drip. Tight chest. Cough non stop. Aug 28 started coughing up yellow mucus.

Other Meds: Levothyroxine. B-12, D. Calcium

Current Illness:

ID: 1658880
Sex: M
Age: 42
State: CO

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: RA

Lab Data: None

Allergies: Coconut, AloeVera

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

Symptoms: Woke up at 3am with violent shaking, chills, and a 103 fever. Fever lasted for 2 days, and body aches and chills lasted for 3 days. Each day the effects reduced.

Other Meds: Atorvastatin, Pepcid AC, Gabapentin, Prilosec

Current Illness: None

ID: 1658881
Sex: F
Age: 78
State: VA

Vax Date: 08/25/2021
Onset Date: 08/30/2021
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: none

Allergies: none known

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Patient Was injected in left Deltoid on August 25,2021 and 1 week later her deltoid had hemorrhaging that larger than a silver dollar around the deltoid on the site of the injection. It is resolving.

Other Meds: none known

Current Illness: none known

ID: 1658882
Sex: F
Age: 63
State: IL

Vax Date: 08/31/2021
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: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

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

Symptoms: Fever (100.9), headache, dizziness, blurred vision, swelling, redness, warm to touch at injection, nausea, vomiting, diarrhea, and weakness.

Other Meds: None

Current Illness: None

ID: 1658883
Sex: F
Age: 17
State: MN

Vax Date: 04/25/2021
Onset Date: 08/29/2021
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: none

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

Symptoms: Headache, cough, runny nose, lethargic starting on 8/29/21

Other Meds: none

Current Illness: none

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am