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: 1662066
Sex: F
Age: 73
State: NC

Vax Date: 02/17/2021
Onset Date: 02/24/2021
Rec V Date: 09/01/2021
Hospital:

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

Lab Data: Blood counts showing iron deficiency. normal chemistry, thyroid and B12 levels. Patient underwent endoscopy secondary to the iron deficiency

Allergies: Cipro, penicillin

Symptom List: Dysphagia, Epiglottitis

Symptoms: About 1 week after receiving the second Pfizer vaccine patient donated blood. Immediately after this she began to have severe fatigue, and shortness of breath. Initially she was found to be iron deficient but this has resolved and her symptoms persist

Other Meds: Wellbutrin, flexeril, gabapentin, hydrochlorothiazide, synthroid, losartan, quetiapine, zocor

Current Illness: none

ID: 1662119
Sex: F
Age: 30
State: IN

Vax Date: 08/30/2021
Onset Date: 08/30/2021
Rec V Date: 09/01/2021
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, eggs

Symptom List: Anxiety, Dyspnoea

Symptoms: Fever, chills, diffuse body aches, severe liquid diarrhea

Other Meds: Aspirin, montelukast, xyzal, bupropion, escitalopram, phenteramine

Current Illness: None

Date Died: 08/31/2021

ID: 1662120
Sex: M
Age: 77
State: PA

Vax Date: 08/25/2021
Onset Date: 08/31/2021
Rec V Date: 09/01/2021
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: Lisinopril

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

Symptoms: DEATH

Other Meds:

Current Illness: Myasthenia gravis Type 2 diabetes mellitus with diabetic chronic kidney disease Essential hypertension

ID: 1662121
Sex: F
Age: 46
State: OH

Vax Date: 08/04/2021
Onset Date: 08/17/2021
Rec V Date: 09/01/2021
Hospital:

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

Lab Data: Listened to lungs via stethescope

Allergies: Sulfa Meds

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Pneumonia - shortness of breath, fluid in lungs, fever, cough, congestion, body aches, dizziness, and runny nose

Other Meds: None

Current Illness: None

ID: 1662123
Sex: F
Age: 59
State: FL

Vax Date: 07/21/2021
Onset Date: 07/31/2021
Rec V Date: 09/01/2021
Hospital: Y

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

Lab Data: 7/31/21: CXR

Allergies: NKA

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

Symptoms: Pt came to ER c/o abdominal pain test Covid positive 4 days after covid vaccination.

Other Meds:

Current Illness:

ID: 1662124
Sex: M
Age: 74
State: NJ

Vax Date: 04/29/2021
Onset Date: 08/17/2021
Rec V Date: 09/01/2021
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: COVID PCR positive 8/31/21

Allergies: amoxicillin penicillin tetracycline

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

Symptoms: 02 sats 88-89% cough SOB

Other Meds: Vitamin B12 ASA Metformin lasix Levemir Flex Pen Glipizide

Current Illness:

ID: 1662125
Sex: M
Age: 62
State: MA

Vax Date: 04/29/2021
Onset Date: 04/29/2021
Rec V Date: 09/01/2021
Hospital:

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

Lab Data: none

Allergies: none

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: I had an anaphylactic reaction. Couldn't breath, pharmacist placed cold water bottle on my neck. They called 911, but it subsided after about 5 min. EMT's checked me out and I went home.

Other Meds: none

Current Illness: none

ID: 1662126
Sex: F
Age: 57
State: GA

Vax Date: 08/23/2021
Onset Date: 08/24/2021
Rec V Date: 09/01/2021
Hospital:

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

Lab Data: n/a

Allergies: n/a

Symptom List: Pharyngeal swelling

Symptoms: Patient states vaccine placement was incorrect. She said it was given too low and medial. Due to the vaccine, she has a rash around the injection site. She states her physician does not know if it is due to the vaccine, incorrect placement, or cellulitis.

Other Meds: n/a

Current Illness: n/a

ID: 1662127
Sex: F
Age: 48
State: AR

Vax Date: 08/13/2021
Onset Date: 08/13/2021
Rec V Date: 09/01/2021
Hospital:

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

Lab Data: NA

Allergies: Penicillin, Keflex

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: 12 hours after injection, I began to have chills and rigors with elevated temp to 101.9 and dull headache. Approximately 16 hours after injection, I began to forcefully vomit, fever/chills/ rigors continued, and pounding headache developed. For the next 24 hours the fever, headache, nausea any myalgia continued.

Other Meds: Dyazide 37.5/25, Omeprazole 20mg, ASA 81mg, Evening Primrose Oil, Atorvastatin 10mg, Losartan 100mg, Melatonin 5mg, Claritin 10mg, Biotin, MVI, CO Q 10, Black Elderberry

Current Illness: None

ID: 1662129
Sex: F
Age: 38
State: NY

Vax Date: 05/22/2021
Onset Date: 05/22/2021
Rec V Date: 09/01/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Menstrual periods stopped. Still not resumed after 4 months.

Other Meds:

Current Illness:

ID: 1662130
Sex: F
Age: 46
State: PA

Vax Date: 02/24/2021
Onset Date: 08/03/2021
Rec V Date: 09/01/2021
Hospital:

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

Lab Data: August 4 - Positive Covid=19 Test

Allergies: None

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

Symptoms: I developed a sore throat and headache on August 3. I tested positive for Covid-19 on August 4. I had a fever on August 4 for about 2 hours I was very tired for several days I developed a cough that is still lingering In general, symptoms remained mild

Other Meds: Aimovig

Current Illness: None

ID: 1662131
Sex: F
Age: 84
State: NC

Vax Date: 02/12/2021
Onset Date: 08/19/2021
Rec V Date: 09/01/2021
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:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: Hospitalization due to COVID-19 Reporting per Pfizer COVID-19 Vaccine EUA

Other Meds: Prednisone, Prolia

Current Illness:

ID: 1662133
Sex: M
Age: 62
State: CO

Vax Date: 03/08/2021
Onset Date: 03/22/2021
Rec V Date: 09/01/2021
Hospital:

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

Lab Data: X- Ray, MRI

Allergies: Penicillin sulfa Keflex

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

Symptoms: sciatic nerve pain

Other Meds: Acyclovir Methylphenidate

Current Illness: None

ID: 1662135
Sex: F
Age: 81
State:

Vax Date: 04/03/2021
Onset Date: 08/18/2021
Rec V Date: 09/01/2021
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: Total Antibody positive IgG Antibody negative

Allergies:

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

Symptoms: Hospitalization due to COVID-19 Reported per Pfizer COVID-19 Vaccine EUA

Other Meds:

Current Illness:

ID: 1662136
Sex: F
Age: 48
State: AL

Vax Date: 08/04/2021
Onset Date: 08/05/2021
Rec V Date: 09/01/2021
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: Moderate joint pain in the hips, severe joint pain in the right hand and arm

Other Meds: Biotin Vitamin D Bariatric multivitamin Vitamin B1 Vitamin B12 Melatonin Gabapentin Medication to help constipation (can?t remember name)

Current Illness: None

ID: 1662137
Sex: F
Age: 54
State: MO

Vax Date: 08/31/2021
Onset Date: 08/31/2021
Rec V Date: 09/01/2021
Hospital:

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

Lab Data: None

Allergies: N/a

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

Symptoms: Headache pretty soon after shot that continues.. 15 hours after, fever, chills, vomiting, nausea, body aches

Other Meds: Pravastatin

Current Illness: None

ID: 1662138
Sex: F
Age: 30
State: IL

Vax Date: 08/30/2021
Onset Date: 09/01/2021
Rec V Date: 09/01/2021
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: Penicillin, amoxocilin, clindamyacin, arythromycin,sulfa drugs

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

Symptoms: Extreme muscle pain and spasms throughout body 23 weeks pregnant 2 days, history or preterm birth estimated due Date December 27,2021

Other Meds: Lithium carbonate, Seroquel, clonopin, Prozac, synthroid, prenatal

Current Illness: No

ID: 1662139
Sex: F
Age: 79
State: MI

Vax Date: 05/06/2021
Onset Date: 08/16/2021
Rec V Date: 09/01/2021
Hospital: Y

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

Lab Data: COVID-19 test positive on 8/16/2021.

Allergies: Ativan (delirium), azithromycin (hives), codeine (nausea, vomiting)

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Patient presented to emergency department on 8/16/2021 after falling at home. Patient presented with altered mental status associated with hyperventilation and diaphoresis. She was treated for metabolic encephalopathy related to COVID-19 infection. Her daughter had tested positive for COVID-19 prior to patient's admission. She did not requirement treatment of COVID-19 symptoms during admission with antivirals, steroids, or supplemental oxygen.

Other Meds: acetaminophen (TYLENOL) 325 MG tablet albuterol (VENTOLIN) (2.5 mg/3 mL) 0.083% nebulizer solution amLODIPine (NORVASC) 10 MG tablet aspirin (ECOTRIN) 81 MG EC tablet atorvastatin (LIPITOR) 80 MG tablet Blood Pressure kit clopidogrel (PLAVI

Current Illness: None known

ID: 1662140
Sex: F
Age: 41
State: TX

Vax Date: 08/01/2021
Onset Date: 08/31/2021
Rec V Date: 09/01/2021
Hospital:

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

Lab Data:

Allergies: Bactrum

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Soreness/tenderness at injection site, achy joints, left Axillary swelling and tenderness

Other Meds: Tylenol, ibuprofen

Current Illness:

ID: 1662142
Sex: F
Age: 56
State: KY

Vax Date: 02/01/2021
Onset Date: 07/01/2021
Rec V Date: 09/01/2021
Hospital:

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

Lab Data: I had two CT Scans

Allergies: Cleo Collin

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

Symptoms: I experienced fever, chills, and developed liver issues.

Other Meds: Acebutolol; Imperium; Zyrtec; Prilosec; baby aspirin; vitamins

Current Illness: Covid 01-2021

ID: 1662143
Sex: M
Age: 86
State: NC

Vax Date: 02/10/2021
Onset Date: 08/19/2021
Rec V Date: 09/01/2021
Hospital: Y

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: COVID-19 PCR positive with cycle threshold of 19.1 on 8/19/21

Allergies:

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

Symptoms: Hospitalization due to COVID 19 Reported per Pfizer COVID-19 Vaccine EUA

Other Meds:

Current Illness:

ID: 1662144
Sex: F
Age: 24
State: IN

Vax Date: 08/30/2021
Onset Date: 08/30/2021
Rec V Date: 09/01/2021
Hospital:

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

Lab Data:

Allergies: Soy

Symptom List: Unevaluable event

Symptoms: Extremely fever ranges from101.3- 103.9 on 8/30- 8/31 Extreme nausea Diarrhea Pain in lower extremities Swelling in arm Extreme headache

Other Meds: Wellbutrin Sprintec Metformin Biotin Prenatal one a day

Current Illness: Pcos ADHD Depression Anixety

ID: 1662145
Sex: M
Age: 32
State: VA

Vax Date: 08/30/2021
Onset Date: 08/30/2021
Rec V Date: 09/01/2021
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: Benadryl

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

Symptoms: Aug 30th: 6PM - Chills 7PM - Fever 8PM - Migraine 12AM - Vomiting Aug 31st: 1AM - Sweats 6AM - loss of apatite 6AM - 9pm muscle aches and migraine

Other Meds: NONE

Current Illness: None

ID: 1662147
Sex: F
Age: 40
State: FL

Vax Date: 08/30/2021
Onset Date: 08/30/2021
Rec V Date: 09/01/2021
Hospital:

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

Lab Data: unknown

Allergies: iodine, codeine, ibuprofen

Symptom List: Injection site pain, Pain

Symptoms: pt stated her tongue and partial throat were numb, not swollen. provided two doses of liquid diphenydromine 25mg 20 minutes apart. numbness went away by next day but then patient developed metallic taste in mouth.

Other Meds: unknown

Current Illness: unknown

ID: 1662148
Sex: F
Age: 38
State: MN

Vax Date: 04/07/2021
Onset Date: 08/13/2021
Rec V Date: 09/01/2021
Hospital:

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

Lab Data: COVID19 PCR swab at ED on 8/29/21

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Patient fully vaccinated with Pfizer: dose 1 on 3/17/21 and dose 2 on 4/7/21. patient is known to be immunocompromised at baseline. Patient reported COVID symptoms of cough, shortness of breach, headache, body aches, runny nose, watery eyes, fever, sore throat, fatigue, loss of taste starting on 8/13/21. Patient reported to the Hospital Emergency Department on 8/29/21 for worsening symptoms and then received a COVID test which was positive. Patient remains symptomatic as of 8/31/21.

Other Meds:

Current Illness:

Date Died: 08/30/2021

ID: 1662149
Sex: F
Age: 87
State: NJ

Vax Date: 02/10/2021
Onset Date: 07/24/2021
Rec V Date: 09/01/2021
Hospital: Y

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

Lab Data: The patient tested COVID + via rapid antigen test on 7/24/21 and again on 8/27/21 via both PCR and antigen test (vaccination breakthrough).

Allergies: UNKNOWN

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

Symptoms: I am the epidemiologist reporting on behalf of 89-year-old female patient. The patient received two doses of the Pfizer vaccine on 1/20/21 and 2/10/21. The patient tested COVID + via rapid antigen test on 7/24/21 and again on 8/27/21 via both PCR and antigen test (vaccination breakthrough). The patient was reported as having died on 8/30/21. Cause of death is listed as acute hypoxic respiratory failure; COVID 19 pneumonia. Underlying health conditions are not provided in system.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1662150
Sex: M
Age: 74
State: MI

Vax Date: 04/03/2021
Onset Date: 08/22/2021
Rec V Date: 09/01/2021
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 positive on 8/22/2021

Allergies: Rubbing alcohol (passes out)

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Patient presented to emergency department on 8/22/2021 with cough, congestion, generalized body aches, chills, and nausea for approximately 1.5 weeks. He was found to be COVID-19 positive and hypoxic. He was admitted for further management. He was treated with supplemental oxygen, remdesivir, and decadron during admission. He was discharge home on 8/27/2021 and still required supplemental oxygen at that time.

Other Meds: Sildenafil

Current Illness: Was seen on 3/9/2021 by PCP for postural dizziness.

ID: 1662151
Sex: F
Age: 67
State: GA

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 09/01/2021
Hospital:

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

Lab Data: No

Allergies: No

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: I started getting a rash on my stomach and it moved up my body to the chest, mouth tenderness and inflammation in my gums. I had herpes virus 35 years prior to my vaccine and I think that vaccine triggered the virus and giving me a boost of that virus.

Other Meds: Yes

Current Illness: No

ID: 1662153
Sex: M
Age: 51
State: CT

Vax Date: 04/20/2021
Onset Date: 07/28/2021
Rec V Date: 09/01/2021
Hospital: Y

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

Lab Data: Way too many to list here successfully - I was in the hospital for two weeks and had over 100

Allergies: None

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

Symptoms: Per hospitalization: Myopericarditis NSTEMI Heart failure with reduced ejection fraction Hypotension Fever

Other Meds: Metformin 850mg Amlodipine 10mg Lisinopril 40mg

Current Illness: None

ID: 1662154
Sex: F
Age: 35
State: MI

Vax Date: 08/30/2021
Onset Date: 08/30/2021
Rec V Date: 09/01/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Nausea

Symptoms: Hives and patches of red, swollen, itchy skin on both upper arms, stomach/lower chest/both upper and lower back. Started a few hours after the shot and progressively got worse during the day peaking the morning of day 2. Extremely uncomfortable but felt fine otherwise. Day 3 my symptoms are still here but have gone down a lot, nearly gone.

Other Meds: albuterol, advair

Current Illness: none

ID: 1662155
Sex: F
Age: 48
State: FL

Vax Date: 08/02/2021
Onset Date: 08/05/2021
Rec V Date: 09/01/2021
Hospital:

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

Lab Data: n/a

Allergies: naproxen, hydrocodone

Symptom List: Injection site pain

Symptoms: Severe itching at injection site and radiating out a few inches on my arm that lasted about 6 days.

Other Meds: armour thyroid, amlodipine, doxazosin, progesterone, nadolol, multiviitamins, zinc, selenium, vitamin C

Current Illness: none

ID: 1662156
Sex: M
Age: 55
State: FL

Vax Date: 05/27/2021
Onset Date: 05/29/2021
Rec V Date: 09/01/2021
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-positive. CXR.

Allergies: NKA

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

Symptoms: Pt came to ER c/o cough, fever, body aches, diarrhea, received vaccine for Covid day last night.

Other Meds:

Current Illness:

ID: 1662158
Sex: M
Age: 72
State: NC

Vax Date: 02/04/2021
Onset Date: 08/19/2021
Rec V Date: 09/01/2021
Hospital: Y

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

Lab Data: COVID PCR positive with cycle threshold of 19 on 8/19/21

Allergies:

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

Symptoms: Hospitalization due to COVID-19 Reported per Moderna COVID-19 Vaccine EUA

Other Meds:

Current Illness:

ID: 1662159
Sex: M
Age: 48
State: CA

Vax Date: 08/31/2021
Onset Date: 08/31/2021
Rec V Date: 09/01/2021
Hospital:

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

Lab Data: None at this time

Allergies: Strawberries

Symptom List: Tremor

Symptoms: Flush face, numb face, cold feeling left arm with slight numbness, pain at injection site, warmth at injection site, sensation of facial warmth, dizziness, lightheadedness, feeling similar to "a slight buzz after an alcoholic drink or two, diarrhea, tachycardia

Other Meds: none

Current Illness: None

ID: 1662161
Sex: M
Age: 68
State: MI

Vax Date: 03/25/2021
Onset Date: 08/23/2021
Rec V Date: 09/01/2021
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: Patient reported COVID-19 positive test on 8/23/2021.

Allergies: Augmentin

Symptom List: Erythema, Pruritus

Symptoms: Patient presented to emergency department on 8/26/2021 with cough and shortness of breath that started 5 days prior. He tested positive for COVID-19 at an outside facility on 8/23/2021. He was admitted for further management. He required additional oxygen supplementation about his baseline of 3L. He was also treated with remdesivir and decadron. Patient's symptoms improved and was discharged home on 8/30/2021.

Other Meds: aspirin (HALFPRIN) 81 MG tablet buPROPion (WELLBUTRIN-SR) 150 MG SR tablets cilostazol (PLETAL) 50 MG tablet citalopram (CELEXA) 20 MG tablet clopidogrel (PLAVIX) 75 MG tablet Glucosamine-Chondroitin (OSTEO BI-FLEX REGULAR STRENGTH) 250-200

Current Illness: None known

ID: 1662162
Sex: M
Age: 34
State: NY

Vax Date: 08/31/2021
Onset Date: 08/31/2021
Rec V Date: 09/01/2021
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: None

Allergies: None

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

Symptoms: Syncope within 3 minutes of vaccination

Other Meds: None, except glucose water

Current Illness: None

ID: 1662164
Sex: M
Age: 68
State: FL

Vax Date: 08/26/2021
Onset Date: 08/29/2021
Rec V Date: 09/01/2021
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: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: Significant joint pain (shoulders, hips, knees)

Other Meds: Atorvastatin Losartan Fish Oil Multivitamin

Current Illness: None

ID: 1662166
Sex: M
Age: 65
State: FL

Vax Date: 08/27/2021
Onset Date: 08/27/2021
Rec V Date: 09/01/2021
Hospital:

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

Lab Data: none

Allergies: Penicillin

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: 1 1/2 hours after shot intense pain down back muscles of left leg to the point of not being able to stand. Lasted until next morning. Now just soreness behind knee. Nasal congestion lasted 3 days. Now runny nose Sore throat lasted 2 days. Mostly recovered

Other Meds: Trelegy, Gemfibrozil, Rosuvastatin, Montelukast, Claritin

Current Illness: n/a

ID: 1662167
Sex: F
Age: 60
State: OH

Vax Date: 03/11/2021
Onset Date: 03/14/2021
Rec V Date: 09/01/2021
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:

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

Symptoms: Tachycardia, fatigue, no energy, right leg began swelling, rash.

Other Meds: Topamax.

Current Illness:

ID: 1662168
Sex: F
Age: 37
State: NC

Vax Date: 03/08/2021
Onset Date: 08/21/2021
Rec V Date: 09/01/2021
Hospital: Y

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: COVID-19 PCR positive with cycle threshold of 19.5 on 8/22/2021

Allergies:

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

Symptoms: Hospitalization for COVID-19 Reported per Janssen COVID-19 Vaccine EUA

Other Meds:

Current Illness:

ID: 1662169
Sex: M
Age: 52
State: FL

Vax Date: 05/08/2021
Onset Date: 05/28/2021
Rec V Date: 09/01/2021
Hospital: Y

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

Lab Data: Covid test -positivie, CXR.

Allergies: Ancef, anti inflammatories, aspirin, prilosec.

Symptom List: Pain in extremity

Symptoms: Pt came to ER with fever and SOB.

Other Meds:

Current Illness:

ID: 1662171
Sex: F
Age: 59
State: FL

Vax Date: 08/31/2021
Onset Date: 08/31/2021
Rec V Date: 09/01/2021
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, vistiril, metformin,

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

Symptoms: My right arm started hurting around 8pm. Could not get comfortable in bed, hurt to move arm . When I woke up the next morning still hurting just as bad & can?t really use it because it hurts. I did not have this issue with 1st shot. If I had known this shot would hurt this bad, I would never have gotten this shot. The pain is bad & I can barely use my arm.

Other Meds: Morphine sulphate Wr 60mg 3x a day, 30mg ER 1x day, morphine sulphate IR 15mg 3x a day, atenolol 25mg 1xday, lisiniprol 2.5mg 1xday, Emeprazole 1x day, Rostavastatin 1xday, novolog flex pen 5 units before meals, Lantus 24 units before bed a

Current Illness: None

ID: 1662172
Sex: F
Age: 34
State: PA

Vax Date: 03/09/2021
Onset Date: 03/10/2021
Rec V Date: 09/01/2021
Hospital:

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

Lab Data: MRI 4/7 MR head angio veins IV contrast 6/20 ER visit with CT scan March 28th lot of bloodwork All tests have come back normal, but still definitely not feeling normal

Allergies: ceclor

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

Symptoms: Parenthesis began middle of the night the night of vaccine (felt like body was on fire) The buzzing/parenthesis still persists everyday and it has been 6 months. In the beginning, extreme dizziness, joint pain, heavy legs, persistent headaches and feeling of pressure in back of head, feeling of imbalance, tinnitus (ringing in one ear, clicking in the other ear), feeling of rocking in boat, muscle tremors, tingling all over body, brain zaps. Most symptoms disappeared after a few months, the buzzing feeling and clicking in one ear still remains along with periodic bouts of dizziness and periodic headaches almost six months later.

Other Meds: ortho tri cyclen lo

Current Illness: None

ID: 1662173
Sex: F
Age: 39
State: NY

Vax Date: 07/16/2021
Onset Date: 08/07/2021
Rec V Date: 09/01/2021
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. Candida albicans

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

Symptoms: Hormonal changes with no other explanation. Extreme period bleeding and clotting (atypical for me), cystic acne on neck and back (atypical for me), extreme cramping (atypical for me). None of my normal menstrual symptoms were present - which are usually only limited to irritability, and occasional light cramping which ceases as soon as my flow starts. My periods have been irregular, stronger, and longer. I am experiencing clotting and severe pain. I am currently on my second period since both doses. I?m am experiencing symptoms I have never or rarely experienced with my periods in adulthood, and most definitely have not experienced any of these symptoms in over 12 years (since pregnancy and child birth). I have kept monthly records of my cycle for years, as I?ve anticipated changes as I age, but experienced no changes until I received the covid vaccine.

Other Meds: Flonase.

Current Illness: None

ID: 1662174
Sex: F
Age: 33
State: TN

Vax Date: 08/24/2021
Onset Date: 08/24/2021
Rec V Date: 09/01/2021
Hospital:

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

Lab Data: EKG, at-home holter monitor, CBC, troponin levels

Allergies: Phenegren (promethazine)

Symptom List: Vomiting

Symptoms: Significant heart palpitaions in otherwise healthy individual. (11 months postpartum). Symptoms persisted 5 days after vaccination. Administration of the shot occurred in incorrect position, posterior area of arm muscle, leading to tigling and numbness in fingers and hand.

Other Meds: Prenatal vitamin, Vitamin D, Flonase

Current Illness: n/a

ID: 1662176
Sex: M
Age: 59
State: FL

Vax Date: 05/18/2021
Onset Date: 05/28/2021
Rec V Date: 09/01/2021
Hospital:

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

Lab Data: Covid test-positive, CT abd.

Allergies: NKA

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Pt came to ER c/o abdominal pain, nausea, and vomiting x 4 days.

Other Meds:

Current Illness:

ID: 1662177
Sex: F
Age: 15
State: RI

Vax Date: 09/01/2021
Onset Date: 09/01/2021
Rec V Date: 09/01/2021
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: blood pressure was taken

Allergies: unknown

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

Symptoms: After receiving the vaccine patient reported feeling faint, hot, and having a hard time breathing. Requested that rescue be called. Rescue took her blood pressure and it was low, patient denied transportation

Other Meds: unknown

Current Illness: unknown

ID: 1662178
Sex: F
Age: 60
State: PA

Vax Date: 02/23/2021
Onset Date: 08/23/2021
Rec V Date: 09/01/2021
Hospital: Y

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

Lab Data: 08/23/21 2046 Respiratory virus detection panel Collected: 08/23/21 1946 | Final result | Specimen: Swab from Nasopharynx Adenovirus Not Detected Mycoplasma pneumoniae Not Detected Chlamydophila pneumoniae Not Detected Parainfluenza Not Detected COVID-19 SARS-CoV-2 Overall Result DetectedCritical Enterovirus/Rhinovirus Not Detected Coronavirus Not Detected Respiratory Syncytial Virus Not Detected Influenza A Not Detected Bordetella pertussis Not Detected Influenza B Not Detected Bordetella parapertussis Not Detected Metapneumovirus Not Detected Procedure Component Value Ref Range Date/Time CT angiogram chest pulmonary embolism with and without contrast Resulted: 08/30/21 0802 Order Status: Completed Updated: 08/30/21 0802 Narrative: CTA CHEST PULMONARY EMBOLISM W WO CONTRAST IMPRESSION: 1. Limited exam for the assessment of pulmonary embolism. No large central embolism present. 2. Findings characteristic for COVID related lung disease. END OF IMPRESSION: INDICATION: Shortness of breath and cough, COVID positive, assess for pulmonary artery embolism. TECHNIQUE: Enhanced helical CT scan of the chest was performed from the lung apices to below the diaphragm. 2 mm axial reconstruction with MPR coronal, oblique and sagittal images were created. 3D shaded surface images also created on a separate workstation and permanently stored. Images were obtained without and with contrast. CONTRAST: 80mL of IODIXANOL 320 MG IODINE/ML INTRAVENOUS SOLUTION administered INTRAVENOUS. Quality of contrast opacification was inadequate. COMPARISON: 12/13/2012. FINDINGS: Exam is limited by poor opacification of the pulmonary arteries. No large central embolism is identified in the main pulmonary arteries. The heart, aorta, and main pulmonary artery are within normal limits in size. Calcified plaque is noted in the aorta and coronary arteries. There is moderate predominantly peripheral patchy groundglass opacity bilaterally, characteristic for COVID-19 lung disease. No endobronchial lesions are identified. No pleural effusion nor pneumothorax is present. No acute findings are identified in the upper abdomen. There is mild degenerative change in the spine. There are no acute bone findings.

Allergies: Sulfamethoxazole-trimethoprim

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Cough, Acute hypoxemic respiratory failure ED to Hosp-Admission Discharged 8/23/2021 - 8/28/2021 (5 days) Hospital covid, hypoxia, htn Presenting Problem/History of Present Illness/Reason for Admission COVID-19 virus infection Hospital Course 60-year-old female presented with acute respiratory insufficiency secondary to COVID-19 pneumonia with bilateral infiltrates on CT scan and negative for PE She was placed on oxygen had convalescent plasma and a 5-day course of remdesivir and she started on dexamethasone 6 mg daily Her oxygen was weaned to room air but needs 6 L with exertion and sleep and she is on room air with being awake at rest She has essential hypertension she presented with severe hypokalemia the potassium was 2.6 her blood pressures were on the low side we held her blood pressure medication she had AKI as well her losartan was held as well The AKI resolved the hypokalemia resolved with replacement and we restarted her on her blood pressure medications amlodipine and losartan but hold the hydrochlorothiazide which she might restart at home depending on what her blood pressures are. The blood pressure at the time of discharge is 130/80 with a heart rate of 70

Other Meds: albuterol HFA (PROVENTIL;VENTOLIN) 90 mcg/actuation inhaler amLODIPine (NORVASC) 10 mg tablet atorvastatin (LIPITOR) 40 mg tablet benzonatate (TESSALON) 100 mg capsule dexAMETHasone (DECADRON) 6 mg tablet losartan (COZAAR) 100 mg table

Current Illness:

ID: 1662179
Sex: F
Age: 74
State: MI

Vax Date: 03/18/2021
Onset Date: 08/13/2021
Rec V Date: 09/01/2021
Hospital: Y

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

Lab Data: COVID-19 test positive on 8/13/2021.

Allergies: Rabeprazole

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

Symptoms: Patient presented to emergency department on 8/13/2021 after testing positive for COVID-19 at an outside facility. She had complained of dizziness and had one instance of nonbloody emesis. Reports no other symptoms related to COVID-19 infection. She was given monoclonal antibodies while in the emergency department. Patient was discharged on 8/13/2021 from ED to home. Patient presented to the emergency department on 8/14/2021 after a syncopal episode while showering at home. Patient was admitted due to quarantine restrictions at assisted living facility. She remained asymptomatic for COVID-19 during admission. Patient was discharged on 8/23/2021 back to facility.

Other Meds: Cholecalciferol (VITAMIN D3) 1000 UNIT tablet donepezil (ARICEPT) 10 MG tablet FLUoxetine (PROZAC) 20 MG capsule hydrochlorothiazide (HYDRODIURIL) 25 MG tablet memantine (NAMENDA) 5 MG tablet multivitamin (ONCE-A-DAY GEQ VIT) tablet

Current Illness: None known

ID: 1662181
Sex: F
Age: 35
State: TX

Vax Date: 08/25/2021
Onset Date: 08/25/2021
Rec V Date: 09/01/2021
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. pics taken, reported to physician.

Allergies: mango

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

Symptoms: About 3-4 hours after receiving vaccine, developed itchy red rash on both sides of abdomen and neck. Then i began having tingling and numbness on left side of body along with nausea and dizziness. My neck became tingly and then my bottom lip went numb. Lasted several hours, almost thought my throat was going to began closing. Took multiple Benadryl, rash did not get better. Had to call doctor next day to get steroids. Day 6 rash is clearing up. Still have random tingling to left side.

Other Meds: Pepcid, zyrtec

Current Illness: none.

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am