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**
PLEASE CHECK BACK SOON
Download the files above while you wait.







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: 1665759
Sex: M
Age: 36
State: CA

Vax Date: 08/16/2021
Onset Date: 08/16/2021
Rec V Date: 09/02/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1665760
Sex: M
Age: 29
State: CA

Vax Date: 08/18/2021
Onset Date: 08/18/2021
Rec V Date: 09/02/2021
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:

Symptom List: Anxiety, Dyspnoea

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1665954
Sex: F
Age: 74
State: DE

Vax Date: 08/31/2021
Onset Date: 08/31/2021
Rec V Date: 09/02/2021
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: Systemic: Allergic: Itch Generalized-Severe, Systemic: Allergic: Rash Generalized-Severe

Other Meds:

Current Illness:

ID: 1665955
Sex: F
Age: 56
State: NJ

Vax Date: 02/03/2021
Onset Date: 08/25/1921
Rec V Date: 09/02/2021
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: Breakthrough COVID infection Symptoms began 8/23 and patient tested positive on 8/25

Other Meds:

Current Illness:

ID: 1665956
Sex: F
Age: 40
State: MA

Vax Date: 09/01/2021
Onset Date: 09/01/2021
Rec V Date: 09/02/2021
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: Systemic: Seizure-Mild, Additional Details: Patient suffered a seizure about 10 minutes after vaccine administration. She came out of the seizure as she was being brought to the floor from the chair. She was able to explain that she has suffered from seizure in the past. She was taken to the hospital by EMTs.

Other Meds:

Current Illness:

ID: 1665957
Sex: F
Age: 69
State: OH

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

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

Lab Data:

Allergies:

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

Symptoms: Error: Incorrect Reconstitution-

Other Meds:

Current Illness:

ID: 1665958
Sex: F
Age: 48
State: CT

Vax Date: 08/31/2021
Onset Date: 08/31/2021
Rec V Date: 09/02/2021
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 known

Allergies: none known

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Pt had dizziness and shaking that began a few minutes after fist dose. After about 10 minutes with legs elevated, she began to have a metallic taste in mouth, tingly right cheek, right neck, then arm. Called 911.

Other Meds: none known

Current Illness: none

ID: 1665959
Sex: F
Age: 28
State: NJ

Vax Date: 09/01/2021
Onset Date: 09/01/2021
Rec V Date: 09/02/2021
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: Systemic: Dizziness / Lightheadness-Mild, Systemic: Fainting / Unresponsive-Mild, Systemic: Flushed / Sweating-Mild, Systemic: Nausea-Mild, Systemic: Vomiting-Mild, Additional Details: Patient was very anxious about the vaccination. Within a few minutes of vaccine administration she passed out. She was awoken shortly after. When i went to check on her she was conscious and responsive. She told me she had no trouble breathing and she believed she was having a panic attack. I gave the patient water and helped her sit up while waiting for EMTs to arrive. The patient also experienced symptoms of nausea/vomiting. She decided to go to the hospital for further evaluation to be safe.

Other Meds:

Current Illness:

ID: 1665960
Sex: M
Age: 64
State: OK

Vax Date: 01/01/2021
Onset Date: 05/23/2021
Rec V Date: 09/02/2021
Hospital: Y

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

Lab Data: 5/25 Heart cath- no significant coronary artery disease, chest x-ray pulmonary vascular congestion, 5/26 C Reactive Protein 190 (normal less than 0.9). Cardiac enzymes remained normal, Covid PCR test negative,

Allergies: Thimerosal

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Myocarditis with ventricular tachycardia, second degree heart block with chest pain. Spent 8 days in Memorial Hospital on monitor and had a heart cath that showed no atherosclerosis. Symptoms subsided with steroids. CRP was an unheard of 190!

Other Meds: Amlodipine, Losartan, Clonidine, Lasix, Pepcid, Aspirin, Tylenol

Current Illness: Hypertension

ID: 1665961
Sex: F
Age: 59
State: GA

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

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Rapid heart rate

Other Meds: None

Current Illness: None

ID: 1665962
Sex: F
Age: 66
State: CA

Vax Date: 08/30/2021
Onset Date: 08/31/2021
Rec V Date: 09/02/2021
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: Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium, Additional Details: pt says she developed a softbaal sized lamp like swelling over the left arm where the vaccine was place

Other Meds:

Current Illness:

ID: 1665963
Sex: F
Age: 38
State: MS

Vax Date: 08/23/2021
Onset Date: 08/24/2021
Rec V Date: 09/02/2021
Hospital:

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

Lab Data: None

Allergies: Morphine

Symptom List: Rash, Urticaria

Symptoms: Extremely sore arm 3 days Redness and swelling at injection site Lump at injection site 3 days of nausea 9days post vaccination return of swelling and lump at injection site Itchiness at injection site

Other Meds: Prenatal Vit C Vit D3

Current Illness: None

ID: 1665964
Sex: F
Age: 60
State: TX

Vax Date: 08/23/2021
Onset Date: 08/25/2021
Rec V Date: 09/02/2021
Hospital:

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

Lab Data: COVID 19 test scheduled for today, September 2, 2021

Allergies: n/k

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

Symptoms: body aches, chills/sweats, severe headache, nausea (w/o vomiting), dizziness, fatigue

Other Meds: Estradiol, Folic Acid, Methotrexate, multivitamin, calcium, lysine, flaxseed, 81 mg aspirin, vitamin C, zync, D3 Simponi Aria infusions

Current Illness: n/k

ID: 1665965
Sex: F
Age: 28
State: NJ

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

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

Symptoms: Systemic: Dizziness / Lightheadness-Mild, Systemic: Fainting / Unresponsive-Mild, Systemic: Hyperventilation-Mild, Systemic: Nausea-Mild, Systemic: Vomiting-Mild, Additional Details: The patient was very anxious getting the vaccine. Very shortly after the vaccination she passed out. When I went to help her she was awake and responsive to me. She said she didnt have any difficulty breathing. She expressed she believed she was having a panic attack. She had a small cut on her cheek from the fall, was experiencing nausea/vomiting, and felt too dizzy to stand up. I helped to sit her up and got her some water to drink. The EMTs arrived and she went to the hospital to be safe.

Other Meds:

Current Illness:

ID: 1665966
Sex: M
Age: 58
State: MD

Vax Date: 04/11/2021
Onset Date: 05/09/2021
Rec V Date: 09/02/2021
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: Since the vaccination - have often been breaking out in hives when in extreme heat and sunshine. Until recently never put the two together that it may have been connected to the Covid vaccination. Didn't start occurring till the vaccination. Haven't changed detergent, bath soap, food - or any other lifestyle change. Saw doctor yesterday who is sending me to an allergist. See allergist on 27 September 2021.

Other Meds: Lipitor 20mg

Current Illness: None

ID: 1665967
Sex: M
Age: 83
State:

Vax Date: 02/15/2021
Onset Date: 09/02/2021
Rec V Date: 09/02/2021
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:

Allergies:

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

Symptoms: hospitalized, SARS-CoV-2 positive

Other Meds:

Current Illness:

ID: 1665968
Sex: F
Age: 23
State: WA

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

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

Lab Data:

Allergies:

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

Symptoms: Systemic: Abdominal Pain-Severe, Systemic: Chills-Severe, Systemic: Dizziness / Lightheadness-Severe, Systemic: Fainting / Unresponsive-Mild, Systemic: Flushed / Sweating-Severe, Systemic: Shakiness-Severe, Systemic: Visual Changes/Disturbances-Medium

Other Meds:

Current Illness:

ID: 1665969
Sex: F
Age: 56
State: IN

Vax Date: 04/06/2021
Onset Date: 04/10/2021
Rec V Date: 09/02/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Severe lower abdomen pain, severe nausea, syncope

Other Meds:

Current Illness:

ID: 1665970
Sex: M
Age: 63
State: FL

Vax Date: 04/06/2021
Onset Date: 06/24/2021
Rec V Date: 09/02/2021
Hospital:

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

Lab Data: MRI

Allergies: None

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Weak left leg muscles inability to walk correctly falling for lack of balance. Muscle wasting and muscle tingling. Soreness and pain in the left leg both above and below it in the knee.

Other Meds: Insulin

Current Illness: Diabetes

ID: 1665971
Sex: M
Age: 15
State: AL

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

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

Lab Data:

Allergies:

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

Symptoms: Systemic: Fainting / Unresponsive-Severe, Systemic: Seizure-Severe, Additional Details: Child had the seizure in the lobby of pharmacy.

Other Meds:

Current Illness:

ID: 1665972
Sex: M
Age: 72
State:

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

Allergies:

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

Symptoms: hospitalized, SARS-CoV-2 positive

Other Meds:

Current Illness:

ID: 1665973
Sex: M
Age: 58
State: SC

Vax Date: 08/27/2021
Onset Date: 08/27/2021
Rec V Date: 09/02/2021
Hospital:

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

Lab Data: UPON CALLING THE CDC ON 8/28/2020 TO SPEAK TO A NURSE ABOUT WHAT THE PATIENT CAME BACK THE NEXT DAY TO REPORT, THE RPH ON DUTY WAS ADVISED TO ENTER THIS ADVERSE EVENT AS A VACCINATION ADMINISTRATION ERROR. THE PATIENT WAS MORE THAN ADAMANT THAT HE DID NOT RECEIVE THE FULL DOSE.

Allergies: NONE MENTIONED

Symptom List: Unevaluable event

Symptoms: AT THE TIME OF VACCINATION PATIENT SAYS THAT HE DID NOT RECEIVE ADEQUATE AMOUNT BECAUSE HE WITNESSED VACCINE DRAINING FROM HIS ARM AND POOLING AROUND HIS WATCH

Other Meds: NONE MENTIONED

Current Illness: NONE MENTIONED

ID: 1665974
Sex: F
Age: 33
State: GA

Vax Date: 08/17/2021
Onset Date: 08/17/2021
Rec V Date: 09/02/2021
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: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

Symptoms: Error: Booster Given Too Early-

Other Meds:

Current Illness:

ID: 1665975
Sex: M
Age: 19
State: CA

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

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1665976
Sex: F
Age: 14
State: CA

Vax Date: 08/19/2021
Onset Date: 08/19/2021
Rec V Date: 09/02/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1665977
Sex: M
Age: 73
State: MI

Vax Date: 02/18/2021
Onset Date: 08/28/2021
Rec V Date: 09/02/2021
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: COVID positive on 8/28/21

Allergies:

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

Symptoms: COVID vaccine breakthrough case

Other Meds:

Current Illness:

ID: 1665978
Sex: M
Age: 12
State: CA

Vax Date: 08/14/2021
Onset Date: 08/14/2021
Rec V Date: 09/02/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1665979
Sex: M
Age: 54
State: GA

Vax Date: 04/27/2021
Onset Date: 04/30/2021
Rec V Date: 09/02/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Admits to decreased vision in R eye a few days after COVID vaccination. was followed up with ophthalmology who stated there was blood in his eye obscuring his retina.

Other Meds:

Current Illness:

ID: 1665980
Sex: M
Age: 14
State: CA

Vax Date: 08/18/2021
Onset Date: 08/18/2021
Rec V Date: 09/02/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1665981
Sex: F
Age: 48
State:

Vax Date: 08/27/2021
Onset Date: 08/27/2021
Rec V Date: 09/02/2021
Hospital:

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

Lab Data: none

Allergies: PCN, Sulfa, Gluten

Symptom List: Nausea

Symptoms: headache, fatigue, weakness, nausea, congestion and drainage

Other Meds: MVI, Vit C

Current Illness: none

ID: 1665982
Sex: F
Age: 23
State: FL

Vax Date: 04/27/2021
Onset Date: 05/01/2021
Rec V Date: 09/02/2021
Hospital: Y

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

Lab Data: Covid Test: posititive, CXR.

Allergies: Morphine

Symptom List: Injection site pain

Symptoms: Pt came to ER c/o fever, chills, headache, cough, generalized body aches for the prior few days.

Other Meds:

Current Illness:

ID: 1665983
Sex: M
Age: 41
State: CA

Vax Date: 08/18/2021
Onset Date: 08/18/2021
Rec V Date: 09/02/2021
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 induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1665984
Sex: F
Age: 36
State: IN

Vax Date: 08/25/2021
Onset Date: 09/02/2021
Rec V Date: 09/02/2021
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: Developed a large, red, slightly raised area around the injection site on my upper right arm. Area is tender.

Other Meds:

Current Illness:

ID: 1665985
Sex: M
Age: 59
State: PA

Vax Date: 03/03/2021
Onset Date: 03/10/2021
Rec V Date: 09/02/2021
Hospital:

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

Lab Data: M.R.I. C.T. scan, audiologist testing, Lyme testing plus other labs all showing normal results.

Allergies:

Symptom List: Tremor

Symptoms: Tinnitus , headache, pressure in head, tightening in forehead, kidney pain with a tightening in cheats. Treated with hearing aids, steroids, and pain medications.

Other Meds: Cephalexin 500 mg once daily, omeprazole 20 mg once daily

Current Illness: Chronic osteomyelitis

ID: 1665986
Sex: M
Age: 40
State: CA

Vax Date: 08/15/2021
Onset Date: 08/15/2021
Rec V Date: 09/02/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1665987
Sex: F
Age: 44
State: CA

Vax Date: 08/15/2021
Onset Date: 08/15/2021
Rec V Date: 09/02/2021
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:

Allergies:

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

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1665988
Sex: F
Age: 57
State: NC

Vax Date: 08/11/2021
Onset Date: 08/16/2021
Rec V Date: 09/02/2021
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: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: Paresthesia of upper and lower limbs which is exacerbated by sitting or lying. Symptoms are worse at night causing sleeplessness.

Other Meds: multivitamin ASA 81 mg

Current Illness: none

ID: 1665989
Sex: M
Age: 18
State: CA

Vax Date: 08/17/2021
Onset Date: 08/17/2021
Rec V Date: 09/02/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Error: Improper storage (temperature).

Other Meds:

Current Illness:

ID: 1665990
Sex: F
Age: 51
State: FL

Vax Date: 03/16/2021
Onset Date: 03/17/2021
Rec V Date: 09/02/2021
Hospital:

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

Lab Data:

Allergies: none know

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

Symptoms: Lymph nodes became epically swollen after on my left collar bone and around my arm pit on the same arm . This has resulted what presents as frozen shoulder. My lymph nodes and/or bursa are still reactive. I can't move my arm without sharp pain. I can't put on a bra regularly. It has dramatically limited my ability to exercise especially with yoga. In addition my shoulder became so inflammed and tight a chiropractor was able to lessen the pain. I have had headaches as a result several times a week that are severe that I didn't have prior to the injection. Besides the chiropractor, no one seems to care and I am told it could take years to subside.

Other Meds: Multi vitamin Bcomplex Vit d3 Turmeric Probotic

Current Illness: Not one month prior but had Melanoma surgery in November 2020. This included removal of Lymph nodes and my reaction has been within the same system

ID: 1665991
Sex: F
Age: 14
State: CA

Vax Date: 08/17/2021
Onset Date: 08/17/2021
Rec V Date: 09/02/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1665992
Sex: F
Age: 34
State: MD

Vax Date: 08/31/2021
Onset Date: 09/01/2021
Rec V Date: 09/02/2021
Hospital:

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

Lab Data:

Allergies: B12 Vaccine.

Symptom List: Pain in extremity

Symptoms: The day after i got my 2nd dose of the vaccine, my whole body ached my head was pounding i didn't eat anything really but i did keep hydrated, and i slept most of the day and i had cold chills. but it only lasted 24 hours, i feel better now.

Other Meds: None.

Current Illness: None.

ID: 1665993
Sex: F
Age: 60
State:

Vax Date: 08/21/2021
Onset Date: 08/21/2021
Rec V Date: 09/02/2021
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: Macrodantin

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

Symptoms: Pain in left elbow and breast, heart palpitations and pain, and fatigue.

Other Meds: Hydroxychloroquine 2000mg (once daily) Super C Vitamin

Current Illness: None

ID: 1665994
Sex: F
Age: 60
State: CA

Vax Date: 08/13/2021
Onset Date: 08/13/2021
Rec V Date: 09/02/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1665995
Sex: F
Age: 59
State: FL

Vax Date: 04/05/2021
Onset Date: 04/30/2021
Rec V Date: 09/02/2021
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: 4/30/21: covid positive, cxr.

Allergies: Formaldehyde

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

Symptoms: Pt came to ER c/o RUQ pain x 2 days with nausea and vomiting.

Other Meds:

Current Illness:

ID: 1665996
Sex: F
Age: 57
State: NE

Vax Date: 04/15/2021
Onset Date: 04/22/2021
Rec V Date: 09/02/2021
Hospital:

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

Lab Data:

Allergies: Cephalexin

Symptom List: Vomiting

Symptoms: Worsening of joint pain.

Other Meds: Bupropion, Ropinirole, Gabapentin, Divalproex, Singular, Clonidine, Tizanidine, Naprosyn, Crestor, Lamictal, Advair

Current Illness:

ID: 1665997
Sex: M
Age: 52
State: IL

Vax Date: 08/26/2021
Onset Date: 08/27/2021
Rec V Date: 09/02/2021
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: None

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Flu-like symptoms Sneezing, coughing Symptoms are running their course

Other Meds: None

Current Illness: None

ID: 1665998
Sex: M
Age: 59
State: CA

Vax Date: 08/14/2021
Onset Date: 08/14/2021
Rec V Date: 09/02/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1665999
Sex: M
Age: 16
State: CA

Vax Date: 08/14/2021
Onset Date: 08/14/2021
Rec V Date: 09/02/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1666000
Sex: M
Age: 31
State: IN

Vax Date: 08/29/2021
Onset Date: 08/31/2021
Rec V Date: 09/02/2021
Hospital:

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

Lab Data: COVID Test - Result: Negative for Coronavirus

Allergies:

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

Symptoms: Fever, Chills, Exhaustion,Body Aches,Congestion,Runny Nose,

Other Meds:

Current Illness:

ID: 1666001
Sex: M
Age: 15
State: CA

Vax Date: 08/17/2021
Onset Date: 08/17/2021
Rec V Date: 09/02/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am