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: 1667730
Sex: F
Age: 36
State: NC

Vax Date: 04/01/2021
Onset Date: 07/08/2021
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: Cbc, comprehensive metabolic panel, RA factor screen, TSH 3r dgeneration, free t4, magnesium, cpr non cardiac, parvovirus b19, ehrlichia /anaplasma DNA cpr, EBV profile extended, lyme test, CT scan, x-ray chest and back, strep, pregnancy test, hemoglobin a1c,

Allergies: Cats, rabbits, dogs

Symptom List: Dysphagia, Epiglottitis

Symptoms: Body aches from head to toes, lethargy, headaches, coughing, anxiety heart palpation, sore throat, lack of appetite

Other Meds: Loretadine 10mg, montelukast 10mg, symbicort 160-4.5, b complex, Vitamin d3, b complex, ketoconozole shampoo, prenatal vitamins

Current Illness: Allergies and asthma

ID: 1667731
Sex: F
Age: 63
State: WA

Vax Date: 04/21/2021
Onset Date: 04/21/2021
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: None

Allergies: Erythromycin (rash), codeine (headache)

Symptom List: Anxiety, Dyspnoea

Symptoms: 04/21/2021: After my first shot on this date, I had an ache over the injection site within a minute or two, and this subsided after about 10 minutes. The site felt bruised to the touch for about 3 days, and then it was OK. 05/12/2021: After my 2nd shot on this date, no ache, but same bruised feeling. No other symptoms.

Other Meds: Vitamins & supplements: Vit B-12, Vit C, Vit D, Vit E, calcium, kelp, zinc,

Current Illness: None

ID: 1667732
Sex: F
Age: 53
State: MI

Vax Date: 08/09/2021
Onset Date: 08/09/2021
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: Pt has dr appt scheduled 8/31 at 815am

Allergies:

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

Symptoms: -Pt reported sore arm after Injection, and claimed she experienced heart palpitations -8/30/21 she still has sore arm, limited range of motion, spasm in left arm from neck down to elbow.

Other Meds:

Current Illness:

ID: 1667733
Sex: F
Age: 57
State: SC

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: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data: None

Allergies: NKA

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: About 8 hours after receiving the flu shot, I began to have a headache and body aches. Later on in the evening, I developed a fever which ranged from 99.1-101.1. I had chills and severe body aches and a headache all night and most of the following day. I felt like I had the full blown flu. I also had a sore arm. The shot really hurt and stung bad when they jabbed me,

Other Meds: Synthroid 125mcg Vitamin D Fish Oil Magnesium

Current Illness: None

ID: 1667734
Sex: M
Age: 62
State: OR

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

Lab Data: CT Scan at hospital.

Allergies: Mirapex Topiramate Botox Niacin Fluconazole Reglan Statins Zonegran Sulfa DS Fluoroquinolone Bactrim DS Amoxicillin Clavamox Erythromycin Azithromycin

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

Symptoms: 2nd and 3rd day, severe muscular pain, headaches, fatigue, pain in right arm 3rd day, onset of acute hypertension, headaches, noise in ears. Average BP 175/125, pressures up to 251/155. Clonidine 0.1 mg once / twice daily is holding BP at 145/96

Other Meds: aluminum, magnesium acetaminophen alprazolam celecoxib domperidone fludrocortisone galcanezumab hydromorphone levothyroxine lorazepam omeprazole pregabalin

Current Illness: None

ID: 1667735
Sex: F
Age: 54
State: MO

Vax Date: 08/20/2021
Onset Date: 08/20/2021
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: X-ray and CT scan

Allergies: None

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

Symptoms: Body was very hot with no fever, dry cough for 8 days turned into productive cough, left chest pain, blood clot in lung

Other Meds: None

Current Illness: None

ID: 1667737
Sex: F
Age: 32
State: NE

Vax Date: 04/28/2021
Onset Date: 04/28/2021
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: Shrimp, Bees

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Appears to have been anaphylaxis that resolved spontaneously without epinephrine. She notes nausea, vomiting, throat sensation of closure, dyspnea and oral tingling. Of note, lot number is either ER8736 or 91300, I am unsure but venture to guess ER8736 is correct.

Other Meds: None

Current Illness: None

ID: 1667738
Sex: F
Age: 69
State: CO

Vax Date: 03/31/2021
Onset Date: 03/31/2021
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-19 RNA test

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Fever, fatigue

Other Meds:

Current Illness:

ID: 1667739
Sex: M
Age: 62
State: KS

Vax Date: 08/23/2021
Onset Date: 08/23/2021
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 Rapid Test (Negative)

Allergies: N/A

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Headache, Fever (Ave 100.2?) - Started eight days after vaccination

Other Meds: Azathioprine, Glipizide, Ozempic

Current Illness: N/A

ID: 1667740
Sex: F
Age: 37
State: CA

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: No

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Headache, fatigue, heart/chest pressure is most disturbing. Took Tylenol for headache at 1:00p

Other Meds: Leupron

Current Illness: No

ID: 1667742
Sex: F
Age: 36
State: NC

Vax Date: 08/26/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: Penicillin

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

Symptoms: Day 1?3: Chest pain, joint pain, muscle aches, headaches , fatigue 3-5: headaches, joint pain Day 6-Present: Hives, urticaria, headaches, chest pain, increased blood pressure, increased heart rate, severe joint pain high dose steroids - oral and IM, multiple antihistamine medications , Anti inflammatory and pain relievers

Other Meds:

Current Illness:

ID: 1667743
Sex: F
Age: 64
State: CA

Vax Date: 03/26/2021
Onset Date: 04/02/2021
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: None

Symptom List: Rash, Urticaria

Symptoms: 4/2/21 - Large red, hot itchy rash approximately 4" in diameter around left arm vaccination site, lasting approximately 6 days. Inflamation treated with Zyrtec, per pharmacy advice. Subsequent hypersensitivity/allergic reactions to insect bites on multiple occasions following vaccines, including on 5/2/2021 and 8/28/2021 not previously experienced and lasting over one week. Unknown insect and mosquito bites red, hot, itchy, burning, raised and inflamed up to 3" in diameter with additional swelling over large area surrounding the bite. Treated with Benadryl, per pharmacy advice.

Other Meds: Women's multi-vitamin Fish Oil D3-Calcium Levothyroxin Atorvastatin

Current Illness: None

ID: 1667871
Sex: F
Age: 34
State: SC

Vax Date: 08/30/2021
Onset Date: 08/30/2021
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: None

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

Symptoms: Facial numbness

Other Meds: None

Current Illness: None

ID: 1667872
Sex: F
Age: 13
State: FL

Vax Date: 02/27/2018
Onset Date: 02/27/2018
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 and surgery

Allergies: none

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

Symptoms: The first dose headaches after the second dose syncope sindrome , abcent seizures , auras , dropping seizures , allergies , sleep apnea , toncilitis.

Other Meds: none

Current Illness: Headaches after first HPV9 vaccination

ID: 1667873
Sex: M
Age: 29
State: KY

Vax Date: 08/30/2021
Onset Date: 09/02/2021
Rec V Date: 09/02/2021
Hospital: Y

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

Lab Data: EKG, troponin, emergency department visit and admission to hospital for observation.

Allergies: NKDA

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

Symptoms: Patient recieved their second dose of Pfizer vaccine on 8/30/21 and presented to the ED on 9/2/21 with complaints of chest pain. Ultimately patient has mild pericarditis with an elevated troponin of 0.499.

Other Meds: No Prior to Admission Medications Entered

Current Illness: None

ID: 1667874
Sex: F
Age: 46
State: NJ

Vax Date: 05/01/2021
Onset Date: 06/01/2021
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: None

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

Symptoms: Bells palsy approx 3 weeks after 2nd shot.

Other Meds: Multi vitamin

Current Illness: None

ID: 1667875
Sex: F
Age: 49
State: CA

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: None

Allergies: Vicodin

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

Symptoms: Numbness,tingling, and swelling of left side of face Numbness, tingling, and swelling of lips Numbness, tingling of toes and finger on left hand and both feet Hot over entire body and felt like organs were on fire Dizziness difficulty walking

Other Meds: Armours Thyroid , multi vitamin

Current Illness: Strep Throat August 4, 2021

ID: 1667876
Sex: F
Age: 39
State: NM

Vax Date: 09/01/2021
Onset Date: 09/02/2021
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: N/A

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Patient received 1st dose of Moderna vaccine 9/1/2021 at 12:45 pm. She came to the pharmacy on 9/2/2021 ,stating that she had adverse reaction to vaccine and wanted to report it. She states that on 9/2/2021 in the morning she experienced hives/mild fever .She has Benadryl at home and will go to urgent care if needed. She does not have PCP at this time.

Other Meds:

Current Illness:

ID: 1667877
Sex: F
Age: 36
State: FL

Vax Date: 07/26/2021
Onset Date: 07/26/2021
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:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Patient report still having pain in arm weeks after vaccination

Other Meds:

Current Illness:

ID: 1667878
Sex: M
Age: 12
State: TN

Vax Date: 08/23/2021
Onset Date: 08/28/2021
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: Normal echocardiogram ST changes on EKG

Allergies: none

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

Symptoms: pericarditis detected 5 days after onset of symptoms. Exact timing of first vaccine is unknown to family ; however, second dose was on 9/13 so presumed 3 weeks prior. Clinically stable Treated with ibuprofen and rest from activity

Other Meds: none

Current Illness: none

ID: 1667880
Sex: M
Age: 49
State: CO

Vax Date: 07/21/2021
Onset Date: 07/22/2021
Rec V Date: 09/03/2021
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: CRP elevated at 13.6 on 8/4/21 CRP down to 2.33 on 9/1/21 following administration of prednisone Sed rate elevated at 29 on 9/2/21; repeat CRP on 9/2/21 was elevated at 25.2; CMP normal on 9/2/21 except for glucose of 203; CBC normal 9/2/21 except for WBC ct of 10.8; Rheumatoid factor was negative on 9/2/21; Uric acid = 6.3 on 9/2/21

Allergies: none

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

Symptoms: pt developed severe myalgia throughout his entire body approximately 24 hrs. following his 2nd dose of Moderna COVID vaccine that was not given through our clinic - I have contacted the patient to find out where he had his vaccine administered and what was the lot number. He had a sore arm for 24-48 hrs. with the first dose of Moderna COVID vaccine. The myalgia persisted and he was seen and evaluated in our office on 8/4/21. Labs (CBC, CMP, lactic acid, CPK, and CRP) were drawn - all were normal except for CRP elevated at 13.6 and glucose of 129. His pravastatin was held. On 8/25 we spoke with patient and he was continuing to have severe muscle pains in trunk, arms, and legs. Prednisone was started at per day. Within 24 hrs. his symptoms were tremendously improved. He finished a five day course of prednisone and within 48 hrs. his symptoms were returning. On 9/1/21 he was given the diagnosis of polymyalgia rheumatica and was restarted on 20 mg daily of prednisone. His CRP at that time was down to 2.33. His HgbA1C was stable at 6.3. He will continue to follow-up in our office.

Other Meds: Lisinopril. pravastatin, metformin, omeprazole, and aspirin

Current Illness: none, other than long-term health conditions (see below)

ID: 1667881
Sex: M
Age: 65
State: OR

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

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

Lab Data: None

Allergies: Penecillin, Hyzaar, Hydralazine

Symptom List: Unevaluable event

Symptoms: Exhaustion, headache, severe body aching, blister at injection site

Other Meds: Sertraline 10 mg, Losartan Potassium 100 mg, Amlodipine Besylate 10 mg, Finasteride 5 mg, Ezetimbe 10 mg, Isosorbide Mononit ER 30 mg (2 tabs daily), Torsemide 10 mg (7 tabs daily), Gabapentin 300 mg (6 capsules daily), Pitavastatin 2 mg,

Current Illness: None

ID: 1667882
Sex: M
Age: 13
State: NJ

Vax Date: 06/01/2021
Onset Date: 08/27/2021
Rec V Date: 09/03/2021
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: PCR + for Covid 8/30/2021

Allergies: none known

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

Symptoms: Client had Pfizer vaccines x 2 in June, 2021 at the appropriate intervals. Client developed Covid symptoms on 8/27/2021 (fever x 1 day, nasal congestion) and tested PCR positive for Covid on 8/30. Reported as case of breakthrough Covid in a fully vaccinated person.

Other Meds: none known

Current Illness: none known

ID: 1667883
Sex: M
Age: 38
State: TX

Vax Date: 08/30/2021
Onset Date: 09/01/2021
Rec V Date: 09/03/2021
Hospital:

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

Lab Data: Apparently, all my test results showed negative markers. Ive read the flow chart tho, and it eventually says if no visual sign, then its probably viral...I think thats why these are under reported. Because we are given the virus, but the immune system thinks we did. There should be a better SOP for this across the world.

Allergies: Sulfa

Symptom List: Injection site pain, Pain

Symptoms: I woke up on Wednesday, and felt slight pressure, a little sharpness. Eventually, the pressure and pain was too much, I went to the ER. I coudnt drive myself, as I was dizzy I eventually self-diagnosed pericarditius When I got there at 9pm, tachycardia of over 160.

Other Meds: I wasnt able to get a prescription strength anti-inflammatory from the Doctors. I went to the ER, and they acted like they never heard of the connection between Pfizer and cardiatic issued. I feel this should be relayed down, so we can all

Current Illness: None

ID: 1667884
Sex: F
Age: 20
State: WA

Vax Date: 03/12/2021
Onset Date: 05/07/2021
Rec V Date: 09/03/2021
Hospital:

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

Lab Data: MRI of brain normal full audio logic exam dx with cranial nerve 7 vestibular neuritis

Allergies: none

Symptom List: Injection site pain, Menorrhagia

Symptoms: 5/7/21 started having vertigo 4/28/21 started to wean off of citalopram onto wellbutrin 5/5/21 started on cephalexin for UTI 6/23/21 started working up vertigo as it worsened eventually saw ENT and audiologist and diagnosed with vestibular neuritis

Other Meds: citalopram, cryselle, cephalexin

Current Illness:

ID: 1667885
Sex: F
Age: 37
State: UT

Vax Date: 05/31/2021
Onset Date: 06/07/2021
Rec V Date: 09/03/2021
Hospital:

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

Lab Data: None

Allergies: None

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

Symptoms: Bruising all over the body for more than 90 days now as well as left shoulder blade and left shoulder pain and constant stiff neck for more than 90 days now. The random bruising hasn?t stopped and my stiff neck and pain in my shoulder blade hasn?t stopped. I?ve also had a sore throat and sinus and plugged ears since my first dose over 90 days ago too. And body aches and fatigue pretty much every day that hasn?t let up.

Other Meds: None

Current Illness: None

ID: 1667886
Sex: M
Age: 55
State: NV

Vax Date: 07/26/2021
Onset Date: 08/30/2021
Rec V Date: 09/03/2021
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: Ct scan - negative for stroke.

Allergies: None

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Slightly elevated temp, general body ache, very sore injection site, restlessness for first several days. Approx 7:30 PM on Aug 30, 2021, felt sharp pain in left side of neck while filling in reports.. Numbness in lip and left side of face. Left eye felt very irritated and began watering. When to bathroom to wash face and noted left side droop. Consulted with on duty medic and confirmed assessment of possible stroke. Transported to ER, a stroke destination hospital. Initial assessment resulted in a CT scan which showed negative results for stroke. MD assessed partial facial paralysis due to Bells Palsy. Prednisone, Acyclovir, and eye drops prescribed with orders for follow up with internal medicine specialist and PCP.

Other Meds: Prednisone 20mg; Acyclovir 400mg; GenTeal eye drops

Current Illness: None

ID: 1667888
Sex: F
Age: 39
State: CA

Vax Date: 03/18/2021
Onset Date: 03/18/2021
Rec V Date: 09/03/2021
Hospital:

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

Lab Data: Full Blood work Allergy test

Allergies: Penicillins and codeine

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: The day of the first injection I noticed a little swelling under my eyes where fillers were 2 years ago. The next day after the vaccine I felt very drowsy and tired, chills, body aches. After the second vaccine I felt flu like symptoms for two days. Body aches, fever, chills, headache. I had fillers done on my lips the week prior to the 1st vaccine and they started to get lumpy. 6/28 my lips got very lumpy and swollen. The next day my eye was swollen and left side of face. I went to urgent care where I was given Prednisone for an allergic reaction. The swelling continued. Contacted primary care Dr who prescribed Medrol. While taking medrol and 10mg or zyrtec or Benadryl the swelling lessened. After medrol was done swelling continued along with inflammation. I went to the ER because my life side started feeling tingly, swelling continued and started having inflammation throughout. Lab Work showed some things off like glucose and kidney. Prescribed more prednisone, Pepcid, hydrooxyzine. Saw the Allergist who recommended I take 40 mg daily of zyrtec. I than put myself on an anti inflammatory diet. Developed a sensitivity to certain foods like nuts and tomatoes. Caused lots of headaches and inflammation and swelling. Took zyrtec and had my fillers dissolved. Gradually with time I started feeling better, swelling went away. August 5 is when I started feeling better.

Other Meds: None

Current Illness: None

ID: 1667889
Sex: F
Age: 29
State: CT

Vax Date: 08/18/2021
Onset Date: 08/18/2021
Rec V Date: 09/03/2021
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: Amoxicillin

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

Symptoms: I began spotting heavily as if I had my period almost instantly. I never ever get my period early or spot unless I miss a birth control pill which I did not. I also got intense back pains, what I felt when I am about to get my period, which I was not going to get for 2 weeks. Again, I?ve had a very exact schedule for 10+ years. Very concerning.

Other Meds: N/A

Current Illness: None

ID: 1667890
Sex: F
Age: 44
State: NC

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

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

Lab Data: None, uninsured and low income.

Allergies: None

Symptom List: Nausea

Symptoms: Severe debilitating dizziness/ lightheadedness, nausea, migraine, insomnia, loss of balance. Started within 6-8 hours of vaccine. Currently one month later after first dose and no improvement, getting worse.

Other Meds: None

Current Illness: None

ID: 1667891
Sex: M
Age: 46
State: NC

Vax Date: 08/23/2021
Onset Date: 09/03/2021
Rec V Date: 09/03/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: Tinnitus in my left ear

Other Meds:

Current Illness:

ID: 1667892
Sex: F
Age: 59
State: OR

Vax Date: 06/08/2021
Onset Date: 06/09/2021
Rec V Date: 09/03/2021
Hospital:

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

Lab Data:

Allergies: lactose intolerant serotonin allergy allergy to gabapentin

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

Symptoms: increased joint pain. Increased nerve pain in knees and behind eyes.Shooting nerve pain is sharpened. Extreme fatigue at times.

Other Meds: Fluoxetine, Fioricet, Oxycodone, magnesium, calcium. vit d.

Current Illness: Migraines Glaucoma osteoarthritis spinal stenosis fibromyalgia

ID: 1667893
Sex: F
Age: 77
State: TX

Vax Date: 01/28/2021
Onset Date: 02/21/2021
Rec V Date: 09/03/2021
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: skin biopsy confirming bullous pemphigoid.

Allergies:

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

Symptoms: Patient broke out in bullous eruption diffusely on the entire body with the diagnosis of bullous pemphigoid.

Other Meds: alendronate, citalopram, famotidine, fergon, hydralazine, methimazole

Current Illness:

ID: 1667894
Sex: F
Age: 30
State:

Vax Date: 07/24/2021
Onset Date: 07/24/2021
Rec V Date: 09/03/2021
Hospital:

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

Lab Data: Negative pregnancy test

Allergies:

Symptom List: Tremor

Symptoms: Period late by 16 days, very strong pms and menstrual cramps

Other Meds:

Current Illness:

ID: 1667895
Sex: M
Age: 51
State: VA

Vax Date: 09/03/2021
Onset Date: 09/03/2021
Rec V Date: 09/03/2021
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, shellfish

Symptom List: Erythema, Pruritus

Symptoms: Just a few minutes after the shot became very dizzy, had severe medicine head for about 25 minutes. Face was very flushed and felt extremely tired. Symtoms subsided at around 30 min. Flu-like symptoms the rest of the day

Other Meds: Amlo Benaz

Current Illness: Na

ID: 1667896
Sex: F
Age: 61
State: MS

Vax Date: 04/03/2021
Onset Date: 04/05/2021
Rec V Date: 09/03/2021
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: Lab Results From 08/17/2021: C-Reactive Protein, Quant - Results and Flag: 81 (High), Previous Result and Date: 56 (05/14/2021); Sedrate - 122 (High) ...

Allergies: NO KNOWN DRUG ALLERGIES

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

Symptoms: Patient was seen in the Clinic on May 14, 2021 and reported that she was having pain and swelling in her injection site from her Covid-19 Johnson and Johnson vaccine that was given on April 3, 2021 Clinic. Vitals at that time were BP: 118/78, Left Arm, Pulse: 96, Temp: 97.7 F, Weight: 164 lbs, Oximetry: 97%, BMI: 26.47 kg/m2. She was having swelling in her hands and feet as well and also was having difficulty arising from a seated position. Sedrate at that time was 114, C-reactive protein 56, ANA screen positive speckle pattern 1:160, and a CK of 71. She has a calendar that maps out her reactions over the 42 days after the injection ...

Other Meds: NAPROXEN (ONLY AS NEEDED)

Current Illness: NONE

ID: 1667898
Sex: F
Age: 13
State: NY

Vax Date: 09/01/2021
Onset Date: 09/02/2021
Rec V Date: 09/03/2021
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: nausea, weakness, headache, malaise

Other Meds: none

Current Illness: none

ID: 1667899
Sex: M
Age: 29
State: CA

Vax Date: 09/02/2021
Onset Date: 09/02/2021
Rec V Date: 09/03/2021
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: None

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: After receiving shot,1-2 minutes later began to feel light headed and vision blurred and slightly darkened. Began to feel extremely hot and body began to sweat all over. Skin color turned very pale more specifically the face. I was nervous prior to the shot and was already feeling hot while waiting for the vaccine shot. Staff provided water and I removed mask to better aid in breathing and regulating body temperature. 20 minutes after receiving the shot my body cooled down and vision returned to normal. I was able to leave the store shortly after. 2+ hours later feel normal and not experiencing the symptoms that had occurred immediately following the shot.

Other Meds: None

Current Illness: Had Covid-19 but tested negative a week prior to receiving the vaccine.

ID: 1667900
Sex: F
Age: 71
State: HI

Vax Date: 09/02/2021
Onset Date: 09/02/2021
Rec V Date: 09/03/2021
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: penicillin

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

Symptoms: Needle hit bone and patient reported pain not usually felt with vaccine. Patient arm was very small and not much muscle. Patient was responsive and alert when leaving vaccination area, but became distressed and overheated by the time she reached her husband outside. (it was quite warm in the store today ). Called patient later to check on her and she felt fine but felt like the vaccine was too high on her arm. I apologized and told her about possibilty of shoulder impingement and she had no side effects at the time.

Other Meds: montelukast 10mg

Current Illness:

ID: 1667901
Sex: F
Age: 56
State:

Vax Date: 08/31/2021
Onset Date: 08/31/2021
Rec V Date: 09/03/2021
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: Dr has not responded to email of symptoms yet

Allergies: Sulfa, Penicillin, Guaifenesin, Sulfites, Latex, Red Wine, Soy, Broccoli, Califlower, Propelyne Glycol, Mineral Oil, Suntan lotion, Perfumes

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

Symptoms: 8/31: Headache right away, then dizziness and rapid heart rate starting at 6pm right after the shot. Constant clearing of throat, red, swollen, warm arm at injection site and unable to move arm over head. 9/1 Continued headache through the night into the morning, same symptoms as above with the addition to light sensitivity, muscle aches and joint pain. Unable to make fist with right hand due to joint pain and swelling. Intermittent profuse sweating. Increased SOB while walking up hill. 9/3: Same symptoms as above to include tingling and slight numbness on left side of face in the morning after waking up. By 2pm increased numbness and tingling of whole face with sharp stabbing pains in head. Brain feels foggy.

Other Meds: NA

Current Illness: NA

ID: 1667902
Sex: M
Age: 19
State: CA

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

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

Lab Data: None

Allergies: No known allergies, none mentioned by patient

Symptom List: Pain in extremity

Symptoms: Approximately ~4 minutes after immunization, pt fainted as he was walking to purchase water to drink. (Pt was instructed by immunizing pharmacist to take a seat for 15 minutes after immunization). When immunizing pharmacist reached the patient, patient was already sitting up straight on a chair and drinking water from a water bottle. Pharmacist asked if patient was experiencing any symptoms of anaphylactic shock, i.e. difficulty breathing, rashes/hives, and/or swelling. Patient denied having any of those symptoms. Immunizing pharmacist had oral benadryl and epinephrine pen ready in case they needed to be administered. At the end of observation, pt felt strong enough to get up and walk. Pt was instructed by immunizing pharmacist to seek medical attention ASAP if he started to experience any symptoms of anaphylactic shock. No epinephrine or oral benadryl was administered to patient during the incident. No 911 was called either.

Other Meds: None mentioned by patient

Current Illness: None mentioned by patient

ID: 1667903
Sex: F
Age: 28
State: PA

Vax Date: 04/16/2021
Onset Date: 04/18/2021
Rec V Date: 09/03/2021
Hospital:

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

Lab Data: Allergies, Lupus and Hashimoto?s ruled out after doing several blood tests.

Allergies: None

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

Symptoms: Localized chronic urticaria on cheeks. It comes and goes. It tingles when it?s about to flare. It?s not gone yet, even after trying several treatments given by different specialists.

Other Meds: Levothyroxine and Spironolactone

Current Illness: None

ID: 1667906
Sex: M
Age: 36
State:

Vax Date: 09/01/2021
Onset Date: 09/01/2021
Rec V Date: 09/03/2021
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: Joint pain, fever, insomnia, fatigue

Other Meds: Escitalopram, Finasteride

Current Illness:

ID: 1667907
Sex: F
Age: 62
State: CA

Vax Date: 08/15/2021
Onset Date: 08/20/2021
Rec V Date: 09/03/2021
Hospital:

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

Lab Data: I had a visit today with my rheumatologist to figure this out.

Allergies: Cipro. Codeines

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

Symptoms: I received the MMR vaccine again in 1983 due to the fact my testes said I had no immunities, I had a huge joint flare which was my first exposure to RA,. Now this vaccination and within 5 days broke through my treatment of 32 years with horrific psoriasis and joint pain, which is why I have been on these toxic drugs for 32 years.

Other Meds: Methotrexate, Leucovorin, Cosentyx, Diclophenac, Breo, Singulair,

Current Illness: boggy wrist arthritis

ID: 1667908
Sex: F
Age: 28
State: IL

Vax Date: 07/24/2021
Onset Date: 08/14/2021
Rec V Date: 09/03/2021
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:

Symptom List: Vomiting

Symptoms: . One minute im freezing the next im hot, I can't breath out my nose and now my body feel like I got rash that irritated all over and feel like im about to throw up. Arm stiffness

Other Meds:

Current Illness: Arm pain, almost like my arm wants to give out . Hurts to raise arm even a little bit. Burning sensation in arm

ID: 1667909
Sex: F
Age: 32
State: CA

Vax Date: 08/06/2021
Onset Date: 08/07/2021
Rec V Date: 09/03/2021
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: Hyperalgesia and mild edema in the ipsilateral axilla that persisted for ~36 hours and self-resolved. *Note: Currently breastfeeding; ~2.5 weeks postpartum.

Other Meds: Prenatal Vitamin

Current Illness: 2.5 weeks postpartum (breastfeeding)

ID: 1667910
Sex: F
Age: 32
State: CA

Vax Date: 08/06/2021
Onset Date: 08/07/2021
Rec V Date: 09/03/2021
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: Hyperalgesia and mild edema in the ipsilateral axilla that persisted for ~36 hours and self-resolved. *Note: Currently breastfeeding; ~2.5 weeks postpartum.

Other Meds: Prenatal Vitamin

Current Illness: 2.5 weeks postpartum (breastfeeding)

ID: 1667911
Sex: F
Age: 84
State: OH

Vax Date: 02/17/2021
Onset Date: 08/16/2021
Rec V Date: 09/03/2021
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:

Allergies: penicillin, lipitor

Symptom List: Injection site swelling, Limb discomfort

Symptoms: 8/16/21: COVID pos presented to ED with cough, clear phlegm, fatigue, weakness 8/18/21: discharged on steroids and told to f/u with PCP as needed

Other Meds: acetaminophen, albuterol, alendronate, ASA, calcium and Vit D, chlorhexidine, gabapentin, ibuprofen, isosorbide mononitrate, levothyroxine, lisinopril/HCTZ, metformin, metoprolol, multivitamin, macrobid, KCl, psyllium seed, rosuvastatin,

Current Illness:

ID: 1667913
Sex: F
Age: 34
State: OH

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

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

Lab Data: None to date

Allergies: Lavander

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

Symptoms: I'm off 7 days after getting the vaccination my arm around or near the injection site became irritated itchy with increasing intensity of burning and pain and swelling September 2nd went to emergency room in city there they diagnosed me with post-injection inflammation gave me over the counter Benadryl antibiotics and naproxen for pain redness has dissipated but swelling has increased irritating ended up noxious it's sensitive I am feeling feverish under the weather a irritable and uncomfortable.

Other Meds: None

Current Illness: N/A

ID: 1668479
Sex: F
Age: 21
State:

Vax Date: 09/02/2021
Onset Date: 09/02/2021
Rec V Date: 09/03/2021
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: Seasonal pollen allergies

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

Symptoms: shortness of breath, rapid heartbeat, barely able to move arm at all, dizziness, could barely walk at all, constantly shaking, hard to swallow

Other Meds: Amoxicillin, birth control, women?s daily vitamin, adderall

Current Illness: Sinus infection

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am