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: 1670365
Sex: F
Age: 63
State: AL

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

Lab Data:

Allergies: Demerol, Lomotil, Morphine, Sporanox

Symptom List: Dysphagia, Epiglottitis

Symptoms: Patient reports waking up to severe pain Wednesday night (9/1/21). She describes the pain as, "pain that radiated all over my body. It felt like I was in labor. I was hot all over, but I did not have a fever." The pain lasted around 4 hours. The patient was unable to sleep or sit comfortably. She experienced severe nausea, headache, and weakness throughout Thursday (9/2/21). These symptoms were severe enough that she left work early. She had joint, bone (including jaw), and muscle pain that last from Wednesday night (9/1/21) to Friday (today, 9/3/21). She is also experiencing dull chest discomfort. This discomforted started today (Friday 9/3/21). Patient treated pain with Tylenol extra strength (OTC) 2 tablets in the morning and 2 tablets at night. She is still experiencing discomfort.

Other Meds: Aspirin 81mg 2 tablets by mouth once daily

Current Illness: NA

ID: 1670366
Sex: F
Age: 56
State: MD

Vax Date: 08/26/2021
Onset Date: 09/02/2021
Rec V Date: 09/03/2021
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: None

Symptom List: Anxiety, Dyspnoea

Symptoms: Rapid heart rate of 140 BPM for an hour while I was sitting and watching TV! It took almost 3 hours to get back to my normal 63 BPM.

Other Meds: Multi vitamin, fish oil, calcium, probiotic

Current Illness: None

ID: 1670367
Sex: F
Age: 64
State: GA

Vax Date: 08/27/2021
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: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: erythromycin

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

Symptoms: A few hour after the injection I experienced sharp pains in my neck , numbness and tingling in the left facial cheek (similar to a shot of Novocaine wearing of after dental work)and headaches. I am still having the feeling in my left facial cheek and the headaches sill come and go but not as often

Other Meds: vitamin D, C, zinc, calcium, quercetin

Current Illness: none

ID: 1670368
Sex: M
Age: 14
State: OH

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

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

Lab Data:

Allergies: None

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Severe rash and throat swelling

Other Meds: None

Current Illness: None

ID: 1670369
Sex: F
Age: 44
State:

Vax Date: 08/24/2021
Onset Date: 08/27/2021
Rec V Date: 09/03/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: shortness of breath, diagnosed with pulmonary embolism, exacerbation of severe persistent steroid-dependent asthma, and RSV infection

Other Meds:

Current Illness:

ID: 1670370
Sex: F
Age: 65
State: SC

Vax Date: 09/01/2021
Onset Date: 09/03/2021
Rec V Date: 09/03/2021
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: none

Allergies: penicillin

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

Symptoms: Arm below shot developed a rash.

Other Meds: not known

Current Illness: lukemia

ID: 1670371
Sex: F
Age: 49
State: MO

Vax Date: 08/31/2021
Onset Date: 09/01/2021
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:

Allergies: none

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: EXTREME SWOLLEN LYMPH NODES, LEFT AXILLA (LUMP VISIBLE TO NAKED EYE, APPROX 4" IN DIAMETER AND PAINFUL). ONGOING. BODY PAIN LASTING APPROX 2DAYS.

Other Meds: none

Current Illness: none

Date Died: 07/28/2021

ID: 1670372
Sex: M
Age: 67
State:

Vax Date: 02/05/2021
Onset Date: 07/28/2021
Rec V Date: 09/03/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Hospice patient, COPD, positive COVID test, diabetic, BPH

Other Meds:

Current Illness:

ID: 1670373
Sex: F
Age: 14
State: ME

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

Lab Data:

Allergies: Watermelon

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Patient received concentrated dose of vaccine. When mix Pfizer vaccine was diluted with 0.8 ml instead of 1.8 ml sodium chloride. Patient had no adverse event while waiting 15 minutes in the clinic after receiving vaccine.

Other Meds: None

Current Illness: Scabies

ID: 1670374
Sex: F
Age: 32
State: NC

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: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Erythromycin, Sulfa, Benadryl, Theophylline

Symptom List: Diarrhoea, Nasal congestion

Symptoms: itching, redness

Other Meds: tylenol

Current Illness: Negative

ID: 1670375
Sex: M
Age: 60
State: MN

Vax Date: 03/20/2021
Onset Date: 08/21/2021
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: 2 - covid tests 1st one was nasal swab/ 2nd was saliva tests

Allergies: demerol

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

Symptoms: I had a tooth extracted on 8/19 had issues lost taste smell was given amoxicillin and 5 day supply of steroid pills. that was done by 8/25. i was traveling from 8/21 to 8/28. When i got home had a rapid test for covid came in negative. On Wednesday 9/1 / i had another tests and was told on 9/2 that it was positive. i had no smell or taste for 2 weeks my taste came back last night. No fever just congested and slight headache as of now.

Other Meds: nasal decongestion pills/ neddy pot

Current Illness: no

ID: 1670376
Sex: M
Age: 33
State: KY

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: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data: Blood glucose-102 O2-97 Pulse- 97 Bp-108/60

Allergies:

Symptom List: Rash, Urticaria

Symptoms: 10 minutes after injection patient was sitting in chair became diaphoretic and unconscious. Patient heart rate dropped to 51. After 2 minutes patient was aroused to consciousness and moved to a lying position. Patient began to shake and complain of crushing left shoulder and chest pain.

Other Meds:

Current Illness: Hepatitis C

ID: 1670377
Sex: F
Age: 26
State: CT

Vax Date: 08/24/2021
Onset Date: 08/31/2021
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: P

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

Symptoms: Exactly one month later hitting 31 August I experience full body rash starting from my thighs to my legs to my toes going to my entire back up into my chest. Red dots everywhere of extreme itchiness and scratching. It will happen 3-4 times a day. Last about an hour or two and completely go away. This outbreak has happened to me about 11 times all together and it?s still happening. I have tried everything to stop it I have not changed detergents I have not gone outside by plants I have not been around animals or be in different foods of any sort.

Other Meds: 0

Current Illness: 0

ID: 1670378
Sex: M
Age: 69
State: SC

Vax Date: 03/31/2021
Onset Date: 05/04/2021
Rec V Date: 09/03/2021
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: On 5/4/2021 I awoke with pain in the muscle area at the base of my left thumb with stiffness resulting in limited motion. No prior activity or injury explained the cause. The condition persisted for several weeks and expanded to pain/discomfort when pinching my thumb together with my index and middle fingers. Some weakness and occasional pain persists to this day. In early July I awoke with stiffness and pain in the muscles on the right side of my neck. Again, no prior activity or injury explained the cause. A week later I discussed both conditions during a regularly scheduled visit with my doctor. When asked, he discounted a possible connection with the vaccine and suggested stretching exercises for my neck. The recommended neck muscle stretching exercises resulted in only limited, temporary relief of the stiffness in my neck. I began to feel additional pain and stiffness in the muscles in my right upper shoulder and arm. Discomfort, included a searing sensation in the front of my shoulder joint that sometimes persists to today along with some weakness in my right shoulder muscles. I also started to experience loud popping in my shoulder which has now diminished to some extent.

Other Meds: Benazepril, Atorvastatin, Multi-vitamin

Current Illness:

ID: 1670379
Sex: F
Age: 20
State: MI

Vax Date: 04/23/2021
Onset Date: 04/23/2021
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: Chest x-ray at time of event. One done at urgent care showed fluid in the lungs (according to the Dr there), one done at the ER was interpreted as normal. Blood tests ordered by Dr months following the reaction, to rule out autoimmune disease. C-reactive protein, D-Dimer, sedimentation rate, ANA screening algorithm were positive or abnormal. Negative for autoimmune-specific antibodies or other indicative things.

Allergies: None

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

Symptoms: Throat and vocal cord spasms, leading to uncontrollable coughing and gagging and trouble breathing in and out. Excessive sweating and hot flashes. Treatment was nebulized lidocane and epinepherine, along with a number of other nebulized medications, steroids, and anti nausea medication. Active symptoms lasted about 30 hours. For the following 5-10 weeks I had episodes of coughing up watery, pink, foamy liquid, and intense gagging without throwing up. I still have allergic symptoms that began after the vaccine reaction: fatigue, crampy stomach pain with diarrhea, skin rash, hives and swelling, joint pain, hair loss, low grade fever.

Other Meds: Prozac 20mg Propranolol 60mg XR

Current Illness: None

ID: 1670380
Sex: F
Age: 49
State: KY

Vax Date: 08/27/2021
Onset Date: 08/28/2021
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: 9/2/21 covid swab negative, cbc normal, cmp normal (except sl elevation of alt improved from past), tsh normal

Allergies: none

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

Symptoms: On Friday August 27, 2021 at 10:15 am I received the Johnson and Johnson covid vaccine from the County Health Department. I returned to work and finished my work day. On Saturday, August 28, 2021 at 12pm I started feeling fatigued and fuzzy and by 2pm I started feeling dizzy, nauseated and unsteady with heaviness in my legs. Later that evening I developed a sore throat, headache and generalized achiness. These symptoms have continued,causing me to be unable to work this week and so far I have missed three days of work. I cannot be upright without dizziness and if I remain upright I become nauseated. My thought processing is slow and difficult when upright. If I am lying down I feel much better. My stomach is upset and eating causes abdominal discomfort. I was instructed by my acting Manager to call the workmans comp number. After calling and reporting my reaction to the vaccination, I received a call from employee health informing me that it had been reported that I was having covid symptoms or had been tested for covid. I reported the above history to her and informed her that I had not been tested for Covid, exposed to Covid or had any symptoms of Covid until the day after my covid vaccination and had just filed a report as instructed. She asked me to call the COVID Hotline to make a report. I called the covid hotline and was told to leave a message for call back. I did this immediately after speaking to her. She called me again a little while later and informed me that workmans comp had approved me to see my primary care physician to be evaluated to make sure that ?nothing else was causing my symptoms? including covid. I did assure her that as a nurse practitioner I was very aware of my health and feel certain that these symptoms have been caused by the vaccine. I called my primary care physician and was given an 11am appointment for tomorrow morning Thurs, Sept 2, 2021. Primary Care video visit with Dr. Documentation of symptoms and labs were ordered. Dr. noted that these symptoms are likely a reaction to the vaccination. I went to the hospital to have the labs done. No change in symptoms: still dizzy and hot sweats and chills, fuzzy thinking, no appetite, nausea if upright and stomach ache if I eat anything and achy all over. I am continuing to hydrate well with electrolytes and fluids, taking meloxicam, vit C, vit D, and zinc along with tylenol. Friday, September 3,2021, test results from yesterday show negative Covid test and routine labs show normal blood count (no signs of infection) and normal electrolytes and normal thyroid. These ruled out other causes of my symptoms. I called Employee health and she noted my updates and asked for me to have Dr. office fax her a copy of the visit for workmans comp claim. I have still not been contacted by the Covid Hotline which I called 2 days ago. I am filing a Vaers report today. Yesterday afternoon for a brief period I felt better but then within an hour my symptoms worsened again with soaking sweat, nausea, stomach ache, dizziness, headache, sore throat and generalized aches, and brain fuzziness/fog. I still cannot sit up in a chair for long without worsening of symptoms, I must be lying flat. Today is still the same. I have tried to exercise for less than 30 min a day the last 3 days to maintain my muscle strength with superhydration before activity and I made it through the activity but with severe dizziness and malaise.

Other Meds: tylenol, vitamin C, Vit D, zinc, calcium, magnesium, Optivite pmt multivitamin, probiotic 10, simethicone, meloxicam rarely, pantoprazole, famotidine, amitriptyline 25mg q hs for ibs, paxil 10mg qhs for hot flashes, baclofen 10mg qhs as nee

Current Illness: none

ID: 1670381
Sex: F
Age: 43
State: IL

Vax Date: 01/01/2021
Onset Date: 08/31/2021
Rec V Date: 09/03/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: Unknown date of vaccine or lot number info. Patient hospitalized with a breakthrough COVID-19 diagnosis

Other Meds:

Current Illness:

ID: 1670382
Sex: M
Age: 61
State: IL

Vax Date: 01/01/2021
Onset Date: 08/23/2021
Rec V Date: 09/03/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: date and clinic for vaccines unknown. sick at home for 5-6 days prior to ED admit with SOB, pneumonia, fever 100.9, loss of appetite, cough tested + 8/25/2021; Remdesivir, Decadron, Lovenox, Azithromycin, Rocephin; O2

Other Meds:

Current Illness:

ID: 1670383
Sex: M
Age: 72
State: WI

Vax Date: 04/01/2021
Onset Date: 08/30/2021
Rec V Date: 09/03/2021
Hospital:

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

Lab Data:

Allergies: No known Allergies

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Patient contracted COVID after being fully vaccinated - Shortness of breath, runny nose, congestion, dyspnea, cough, fatigue, myalgias

Other Meds: Vitamin C 500mg daily, aspirin 81mg daily, Fish Oil 1,000mg daily, Valacyclovir 1 gram BID prn for herpes outbreaks

Current Illness: None documented

ID: 1670384
Sex: F
Age: 40
State: MN

Vax Date: 01/26/2021
Onset Date: 09/02/2021
Rec V Date: 09/03/2021
Hospital:

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

Lab Data: COVID 19 PCR/MOLECULAR NP swab - positive result. tested 9/2/21.

Allergies:

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

Symptoms: Pt fully vaccinated with Pfizer: dose 1 1/5/21 and dose 2 1/26/21. Pt. reports COVID symptoms of cough, sore throat, runny nose, chills, headache, and fatigue starting 9/2/21. Tested positive on 9/2/21.

Other Meds:

Current Illness:

ID: 1670385
Sex: M
Age: 22
State: UT

Vax Date: 04/10/2021
Onset Date: 04/20/2021
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: Blood Tests from Radiance Diagnostics has show extremely elevated blood tests for the markes of TNF-ALPHA, IL-4, IL-2, SCD40L, CCL5, CCL3, IL-6, IL-10, IFN-GAMMA, VEGF, and IL-8. as of the results reported 8/02/2021 at 10:37 pm.

Allergies: Augmentin, cephalexin

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

Symptoms: Vision Issues, Floaters in vision, Raised blood pressure, heart palpitations, and possible TIA. Discovery of Long Covid or PASC for almost 6 months and counting after receiving the vaccine. Strong disorentation, Unable to drive or to work due to the dizziness, visual issues, brain fog, body pains, muscle twitches, heart issues, and high blood pressure.

Other Meds: Daily Vitamins

Current Illness: none

ID: 1670386
Sex: F
Age: 0
State: FL

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

Lab Data: Rapid positive PCR completed 9/3/21

Allergies: None

Symptom List: Unevaluable event

Symptoms: Congestion

Other Meds:

Current Illness: None

ID: 1670387
Sex: F
Age: 43
State: VA

Vax Date: 08/27/2021
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: CBC normal. BMP normal

Allergies: none

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

Symptoms: syncope and fall. also had myalgia and low grade fever. got up middle night to go bathroom. syncope and LOC. fell and hit corner head. needed 7 stitches

Other Meds: sertraline 50 mg po qday

Current Illness: none

ID: 1670388
Sex: F
Age: 70
State: NC

Vax Date: 05/01/2021
Onset Date: 06/01/2021
Rec V Date: 09/03/2021
Hospital: Y

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

Lab Data:

Allergies: diclofenac, tape, and voltaren

Symptom List: Injection site pain, Pain

Symptoms: Bilateral lower extremity weakness, multiple falls

Other Meds:

Current Illness: None

ID: 1670389
Sex: F
Age: 58
State: NH

Vax Date: 02/11/2021
Onset Date: 07/22/2021
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 brain: 8/19/2021 MRI cervical spine: 8/19/2021 MRI thoracic spine: 8/7/2021 MRI lumbar spine: 8/7/2021 CBC; 8/20/2021; CMP: 8/20/2021; LFT: 8/20/2021 Magnesium: 8/20/2021 Phosphorous: 8/20/2021 ESR: 8/20/2021 Urine: 8/20/2021 Urine sediment: 8/20/2021 Syphilis antibody screen: 8/20/2021 NMO evaluation serum: 8/23/2021 MOG iGg: 8/23/2021 Lyme: 8/23/2021 CRP" 8/23/2021

Allergies: PCN, sulfa, doxycycline

Symptom List: Injection site pain, Menorrhagia

Symptoms: acute transverse myelitis impacting cervical and thoracic spine

Other Meds: lisinopril

Current Illness: none

ID: 1670390
Sex: F
Age: 51
State: NY

Vax Date: 05/28/2021
Onset Date: 05/28/2021
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: N/A

Allergies: No.

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

Symptoms: Numbness/tingling in both hands, dizziness/lightheadedness (lasted about 1 hour), strong metallic taste in the mouth, tongue thickness (lasted about 12 hours).

Other Meds: N/A

Current Illness: No.

ID: 1670391
Sex: F
Age: 67
State:

Vax Date: 02/25/2021
Onset Date: 07/09/2021
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: Bloodwork - all was good just last week

Allergies: No

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Shingles diagnosis I got 4.5 half after the vaccine. 9th pain, 15th rash.

Other Meds: Turmeric; DHA

Current Illness: No

ID: 1670392
Sex: F
Age: 43
State: MO

Vax Date: 04/26/2021
Onset Date: 08/29/2021
Rec V Date: 09/03/2021
Hospital: Y

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

Lab Data: unknown

Allergies: unknown

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: 2nd vax 4/26/2021. Admitted to Hospital for unknown reasons. Case has been attempted 3x with no return phone call.

Other Meds: unknown

Current Illness: unknown

ID: 1670393
Sex: M
Age:
State: FL

Vax Date: 09/03/2021
Onset Date: 09/03/2021
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: Rapid positive PCR completed 9/3/21

Allergies: None

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

Symptoms: Congestion

Other Meds:

Current Illness: Parkinson's DM 2 Bipolar Alzheimer's

ID: 1670394
Sex: F
Age: 14
State: OK

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: RA

Lab Data: n/A

Allergies: None

Symptom List: Nausea

Symptoms: Patient was here for second dose of Pfizer COVID-19 vaccine; inadvertently given dose of Moderna COVID-19 instead

Other Meds: None

Current Illness: None

ID: 1670395
Sex: F
Age: 17
State: ME

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

Lab Data:

Allergies: Amoxicillin Animal Dander Cat Saliva Dog Saliva Horsetail (Equisetum)

Symptom List: Injection site pain

Symptoms: Patient received concentrated dose of vaccine. When mix Pfizer vaccine was diluted with 0.8 ml instead of 1.8 ml sodium chloride. Patient had no adverse event while waiting 15 minutes in the clinic after receiving vaccine.

Other Meds: Fluoxetine Propranolol

Current Illness: Seizure

ID: 1670396
Sex: F
Age: 68
State: WI

Vax Date: 08/24/2021
Onset Date: 08/30/2021
Rec V Date: 09/03/2021
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-19 PCR NP swab 8/30/21 Positive X-ray chest 8/30/21 Slight increase in mild nonspecific bibasilar groundglass attenuation, consistent with atelectasis secondary to patient recumbency versus minimal dependent vascular congestion. No frank pulmonary edema. Lungs are otherwise clear.

Allergies: Amoxicillin, Buspirone, Tramadol, Simvastatin

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

Symptoms: Pt completed the COVID-19 Pfizer immunization series on 8/24/21. Pt was admitted to reporting hospital on 8/30 and discharged on 8/31/21. Patient had been having symptoms for 5 days prior to seeking help. Her primary complaint was fatigue, cough, urinary frequency, loose stools and headache. Symptomatic COVID-19 screening was positive 8/30/21 via PCR NP swab.

Other Meds: Tylenol, albuterol 108, zyloprim 100mg, lipitor 20mg, coreg 12.5mg, vitamin D, fish oil, flonase, lasix 20mg, guaifenesin ac, norco, lidoderm, lisinopril 10mg, claritin, centrum silver, prilosec, glycolax, micro-K, estradiol.

Current Illness: morbid obesity, GERD, bilateral hearing loss, ICD in place, hypertension, hyperlipidemia, asthma

ID: 1670397
Sex: M
Age: 62
State: MN

Vax Date: 12/29/2020
Onset Date:
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:

Allergies:

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

Symptoms: Vaccine breakthrough, asymptomatic. Inpatient admit 9/1-9/2/21

Other Meds:

Current Illness:

ID: 1670398
Sex: F
Age: 31
State: KY

Vax Date: 05/19/2021
Onset Date: 08/28/2021
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: Tremor

Symptoms: pt was vaccinated using Janssen vacine on 5/19/21 (Lot 204A21A). S/O 08/27/21, tested + 8/28/2021

Other Meds:

Current Illness:

ID: 1670399
Sex: M
Age: 14
State: TX

Vax Date: 06/08/2021
Onset Date: 08/07/2021
Rec V Date: 09/03/2021
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: Glucose labs, antibody testing, ketone testing, IA-2 Antibody testing

Allergies: None

Symptom List: Erythema, Pruritus

Symptoms: Shortly after the second dose of the Pfizer COVID vaccine patient developed signs of Type 1 diabetes. Mostly excessive thirst. Patient was not ill anytime close to prior to this and has been perfectly healthy up until this. No family history of diabetes. Diagnosis confirmed 08/12/2021, 2 months after second vaccination.

Other Meds: None

Current Illness: None

ID: 1670400
Sex: F
Age: 90
State: FL

Vax Date: 03/27/2021
Onset Date: 09/01/2021
Rec V Date: 09/03/2021
Hospital: Y

Vax Type: UNK
Manufacturer: UNKNOWN MANUFACTURER
Vax Name: VACCINE NOT SPECIFIED (NO BRAND NAME)
Lot:
Dose Series: UNK
Vax Route: SYR
Vax Site: UN

Lab Data:

Allergies: NKA

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

Symptoms: She completed Pfizer COVID vaccines on 3/27/21. She was tested positive with COVID on 8/28/21. She went to the local urgent care due to worsening cough, SOB, body aches, and nausea, and she was transferred to Hospital, and admiited for further treatment. Hospital on 9/1/21. Hospital day 3: She is on O2 2L and receiving Remdesivir and Dexamethasone.

Other Meds:

Current Illness:

ID: 1670401
Sex: F
Age: 56
State: NY

Vax Date: 08/24/2021
Onset Date: 08/25/2021
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: reported to primary care physician

Allergies: Sulpha

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

Symptoms: Rash on body, arms, and legs Mast Cell Activation Syndrome symptoms: electrical sensation and itchiness all over the body, nausea when eating, chest pain, heart palpitations, dizziness

Other Meds: Coumadin 10mg Quercetin 100mg Cemitidine 10mg Famotidine 10mg

Current Illness: Mast Cell Activation Syndrome with Histamine Intolerance Antiphospholipid Antibody Syndrome DVT

ID: 1670402
Sex: F
Age: 67
State: WI

Vax Date: 03/17/2021
Onset Date: 03/17/2021
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: Asthenia, Chills, Headache, Myalgia

Symptoms: Received moderna lot# 013A21A on 02/24/2021. Received Pfizer for second dose. Pt. admits to guessing that 1st dose was Pfizer. Apparently vaccinator did not check records.

Other Meds:

Current Illness:

ID: 1670403
Sex: M
Age: 64
State: CA

Vax Date: 03/03/2021
Onset Date: 04/22/2021
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: SYR
Vax Site: LA

Lab Data: CT Scan.

Allergies: N/A

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

Symptoms: Seven weeks after the vaccine I was hospitalized with Dissection Type B. I woke up in the morning and I got a severe pain in my back. I was also sweating profusely. I went to the hospital by ambulance on 04/22/2021 and I was released on 04/29/2021. I returned to the hospital on 04/30/2021 with a Pulmonary Embolism in my Upper Left Lung and released on 05/05/2021. I am scheduled to go back for a CT scan to check on healing in the Dissection. The previous CT scan showed some healing. I had Covid-19 in March of 2020.

Other Meds: Metformin, Amlodipine, Atorvastatin, Aspirin

Current Illness: N/A

ID: 1670404
Sex: M
Age: 41
State: WI

Vax Date: 04/14/2021
Onset Date: 05/18/2021
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: None

Allergies: None

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

Symptoms: No affects on patient. Received Pfizer for first dose. Refused second dose initially then facility ran out of Pfizer by the time patient requested to have second dose. Was given Moderna instead.

Other Meds: None

Current Illness: None

ID: 1670405
Sex: M
Age: 77
State: IN

Vax Date: 03/01/2021
Onset Date: 04/18/2021
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: X-rays

Allergies: Sulfur

Symptom List: Pain in extremity

Symptoms: Chest and shoulder pain.

Other Meds: Yes

Current Illness: Heart condition

ID: 1670406
Sex: F
Age: 49
State: MI

Vax Date: 02/12/2021
Onset Date: 02/19/2021
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: CT Scan/Chest X-ray Chest, Abdominal X-ray/CT Scan, CT Scan Head, Bloodwork, Ultrasound of both legs

Allergies: NA

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

Symptoms: I experienced dizziness, weird noise in my ears, brain fog, and neck pain. I also had shooting pains in my chest, heart palpitations, extreme nausea, cramps after eating. I experienced severe pain in my right side and upper abdominal pain. My liver felt like I was carrying a baby because it was so enlarged. I had severe calf cramps and I felt like I was having a gallbladder attack but I don't have a gallbladder. I ended up having a blood clot in my lung. I had herniated disc in my neck and it exacerbated the pain was way worse than it has ever been. I am on an inhaler for continuous of shortness of breath. I was diagnosed with segmental atelectasis in my lungs which I never had before. I am still suffering with gastritis and taking medication for that. I had 3 ER visits at the Hospital for these issues.

Other Meds: Humira; Plaquenil; HCTZ; Aldactone

Current Illness: NA

ID: 1670407
Sex: M
Age: 70
State: WI

Vax Date: 03/17/2021
Onset Date: 03/17/2021
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: Received moderna lot# 013A21A on 02/24/2021. Received Pfizer for second dose. Pt. admits to guessing that 1st dose was Pfizer. Apparently vaccinator did not check records.

Other Meds:

Current Illness:

ID: 1670408
Sex: M
Age: 18
State: SC

Vax Date: 07/19/2021
Onset Date: 07/19/2021
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: No

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

Symptoms: Hands paralyzed for 4-6 hours, 102.5 temp for 24 hours, delusional, splitting headach for 24 hours. Tired on 3rd day

Other Meds: No

Current Illness: No

ID: 1670409
Sex: F
Age: 40
State: KY

Vax Date: 02/26/2021
Onset Date: 04/01/2021
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: No

Allergies: Steroids

Symptom List: Vomiting

Symptoms: I experienced heart palpitations and its still ongoing.

Other Meds: No

Current Illness: No

ID: 1670410
Sex: M
Age: 25
State: OR

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: SYR
Vax Site: LA

Lab Data: Full lab/bloodwork for baseline monitoring of potential HIV/HBV/HCV infection. HIV PEP prescribed

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Accidental needlestick of administering technician. Failure of safety cap device on a needle in the sharps container led to a needlestick when putting a used vaccine into the sharps container.

Other Meds:

Current Illness:

ID: 1670411
Sex: F
Age: 59
State: TX

Vax Date: 03/04/2021
Onset Date: 08/11/2021
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: Severe headache, nausea, diarrhea, green bowel and vomit for about 36 hours.

Other Meds: Glipizide; acarbose; metformin; loxoribine

Current Illness:

ID: 1670413
Sex: M
Age: 67
State: TX

Vax Date: 02/01/2021
Onset Date: 07/13/2021
Rec V Date: 09/03/2021
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: Covid test negative

Allergies: None

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Antibiotic and steroids

Other Meds: Fish oil,ecotrin,vitamin d,vitamin c,stool softener, pravastatin, lisenapril.

Current Illness: None

ID: 1670414
Sex: F
Age: 28
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: RA

Lab Data:

Allergies:

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

Symptoms: 2nd dose give too soon. Pt's first dose was 8/11/21. 2nd dose was given on 9/2/21.

Other Meds:

Current Illness:

ID: 1670415
Sex: F
Age:
State: NC

Vax Date: 03/01/2015
Onset Date: 07/01/2021
Rec V Date: 09/03/2021
Hospital: Y

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

Lab Data: N/a

Allergies: Sulfa

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

Symptoms: Was sore for a few days burned bad being injected two months give or take had two small strokes

Other Meds: Yes prescription medication

Current Illness: No

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am