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: 1675177
Sex: F
Age: 45
State: NY

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

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

Lab Data: None

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: 12 hours after the vaccine began to feel throat tightening, difficulty breathing, itchiness

Other Meds:

Current Illness:

ID: 1675178
Sex: F
Age: 60
State: PR

Vax Date: 08/23/2021
Onset Date: 08/24/2021
Rec V Date: 09/05/2021
Hospital:

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

Lab Data: She went to Health Group the first time 3 days after the vaccine administration, they administered DECADRON 2mg IM and BENADRYL 25mg. BENADRYL every 4 to 6 hours and to continue treatment at home. The second was on September 2, 2021 she visit Health Group with edema in the tongue, DECADRON 4mg IM and to keep taking BENADRYL 25mg PO at home.

Allergies: Pepper

Symptom List: Anxiety, Dyspnoea

Symptoms: The patient reports that the following day of the vaccine administration, she saw a rash all over her body. The next day she had painful hives and urticaria that were like burns. The next day she had edema in her tongue, she could expand her lungs but could not remove saliva from her mouth. She had pain in the thorax posterior area. She also had fatigue and tiredness, dizziness that persists to this day.

Other Meds: None

Current Illness: Thyroid; Osteoarthritis; Irritable Bowel Syndrome; Colitis; Fatty Liver; Kidney Stones; HBP

ID: 1675179
Sex: F
Age: 22
State: GA

Vax Date: 08/31/2021
Onset Date: 09/02/2021
Rec V Date: 09/05/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Patient reported neck swelling. Patient was hospitalized due to concern for anaphylaxis. She was discharged on 9-4 with steriods. She is feeling much better.

Other Meds:

Current Illness:

ID: 1675180
Sex: M
Age: 77
State: NC

Vax Date: 08/28/2021
Onset Date: 08/31/2021
Rec V Date: 09/05/2021
Hospital:

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

Lab Data:

Allergies: n/a

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: reports pain radiating up shoulder, no rash or redness, that started 3 days after vaccine

Other Meds: n/a

Current Illness: n/a

ID: 1675181
Sex: M
Age: 41
State: SC

Vax Date: 03/18/2021
Onset Date: 03/19/2021
Rec V Date: 09/05/2021
Hospital: Y

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

Lab Data: Unsure

Allergies: Seasonal environmental allergies

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

Symptoms: The morning after getting the second shot, I do not remember it but I had passed out and was taken to the ER. My blood pressure was 88/33. I am not sure what they did. I was sent home the next day.

Other Meds: Trulicity 1.5/0.5 Weekly injection; Vitamin D3 25 mcg daily; Allegra 10mg daily.; Farxiga 10mg daily; Citalopram 20mg daily; Lovothyroxine 137mcg daily; Protonix 40mg daily; Singular 10 mg daily; loratadineb10mg ; Ambien 6.5mg for sleep; T

Current Illness: None

ID: 1675182
Sex: M
Age: 74
State: WA

Vax Date: 04/02/2021
Onset Date: 08/28/2021
Rec V Date: 09/05/2021
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: ER Evaluation, CAT scan to eliminate possiblity of stroke, visit to ophthamologist for eye evaluation

Allergies: None known

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

Symptoms: Onset of Bell's Palsy

Other Meds: See continuation page

Current Illness:

ID: 1675183
Sex: U
Age:
State: NY

Vax Date: 09/03/2021
Onset Date: 09/04/2021
Rec V Date: 09/05/2021
Hospital:

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

Lab Data: n/a

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Vaccine information unavailable. s/p flu vaccine with pcp on Fri in pcp office. Sat am awoke with local redness.

Other Meds: denies

Current Illness:

ID: 1675184
Sex: F
Age: 91
State: CA

Vax Date: 03/09/2021
Onset Date: 05/24/2021
Rec V Date: 09/05/2021
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: Penicillin

Symptom List: Pharyngeal swelling

Symptoms: Junctional Bradycardia; S/P Dual Chamber Pacemaker Implantation; resolved

Other Meds: Metoprolol, Eliquis, Famotidine, Atorvastatin, Vit C, Docusate, Vit D, Zinc

Current Illness: UTI (with hematuria)

ID: 1675185
Sex: M
Age: 55
State: FL

Vax Date: 03/29/2021
Onset Date: 03/30/2021
Rec V Date: 09/05/2021
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: None

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Since the morning after receiving the vaccine, I have had cold sores on both sides of my mouth. I never had a cold sore previously.

Other Meds: Losartan

Current Illness: None

ID: 1675186
Sex: M
Age: 59
State: OH

Vax Date: 08/29/2021
Onset Date: 08/30/2021
Rec V Date: 09/05/2021
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: Penicillin - hives, facial swelling

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Patient received vaccine on 8/29/21 at around 4:45pm. The next morning around 9am patient had trouble standing/walking, dropped to his knees and felt weak. An ambulance was called and he was transported to hospital emergency dept. Sometime after he arrived hives developed over his body. He did not experience swelling in his face or throat. He spent approximately 5 hours there.

Other Meds:

Current Illness:

ID: 1675187
Sex: F
Age: 75
State: MO

Vax Date: 09/03/2021
Onset Date: 09/04/2021
Rec V Date: 09/05/2021
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: Red arm ring 6 inches in diameter, suggested ibuprofen and benadryl

Other Meds:

Current Illness:

ID: 1675188
Sex: F
Age: 10
State: FL

Vax Date: 08/13/2021
Onset Date: 08/13/2021
Rec V Date: 09/05/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: On 8/13/2021 patient was vaccinated with 1st dose Pfizer vaccine . On 9/5/2021 patient came with her parents for the second dose and upon checking in at registration patient was identified to be under age and second dose was not administered

Other Meds:

Current Illness:

ID: 1675189
Sex: F
Age: 44
State: NY

Vax Date: 08/01/2021
Onset Date: 08/30/2021
Rec V Date: 09/05/2021
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

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

Symptoms: 1. My menstruation occurred twice in a month which has never happened to me before. I am very regular at 28 day cycle. It also came in clumps of blood, like blood clots. 2. I feel random palpitations when I am sitting and relaxing, almost as if my heart skips a beat. I do have a heart murmur. But I?ve never felt this unless I was very nervous about a stressful event. However now it happens when I am relaxed. This all started maybe 2 weeks after second dose of the vaccine.

Other Meds: Lexapro

Current Illness: None

ID: 1675190
Sex: M
Age: 43
State: CA

Vax Date: 09/02/2021
Onset Date: 09/03/2021
Rec V Date: 09/05/2021
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: Sulpha

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

Symptoms: Shortness of breath, can't walk up stairs even. Pain in the base of spine.

Other Meds: None

Current Illness: None

ID: 1675191
Sex: M
Age: 75
State: TX

Vax Date: 08/25/2021
Onset Date: 09/04/2021
Rec V Date: 09/05/2021
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: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: Small blood clots in veins in hands and both arms from elbows down appear reddened

Other Meds: Otrexup 12.5mg SQ weekly; Protonix; Folic Acid; Vitamion C;Carafate; Zinc; Prednisone; Xarelto 20 mg daily; lasix 40mg daily; Adderall 25mg; Plaquenil 200mg BID; Super B complex; Calcium; Vat D3; Omega 3; Ditropan Xl 5mg; Symbicort inhaler

Current Illness: Vasculitis ,Wegeners Granulomatosis, Microscopic Ployangiitis

ID: 1675192
Sex: M
Age: 39
State: HI

Vax Date: 01/07/2021
Onset Date: 09/03/2021
Rec V Date: 09/05/2021
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: Symptomatic 9/3/21 and COVID positive 9/4/21 after being fully vaccinated for COVID-19

Other Meds:

Current Illness:

ID: 1675193
Sex: F
Age: 46
State: NV

Vax Date: 08/08/2021
Onset Date: 08/09/2021
Rec V Date: 09/05/2021
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: Sulfa and sulfa based drugs Zyrtec Hydroxyzine

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

Symptoms: Started developing what I initially thought was bug bites on my stomach, thighs, arms and upper trunk. Turns out they are hives and they are non stop, new ones keep popping up, but as they go, they dry up and become eczema like. In addition, after the vaccination, my mast cell activation symptoms that were in remission flared up immediately as well as my POTS symptoms flared up that were in remission as well.

Other Meds: Multi vitamin / Mineral , fish oil, tumeric

Current Illness: Lyme disease

ID: 1675194
Sex: F
Age: 38
State: FL

Vax Date: 08/26/2021
Onset Date: 09/04/2021
Rec V Date: 09/05/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Activation and outbreak of Herpes Zoster under where the vaccine was administered in the left arm. Never before has an outbreak of Herpes Zoster been activated in that area.

Other Meds: N/A

Current Illness: N/A

ID: 1675195
Sex: M
Age: 22
State: PR

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

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

Lab Data:

Allergies: N/A

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Patient refers lack of hearing, dizziness and nausea. Patient is pale and sweaty. Vitals are taken 110/60 BP, 99% oxygen, 65 pulse, and Dextrose 52. Glucose tablet is administered and Dextrose is taken with a results of 57. 20ml of syrup and after 5 minutes his Dextrose had a result of 77.

Other Meds: N/A

Current Illness: N/A

ID: 1675196
Sex: F
Age: 22
State: FL

Vax Date: 09/05/2021
Onset Date: 09/05/2021
Rec V Date: 09/05/2021
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: Patient complained of seeing spots then passed out for a short time then woke back up.

Other Meds:

Current Illness:

ID: 1675197
Sex: M
Age: 17
State: VA

Vax Date: 09/05/2021
Onset Date: 09/05/2021
Rec V Date: 09/05/2021
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: n/a

Allergies: n/a

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

Symptoms: 17 year old had sob and nauseated shortly after vaccine adminstration . pt having mask over his nose may have contributed to it since he never wore mask over nose and also did not eat breakfast

Other Meds: n/a

Current Illness: n/a

ID: 1675198
Sex: F
Age: 52
State:

Vax Date: 01/29/2021
Onset Date: 09/02/2021
Rec V Date: 09/05/2021
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: Unevaluable event

Symptoms: Individual with symptoms of congestion, cough, and HA since 9/2/21. Tested positive on 9/4/21 then began to isolate from family on 9/5/21 for at least ten days. Updated per individual. She participated in a study and will have antibody testing when cleared from isolation.

Other Meds:

Current Illness:

ID: 1675199
Sex: F
Age: 68
State: FL

Vax Date: 08/29/2021
Onset Date: 09/01/2021
Rec V Date: 09/05/2021
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: none

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

Symptoms: Patient had hives over the entire body 3 days after the vaccine administration

Other Meds: unknown

Current Illness: none

ID: 1675200
Sex: F
Age: 58
State: TN

Vax Date: 08/23/2021
Onset Date: 08/27/2021
Rec V Date: 09/05/2021
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: CTA chest 08-27-2021no Pulmonary Embolism; no infiltrate; no pleural effusion-Left heart cath 08-31-2021normal coronary arteries

Allergies: no known drug allergies

Symptom List: Injection site pain, Pain

Symptoms: She states that she had a deep pain in her chest which began on Wednesday August 25th. She felt the sensation start on Wednesday August 25. She felt it coming on. The severe pain hit her Friday August 27th. She came to our facility for evaluation and treatment and required dopamine to keep a blood pressure of for 48 hours. She states that that the pain is resolving. It lasted longer more on the right. She states that when it was occurring initially on Friday August 27th she could not really take a deep breath in. She states that this pain was worse than labor pain. She has atypical pleural pain or atypical pleuritis with no pleural effusion.

Other Meds: Aspirin (Aspirin Chewable) 81 MG ORAL DAILY Citalopram (CeleXA) 40 MG ORAL DAILY Atorvastatin (Lipitor) 20 MG ORAL BEDTIME

Current Illness: none

ID: 1675201
Sex: M
Age: 19
State: NY

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

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

Lab Data: EKG diffuse ST elevation Troponin 23

Allergies: No allergies

Symptom List: Injection site pain, Menorrhagia

Symptoms: 1 day after vaccination, sternal chest pain , non radiating 0/10-5/10

Other Meds: None

Current Illness: No allergies or recent illnesses

ID: 1675202
Sex: M
Age: 74
State: MT

Vax Date: 08/27/2021
Onset Date: 08/31/2021
Rec V Date: 09/05/2021
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:

Allergies:

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

Symptoms: Developed respiratory failure due to COVID-19 pneumonia

Other Meds:

Current Illness:

ID: 1675203
Sex: M
Age: 15
State: FL

Vax Date: 09/04/2021
Onset Date: 09/05/2021
Rec V Date: 09/05/2021
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: None

Allergies: None

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: He woke up with shortness of breath, Fever, sore throat, nasal congestion, cough, body aches, and sore throat.

Other Meds: None

Current Illness: None

ID: 1675204
Sex: F
Age: 56
State: VA

Vax Date: 04/19/2021
Onset Date: 04/19/2021
Rec V Date: 09/05/2021
Hospital:

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

Lab Data:

Allergies: Now I know PEG/PG, eggs/wheat/dairy/peanut/environ

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Abnormal breathing patterns,lightheaded, cold, clammy, primary impressions: respiratory/acute distress/breathing difficulty Secondary: Allergic reaction (ht:86, BP: 148/92, R: 20, T: 99.0) Hx of first inoculation included mild respiratory reaction, treated with Benedryl. EMT arrived post swelling of entire face and sinuses. Post vaccination patient experienced increased sensitivity to known food ?sensitivities' and airborne allergens. Patient was diagnosed with asthma as dry cough was continuous. Patient was proscribed asthma medication: Symbicort, Losartan-HVTZ, Nasacort and Zertec. Cont.

Other Meds: See additional comments*

Current Illness: Chronic daily migraine, hypothyroid, hypertension

ID: 1675205
Sex: F
Age: 62
State: NY

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

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

Lab Data: none

Allergies: allergies: sulfa, amoxicillin sensitive to most antibiotics lactose intolerant, sensitive to eggs, scallops, cauliflower, and chick peas

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

Symptoms: Headache, body aches, chills, fatigue Treated with Tylenol and lots of sleep, resolved after 48 hours.

Other Meds: calcium, magnesium, Vitamin D3, NAC, flaxseed oil capsules, turmeric capsules, zinc, milk thistle, B12, biotin.

Current Illness: none

ID: 1675206
Sex: F
Age: 58
State: TX

Vax Date: 01/06/2021
Onset Date: 01/07/2021
Rec V Date: 09/05/2021
Hospital:

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

Lab Data: Head MRI, normal; Vestibular testing, normal; Hearing loss, normal; Labs, WNL

Allergies: Codeine; Benedryl; Phenergan

Symptom List: Nausea

Symptoms: Within 12 hours after the shot, I awoke during the night feeling very strange, went to get some juice and i do not remember what happened. I woke up on the kitchen floor. Feeling very weak moved to the couch. When i woke in the morning i had alight rash to my arms and legs. After 48 hours of getting the shot, I had a read rash over my entire body, very weak with a terrible headache. I had the rash for 3 days, was weak with the headache for 5 days. Within a couple of weeks I developed pressure in my ears and dizziness. I sought out an ENT and underwent some testing that all come back WNL. Over the last two months my dizziness has become debilitating. I returned to my ENT for further test, MRI, lab work and vestibular testing have all been normal. I have taken oral steroid with no relief.

Other Meds: Gabapentin; Lorsartan; HCTZ

Current Illness: None

ID: 1675207
Sex: F
Age: 55
State: MI

Vax Date: 03/24/2021
Onset Date: 03/30/2021
Rec V Date: 09/05/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List: Injection site pain

Symptoms: Work up on March 30th, 2021 at 2 am with severe pain in my right forearm. It felt as if I had a blood pressure cuff on way too tight. I got out of bed and took two Advil. When the alarm went off at 5:50 am, I told my husband about my pain and he called my doctor's office and got me an appointment at 8:30 am with a PA. She told me to ice my arm and to take 600 mg of Advil every 6 hours. The pain seemed to have lessened, but on Friday, April 2nd, I realized I couldn't bend the top knuckle of my right thumb, and both my right and left forearms were numb. I got another appt with the PA, and she ordered an x-ray of my cervical spine/neck.

Other Meds: Women's chewable vitamins, chewable vitamin C

Current Illness: N/A

ID: 1675208
Sex: M
Age: 39
State: NY

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

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

Lab Data: None known

Allergies: dicloxacillin

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

Symptoms: Patient was fine initially after vaccination at 430 PM, 15 minutes later as I was giving him his card he described suddenly feeling lightheaded and nauseous. I gave him some water and a Benadryl tab, within a minute he asked to go to my bathroom. He than began to vomit for a few minutes. By 5 PM he came to me, saying he felt better. I had him take a second Benadryl tablet, and he felt well enough to walk home.

Other Meds: pantoprazole, miralax, dicyclomine

Current Illness:

ID: 1675209
Sex: F
Age: 51
State: SC

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

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

Lab Data: n/a

Allergies: n/a

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

Symptoms: patient felt lightheaded and very hot. she was given water and a banana after she stated she had not eaten all day. 15 minutes after finishing banana and drinking water patient felt much better and headed home.

Other Meds: n/a

Current Illness: n/a

ID: 1675210
Sex: F
Age: 40
State: OH

Vax Date: 04/06/2021
Onset Date: 07/28/2021
Rec V Date: 09/05/2021
Hospital:

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

Lab Data: Aug 28 2021

Allergies: Macrobiotic

Symptom List: Tremor

Symptoms: Chest pains shortness of breathe dizzieness

Other Meds: None

Current Illness: None

ID: 1675211
Sex: F
Age: 40
State: CT

Vax Date: 08/09/2021
Onset Date: 08/10/2021
Rec V Date: 09/05/2021
Hospital:

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

Lab Data: Ultrasound, blood work, urine, and recently in the ER

Allergies: Nka

Symptom List: Erythema, Pruritus

Symptoms: Hot pain in my stomach area. Lymph nodes and rash under both armpits, and itching under both armpits. Recently got cellulitis on my lower left stomach area which has a lot of puss

Other Meds: Amolodepine

Current Illness: None

ID: 1675212
Sex: M
Age: 54
State: HI

Vax Date: 01/03/2021
Onset Date: 09/04/2021
Rec V Date: 09/05/2021
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: Developed S/S of COVID and COVID + after being COVID vaccinated.

Other Meds:

Current Illness:

ID: 1675213
Sex: F
Age: 75
State: NJ

Vax Date: 08/29/2021
Onset Date: 08/30/2021
Rec V Date: 09/05/2021
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: N/a

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

Symptoms: erythema, pruritus at injections site and distal to same, onset next day; benadryl at home provided no relief. Medrol dosepak prescribed today

Other Meds: Atorvastatin

Current Illness: unk

ID: 1675214
Sex: M
Age: 25
State: MI

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

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

Lab Data: N/A.

Allergies: No Known Drug Allergies.

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Upon receiving Pfizer vaccine, patient was instructed to remain in store for any reactions. Patient began walking in the aisle of the store, then quickly approached pharmacy lobby area while holding back of head with dripping blood. He reported feeling dizzy and fainted. Pharmacy staff came to quickly aid with ice packs and water. Emergency personnel was contacted as well as patient's family members. Patient was closely monitored for consciousness and activity. Patient's father and girlfriend had arrive and was also monitoring patient. Emergency response was contacted a 2nd time for ETA arrival. Paramedics arrived on scene within 15 minutes and carefully assessed patient. After thorough assessment, patient decided to have his father transport him to urgent care. Paramedics and pharmacy staff safely escorted patient and family members off pharmacy premises. Patient was transported to urgent care with father.

Other Meds: N/A.

Current Illness: N/A

ID: 1675215
Sex: F
Age: 31
State: FL

Vax Date: 08/26/2021
Onset Date: 09/04/2021
Rec V Date: 09/05/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: 5 square inch round red spot at injection site. The spot is itchy, hot to touch, sore to touch. Spot was small after initial injection, went away after 3 days. Came back on 9/4/21 larger than the original spot. Continues to get larger each day.

Other Meds:

Current Illness:

ID: 1675216
Sex: M
Age: 61
State: PA

Vax Date: 09/01/2021
Onset Date: 09/02/2021
Rec V Date: 09/05/2021
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: Variety of Statins; Mussels; Seasonal Polens, Cats

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

Symptoms: Sep 1: No side effects Sep 2: Injection site soreness; Fatigue; Feeling unwell; Diarrhea, required Imodium to control. Sep 3: Injection site soreness; Fatigue; Feeling unwell; Bloating and Gas; Kidney pain; Severe nephropathy pain in the feet (Note: nephropathy was under control due to low cab diet changes, current A1C is 5.4. Psoriasis is also under control.) Sep 4: Injection site soreness; Fatigue Sep 5: Unusual skin sensitivity. Hard to quantify; Small Hematoma on left elbow, blood pooling about the size of a quarter, of unknown origin. No other side effects.

Other Meds: Flu Shot (I believe GSK) at the same time as the first Moderna Vaccine shot. LIVALO 2mg; Lovaza Omega-3-acid; Vitamin D3 5000 IU; Glutathione 500mg; Choline & Insole; Vitamin K2 100 MCG; Super B-Complex; Magnesium Glycinate; Milk Thistle

Current Illness:

ID: 1675217
Sex: F
Age: 16
State: MD

Vax Date: 09/05/2021
Onset Date: 09/05/2021
Rec V Date: 09/05/2021
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: Pain in extremity

Symptoms: patient experienced being dizzy after getting a vaccine . and fell.

Other Meds: birth control, Zyrtec

Current Illness: none

ID: 1675218
Sex: F
Age: 30
State:

Vax Date: 08/12/2021
Onset Date: 09/05/2021
Rec V Date: 09/05/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Left arm started to tingle shortly after receiving shot then after a few hours, my arm went completely numb and feeling didn't return for 2 days.

Other Meds:

Current Illness:

ID: 1675219
Sex: F
Age: 63
State: FL

Vax Date: 03/22/2021
Onset Date: 03/29/2021
Rec V Date: 09/05/2021
Hospital:

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

Lab Data: Have not scheduled to have it checked. I will try to get breast exam first but will discuss with my doctor on my Sept appointment.

Allergies: Allergic to certain nuts Cipro and most antibiotics

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

Symptoms: When i had my first shot, I noticed that my armpits and breast started to hurt on the 7th day. It has been like that on and off. Sometimes it will go a week without then i feel it again. There were times that it does not hurt for how many days but it comes back. I never had those pains before the vaccine. On my second shot i told that to the nurse. She said she heard that from some people then i read also that more people were having that same effect. So i tried to ignore it even though it still came and went after the 2nd shot. I even followed the instructions not to get mammogram and wait 2 months before getting one. So now it has been 5 and a half months and i have these sudden armpit pains. They do not last very long though. Sometimes it is breast but pain goes away . I just put ice. I tried to feel for lumps but i have not felt one. I am scared to get my mammogram now and more scared to take the booster shot until I see what it is doing to my breast. Can someone enlighten me on this?

Other Meds: Lorazepam, Losartan, zyrtec vitamin c, coq10, calcium, vit d selenium flaxseed

Current Illness: None

ID: 1675220
Sex: F
Age: 73
State:

Vax Date: 03/03/2020
Onset Date: 03/15/2021
Rec V Date: 09/05/2021
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: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: On March 15th I had a complete physical with Dr and it was showing slight anemia for the first time ever in my life. I had to go back in 3 weeks for blood work again and was told my red blood was down but Iron was ok. I was sent to gastro for test to see if i was loosing blood. He did not find anything, but i am getting tired and really cold . Went back in for more blood work an it was down more so she said I will give you Iron and hope that will help . I just got blood checked again and it was up a little

Other Meds: blood pressure meds

Current Illness: asthma

ID: 1675221
Sex: F
Age: 30
State:

Vax Date: 01/19/2021
Onset Date: 09/04/2021
Rec V Date: 09/05/2021
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: Sore thraot, cough, chills, loss of taste and smell, and nasal congestion. COVID (+), Vaccinated

Other Meds:

Current Illness:

ID: 1675222
Sex: M
Age: 68
State: IN

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

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

Lab Data: Hearing Test. Shows lost of hearing in both ears. Date 7-21-21 Numness in Left thump and baby finger. Date 7-13-21

Allergies: Cefaclor Lisinopril

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Buzying in both ears. Done hearing test, lost of hearing in both ears. numnese in left hand, baby finger and thumb. Just talked to the Doctor and he stated that I could have metal pins insturt into my skin to find out where my troubles are.

Other Meds: Omepradzole 20mg Multivitimin Rosuvastatin 10 mg Clopidogrel 75 mg Spring Valley Iron Pill

Current Illness:

ID: 1675223
Sex: F
Age: 46
State: WA

Vax Date: 04/02/2021
Onset Date: 04/02/2021
Rec V Date: 09/05/2021
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: On April 17, 2021, I had an MDLive consultation during which the urinary tract infection was diagnosed and antibiotics were prescribed.

Allergies: DPT shot - allergic reaction when I was a child

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

Symptoms: Starting about 6 hours after the shot on April 2, 2021 and for approximately 48 hours after symptoms started, I experienced extreme fatigue, chills, sweats, muscle aches, and some dehydration. A few weeks later, on April 15, 2021 I developed a urinary tract infection, which I was positively diagnosed and treated for on April 17, 2021. I have only had one other urinary tract infection in my life, and that was more than 15 years ago, so this was quite uncommon. At the beginning of May 2021, I noticed that four of my fingernails had deep horizontal ridges that have finally just grown out to the edge of the nail tip ~5 months after receiving the vaccine.

Other Meds: tamoxifen

Current Illness: None

ID: 1675224
Sex: F
Age: 67
State: FL

Vax Date: 09/02/2021
Onset Date: 09/03/2021
Rec V Date: 09/05/2021
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: unknown

Symptom List: Injection site swelling, Limb discomfort

Symptoms: pt stated that she requested both shots be given in the same arm. pt stated that she had a bruise on her arm from the previous day of running into a door frame. pt presented with a bruise on her arm and a dark purple spot to the bottom left of the bruise. pt had red, blotchy area around the purple spot. I asked the pt if she was bitten by something . she denies being bitten. the area in question is away from the injection site per the pt. she states that her arm is very sore. I advised the pt to take Benadryl to see if the redness would go away since it looked like an allergic reaction. I followed up with the pt on sunday. pt stated that her arm was still sore and the redness was still there

Other Meds: unknown

Current Illness: unknown

ID: 1675225
Sex: M
Age: 37
State: WA

Vax Date: 08/25/2021
Onset Date: 08/28/2021
Rec V Date: 09/05/2021
Hospital:

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

Lab Data:

Allergies: Dairy

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

Symptoms: Shortness of breath, tightness of chest, rapid heart beat

Other Meds: None

Current Illness: None

ID: 1675226
Sex: F
Age: 71
State: TX

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

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

Lab Data: Basic vitals, quick assessment by EMT.

Allergies: Gentamicin and Penicillin

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

Symptoms: The patient got the shot at 1300. At 1330 patient states she has an itchy arm, her tongue felt weird, and there was tingling down her legs. She said she also had a headache. I called an ambulance as tongue swelling could lead to airway obstruction. She stated that she has bouts with anxiety. The EMTs came and stated that there was not a rash and anaphylaxis usually occurs within 10 to 15 minutes. Around this time was 1400. Patient purchased some benadryl. Patient refused EMTs offering to take her to the hospital. Her BP/pulse was elevated and she said she had a headache and was shaky. The EMTs left and I advised her to have someone drive her home. I called the patient at approximately 1500 and she said she was feeling better and her daughter picked her up..

Other Meds: Unknown

Current Illness: unknown

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am