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: 1675380
Sex: F
Age: 55
State: NY

Vax Date: 04/20/2021
Onset Date: 05/30/2021
Rec V Date: 09/06/2021
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: Dairy

Symptom List: Dysphagia, Epiglottitis

Symptoms: Pain and stiffness in both ankles, appeared suddenly with no history of ankle problems.

Other Meds: Multivitamin, low dose aspirin

Current Illness: None

ID: 1675381
Sex: F
Age: 30
State: MI

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

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

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Got second dose at around 1:10pm on sept 5th, could not sleep that night. Woke up and threw up at 4:30Am on sept 6th.

Other Meds:

Current Illness:

ID: 1675382
Sex: M
Age: 61
State: CA

Vax Date: 08/20/2021
Onset Date: 08/27/2021
Rec V Date: 09/06/2021
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: medical center

Allergies: None

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

Symptoms: After 7 days , my blood pressure was high . I started to have a-fib , 7 days more . I was worried. I went to my local ER . I was in a-fib . They did blood work and than a CT scan of my brain, and a Echo cardio exam. They gave me blood thinner and a beta blocker metoprolol tartrate 25 mg , and Apixban 5 GM. It has been two days . My blood pressure is normal , and my heart rhythm is normal.

Other Meds: Lisinopril-hctz 20-25mg

Current Illness: None

ID: 1675383
Sex: F
Age: 48
State: NC

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

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Since I was vaccinated I have a strong pain in the muscular arm that day by day grows and does not let me move the Arm.

Other Meds:

Current Illness:

ID: 1675385
Sex: M
Age: 41
State:

Vax Date: 09/06/2021
Onset Date: 09/06/2021
Rec V Date: 09/06/2021
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: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Patient arrived to clinic for appointment and update on vaccines. Patient stated he was due for Typhoid and when it was being verified the date was misread for another vaccine the patient had due. Patient was given one extra typhoid dose too early. Patient did not have any symptoms and was stable after the vaccine was given.

Other Meds: Rosuvastatin, Amlodipine and Benazepril

Current Illness: None

ID: 1675386
Sex: M
Age: 32
State:

Vax Date: 08/20/2021
Onset Date: 08/30/2021
Rec V Date: 09/06/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Sudden vertigo and nausea, 10 days and 17 days after vaccination. The first time was from a seated position; my field of vision rotated swiftly by 90 degrees and then back to normal. The entire incident started and finished within 1 second, but was followed by nausea for the following 24 hours. The second time was from a standing position and I almost fell over. The second incident of vertigo lasted 1 second and was also followed by nausea.

Other Meds:

Current Illness:

ID: 1675387
Sex: F
Age: 31
State: TX

Vax Date: 09/03/2021
Onset Date: 09/04/2021
Rec V Date: 09/06/2021
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:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Nausea, vomiting, fever of 101.2, headache, chills, muscle tenderness, fatigue, increase heart rate 103. Increase respiration. 09/04/2021-09/05/2021

Other Meds: None

Current Illness:

ID: 1675388
Sex: F
Age: 40
State: CT

Vax Date: 08/30/2021
Onset Date: 09/04/2021
Rec V Date: 09/06/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Systemic: Pt reports swelling in L armpit and pain radiating down her L arm-Mild, Systemic: Lymph Node Swelling-Mild, Additional Details: Patient reported significan swelling in L armpit 5 days post injection in addition to pain radiating down her arm. This occurred on 9/4/21; patient reported events on 9/5/21 and says these symptoms have resolved.

Other Meds:

Current Illness:

ID: 1675389
Sex: F
Age: 48
State: IL

Vax Date: 09/02/2021
Onset Date: 09/02/2021
Rec V Date: 09/06/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: Site: Swelling at Injection Site-Mild, Systemic: Body Aches Generalized-Medium, Systemic: Chills-Medium, Systemic: Dizziness / Lightheadness-Medium, Systemic: Exhaustion / Lethargy-Medium, Systemic: Fever-Medium, Systemic: Flushed / Sweating-Medium, Systemic: Headache-Medium, Systemic: Nausea-Medium, Systemic: Shakiness-Medium, Systemic: Weakness-Medium

Other Meds:

Current Illness:

ID: 1675390
Sex: F
Age: 31
State: KY

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

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

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Error: Booster Given Too Early-

Other Meds:

Current Illness:

ID: 1675391
Sex: M
Age: 23
State: FL

Vax Date: 09/02/2021
Onset Date: 09/02/2021
Rec V Date: 09/06/2021
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: Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Medium

Other Meds:

Current Illness:

ID: 1675392
Sex: M
Age: 54
State: AZ

Vax Date: 08/24/2021
Onset Date: 09/04/2021
Rec V Date: 09/06/2021
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: Site: Redness at Injection Site-Mild, Systemic: Allergic: Rash (specify: facial area, extremeties)-Medium, Systemic: Abdominal Pain-Mild, Additional Details: Rash on upper extremeties and torso

Other Meds:

Current Illness:

ID: 1675393
Sex: M
Age: 66
State: NY

Vax Date: 08/12/2021
Onset Date: 08/15/2021
Rec V Date: 09/06/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: Site: Itching at Injection Site-Medium, Site: Pain at Injection Site-Severe, Site: Redness at Injection Site-Severe, Site: Swelling at Injection Site-Severe, Systemic: Allergic: Rash (specify: facial area, extremeties)-Severe, Systemic: Allergic: Rash Generalized-Severe, Systemic: Allergic: Swelling of Face / Eyes / Mouth / Tongue-Severe, Additional Details: Patient reported developing carbuncles and followed up with urgent care, and then PCP - both prescribed antibiotics and prednisone.

Other Meds:

Current Illness:

ID: 1675394
Sex: F
Age: 30
State: FL

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Systemic: Fainting / Unresponsive-Mild, Systemic: Flushed / Sweating-Mild, Additional Details: Patient fainted about 5 minutes post vaccination

Other Meds:

Current Illness:

ID: 1675395
Sex: F
Age: 16
State: VA

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

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

Symptoms: Systemic: Fainting / Unresponsive-Mild, Additional Details: Patient fainted outside in parking lot, hitting her head. Attended to by EMS, vitals within normal limits and went home.

Other Meds:

Current Illness:

ID: 1675396
Sex: M
Age: 63
State: AL

Vax Date: 08/31/2021
Onset Date: 09/02/2021
Rec V Date: 09/06/2021
Hospital: Y

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

Lab Data:

Allergies: None

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

Symptoms: Stroke on 9/2/21

Other Meds:

Current Illness: None

ID: 1675397
Sex: F
Age: 42
State: CT

Vax Date: 04/15/2021
Onset Date: 05/25/2021
Rec V Date: 09/06/2021
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: 6/08: Abd US GB wall thickening, LFTs - abn, 6/10 - echo large pericardial effusion, signs of tamponade, serial echos 6/11, 6/12, 6/13 - stable, 7/21 - large pericardial effusion

Allergies: None

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

Symptoms: Pt presented on 6/8/21 with epigastric pain radiating to her back, nausea, bloating and chest pressure. Abd US on that day showed gallbladder wall thickening, LFTs: elevated AST/ALT/APhos. Pain worsened so on 6/10 she went to Hospital ER. CT Abd: thick gallbladder, ascitis, pericardial effusion. Echo: large pericardial effusion with signs of tamponade. Pt underwent emergency pericardiocenthesis obtaining 2 L clear fluid. Inital cytology and complete AI w/u was non contributory. After 3 days in ICU with serial echos showing stable trace pericardial effusion pt was discharged home on colchicine. Repeat echo 7/21: reaccumulation of pericardial effusion, pt required pericardial window.

Other Meds: Valsartan-HCT,pantoprazole,Ventolin

Current Illness: None

ID: 1675398
Sex: M
Age: 26
State: AL

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

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

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Systemic: Fainting / Unresponsive-Mild, Systemic: Seizure-Medium, Additional Details: immediately follwing administration patient appeared to be incoherent ( could not support head)/ fainted and became rigid and had a seizure. Patient fell out of chair and then became responsive. Patient was not in pain, was breathing okay and coherent. Paramedics were called and all vital signs were okay.

Other Meds:

Current Illness:

ID: 1675399
Sex: M
Age: 19
State: WV

Vax Date: 09/05/2021
Onset Date: 09/05/2021
Rec V Date: 09/06/2021
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: Error: Wrong Dose of Vaccine - Too High-

Other Meds:

Current Illness:

ID: 1675400
Sex: M
Age: 38
State: TX

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

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

Lab Data:

Allergies:

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

Symptoms: Systemic: Dizziness / Lightheadness-Severe, Systemic: Fainting / Unresponsive-Mild, Systemic: Flushed / Sweating-Mild, Systemic: Weakness-Severe

Other Meds:

Current Illness:

ID: 1675401
Sex: M
Age: 30
State: CA

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

Allergies:

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

Symptoms: Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Medium

Other Meds:

Current Illness:

ID: 1675402
Sex: M
Age: 25
State: NE

Vax Date: 09/05/2021
Onset Date: 09/05/2021
Rec V Date: 09/06/2021
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: Systemic: Fainting / Unresponsive-Mild

Other Meds:

Current Illness:

ID: 1675403
Sex: M
Age: 31
State: CA

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

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

Lab Data:

Allergies:

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

Symptoms: Systemic: Fainting / Unresponsive-Medium, Systemic: Shakiness-Medium, Additional Details: Pt fainted from seated position and hit the floor face first. He was responsive and able to roll onto back and rest for several minutes before sitting up. Emergency services arrived and took vitals. He almost fainted again and so was taken to hospital but not admitted. He has since recovered. Pt states he was most likely dehydrated before the vaccination.

Other Meds:

Current Illness:

ID: 1675404
Sex: M
Age: 22
State: CA

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

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Systemic: Dizziness/Lightheadedness-Mild, Systemic: Fainting/Unresponsive-Medium, Additional Details: Approximately 5 min after vaccine administration, patient fell over in the chair he was sitting in. He was unresponsive for approximately 10 sec. He stayed on the floor while alert until the ambulance arrived. The EMT's took over care and proceeded to check patient. The patient was removed from the pharmacy area via gurney and taken to a nearby hospital.

Other Meds:

Current Illness:

ID: 1675405
Sex: F
Age: 15
State: MD

Vax Date: 08/04/2021
Onset Date: 08/04/2021
Rec V Date: 09/06/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Systemic: Chest Tightness / Heaviness / Pain-Mild, Additional Details: patient said after approx 10 minutes she experenced mild to moderate chest heavieness with slight difficulty breathing. patient stated she has a history of asthma. she said it had improved to mild chest tightness over the past 5 minutes so did not seem to be an allergic reaction. patient denied offer of benadryl. patient described her mother having a severe reaction which warrented an ER visit which she seemed very anxious about which may have exacerbated these symptoms.

Other Meds:

Current Illness:

ID: 1675406
Sex: F
Age: 17
State: CA

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

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

Lab Data:

Allergies:

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

Symptoms: Systemic: Dizziness / Lightheadness-Medium, Systemic: Flushed / Sweating-Medium, Systemic: Nausea-Mild, Systemic: Tingling (specify: facial area, extemities)-Mild, Systemic: Weakness-Mild, Additional Details: skin looks pale

Other Meds:

Current Illness:

ID: 1675407
Sex: M
Age: 40
State: NJ

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

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

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Systemic: Dizziness / Lightheadness-Severe, Systemic: Fainting / Unresponsive-Severe, Additional Details: Patient came for 2nd dose, Patient was in good shape. After receiving the 2nd dose after maybe 5 to 7 mins patient fainted. i was standing at the door with my back and then i heard patient fell to the floor and bleeding from the nose. i asked him with happended, and patient responsed that he felt light headed and fainted. Patient then was able to get up and sit on the chair, i called 911 and 10 to 15 minutes later Police arrive and few mins later the Paramatics arrived.

Other Meds:

Current Illness:

ID: 1675408
Sex: F
Age: 32
State: NY

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

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

Lab Data: N/A

Allergies: Codeine

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Headache following day, stopped with medication. Swollen and sore left armpit, ongoing

Other Meds: Gabapentin, bupropion, venlafaxine, iron, d3

Current Illness: N/A

ID: 1675409
Sex: F
Age: 45
State: PR

Vax Date: 12/30/2020
Onset Date: 12/31/2020
Rec V Date: 09/06/2021
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: No

Allergies: Latex

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

Symptoms: 1st dose, I presented headache and tiredness, 2 gives dose I presented the same symptoms but also strong pain in the joints, mostly in the hip that did not go away, then the intensity decreased but remains although mild, the discomfort persists.

Other Meds: N/A

Current Illness: N/A

ID: 1675410
Sex: M
Age: 62
State: UT

Vax Date: 08/13/2021
Onset Date: 08/20/2021
Rec V Date: 09/06/2021
Hospital:

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

Lab Data: Covid test August 24, 2021 D-Dimer test administered 9/4/2021 Ultrasound administered 9/24/2021

Allergies: none

Symptom List: Nausea

Symptoms: 1) Caught Covid 19 just about 9 days after receiving first dose of vaccine 2) Was treated for Superficial Vein Thrombosis that was first manifested on August 31, 2021. No previous history of blood clots.

Other Meds: levothyroxine

Current Illness: none

ID: 1675411
Sex: F
Age: 29
State: MO

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

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

Lab Data:

Allergies: No

Symptom List: Injection site pain

Symptoms: Nausea, fatigue, chills/hot flashes and headache.

Other Meds: Tylenol

Current Illness: No

ID: 1675412
Sex: F
Age: 42
State: MI

Vax Date: 08/15/2021
Onset Date: 09/03/2021
Rec V Date: 09/06/2021
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: Augmentin, keflex

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

Symptoms: Irregular menstrual cycle; initially short and light and now bleeding in between cycle with cramping

Other Meds: Levothyroxine 75 mcg, Lisinopril 40 mg, vitamin d 1.25 mg, Zyrtec 10 mg

Current Illness: Seasonal allergies

ID: 1675544
Sex: F
Age: 60
State: IL

Vax Date: 04/20/2021
Onset Date: 04/20/2021
Rec V Date: 09/06/2021
Hospital:

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

Lab Data: Visits with: Hand/Wrist Surgeon; - had X-Rays of hands/wrists, and nerve tests done on both arms Hip/Knee Surgeon - had X-Ray Spine Surgeon - Had MRI of Spine Primary Care doctor - check up and labs Have upcoming visit with a Rheumatologist on 9/15/21.

Allergies: None

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

Symptoms: 2nd Vaccine at noon on 4/20/21. At approx 9:00 pm, hands and wrists became painful. Woke up at 1:00 with typical flu-like symptoms, fever, body aches, etc for about 16 hours. After that, pain in hands/wrists never went away, became worst over time. Then right hip, left knee, arms, became painful. Over next few months, left arm and both hands went numb every night. To date, hand/wrist are crippling each morning, along with joint pain. Hands and wrists are painful through out the day.

Other Meds: Levothyroxine; Atorvastatin, Sertraline, Bayer Aspirin

Current Illness: None

ID: 1675545
Sex: F
Age: 39
State: NJ

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 09/06/2021
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: None

Symptom List: Tremor

Symptoms: Arm is numb since the injection. Severe left arm pain. Chest pain on the left side

Other Meds:

Current Illness: None

ID: 1675546
Sex: M
Age: 15
State: TX

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

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

Lab Data: None as of yet.

Allergies: Severe Tree nut allergy

Symptom List: Erythema, Pruritus

Symptoms: Adverse event reporting: testicular pain (left testicle). He has never had this type of pain before. It mainly hurts when he moves. He also had chills, mild fever (101.5), aches. We knew to expect those but did want to report the testicular soreness since it?s not a listed side effect. It may not be related and just coincidental but wanted to report in case there is a connection.

Other Meds: Zyrtec, elderberry / vitamin c / vitamin d, antibiotic for acne

Current Illness: None

ID: 1675547
Sex: F
Age: 23
State: NY

Vax Date: 04/26/2021
Onset Date: 05/04/2021
Rec V Date: 09/06/2021
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: blood work, CT head and lumbar spine, EEG

Allergies: shellfish, penicillin, chloraheavine, iodine,

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

Symptoms: I was driving to work like I normally do, I had a blackout episode for 30 minutes I came to I still was driving my car and my right arm was clenched to my body and left leg was clenched out and no feeling on the right side of my body, I tried pulled over, I called my mom. I thought I was having a stroke. My mom told me to call 911 an ambulance came to my car. When i was in ambulance they gave me benadryl and valium neither worked. They admitted, They thought I was on drugs and I wasn't so all test came back showing truth. DR. saw me on third day in hospital he felt like it was a reaction to vaccine. when I left hospital I couldn't walk, I was peeing my panted, I could barely wiggle my toes. I was discharged with home care. I had to do intensive home care PT. I recently got a new diagnosis of angioma edema, my POTS was extremely aggravated from vaccine mt BPM 200 BP was 168/100 . They put me on 50 mg of Prednisone 2 months, IV ativan. now I'm on IV saline 3 times a week, Atenolol 12.5 mg , midarine 10 mg 3 times a day.

Other Meds: gabapentin, valacyclovir, caffeine, metoprolol,

Current Illness:

ID: 1675548
Sex: F
Age: 51
State: GA

Vax Date: 08/13/2021
Onset Date: 08/14/2021
Rec V Date: 09/06/2021
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: Wheat Yeast Milk

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

Symptoms: Fever 100.4 Headache Nausea Fatigue Joint pain

Other Meds: Plaquenil Zyrtec Singular Zarelto Cymbalta

Current Illness: None

ID: 1675549
Sex: F
Age: 41
State: GA

Vax Date: 09/02/2021
Onset Date: 09/03/2021
Rec V Date: 09/06/2021
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: NKDA

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Along with mild flu-like symptoms--esp achy bones, and pain at needle entry site returning next day and lingering, the ball of my right foot became so painful I could hardly walk on it. Feels swollen and hot but not to eye or touch. Any bending or stretching of toes or pressure on the ball is excruciating. Some improvement to almost gone with treatment and over the course of day, by 2nd day, but returns overnight and moving foot in bed causes pain.

Other Meds: none

Current Illness: none

ID: 1675550
Sex: F
Age: 71
State: PA

Vax Date: 03/03/2021
Onset Date: 07/11/2021
Rec V Date: 09/06/2021
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: Chest X-rays, CT Scan, blood work

Allergies: Penicillin, Neomycin, Lisinopril

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

Symptoms: I had severe difficulty breathing and was hospitalized for 3 days at hospital with multiple blood clots in my lungs. As of today I still have blood clots in my lungs. I have an upcoming follow up for CT scan to check my lungs for the blood clots at Hospital.

Other Meds: Atorvastatin, Amlodipine, Floresomide, Magnesium, Dexcolunt, Vit D 3, Aspirin

Current Illness: No

ID: 1675551
Sex: F
Age: 21
State: IN

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

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Patient was given vaccine. Within 5 minutes patient fainted and revived with smelling salts. Patient sat in pharmacy under care for 30 minutes. Patient was ok to leave pharmacy walking by themselves. Patient was checked on 2 hours later and still doing fine.

Other Meds:

Current Illness:

ID: 1675552
Sex: F
Age: 17
State: NJ

Vax Date: 08/27/2021
Onset Date: 08/28/2021
Rec V Date: 09/06/2021
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: Low grade fever for full day range from 100.2 to 101.2 Vomiting at least seven times for full day, contacted pediatrician and had telemed appt with on-call nurse practioner. Was given the ok to administer ondansetron to alleviate nausea.

Other Meds: none

Current Illness: none

ID: 1675553
Sex: F
Age: 66
State: TX

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

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

Lab Data:

Allergies: Penicillin

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

Symptoms: Fever, (101), chills, muscle aches. Arm is swollen, hot to the touch, red. Has lasted over 24 hrs. Taking Ibuprofen, which helps.

Other Meds: Multi vitamin, Omega 3, calcium

Current Illness: None

ID: 1675554
Sex: F
Age: 34
State: VT

Vax Date: 04/23/2021
Onset Date: 05/04/2021
Rec V Date: 09/06/2021
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: Sulfa drugs, Cephalosporins

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

Symptoms: Frequent menstruation for months after 2nd vaccine - May 4, May 18, June 3, June 18

Other Meds:

Current Illness: Calcific tendinitis

ID: 1675555
Sex: F
Age: 48
State: NJ

Vax Date: 09/03/2021
Onset Date: 09/04/2021
Rec V Date: 09/06/2021
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: severe headache and fatigue low grade fever ranging from 100.1 to 100.9 took tylenol for fever and headache

Other Meds: none

Current Illness: covid-19

ID: 1675556
Sex: F
Age: 56
State: NY

Vax Date: 09/03/2021
Onset Date: 09/03/2021
Rec V Date: 09/06/2021
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: Major swelling of lymph node underarm, persistent pain, fatigue and nausea ongoing

Other Meds: Fluoxetine 20 mg, Clonazapam .5 prn, Levothyroxine/liothyronine .100/75

Current Illness: None

ID: 1675557
Sex: F
Age: 38
State: VA

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

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

Lab Data: Please contact Dr.

Allergies: none

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: 1 week after 1st Moderna shot I became dizzy every waking moment. At first, I believed to be due to loss of appetite and lack of sleep relating to depression. But it continued on for over 2 months. 1 week after 2nd Moderna shot, in addition to the dizziness, the ringing in both ears started and hasn't gone away. My primary care physician instructed me to see an ENT Specialists and so I did on 8/12/2021. They said I'm not the only one having the issue after having the 2nd Moderna shot. Please note, I have no prior case of Tinnitus. I have occassional/rare ringing for only few seconds then it goes away. Never has it stayed for so long.

Other Meds: Apri, MultiVitamin, Sertraline 50mg

Current Illness: After the 2nd Moderna shot, I got fever the same evening and lasted for 4 days with high of 104. I was also very dizzy for 2-3 months daily. On the 7th day after 2nd Moderna shot, ringing on both ears started. I saw an ENT and so now I have tinnitus since and hasn't gone away.

ID: 1675558
Sex: F
Age: 71
State: FL

Vax Date: 08/10/2021
Onset Date: 08/11/2021
Rec V Date: 09/06/2021
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: Pt reported swollen tongue occurring one day after vaccine and resolving after about 4 days. Rph discovered upon doing a follow up call on 09/05/21 alerting Pt about second dose coming up. Pt took Benadryl and helped resolve.

Other Meds:

Current Illness:

ID: 1675559
Sex: F
Age: 12
State: SC

Vax Date: 09/04/2021
Onset Date: 09/04/2021
Rec V Date: 09/06/2021
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: None

Allergies: None

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Fever (99.8), congestion, runny nose, cough, sore throat, myalgia, arthralgias. Treated with ibuprofen 600mg PO q8hx3 doses, phenylephrine 10mg PO x1 dose, phenylephrine nasal x1spray each nostril once. Fever, myalgia, arthralgias resolved in 36 hours. Cough, congestion still resolving.

Other Meds: Multiple vitamins daily, loratadine 10mg daily

Current Illness: None

ID: 1675560
Sex: F
Age: 50
State: TX

Vax Date: 08/23/2021
Onset Date: 08/24/2021
Rec V Date: 09/06/2021
Hospital:

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

Lab Data:

Allergies: Sulfa drugs, yellow dye, bees

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

Symptoms: Had the typical reactions that are said to be expected. However, by 3rd day, glands swelled up, especially the one under my arm pit on the arm where I received the shot. It became the size of a golf ball and was so painful. Then the rest of my glands became swollen. A week later, my right foot/ankle/leg is giving me problems. It swells up pretty bad. I keep it propped up which to help, but I can't live in bed as I have to work and function. Everyone is saying I should get checked for a blood clot, but this seems lymphatic in nature. I don't know what to do or who to see for it and have no desire to wait 8 hours at the ER, then pay a $600.00 copay.

Other Meds: Estradiol

Current Illness:

ID: 1675561
Sex: M
Age: 44
State:

Vax Date: 08/27/2021
Onset Date: 08/28/2021
Rec V Date: 09/06/2021
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: CT scan, MRI, had to have ventriculostomy

Allergies: none

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

Symptoms: MRI demonstrates acute infarct in the bilateral cerebellar hemispheres, vomiting, dizziness, headache

Other Meds: none

Current Illness: unknown

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am