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: 1675562
Sex: M
Age: 52
State: AR

Vax Date: 09/01/2021
Onset Date: 09/04/2021
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: LA

Lab Data: CT angiogram of chest

Allergies: NONE

Symptom List: Dysphagia, Epiglottitis

Symptoms: Bilateral pulmonary emboli, syncopal episode

Other Meds: NONE

Current Illness: NONE

ID: 1675563
Sex: F
Age: 59
State: TX

Vax Date: 08/24/2021
Onset Date: 08/27/2021
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: Sulfa

Symptom List: Anxiety, Dyspnoea

Symptoms: 13 days after first dose injection site is hot, red, and painful.

Other Meds: None

Current Illness: None

ID: 1675564
Sex: F
Age: 39
State: KY

Vax Date: 08/30/2021
Onset Date: 08/30/2021
Rec V Date: 09/06/2021
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: CBC, Comp Chem, RPR,

Allergies: None

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

Symptoms: Significant allergy reaction. Almost full body Hives, including itching and painful tingling all over.

Other Meds: None prior to Vaccine, several prescriptions prescribed due to adverse reaction.

Current Illness: None

ID: 1675565
Sex: F
Age: 52
State: VA

Vax Date: 08/28/2021
Onset Date: 09/01/2021
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: N/A

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Started getting ear pain, shooting jolts from left ear, coming every few minutes. Called online clinic around 8:00. Ruled out swimmers ear. Took one Tylenol woke up throughout night. In the morning pain moved to scalp, left side toward front of head. Still jolting, intense at times if I touched hair or scratched scalp. Took two Tylenol, frequency and intensity greatly reduced. Pain returned hours later. Took 2 more Tylenol and again pain reduced. Looked up - experience 100% matched Trigemenial Neuralgia. Went away completely 2 days later.

Other Meds: Prograf, cellcept, valsartan, Claritin, albuterol

Current Illness: N/A

ID: 1675566
Sex: F
Age: 53
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:
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: Large swelling and redness at injection site. Tiredness, chills, muscle ache.

Other Meds: Vitamins, a, c, b, d, cranberry, d-mannose, calcium

Current Illness: None

ID: 1675567
Sex: F
Age: 55
State: WI

Vax Date: 09/03/2021
Onset Date: 09/03/2021
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: N/A

Allergies: Nubain sensitivity, Codeine sensitivity

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

Symptoms: Flushed - like a surge of adrenaline. This happened twice. First time it occurred, it lasted a few minutes. The second time it was more intense , I got dressed in case it didn?t go away I was prepared to go to the ER. that lasted several minutes as well. I also felt anxious (separate occasion). I am currently experiencing continual tinnitus. It started yesterday 9/5/2021.

Other Meds: Escitalipram 20mg/day, 100% natural psyllium husk fiber capsules, PEScience TruMulti Women?s Formula vitamins, Vital Proteins Collagen Peptides 10g/day.

Current Illness: None

ID: 1675568
Sex: M
Age: 13
State: TX

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

Allergies: Pinicillin family

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: After 2nd vaccination was given to patient (my son) by nurse following completion of WV by physician. We proceeded to the check out down the hall. As I was speaking with admin staff for a school note, my son whom stood behind me said "Man I feel dizzy as crap". Before I completely turned around I felt his hand attempt to grasp my shoulder and slipped as he went to the ground. I was able to catch his head and ease him there during this spell. He sat on his butt leaning against the wall for several minutes and looked rather pale. Dr. and nurse gave him some cool water and small bag of chips. He was fine after several minutes and ensured me he was okay. After I took him to eat as it is notable to mention that he skipped lunch that day.

Other Meds: None. Tylenol or aspirin occasionally as needed for minor headaches or pain.

Current Illness: None

ID: 1675569
Sex: F
Age: 38
State: MA

Vax Date: 08/29/2021
Onset Date: 08/29/2021
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: Went to urgent care. They did covid test , which is negative. Checked my breathing and lungs. My pcp gave me steroid inhaler the next day.

Allergies: Amoxicilin Penicillin Doxicyclin Shell fish CT contrast

Symptom List: Pharyngeal swelling

Symptoms: Nausea and dizzy right away. Stayed at the pharmacy for 20 mins. Within and hour of receiving the vaccine I was wheezing, SOB, hives on my hands and heart rate was going from 159 to 55. I had to lay down due to extreme nausea and the above symptoms. Hives went away in an hour. Other symptoms reduced by the next day. I'm still wheezing and SOB at times. Seeked triage and urgent care at my DR office following days. 1 week later, prescribed steroid inhaler. Still feel very sick with nausea and dizziness. Swollen lymph nodes around my body.

Other Meds: Propranolol Famotidine

Current Illness: N/a

ID: 1675570
Sex: F
Age: 48
State: RI

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

Lab Data: Blood Work, Chest X-Ray, Cat Scan

Allergies: None

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Headache, Sore & Itchy Arm, Bruise on Rt Leg, Lightheaded, Nausea, Blurred Vision, Chest Pain, Cough, Difficulty Breathing, Elevated D-Dimer

Other Meds: Levothyroxine (1 month), chlorophyll

Current Illness: None

ID: 1675571
Sex: F
Age: 56
State: TN

Vax Date: 08/30/2021
Onset Date: 09/01/2021
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: Lab work - 9/1/2021

Allergies: Demoral, Hydrochlorothiazide, Septra, Sulfa Drugs, Tetanus Vaccine, Vibramycin, Aspartame

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Arm tenderness last for a couple of days - not sever. Pain in neck shoulders and whole spine lasted for about 24 hours started 2 days after vaccine. Also could not seem to stay awake this day - slept on and off for about 14 hours. That evening started having blood in urine lasting into the next day - wasn't sure if covid vaccine related so went to Dr. That issue was most likely kidney stone according to lab work. Also had severe abdominal cramping the third evening after vaccine - took ibuprofen and rested and the next morning it was better. Cramps came up periodically but not as severe as the day before. It has been a week now and all side effects seem to be gone.

Other Meds: Synthroid, Diclofenac, Oxybutynin, Rosuvastatin, Toprol, Pramipexole, Spironolactone, Metformin, Icaps Areds 2, Citalopram, Multivitamin, Zinc, Vitamin D, Vitamin C

Current Illness:

ID: 1675572
Sex: F
Age: 17
State: NY

Vax Date: 08/01/2003
Onset Date: 08/01/2003
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: Biopsy of welts on left leg - 9/2003

Allergies: Peanuts, nuts

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

Symptoms: 103 fever x3 weeks, welts developed all over body mostly on the legs but some on abdomen and back - general flu like symptoms

Other Meds: None

Current Illness: None

ID: 1675573
Sex: M
Age: 51
State: NY

Vax Date: 08/28/2021
Onset Date: 09/01/2021
Rec V Date: 09/06/2021
Hospital:

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

Lab Data:

Allergies: PCN and Levaquin

Symptom List: Rash, Urticaria

Symptoms: Bad rash and hives in various parts of body Eyes swollen Itchy

Other Meds: Amlodipine, Advair, BenicarHCT, Omeprazole, Montelukast, Bystolic, Pristiq

Current Illness: High blood pressure, acid reflux and asthmas

ID: 1675574
Sex: M
Age: 64
State: NY

Vax Date: 08/24/2021
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: none

Allergies: Shellfish/Iodine

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

Symptoms: rash two weeks later

Other Meds: Effient. Crestor. Lisinopril. Bisoprolol Fumarate. Vitamin D3. CoQ-10. Ranexa. Xarelto.

Current Illness: none

ID: 1675575
Sex: F
Age: 42
State: FL

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: SYR
Vax Site: LA

Lab Data:

Allergies: penicilin

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

Symptoms: At exactly 5pm I was driving and starting to feel weak, I saw my left arm (not on the site of the injection) and I had raised, itchy, red rash (hives) on the front part of my elbow and forearm. I took a picture of it at exactly 5:17pm that I could stop driving. I saw my neck and it was also itchy and red. I got home and at 5:40pm took 1 pill of loratadine 10mg, the hives vanished an hour later, the itchiness in my neck, face and arms didn't. So I took another loratadine 10mg at 10pm and applied my self an intramuscular shot of Chlorphenamine. The next morning I had no itchiness or hives on arms, though the skin around my neck and chin stills feels kind of itchy, but not like it was on saturday. I am visiting the country, I am a dentist, so I came prepared and treated myself. I just want to know if I should get or not the 2nd dose.

Other Meds: none

Current Illness: none

ID: 1675576
Sex: F
Age: 33
State: TX

Vax Date: 08/29/2021
Onset Date: 08/31/2021
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: Sulfa medications, bananas.

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

Symptoms: Swelling began with in a few hours. It Increased swelling at site injection over the next 2 days. now developing a rash starting the night of the 3rd. Now the rash is spreading over swelling. Pictures taken. This morning Allegra was taken. Will take Benadryl shortly

Other Meds:

Current Illness:

ID: 1675578
Sex: F
Age: 51
State: MD

Vax Date: 02/24/2021
Onset Date: 03/01/2021
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: nka

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

Symptoms: Developed swelling on March 1, 2021 in right breast and right arm. Seen by Radiation oncologist and diagnosed with lymphedema of right breast and right arm, referred to physical therapist

Other Meds: Tamoxifen 20 mg Celexa 20 mg Vitamin D Cetirizine 10 mg

Current Illness:

ID: 1675579
Sex: F
Age: 28
State: FL

Vax Date: 08/11/2021
Onset Date: 08/13/2021
Rec V Date: 09/06/2021
Hospital:

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

Lab Data: Bloody diarrhea

Allergies: None

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

Symptoms: Severe flare up of ulcerative colitis

Other Meds: LDN 4.5mg

Current Illness: None

ID: 1675580
Sex: F
Age: 43
State: AL

Vax Date: 03/21/2021
Onset Date: 03/23/2021
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: Hives for about 2- 3 weeks after second dose

Other Meds:

Current Illness:

ID: 1675581
Sex: M
Age: 56
State: AL

Vax Date: 09/02/2021
Onset Date: 09/02/2021
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: none

Allergies: None

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Fever for 48-72 hours(99-101), chills--uncontrollable sweating. A couple of dizzy spells. Janssen-J&J

Other Meds: aspirin, Lipitor, omeprazole--Norco and zanex as needed.

Current Illness: None

ID: 1675582
Sex: F
Age: 68
State: WA

Vax Date: 09/04/2021
Onset Date: 09/04/2021
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: Almost all antibiotics, blue dye in foods, wool, lanolin.

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

Symptoms: Almost immediately after receiving the shot, I could taste a strong metalic taste in my mouth. My saliva increased. It made me feel very nauseous. About two hours later, my bottom lip started to swell and my mouth on the inside and outside felt like it was on fire. About 4 hours later I felt very weak. After drinking tons of water, these symptoms disapated. The next day, my mouth was better but not completely free of the bitter, bitter taste!

Other Meds: Tylenol

Current Illness: tooth work done at dentist for cavities.

ID: 1675583
Sex: M
Age: 70
State: FL

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: Soreness, fatigue, swelling, headache, joint pain

Other Meds: atenolol, verapamil, ezetimibe, aspirin, atorvastatin, lutein, losartin

Current Illness:

ID: 1675584
Sex: M
Age: 14
State: OH

Vax Date: 09/01/2021
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: Unevaluable event

Symptoms: Sore arm, upset stomach, chills

Other Meds: None

Current Illness: None

ID: 1675585
Sex: F
Age: 37
State: NY

Vax Date: 09/02/2021
Onset Date: 09/02/2021
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: Urinalysis negative for infection Bloodwork normal at ER Bladder retention test- 33 ml

Allergies: Sulfa, Ceclor

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

Symptoms: Thursday evening, 7 pm, chills, fever, hip pain, headache, significant weakness B Lower extremities causing difficulty walking. Heaviness and difficulty lifting feet off the ground to take steps. Tingling B lower extremities. By 3 am-7-am, most symptoms resolved. By 12 pm- all symptoms resolved except decreased bladder and vaginal sensation. Difficulty feeling the need to urinate. No incontinence. Decreased sensation around vulvar area as well. The sensation is slowly improving, but continues as reduced. ER visit 9/5/21 for eval.

Other Meds: Vitamin c Zinc Quercetin NAC Vitamin D Milk thistle Multivitamin Magnesium Turmeric & black pepper

Current Illness: None

ID: 1675586
Sex: F
Age: 45
State: TN

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: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: PCN

Symptom List: Injection site pain, Pain

Symptoms: 21 hours after my 2nd dose while waiting in line at a restaurant i began to feel very hot. I suddenly became nauseated and dizzy. I began to feel my body stiffen and start to shake but I could not stop it. The harder I tried the worse it got, my vision became distorted and I don't remember much after that. According to witnesses I was talking during the shaking and began to fall, they helped me to the floor where my eyes rolled back in my head and I proceeded to pass out. They advised I was out for maybe 30 sec before I began to come to. I was disoriented and feeling very flushed, I felt very fuzzy and everything was in a haze. I could not move at this point. Slowly as i began to get my bearings about me i began to talk and console my mother verbally as they kept me on the ground till paramedics showed up. They advised my blood sugar was at 120 , my bp was palpable at 70 systolic. The restaurant was too loud for them to get a reg. bp. The FD and Police were on scene. This all occurred at the cafe in the mall as there were many many witnesses. I do not have ins. so I did not want to be taken to the hospital. There has been pressure in my head ever since the episode. No new meds or food has been introduced to my system. I do not have any significant medical history. None that would have caused an episode as this.

Other Meds: Duloxetine, Valtrex, Excedrin Migraine

Current Illness:

Date Died: 08/31/2021

ID: 1675587
Sex: M
Age: 63
State: AR

Vax Date: 07/29/2021
Onset Date: 07/31/2021
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: Many tests were done at Hospital

Allergies: None

Symptom List: Injection site pain, Menorrhagia

Symptoms: Immune response, COVID-19 pneumonia. Patient told the pharmacist giving vaccine he was not feeling well. They did not test him for COVID and gave vaccine anyway. It is unknown if he officially had COVID-19, but he became sick almost immediately after getting the vaccine. Taken to hospital by ambulance on 08/06/2021, put on a ventilator on 08/13/2021 and died on 08/31/2021.

Other Meds: Cabergoline .5 mg 2x/week

Current Illness: Chest congestion, cough, cold/flu symptoms.

ID: 1675588
Sex: M
Age: 36
State: FL

Vax Date: 04/30/2021
Onset Date: 06/10/2021
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: 4 MRIs head neck thoracic lumbar

Allergies: None

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

Symptoms: Tingling numbness sensitivity and discomfort from my knees and below all the way to my feet

Other Meds: None

Current Illness: None

ID: 1675589
Sex: F
Age: 36
State: IL

Vax Date: 08/01/2021
Onset Date: 08/17/2021
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: 09/01/2021 ER: EKG, echocardiogram, CT scan with contrast, blood work. EKG, Echocardiogram, CT scan all showed everything is ok. Blood work shows my bilirubin is high and my blood pressure was high. I normally have no issues with either of those things. Blood pressure is usually 110/70. That day it was all over the place 155/92 to 138/92.

Allergies: None

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Lymph nodes right arm pit swollen huge and painful 8/17-8/29, went down but still slightly swollen 9/6. 8/29 started having chest pain, high blood pressure, dizziness, shortness of breath, migraines, shaking. Went into the ER 9/1 to make sure my heart was ok.

Other Meds: None

Current Illness: None

ID: 1675590
Sex: F
Age: 59
State: FL

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 09/06/2021
Hospital: Y

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

Lab Data: Bloodwork, x-rays, CT scan, Cpap/oxygen. heart monitor

Allergies: Septra , morphine. tape

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Initially watery eyes and sneezing with scratchy throat, later wheezing then severe difficulty breathing even after steroids and breathing treatments requiring hospitalization for 6 days.

Other Meds: Align Alprazolam Aspart Flexpen Insulin B12 Bayer Low Dose Carvedilol Dexilant Entresto Flovent HFA Folic Acid Furosemide Januvia Levalbuterol Levothyroxine Lyrica Orencia Omega-3 Krill Perforomist Rosuvastatin Spironolactone Tramadol Tresi

Current Illness: None

ID: 1675592
Sex: M
Age: 67
State: IA

Vax Date: 02/25/2021
Onset Date: 05/23/2021
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: No allergies

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

Symptoms: My "man boobs" have been sore since May! Had mammogram, looked o.k., some lumps.

Other Meds: Baby Aspirin, Pantoprazole, CoQ10, Gabapentin, Bupropion Help Sr1, Pravastatin, Hydroxyzine Hel, Losartan

Current Illness: No Illnesses

ID: 1675594
Sex: M
Age: 29
State:

Vax Date: 09/01/2021
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: RA

Lab Data:

Allergies: none

Symptom List: Nausea

Symptoms: swollen armpit lymph nodes on side of injection - two days after administration and continuing currently on third day

Other Meds: Multivitamin

Current Illness: none

ID: 1675595
Sex: F
Age: 54
State: OH

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data: None

Allergies: Lisinopril

Symptom List: Injection site pain

Symptoms: Patient received the Moderna shot in March and had tingly lips, so she did not finish the series. I administered the Pfizer shot 9/5/21 and did not know about the previous shot until I had already given her the Pfizer shot.

Other Meds: Trulicity, Losartan, Metformin, Pravastatin

Current Illness: None

ID: 1675596
Sex: F
Age: 49
State: VT

Vax Date: 05/03/2021
Onset Date: 05/01/2021
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 induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Tightness, heat, pain in chest radiating out to armpits and arms. Lasted about 2 months. Also developed jaundice, fatigue and headache.

Other Meds: cod liver oil

Current Illness: migraines, Gilbert's syndrome

ID: 1675597
Sex: F
Age: 37
State: KY

Vax Date: 08/03/2021
Onset Date: 08/03/2021
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: Bloodwork done in ER. No issues with organs and no anemia. Released to follow up with obgyn even with pains in chest and pelvis

Allergies: Penicillin . Erithromycin. Veneflaxin.

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

Symptoms: 30 min after shot (my period which was almost over) became heavy and I bled for 39 days. I had lightheaded ness for about an hour after the shot, and now that the bleeding stopped I have chest and pelvic pains. Still in the works of going to obgyn to figure out more. Never had period issues prior to shot

Other Meds: Kolonopin - seizures & anxiety

Current Illness: None

ID: 1675598
Sex: F
Age: 78
State: WA

Vax Date: 02/04/2021
Onset Date: 07/15/2021
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: 7-29 21 Iron-20% Saturation 6% Ferritin - 17 Various components of CBC are flagged either high or low.

Allergies:

Symptom List: Tremor

Symptoms: Very tired. The tiredness had been progressing over time, but iron deficiency showed up in test results. I?m taking iron pills and had one iron infusion. Researched and found others had this condition after having vaccine. Iron retested this week. Video Dr appt. next week to determine course of action.

Other Meds: I take numerous medications and am unable to copy and paste.

Current Illness: None

ID: 1675599
Sex: F
Age: 42
State: VA

Vax Date: 08/27/2021
Onset Date: 08/27/2021
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: N/A

Symptom List: Erythema, Pruritus

Symptoms: Patient received pfizer covid vaccine. At first her left felt typically sore after vaccination but over the past week it has been gradually getting worse and now she feels a sharp pain from her upper shoulder arm that radiates down to her hand. She thinks it is due to the vaccine itself but there is also a possibility that it has been given incorrectly. She is unable to lift her arm well and it is difficult to perform daily tasks. She is not experiencing any other type of symptoms or reactions (no shortness of breath, rash, etc). Patient was advised to see a doctor right away to see what is going on.

Other Meds: N/A

Current Illness: N/A

ID: 1675600
Sex: F
Age: 53
State: KY

Vax Date: 08/27/2021
Onset Date: 09/03/2021
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: WBC-16.60 (9/4/21); 13.80 (9/5/21); 14.50 (9/6/21) Hgb 16.3 (9/4); 14.6 (9/5); 13.7 (9/6) PLT 267 (9/4); 218 (9/5); 207 (9/6) Na 135, 140, 136 (Same dates as above) K 4.7, 4.3, 3.4 (Same dates as above) CRP 0.4 (9/4/21) Urine 2+ Protein, Trace Blood, 2+ urine bacteria (9/4/21) Diarrhea PCR Panel (Neg for all infectious causes, pos for blood and lactoferrin (9/4/2021) Respiratory PCR Panel (Biofire), (Neg for all infections tested including SARS Co V2) (9/4/21) INR 0.97 (9/5/21) PTT 23.4 (9/5/21) (below normal) Hypercoag panel pending CT abd/pelvis with IV contrast IMPRESSION: 1. Extensive colonic inflammatory change within the left colon spanning the distal transverse through the sigmoid. Differential considerations include both infectious and inflammatory colitis entities. Less likely vascular/ischemic injury given the distribution of findings and the patient's lack of atherosclerosis. 2. No bowel perforation, pneumatosis, portal venous gas, free air, or abscess. 3. No acute intraabdominal findings are otherwise apparent. Colonoscopy 9/5/21 - Provisional diagnosis ischemic colitis

Allergies: NKDA

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

Symptoms: The patient developed severe left sided abdominal pain, followed by frank bloody diarrhea. Current provisional diagnosis is ischemic colitis.

Other Meds: Tylenol, Probiotics, Fish Oil, Zyrtec, MVI, Immunoflex

Current Illness: None

ID: 1675601
Sex: M
Age: 77
State: NE

Vax Date: 05/09/2021
Onset Date: 05/15/2021
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: EKG, classic AFIB

Allergies: Penicillin; iodine

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

Symptoms: I had no adverse at the time, eight days later woke up early am in classic Afib, high heart rate. I went to the emergency room, we were traveling at the time. At home I went to my cardiologist they cardioverted me back, i have been fine since.

Other Meds: Brilinta; Synthroid; baby aspirin; rosuvastatin; metoprolol tartrate; valsartan; tamsulosin; pantoprazole; vit D; Ocuvite; generic multivitamin

Current Illness:

ID: 1675602
Sex: F
Age: 51
State: MI

Vax Date: 08/23/2021
Onset Date: 08/23/2021
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: NKA

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: -Headache -Fever -Chills -Body aches -Joint pain *These symptoms started at 11pm on 8/23 and lasted through 8/27 -Dizziness -Hot flashes *These symptoms started at 11pm on 8/23 and are ongoing to this date

Other Meds: Lisinopril HCTZ Adderall

Current Illness: None

ID: 1675603
Sex: F
Age: 67
State: GA

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: 011J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data: None

Allergies: Adhesives, tamiflu

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

Symptoms: Became very ill in about 8 hours after booster (third) vaccination. Symptoms of systemic nature included Chills, low fever, aches and pains, pain in neck and head area, eye muscle soreness, all over body tingling and skin sensitivity, followed several hours later by nausea, diarrhea, severe headache, neck glands tenderness, profuse sweating, insomnia due to discomfort in bed, dryness of mouth and nose, nasal stuffiness,. Diarrhea lasted for 48 hours. Other symptoms subsided when I took one dose of Tylenol approximately 8 hours after first onset of symptoms. Had sweating, stomach pains, eye muscle pain, and diarrhea for approximately 48 hours after injection. I felt very ill for a24 hours after first onset of symptoms.

Other Meds: Oral prednisone, irbesartan, trazadone, hydroxychloroquine, alprazolam, latanoprost, lucentis ophthalmic injections, prolia

Current Illness: None

ID: 1675605
Sex: F
Age: 37
State: TX

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: Latex, penicillin, Zofran, bananas, certain artificial colors and flavors

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

Symptoms: Sore arm within hour of injection that got worse with rest, facial paralysis within 3 hours, muscle weakness within 12 hours

Other Meds: Fish oil, vitamin d, vitamin c, probiotic, iron

Current Illness: Virus with post nasal drip and cough

ID: 1675606
Sex: F
Age: 16
State: MO

Vax Date: 07/23/2021
Onset Date: 07/26/2021
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: Blood work 8/10, neurologist appt bloodwork 8/13, MRI 8/27

Allergies: None

Symptom List: Pain in extremity

Symptoms: Numb hand 3 days after, few weeks later pins and needles in feet, numb legs

Other Meds: Wellbutrin generic, multivitamin

Current Illness: None

ID: 1675607
Sex: M
Age: 46
State: NY

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

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

Symptoms: N/A

Other Meds:

Current Illness:

ID: 1675608
Sex: F
Age: 42
State: SC

Vax Date: 08/30/2021
Onset Date: 08/31/2021
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: None

Allergies: NKA

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

Symptoms: Recieved the vaccine on 8/30/21 at approximately 4 p.m. The next morning I had sinus like drainage from eyes with a slight runny nose. During the course of the 1st twenty four hours, I started to feel worse. I was lethargic and felt icky. When I got up on the morning of 9/1/21, the icky, flu-like feeling and symptoms had worsen. In addition, the injection site and along my left arm (to just above my elbow) was severely swollen and hot. I was quite fearful that I might have been having a stroke. This feeling last for about the next 2 days accompanied by sore shoulder and neck muscles and a floating headache. The arm and muscle soreness finally subsided on about day 3 - 4. However, I still have the floating headache.

Other Meds: Diamox; Protonix; Benicar; Linzess; Probiotic

Current Illness: None

ID: 1675609
Sex: F
Age: 29
State: TX

Vax Date: 07/02/2021
Onset Date: 07/02/2021
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

Allergies: Sulpha, Coedine

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

Symptoms: Bed bound, severe arm pain, could not move, racing heart, felt like has a virus, worse symptom: Extreme spasms and uncontrollably full body shaking all night. Looks like a seizure with how dramatic body was spasming. As time went on, had several SVT attacks and worsened chronic migraines.

Other Meds: Microgestin, Venaflaxine (Effexor), Fludrocortizone

Current Illness: None.

ID: 1675610
Sex: M
Age: 45
State: LA

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: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Vomiting

Symptoms: Migraine, nauseated, fever, chills, weak, tired

Other Meds: Vitamin c, vitamin D

Current Illness: None

ID: 1675612
Sex: F
Age: 68
State: GA

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

Lab Data: Adverse reaction to COVID-19 vaccine, Received meds through IV at ER, sent home with prescriptions for continuation of meds. 9/6/21 I am better, voice still very raspy sounding, arm still very red at injection site.

Allergies: Losarten, shellfish,

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: About 15 minutes from injection, tongue tingling, about an hour waves of nausea, eyes watering & sensitive to light, nasal drips, about 3 hours after, felt like stinging on ankles, arms, moving to different parts of body, about 6 hours, welt & red streak on arm at injection, lips swelling, tongue swelling, and throat felt like it had something in it. Very hoarse voice. Took 2 benadryl and went to ER.

Other Meds: Triamterene 37.5mg, Vitamin B12 5000mcg

Current Illness: N/A

ID: 1675613
Sex: F
Age: 69
State:

Vax Date: 04/08/2021
Onset Date: 09/06/2021
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: Patient did not have reaction to the vaccine but did test positive for COVID on 09/02/2021

Other Meds:

Current Illness:

ID: 1675614
Sex: F
Age: 34
State: CA

Vax Date: 04/04/2021
Onset Date: 04/12/2021
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:

Allergies: Penicillin

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Severe changes in menstrual cycle that have not gotten better since getting the vaccine. Off cycle, heavy, extremely painful, often more frequent. Spotting. I have never had issues with my cycle like this. Majority of my female friends have been struggling with seminar issues for months now.

Other Meds: Magnesium, melatonin

Current Illness: None

ID: 1675615
Sex: F
Age: 55
State: IA

Vax Date: 08/19/2021
Onset Date: 08/21/2021
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: CBC on 8/31/21was all within normal limits

Allergies: Compazine

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

Symptoms: I woke up two days later with Vertigo. I could not turn fast or bend forward without Vertigo. I tried my chiropractor first, times two different sessions. I then found myself dizzy even during sleep Aug 30th into the 31st. On the 31st of August I sought the help from my Doctor. Doctor B was unavailable, so I saw Doctor T. She placed me on a new medication Meclizine for my Verito

Other Meds: Metformin ER, Atorvastatin, Glimepiride, Baby Aspirin, Methimazole, Vitamin D3, Trulicity

Current Illness:

ID: 1675616
Sex: F
Age: 43
State: TX

Vax Date: 03/30/2021
Onset Date: 04/11/2021
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: RA

Lab Data:

Allergies: N/a

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

Symptoms: Chronic idopathic urticaria

Other Meds: Bcp

Current Illness: Covid

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am