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: 1675675
Sex: M
Age: 70
State: KY

Vax Date: 05/15/2021
Onset Date: 09/03/2021
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:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: pt tested positive for COVID on 9/3, admitted to the hospital 9/5. On supplemental oxygen, decadron and remdesivir

Other Meds:

Current Illness:

ID: 1675676
Sex: F
Age: 65
State: NV

Vax Date: 02/19/2021
Onset Date: 02/24/2021
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: I had more CT scans and injections.

Allergies: Biaxin; trimethoprim; sulfamethoxazole

Symptom List: Anxiety, Dyspnoea

Symptoms: 08/12 ? I had a CT scan and it was noted that the Ground glass resolved itself. 08/23 ? Saw a dr. I stopped taking methotrexate because it started to give me sores in my mouth. My last dose was 07/02. I also saw another dr., and he started me on leflunomide. I was also given prednisone 10mg per day. I'm supposed to work off of it when I started feeling better. I am still taking the full prescription. I saw a dr., and he gave me a steroid injection in my left knee and left shoulder. The injections were supposed to give me relief, but they did not. He also gave me an injection of Xarelto in both knees. I had some relief, but not a lot. The pain in my left shoulder and knee are still here. I also have pain in my right wrist and left foot. I saw my PCP, 09/02, and we discussed going to a clinic so they can work everything at once instead of going to different doctors about different areas on my body. I'm hoping to get in to see a specialist soon, who can look at the overall reactions on my body.

Other Meds: Synthroid; D3; E; magnesium citrate; Claritin; probiotic; pantoprazole NA; ezetimibe; BREO albuterol sulfate inhalation with nebulizer; temazepam; Calcium; montelukast; cimetidine; ibuprofen; valacyclovir; prednisone.

Current Illness: Strep throat

ID: 1675677
Sex: F
Age: 51
State: TX

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: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Mucinex

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

Symptoms: I noticed when I was taking a shower my neck was really tender swollen like a knot, couple days it got worse, then died down, never went away. I called to make an appointment with my doctor. My doctor believed it was a swollen lymph node, she said to watch it for 7 days and we would go from there if it doesn't go away she will run more test. This happened on my first vaccine, I didn't think anything of it.

Other Meds: Multivitamin; levothyroxine; Lorsarta

Current Illness:

ID: 1675678
Sex: F
Age: 28
State:

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

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: vaccinated but tested covid positive post travel

Other Meds:

Current Illness:

ID: 1675679
Sex: F
Age: 72
State: TX

Vax Date: 02/24/2021
Onset Date: 04/15/2021
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: None

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

Symptoms: My adverse event is small to moderate generalized pericardial effusion, diagnosed with a 4/15/21 echo cardiogram. Cardiologist said it can go away on its own, so she performed another limited echo cardiogram on May 25; results showed pericardial effusion still present. A 7/26/21 cardiac MRI confirmed I have an enlarged heart from the pericardial effusion. On 8/6/21 cardiologist began treating me with 90 days of Colchicine 0.2mg, tablet taken orally two times per day. I am 30 days into treatment. Cardiologist will perform a limited echo cardiogram on 9/7/21 to check pericardial effusion. IMPORTANT: Symptoms such as chest pain, dry cough, and reduced speed when walking for exercise were experienced back in 2020. 6/29/20 visit to the Emergency Room for chest pain, dry cough, and reduced endurance while walking for exercise ruled out heart attack, blood clot, pneumonia, but the emergency doctor believes my chest pain was muscular/skeletal in nature or inflammatory such as pericarditis or pleurisy. If I had this pericardial effusion on 6/29/20, that was well before my first COVID-19 vaccination on 1/27/21. I do not believe I have ever had COVID-19; however, I was sick with a respiratory illness and flu-like symptoms for two weeks while onboard ship during the period of 1/4/20 through 3/22/20, traveling. My symptoms were much like a cold, but I also had a low temperature, and the worst cough I have ever experienced.

Other Meds: Amlodipine besylate, lisinopril, metoprolol, doxazosin, omeprazole, rosuvastatin, kenalog injections for back pain, prolia injections for osteoporosis, aspirin, calcium, vitamin D, omega 3 fish oil, vitamin B-12, zinc, multiple vitamin.

Current Illness:

ID: 1675680
Sex: F
Age: 55
State: MI

Vax Date: 08/01/2021
Onset Date: 08/01/2021
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: unknown

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

Symptoms: Near immediate swelling, and some itchiness throughout body. Face most severe, lips swelled so they didn?t quite meet. Tongue felt huge. Eyes swollen puffy. Throat scratchy, sore. Stomach upset, also felt kind of scratchy, hard to describe. As it worsened slight dizziness faintish feeling, Pharmacist prepped epinephren but started with anti-histamine, drank lots of water. Swelling gradually slowed. Remained nearby for observation for approximately two hours following vaccination. Symptoms gradually decreased, took more antihistamine at few hours as still feeling mild symptoms

Other Meds: none

Current Illness: none

ID: 1675681
Sex: M
Age: 49
State: LA

Vax Date: 08/20/2021
Onset Date: 08/21/2021
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: 8/25/2021 Covid test given with negative results. Went to primary care doctor 8/30/21 received medicine for headaches (Butalbital/Acetaminophen)and dizziness (Meclizine 25mg) with instructions to take every 8 hours or as needed. Returned to primary care physician on 9/2/2021 and the headaches and dizziness stopped briefly. Severe headaches returned(9/4/2021) and are still currently persistent. Severe headaches will not go away even with meds.

Allergies: None

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Severe headache, fatigue, dizziness, off balance, and severe night sweats. Started the day after vaccine was given (8/20/2021)and is still happening.

Other Meds: Acetaminophen

Current Illness: None

ID: 1675682
Sex: F
Age: 33
State:

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: redness and swelling at the site of injection

Other Meds:

Current Illness:

ID: 1675683
Sex: F
Age: 55
State: NY

Vax Date: 08/12/2021
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: CT abd/pelvis with contrast, labs

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Pancolitis

Other Meds:

Current Illness:

ID: 1675684
Sex: F
Age: 44
State: MS

Vax Date: 07/15/2021
Onset Date: 07/15/2021
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: cipro lisinopril

Symptom List: Diarrhoea, Nasal congestion

Symptoms: When she tries to left arm, patient has pain and can barely lift. When wakes up it takes a while for her to get it moving. Not sure if how she is sleeping on arm. Hurts in the generally area in the joint. Patient has been rubbing with green alcohol and taking Tylenol. Patient will rotate shoulder from front to back to see if any relief.

Other Meds: Atenolol amlodipine tylenol metformin

Current Illness: NA

ID: 1675685
Sex: F
Age: 39
State: MD

Vax Date: 03/31/2021
Onset Date: 06/16/2021
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: Pathology and chromosome tests following the delivery were performed

Allergies: None

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

Symptoms: At the time of my COVID-19 vaccine on March 31st, I was nearly 27 weeks pregnant with my second child. Eleven weeks later on June 16th I went into the doctor for a routine sonogram to discover the baby no longer had a heartbeat and the next day (June 17) she was delivered stillborn.

Other Meds: Prenatal vitamin

Current Illness: None

ID: 1675686
Sex: F
Age: 70
State: OH

Vax Date: 06/19/2021
Onset Date: 06/20/2021
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: per pt "alomost had a stroke, blood pressure went up to 244

Other Meds:

Current Illness:

ID: 1675687
Sex: M
Age: 74
State: CT

Vax Date: 02/28/2021
Onset Date: 09/02/2021
Rec V Date: 09/06/2021
Hospital: Y

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

Lab Data: Vikor SARS-CoV-2 9/2/2021

Allergies: bees, lisinopril, morphine

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

Symptoms: covid outbreak testing, resident converted to positive

Other Meds: epinephrine, Fish Oil, Folic Acid, Glucosamine, Losartan Potassium, magnesium oxide, melatonin, Namzaric, pantoprazole, simvastatin, trazodone, Vitamin B12

Current Illness:

ID: 1675688
Sex: F
Age: 58
State: TX

Vax Date: 08/11/2021
Onset Date: 08/12/2021
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: SYR
Vax Site: LA

Lab Data: None, patient in uninsured.

Allergies: None

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

Symptoms: Very Sore Arm 08/11/21 Nausea on 08/12/21 Nausea, Diarrhea and Loss of Appetite 08/13 - 08/18

Other Meds: None

Current Illness: None

ID: 1675689
Sex: F
Age: 29
State: AK

Vax Date: 07/14/2021
Onset Date: 07/15/2021
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 normal. Trop neg. Mg 1.7. K 4.0. TSH sl elevated 3.799 with normal free T4 0.94.

Allergies: NKDA

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

Symptoms: Palpitations, severe headache, nausea and fatigue day following vaccination with Moderna covid vaccine #2 on 7/14/21. She presented to ED on 7/17/21 with improving palpitations. Headache resolved. EKG normal. Trop neg. Mg 1.7. K 4.0. TSH sl elevated 3.799 with normal free T4 0.94. No treatment recommended. Observation.

Other Meds: None

Current Illness:

ID: 1675690
Sex: F
Age: 45
State: TN

Vax Date: 08/18/2021
Onset Date: 08/20/2021
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: Dr visit 8/30/21

Allergies: None

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

Symptoms: Numbness & tickling in face from tip of nose to under chin.. started 2 days after injection & has not charged( or gotten any better) since.

Other Meds: Duopatch hormones

Current Illness: None

ID: 1675691
Sex: F
Age: 32
State: TX

Vax Date: 09/02/2021
Onset Date: 09/04/2021
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:

Allergies: Sulfa

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

Symptoms: Sore arm, redness at injection site, bright red blood in urine for 2 days

Other Meds: Adderall XR, lialda, spironolactone, Zyrtec, topamax, metoprolol, Entyvio

Current Illness: RSV (3weeks prior)

ID: 1675692
Sex: F
Age: 62
State: TX

Vax Date: 08/28/2021
Onset Date: 08/28/2021
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: none

Allergies: no

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Covid arm - red, swollen, itchy fever, headache, nausea for 36 hours Burped all day the next day Have burped everyday since the first vaccine on 7/31, still has not stopped

Other Meds: levothyroxine 50mcg,amlodipine-benazepril 5-20mg,atorvastatin 40mg,ezetimibe 10mg

Current Illness: none

ID: 1675693
Sex: F
Age: 56
State: MO

Vax Date: 08/31/2021
Onset Date: 08/31/2021
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: Sept 4th: CBC with differential, Comprehensive metabolic panel, CT head WO contrast, EKG 12-lead (minimal ST elevation), MRI Brain WO contrast, XR Chest PA OR AP 1 VW.

Allergies: Sensitivity to soy

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Numb left side of torso, whole neck, left side of face for two days. Left eye twitching for 3 days. Left side weak so could pick up dog for 5 days. Weakness and some numbness continues up time of report.

Other Meds: Multivitamin, Mag Citrate, Vitamin D3, CoQ10, Omega 3, Calcium

Current Illness: None

ID: 1675694
Sex: M
Age: 61
State: TN

Vax Date: 03/08/2021
Onset Date: 03/09/2021
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: None

Allergies: Iodine

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

Symptoms: 1st dose 3/8/2021 - long term, almost debilitating muscle and joint pain & discomfort for 4 weeks above the injection site in left arm and left shoulder joint. As the pain ended, took 2d dose 3 days later. 2d dose occurred 4/9/2021- similar long-term, almost debilitating muscle and joint pain, same location for a 6-7 week period. Treatment included otc analgesic cream & acetaminophen. Eased pain and discomfort somewhat. Attribute some of this reaction to constant use and resultant wear & tear of upper body and arms due to manual wheelchair use and transfer from chair to bed, shower, vehicle driver's seat in daily routine. Pt is otherwise healthy active employed male.

Other Meds: Losartin potassium 50mg, rosuvastatin calcium 20mg, aspirin 88mg, loratadine 10mg, multivitamin, krill oil, ubiquinol, super B complex, Vit C, Vit E, Vit D, Zinc, cranberry supp

Current Illness: none

ID: 1675695
Sex: F
Age: 48
State: CA

Vax Date: 09/02/2021
Onset Date: 09/03/2021
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: Went to ER where I was vomiting and needed an IV for dehydration. They also injected zofran. Conducted blood tests and EKG.

Allergies:

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

Symptoms: Received vaccine Thursday 4pm. By Friday 9am started to get chills. A few hours later fever of 101.9. Overnight chills and fever for worse raising to 102.7. Sweats, nausea and waking up to blood pressure dropping where I had passed out twice. Today, 9/6 still feeling lightheaded, headache and dizziness.

Other Meds:

Current Illness:

ID: 1675696
Sex: F
Age: 48
State: NJ

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

Lab Data: none

Allergies: NKDA

Symptom List: Unevaluable event

Symptoms: Ringing in right ear and distortion of sound in both ears; decreased hearing bilaterally

Other Meds: Birth control pills

Current Illness: none

ID: 1675697
Sex: F
Age: 32
State: KY

Vax Date: 02/02/2021
Onset Date: 09/03/2021
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: CASE WAS VACCINATED USING MODERNA 1/05/21 (LOT 025J20A) + 2/02/21 (LOT 03OL20A). S/O BEGAN 8/29/21, TESTED + 9/3/21

Other Meds:

Current Illness:

ID: 1675698
Sex: M
Age: 48
State: OH

Vax Date: 08/16/2021
Onset Date: 08/16/2021
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: No testing

Allergies: No Known Allergies

Symptom List: Injection site pain, Pain

Symptoms: Patient reported a joint pain on the medial elbow that was not present before they shot, he states it feels like an "arthritic, joint pain" in the elbow. He states that it worsened during the week of his first shot but after that week seemed to get better but still has pain when lifting objects and when making a fist that he feels discomfort.

Other Meds: NA

Current Illness: NA

ID: 1675699
Sex: F
Age: 70
State: KY

Vax Date: 03/30/2021
Onset Date: 08/31/2021
Rec V Date: 09/06/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: PT VACCINATED USING PFIZER ON 3/1/21 (LOT EL3248) + 3/30/21 (LOT EN6204). S/O 8/29/21, TESTED + 8/31/21

Other Meds:

Current Illness:

ID: 1675700
Sex: F
Age: 75
State: FL

Vax Date: 08/23/2021
Onset Date: 08/30/2021
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: None

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

Symptoms: Intermittent nausea.

Other Meds: Leflunomide, pregabalin, cyclobenzaprine, sometimes Xanax

Current Illness: None

ID: 1675701
Sex: M
Age: 35
State: GA

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

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: No adverse reactions. Patient received 2 different doses (Moderna as the first dose and Pfizer as the second dose).

Other Meds: N/A

Current Illness: N/A

ID: 1675702
Sex: M
Age: 56
State: WI

Vax Date: 09/05/2021
Onset Date: 09/06/2021
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: 9/6/21 CToH: negative for bleed 9/6/21 CT angio: negative for occlusion

Allergies: No allergies reported by pt or family

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Presented to hospital with N/V and dizziness. Reported that before presentation he could not ambulate and the room was suddenly spinning. LKW was 0800 9/6/2021. He had both horizontal nystagmus as well as nystagmus with upward gaze. CT of the head was negative. Given concern for stroke and no other contraindication he was a candidate for TPA. Given TPA. Follow up CT angio negative, and at ~1200 9/6/21 patient began seizing, managed with levetiracetam & transferred to neuro ICU.

Other Meds: No medications reported by pt or family

Current Illness: No significant past medical history

ID: 1675703
Sex: M
Age: 41
State: FL

Vax Date: 08/27/2021
Onset Date: 08/28/2021
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: PCN

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

Symptoms: Received the vaccine 27Aug2021 and 8 hours later felt chills, nausea, body aches, and severe headaches which limited me to just the bed for 48 hours. I took some tylenol which cured most symptoms and was able to do normal activities after 72 hours on 30Aug2021. Then the headaches came back within the next 24 hours with a throbbing pressure at the base of my cranium towards the rear, the temple areas, and sometimes radiating throughout my jaw. I would take tylenol and it would temporarily relieve the pain, but would eventually come back. I recognized that there was a problem and on 3Sept2021, I talked to the COVID19 Information hotline and they directed me to see a doctor. That same day I went to a walk-in clinic and the Doctor recommend I go to the ER to rule out any blood clots. I then proceeded to the ER and received an IV cocktail - Benadryl, Compazine, Toradol. The Doctor took some blood, urine, and a conducted a CT Scan of my head. My vital signs were normal and the Doctor discharged me saying that there was no indication of blood clots from the CT Scan. I still continue to have the headaches at least one a day which is remedied by tylenol.

Other Meds: None

Current Illness: None

ID: 1675704
Sex: F
Age: 44
State: FL

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

Lab Data: N/A

Allergies: codeine, environmental allergies (grass, ragweed, oak, dust)

Symptom List: Nausea

Symptoms: Within an hour of the shot, elevated heart rate recorded on smart watch and continued for 24 hours. Resting heart rate is usually 85; after shot it was sustained at 120 bpm, spiking as high as 145 bpm at times. No physical activity was recorded after the shot. Occasionally, heart rate increases to 120 at rest, even 96 hours later. Extreme thirst noted at 1am, woke up from sleep. Dehydration continues 96 hours later. Also, bad taste in mouth has been noted since the shot. Nothing has helped. Headache, migraine like, began at 2am, continued for 72 hours. Anacin used but did not help much. Elevated temperature 100.2 noted at 8pm, continued for 24 hours.

Other Meds: Pantoprazole, claritin, anacin

Current Illness: none

ID: 1675705
Sex: F
Age: 4
State: CA

Vax Date: 09/01/2021
Onset Date: 09/01/2021
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: no known drug allergies

Symptom List: Injection site pain

Symptoms: fever, restlessness, abdominal pain, limb pain all resolved within 24 hours

Other Meds: n/a

Current Illness: no

ID: 1675706
Sex: F
Age: 50
State: KY

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

Lab Data:

Allergies: Reglan, codine

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

Symptoms: Swelling and pain in left arm, fever, chills, headache and exhausted.

Other Meds: Zyrtec10mg, pantoprazol 40mg, milk thistle, chromium picolonare, colace

Current Illness: None

ID: 1675707
Sex: F
Age: 46
State: CA

Vax Date: 04/09/2021
Onset Date: 04/16/2021
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: On going investigation with doctors

Allergies:

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

Symptoms: Fever, severe body ache, muscle pain, headache on the next day after J&J Vaccine, back pain developed afterwards within a month. Menstrual disorder bleeding almost daily since May 2021, some periods of heavy bleeding with large volume of clots; back pain and muscle ache since then. Leg tingling and pain started in August last month and developed swelling in both lower legs (left was worse than the right) on August 24th Emergency Department, including brushing on leg, foot, toe and both hands. P.S. I am living out of state now and in the process of seeking for consultation/evaluation.

Other Meds: Contraceptive ring

Current Illness: Fever, severe body ache, muscle pain, headache on the next day after J&J Vaccine, back pain developed afterwards within a month. Menstrual disorder bleeding almost daily since May 2021, some periods of heavy bleeding with large volume of clots; back pain and muscle ache since then. Leg tingling and pain started in August last month and developed swelling in both lower legs (left was worse than the right) on August 24th Emergency Department, including brushing on leg, foot, toe and both hands. P.S. I am living in out of the state now and in the process of seeking for consultation/ evaluation.

ID: 1675708
Sex: F
Age: 70
State: NC

Vax Date: 03/15/2021
Onset Date: 03/16/2021
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: Dr. ordered x-ray and referred me to walk-in clinic.

Allergies: aspirin, Keflex, Z-Pac - (local rash)

Symptom List: Tremor

Symptoms: 3/16/2021 -Side Effects began with pain in both hips. Pain persisted. 3/23/2021 ? reported these side effects to Pfizer 4/20/21 ? reported pain to Dr. at annual checkup visit. 5/20/21 - Went to Dr. because pain in hips has not resolved. She suggested I go to Emergency walk-in clinic. 6/1/2021 ? Dr. treated with corticosteroid injection in both hips. 7/9/2021 ? Dr. treated with an oral run of methylprednisolone. Suggested physical therapy. 7/27/21 ? Began Physical Therapy. Ongoing PT

Other Meds: Calcium, Magnesium, Omega 3 fish oil, Vitamin D, Vitamin C, Zinc, Turmeric

Current Illness: N/A

ID: 1675709
Sex: M
Age: 56
State: CA

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: Pennicillin

Symptom List: Erythema, Pruritus

Symptoms: Sweats aches and pains and diaherra, high heart rate

Other Meds: Metfoemin, oz em pic, Trejo, larsarton, meloxicam

Current Illness: Sinus infection and cephalexin

ID: 1675711
Sex: F
Age: 36
State: PA

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

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

Symptoms: Started with shoulder pain, then in the night I had pain in my forearm down into my wrist and hand that led to tingling in my fingers

Other Meds: None

Current Illness: None

ID: 1675712
Sex: F
Age: 48
State: GA

Vax Date: 03/08/2021
Onset Date: 03/08/2021
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: 3 MRI on 3/31/2021. All came back normal.

Allergies: Nexium

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

Symptoms: Debilitating pressure and pain in my head, face and neck. Severe migraines for 6 months. dizzy, extreme pain and numbness in left side of my face. Extreme sensitive to light and sound, motion sickness and nauseous.

Other Meds: None

Current Illness: None

ID: 1675713
Sex: F
Age: 67
State: KY

Vax Date: 03/11/2021
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:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: PT WAS VACCINATED USING PFIZER 2/15/21 (LOT EL9267) + 3/11/21 (LOT EN6206). S/O BEGAN 8/30/21, TESTED + 9/3/21

Other Meds:

Current Illness:

ID: 1675714
Sex: F
Age: 61
State: OR

Vax Date: 01/28/2021
Onset Date: 07/29/2021
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:

Allergies:

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

Symptoms: No symptoms tested positive from weekly testing

Other Meds:

Current Illness:

ID: 1675716
Sex: F
Age: 36
State: HI

Vax Date: 01/13/2021
Onset Date: 09/01/2021
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: malaise and congestion

Other Meds:

Current Illness:

ID: 1675717
Sex: F
Age: 52
State:

Vax Date: 04/21/2021
Onset Date: 07/13/2021
Rec V Date: 09/06/2021
Hospital: Y

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

Lab Data: Abdominal ultrasound and CT scan, echocardiogram

Allergies:

Symptom List: Pain in extremity

Symptoms: I am a serious athlete and went from feeling perfectly healthy and swimming two miles a day several times a week and working out at the gym the rest of the days each week, and winning regional swimming races, to suddenly suffering from debilitating fatigue, chest heaviness and upper abdominal pain 10 weeks after my second vaccination. I received a diagnosis of pericarditis and am recovering with medication for that. I have elderly parents, and have gotten tested regularly for covid for their protection throughout the pandemic and never tested positive and also never had covid symptoms. I'm wondering if this could be an adverse affect from the vaccine. I am pro-vaccination but am trying to get to the root of what suddenly and dramatically transformed my life.

Other Meds:

Current Illness:

ID: 1675718
Sex: F
Age: 48
State:

Vax Date: 08/24/2021
Onset Date: 08/25/2021
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: Blood glucose 511 on 8/25/2021

Allergies:

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

Symptoms: Extremely high blood glucose, prescribed Metformin to hopefully get BG under control

Other Meds:

Current Illness:

ID: 1675719
Sex: M
Age: 53
State: FL

Vax Date: 08/23/2021
Onset Date:
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: Going to the ER

Allergies:

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

Symptoms: I have terrible ringing in my ears., and terrible ear pain. My sister does also

Other Meds:

Current Illness:

ID: 1675720
Sex: F
Age: 55
State: VA

Vax Date: 09/01/2021
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:

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

Symptoms: Site: Itching at Injection Site-Severe, Systemic: Allergic: Rash (specify: facial area, extremeties)-Severe

Other Meds:

Current Illness:

ID: 1675721
Sex: M
Age: 59
State: KS

Vax Date: 07/15/2021
Onset Date: 08/09/2021
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: Reporting to vaccination location in person

Allergies: None

Symptom List: Vomiting

Symptoms: Pain injection site partial paralysis right arm shooting pain palsy like

Other Meds: Insulin Metformin, Lexipro Lipitor

Current Illness: None

ID: 1675722
Sex: F
Age: 64
State: GA

Vax Date: 08/16/2021
Onset Date: 09/01/2021
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:

Allergies: none

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: itchy rash came and went on various parts of body ... stomach, then back , then breasts, then back of neck

Other Meds: Vimpat and Keppra

Current Illness: none

ID: 1675723
Sex: M
Age: 84
State: OR

Vax Date: 01/28/2021
Onset Date: 08/21/2021
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: Bronchitis symptoms and diagnosis, resulting in a positive test from Dr

Other Meds:

Current Illness:

ID: 1675724
Sex: F
Age: 71
State: NY

Vax Date: 03/08/2021
Onset Date: 03/08/2021
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: Chills, pain in all joints, very severe headache, temp over 103 and Frightening irregular heart beat. Next day felt better but experienced phantom smells for over 5 months numerous times a day

Other Meds: Simvastatin, low dose aspirin, formidadine, osteo biflex, vitamins C & D

Current Illness:

ID: 1675725
Sex: F
Age: 52
State: VA

Vax Date: 01/16/2021
Onset Date: 02/20/2021
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: Have had a MRI to rule out tumor. And several hearing test by Audiologist that confirmed significant sudden hearing lose in right ear.

Allergies: No

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

Symptoms: Had vertigo 2 weeks after first dose then 1 week after second dose woke up with right ear stuffy and deaf. Went to ENT out on steroids and after a few months hearing improved some. Will be getting a hearing soon.

Other Meds: Estradiol, magnesium, vitamin D

Current Illness: Nothing

ID: 1675726
Sex: M
Age: 64
State: KS

Vax Date: 04/30/2021
Onset Date: 05/31/2021
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: EKG, blood test

Allergies:

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

Symptoms: Around May 31st, a month after my vaccine I noticed some pain in my legs but mostly in the left leg accompanied with swelling of the left foot. I went to the emergency room and they did a couple of blood test and a ekg of my leg and saw that I had developed symptoms of DVTs. I was there for about 8 hours and received my prescription for Eliquis and returned home. The following days I immediately felt and saw results and have not had a problem since.

Other Meds: Eliquis

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am