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: 1678525
Sex: M
Age: 49
State:

Vax Date: 05/24/2021
Onset Date: 05/24/2021
Rec V Date: 09/07/2021
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:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1678526
Sex: F
Age: 69
State:

Vax Date: 05/24/2021
Onset Date: 05/24/2021
Rec V Date: 09/07/2021
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: Vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1678527
Sex: F
Age: 46
State:

Vax Date: 05/24/2021
Onset Date: 05/24/2021
Rec V Date: 09/07/2021
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:

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

Symptoms: Vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1678528
Sex: F
Age: 44
State:

Vax Date: 05/24/2021
Onset Date: 05/24/2021
Rec V Date: 09/07/2021
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: Vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1678529
Sex: F
Age: 81
State: KY

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

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

Lab Data:

Allergies:

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

Symptoms: Moderna on 4/9 and 5/6. Positive on 9/5 admitted 9/6 to current

Other Meds:

Current Illness:

ID: 1678530
Sex: F
Age: 63
State:

Vax Date: 05/24/2021
Onset Date: 05/24/2021
Rec V Date: 09/07/2021
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: Vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1678531
Sex: F
Age: 50
State:

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

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

Lab Data: NA

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Patient falsified the COVID questionnaire and did not disclose they had previous received both doses of Moderna. Patient then received Pfizer under the impression it was their first dose from their screening with a healthcare professional. No adverse reactions at this time.

Other Meds:

Current Illness:

ID: 1678532
Sex: M
Age: 67
State:

Vax Date: 05/24/2021
Onset Date: 05/24/2021
Rec V Date: 09/07/2021
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: Vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1678533
Sex: M
Age: 78
State: KY

Vax Date: 04/08/2021
Onset Date: 09/05/2021
Rec V Date: 09/07/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Moderna 3/11 and 4/8. Positive on 9/5 admitted 9/5 to current

Other Meds:

Current Illness:

ID: 1678534
Sex: F
Age: 46
State: MO

Vax Date: 08/30/2021
Onset Date: 09/04/2021
Rec V Date: 09/07/2021
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: PPD skin test

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Day 5 post injection: dizziness, headache, nauseous Day 6 post injection: numbness to my tongue, left eye burning Day 7 post injection: unable to blink my left eye, total paralysis of left side of my face

Other Meds: Prozac Prilosec Metoprolol HCTZ Vyvanse

Current Illness:

ID: 1678535
Sex: F
Age: 42
State:

Vax Date: 05/24/2021
Onset Date: 05/24/2021
Rec V Date: 09/07/2021
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: Vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1678536
Sex: F
Age: 31
State: WA

Vax Date: 08/18/2021
Onset Date: 09/02/2021
Rec V Date: 09/07/2021
Hospital:

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

Lab Data: Covid-19 test

Allergies: sulfur and bactrim

Symptom List: Rash, Urticaria

Symptoms: I'm having fatigue, muscle soreness, shortness of breath, no change in smell or taste, I'm having a fever, and bad cough.

Other Meds: None

Current Illness: None

ID: 1678538
Sex: M
Age: 20
State:

Vax Date: 05/24/2021
Onset Date: 05/24/2021
Rec V Date: 09/07/2021
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: Vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1678539
Sex: M
Age: 32
State:

Vax Date: 05/24/2021
Onset Date: 05/24/2021
Rec V Date: 09/07/2021
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: Vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1678540
Sex: M
Age: 30
State:

Vax Date: 05/24/2021
Onset Date: 05/24/2021
Rec V Date: 09/07/2021
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: Vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1678541
Sex: F
Age: 58
State: FL

Vax Date: 09/04/2021
Onset Date: 09/05/2021
Rec V Date: 09/07/2021
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: REDNEES RASH LEFT ARM AND SWELLING LEFT CERVICAL AREA

Other Meds: Tylenol

Current Illness: SICCA SYNDROME, IMFLAMMATORY POLYNEUROPATHY,CHRONIC PAIN

ID: 1678542
Sex: M
Age: 49
State:

Vax Date: 05/24/2021
Onset Date: 05/24/2021
Rec V Date: 09/07/2021
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:

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

Symptoms: Vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1678543
Sex: F
Age: 33
State: TN

Vax Date: 08/20/2021
Onset Date: 09/03/2021
Rec V Date: 09/07/2021
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: Consumer states that she has a twitch near injection site that comes and goes

Other Meds:

Current Illness:

ID: 1678544
Sex: M
Age: 16
State: GA

Vax Date: 09/03/2021
Onset Date: 09/04/2021
Rec V Date: 09/07/2021
Hospital:

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

Lab Data: N/A

Allergies: NKDA

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: He started feeling bad around midnight 9/3-9/4/2021, he vomited, tiredness, dizzy, shortness of breath, fever, chills. His mother gave him Tylenol. He slept most of the day. Mom reports he was irritable when he was awake but he slept most of the day. Started feeling better around lunchtime on Sunday, 9/5/2021.

Other Meds: Does not take medications

Current Illness: None

ID: 1678545
Sex: F
Age: 65
State:

Vax Date: 05/24/2021
Onset Date: 05/24/2021
Rec V Date: 09/07/2021
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: Vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1678546
Sex: F
Age: 74
State: AR

Vax Date: 08/25/2021
Onset Date: 08/26/2021
Rec V Date: 09/07/2021
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: Xray shoulder MRI shoulder

Allergies: NKDA

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

Symptoms: COVID booster injection in left arm. Patient experienced onset of pain and limitation of range of motion. Pain has improved but continues to have limitation of range of motion. There is concern for shoulder injury after vaccine administration

Other Meds: anastrozole (ARIMIDEX) 1 mg tablet Take 1 mg by mouth daily. Saccharomyces boulardii (FLORASTOR) 250 mg Capsule Take by mouth. pyridoxine (VITAMIN B6) 100 mg Tablet Take 1 Tablet (100 mg) by mouth daily. nystatin-triamcinolone (MYCOLOG) 100

Current Illness: Chronic renal insufficiency, stage 3 (moderate) Essential hypertension Infiltrating ductal carcinoma of breast Postoperative hypothyroidism Rheumatoid arthritis involving multiple sites with positive rheumatoid factor

ID: 1678547
Sex: M
Age: 32
State:

Vax Date: 05/24/2021
Onset Date: 05/24/2021
Rec V Date: 09/07/2021
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: Vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1678548
Sex: M
Age: 57
State:

Vax Date: 05/24/2021
Onset Date: 05/24/2021
Rec V Date: 09/07/2021
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: Vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1678549
Sex: F
Age: 66
State: FL

Vax Date: 03/06/2021
Onset Date: 03/20/2021
Rec V Date: 09/07/2021
Hospital:

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

Lab Data: X-ray, MRI

Allergies: Sulfa; naproxen

Symptom List: Injection site pain, Pain

Symptoms: About 2 weeks after the 2nd dose, I started experiencing a lot o hip pain in my right hip. It got worse to the point where I could barely walk I went to an urgent care where they did x-rays and found arthritis and inflammation in ONLY the right hip. They gave me a prednisone shot. I got a bit of relief for about 10-14 days. Then the pain came back just as bad. I was sent from MRI where it said moderate to severe right labral tears. Tendinosis of gluteus minimus tendons. They sent me to an orthopedic surgeon who thought I had the arthritis for years, but the vaccine might've caused inflammation which triggered it. I did a month of physical therapy and took OTC Advil. I also used voltaren cream. I was put on fish oil 1x/day and my Osteo Biflex was increased to 2x/day. I also used Icy Hot. I did not have to use any narcotics. With all of this, it has gradually gotten better. It is better now than it was, the most acute was in April and May. In June, it began it get better. I am now back in the gym doing all my normal activities. I cannot do long walks.

Other Meds: Lisinopril; atorvastatin; Synthroid; Osteo Biflex; Centrum Silver

Current Illness: I had Covid arm from the first dose of the vaccine

ID: 1678551
Sex: F
Age: 77
State:

Vax Date: 02/01/2021
Onset Date: 02/28/2021
Rec V Date: 09/07/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: At first pneumonia. A few months later pericardium effusion

Other Meds:

Current Illness:

ID: 1678552
Sex: F
Age: 70
State: MD

Vax Date: 09/02/2021
Onset Date: 09/02/2021
Rec V Date: 09/07/2021
Hospital:

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

Lab Data: None

Allergies: niacin, imodium, pennicillin, oysters

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

Symptoms: Very sick with headache, joint/skin aches & pains x 2 days, followed by diarrhea, unsettled stomach, fatigue x 2 days; still have lingering headache, fatigue & stomach upset. Have never been this sick before after a flu shot.

Other Meds: Mg Citrate Budesonide nasal rinse

Current Illness: seasonal allergies

ID: 1678553
Sex: M
Age: 22
State:

Vax Date: 05/24/2021
Onset Date: 05/24/2021
Rec V Date: 09/07/2021
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: Vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1678555
Sex: F
Age: 74
State: NH

Vax Date: 03/06/2021
Onset Date: 03/13/2021
Rec V Date: 09/07/2021
Hospital: Y

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

Lab Data: CT scan, EKG, EEG, blood work, carotid ultrasound, chest xray, brain MRI; discharged with ZIO patch, worn for a week. Saw my cardiologist after all results were in and none of hte tests showed any abnormality. He felt the incident was likely a spell of transient global amnesia. Because my BP was elevated during the event and inthe the hosptical, I was rpescribed by the hosptial docs Norvasc and Lipitor. Doctor and my primnary care doc said no need for those and I did nit take them

Allergies: codeine make me itch

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: I have reported this before but been unable to discuss. On 3/13, a week after my second shot, I was hiking. I felt woozy a couple of times on the climb (not usual) and when we stopped at the summit, I "lost" ten minutes, having no recall of conversations with my companion (a veterinarian) or of our actions. She told me later that I said things and did things that made no sense (lke saying we had no map when we had consulted it several times en route. I also looked for it in my pack and that is not where I keep it. I also tried to tell her a hiking trail nearby was a ski trail). After about ten minutes during which we (apparently) decided the location we were in was to windy for lunch, we went into a protected wooded area. At that point my memory kicked back in. She was so alarmed at my behavior that she called 911 and we were evacuated from the summit. I declined transport to a hospital, as I seemed OK by then. Monday, I called my doc and was sent to the ER of Medical Center. They kept me overnight and ran many tests.

Other Meds: carvedilol; multivitamin; low dose aspirin

Current Illness: None

ID: 1678556
Sex: F
Age: 71
State:

Vax Date: 05/24/2021
Onset Date: 05/24/2021
Rec V Date: 09/07/2021
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: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: Vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1678557
Sex: M
Age: 45
State:

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

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

Lab Data: NA

Allergies:

Symptom List: Nausea

Symptoms: Patient falsified covid questionnaire and reported they had not received any previous covid vaccinations. That was determined to be false after medication administration it was determined patients had received both doses of moderna prior to receiving the dose of Pfizer. Patient contacted and he did not have any adverse effects.

Other Meds:

Current Illness:

ID: 1678558
Sex: F
Age: 57
State:

Vax Date: 05/24/2021
Onset Date: 05/24/2021
Rec V Date: 09/07/2021
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: Injection site pain

Symptoms: Vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1678560
Sex: F
Age: 85
State: FL

Vax Date: 01/23/2021
Onset Date: 09/04/2021
Rec V Date: 09/07/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: The patient presents with weakness. The onset was 1 weeks ago. Risk factors consist of hypertension and HYPERLIPIDEMIA. 86-YEAR-OLD FEMALE PAST MEDICAL HISTORY HYPERTENSION, HYPERLIPIDEMIA PRESENTS WITH 1 WEEK HISTORY OF FEELING GENERALIZED WEAKNESS. PATIENT STATES THAT A COUPLE WEEKS AGO SHE DID HAVE A RUNNY NOSE AND COUGH THAT HAS SINCE RESOLVED. PATIENT IS FULLY VACCINATED FOR COVID-19 WITH PFIZER. DENIES ANY ABDOMINAL PAIN, NAUSEA VOMITING DIARRHEA. REPORTS SOME SHORTNESS OF BREATH..

Other Meds:

Current Illness:

ID: 1678561
Sex: F
Age: 61
State: PA

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

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

Lab Data: I have an ultrasound coming up

Allergies:

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

Symptoms: I had a fever, chills, body aches, swelling in pain. Swollen lymph nodes. I have recovered from everything except the swollen lymph nodes.

Other Meds:

Current Illness:

Date Died: 09/05/2021

ID: 1678562
Sex: F
Age: 69
State: TN

Vax Date: 02/04/2021
Onset Date: 09/05/2021
Rec V Date: 09/07/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: PT EXPIRED FROM COVID-19 ON 9/5/2021; BREAKTHROUGH CASE

Other Meds:

Current Illness:

ID: 1678563
Sex: F
Age: 64
State: MD

Vax Date: 08/18/2021
Onset Date: 08/19/2021
Rec V Date: 09/07/2021
Hospital:

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

Lab Data: 9/1/21 telemed visit, continued fatigue, achiness but no fevers

Allergies: sulfa

Symptom List: Erythema, Pruritus

Symptoms: Per pt: I received a 3rd vaccine (Pfizer) on August 18 due to my immune deficiency. I felt mild symptoms about 24 hours after the shot and they last for 1/2 day. On the 20th I was fine. On the 21st and 22nd, I had extreme fatigue and a low grade fever (100.4). After that I was fine for 6 days. On Saturday the 28th, I was again hit with the fatigue, chills and hot flashes. The 29th was okay, but both yesterday and today have been back to the symptoms again.

Other Meds: acyclovir, aspirin, voltaren, hizentra, atrovent

Current Illness: none

ID: 1678564
Sex: F
Age: 30
State: WI

Vax Date: 08/31/2021
Onset Date: 09/02/2021
Rec V Date: 09/07/2021
Hospital: Y

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

Lab Data:

Allergies: Contrast (anaphylaxis), Penicillin unknown, Sulfamethoxazole (rash)

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

Symptoms: 9/2/21: The patient is a 30 year old female who presents to the ED for evaluation of strokelike symptoms. At approximately 11 PM tonight the patient reports having sudden onset of confusion and difficulty speaking. Patient and family explain she is having difficulty getting words out and has slurred speech. She also reports experiencing left-sided weakness and numbness. A short while after also started to experience dizziness and if she tries to focus on something she sees double. Denies any associated headache or neck pain. No chest pain or dyspnea. No fever or recent illness. No recent trauma. Patient states she received the J&J vaccine 2 days ago, denies any other new medications. Denies similar episode 30-year-old acute female here for evaluation of strokelike symptoms. Patient evaluated on arrival as a stroke alert. Last known normal was approximately 11 PM. Neurologic deficits include slurred speech, left-sided numbness and weakness, dizziness and double vision. On exam, the patient is noted to have decreased sensation to the left face/arm/leg as well as decreased grip strength and left lower extremity weakness. NIHSS 4. Patient transferred emergently to CT which returned negative for acute intracranial hemorrhage. Case discussed with teleneurology who also evaluated patient. Decision made to treat with TPA. Patient was monitored closely post TPA infusion and on serial neurologic exams was noted to have significant improvement in her speech, sensory deficits and strength testing. NIHSS improved to 2. Toxic/metabolic work-up overall returned reassuring. Patient to be admitted to ICU for further care and evaluation 9/4/21 Cardiology: 1. Acute neurological event resolving after TPA administration with subsequent large PFO found on transthoracic echocardiogram. Treatment recommendations regarding her PFO ultimately revolve upon what neurology feels etiology of her neurologic event was. If it was felt it was ischemic in nature treatment options include aspirin and Plavix for 3 weeks followed by a long-term low-dose aspirin versus PFO closure. Numerous randomized trials PFO closures only shown to be beneficial in patients with minimal atherosclerotic risk factors, large PFO's and positive neuroimaging. With a negative diffusion-weighted MRI I do not believe there is any indication for closure. If it is felt that her neurologic event is a complication of the Covid vaccine no further management of her PFO is indicated. If it is felt that it was a true ischemic event despite her negative diffusion-weighted MRI then would recommend dual antiplatelet therapy for 3 weeks followed by low-dose aspirin indefinitely. Appreciate the opportunity to participate in patient's care. Please call with any questions. 9/4/21: DISCHARGE 9/5/21: READMIT 30-year-old female with depression, anxiety, and GERD presents to the ED with recurrent neurological symptoms. She reports the onset 1 hour prior to arrival of difficulty speaking, left-sided weakness. She had a similar presentation 3 days ago and actually received intravenous TPA with improvement in her symptoms. Her evaluation included a normal head CT. She had an MRI/MRA of the head, MRA neck, and MRV, all of which were normal. 9/5/21 ICU: This is a 30 year old female who was recently hospitalized for expressive aphasia and left sided weakness several days after after receiving the J&J COVID-19 vaccine, and subsequently was given TPA and sent to the ICU. MRI of the brain, MRA of the head/neck, and MRV of the head were unremarkable at that time. TTE demonstrated a patent foramen ovale, however cardiology was consulted and there was no indication for closure. Patient symptoms returned to normal and she was discharged from the hospital on 9/4/2021. She returned to the hospital today complaining of aphasia and left-sided weakness. Teleneurology was consulted in the ED and recommended imaging as well as admission to observation for possible LP. MRI brain and MRV head were negative for acute intracranial abnormality; however, there were several small punctate foci of increased hyperintensity within the white matter which were nonspecific findings. On presentation, she is afebrile with temperature 98.5 ?F, heart rate ranged 80-132 bpm, RR 16, BP 147/86 mmHg, SPO2 100% on room air. On exam she is laying flat on her back in bed, no acute distress, pleasant. Flat affect. Tired appearing. Alert and oriented x3. CN II through XII grossly intact bilaterally. Strength 5/5 in all extremities. Speech is slowed but not dysarthric. Sensation is intact throughout except for mild numbness in the lateral aspect of her left leg. Heart is regular rate and rhythm, distal extremities are warm and well perfused. Lungs are clear to auscultation, breathing comfortably on room air. Abdomen is soft, bowel sounds present, nondistended. 9/5/21 Neurology: Impression: Transient speech change and L sided weakness/numbness Recommendations: 1) LP - cell count differential protein glucose cytology cultures, lyme ACE, VDRL 2) EEG 3) Check ANA, SSA/SSB, Complement, Anti-TPO, autoimmune panel 4) Can be discharged home if initial results negative with close outpatient follow up. 9/6/21 Hospitalist: Radiology call - showing "moderate to large epidural hematoma within the posterior epidural space with hemorrhagic fluid seen from the level of L1 extending caudally to the L5 level with the most significant portion of the hemorrhage located at L2-L3 causing severe central canal stenosis at L2-L3." 9/6/21: The patient is a pleasant 30 y.o female with severe back pain and left leg paresthesias with a large epidural hematoma from L1 to L5 with severe stenosis at L2/3 causing lumbar radiculopathy. I discussed with her the options including conservative care versus surgical intervention. Given the patients significant symptoms with severe stenosis at L2/3, I recommended surgical intervention which would entail a L2 and L3 laminectomy and evacuation of epidural hematoma. I discussed with her the potential risk, complications and lack of guarantees. Pt wishes to proceed with surgery. The Intensivist discussed with Hematology who agrees that the tPA should be out of her system. Pt had PT, PTT and INR today that are normal. The LP was performed at the L2/3 level and I may need to place a patch and glue if there is any CSF detected. We will proceed with surgery urgently.

Other Meds: Amphetamine/Dextroamphetamine 30 mg once daily, Cholecalciferol 5,000 units daily, clonazepam 0.5 mg twice daily as needed, cyclobenzaprine 5 mg nightly as needed, doxycycline 100 mg daily, famotidine 20 mg daily, metoprolol tartrate 12.5 m

Current Illness: N/A

ID: 1678565
Sex: F
Age: 27
State: AR

Vax Date: 09/03/2021
Onset Date: 09/03/2021
Rec V Date: 09/07/2021
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: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: Vaccine was given past the 6 hour time limit from first puncture

Other Meds:

Current Illness:

ID: 1678566
Sex: F
Age: 77
State:

Vax Date: 05/24/2021
Onset Date: 05/24/2021
Rec V Date: 09/07/2021
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: Vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1678567
Sex: U
Age: 81
State:

Vax Date: 05/24/2021
Onset Date: 05/24/2021
Rec V Date: 09/07/2021
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: Vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1678568
Sex: M
Age: 46
State: MN

Vax Date: 09/01/2021
Onset Date: 09/03/2021
Rec V Date: 09/07/2021
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: Diagnosed with Bell's Palsy

Allergies: No

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

Symptoms: Loss of facial muscle control on right side of face lips, eyes etc approx 36 hrs after shot

Other Meds: Ambien , Lexapro

Current Illness: None

ID: 1678569
Sex: M
Age: 29
State:

Vax Date: 05/24/2021
Onset Date: 05/24/2021
Rec V Date: 09/07/2021
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: Pain in extremity

Symptoms: Vaccine expired in fridge

Other Meds:

Current Illness:

Date Died: 08/14/2021

ID: 1678570
Sex: F
Age: 75
State:

Vax Date: 01/16/2021
Onset Date: 08/13/2021
Rec V Date: 09/07/2021
Hospital: Y

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: Acute respiratory distress, SOB, positive COVID test

Other Meds:

Current Illness:

ID: 1678571
Sex: M
Age: 61
State: FL

Vax Date: 05/28/2021
Onset Date: 06/30/2021
Rec V Date: 09/07/2021
Hospital:

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

Lab Data: Blood tests

Allergies:

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

Symptoms: Started with bruise on abdomen with lump. Thrombosis and low Iron.

Other Meds: Vitamin C Vitamin D Zinc

Current Illness:

ID: 1678572
Sex: M
Age: 66
State:

Vax Date: 05/24/2021
Onset Date: 05/24/2021
Rec V Date: 09/07/2021
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: Vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1678573
Sex: F
Age: 15
State: TX

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data: none

Allergies: NKA

Symptom List: Vomiting

Symptoms: PT c/o dizziness and chest discomfort 15 minutes after taking 2nd dose Pfizer. No shortness of breath noted. No rash or swelling noted. PT remains alert, oriented and talkative. VS taken O2 Sat 100%, HR 72, RR-20, BP 110/70 PT stated that she didn't eat breakfast and was a little anxious prior to shot. Mom gave food and water which PT tolerated well & stated she felt better. PT monitored for additional 30 minutes and remains alert, oriented & talkative. Vitals RR 18, HR 66, BP 110/70, O2 sat 100%. No further c/o of dizziness or chest discomfort, PT cleared. Parents instructed to seek medical attention if PT's symptoms return. Parents verbalized understanding. PT walking at steady gait & voices no concerns or questions.

Other Meds: None

Current Illness: None

ID: 1678574
Sex: F
Age: 48
State: OH

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

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

Lab Data: None

Allergies: NA

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Pt was nauseated, no other symptoms. BP: 118/82, so she was monitored for 15 more minutes. Pt states she is felling fine, so she left the building after 30' of monitoring.

Other Meds: Zoloft

Current Illness: NA

ID: 1678575
Sex: M
Age: 64
State:

Vax Date: 05/24/2021
Onset Date: 05/24/2021
Rec V Date: 09/07/2021
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: Vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1678576
Sex: M
Age: 30
State: PA

Vax Date: 08/14/2021
Onset Date: 08/22/2021
Rec V Date: 09/07/2021
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: They preformed an EKG with Rhythm Strip: Results normal. A Rapid SARS-CoV-2 Antigen w/ Relflex: Results Negative. SARS-CoV-2 RNA RT-PCR: Results Not Detected Chest X-ray: Results lungs clear. hearts size normal. The hilar and mediastinal structures appear unremarkable No acute cardiopulmonary abnormality. Bloodwork

Allergies: N/A

Symptom List: Injection site swelling, Limb discomfort

Symptoms: I had tightness in my chest my heart felt like it was beating rapidly and I felt sharp pain in my chest. I felt extremely dizzy also where the room felt like it was spinning but there was nothing I could do about it to really make it stop; laying down, sitting up, or standing did not help with the pain or dizziness. I also had a headache much of like the one you have when you actually have covid-19. I along with the symptoms listed above I have also had a sore throat. After not being able to deal with the dizziness and chest pain I went to my local ER around 6pm 8/22/21. They treated my symptoms and release me the same day. They diagnosed me with Benign Positional Vertigo and Nonspecific Chest pain. The throat pain still continues today to as of 9/7/21 along with some chest pain and dizziness.

Other Meds: N/A

Current Illness: nothing that I am aware of.

ID: 1678578
Sex: F
Age: 64
State:

Vax Date: 05/24/2021
Onset Date: 05/24/2021
Rec V Date: 09/07/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1678579
Sex: M
Age: 42
State:

Vax Date: 05/24/2021
Onset Date: 05/24/2021
Rec V Date: 09/07/2021
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:

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

Symptoms: Vaccine expired in fridge

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am