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: 1678635
Sex: F
Age: 50
State: WA

Vax Date: 07/02/2021
Onset Date: 07/05/2021
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: none

Allergies: mome

Symptom List: Dysphagia, Epiglottitis

Symptoms: Dry and then wet cough that has lasted 2 months. Break out of eczema on feet, hands and arms that has yet to resole after 2 month. In 2 days of vaccine, a flare of microscopic colitis that has yet to resole. Was in remission prior to vaccine. Fatigue and brain fog.

Other Meds: none

Current Illness: none

ID: 1678636
Sex: M
Age: 54
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: 1678637
Sex: M
Age: 76
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: 1678638
Sex: M
Age: 23
State: MN

Vax Date: 07/12/2021
Onset Date: 09/02/2021
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: Patient swabbed at our offsite testing location. Please contact PCP with further questions.

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Patient vaccinated and then tested positive for COVID-19 on 9/2/21

Other Meds: Patient swabbed at our offsite testing location. Please contact PCP with further questions.

Current Illness: Patient swabbed at our offsite testing location. Please contact PCP with further questions.

ID: 1678639
Sex: M
Age: 58
State: PA

Vax Date: 05/03/2021
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: See above.

Allergies: Penicillins

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

Symptoms: Low grade fevers, fatigue, arthralgias with joint swelling, anorexia, and weight loss, starting about 3 weeks after his first COVID19 (Pfizer) vaccine. Cultures were negative, but inflammatory markers were elevated (ESR, CRP, ferritin). He also developed pancytopenia. His appetite recovered with steroids but he has continued to have unexplained weight loss (55 pounds since May). Restaging scans and bone marrow biopsy showed no evidence of recurrent mantle cell lymphoma.

Other Meds: Flomax, Theragran MVI

Current Illness:

ID: 1678640
Sex: F
Age: 74
State: FL

Vax Date: 03/27/2021
Onset Date: 03/28/2021
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: N/A

Allergies: No

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

Symptoms: Vomiting, fever, headache, tired

Other Meds: Tylenol & Advil

Current Illness: None

ID: 1678641
Sex: M
Age: 70
State: MO

Vax Date: 02/04/2021
Onset Date: 02/07/2021
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: none.

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: 3 days after receiving the vaccination patient started to urine blood for a week. After a week it stopped, but after receiving the second dose of the vaccination the bleeding in the urine returned. Was examined by healthcare provider there were no problems found.

Other Meds:

Current Illness:

ID: 1678642
Sex: M
Age: 49
State: GA

Vax Date: 03/02/2021
Onset Date: 03/26/2021
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: I had an ultrasound on April 15, 2021 that confirmed a deep vein thrombosis in my left calf muscle

Allergies: None

Symptom List: Pharyngeal swelling

Symptoms: On March 26th I had acute onset of pain in my left calf. The pain waxed and wanted but continued to increase in intensity until I had an ultrasound 21 days later.

Other Meds: None

Current Illness: None

ID: 1678644
Sex: F
Age: 60
State: FL

Vax Date: 03/16/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: The patient presents with difficulty breathing. Patient presents to emergency department cough as well shortness of breath or 1 week. Patient describes fevers. Patient with chest pain as well as vomiting but no diarrhea. Patient states the vomiting has resolved. Patient's symptoms have been constant since onset. Patient has been on her normal O2 at home for her COPD. Patient with recent admission for metabolic encephalopathy discharged on August 26. Patient was negative for COVID at that time. Patient had a COVID-19 vaccination in April of this year..

Other Meds:

Current Illness:

ID: 1678645
Sex: F
Age: 77
State: MA

Vax Date: 02/25/2021
Onset Date: 03/02/2021
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: Contacted Dr who suggested phototherapy to help.

Allergies: penicillin, gluten sensitive, lactose intolerant

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Had psoriasis on front lower legs and a few outbreaks on lower back. Shortly after second Moderna, shot, psoriasis on hands, one elbow, more on back, upper legs and one ear

Other Meds: Calcipotriene, clobetasol, vitamin D, Areds 2

Current Illness: Bronchitis

ID: 1678646
Sex: F
Age: 45
State: MS

Vax Date: 01/04/2021
Onset Date: 01/11/2021
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: stool culture 1/22/2021: negative for Shiga Toxin

Allergies: Keflex: Narcolepsy

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

Symptoms: I developed diarrhea 4 days after the vaccine, which was Friday, January 8. I took over the counter anti-diarrheal medication because I was told the vaccine could cause GI upset. The diarrhea continued for another 2 weeks with increasing severity that turned into hematochezia and watery stool on January 22, whereby I reached out to my PCP and a stool culture was obtained along with a prescription of antibiotics. Although the lab result came back negative for shiga toxin and could not be tested for other pathogens, my symptoms gradually improved after I began taking oral antibiotics.

Other Meds: Zanaflex 4mg once a night; Zoloft 50mg once a day;

Current Illness: Covid 19 + test resulted December 2, 2020

ID: 1678647
Sex: M
Age: 46
State: NC

Vax Date: 06/08/2021
Onset Date: 06/08/2021
Rec V Date: 09/07/2021
Hospital: Y

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: Visit date 02 SEP 21:- The patient is a 46 yo male with a history of HTN and obesity developed natural COVID infection in APRIL and continued prolonged dyspnea and fatigue. He received Janssen COVID vaccine #1 08 JUN 21 followed by severe flulike symptoms with n/v/d dizziness and vertigo and CP for at least several days. He continued with fatigue, dizziness and vertigo symptoms and was ultimately diagnosed SSS and received a pacemaker in AUG 2021.

Other Meds: ZALEPLON, 10 MG, ALPRAZOLAM, 0.5 MG CITALOPRAM HBR , 40 MG TOPIRAMATE , 25 MG Multivitamin

Current Illness:

ID: 1678648
Sex: M
Age: 82
State: MN

Vax Date: 02/25/2021
Onset Date: 08/31/2021
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: Ciprofloxacin - edema

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

Symptoms: Patient is COVID-19 + on 8/31/21. Patient was admitted for recurrent UTI but has since developed acute hypoxemic respiratory failure with possible bacterial pneumonia. The patient was transferred from medical floor to ICU and put on high flow oxygen. Resulting in prolongation of existing hospitalization.

Other Meds: Acetaminophen, Allopurinol, Aveeno Daily moisturizing lotion, glimepiride, levothyroxine, Preservision areds

Current Illness:

ID: 1678649
Sex: M
Age: 62
State: CO

Vax Date: 03/05/2021
Onset Date: 03/05/2021
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: Hearing test

Allergies: None

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

Symptoms: I have had several doctor follow-ups since my last VAERS report on 4/22/2021 (VAERS #1242038). I started a new medication called trazodone 50 mg at bedtime which has help my anxiety and allowing me to sleep. I have also been using a sound machine to help me sleep. The tinnitus has not resolved and have worsen. My tinnitus is nonstop 24/7. I have noticed that some high pitch sounds can trigger other high pitch noises (chalkboard scratching sound). This happens a few times a week. I am able to resolve the high pitch sounds by putting in my ear plugs. The doctor says there is nothing they can do and just wait and see in hopes it may go away on it own. The doctor did say that it is a possible side effect from the vaccine.

Other Meds: Metformin; simvastatin; fenofibrate; multivitamin

Current Illness: None

ID: 1678650
Sex: F
Age: 39
State: MN

Vax Date: 03/12/2021
Onset Date: 09/02/2021
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: Patient swabbed at our offsite testing location. Please contact PCP with further questions.

Allergies: Patient swabbed at our offsite testing location. Please contact PCP with further questions.

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

Symptoms: Patient vaccinated and then tested positive for COVID-19 on 9/2/21

Other Meds: Patient swabbed at our offsite testing location. Please contact PCP with further questions.

Current Illness: Patient swabbed at our offsite testing location. Please contact PCP with further questions.

ID: 1678651
Sex: F
Age: 59
State:

Vax Date: 08/20/2021
Onset Date: 08/20/2021
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: None

Allergies: None

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

Symptoms: Mild headache, fatigue, sore throat, white patches and red streaks in throat, body aches, swollen mouth, bright pink spot on the back of leg.

Other Meds: Simvastatin 20mg (once daily) Fluoxetine HCL 20mg (one tablet twice daily) Montelukast SOD 10mg (once daily) Levothyroxine 100mcg (once daily) Nasacort (2 sprays per nostril once daily) Tylenol Arthritis 650 mg (once daily) Naproxen 220mg (

Current Illness: None

ID: 1678652
Sex: F
Age: 41
State:

Vax Date: 06/07/2021
Onset Date: 06/29/2021
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: bloodwork done to rule out autoimmune diseases, all came back normal only showing minimal liver and inflammatory markers

Allergies: eggs, monistat creams

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

Symptoms: Rash on both arms and neck leaving permanent scarring and skin discoloration that is ongoing, joint pain and swelling significantly impacting mobility - used steroids to relieve symptoms, red spots on hands/fingers/feet that are on going

Other Meds: Birth control pills, daily vitamin, seasonal allergy medication

Current Illness: N/A

ID: 1678653
Sex: F
Age: 31
State: PA

Vax Date: 09/01/2021
Onset Date: 09/01/2021
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: Carrries EPIPEN for prior anaphylaxis NYD

Symptom List: Ear pain, Hypoaesthesia

Symptoms: 31 year-old female got the first Pfizer vaccine around 11AM. She started getting hives and flush and then started to feel like her eyes and bottom of tongue were swelling. No difficulty breathing or swallowing. Bottom lip feels swollen. She feels a little tight in her chest but this can be baseline for her. She took Zyrtec at 12:30PM and hives have started to improve. She has never had an allergy to a vaccine in the past.

Other Meds: Provigil, Aubagio

Current Illness: post covid syndrome, MS

ID: 1678654
Sex: F
Age: 12
State: TX

Vax Date: 08/28/2021
Onset Date: 08/30/2021
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:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Chills without fever started 2 days after injection and lasted 1 day. No treatment given. AE resolved

Other Meds:

Current Illness:

ID: 1678655
Sex: F
Age: 57
State: MI

Vax Date: 09/07/2021
Onset Date: 09/07/2021
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: n/a

Allergies: none listed

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

Symptoms: Patient is 57 years old, and received the adjuvant flu shot rec for 65 years and older

Other Meds: unknown

Current Illness: m/a

ID: 1678656
Sex: F
Age: 30
State: IL

Vax Date: 08/24/2021
Onset Date: 08/25/2021
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: N/A

Allergies: No allergies.

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

Symptoms: I developed an itchy rash which felt hot and was swollen to the touch. The rash persisted for two weeks. At times it seemed the rash was receding, but about a week after receiving the vaccine, the injection site became swollen and raised again, and began spreading on my arm. It was very noticeably red, extremely itchy. Now, about a full two weeks after receiving the vaccination, it seems to have subsided.

Other Meds: Azurette - birth control.

Current Illness: No other illnesses.

ID: 1678657
Sex: F
Age: 45
State: VA

Vax Date: 08/19/2021
Onset Date: 08/23/2021
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: n/a

Allergies: Sulfa

Symptom List: Unevaluable event

Symptoms: Herpes outbreak in eye and mouth.

Other Meds: Prozac Busparone

Current Illness: n/a

ID: 1678658
Sex: F
Age: 42
State: MI

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

Allergies: NA

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

Symptoms: Advised she was given two doses in her vaccine yesterday. (error occurred in multiple patients - reporting all patients here) All received vaccine on the same day, at the same location, same manufacturer, same lot number. Pfizer vaccine was drawn up incorrectly and given to six patients. Pfizer vaccine vial was mixed with another Pfizer vial, diluent was not used. Reached out to Pfizer manufacture and CDC. All patients called to follow up on them and advised what had happened and documented in their chart. Please see MRN's below. All patient's providers were notified.

Other Meds: NA

Current Illness: NA

ID: 1678659
Sex: M
Age: 72
State:

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

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Patient developed COVID-19 requiring hospitalization

Other Meds:

Current Illness:

ID: 1678660
Sex: M
Age: 65
State: CO

Vax Date: 04/13/2021
Onset Date: 04/24/2021
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: None

Symptom List: Injection site pain, Menorrhagia

Symptoms: Worsening of bilateral tinnitus, with return to baseline

Other Meds: None

Current Illness:

ID: 1678661
Sex: M
Age: 14
State: MI

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:

Allergies: None

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

Symptoms: Per call from patient's mother, patient received vaccine and while travelling in car on way home suffered what appeared to be a seizure. Patient was taken to hospital and given supportive care.

Other Meds: None

Current Illness: None

ID: 1678663
Sex: M
Age: 30
State: OH

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

Allergies: NKA

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Pt. c/o feeling dizzy once 15 min waiting period was completed. Vital signs were checked and were stable. Pt stated after VS were checked that he no longer feels dizzy. Will continue to monitor for another 15 min. Offered snacks and fluids, patient refused. VS @ 1144 AM: BP 116/74, RR 16, OxSat 97%, HR 63 . VS @ 1159 AM BP 108/70, RR14, Ox Sat 98%, HR 83 Pt left after30 min monitoring.

Other Meds: NA

Current Illness: None

ID: 1678664
Sex: F
Age: 44
State: NY

Vax Date: 08/27/2021
Onset Date: 09/04/2021
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: RA

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: About a week after injection I started to notice some itching at the injection site on my left arm. I didn't think anything of it until it continued for another day or two. It felt a bit warm and started to notice some redness. I then googled it and read about Covid arm. On day 2/3 a small rash appeared and on day 4/5 it more than doubled in size and is rather itchy.

Other Meds:

Current Illness:

ID: 1678665
Sex: F
Age: 44
State: TN

Vax Date: 08/30/2021
Onset Date: 08/31/2021
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: Was feeling fine before shot no symptoms of anything, took shot next day feeling run down chills coughing. that continued for 2 days. The next few days feeling run down no energy still coughing and today is one week still not up to normal yet.

Other Meds:

Current Illness:

ID: 1678667
Sex: F
Age: 36
State: TX

Vax Date: 09/01/2021
Onset Date: 09/02/2021
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: Nausea

Symptoms: Employee received the Pfizer vaccine dose #1 on 09/01 at vaccine event. The injection was in the right upper arm in deltoid. Started have symptoms the next day on 09/02 after vaccine: body aches, fever (unknown max temp), and chills,. Has been off of work since 09/03 and 09/07. she has been taking Aspirin and ibuprofen around the clock every 6 hours. has been helping a little still doesn't feel well. Was told to give a follow up call about Symptoms, if they worsen, and advise to go to PCP and follow up

Other Meds:

Current Illness:

ID: 1678668
Sex: F
Age: 60
State: AL

Vax Date: 08/26/2021
Onset Date: 08/30/2021
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: After Covid I had many tests to help diagnose or possibly rectify my long haul symptoms. I was doing better and then the vaccine set me back. I?m waiting to see if this subsides on its own.

Allergies: Allergic to codine and hydrocodone

Symptom List: Injection site pain

Symptoms: Digestive issues, dry eyes and skin and hair, tachycardia , brain fog I.e. processing and memory complications. Thyroiditus. These are the symptoms I had with long haul and they have been exacerbated with the vaccine.

Other Meds: Concerta 18mg 1xd, progesterone, vitamin b12, vitamin d

Current Illness: None

ID: 1678669
Sex: F
Age: 67
State: FL

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

Lab Data: None

Allergies: None

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

Symptoms: Very bad headache about 3 hours after vaccine on 9/5 Chills, sore arm, headache & palpitations 1am 9/6 Fever. 101.9, headache, sore arm, palpitations most of the day 9/6 Headache & rash at injection site 9/7 Fluids & ibuprofen not helping

Other Meds: Albuterol 90mcg Aspirin 81mg Atorvastatin 40mg Lisinopril 10mg Metoprolol 25 mg Pantoprazole 40mg Vitamin D3 125mg Wixela 50mcg Zyrtec 10mg

Current Illness: None

ID: 1678671
Sex: F
Age: 46
State: IL

Vax Date: 04/28/2021
Onset Date: 04/28/2021
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:

Allergies: Penicillin

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

Symptoms: Persistent arm pain, weakness in hand which started after the second shot and continues to date.

Other Meds: None known

Current Illness: None known

ID: 1678672
Sex: F
Age: 75
State: MN

Vax Date: 03/31/2021
Onset Date: 09/04/2021
Rec V Date: 09/07/2021
Hospital: Y

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

Lab Data:

Allergies: Atenolol - myalgia, Ciprofloxacin - rash, influenza virus vaccine - flu like symptoms, Macrobid - nausea, Statins - myalgia, Sulfa antibiotics - rash, hives

Symptom List: Tremor

Symptoms: Patient was admitted to hospital for COVID-19 + pneumonia. In ER patient had temp of 100. Patient received steroids and remdesivir. Patient was discharged on oxygen.

Other Meds: Acetaminophen with codeine, Aspirin, Vitamin D, Fluticasone nasal solution, lisinopril, metformin, nystatin cream, omeprazole, ondansetron, sertraline

Current Illness:

ID: 1678673
Sex: F
Age: 30
State: TX

Vax Date: 09/05/2021
Onset Date: 09/06/2021
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: None

Allergies: None

Symptom List: Erythema, Pruritus

Symptoms: Chills and body aches started 3 AM on Monday. I took 600mg of IBUProfen at 6 AM. For the rest of the day, I experienced body aches, chills, and fevers. Later in the afternoon, around 12 PM, I was experiencing light-headedness, off-balanced, and the feeling like I was going to faint along with shortness of breath. Later at night, around 6 PM - just getting up and down off the couch would make me dizzy. It felt like at the blood was rushing out of my head. I was also nauseous and felt like my heart was acting weird.

Other Meds: None

Current Illness: None

ID: 1678674
Sex: F
Age: 31
State: WI

Vax Date: 08/17/2021
Onset Date: 08/27/2021
Rec V Date: 09/07/2021
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: None

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

Symptoms: On Friday 8/27/2021 I started noticing a tickle in the back of my throat that causes me to cough many times throughout the day. As of 9/7/2021 this cough has not resolved. Cough is caused by nasal drip which is unusual for me. Any allergies I have are normally resolved by the Cetirizine pill that I take daily.

Other Meds: Cetirizine, magnesium, selenium

Current Illness: None

ID: 1678675
Sex: M
Age: 56
State: IL

Vax Date: 09/07/2021
Onset Date: 09/07/2021
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: None yet. Will see doctor if symptoms persist tomorrow.

Allergies: None

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

Symptoms: Tingling sensation all extremities. Hand and forearm cramps in left arm (injection site) now affecting left leg (calf) Left side of face has spasms and numbness.

Other Meds: None

Current Illness: None

ID: 1678676
Sex: M
Age: 60
State:

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

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: Patient doesnt remember which vaccine. Patient developed acute weakness and we are suspecting GBS

Other Meds:

Current Illness:

ID: 1678677
Sex: F
Age: 30
State:

Vax Date: 08/22/2021
Onset Date: 09/07/2021
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: Patient received Moderna Vaccine on 1/10/2021. Then received Pfizer COVID vaccine on 8/1/2021. Lot #- EW0178. Then patient received another dose of Pfizer vaccine on 8/22/2021 as documented on this report.

Other Meds:

Current Illness:

ID: 1678678
Sex: F
Age: 49
State: MI

Vax Date: 04/08/2021
Onset Date: 08/20/2021
Rec V Date: 09/07/2021
Hospital: Y

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: Hospitalization, Thromecomty procedure with multiple clot removal Aug. 21, 2021

Allergies: NKA

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

Symptoms: Subarachnoid Venous Thrombosis

Other Meds: Claratin-D

Current Illness: None

ID: 1678679
Sex: F
Age: 34
State: VA

Vax Date: 03/07/2021
Onset Date: 08/21/2021
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: No

Symptom List: Pain in extremity

Symptoms: small, red, bumpy rash on torso and upper legs.

Other Meds: None

Current Illness: None

ID: 1678680
Sex: F
Age: 36
State: SC

Vax Date: 08/20/2021
Onset Date: 08/22/2021
Rec V Date: 09/07/2021
Hospital:

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

Lab Data: EKG, CBC, BMET, Cardiac enzymes, Chest X-ray

Allergies:

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

Symptoms: Chest pain - felt like heart was rubbing against ribs Chest flutters and heaviness

Other Meds:

Current Illness:

ID: 1678682
Sex: F
Age: 33
State: IN

Vax Date: 08/17/2021
Onset Date: 08/22/2021
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: none yet

Allergies: PCN, peanuts

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

Symptoms: Since about 5 days post vaccine I have experienced tingling/ "pins and needles" type feeling in my bilateral arms and hands. It is intermittent, but has happened multiple times a day, every day, with no known reason. Due to this I feel very uneasy about getting the second vaccine in the series in case this reaction becomes worse.

Other Meds: Lexapro 20mg QD. Tylenol, ibuprofen PRN

Current Illness: none

Date Died: 09/03/2021

ID: 1678683
Sex: F
Age: 82
State: MN

Vax Date: 04/08/2021
Onset Date: 09/03/2021
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: Lasix

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

Symptoms: Patient passed away on 09/03/2021.

Other Meds: Acetaminophen, Hygroton, Synthroid, Coumadin, Klor-Con, Toprol, Claritin, Pepcid, Vit D, Lotrimin, Calmoseptine, Prilosec, Ventolin

Current Illness:

ID: 1678684
Sex: F
Age: 31
State: FL

Vax Date: 09/03/2021
Onset Date: 09/04/2021
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: COVID-19 Cue Molecular Test on 09/07/2021 was negative Client was advised to go to her primary care physician or walk-in clinic for additional testing for influenza A/B.

Allergies: Amoxicillin- swelling of face, eyes, or tongue

Symptom List: Vomiting

Symptoms: Client states, "about 24 hours after my vaccine I felt super sick, my arm hurt really bad, and I had a fever. I was dizzy and just felt super super sick." Per client she was unsure of what her fever was as her thermometer wasn't working correctly.

Other Meds: Yaz 1 tab PO daily Vitamin D Gummies PO BID

Current Illness: Denies

ID: 1678685
Sex: M
Age: 89
State: GA

Vax Date: 02/18/2021
Onset Date: 08/13/2021
Rec V Date: 09/07/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Patient is fully vaccinated. Hospitalized due to COVID-19. Patient fell on 8/11/2021 due to weakness and was seen in the ER where he was tested positive by PCR. States he has since been hospitalized on 8/16/2021 and was discharged. He is still pretty weak and has not fully recovered from the illness.

Other Meds:

Current Illness:

ID: 1678686
Sex: F
Age: 51
State:

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

Allergies: None

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

Symptoms: Unable to walk, excruciating muscle spasm in back, legs and arms. Unbearable pain throughout the day. Amplified arthritis pains.

Other Meds: Tramadol 50mg (once daily)

Current Illness: None

ID: 1678687
Sex: M
Age: 51
State: FL

Vax Date: 03/11/2021
Onset Date: 08/25/2021
Rec V Date: 09/07/2021
Hospital: Y

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:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Patient is a 51 yr old male with a PMHx significant for HTN, HLD, and bilateral uveitis who presented to ED after testing positive for COVID19 with worsening symptoms of chills, malaise, and shortness of breath. Patient states he tested positive for COVID 14 days ago. He continue to experience worsening symptoms so he called his PCP on 08/19 and was prescribed methylprednisone and a zpack. Pt states he took it for 2 days however his symptoms persisted so pt presented to the ED at another hospital system\ on 08/22 where a chest xray showed COVID19 pneumonia. Pt was prescribed Pulmicort and scheduled for convalescent plasma on 02/25. He was not admitted as he was noted to have a sat of 99% and was tolerating room air at the time. He presented to receive his convalescent plasma today. Patient states during his treatment he continued to be short of breath and his O2 sats dropped to the 90s. Patient was brought to the ED via EMS. On admission he was found to an elevated CRP and ferritin. His white count was stable and he was afebrile. His chest x-ray showed bibasilar patchy airspace opacities favoring infectious etiology. Patient states he was vaccinated with Johnson & Johnson on 03/2121. Patient is currently being admitted for further care.

Other Meds:

Current Illness:

ID: 1678688
Sex: F
Age: 12
State: VA

Vax Date: 08/23/2021
Onset Date: 08/23/2021
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: N/A

Allergies: none

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

Symptoms: Child received Meningococcal (MCV4) IM in deltoid instead of HPV9 vaccine. Mother of child stated that child has no adverse reaction.

Other Meds: None

Current Illness: None

ID: 1678689
Sex: M
Age: 84
State: MI

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

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

Lab Data:

Allergies:

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

Symptoms: ED Note: 84-year-old male with past medical history of multiple myeloma, CKD, squamous cell carcinoma of the lung (diagnosed in 2008 status post left upper lobectomy), clear cell carcinoma of the kidney (diagnosed in 2009 status post left nephrectomy), and anemia presented to the emergency room complaint of shortness of breath. He states his symptoms began 1 week ago. He states initially started off as a cough which was mostly dry, occasionally productive with clear sputum. He states he then began to experience some shortness of breath which she described as trouble catching his breath, and states worse with exertion. He states last week he was having some chills and myalgias. He went to the drugstore on Wednesday, 9/1/2021, and tested positive for Covid. He denies any trauma, injury or fall. Denies any fevers, headache, vision changes, eye pain, neck pain, back pain, chest pain, palpitations, lightheadedness, dizziness, syncope, hemoptysis, abdominal pain, nausea, vomiting, diarrhea, dysuria, hematuria, extremity numbness or tingling, or focal weakness.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am