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: 1684703
Sex: M
Age: 70
State: DE

Vax Date: 02/24/2021
Onset Date: 07/22/2020
Rec V Date: 09/09/2021
Hospital:

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

Lab Data: PSA test, Biopsy on 07/2020 then again 07/2021

Allergies: NONE

Symptom List: Dysphagia, Epiglottitis

Symptoms: Diagnosed with prostate cancer in 2020 prior to vaccinations. Error in reporting adverse event as preexisting condition.

Other Meds: Xarelto, Rovastatin. Metroprolol, Fish Oil,

Current Illness: Atrial Fibrillation

ID: 1684704
Sex: F
Age: 61
State: OR

Vax Date: 08/24/2021
Onset Date: 09/07/2021
Rec V Date: 09/09/2021
Hospital:

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

Lab Data: Had COVID 19 on July 9th COVID antibody test July 20th results HIGH and REACTIVE COVID Jansen vaccine July 24th

Allergies: Codeine and hydrocodone

Symptom List: Anxiety, Dyspnoea

Symptoms: Pain in left arm from shoulder to wrist during the first 24 hours. Waves of severe fatique for 4 days 2 weeks later herpes on Right lower lip which has not occured for over 2 years and is now painfull despite anti herpes cream

Other Meds: Zinc 25 mg , Quercetin 250mg, Vit D3 5,000 U, vit C 500 mg, ASA 81 mg. symbicort inhaler

Current Illness: 6 weeks prior to vaccine I had COVID positive and was sick with Covid for 48 hours. Lab test Aug 20th results for Covid antibodies HIGH and REACTIVE. Because I work at a hospital my employer wanted me vaccinated even though I had positive antibody test and CDC recomendation is vaccine.

ID: 1684705
Sex: M
Age: 71
State: NC

Vax Date: 07/26/2021
Onset Date: 07/30/2021
Rec V Date: 09/09/2021
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: No test, just a movement discussion with Orthopedic specialist.

Allergies: None

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

Symptoms: After the shot, 4 to 5 days later, my body started aching as I noticed when I would wake up in the a.m. I am usually "pain free" and noticed that I was in pain when getting out of bed. My left arm was ok after injection but is now very painful to move "up and down" like a shoulder impingement. I later noticed a problem moving my head(neck) left and right as if I had slept wrong. I am still having that problem. This type of problem I have experience but it usually goes away in a couple of days. This morning I am in whole body pain. Not debilitating but very noticeable. I went to an orthopedic appointment Tuesday(9-7) and informed the doctor of my pains. He prescribed muscle relaxers and told me to return if not better. He did suggest physical therapy but am not doing that at this time. Did not discuss if it could be injection related.

Other Meds: Jardiance, testosterone gel, famotidine 40mg ginkgo biloba, turmeric, vitamin B complex, vitamin C, vitamin D3 5,000 unit, vitamin K, Zinc

Current Illness: None

ID: 1684706
Sex: F
Age: 61
State:

Vax Date: 04/01/2021
Onset Date: 08/30/2021
Rec V Date: 09/09/2021
Hospital: Y

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

Lab Data: COVID PCR (8/30/3021) = detected COVID Antibody IgG (8/30/2021) = negative Influenza A&B (8/30/2021) = negative

Allergies: Amoxicillin, Cefaclor, Sulfa

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Patient presented to the ED on 8/30/2021 with shortness of breath that started the previous day. Prior to admission, she was on chronic steroids (prednisone 10 mg daily) for COPD. She was also on CPAP at night prior to admission, but on room air during the day. Upon admit to ED, she was started on 3L of oxygen, increased steroids, and remdesivir x 5 days. She was also started on antibiotics due to concern for bacterial infection given history of COPD and multiple antibiotic courses in the previous 5 months. She was eventually weaned off oxygen during the day and discharged home.

Other Meds:

Current Illness:

ID: 1684707
Sex: F
Age: 30
State: KY

Vax Date: 09/01/2021
Onset Date: 09/02/2021
Rec V Date: 09/09/2021
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: NKA

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

Symptoms: Next day arm pain, headache, muscle weakness, back pain . Day 6 noticed large inflamed area covering majority of deltoid area with x3 additional inflamed areas inferior to deltoid, hot to touch.

Other Meds: Wegovy 1mg Tri-spintec Multivitamin Vit B12 2000 mcg Vitamin D 50,000 unit Wellbutrin 300 mg

Current Illness: N/A

ID: 1684708
Sex: M
Age: 16
State: KY

Vax Date: 08/11/2021
Onset Date: 08/11/2021
Rec V Date: 09/09/2021
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: I administered the first dose of the Moderna Covid vaccine to a 16 year old patient on August 11, 2021. No adverse reactions or symptoms have been reported.

Other Meds:

Current Illness:

ID: 1684709
Sex: M
Age: 26
State: NJ

Vax Date: 07/02/2021
Onset Date: 07/02/2021
Rec V Date: 09/09/2021
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: Fainting, heart palpitations, seizure-like movements resulting in hospitalization

Other Meds: None

Current Illness: None

ID: 1684710
Sex: F
Age: 47
State: MD

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

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

Lab Data:

Allergies: none

Symptom List: Pharyngeal swelling

Symptoms: Two months of very heavy menstrual cycles which is not normal for the patient.

Other Meds: Sumatriptan prn, rarely taken and was not taken at the time of vaccination.

Current Illness:

ID: 1684711
Sex: M
Age: 62
State: PA

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 09/09/2021
Hospital:

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

Lab Data: blood work, stress test, lung scan, chest x-rays, echocardiogram

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Day after I got the shot, I went into a huge exhaustion. I was falling asleep at work at my desk, I would have to stop on my drive home. I couldn't mow the lawn. I could work for 5 to 10 minutes and walking upstairs I would be exhausted. This went on and I finally went to doctors in August. All my tests for my heart and lungs came back normal.

Other Meds: amlodipine, atorvastatin, lansoprazole, montelukast, metformin, Januvia, Aspirin, Tamsulosin

Current Illness:

ID: 1684712
Sex: F
Age: 56
State: FL

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

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

Lab Data: Due to come back today.

Allergies: nitrofurantoin

Symptom List: Diarrhoea, Nasal congestion

Symptoms: 9/3 Booster received. 9/4 she developed malaise, fever, headache, nausea, and abdominal pain. Treated with acetaminophen, clear liquids, antacids, rest. 9/5 not tolerating oral intake, low grade fever, nausea, and vomiting.. received IV fluids with vitamins. 9/6 still symptomatic, more IV fluids. 9/7 still symptomatic treated with acupuncture, homeopathy. Now fatigued but afebrile.

Other Meds: Unknown

Current Illness: N/A

ID: 1684713
Sex: F
Age: 33
State: NY

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

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

Lab Data: n/a

Allergies: All Seafood, egg, penicillin, bactrim, codeine

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

Symptoms: 1. I lost the sense of touch from my elbow up to my shoulder and down the left half of my back. A month after the vaccine I have regained some feeling, but the skin on my left should still cant sense touch. 2. 12 hours after vaccination, I experienced severe kidney pain that lasted 72 hours. I have had kidney stones and a kidney infection so I know that it was my kidneys that felt as though they were rupturing. I couldn't sleep or sit still for three days. I did not take any pain medication as I did not want to overwhelm kidneys. After 72 hours the pain finally subsided.

Other Meds: Aviane- Oral birth control Vitamin B12 Vitamin D

Current Illness: none

ID: 1684714
Sex: F
Age: 38
State:

Vax Date: 02/01/2021
Onset Date: 09/08/2021
Rec V Date: 09/09/2021
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: hospitalized 9/8/21 with Salmonella enteritis- SARS-CoV-2 positive. Patient denies shortness of breath, cough; oxygen saturation documented 95-97% on room air

Other Meds:

Current Illness:

ID: 1684715
Sex: M
Age: 28
State: SC

Vax Date: 08/20/2021
Onset Date: 08/31/2021
Rec V Date: 09/09/2021
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: 20 days later post 2nd shot tingling in arms legs hands and feet, right calf muscle sore and spasms.

Other Meds:

Current Illness:

ID: 1684716
Sex: F
Age: 47
State: MN

Vax Date: 08/31/2021
Onset Date: 09/01/2021
Rec V Date: 09/09/2021
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: have not went to see DR

Allergies: Shrimp

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

Symptoms: Patient report that she has serve headaches that started the day after... 4 days later she was vomiting (has stopped now)... 3 days after she started to get itchy red bumps on both feet

Other Meds: Inhaler Naltrexone

Current Illness: no

ID: 1684717
Sex: M
Age: 57
State: TX

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

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

Lab Data: creatinine increased from baseline of 1.3 to 1.9

Allergies: none

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

Symptoms: elevated creatinine and decreased GFR

Other Meds: none

Current Illness: none

ID: 1684718
Sex: M
Age: 55
State: NY

Vax Date: 02/09/2021
Onset Date: 04/01/2021
Rec V Date: 09/09/2021
Hospital: Y

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

Lab Data: Nuclear Stress Test and ultrasound May 17 2021.

Allergies: Wool, grass, dust mites

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

Symptoms: Hospitalized in May 2021 for heart issues.. EKG 3rd lead showed inverted T Wave. Nuclear Stress test and ultrasound of heart indicated oxygen deficit. (EKG prior to any vaccine was fine). Can no longer climb one flight of stairs without chest pain and shortness of breath. Newly prescribed 81mg aspirin, Metoprolol, and Prevastatin .

Other Meds: Lialda, Advair, Montelukast, Pantoprazole, Vitamin D, Multivitamin (Freedavite), CPAP

Current Illness: N/A

ID: 1684720
Sex: F
Age: 36
State: GA

Vax Date: 08/21/2021
Onset Date: 08/21/2021
Rec V Date: 09/09/2021
Hospital:

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

Lab Data: They performed a ct scan and ran several labs and performed a blood draw at emergency room

Allergies: Iodine dye

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

Symptoms: From receiving the injection I had an onset of a headache immediately, the headache lasted for over a week, I could only lift my arm at a 90 degree angle and was fatigued because I was getting no sleep because of the headache, I ended up in both urgent care and the emergency room where they provided a cocktail of medications to try to help alleviate the headache

Other Meds: Birth control pill form

Current Illness: None

ID: 1684721
Sex: F
Age: 36
State: OK

Vax Date: 08/27/2021
Onset Date: 08/27/2021
Rec V Date: 09/09/2021
Hospital: Y

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

Lab Data: Blood work, CT, appendectomy

Allergies: Egg, Latex, Ranitidine, Fentanyl, Adhesive

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Vaccine Symptoms 8/27/21 @ 2:38 pm, Initial dose-Pfizer: 2:43pm dizzy/light headed, like something pushing on chest; 2:48pm increased heart rate to 120bpm, left eye twitching; 2:53pm same symptoms as above; 2:58pm itching in left arm and chest; 3:03pm minor full body shakes; 3:08pm same symptoms; 3:13pm same; 3:18pm same; 3:23pm same; 3:28pm same; 3:33pm same; 3:38pm same released home; 4:00pm feel drained, arm sore, same symptoms as above; 4:30pm shaking eased up; 5:00pm heart rate returning to normal; 5:30pm muscle pain intensifying, pain across chest, feels tight, face pain across cheeks, forehead, orbital areas; 6:00pm neck and base of skull feel tight, painful, jaw pain and same face pain symptoms, right eye twitching; 7:00pm neck stiffness worse, could fall asleep now, muscle pain still getting worse, face pain; 8:00pm muscle pain includes back now, almost like kidney/upper abdominal pain; 9:00pm same; 10:30pm same; 8/28; 2:30am kidney/upper abdominal pain getting worse, slight cough; 5:30am diarrhea, coughing increased; 6:15am left kidney/upper abdominal area pain intensifying, like a stabbing pain now, not just an ache; 8:00am stabbing pain not as bad. Body aches and joint pain; 11:00am stomach/mid abdominal pains, body/muscle/joint aches; 12:00pm stomach pains back, right side; 12:45pm horrible side pains, diarrhea; 1:00PM diarrhea, abdominal pains; 1:30PM abdominal pains; 2:00PM self administered epi pen, Albuterol, called 911; 2:15PM In ambulance, morphine, Zofran, no relief; 2:40PM @ SFH; Blood work, CT, confirmed appendix inflamed; 10:30ish pm appendectomy and repair of internal bleeding; 8/29; 2:00am released to home.

Other Meds: Ezitimbe, Albuterol, Pantoprazole, Montelukast, Zyrtec

Current Illness: None

ID: 1684722
Sex: F
Age: 63
State:

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

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

Lab Data: UNKNOWN, RESULTS/OUTCOME BELOW ARE UNKNOWN

Allergies: Meperidine (anaphylaxis, hives/urticaria, hallucinations, shortness of breath/dyspnea), Bactrim - hives/urticaria, itching

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: PT PRESENTED FOR SECOND COVID VACCINE, STATED HAD "RASH/WELTS" ON RIGHT ARM AFTER FIRST DOSE (RECEIVED IMMUNIZATION IN RIGHT ARM), SHE DISCUSSED WITH MD AND ENCOURAGED TO PROCEED WITH SECOND DOSE, AFTER ADMINISTERING 2ND DOSE IN LEFT ARM, PT REPORTED SWELLING IN FACE NEAR THE LEFT LIP, REPORTER OBSERVED THAT SHE DID HAVE SLIGHT SWELLING OVER HER LEFT LIP.

Other Meds: Was not taking her tofacitinib 5mg tablet for rheumatoid arthritis at time of vaccination.

Current Illness: No known

ID: 1684723
Sex: M
Age: 31
State: MI

Vax Date: 09/07/2021
Onset Date: 09/07/2021
Rec V Date: 09/09/2021
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: none

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

Symptoms: Client was given his second dose of the Pfizer vaccine and 10 to 15 minutes following the injection the client c/o a headache an the left and right side of his head. He stated that he did not have an reaction to the first dose. he said that he thought it would just past but it didn't. So I took vitals immediately and asked if he had any pre-existing conditions to which he answered no. His vitals were normal and remained normal throughout the incident (144/92, 71, 20, 98% o2, 97.1. He denied any allergies. His breathing and safety was maintained throughout the event. He did say he had not eaten anything so we gave him some cracker and water. After 10-15 minutes he stated that he felt much better and the headache was just about gone. He denied any dizziness or nausea. I kept him for another 15 minutes and he answered all question appropriately and I had him stand and ambulate without incident. So I discharged him and advised him to follow-up with his doctor. Retook vitals (136/88, 68, 18, 98% o2). He ambulated himself out of the clinic without incident.

Other Meds: none

Current Illness: none

ID: 1684724
Sex: F
Age: 15
State: KY

Vax Date: 08/25/2021
Onset Date: 08/30/2021
Rec V Date: 09/09/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Covid positive...school

Other Meds:

Current Illness:

ID: 1684725
Sex: M
Age: 29
State: TX

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

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

Lab Data: Blood Glucose was 94 Patient was administered one dose of EPI at the clinic.

Allergies: Patient stated he had environmental allergies. NKDA

Symptom List: Unevaluable event

Symptoms: About 8 minuets after receiving the vaccine patient began to have a severe runny nose. Then about another 5 min after patient began to have difficulty swallowing with dyspnea.

Other Meds: Allergy medications (Benadryl and Zyrtec) Prilosec

Current Illness: None stated or determined during the screening process

ID: 1684726
Sex: F
Age: 37
State: FL

Vax Date: 09/01/2021
Onset Date: 09/01/2021
Rec V Date: 09/09/2021
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: NKA

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

Symptoms: Heavy menstruation/bleeding beginning hours after receiving the second dose of vaccine. This happened in the middle of my cycle AND while on oral contraceptives. I am currently on day 8 of a heavy menstruation and concurrent oral contraceptives.

Other Meds: Aviane (oral contraceptive), Losartan/HCTZ

Current Illness: NO

ID: 1684727
Sex: F
Age: 32
State: MI

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

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

Lab Data: none

Allergies: antibiotics

Symptom List: Injection site pain, Pain

Symptoms: pruritis without rash, scratchy throat

Other Meds: none

Current Illness: none

ID: 1684728
Sex: M
Age: 70
State:

Vax Date: 02/25/2021
Onset Date: 09/08/2021
Rec V Date: 09/09/2021
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: hospitalized 9/8/21 with Acute Hypoxic Respiratory Failure, COVID-19 pneumonia, SARS-CoV-2 positive 9/3/21

Other Meds:

Current Illness:

ID: 1684729
Sex: F
Age: 15
State: AL

Vax Date: 09/08/2021
Onset Date: 09/08/2021
Rec V Date: 09/09/2021
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: NKDA

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

Symptoms: Event occurred 09/08/2021: Pt had syncopal vs seizure like episode after vaccines. Patient received TDAP, MMR, Varicella, Hep A, HPV 9 and MCV4. Last vaccine given at approx 11:41am. Patient was scared and upset while receiving vaccines. As soon as last vaccine (HPV 9) was given patient had syncopal episode, but also appeared to have a seizure. The seizure like activity only lasted for approx 10 seconds. Patient didn't appear to have a post-ictal period. 911 called at 11:45am. VS at 11:45am BP 110/64, HR 96 and O2sat 99. Fire Dept arrived at 11:52am. Patient evaluated. Mother refused for patient to to hospital. Fire Dept also believes that patient had a seizure based on the way patient was acting. Heavily educated mother on the need for child to go to the doctor to be evaluated. Fire Dept escorted patient to vehicle. 09/09/2021 Called mother this morning to check on patient. Mother states that patient is fine, and she did not take her to the doctor. Mother says that patient is at school this morning.

Other Meds: none

Current Illness: none

ID: 1684730
Sex: M
Age: 66
State: KY

Vax Date: 04/14/2021
Onset Date: 08/27/2021
Rec V Date: 09/09/2021
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: Covid positive...household

Other Meds:

Current Illness:

ID: 1684731
Sex: F
Age: 50
State: NY

Vax Date: 08/29/2021
Onset Date: 08/01/2021
Rec V Date: 09/09/2021
Hospital:

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

Lab Data: They did not do any lab or medical tests

Allergies: None

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: It has been 11 days since my first vaccine. I can not move my arm to the side or back. I have been to the urgent care and yesterday followed up. My upper arm is swollen.My. Primary at this appointment told me that due to the shot I now have tendinitis in my shoulder and there is inflammation in my upper arm. They gave me a prescription for stronger ibuprofen and told me that if it wasn?t better in a few days I would have to go to Orthopaedic.

Other Meds: Atorvastayin 20mg 1x a day Hydroxide hc1 25 mg 3x a day as needed Omeprazole 40mg 1 x a day Escotalopram Ocalate 20mg 1x a day

Current Illness: No illnesses.

ID: 1684732
Sex: M
Age: 44
State: SC

Vax Date: 08/23/2021
Onset Date: 08/24/2021
Rec V Date: 09/09/2021
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 as of yet. Trying to get into see a doctor.

Allergies: No food allergies. No drug allergies.

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

Symptoms: Tinnitus - Has been present before and was only observed in ultra quiet environments. Seemed to be exacerbated by physical stress, such as exercise. However it has become significantly worse and remains unabated. It is non-stop and is audible even in loud environments.

Other Meds: Daily multivitamin

Current Illness: No other illness

ID: 1684733
Sex: F
Age: 49
State: NY

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

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

Lab Data: Pelvic ultrasound Hormone bloodwork

Allergies: None

Symptom List: Nausea

Symptoms: Vaginal bleeding after 7 years menopausal

Other Meds: 10mg escitalopram

Current Illness: Diverticulitis

ID: 1684735
Sex: F
Age: 15
State: MS

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

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

Lab Data:

Allergies: none

Symptom List: Injection site pain

Symptoms: Patient came to get the Pfizer vaccine, but was given the Moderna vaccine instead.

Other Meds: none

Current Illness: none

ID: 1684736
Sex: F
Age: 45
State: ME

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

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

Lab Data:

Allergies: Seasonal

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

Symptoms: A couple of days after getting injection, I started to get weakness and stiffness in the arm of the injection site, my thumb is twitching and pain in my forearm

Other Meds: Singulair, baclofen, vitamin d, fish oil, cod liver oil, magnesium, iron, loratadine

Current Illness: None

ID: 1684737
Sex: F
Age: 48
State:

Vax Date: 09/08/2021
Onset Date: 09/08/2021
Rec V Date: 09/09/2021
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:

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

Symptoms: NUMBNESS OF FACE, RASH. MD PRESCRIBED PREDNISONE FOR 7 DAYS.

Other Meds:

Current Illness:

ID: 1684738
Sex: F
Age: 42
State: KY

Vax Date: 02/14/2021
Onset Date: 09/02/2021
Rec V Date: 09/09/2021
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: Covid positive...unknown contact

Other Meds:

Current Illness:

ID: 1684739
Sex: M
Age: 65
State:

Vax Date: 03/12/2021
Onset Date: 09/08/2021
Rec V Date: 09/09/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: hospitalized 9/8/21, SARS-CoV-2 positive 9/8, COVID pneumonia

Other Meds:

Current Illness:

ID: 1684740
Sex: F
Age: 62
State: NY

Vax Date: 05/05/2021
Onset Date: 06/01/2021
Rec V Date: 09/09/2021
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: Hearing test, nasal scope and extensive ear exams August 31,2021.

Allergies: sulfa

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

Symptoms: High pitch buzzing in ears and head going on for two plus months. Diagnosis is Tinnitus after a thorough exam at the ENT doctor. I was told there is no treatment for this condition.

Other Meds: Valsartan, Advil and Tylenol

Current Illness:

ID: 1684741
Sex: F
Age: 66
State: MD

Vax Date: 03/15/2021
Onset Date: 03/16/2021
Rec V Date: 09/09/2021
Hospital:

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

Lab Data: in er she had a lumbar test and they found elevated proteins in her CSF

Allergies: Motrin, Celebrex

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

Symptoms: on 3/16 her husband said he woke her up and she was conscious but unresponsive, couldn't make sense of instruction, didnt know who her husband or herself was, went to er via ambulance 12 hours she "snapped back into reality"

Other Meds: aspirin metformin levemir pen victoza lipitor dexilant iorn levothyroxine metoprolol XL modafinil fish oil senna-S effexor-XR vitamin d3 neurontin melatonin lipspro prilosec multi vitamin clonazepam

Current Illness:

ID: 1684742
Sex: M
Age: 85
State: NY

Vax Date: 08/16/2021
Onset Date: 08/01/2021
Rec V Date: 09/09/2021
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: THE PATIENT DID NOT EXPERIENCE ANY ADVERSE EVENT, HOWEVER, HE THOUGHT HE WAS GETTING HIS FIRST SHOT AND AT THE TIME THERE WAS NO RECORD OF ANY COVID VACCINES GIVEN IN DATABASE OR PHARMACY RECORDS.

Other Meds:

Current Illness:

ID: 1684743
Sex: M
Age: 66
State: CT

Vax Date: 09/01/2021
Onset Date: 09/08/2021
Rec V Date: 09/09/2021
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: None

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

Symptoms: None stated.

Other Meds:

Current Illness: Had COVID 12/25/20

ID: 1684744
Sex: M
Age: 68
State: MI

Vax Date: 08/21/2021
Onset Date: 08/22/2021
Rec V Date: 09/09/2021
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: Feldine, Codeine, Levaquin

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

Symptoms: Body aches, low grade fever, headache, lymph node under arm swollen. Has seen improvement in those symptoms, but now has SOB and Sore throat, will be seeking testing.

Other Meds: Norvasc, Lasix, Wellbutrin, Proair, Stilto, Albuterol Neb, Metoprolol

Current Illness: no acute illness

ID: 1684745
Sex: F
Age: 52
State:

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

ID: 1684746
Sex: F
Age: 14
State: KY

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

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

Lab Data:

Allergies: Eggs coconut pork

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

Symptoms: 12 hours after injection headache, nausea, tightness in chest and abdominal area, dizzy, confused, body aches low grade fever

Other Meds:

Current Illness:

ID: 1684747
Sex: F
Age: 39
State:

Vax Date: 06/05/2021
Onset Date: 06/05/2021
Rec V Date: 09/09/2021
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: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1684748
Sex: F
Age: 71
State: KY

Vax Date: 02/21/2021
Onset Date: 08/31/2021
Rec V Date: 09/09/2021
Hospital:

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

Lab Data: Rapid test

Allergies:

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

Symptoms: Tested positive for covid

Other Meds:

Current Illness:

ID: 1684749
Sex: F
Age: 30
State: TX

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

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

Lab Data: Called teledoc. Told me to use hydrocortisone cream. If peeling spreads to rest of my body go in to be seen.

Allergies: None.

Symptom List: Vomiting

Symptoms: Hands and feet skin peeling off.

Other Meds: None. Post partum 3 months.

Current Illness: None.

ID: 1684750
Sex: M
Age: 63
State: TX

Vax Date: 09/07/2021
Onset Date: 09/07/2021
Rec V Date: 09/09/2021
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: Fever began 12 hours after shot. Was 101.6 for 12-15 hours. Aches, pains, headache

Other Meds: None

Current Illness: None

ID: 1684751
Sex: U
Age: 38
State:

Vax Date: 06/05/2021
Onset Date: 06/05/2021
Rec V Date: 09/09/2021
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: 1684752
Sex: F
Age: 19
State: KY

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

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Covid positive....friend

Other Meds:

Current Illness:

ID: 1684753
Sex: F
Age: 38
State: MI

Vax Date: 04/01/2021
Onset Date: 04/14/2021
Rec V Date: 09/09/2021
Hospital:

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

Lab Data: MRI, EEG, DATSCAN, blood work,.

Allergies: None

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

Symptoms: Tremor in right hand and arm.

Other Meds: None

Current Illness: None

ID: 1684754
Sex: F
Age: 35
State:

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