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: 1685164
Sex: F
Age: 41
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: IM
Vax Site: LA

Lab Data: none

Allergies: sulfa

Symptom List: Dysphagia, Epiglottitis

Symptoms: Fever of 101. for 48 hours, extreme fatigue, muscle aches, nausea and lighheadedness.

Other Meds: lisinopril and atrovastin

Current Illness: none

ID: 1685165
Sex: F
Age: 67
State: NY

Vax Date: 05/14/2021
Onset Date: 05/15/2021
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:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Woke up with Severe abdominal pain such as I have Never had before in my whole entire life. Could barely walk across room, thinking I might need bathroom. I did not. I figured it was a side effect of the vaccine, but determined if it did not subside pretty soon I would need to go to the hospital. It did ease up somewhat after about 40 minutes, but did not go away completely. Felt mild pain for 5 days afterward.

Other Meds:

Current Illness:

ID: 1685166
Sex: F
Age: 19
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: 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: 1685167
Sex: M
Age: 38
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: 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: 1685168
Sex: M
Age: 92
State:

Vax Date: 02/03/2021
Onset Date: 08/28/2021
Rec V Date: 09/09/2021
Hospital: Y

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

Lab Data: COVID 19 RESULT = POSITIVE at outside hospital (8/27/2021) COVID 19 PCR result = positive (8/29/2021) COVID Antibody IgG = Positive (8/28/2021 at 1441)

Allergies:

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

Symptoms: Patient was seen in the ED at an outside hospital for low oxygen readings at home. He was found to have a large right pleural effusion and tested positive for COVID. He was transferred to this facility for IR drainage of pleural effusion and management of COVID-19. Patent did received casirivimab-imdevimab on 8/28/2021. Thoracentesis done on 8/29/2021. Patient was discharged to home on 8/30/2021

Other Meds:

Current Illness:

ID: 1685169
Sex: F
Age: 55
State: TX

Vax Date: 03/23/2021
Onset Date: 08/27/2021
Rec V Date: 09/09/2021
Hospital: Y

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: 8/28/2021 positive SARS COVID2 result

Allergies: NKDA

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

Symptoms: COVID positive pneumonia

Other Meds: zolpidem, Norco, prednisone, metoprolol, methotrexate, sulfasalazine, folic acid

Current Illness: rheumatoid arthritis, atrial fibrillation, pneumonia

ID: 1685170
Sex: F
Age: 28
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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1685171
Sex: M
Age: 67
State: WI

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

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

Lab Data:

Allergies: Shellfish, Conrast dye

Symptom List: Pharyngeal swelling

Symptoms: Patient had second Moderna COVID shot yesterday and he can tell that he is in atrial fibrillation. He remembers having palpitations on august 24 so they told him to wait to get the second shot. He was feeling fine yesterday just prior to getting the shot. He admits to palpitations today and feels the "pounding". He was seeing cardiology through telehealth. The PT just got a new one and he was going to establish with them in person, but has not yet done so. mild shortness of breath fatigue, brain fog shakiness headache this am no chest pain, pressure tightness of discomfort dizzy and lightheaded EKG in office showed he was in atrial fibrillation with rapid ventricular response. He is not on any blood thinners or anticoagulants and he was brought to ER for hospital admission.

Other Meds: Metoprolol, Irbesartan

Current Illness: none

ID: 1685172
Sex: F
Age: 75
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: Abdominal pain, Chills, Sleep disorder

Symptoms: vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1685173
Sex: F
Age: 94
State: WA

Vax Date: 02/25/2021
Onset Date: 07/15/2021
Rec V Date: 09/09/2021
Hospital: Y

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

Lab Data: CT scan - Legacy Salmon

Allergies: none

Symptom List: Diarrhoea, Nasal congestion

Symptoms: She had a lot of pressure in her upper abdomen - like there was no room for her innards. Bloating. And then she vomited after experiencing this pressure - this was at 05:00 am before she had eaten. I talked to the nurse and I took her to Urgent Care - he did an EKG - he thought she needed to go to ED - for a CT scan - to find out about blockage in GI - they did a CT scan and saw there was an obstruction in her small bowel. Emptied her stomach and put in a new GI tube. They admitted her to make sure it had resolved. She was in the hospital for about a week. They gave her treatment for anemia. The obstructions was constipation and she didn't know that because she had already been using Citricel daily and she thought she was having bowel movements daily. She had a hiatal hernia - it had been there for yours; small bowel obstruction - could have been from scars and adhesions from prior surgeries. It resolved in that week. She uses Miralax daily and Citrucel - daily for bowel movement and they have her on Omeprazole - they think there might be something bleeding with lesions on her hernia.

Other Meds: Long list - of medications

Current Illness: no

ID: 1685174
Sex: F
Age: 50
State: WI

Vax Date: 09/03/2021
Onset Date: 09/07/2021
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: None

Allergies: none

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

Symptoms: No Treatment / no adverse event / vaccine was administrated outside Monera's storage and handing recommendation as outlined in the fact sheet for health care providers

Other Meds: Unknown

Current Illness: none

ID: 1685175
Sex: M
Age: 45
State: MN

Vax Date: 09/02/2021
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: SYR
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: patient was scheduled for 2nd covid dose 1 week too early. not found until after patient left and vaccine was documented.

Other Meds:

Current Illness:

ID: 1685176
Sex: F
Age: 35
State: MN

Vax Date: 08/20/2021
Onset Date: 09/01/2021
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: none

Allergies: none

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

Symptoms: Developed palpitations that lasted 30-60 minutes with some chest discomfort that were worse day 3-4 after symptoms started and by 9/9/21 she had no symptoms by the time of office visit that day and day prior symptoms were about 50% better

Other Meds: none

Current Illness: none

ID: 1685177
Sex: M
Age: 18
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: 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: 1685178
Sex: M
Age: 58
State: TX

Vax Date: 03/04/2021
Onset Date: 08/01/2021
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: None

Allergies: Dust

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

Symptoms: I had the typical shingles rash. It lasted for about 2 weeks. The rash portion was on the torso, on the right side of the body. I am still having some of the nerves effects right now. Like tingling and things like that. I did not have fever. My stomach was upset and I had vomiting. On 08/02/2021 I went to the doctor and they diagnosed me with shingles.

Other Meds: Lisinopril

Current Illness: None

ID: 1685179
Sex: M
Age: 69
State: MT

Vax Date: 03/04/2021
Onset Date: 09/04/2021
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: Diagnosed and hospitalized with COVID while fully vaccinated

Other Meds:

Current Illness:

ID: 1685180
Sex: M
Age: 36
State:

Vax Date: 06/05/2021
Onset Date: 06/05/2021
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:

Allergies:

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

Symptoms: vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1685181
Sex: F
Age: 52
State:

Vax Date: 06/05/2021
Onset Date: 06/05/2021
Rec V Date: 09/09/2021
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: vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1685182
Sex: F
Age: 40
State:

Vax Date: 06/05/2021
Onset Date: 06/05/2021
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:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: vaccine expired in fridge

Other Meds:

Current Illness:

Date Died: 08/25/2021

ID: 1685183
Sex: F
Age: 74
State: TX

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

Vax Type: RV1
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: ROTAVIRUS (ROTARIX)
Lot:
Dose Series: 1
Vax Route: PO
Vax Site: MO

Lab Data:

Allergies: Aleve, Fentanyl

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

Symptoms: Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccine on 03/11/2021 and 04/08/2021. On 8/20/2021, pt presented to ED with increasing shortness of breath. Pt was admitted to a hospital on 8/17/2021 and diagnosed with COVID-19 pneumonia. She was discharged on 8/20/2021 with 4 L NC oxygen. Once discharged patient began to desaturate to 80% and called EMS. Patient was transported to ED and placed on HFNC 50/40 then titrated up to 60/60 and then later 70/60. Her lab work demonstrated elevated procalcitonin and her x-ray demonstrated a multifocal pneumonia. She was given dexamethasone, Rocephin and remdesivir. On morning of 8/25/21 she was noted to be significantly tachypneic with RR to 40s and slightly altered. Despite ongoing treatment, she declined. Patient expired on 8/25/21.

Other Meds: Trelegy Ellipta 100-62.5-25mcg 1 puff daily, lisinopril 10mg daily, prednisone 10mg daily, albuterol 2 puffs q4hours prn, atorvastatin 20mg daily, cetirizine 10mg daily, fluticasone 2 sprays each nostril daily, Floranex 100 million cell gra

Current Illness:

ID: 1685184
Sex: M
Age: 35
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: 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: vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1685185
Sex: F
Age: 28
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: Unevaluable event

Symptoms: vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1685186
Sex: F
Age: 43
State: TX

Vax Date: 04/06/2021
Onset Date: 04/07/2021
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: Bloodwork- came back good

Allergies:

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

Symptoms: After receiving the vaccine, my arm would feel heavy, tired, and achy. It's also sore to the touch at the top part of my arm. It has been in the last 2 months that I noticed it a lot more. My arms hurt and my body would hurt sometimes too. One day I got a headache and then the next day my arm hurt. A week later my feet were really swollen. I went to the doctor and had bloodwork done. They gave me ibuprofen and a water pill. At night it is more uncomfortable. The next day my whole body hurt. I used a one a day women's vitamin and that helped a little bit with my arm discomfort. I can't do anything for extended periods of times without my arms hurting. My left arm hurts more than my right arm most times.

Other Meds:

Current Illness:

ID: 1685187
Sex: F
Age: 26
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: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: vaccine expired in fridge

Other Meds:

Current Illness:

Date Died: 08/25/2021

ID: 1685188
Sex: M
Age: 79
State: TX

Vax Date: 04/02/2021
Onset Date: 08/12/2021
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: Ciprofloxacin, Sulfa

Symptom List: Injection site pain, Menorrhagia

Symptoms: Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccine on 03/11/2021 and 04/02/2021. On 7/12 he began developing symptoms of fatigue, chills, low-grade fevers, body aches, intermittent nausea, poor p.o. intake, poor appetite, some dry cough. He tested COVID positive on 7/16 and continued symptomatic treatment at home. Patient was then admitted 7/24 and discharged on 7/30 with oxygen. Received decadron during this stay. Returned to ER on 8/12 due to worsening shortness of breath. Received vancomycin and cefepime. Started on BiPAP then eventually intubated on 8/17. Patient's respiratory status continued to worsen. Multifocular infarcts noticed on 8/22. Patient treated for PJP on 8/23. Family planned withdrawal of care on 8/24 after discussion of patient's poor prognosis. Patient expired on 8/25/21.

Other Meds: Albuterol 90 mcg 2 puffs q4h prn, amlodipine 5mg daily, Eliquis 5mg BID, benzonatate 200mg TID PRN, Tylenol PM 25-500mg nightly prn, Lomotil 2.5-0.025mg 2 tabs QID prn, famotidine 20mg BID, ibuprofen 200mg 2 tabs QID prn

Current Illness:

ID: 1685189
Sex: M
Age: 42
State: MT

Vax Date: 02/05/2021
Onset Date: 08/29/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Diagnosed and hospitalized while COVID while fully vaccinated

Other Meds:

Current Illness:

ID: 1685190
Sex: F
Age: 22
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: LA

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1685191
Sex: M
Age: 68
State: CO

Vax Date: 03/10/2021
Onset Date: 08/30/2021
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: Not Applicable

Allergies: No

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: I experienced a facial herpes outbreak and I took prescription medication for the outbreak and by the time I went to my Dermatologist he didn't see a need for further treatment.

Other Meds: I took the following medications: Carvedilol, Lisinopril, Atorvastatin, Flexural, and Trazodone.

Current Illness: No

ID: 1685192
Sex: F
Age: 48
State: CO

Vax Date: 03/10/2021
Onset Date: 06/29/2021
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: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: Pt received 2nd dose on March 10 Tested COVID+ on 6/29/21 Received Regeneron on 7/1/21

Other Meds:

Current Illness:

ID: 1685193
Sex: M
Age: 40
State: WY

Vax Date: 02/18/2021
Onset Date: 03/15/2021
Rec V Date: 09/09/2021
Hospital: Y

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

Lab Data: Medical tests run at the emergency room on multiple visits at 3 locations, not sure which test they ordered .Dates ordered from Mid March 2021

Allergies: None

Symptom List: Nausea

Symptoms: Nerve related issues After Second Pfizer-BioNTech Covid 19 Vaccination. 1. Pfizer BioNTech Covid 19 Vaccine : Shooting pain from my tinnitus that developed 2 days after my second Covid 19 vaccination on February 18th) to my nerves on my left side of the body to my foot on March 15th 2021 that possibly developed after finding out from the doctor who ordered the laboratory test that I have Vitamin B12 deficiency. 2.Nerve pain in my feet while driving , vibration feeling in feet and legs. Second type shooting pain from my tinnitus to my nerves at the end of May 2021. 3. Hot, Burning feeling in hands and feet. 4. Sweating of the hands and feet after driving and after taking Gabapentin that was given to me in the Emergency room . 5. Static type nerve shock sensation. 6. Touching electronics with my hands would cause my nerves in my hands and feet to feel warm or feel aggravated. 7. Occasional muscle twitching (could be related to the Cymbalta that im on for the Anxiety that i developed after the vaccination and for the nerve pain I was experiencing, muscle twitching for the most part as stopped) 8. Developed Pyronines Disease from the shooting pain from my tinnitus to my nerves that ill be taking in the future Tadalafil, saw a Urologist about this. Vitamin B12 levels now are normal after B12 injections and oral B12 supplements levels now are in the mid to upper 600 level, was on B12 From Around April 2021 to May 2021. Almost all these symptoms improved and subsided either on its own or possibly with Cymbalta that I'm currently on, been taking it since June 2021 . Current nerve related issues: 1. Once in a while nerve pain in feet while driving to no nerve pain at all. Hands and feet are normal except once in a while will feel warm. Touching electronic has has improved. Static shocks improved. Hospital Stays: 2. Was in the hospital in the observational unit ( division of the psychiatrist unit I think) one night at waiting to see the Neurologist about my nerve issues. Eyes: 3. Some visual floaters, related to the Covid 19 vaccine, after images (could be related to the lorazepam that I was currently on ) 4. Low Vitamin D levels after one the neurologist I saw ordered my Vitamin D to be checked, levels were around 11, was taking vitamin D but stopped after experiencing sweating of the body from the Vitamin B12 supplement. Medications: 1. Lorazepam, was currently on this medication for anxiety stopped taking it in August 2021 2. Developed Pyronines Disease from the shooting pain from my tinnitus to my nerves that ill be taking in the future Tadalafil, saw a Urologist about this. 3. Will be taking Vitamin D again in the future.

Other Meds: Advair, Rogaine, Melatonin

Current Illness: Tinnitus, After Second Pfizer-BioNTech Covid 19 Vaccination, Already reported to VAERS about this.

Date Died: 08/25/2021

ID: 1685194
Sex: M
Age: 91
State: TN

Vax Date: 01/23/2021
Onset Date: 08/15/2021
Rec V Date: 09/09/2021
Hospital: Y

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: fever, fatigue, cough, positive for COVID

Other Meds:

Current Illness:

ID: 1685195
Sex: M
Age: 72
State: IL

Vax Date: 02/01/2021
Onset Date: 09/06/2021
Rec V Date: 09/09/2021
Hospital: Y

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

Lab Data: 9/6/2021 COVID - PCR -Detected 9/6/2021 - Chest x-ray - Atherosclerotic Aorta; Left basilar atelectasis; Osseous changes as described 9/6/2021 CT of Brain WO Contrast - No acute intracranial abnormalities; Mild to moderate cortical atrophy; Sinusitis 9/7/2021 MRI of Brain WO Contrast - No acute infarct; Diffuse cerebral volume loss with chronic small vessel ischemic changes

Allergies: None

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

Symptoms: Feeling nauseous with vomiting and diarrhea for 1 week. Passed out on the bathroom floor and son found him shaking and unresponsive. Diagnosed with Syncope with Convulsions; COVID-19 Infection; Essential Hypertension and GERD

Other Meds:

Current Illness:

ID: 1685196
Sex: F
Age: 66
State: FL

Vax Date: 02/12/2021
Onset Date: 08/11/2021
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: CT scan

Allergies: cefuroxime axetil, compazine-prochlorper, reglan

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

Symptoms: psychogenic non-epileptic seizure

Other Meds: apixaban, atorvastatin, calcium, escitalopram, gaviscon, l-thyroxine, miralax, pramipexole dihydrochloride, solifenacin, trelegy ellipta, vitamin d-3

Current Illness: acid reflux, asthma, AFIB, PVC, PAF, psychogenic non-epileptic seizures

ID: 1685197
Sex: F
Age: 79
State: PA

Vax Date: 01/14/2021
Onset Date: 04/14/2021
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: IM
Vax Site: LA

Lab Data: see attached

Allergies: Sulfa Abx, PCN

Symptom List: Tremor

Symptoms: Patient had stable ITP on IVIG, promacta for a few years. 2-3 months post Moderna covid vaccine, developed severe exacerbation of ITP requiring Rituxan and platelet transfusion. Now slightly improving.

Other Meds: Promacta, Lexapro, Losartan, Proair HFA

Current Illness:

ID: 1685198
Sex: M
Age:
State: GA

Vax Date: 01/13/2021
Onset Date: 08/04/2021
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: As of 8/13/2021 : He received an infusion on 08/05/21. He continued to feel worst, so he went to the ER on 08/10/21. He was admitted to Hospital and is currently still there. He stated he is only on 2 liters of oxygen, and still having a productive cough. He stated 3 years ago he had MRSA in his lungs and the doctor said he only uses about 25% of his lungs due to MRSA scaring.

Other Meds:

Current Illness:

ID: 1685199
Sex: F
Age: 25
State: ME

Vax Date: 09/02/2021
Onset Date: 09/07/2021
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:

Allergies:

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

Symptoms: Friday 9/3. Symptoms the day after vaccine were normal - left arm very sore to the point where I couldn't lift it and very fatigued. Felt as though a cloud covered my eyes and head. Saturday 9/4. Arm still very sore, no better than the day before. Still feeling fatigued but not as bad as the day prior. Sunday 9/5. Arm starting to get better but woke up with a tickle in my throat. Still a bit fatigued but better. Monday 9/6. Arm is back to normal. Not fatigued. Tickle in my throat is a bit worse. Allergy symptoms start coming on (sneezing, runny nose, congestion) ***Tuesday 9/7. Felt the same as Monday until about 8pm. My legs went numb and and whole body started shaking uncontrollably. This didn't let up for the entire night. I was sweating profusely, with shooting pains up and down my body. Puked violently twice. Couldn't sleep all night and developed a headache that didn't let up until the next morning after taking Advil. Wednesday 9/8. Developed a cough. Whole body aches and congestion. Headache and nausea. Thursday 9/9. Same symptoms as Wednesday. Tuesday felt as though I was on my deathbed. I feel that is odd since it was 5 days after receiving the vaccine, and I'm still feeling very ill.

Other Meds:

Current Illness:

ID: 1685200
Sex: M
Age: 54
State: OR

Vax Date: 01/29/2021
Onset Date: 01/30/2021
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: None.

Allergies: None.

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

Symptoms: I first noticed a pronounced rash and swollen lymph nodes under my left arm within 72 hours of my second vaccination. Within 24 hours of that, I noticed that I also had swollen lymph nodes and a rash under my right arm. The rashes were especially sensitive to the touch. The swelling and redness of the rashes became more pronounced over the following days and weeks, and then they gradually began to subside until they finally resolved themselves about 3 or 4 months after the vaccination. During this time, I corresponded with Dr. via email. He advised me that the rashes were likely a result of the vaccination and that they should resolve over time. However, if they got worse, I was to notify him. Since the rashes eventually resolved themselves, I never had to make any in-person visits to the doctor's office.

Other Meds: Pepcid AC, loratadine, fish oil supplement (2400 mg), and vitamin D supplement (400 IU).

Current Illness: None.

ID: 1685201
Sex: M
Age: 39
State: IL

Vax Date: 08/29/2021
Onset Date: 08/29/2021
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: 9/9/2021 CT head: negative

Allergies: None

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Patient has been having light headedness and spells where he feels like I could pass out". States about a week ago he left work due to symptoms. Then states "well yesterday they sent me home because I had a spell again but im always kind of light headed faintish a little bit any ways". Slight chest tightness and "heart palpitations I guess" reports patient. States fatigue from the shot as well but has mostly resolved

Other Meds: Levothyroxine, lisinopril, meloxicam, rosuvastatin, metformin

Current Illness:

ID: 1685202
Sex: M
Age: 59
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: 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: 1685203
Sex: M
Age: 32
State: GA

Vax Date: 08/27/2021
Onset Date: 08/28/2021
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: blood work

Allergies: Sulfa

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

Symptoms: I developed a rash the next day. The rash was on both arms on the elbow and the inside of my arm. on the inside of my legs. Gastrointestinal bleeding and blood in my stool.

Other Meds: Mucinex

Current Illness: Allergies

ID: 1685204
Sex: F
Age: 40
State: NJ

Vax Date: 08/09/2021
Onset Date: 08/10/2021
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: none

Symptom List: Pain in extremity

Symptoms: Sever pain in the injected arm, could not lift arm , radiated into my shoulder. Felt like fire. Also radiated down my arm, and my hand and fingers were numb

Other Meds: Vitamins

Current Illness: none

ID: 1685205
Sex: M
Age: 49
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: 2
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1685206
Sex: F
Age: 51
State: OR

Vax Date: 03/31/2021
Onset Date: 04/02/2021
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: None

Allergies: Cranberries

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

Symptoms: Extremely heavy bleeding with menstrual cycle following first dose of Pfizer vaccine

Other Meds: Famotidine Glipizide Jardiance Victoza Lisinopril Metformin Minocycline rosuvastatin multi vitamin Vitamin D Magnesium

Current Illness: None

ID: 1685207
Sex: M
Age: 28
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: 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: 1685208
Sex: M
Age: 76
State: MN

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

Lab Data: CT, MRI

Allergies: terbinfine, atrovastatin, allopurinol, levofaoxacin

Symptom List: Vomiting

Symptoms: TIA 3 hours after vacciine

Other Meds: cymbalta, protonix, sufasucralfate, claritin, chromium picolinate, co Q 10, vitamin C, vitamin D3, acetaminophen, multivitamin, B complex, B12, magnesium fish oil, probiotics, tramadol, aobuerol inhaler

Current Illness:

ID: 1685209
Sex: F
Age: 50
State: MS

Vax Date: 09/07/2021
Onset Date: 09/08/2021
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: Strep A screen, negative Covid-19 RNA rapid, negative throat culture, no results yet CBC WBC 12.2, RBC 4.49, Hemoglobin 13.9, Hematocrit 41.4, MCV 92.2, MCH31.0, MCHC 33.6, RDW CV 13.9, Platelet 239, MPV 10, A. Neutrophil 8.1, A Lymphocyte 2.3, A. Monocyte 1.24, A Eosinphil 0.48 A. Basophil 0.07, Mono, no results yet

Allergies: latex, penicillin

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: injection site pain, tiredness, headache, muscle pain, joint pain, fever, injection site swelling, injection site redness, nausea, feeling unwell.

Other Meds: albuterol 90 mcg/actuation inhaler, cyclobenzaprine 10mg tablet, gabapentin 300 mg tablet, hydrochlorothiazide 25 mg, meloxicam 15 mg, ropinirole 2 mg, topiramate 25 mg, trazodone 100 mg, citalopram 20 mg, doxylamine-phenylephrine, Maxitrol

Current Illness: arthritis, hypertension, migraines

ID: 1685210
Sex: M
Age: 90
State: MO

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

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

Lab Data: unknown

Allergies: unknown

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

Symptoms: fever, cough, SOB, muscle aches, chills, congestion, runny nose, wheezing, poor appetite, fatigue, headache and constipation

Other Meds: unknown

Current Illness: unknown

ID: 1685211
Sex: M
Age: 27
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: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1685212
Sex: M
Age: 41
State: CA

Vax Date: 08/05/2021
Onset Date: 08/06/2021
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:

Allergies: Allergic to penicillin & ceclor

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

Symptoms: I received my first Pfizer vaccine shot on a Thursday afternoon as referenced in this report. I had no issues immediately after the shot. However, I woke in the night with an extreme case of tinnitus. I have had tinnitus for many years, but, my tinnitus issue worsened horribly just 12-13 hours after my injection. My doctor recommended waiting 3 weeks to see if my condition would improve. It has not. It's now been over a month and I am still stuck with a debilitating tinnitus hiss, and, ringing in my left ear. I am scheduled to see audiologist and ENT in the next 10 days. I am also seeking counseling to help with the mental struggle I am currently facing due to the worsening of my tinnitus.

Other Meds: Zinc, D3, Multi-Vitamin, Fish Oil

Current Illness: none

ID: 1685213
Sex: F
Age: 21
State: KY

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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: c/o itching and dizziness. 25mg PO Benadryl given. Observed for 30 minutes and then went back to work. Stated symptoms improved.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am