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: 1685265
Sex: F
Age: 50
State: MD

Vax Date: 04/01/2021
Onset Date: 04/30/2021
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 yet

Allergies: Sulfa

Symptom List: Dysphagia, Epiglottitis

Symptoms: Terrible pain from injection site extending to breast, chills, fever, exhaustion, difficulty breathing, all for about 5 days. Difficulty breathing persisted for over 2 weeks. Skipped menstrual period for 3 months, resuming in August 2021. Lingering pain left chest as of September.

Other Meds: Bystolic 10mg Singulair 10mg

Current Illness:

ID: 1685266
Sex: M
Age: 20
State: TX

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

Allergies: None

Symptom List: Anxiety, Dyspnoea

Symptoms: Patient c/o tingling and stiff muscle on left side of the neck. Feel normal after 2 minutes. Cleared by nurse on site.

Other Meds: None

Current Illness: None

ID: 1685267
Sex: F
Age: 31
State: TX

Vax Date: 09/09/2021
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: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: Arm examination, no redness or marks on arm. Per doctor, nerve is inflamed due to being hit from injection.

Allergies: Codeine

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

Symptoms: Shooting pain from wrist to inside of elbow. Inside and outside of forearm have spots that feel numb.

Other Meds: None

Current Illness: None

ID: 1685268
Sex: M
Age: 36
State: NJ

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: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Patient received a dose of expired Moderna Covid vaccine. No adverse reaction noted or reported.

Other Meds:

Current Illness:

ID: 1685269
Sex: M
Age: 62
State: TX

Vax Date: 03/04/2021
Onset Date: 03/05/2021
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: n/a

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

Symptoms: High fever (101+) for 2-3 days; body aches; lethargic; prolonged These symptoms appeared after each of my 3 injections. Additional information on the 2nd and 3rd injections are below. 2nd injection: Given on 4/6/2021; COVID19(Moderna); Moderna; 016B21A; Intramuscular; Left Arm; 2 3rd injection: Given on 8/20/2021; COVID19(Moderna); Moderna; 020F21A; Intramuscular; Left Arm; 3

Other Meds: Genvoya, gabapentin, protonix, allopurinol

Current Illness:

ID: 1685270
Sex: F
Age: 47
State: IA

Vax Date: 05/14/2021
Onset Date: 05/28/2021
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: Blood work August 10, 2021 - fine

Allergies: Penicillin, erythromycin.

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

Symptoms: Burning/ scalded tongue two weeks after second dose of vaccine. At first I thought it was a sharp broken tooth. The dentist fixed what little bit he saw, but the problem did not go away. I had my 6 month check up with the rheumatologist and he did not now what it was, so I went to my PCP, he treated me for thrush with Diflucan and a mouth rinse. Still, no relief. I went back to the dentist and he diagnosed me with burning tongue syndrome and gave me Kloonipin. I only took a quarter or half a pill once or twice a day, but it worked. Finally relief. But now the dentist wants someone else to figure it out, and the PCP doesn't know, the blood work came back fine. So I have tried acupuncture and L-lysine. Iron, and zinc. Basically if I just drink water, it's not too bad. But food and some scents seem to make it burn more. As well as stress.

Other Meds: Buspar, plaquenil, topiramate, clonazepam as needed for sleep, cyclobenzeprene, trazadone, multivitamin, vitamin c, vitamin e, vitamin d, vitamin b+, calcium, magnesium, fish oil, flaxseed oil, probiotic,

Current Illness: None

ID: 1685271
Sex: F
Age: 12
State: MI

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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: none

Allergies: no known allergies

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Customer got light headed , then vomited x 2 . Got real sleepy and cold and clammy for about 10-15 minutes. Call EMS and customer was fine by the time they arrived. She had color back to her skin and laughing. She went home with her mother

Other Meds: no known medications

Current Illness: no

ID: 1685272
Sex: F
Age: 90
State: CO

Vax Date: 02/15/2021
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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Penicillin's

Symptom List: Pharyngeal swelling

Symptoms: breakthrough covid in september

Other Meds: Albuterol HFA, Tylenol, Lyrica, Zoloft, Flovent, Premarin tab, Lidoderm patch, Myrbetriq

Current Illness: unknown - pt confused

ID: 1685273
Sex: F
Age:
State: MA

Vax Date: 08/01/2021
Onset Date: 08/22/2021
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: NA

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: On 8/21 just sore arm on 8/22 shortness of breath with pain in my back and chest pain coming and going that is still continuing as of today . I have had blood work and chest X-ray with no findings . Requesting a cat scan that was denied from my insurance. Going today to have a test done at the hospital

Other Meds: Tramadol-HRT-vit c-vit D-vit B12-Motrin -Zinc

Current Illness: NA

ID: 1685274
Sex: F
Age: 52
State: NJ

Vax Date: 03/08/2021
Onset Date: 05/06/2021
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: 2 courses of oral steroids. Prednisone 5/10-5/19. 5/28-6/6. 3 injections of steroids in my ear. 6/16, 6/24, 7/1

Allergies: Lamotrigine

Symptom List: Diarrhoea, Nasal congestion

Symptoms: 8 weeks after receiving my second dose of the Pfizer vaccine I lost a significant amount of hearing in the right ear.

Other Meds: Centrum, Gabapentin

Current Illness: None

ID: 1685275
Sex: F
Age: 35
State: PR

Vax Date: 08/09/2021
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: 1
Vax Route: SYR
Vax Site: LA

Lab Data: Normal Erythrocyte Sedimentation Rate (went well) D-dimer (not clots) COVID molecular test negative

Allergies: Iodine, cinnamon, steroids, HCL

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

Symptoms: second dose: day 1-4 nauseas, day 5 to date severe headache at all times, diarrhea, day 9 to date. Treatment: 4 September: TORADOL, September 5: Panadol, TORADOL, ADVIL, September 8: Gabapentin, Lactobacillus, PEPTIDE, SOLUMEDROL. Symptoms still remain the same.

Other Meds: Does not apply

Current Illness: No

ID: 1685276
Sex: M
Age: 54
State: NY

Vax Date: 09/09/2021
Onset Date: 09/09/2021
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 administered 1 ml of Moderna Covid Vaccine, dose is 0.5 ml, no known s/s

Other Meds:

Current Illness:

ID: 1685277
Sex: F
Age: 12
State: FL

Vax Date: 09/08/2021
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: N/A

Allergies: N/A

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

Symptoms: fever

Other Meds: Straterra 25mg Advil

Current Illness: None

ID: 1685278
Sex: M
Age: 84
State: TX

Vax Date: 03/03/2021
Onset Date: 08/31/2021
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: COVID-19 test- positive

Allergies: sulfa drugs naproxen ophthalmic bacitracin - an ointment that made my eyes swell many years ago

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

Symptoms: On 08/31/2021, muscle aches, mild headaches, temperature at its highest 100.3 within the first 2 or 3 days. On 08/30/2021 I took the COVID-19 self-test and the results were negative. I had a tele-visit with Doctor, on 09/03/2021, and I was swabbed on that same day, for the COVID-19 TEST-results were positive. By 09/05/2021, my symptoms resolved.

Other Meds: Flomax generic Tamsulosin 0.4 mg bd saw palmetto Allegra generic 180 mg od baby aspirin 81 mg od pravastatin 10 mg od Eliquis 5mg bd Toprol generic 100 mg od multivitamin

Current Illness: no

ID: 1685279
Sex: F
Age: 16
State: MA

Vax Date: 09/09/2021
Onset Date: 09/09/2021
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: N/a

Allergies:

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

Symptoms: Pt is 16yoa and received the Janssen vaccine at our clinic. Pt was asymptomatic, notification made to parents.

Other Meds:

Current Illness:

ID: 1685280
Sex: M
Age: 68
State: NM

Vax Date: 04/07/2021
Onset Date: 08/25/2021
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: Aug 25, 2021@17:05:24 FLU A NEGATIVE, FLU B NEGATIVE, RSV NEGATIVE _COVID-19 POSITIVEA*

Allergies: no known allergies

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

Symptoms: 8.25.2021 Routine covid 19 screening

Other Meds: Apixaban, Atorvastatin, Calcipotriene, Clobetasol, Lisinopril, Metoprolol, Pioglitazone, tamsulosin, Vitain D3, Zinc

Current Illness: none

ID: 1685281
Sex: M
Age: 84
State:

Vax Date: 02/10/2021
Onset Date: 08/17/2021
Rec V Date: 09/09/2021
Hospital: Y

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

Lab Data: COVID-19 PCR test positive on 8/17/2021

Allergies: no known

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

Symptoms: 8/18/2021 Admit hospital with COVID Breakthrough .Generalized weakness, cough and chest congestion for the last few days. His wife is also positive. Diagnosed with: minor COVID-19 symptoms, COVID-19 pneumonia Note: patient previously vaccinated with Pfizer COVID-19 vaccine, 2nd dose on 2/10/21. 8/19/21: Discharged

Other Meds: Allopurinol, cetirizine, finasteride, fish oil, furosemide, hydrochlorothiazide-triamterene, levothyroxine, lisinopril, omeprazole, KCL, ASA, meloxicam, metformin

Current Illness:

ID: 1685282
Sex: M
Age: 70
State: CA

Vax Date: 08/31/2021
Onset Date: 08/31/2021
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: NONE

Symptom List: Ear pain, Hypoaesthesia

Symptoms: An immunocompromised patient who had received 2 doses of Moderna, requested 3rd (booster) dose but received Pfizer COVID 19 vaccine instead

Other Meds:

Current Illness:

ID: 1685283
Sex: M
Age: 12
State: PA

Vax Date: 08/31/2021
Onset Date: 09/03/2021
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: Troponins=8.05, 8.24 and 17.10 on 9/3/21; Troponin on 9/4/21 = 9.75, 7.89 ECG 12 lead - NONSPECIFIC ST AND T WAVE ABNORMALITY is noted 2D ECHO - Patient demonstrates normal intracardiac architecture. 2. Good global myocardial performance. 3. Subacute bacterial endocarditis prophylaxis precautions not required CXR on 9/3/21 = Slightly hypoinflated lungs with no acute cardiopulmonary process. AST=77, ALT=122, NT-proBNP=146, C-Reactive Protein=47.0

Allergies: NKDA

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: 12 y/o patient was in another country for 3 months and reported receiving his second dose of the Pfizer vaccine on 8/31/2021. Patient returned home on 9/2/21, and awoke on 9/3/21 with complaints of acute midsternal chest pain - woke him from sleep, 10/10 and constant, not burning but was pleuritic. Did not improve with positioning or drinking water. Associated with nausea and palpitations and globus sensation. Denies associated dizziness, HA, syncope, cough or SOB/DOE. Unknown exactly where in the country patient received vaccine and what the lot numbers were. Dx with suspected Acute myopericarditis.

Other Meds: None known

Current Illness: None

ID: 1685284
Sex: F
Age: 70
State: WI

Vax Date: 02/10/2021
Onset Date: 06/06/2021
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: COVID-19 test x 2 negative

Allergies: None

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

Symptoms: extended chest cold (6 wks) with 1 week diarrhea and extended fatigue. Began 6/6/21 after recent travel, resolved mid July

Other Meds: Digoxin Methotrexate Solifenicin Xarelto Calcium Vitamin D Folic Acid Tylenol Benadryl

Current Illness:

ID: 1685285
Sex: F
Age: 71
State: PA

Vax Date: 04/27/2021
Onset Date: 04/30/2021
Rec V Date: 09/09/2021
Hospital: Y

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: Patient was admitted to hospital with confusion and hallucinations 3 days after receiving her 2nd dose of Moderna COVID-19 vaccine. Patient had been hospitalized at a different facility after receiving her first dose.

Other Meds:

Current Illness:

ID: 1685286
Sex: F
Age: 34
State: PR

Vax Date: 08/16/2021
Onset Date: 08/18/2021
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: No studies or laboratory test have done yet.

Allergies: Phenergan

Symptom List: Unevaluable event

Symptoms: Heavy bleeding with the presence of clots, Dark stools.

Other Meds: None

Current Illness: None

ID: 1685287
Sex: F
Age: 60
State:

Vax Date: 09/06/2021
Onset Date: 09/06/2021
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: na

Allergies:

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

Symptoms: Most unusual event was tinnitus and vertigo about 3 or 4 hours after injection. Lasted for about 5 minutes though was the worst for about a minute then got better. Others are more typical, sore arm, nausea for about the first 2 hours after injection, slight chills no fever, a little achy, feeling very fatigued for 2 days. Generally feeling off but never really bad.

Other Meds:

Current Illness:

ID: 1685288
Sex: F
Age: 48
State: GA

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: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: none

Allergies: sulfa

Symptom List: Injection site pain, Pain

Symptoms: patient was given PCV-23 after having been given PCV-23 10 months prior patient developed severe arm pain, mild weakness and erythema distal to injection site

Other Meds: Adderall, Singular, Flovent

Current Illness: N/A

ID: 1685289
Sex: M
Age: 26
State: IL

Vax Date: 09/09/2021
Onset Date: 09/09/2021
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: Uknown

Symptom List: Injection site pain, Menorrhagia

Symptoms: Patient received 2nd dose too early. First dose was on 8/23/21 and 2nd dose given today 9/9/21

Other Meds: Ukknown

Current Illness: Uknown

ID: 1685290
Sex: M
Age: 34
State: NJ

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:

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

Symptoms: Patient received a dose of expired Moderna Covid vaccine. No adverse reaction noted or reported.

Other Meds:

Current Illness:

ID: 1685291
Sex: F
Age: 62
State: NM

Vax Date: 09/02/2021
Onset Date: 09/02/2021
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: Covid-19 test 09/08/2021 Negative

Allergies: Sulfa

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Thursday p.m. : Muscle spasms, headache Friday: low-grade fever (100.8), chills, joint pain, muscle spasms and pain, headache, fatigue, general malaise, excessive sleepiness , little appetite, sore throat, extremely dry throat and sinuses, eyes, continuing until present day (9/9/2021)

Other Meds: Hydrocodone, Mesalamine, Gabapentin, Trazadone, Carvedilol, Cyclobenzaprine

Current Illness: Crohn's disease

ID: 1685292
Sex: F
Age: 60
State: NC

Vax Date: 04/08/2021
Onset Date: 07/30/2021
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: August 26, 2021 - hearing test

Allergies: none

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: I really don't know if this is related that's what I want to find out. I have developed tinnitus about 4 months after last covid vaccine. I had no symptoms before vaccine and I went to Dr on August 26, 2021 who is an ENT doctor and had tests. I have no hearing lost and nothing that should be causing the tinnitus. I read that some are experiencing tinnitus but soon after vaccination but I know with so little research this could be related.

Other Meds: multivitamin

Current Illness: none

ID: 1685293
Sex: M
Age: 15
State: CA

Vax Date: 09/08/2021
Onset Date: 09/08/2021
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: Systemic: Fainting / Unresponsive-Mild, Additional Details: Patient fainted 5 to 6 minutes after vaccination

Other Meds:

Current Illness:

ID: 1685294
Sex: M
Age: 62
State: OH

Vax Date: 03/05/2021
Onset Date: 08/19/2021
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; Biopsy; I am going to have some pre-operative testing on Monday, 13th of September - Bloodwork and EKG.

Allergies: No

Symptom List: Nausea

Symptoms: My bloodwork for a my annual exam -showed an elevated PSA - May 2021; they did an MRI and found lesions. Then they did biopsy and they discovered cancer - Prostrate - August 3rd, I think. Verified it was cancer on the August 19th. Urologist - He's the one that is going to do the operation. The operations is scheduled for the 21st of September - they will remove my prostrate. Not experiencing any symptoms.

Other Meds: Levothyroxine

Current Illness: No

ID: 1685295
Sex: F
Age: 42
State: NC

Vax Date: 08/09/2021
Onset Date: 08/12/2021
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: No testing done at this office at that time.

Allergies: NKDA

Symptom List: Injection site pain

Symptoms: 5 cm left neck mass became very noticeable fairly rapidly on Thursday three days after vaccination. left ear pain, left jugulodigastric neck mass, and headache.

Other Meds: Pantoprazole 40 mg PO QD

Current Illness: None

ID: 1685296
Sex: M
Age: 38
State: NY

Vax Date: 09/09/2021
Onset Date: 09/09/2021
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: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: patient was administered 1 ml, dose is 0.5 ml

Other Meds:

Current Illness:

Date Died: 08/23/2021

ID: 1685297
Sex: M
Age: 88
State: KY

Vax Date: 12/30/2020
Onset Date: 08/22/2021
Rec V Date: 09/09/2021
Hospital: Y

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

Lab Data: Covid positive 8-16-2021

Allergies: NKDA

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

Symptoms: Fever, cough, recent pneumonia diagnosed by chest xray.

Other Meds: Donepezil 10 mg bid, Amlodipine 5mg daily, Benazepril 10mg daily, Escitalopram 20mg daily, Furosemide 40 mg daily, Memantine HCL 10 mg bid, Multivitamin daily,

Current Illness: None

ID: 1685298
Sex: F
Age: 67
State: AZ

Vax Date: 07/25/2021
Onset Date: 07/30/2021
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: Bananas, avocado

Symptom List: Tremor

Symptoms: 8-12 days after the first injection I broke out with fever sores on the left upper lip. The same occurred after the 2nd injection and this time it was on the lower lip, right side

Other Meds: Tacrolimus, esomeprazole, simvastatin, metoprolol

Current Illness: None

ID: 1685299
Sex: F
Age: 21
State: AZ

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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: Error: Wrong Vaccine Formulation (ex. different manufact. initial and booster)-

Other Meds:

Current Illness:

ID: 1685300
Sex: F
Age: 56
State: NY

Vax Date: 05/18/2021
Onset Date: 05/18/2021
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: None known of but I have seen an allergist and a neurologist for extra insight as to why I am having this reaction.

Allergies: no

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

Symptoms: Dizzyness at time of injection; numb feet that afternoon; lung pain that Saturday, continued pins and needles ///numbness muscle weakness, and very dizzy from lying down to standing. Face felt odd, as if muscles were not fully functioning. It is now 4.5 months of continued numbness and pins & needles.

Other Meds: levothyroxine

Current Illness: group strep B

ID: 1685301
Sex: F
Age: 60
State: FL

Vax Date: 03/20/2021
Onset Date: 09/04/2021
Rec V Date: 09/09/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: Patient is a 61-year-old white female who is vaccinated with Johnson & Johnson COVID-19 vaccine. Presents to the ER with complaints of shortness of breath generalized aches and pains over the last week. She obtained a home kit in tested positive for COVID-19. She went to get Regeneron today and was told because she is hypoxic she needs to go to the ER. She was found have oxygen saturation of 86% at ER presentation. She has been home the last week. Denies any further fevers or chills. Denies any nausea vomiting. Denies loss stasis smell. No other active complaints at this time. She is a nonsmoker.

Other Meds:

Current Illness:

ID: 1685302
Sex: F
Age: 35
State: FL

Vax Date: 05/13/2021
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: IM
Vax Site: LA

Lab Data:

Allergies: amoxicillin

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: She had Pfizer vaccines on 4/22/21 and 5/13/21. She was diagnosed with COVID at an outpatient lab on 8/30/21. She was seen by her PCP and given steroids. However, SOB, cough, and wheezing got worse, so she came to ED and admitted at Hospital on 9/8/21. Hosptal day 2.

Other Meds:

Current Illness:

ID: 1685303
Sex: F
Age: 50
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: 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 came into the office for 2nd dose for the covid vaccine. It was scheduled for Moderna, but patient had Pfizer for the first dose. Patient was given moderna for the 2nd dose.

Other Meds:

Current Illness:

ID: 1685304
Sex: F
Age: 22
State: TX

Vax Date: 09/09/2021
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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Site: Pain at Injection Site-Medium, Systemic: burning pain-Medium, Additional Details: burning pain after shot given. referred to clinic NPs (2) we have on site. shot given IM at left deltoid.

Other Meds:

Current Illness:

ID: 1685305
Sex: F
Age: 39
State: VA

Vax Date: 03/11/2021
Onset Date: 04/01/2021
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: Hearing tests. June 17, 2021

Allergies: PCN, Sulfa

Symptom List: Pain in extremity

Symptoms: In the days after my second shot, my ears started to and continue to ring loudly.

Other Meds: arnuity ellipta

Current Illness:

ID: 1685307
Sex: M
Age: 55
State: IN

Vax Date: 07/17/2021
Onset Date: 07/19/2021
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: Hearing test. Slight hearing loss at high frequency. Date of exam: August 24, 2021 Doctors note: Audio with mild bilateral 4K noise notch.

Allergies: Penacillin

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

Symptoms: Tinnitus ongoing , Vertigo ongoing, pain in armpit ongoing, hand tingling injection side ongoing. Visited PCP and ENT no treatment options given. Second vaccine was Janssen lot no. 205A21A without any worsening of sxs. Date: August 26, 2021 Doctors referral notes: Tinnitus 2 days after Moderna Vaccine audio with mild bilateral 4K noise notch unsteadiness sensation with ambulation and intermittent tingling in left hand and discomfort in axilla

Other Meds: Celexa 40mg Vitamin D 3000 iu Multi Vitamin Zinc 50mg Metamucil

Current Illness: None

ID: 1685308
Sex: F
Age: 42
State: CA

Vax Date: 09/04/2021
Onset Date: 09/04/2021
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: I received my shot at about 1 p.m. on Sept. 4, at a pharmacy. When I returned home, I began noticing unusual brain fog and fatigue around 5 p.m., which quickly led to dizziness and fainting. Once the dizziness and fainting occurred, I began sweating profusely. I laid down in front of a fan and increased hydrating with water and juices. I continued to experience brain fog and mild light headedness the following day (Sept. 5), before it seemed to subside later that evening.

Other Meds:

Current Illness:

ID: 1685309
Sex: M
Age: 71
State: NY

Vax Date: 09/03/2021
Onset Date: 09/03/2021
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: Error: Wrong Vaccine Formulation (ex. different manufact. initial and booster)-

Other Meds:

Current Illness:

ID: 1685310
Sex: F
Age: 49
State: OK

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

Lab Data: See above

Allergies: pneumonia vaccine (arm swelling)

Symptom List: Vomiting

Symptoms: Patient reported tongue soreness and swelling of face. Her pulse was first checked about 15 minutes after administration and was 76 beats per minute. Her blood pressure was checked and found to be 162/86 with pulse of 87 at that time. Repeat blood pressure was 168/72 with pulse of 74. She says she was tingly and dizzy. She was checked by EMT and was allowed to leave after checking out ok.

Other Meds: No known

Current Illness: no known

ID: 1685311
Sex: F
Age: 36
State: NC

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: SYR
Vax Site: LA

Lab Data: None

Allergies: None

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Approximately 10 minutes post-vaccination the patient described her throat being itchy and some difficulty swallowing. She was immediately given diphenhydramine 25 mg x 1 dose and then monitored for the next 4 hours. Her symptoms resolved quickly and had no more complaints. She did report a previous food allergy and carries an Epi-Pen for this issue. She did not report the specific food.

Other Meds: buspirone 15 mg BID, propranolol 40 mg BID, paroxetine 20 mg daily, pregabalin 75 mg daily

Current Illness: No

ID: 1685312
Sex: F
Age: 28
State: FL

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

Lab Data:

Allergies:

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

Symptoms: Systemic: Chest Tightness / Heaviness / Pain-Severe, Systemic: Numbness (specify: facial area, extremities)-Severe

Other Meds:

Current Illness:

ID: 1685313
Sex: M
Age: 71
State: MN

Vax Date: 04/08/2021
Onset Date: 08/26/2021
Rec V Date: 09/09/2021
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: None stated.

Other Meds:

Current Illness:

ID: 1685314
Sex: F
Age: 14
State: VA

Vax Date: 08/11/2021
Onset Date: 08/11/2021
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:

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

Symptoms: Error: Patient Too Young for Vaccine Administered-

Other Meds:

Current Illness:

Date Died: 09/08/2021

ID: 1685315
Sex: F
Age: 72
State: KY

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

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

Lab Data:

Allergies:

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

Symptoms: Patient admitted to COVID floor on 8/25/21 for acute hypoxic respiratory failure secondary to bilateral pneumonia COVID-19. She was initiated on dexamethasone and remdesivir. Pulmonology consulted 8/31 for worsening hypoxemia, on heated high-flow nasal cannula and alternating with noninvasive positive pressure ventilation. On 09/02 patient was transferred to the COVID19 ICU for worsening respiratory status. Patient requested multiple times to delay intubation and maintain on AVAPS. She did have a feeding tube placed and was receiving tube feeds. She essentially became dependent on noninvasive ventilation unable to wean. She did attempt self proning with some improvement in her oxygenation. This morning, patient's oxygen saturations dropped to 60s with increased work of breathing despite noninvasive ventilation and self proning. Discussed with patient again and she was agreeable to being intubated and family agreed. Patient sedated and intubated, unfortunately shortly after intubation patient had a PEA arrest and Code Blue called. See previous note for details. Ultimately, after multiple rounds of CPR, epinephrine, defibrillations without persistent return of spontaneous circulation and approx 35 minutes resuscitation efforts, all resuscitation efforts stopped and time of death called at 08:07am.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am