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

Date Died: 09/03/2021

ID: 1685567
Sex: M
Age: 85
State: WI

Vax Date: 08/12/2021
Onset Date: 08/29/2021
Rec V Date: 09/09/2021
Hospital: Y

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

Lab Data:

Allergies: None

Symptom List: Dysphagia, Epiglottitis

Symptoms: On 8/29/2021, decedent presented to the ER with a three day duration of worsening shortness of breath. He was admitted to the hospital and discharged home on 9/1/2021 with COVID pneumonia.

Other Meds: aspirin,lipitor, vitamin B, iron, midodrine, potassium, gluconate, brilinta, vitamin D, nitro

Current Illness:

ID: 1685568
Sex: F
Age: 82
State: IL

Vax Date: 08/26/2021
Onset Date: 09/01/2021
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: none

Allergies: NKDA, NKFA, NKA

Symptom List: Anxiety, Dyspnoea

Symptoms: 1 week after 3rd dose, pt developed shingles rash/herpes zoster to left forehead (same place she has had shingles in the past)

Other Meds: alprazolam, b12, clonazepam, enalipril, escitalopram, levothyroxine, magnesium, potassium chloride, pravastatin, prednisone, probiotic, turmeric, verapamil, vitamin c, d, zinc, algeaceal anstrontium boost supplement

Current Illness: none

ID: 1685569
Sex: M
Age: 50
State: FL

Vax Date: 03/12/2021
Onset Date: 08/14/2021
Rec V Date: 09/09/2021
Hospital: Y

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: Tested positive for Covid on 8/14/21 prior to admission.

Allergies: nkda

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

Symptoms: 8/18/21: History: patient had recent COVID-19 diagnosis on initial ER visit on 8/14. At that time he was experiencing general malaise, fatigue, fever, cough, and mild congestion. He had f/u ED visit on 8/16 w/ no hypoxia observed but then returned to the ED 8/18 w/ complains of worsening SOB and dyspnea. Admitted 8/18/21. Had J&J Covid-19 vaccine on 3/12/21. Diagnosed with COVID-19 viral pneumonia, acute hypoxic respiratory failure. 9/9/21: patient still admitted at the time of this report submission

Other Meds: amlodipine, benzonatate, chlorthalidone, losartan, rosuvastatin, ergocalciferol, albuterol, promethazine-dextromethorphan oral syrup

Current Illness:

ID: 1685570
Sex: M
Age: 71
State: NC

Vax Date: 02/25/2021
Onset Date: 05/18/2021
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: Ultrasound

Allergies: N/A

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Three months after taking the 2nd dose, I developed a blood clot on my left leg. I was prescribed with Eliquis, a blood thinner. Also, my blood pressure decreased to a very low state. Recently my blood pressure has improved, but I am still dealing with the blood clot.

Other Meds: Olmesartan 40 mg; Indapamide 2.5 mcg; Jentadueto 2.5 mg; Atorvastatin 20 mg; Levothroid 125 mcg; Dexilant 60 mg; Cialis 5 mg; Prednisone 7.5 mg; Vitamin D

Current Illness: N/A

ID: 1685571
Sex: F
Age: 44
State: MI

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: none

Allergies: lidocaine patch., hydromorphone,zomig,, dilaudid

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

Symptoms: total boddy incthing, partailly treated with benadrly , no hives or other symptoms

Other Meds: addrerolcymbalta,zesteril, valtrex

Current Illness: unknown

ID: 1685572
Sex: F
Age: 31
State: NM

Vax Date: 04/07/2021
Onset Date: 08/30/2021
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: Aug 30, 2021@13:40 FLU A (CEPHEID) NEGATIVE, FLU B (CEPHEID) NEGATIVE, RSV (CEPHEID) NEGATIVE _COVID-19 (CEPHEID) POSITIVEA*

Allergies: No known allergies

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

Symptoms: congestion & throat irritation.

Other Meds: None

Current Illness: None

ID: 1685573
Sex: M
Age: 58
State:

Vax Date: 04/29/2021
Onset Date: 05/01/2021
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: CBC NO DIFFERENTIAL; ELECTROLYTE PANEL (NA, K, CL, CO2); BUN; CREATININE; GLUCOSE; PT AND INR; APTT; predniSONE (DELTASONE) 10 mg Oral Tab; Famotidine (PEPCID) 40 mg Oral Tab

Allergies: Penicillin, shrimp

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Extensive hives across legs, arms, torso.

Other Meds:

Current Illness:

ID: 1685574
Sex: M
Age: 24
State: CA

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data: asked for primary doctor info to notify MD, and patient had none.

Allergies: no

Symptom List: Pharyngeal swelling

Symptoms: Third dose was given to patient by accident, patient was feeling well when he left the pharmacy.

Other Meds: no

Current Illness: no

ID: 1685575
Sex: M
Age: 47
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Patient received expired dose of moderna covid vaccine on 9/8/21. No adverse reaction noted or reported

Other Meds:

Current Illness:

ID: 1685576
Sex: F
Age: 58
State:

Vax Date: 09/04/2021
Onset Date: 09/06/2021
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:

Allergies: Aspirin

Symptom List: Diarrhoea, Nasal congestion

Symptoms: hives/rash constant Benadryl may need steroids

Other Meds: n/a

Current Illness: n/a

ID: 1685577
Sex: M
Age: 56
State: IL

Vax Date: 06/09/2021
Onset Date: 06/12/2021
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:

Allergies:

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

Symptoms: Three days after getting the shot, a sudden and continuous ringing in both ears began. Sought treatment from an Audiologist to no effect. Still have the ringing in my ears to this day.

Other Meds: Amlodipine Benazerpril/ Metoprololsucc er

Current Illness:

ID: 1685578
Sex: M
Age: 42
State: AL

Vax Date: 08/18/2021
Onset Date: 08/27/2021
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: Sulfa

Symptom List: Rash, Urticaria

Symptoms: Shingles outbreak left cervical region

Other Meds: Claritin

Current Illness:

ID: 1685579
Sex: F
Age: 23
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Latex allergy and kiwi allergy

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

Symptoms: Diarrhea, fever, sweats and chills, extreme body ache and headaches, light headed ness, feels like I?m not getting a full breath while breathing in. Felt as though I was going to pass out multiple times. I took Tylenol for my fever but it didn?t help. This has been going on for almost 2 days

Other Meds: Omeprazole, Gabapentin

Current Illness:

ID: 1685580
Sex: F
Age: 27
State: FL

Vax Date: 06/04/2021
Onset Date: 08/18/2021
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: SYR
Vax Site: LA

Lab Data: Tested positive for Covid on 8/18/21

Allergies: nka

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

Symptoms: 8/18/21: presents to the ED with tingling of left extremities since 10 am this morning. Per the patient, she tested positive for Covid-19 this weekend, but is currently feeling better. She adds that she is fully vaccinated (4/16/21 & 6/4/21). However, this morning she developed tingling in her left fingers and toes that has now started to progress to her mid arm and shin on her left side. The patient denies fever, loss of sensation, loss of movement, or any further complaints. the course/duration of symptoms is worsening. Location: Left upper extremity lower extremity. The character of symptoms is tingling. Was treated for r/o CVA. No covid related diagnosis or treatment. Discharged to home 8/19/21.

Other Meds: albuterol, norgestimate-ethinyl estradiol (Sprintec)

Current Illness:

ID: 1685581
Sex: M
Age: 55
State: CA

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:

Allergies:

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

Symptoms: patient was given the moderna vaccine and was supposed to be getting a flu vaccine

Other Meds:

Current Illness:

ID: 1685582
Sex: F
Age: 45
State: IA

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

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

Symptoms: Pt received the Moderna series, after having had the J&J 3/9/2021. Pt received her 1st dose 8/6/21, 2nd dose 9/7/21. Both given.

Other Meds: Vyvanse, Citalopram, Crestor, Megestrol and Loratadine.

Current Illness:

ID: 1685583
Sex: F
Age: 51
State: IN

Vax Date: 03/26/2021
Onset Date: 03/27/2021
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: none

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

Symptoms: The morning after the first dose i woke up dizzy. It subsided during the day, but returned that night upon lying down in bed. This reoccurred every morning and night for well over a month and after the second dose. It would subside during the day, but i did have periods of lightheadedness during the day. These still occur every so often. I had never had this issue before. After the second dose i had a rash on parts of my arms and legs that i had never experienced before either. It looked like tiny little bites all clustered but was not any kind of bug bite. None of the spots were severe, but they itched like mad and would appear randomly in different parts of limbs. This lasted maybe a week or two. I took an over-the-counter allergy pill for a few days and it subsided. I still get the occasional bump, but they are not as itchy nor do they last as long. The last thing to happen is the almost chronic joint pain, especially in my hips. I have worked on my feet for almost 40 years and have never had issues with my hips. They just ache and this was a sudden onset, not gradual (as would be expected with aging) and is different than mere pain from workload. This is the most bothersome and my fiance even said he has never heard me complain about the pain as much as i have lately. I take an Aleve almost everyday, where i used to only take one occasionally for lower back pain.

Other Meds: levothyroxin, daily vitamins, calcium/D/C/zinc

Current Illness: none

Date Died: 08/18/2021

ID: 1685584
Sex: M
Age: 81
State: TN

Vax Date: 01/08/2021
Onset Date: 08/15/2021
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:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: SOB, positive COVID test, productive cough, current lung CA

Other Meds:

Current Illness:

ID: 1685585
Sex: F
Age: 53
State: NC

Vax Date: 08/29/2021
Onset Date: 09/02/2021
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: ultrasound; CT scan; chest x-ray

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: I start sweating all over like had fever but I didn't. I was vomiting. Had really bad back and stomach pain. I went to the ER. They did an ultrasound, CT scan, and a chest x-ray. They said I had inflamed small intestines.

Other Meds: Rosuvastatin 20mg 1xday, Metformin 500mg 4xday, Metoprolol 50mg 1xday, Hydrochlorothiazide 12.5mg 1xday, fish oil 1000 unit, vitamin D 500 unit, Aspire 80mg 1xday

Current Illness:

ID: 1685586
Sex: F
Age: 47
State: OR

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

Allergies: Flu shot; pneumonia shot; restoril; Cefzil; Augmentin; Iodine; Eggs; Mushrooms; Truffles; Dates; Sulfa; Morphine

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

Symptoms: difficulty breathing, fever, aching all over, swelling of tongue and lips within 15 minutes of administration

Other Meds: Lisinopril; Protonix; Celexa; Singulair

Current Illness: None

ID: 1685587
Sex: F
Age: 61
State: FL

Vax Date: 04/01/2021
Onset Date: 09/08/2021
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: COVID PCR test ran and was positive on 9/8/2021.

Allergies:

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

Symptoms: Patient presented to hospital with URI symptoms, fever, myalgia, fatigue, and diarrhea.

Other Meds:

Current Illness:

ID: 1685588
Sex: M
Age: 35
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: Patient received expired dose of moderna covid vaccine on 9/8/21. No adverse reaction noted or reported

Other Meds:

Current Illness:

ID: 1685589
Sex: U
Age: 71
State: MO

Vax Date: 02/01/2021
Onset Date: 07/31/2021
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 test

Allergies: Penicillin

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

Symptoms: Covid.

Other Meds: No

Current Illness: No

ID: 1685590
Sex: F
Age: 66
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: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Patient came in and asked for vaccine without telling of previous vaccines being pfizer. They left the store after being given the shot then came back with their vaccination card to be filled out. Upon examining the card we found out that the previous doses were pfizer and not moderna.

Other Meds:

Current Illness:

ID: 1685591
Sex: M
Age: 53
State: UT

Vax Date: 07/26/2021
Onset Date: 07/26/2021
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: Chest X-Rays 07/27/2021 EKG 07/27/2021

Allergies: N/A

Symptom List: Injection site pain, Menorrhagia

Symptoms: Pt. states that after receiving the 2nd dose of Moderna 07/26/2021, started experiencing symptoms immediately of flu-like symptoms, achy, and severe chest pains. Urgent Care visit 07/27/2021, Chest X-Rays, EKG. Recommendations for Follow-Up with Specialist. No noted appt. Symptoms have subsided.

Other Meds: N/A

Current Illness: N/A

ID: 1685592
Sex: F
Age: 43
State: CA

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

Lab Data: n/a

Allergies: n/a

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

Symptoms: pain and muscular aches, fever, chills, sweats, loss of appetite, fatigue, soreness and saelling at site of injection

Other Meds: n/a

Current Illness: n/a

ID: 1685593
Sex: F
Age: 27
State: AZ

Vax Date: 03/31/2021
Onset Date: 06/18/2021
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: June 10 - vaginal ultrasound

Allergies: Cephalexin

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Blighted ovum (miscarriage); found out I was pregnant on May 8, 2021; learned of blighted ovum via vaginal ultrasound on June 10, 2021; completed miscarriage on June 18th, 2021; menstrual cycle returned on July 23rd, 2021.

Other Meds: Xyzal (not taken on vaccination days)

Current Illness:

ID: 1685594
Sex: F
Age: 24
State: NM

Vax Date: 07/15/2021
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: Aug 30, 2021@13:38:07 FLU A NEGATIVE, FLU B NEGATIVE, RSV NEGATIVE _COVID-19 POSITIVE

Allergies: Peanuts

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Felt Feverish, Dry Cough, Headaches, Lost Taste and Smell, Diarrhea, Other Fatigue, nasal congestion.

Other Meds: None

Current Illness: none

ID: 1685595
Sex: M
Age: 37
State: NY

Vax Date: 08/31/2021
Onset Date: 08/31/2021
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

Allergies: penecillin

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

Symptoms: Janssen COVID-19 Vaccine EUA -Onset of fever (101.9 F) approximately 9 hours after vaccine. Fever lasted for about 10 hours. After fever, severe muscle aches/tightness and lethargy for another 12 hours. -Side effects resolved fully within 24 hours. -On 9th day after vaccine, sudden onset of severe dizziness, lightheadedness, tiredness, diarrhea. Diarrhea lasted about 4 hours. Other symptoms continue.

Other Meds: Multi-vitamin, vitamin c, vitamin d, baby aspirin

Current Illness: none

ID: 1685596
Sex: M
Age: 82
State: MO

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

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

Lab Data: unknown

Allergies: unknown

Symptom List: Nausea

Symptoms: unknown

Other Meds: unknown

Current Illness: unknown

ID: 1685597
Sex: M
Age: 60
State:

Vax Date: 05/20/2021
Onset Date: 06/14/2021
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: Patient presented to the ED and was subsequently hospitalized for suicidal ideation within 6 weeks of receiving COVID vaccination.

Other Meds:

Current Illness:

ID: 1685598
Sex: M
Age: 74
State: FL

Vax Date: 02/04/2021
Onset Date: 09/07/2021
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 PCR test done, on9/7/21 and was positive.

Allergies:

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

Symptoms: Patient presented to facility with respiratory distress, SOB. Patient admitted from nursing home. Has left sided Pneumonia.

Other Meds:

Current Illness:

ID: 1685599
Sex: F
Age: 65
State: LA

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: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data: None at the time of this report.

Allergies: Iodine, Sulfa drugs, Seafood

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

Symptoms: Raised itchy rash on neck and in corners of both eyes. On second day started antihistamine ( Claritin) .

Other Meds: Valsartan, Allopurinol, Bisprolol, Synthroid, Omeprazole, Flonase

Current Illness: None

ID: 1685600
Sex: M
Age: 35
State: PA

Vax Date: 08/30/2021
Onset Date: 08/31/2021
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: None

Symptom List: Tremor

Symptoms: 102 degree F fever lasting about 20hrs, joint pain lasting multiple days, severe tiredness for about 20hrs, loss of muscle strength in left arm lasting multiple days, tenderness at injection site lasting multiple days

Other Meds: Eliquis and amitriptline

Current Illness: None

ID: 1685601
Sex: M
Age: 75
State: IN

Vax Date: 09/01/2021
Onset Date: 09/01/2021
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: certain statins

Symptom List: Erythema, Pruritus

Symptoms: Sore arm. ever 100.5. Aches and pains

Other Meds: Nofedipine, plavix, edoxaban, glipizide, bupoprion, mirtazapine

Current Illness:

ID: 1685602
Sex: F
Age: 33
State: IL

Vax Date: 04/01/2021
Onset Date: 09/02/2021
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: 9/2/2021 COVID19 PCR test positive

Allergies: NKA

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

Symptoms: Patient tested positive for COVID 9/2/2021, breakthrough infection Fever 101.7, sore throat, body aches

Other Meds: unknown

Current Illness: unknown

ID: 1685603
Sex: M
Age: 69
State: NC

Vax Date: 03/05/2021
Onset Date: 07/01/2021
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: a lot of test were done

Allergies: codeine

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

Symptoms: Sometime in July, I went to Hospital, I was in the heart and vascular area of the hospital. My wife tells me I was lethargic, I was talking out of my head. They found bleeding in my stomach when I was in the hospital. And Chronic Heart Failure. They gave me medication, Lasix, to reduce the fluid. I was in the hospital for 7 days.

Other Meds: 81 mg Aspirin od Lipitor40 mg od clonidine 0.1 mg od Clavix 75 mg od diltiazem 180 mg od ferrous gluzonate 324 mg od furosemide 40 mg od norco 10-325 mg prn hysingla ER 20 mg od magnesium oxide 400 mg od melatonin 20 mg tablets od metform

Current Illness: no

ID: 1685604
Sex: F
Age: 45
State: OK

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: IM
Vax Site: LA

Lab Data: None at this time. Did see urgent.

Allergies: Morphine Benzoin Adhesives Steri strips Eggs Milk Essential oils

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Swelling in throat, itching on face and scalp, severe headache, pain behind right eye, burning/tingling in nose, light headed, and back pain. Ibuprofen and Benadryl taken. Still having symptoms...

Other Meds: Ibuprofen viviscal glucosamine chondroitin vitamin D3 docusate estradiol adderall aimovig bupropion venlafaxine folic acid methotrexate hydroxychloroquine xeljanz

Current Illness: none

ID: 1685605
Sex: M
Age: 38
State:

Vax Date: 05/13/2021
Onset Date: 05/18/2021
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: SYR
Vax Site: LA

Lab Data: COVID + 8/19/2021

Allergies: seafood, sulfonamides

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

Symptoms: 8/18/21: Admitted for CF exacerbation. tested positive for COVID on 8/19. History of pseudomonas and multidrug-resistant achromobacter culture last year. COVID exposure a few weeks ago and tested negative for COVID-19 last week, feeling sick for past 2 days with increasing cough and yellow sputum. Previously vaccinated with Pfizer COVID-19 vaccine: 1st vaccine 4/22/2021, second 5/13/2021. Diagnosed with CF exacerbation, COVID-19 pneumonia with hypoxia, bronchiolitis 8/26/21: discharged

Other Meds: Creon, TOBI/colistin.

Current Illness: Cystic Fibrosis

ID: 1685606
Sex: M
Age: 60
State: TN

Vax Date: 05/17/2021
Onset Date: 05/18/2021
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: codeine, penicillin

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

Symptoms: continuous ringing in his ear

Other Meds: no

Current Illness: no

Date Died: 04/23/2021

ID: 1685607
Sex: M
Age: 58
State:

Vax Date: 04/07/2021
Onset Date: 04/11/2021
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: LA

Lab Data: ekg - normal

Allergies:

Symptom List: Pain in extremity

Symptoms: chest tightness, shortness of breath after walking short distances, on 23rd collapsed at work and died

Other Meds: predaxa, crestor, matopolol

Current Illness:

ID: 1685608
Sex: M
Age: 42
State:

Vax Date: 08/01/2021
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: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: none

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

Symptoms: Chest pain, irregular heart beat, palpitations.

Other Meds: none

Current Illness: none

ID: 1685609
Sex: F
Age: 56
State: WI

Vax Date: 05/06/2021
Onset Date: 07/30/2021
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: 7/30/2021 CXR - possible infiltrate 7/26/2021 Covid 19 detected per PCR 8/9/2021 CT - ground glass opacities

Allergies: unknown

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

Symptoms: Presented to ED on 7/30/2021 with cough, chest pain, shortness of breath, abdominal pain and diarrhea, hypoxia and tachycardia. -s/p Decadron 10 mg IV in ER, continue Decadron 10 mg x2 doses, then transition to 6 m g x7 pending course, Supportive cares, Antioxidant vitamins, Contact and Droplet precautions, Wean O2 as tolerated, Trend inflammatory markers, D-Dimer elevated to 981, will assess for PE with CT:PE She was discharged to home 8/2/2021. She presented again to the ED on 8/9/2021 with persistent SOB and cough. Patient was given albuterol inhaler, IV fluids, dose of Decadron. She went home with telemedicine/pulse oximetry home monitoring program Submitter does not have access to further detailed medical records or follow up information. If this information is required, please contact Hospital.

Other Meds: unknown

Current Illness: unknown

ID: 1685610
Sex: F
Age: 26
State: MI

Vax Date: 08/30/2021
Onset Date: 09/01/2021
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: benadrly improve the itchiness.

Allergies: none

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

Symptoms: 2 days after vaccine, rash described as large mosquito bites will occure anywhere on her body resolve within 24 hours only to return in a different area. have occurred on palms and head as well as most other areas

Other Meds: vit d3 with calcium, prenatal vit.

Current Illness: none

ID: 1685611
Sex: M
Age: 52
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: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: Patient received an expired Moderna covid vaccine on 9/8/21. No adverse reaction reported or noted.

Other Meds:

Current Illness:

ID: 1685612
Sex: F
Age: 19
State: TN

Vax Date: 03/06/2021
Onset Date: 06/26/2021
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: SYR
Vax Site: LA

Lab Data: blood clot on lung

Allergies: seasonal allergies and melons

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: swelling in left arm, headache, extreme dizziness, nausea, fever

Other Meds: surtuleen , loryna, hydroxoline

Current Illness:

ID: 1685613
Sex: M
Age: 85
State: IL

Vax Date: 01/21/2021
Onset Date: 08/31/2021
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: COVID -19 rapid result positive 9/8/2021

Allergies: Penicillin, Ragweed

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

Symptoms: Presented to Emergency Room with shortness of breath and decreased O2 sats on pulse oximetry. Recently treated at Hospital twice over the past month. Received Ceftriaxone and Azithromycin at Hospital from 8/31-9/7/2021 for Pneumonia.

Other Meds: Abiraterone Acetate, Apixaban, Clonazepan, Ditiazem, Advair, Lopressor, Remeron, Pravastatin, Prednisone, Ramelteon

Current Illness:

ID: 1685614
Sex: F
Age: 68
State: TX

Vax Date: 03/01/2021
Onset Date: 08/16/2021
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: Sulfa

Symptom List: Injection site swelling, Limb discomfort

Symptoms: I tested positive for covid 19 on aug, 19th 2021 Coughing Headache Chills Fever Body aches Shortness of breath Extreme fatigue Loss of smell and taste

Other Meds: Xycal Prozac Singular Lorazepam Flonase Vitamins

Current Illness: None

ID: 1685615
Sex: M
Age: 34
State: FL

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: RA

Lab Data:

Allergies: latex

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

Symptoms: fainted/felt woozy after shot was given, patient laid down on bench in pharmacy, elevated legs and gave ice pack, patient came to and was ok, he was talking with us, we stayed with him the whole time and talked to him, we called his girlfriend and she came and picked him up, he stayed in the pharmacy about 45 mins, we advised girlfriend to monitor him the rest of the day and if symptoms/patient not feeling better, go to ER, patient stated that he felt better when he left

Other Meds: medical marijuana

Current Illness:

ID: 1685616
Sex: F
Age: 49
State: TX

Vax Date: 08/12/2021
Onset Date: 08/13/2021
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: no

Allergies: iodine and morphine

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

Symptoms: the next day in the am headache and nausea , diareahhe ,on the 14aug on migraine meds. every day after you had headaches. Headache did not go away. Everything ended 2 days later except the headache

Other Meds: centrium - multivitamins, effexorxr -150 milligram, gabapentin 300milligrams, amlodipine , metoprolol tartrate and protonix - 40 milligram

Current Illness: no

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am