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**
PLEASE CHECK BACK SOON
Download the files above while you wait.







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: 1688662
Sex: M
Age: 68
State: VA

Vax Date: 08/11/2021
Onset Date: 08/11/2021
Rec V Date: 09/10/2021
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: None

Symptom List: Dysphagia, Epiglottitis

Symptoms: Grade 3 Arm pain, Grade 3 rash. Lasted severe for 3 days and soreness still there 4 weeks later.

Other Meds: None

Current Illness: None

ID: 1688663
Sex: F
Age: 63
State: FL

Vax Date: 03/22/2021
Onset Date: 04/02/2021
Rec V Date: 09/10/2021
Hospital: Y

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

Lab Data: Labwork, covid test-positive, CXR.

Allergies: PCN

Symptom List: Anxiety, Dyspnoea

Symptoms: Pt came to ER c/o cough onset 5 days ago.

Other Meds:

Current Illness:

ID: 1688664
Sex: F
Age: 36
State: IN

Vax Date: 09/09/2021
Onset Date: 09/09/2021
Rec V Date: 09/10/2021
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: Sulfa

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

Symptoms: Extreme muscle spasms and pain at injection site 30 minites after shot was administered. Couldn't move vaccinated arm the next morning.

Other Meds:

Current Illness:

ID: 1688665
Sex: M
Age: 84
State: MI

Vax Date: 04/27/2021
Onset Date: 08/24/2021
Rec V Date: 09/10/2021
Hospital: Y

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

Lab Data: SARS-CoV-2 RNA = DETECTED on 9/7/21

Allergies: none known

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: severe fatigue, cough, fever increasing over 2 weeks, hypoxic at ER presentation requiring oxygen. Admitted for further care and treatment

Other Meds: Flomax Synthroid

Current Illness: unknown

ID: 1688666
Sex: F
Age: 63
State: NY

Vax Date: 09/04/2021
Onset Date: 09/06/2021
Rec V Date: 09/10/2021
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: Sulfa drugs, opioid medications,

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

Symptoms: Severe dizziness, onset early a.m. Monday September 6th, 2021 and continued through Wednesday September 8th, 2021. Lack of appetite during same time frame.

Other Meds: Vitamin D3, Mag 64, 81 MG Aspirin, 0.5 mg ClonazePAM, Trelegy Elipta, Levealbuterol, Calcium, Ezetimibe, CoQ10, Famotidine, Buspirone, Livalo,

Current Illness: COPD, severe osteoporosis, fractured T8 vertebrae, GERD

ID: 1688667
Sex: F
Age: 28
State: PA

Vax Date: 09/03/2021
Onset Date: 09/06/2021
Rec V Date: 09/10/2021
Hospital:

Vax Type: FLUC4
Manufacturer: SEQIRUS, INC.
Vax Name: INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT)
Lot: 276563
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Levaquin

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

Symptoms: Unexplainable itchy hands without bumps or rashes. It feels extremely itchy but when scratched it is unsatisfying and still feels itchy. Kind of hard to explain so I hope you?ll understand.

Other Meds: Junel 24 (birth control)

Current Illness:

ID: 1688821
Sex: F
Age: 71
State: WI

Vax Date: 09/02/2021
Onset Date: 09/03/2021
Rec V Date: 09/10/2021
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: Pyrexia, White blood cell count decreased

Symptoms: Lower Facial swelling under the nose. Given Benadryl and Antihistamine every 6 hours for several days. Four days later swelling went down.

Other Meds: None

Current Illness: None

ID: 1688822
Sex: F
Age: 63
State: OH

Vax Date: 09/07/2021
Onset Date: 09/07/2021
Rec V Date: 09/10/2021
Hospital:

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

Lab Data: None

Allergies: PCN

Symptom List: Pharyngeal swelling

Symptoms: Edema of left axilla, pain in left breast @ 2 a.m. which has continued following injection, ecchymosis along the left lymphatic system from left axilla, medial aspect of left breast, and anterior medial aspect of left arm which began 2nd day. Other symptoms included headache, back pain, rigors, fever, diaphoresis, chills, and myalgia.

Other Meds: Motrin

Current Illness: None

ID: 1688823
Sex: M
Age: 34
State: AZ

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

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

Lab Data: Lipase 127

Allergies: None

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Chest Pain developed one hour after administration. Labs and Imaging completed in the ED. Admitted to observation for pancreatitis.

Other Meds: Metformin, Insulin Detemir, Gemfibrozil, Fenofibrate

Current Illness: COVID-like symptoms 08/13/2021

ID: 1688824
Sex: F
Age: 61
State: IN

Vax Date: 02/03/2021
Onset Date: 02/13/2021
Rec V Date: 09/10/2021
Hospital:

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

Lab Data: n/a

Allergies: Tylenol, Biaxin

Symptom List: Diarrhoea, Nasal congestion

Symptoms: I woke up in the morning with extreme swelling on the right side of my tongue. About a week after my vaccine. I didn't contact my DR, I initiated a telehealth appointment with my insurance and that DR told me to go to the emergency room so that is what I did. If I remember right, they gave me a steroid shot.

Other Meds: Not comfortable giving that information.

Current Illness: n/a

ID: 1688826
Sex: F
Age: 29
State: IN

Vax Date: 08/31/2021
Onset Date: 09/02/2021
Rec V Date: 09/10/2021
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: Sulfa

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

Symptoms: I previously had the COVID virus in December of 2020. I drew antibody titers in May and had high level of antibodies (I believe the result was 186 ng/dL). I received the vaccine on Tuesday 8/31 at 1:30 pm. By that evening I felt like a truck ran over my whole body, the joint pain was very intense. (Immunologic storm) It started getting better by the afternoon that next day, sore arm for 3 days. That next day is when I first start leaking amniotic fluid, more noticeable Thursday and definitely larger gushes by Friday. I ended up in preterm labor and gave birth to my baby at 34+4 weeks. My original due date was 10/15/2021. Baby?s birth weight 4 lb 7 oz

Other Meds: 156 mg aspirin Prenatal vitamin

Current Illness: N/A

ID: 1688827
Sex: M
Age: 70
State: NJ

Vax Date: 03/02/2021
Onset Date: 09/09/2021
Rec V Date: 09/10/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data: SARS-CoV-2 Antigen (+) on 9/9/2021

Allergies: Meperidine, tincture of benzo

Symptom List: Rash, Urticaria

Symptoms: The patient is a 70 year old male with PMH including HTN, HLD, and NIDDM2. He was sent to the ED by his PCP for possible monoclonal antibody infusion. In the ED, he was noticed to be hypoxic with a saturation of 87% on R/A and required oxygen. He did test positive for Covid-19. He received the Moderna vaccine in January/February 2021. His inflammatory markers were elevated and CXR showed bilateral infiltrates. He recieved decadron IV and IVF and he is admitted to the medical floors.

Other Meds: amLODIPine 10 mg Tablet Directions: 1 tablet oral daily every morning (Active) aspirin (Aspirin Childrens) 81 mg tablet,chewable Directions: 1 tablet oral daily every morning (Active) empagliflozin-metformin (Synjardy XR) 12.5 mg-1,00

Current Illness:

ID: 1688828
Sex: M
Age: 38
State: VT

Vax Date: 08/27/2021
Onset Date: 08/31/2021
Rec V Date: 09/10/2021
Hospital:

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

Lab Data: Electrolyte count, glucose test, kidney function, Covid test, bloood panel

Allergies: Cephalosporins Penicillin

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

Symptoms: Dizzyness, lightheaded, fainting, vomiting, blurred vision, extreme full body pain, extreme cramping, multiple joints locked up causing a temporary but frequent inability to move, reduced range of motion, elevated blood pressure

Other Meds: Lisinopril Metoperal Daily Vitamin & Mineral

Current Illness:

ID: 1688829
Sex: M
Age: 51
State: VA

Vax Date: 08/31/2021
Onset Date: 08/31/2021
Rec V Date: 09/10/2021
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: None.

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

Symptoms: Patient became dizzy, lightheaded and felt faint within 2-3 minutes following injection. After being seated, patient continued to feel faint but did not lose consciousness. Patient slowly recovered over the next 10-20 minutes.

Other Meds: None.

Current Illness: None.

ID: 1688830
Sex: F
Age: 89
State: FL

Vax Date: 01/16/2021
Onset Date: 04/30/2021
Rec V Date: 09/10/2021
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: Covid test, cxr

Allergies: Phenobarbital, sulfa drugs

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

Symptoms: Pt came to ER c/o weakness, lack of stamina.

Other Meds:

Current Illness:

ID: 1688831
Sex: F
Age: 41
State: KY

Vax Date: 09/07/2021
Onset Date: 09/08/2021
Rec V Date: 09/10/2021
Hospital:

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

Lab Data: none

Allergies: NKDA

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

Symptoms: About 12 hours after vaccine my arm pit was hurting and that evening I noticed swelling in my axillary area and extended into my upper chest and neck area and chest wall. I have monitored the area and will seek further medical care if it persistent.

Other Meds: Nexium, Pepcid, Zyrtec, Flonase and MVI

Current Illness: none

ID: 1688832
Sex: F
Age: 17
State: GA

Vax Date: 06/01/2021
Onset Date: 08/01/2021
Rec V Date: 09/10/2021
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: cANCA: 1:640 Pr3: 2,000 creatinine: 3.5

Allergies: None

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

Symptoms: Development of Granulomatosis with Polyangiitis, with severe renal involvement.

Other Meds: None

Current Illness: None

ID: 1688833
Sex: F
Age: 51
State: IN

Vax Date: 08/06/2021
Onset Date: 09/06/2021
Rec V Date: 09/10/2021
Hospital:

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

Lab Data:

Allergies: Numerous

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Post menopausal vaginal bleeding. Minor immediate reactions after 1st shot is a funny metallic taste in my mouth that hasn't gone away and a funny smell in my nose reducing my sense of smell.

Other Meds: Allegra, amlodipine bestylate, amitriptyline, azelystine, tamoxifin

Current Illness: None

ID: 1688834
Sex: F
Age: 44
State: AL

Vax Date: 09/03/2021
Onset Date: 09/03/2021
Rec V Date: 09/10/2021
Hospital:

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

Lab Data: None

Allergies: codein

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Fever the night of the shot (101.3) and fever the next night (102.0) but no fever during the day.

Other Meds: At night: Gaba 250 mg Naltrexone 4.5 mg (prescription) Morning: In water 1 scoop of magnesium citrate (rootcology) 1 scoop of electrolyte blend (rootcology) Morning shake: Berries frozen 1 scoop of Glutashield (ortho molecular products)

Current Illness: none

ID: 1688835
Sex: F
Age: 40
State: FL

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

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

Lab Data:

Allergies: None

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

Symptoms: Morning after: Arm hurts to point can't lift, hands became blue and tinglingly, nausea, dizziness, body aches, fatigue, headache, chills, fever, and excessive sweating. The following morning: eyes are extremely puffy/swollen, entire orbital area hurts and vision is blurred!

Other Meds: None

Current Illness: None known

ID: 1688837
Sex: F
Age: 48
State: ME

Vax Date: 05/18/2021
Onset Date: 09/03/2021
Rec V Date: 09/10/2021
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: none

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

Symptoms: Appendicitis and emergency appendectomy on 9/4/2021.

Other Meds: B-12 vitamin

Current Illness: none

ID: 1688838
Sex: M
Age: 26
State: IN

Vax Date: 09/08/2021
Onset Date: 09/08/2021
Rec V Date: 09/10/2021
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: Headache, fever, chills, shaking, hot flashes. Duration: 12 hours.

Other Meds:

Current Illness:

ID: 1688839
Sex: F
Age: 62
State: KY

Vax Date: 03/04/2021
Onset Date: 09/01/2021
Rec V Date: 09/10/2021
Hospital: Y

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

Symptoms: Patient presented to ED with shortness of breath. Symptoms started on 9/1/21 with diagnosis of COVID-19. PCP prescribed doxycycline for PNA. Patient took 1 dose and came to the ER because it did not make her feel any better.

Other Meds:

Current Illness:

ID: 1688840
Sex: F
Age: 49
State: MI

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

Symptom List: Injection site pain, Pain

Symptoms: SOB, "like throat tightening" and dizzy

Other Meds: norvasc, normodyne,dyazide

Current Illness: none

ID: 1688841
Sex: F
Age: 29
State: GA

Vax Date: 09/03/2021
Onset Date: 09/04/2021
Rec V Date: 09/10/2021
Hospital:

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

Lab Data: 9/7/21- Negative Covid Test & Chest X-ray

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: On 9/4/21 started feeling very sick- fevered. From 9/5 through today 9/10/21 I have been feeling very fatigued. Cough, shortness of breath, and low grade fever.

Other Meds: Zoloft- 100 mg

Current Illness: I had a Cold earlier in the week

ID: 1688843
Sex: F
Age: 22
State: FL

Vax Date: 09/09/2021
Onset Date: 09/09/2021
Rec V Date: 09/10/2021
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: penicillin

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

Symptoms: The feeling of passing/blacking out when standing. No loss of consciousness occurred. As well as dizziness with postural changes. Headache.

Other Meds:

Current Illness:

ID: 1688844
Sex: F
Age: 83
State: KY

Vax Date: 08/23/2021
Onset Date: 09/07/2021
Rec V Date: 09/10/2021
Hospital: Y

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: Patient presented to ED with 3-4 day history of of increasing dyspnea, generalized weakness and cough. She was diagnosed with COVID-19 and is current inpatient for treatment.

Other Meds:

Current Illness:

ID: 1688846
Sex: F
Age: 41
State: TX

Vax Date: 08/12/2021
Onset Date: 08/12/2021
Rec V Date: 09/10/2021
Hospital:

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

Lab Data: None

Allergies: Sulfa, cipro, levaquin, halodol, phenergran, IV contrast dye, reglan, latex

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Started shaking all over body about 4 hrs later. Then muscles cramped up and felt like I was about to have a seizure around 6:00pm. Took my Topomax and my Lyrica after that happened. Then took the rest of night meds around 9:30 and by 2:00pm the reaction finally subsided.

Other Meds: Butorphanol Tartrate Spray

Current Illness: Yeast infection

ID: 1688847
Sex: F
Age: 37
State: NY

Vax Date: 03/06/2021
Onset Date: 07/23/2021
Rec V Date: 09/10/2021
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: EKG, blood pressure machine, CT scan, blood work

Allergies: Scopolamine

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

Symptoms: Escalated heart rate and blood pressure.

Other Meds: Sudafed, aspirin, Claritin, calcium, vitamin D3, multi vitamin, fish oil, cinnamon, biotin, Kariva, Mucinex

Current Illness: None

ID: 1688848
Sex: F
Age: 27
State: SC

Vax Date: 09/07/2021
Onset Date: 09/08/2021
Rec V Date: 09/10/2021
Hospital:

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

Lab Data:

Allergies: NONE

Symptom List: Nausea

Symptoms: PUFFY RED FACE. SKIN PEELING. FEVER. MIRGRIANE. CHILLS. ACHES.

Other Meds: NA

Current Illness: NONE

ID: 1688849
Sex: F
Age: 53
State: FL

Vax Date: 08/27/2021
Onset Date: 08/31/2021
Rec V Date: 09/10/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Injection site pain

Symptoms: Was diagnosed with posterior vitreous detachment.

Other Meds: None

Current Illness: None

ID: 1688850
Sex: F
Age: 50
State:

Vax Date: 01/11/2021
Onset Date: 09/09/2021
Rec V Date: 09/10/2021
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: Limited information available. Patient had an office appointment and allergies were updated to include the Moderna COVID mRNA vaccine with a reported reaction as angioedema.

Other Meds:

Current Illness:

ID: 1688851
Sex: F
Age: 36
State: MS

Vax Date: 08/19/2021
Onset Date: 08/01/2021
Rec V Date: 09/10/2021
Hospital:

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

Lab Data:

Allergies: Hydroxychloroquine, sulfa, phentermine, mangos

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

Symptoms: Muscle cramps and weakness, cold/numbness/tingling bilateral upper extremities. Abnormal vaginal bleeding, prolonged menstrual cycle. Daily headaches. Near syncope twice.

Other Meds: None at the time

Current Illness: None

ID: 1688853
Sex: F
Age: 52
State: NV

Vax Date: 01/23/2021
Onset Date: 01/23/2021
Rec V Date: 09/10/2021
Hospital:

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

Lab Data: CT of mouth done on 2-2021 and dental x-rays on 1-2021

Allergies: Penicillin, Sulfa, Codeine, Ferrlecit

Symptom List: Tremor

Symptoms: Starting the night of second dose of Moderna COVID vaccine, white oral lesion on right upper palate and right upper molar pus and erosion of tooth bone developed and lasted for 6 weeks. Fever present for 3 days. Fatigue and hot flashes lasted 1 month. Treated with doxycycline with no improvement . Debridement also done. Outcome is good. No loss of tooth. Full recovery. Cause unknown.

Other Meds: Magnesium 400 mg 2 pills once a day, Excedrin migraine 2 pills once a day as needed., Ubrevly 100 mg one pill a day as needed

Current Illness:

ID: 1688855
Sex: F
Age: 51
State: MD

Vax Date: 09/01/2021
Onset Date: 09/02/2021
Rec V Date: 09/10/2021
Hospital:

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

Lab Data: n/a

Allergies: Allergic to Penicillin, Bactrim, Sulfa, Sulfites and Sulpha.

Symptom List: Erythema, Pruritus

Symptoms: Extreme fatigue as expected in the evening of 9/1/21 but woke up on 9/2/21 with painful and warm swollen lymph nodes under right arm and right breast, hot painful lump at injection site which continued to swell over next 2 days to size of golf ball. Felt like I had a cold, uncomfortable headache, fever of 99.9, but worse part was the swollen lymph nodes as I am already battling lymphedema on left side from cancer and radiation damage.

Other Meds: Benicar 20mg, Anastrozole 1mg, Metoprolol ER 100mg, Atorvastatin 10mg, Alprazolam .5mg, Ezetimibe 10mg, Pantoprazole Sod 40mg, and Vitafusion Women's Gummies

Current Illness: Corded lymphedema from radiation, receiving PT treatment for past 8 weeks.

ID: 1688856
Sex: F
Age: 57
State: PA

Vax Date: 08/24/2021
Onset Date: 08/25/2021
Rec V Date: 09/10/2021
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

Allergies: Mango, Tomato, Percocet, adhesive

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

Symptoms: Pain began in right jaw beginning around noon on August 25th. Pain then radiated up towards right eye. It lasted about 5 days until it was fully gone. I treated it with ice, heat and tylonel. I did call my doctor's office to let them know and put it in my medical chart.

Other Meds: Valsartan omeprazole triamterene-hydrochlorothiazide

Current Illness: No, but had Covid-19 on March 17, 2021

ID: 1688857
Sex: F
Age: 32
State: CO

Vax Date: 04/06/2021
Onset Date: 05/21/2021
Rec V Date: 09/10/2021
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: N/A

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

Symptoms: after 1st shot experienced flu like symptoms. 2 weeks after second dose, experienced breakthrough bleeding/spotting in menstrual cycle until period. Breakthrough bleeding/spotting stopped once actual menstrual cycle began 2 weeks later. No further issues until 9/1, breakthrough bleeding/spotting began again, extremely painful menstrual cycle. Menstrual cycle began on 9/5.

Other Meds: Junel Fe

Current Illness: N/A

ID: 1688859
Sex: F
Age: 49
State:

Vax Date: 09/01/2021
Onset Date: 09/05/2021
Rec V Date: 09/10/2021
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: HCTZ - rash

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: swelling in the right knee, swelling and arthalgias

Other Meds: trandate and pariet

Current Illness: nil

ID: 1688860
Sex: F
Age: 67
State: TN

Vax Date: 09/09/2021
Onset Date: 09/09/2021
Rec V Date: 09/10/2021
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: SMALL BUMP / HARD, LUMP AT INJECTION SITE UPON REMOVAL OF NEEDLE. REDNESS AROUND BUMP THAT EXTENDED OUT ABOUT 1 INCH, PT FELT BURNING AT SITE AND UP TO SHOULDER.

Other Meds:

Current Illness:

ID: 1688861
Sex: F
Age: 41
State: NC

Vax Date: 09/09/2021
Onset Date: 09/09/2021
Rec V Date: 09/10/2021
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: none

Allergies: n/a

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

Symptoms: Right upper arm pain; nausea; bloating, diarrhea; right breast pain; joint pain in hips, knees and ankle; skin is sore to the touch all over body; chills; extreme fatigue

Other Meds: Labetalol 100mg PO BID HCTZ 12.5mg PO once daily

Current Illness: none

ID: 1688862
Sex: F
Age: 61
State: AR

Vax Date: 08/30/2021
Onset Date: 09/01/2021
Rec V Date: 09/10/2021
Hospital:

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

Lab Data: No tests performed. Started measuring on Friday. Incompassed a large portion of upper arm by Saturday.

Allergies: All antibiotics Pinesol cleaner

Symptom List: Pain in extremity

Symptoms: Normal reaction, fever, muscle aches, pain until 3rd day. Arm began swelling, knots formed through out upper arm, spreading, with extreme heat and extreme pain. Continued to spread upper arm. Finally stopped swelling on Saturday Sunday after shot.

Other Meds: amlodipine Tramadol

Current Illness: Seasonal allergies

ID: 1688863
Sex: F
Age: 45
State: IN

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

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

Lab Data: No

Allergies: None

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

Symptoms: Chills, Fever, Fatigue

Other Meds:

Current Illness: Non COVID viral illness

ID: 1688865
Sex: F
Age: 33
State: FL

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

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

Lab Data: N/a

Allergies: Latex

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

Symptoms: Fever, chills, back pain, gross hematuria, headache

Other Meds: Pepcid as needed and prenatal vitamins

Current Illness: None

ID: 1688866
Sex: F
Age: 37
State: PA

Vax Date: 08/13/2021
Onset Date: 08/13/2021
Rec V Date: 09/10/2021
Hospital:

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

Lab Data: 8/19/2021: blood work, d-Dimer, EKG, CT-scan 9-1/2021, MRI HEART

Allergies: Nkda

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

Symptoms: Hi August 13, 2021 I receive the Covid vaccine at 3:30 PM. Later on that evening at 7:45 PM I began to experience severe fatigue headache bodyaches and tingling in both legs. On August 15, symptoms began to improve slightly but we're still present. On August 18, 2021, I began to experience a new onset of severe chest pain, tightness, palpitations, difficulty breathing and headache at 4:45 PM. On August 19, 2021 I went to work despite still experiencing symptoms from the day before I was taken to Occupational medicine and advised to be seen in the ER. While in Emergency room, a blood test, EKG and CT scan were done. D/dimer test came back elevated CT scan showed no signs of low clots in my lungs. I was referred to my primary care physician. On August 20, 2021, I will send an occupational medicine at 2:49 PM I explain my symptoms I was still experiencing headache chest pain tingling only now in the right leg shortness of breath. At 4 PM that same day I was seen by my primary care doctor and explained my symptoms since receiving the vaccine my lungs were examined with a stethoscope. They tested my reflexes and strength in both legs and arms. It was discovered that my right lower extremities in my leg or weaker than my left. MRI of the brain/Spine, and heart will order. On September 1, 2021 MRI of my chest was done. On September 3, 2021, MRI was interpreted and it was discovered that I had inflammation of the lateral and inferolateral walls of my heart. There was also around nodules structure seen in the left atrial which prevented them from ruling out thrombus.

Other Meds: None

Current Illness: None

ID: 1688867
Sex: F
Age: 12
State: NJ

Vax Date: 08/31/2021
Onset Date: 09/07/2021
Rec V Date: 09/10/2021
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: Penicillins

Symptom List: Vomiting

Symptoms: Started menstruating for the first time exactly 7 days after the 2nd shot

Other Meds: None

Current Illness: None

ID: 1688868
Sex: M
Age: 80
State: FL

Vax Date: 03/23/2021
Onset Date: 04/06/2021
Rec V Date: 09/10/2021
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: CXR, covid test.

Allergies: Nka

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Pt came to ER c/o generalized weakness, dizziness, cough, chest congestion, diarrhea, and fever x 2 weeks.

Other Meds:

Current Illness:

ID: 1688869
Sex: F
Age: 67
State: NY

Vax Date: 03/03/2021
Onset Date: 08/30/2021
Rec V Date: 09/10/2021
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: EKG, chest x- ray, blood work. All done on 8/30/21

Allergies: Seasonal allergies- dust, mold, grasses, etc

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

Symptoms: Palpitations lasting 6 hours

Other Meds: Gabapentin, Vitamin d, Vitamin b12

Current Illness: Peripheral neuropathy - genetic type

ID: 1688870
Sex: F
Age: 17
State: NY

Vax Date: 07/01/2021
Onset Date: 08/01/2021
Rec V Date: 09/10/2021
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: none, child is away at college, will be taking her to an urgent care facility this weekend

Allergies: Hydrocodone

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Child developed difficulty using left thumb after vaccine recieved. symptoms similiar to that of trigger finger. uncle and cousin also had similar reaction after recieving their vaccine which self resolved in approx 6 weeks

Other Meds: Norethindrone 5mg QD Multivitamins Tylenol

Current Illness: none

ID: 1688872
Sex: F
Age: 33
State: MN

Vax Date: 02/16/2021
Onset Date: 09/07/2021
Rec V Date: 09/10/2021
Hospital:

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

Lab Data: COVID 19 molecular NP swab collected on 9/7/21 @ Urgent Care

Allergies:

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

Symptoms: Pt. fully vaccinated with Pfizer vaccine - dose 1 1/26/21 and dose 2 2/16/21. Pt. reported COVID symptoms of Nausea, vomiting, and headache starting 9/7/21. Pt. tested PCR positive for COVID on 9/7/21. Pt. did not require medical care as of 9/10/21

Other Meds:

Current Illness:

ID: 1688873
Sex: F
Age: 55
State: LA

Vax Date: 07/30/2021
Onset Date: 08/05/2021
Rec V Date: 09/10/2021
Hospital:

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

Lab Data: I have a gyn appointment scheduled for September 15.

Allergies: Keflex, meloxicam, clyndomiacin

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

Symptoms: Vaginal bleeding like a period lasting 5 days then no bleeding for 7 days then vaginal bleeding for 17 days so far.

Other Meds: Metformin, glipizide, enalapril

Current Illness: None

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am