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: 1689079
Sex: M
Age: 49
State: NJ

Vax Date: 04/18/2021
Onset Date: 05/03/2021
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: Blood work on 6/4/21. Everything came back within normal ranges (including testosterone level 809).

Allergies: None

Symptom List: Dysphagia, Epiglottitis

Symptoms: Gradual loss of libido/unable to maintain an erection. PCP prescribed viagra to remedy the issue. Prior to vaccination patient's sex drive was off the charts (would have sex/masturbate at least twice a day).

Other Meds: None

Current Illness: None

ID: 1689080
Sex: F
Age: 28
State:

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

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

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: At clinic, patient experienced hives, pruritus, flushing, injection site redness, shortness of breath, sensation of throat closing, wheezing, tachycardia and diaphoresis. Epi given and patient transported to ED. Patient premedicated prior to her vaccination with prednisone 30 mg and Benadryl 25 mg. IV placed with IV fluids, steroids, H2 blocker, and antihistamines. Additionally, given her ongoing respiratory distress treated with epinephrine intramuscularly. Patient significantly improved after epinephrine and nebulizer. No hypoxemia. No hypotension. Good aeration throughout all lung fields. No significant wheezing. Pruritus is resolved. Patient has improved significantly has been monitored for 4 hours without deterioration. At this time, we will discharge the patient.

Other Meds:

Current Illness:

ID: 1689081
Sex: M
Age: 53
State:

Vax Date: 05/21/2021
Onset Date: 05/21/2021
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:

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

Symptoms: vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1689082
Sex: F
Age: 60
State: AL

Vax Date: 02/15/2021
Onset Date: 03/08/2021
Rec V Date: 09/10/2021
Hospital:

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

Lab Data: Tested Covid positive 8/16/2021.

Allergies: Lortab IV Contrast Dye Lisinopril Amlodipine Tamiflu Flonase

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Symptoms: headache, fatigue, abdominal pain the first 10 days, loss of smell and dry cough

Other Meds: Metformin 500 mg Triamterene/HCTZ qd Atorvastatin 20 mg qd Pepcid 20 mg (OTC) qd Asmanex inhaler 220 mcg 1 inhalation qd

Current Illness:

ID: 1689083
Sex: M
Age: 57
State:

Vax Date: 05/21/2021
Onset Date: 05/21/2021
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 erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1689084
Sex: F
Age: 43
State:

Vax Date: 05/21/2021
Onset Date: 05/21/2021
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:

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

Symptoms: vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1689085
Sex: F
Age: 45
State: FL

Vax Date: 09/01/2021
Onset Date: 09/04/2021
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: swollen red super itchy rash on trunk, extremities and feet . Bleeds when scratched too much.

Other Meds: Fluoxetine, Spironolactone

Current Illness: none

ID: 1689086
Sex: M
Age: 64
State:

Vax Date: 05/21/2021
Onset Date: 05/21/2021
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:

Symptom List: Pharyngeal swelling

Symptoms: vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1689087
Sex: F
Age: 34
State: NC

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: Abdominal pain, Chills, Sleep disorder

Symptoms: Pt experienced a headache 5 minutes after injection of first COVID vaccine which lasted approxiamtely 10 minutes. She stated it was located around the right of her temple and moved towards the center of her head. We gave her water and asked her to remove he mask to help with breathing. She rested for an additional 30 minutes. She reported she was then ok and left. When contacted later in the afternoon she reported she was fine.

Other Meds:

Current Illness: Low hg due to prior miscarriage in July, was told by provider would return to normal by October

ID: 1689088
Sex: F
Age: 36
State: WI

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: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: sulfano

Symptom List: Diarrhoea, Nasal congestion

Symptoms: body aches, chills, fever, headaches, muscle pains in arms,

Other Meds: levothyroxine

Current Illness: no

ID: 1689089
Sex: F
Age: 71
State:

Vax Date: 05/21/2021
Onset Date: 05/21/2021
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:

Allergies:

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

Symptoms: vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1689090
Sex: F
Age: 58
State: MD

Vax Date: 03/15/2021
Onset Date: 08/31/2021
Rec V Date: 09/10/2021
Hospital:

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

Lab Data: I don't know if my symptoms are related to the vaccine. Have not been seen by a doctor.

Allergies: Penicillin

Symptom List: Rash, Urticaria

Symptoms: Began around 8/31/21: Lips dry, peeling and burning with small papules around edge, with ulcers inside mouth. Was present for a week, subsided, and is now beginning again. No significant change in diet. Took a 7 day course of doxycycline for a puncture wound 8/24/21-8/30/21.

Other Meds: Synthroid, Liothyronine, vitamins, Lithium Orotate

Current Illness:

ID: 1689091
Sex: F
Age: 42
State: LA

Vax Date: 08/24/2021
Onset Date: 08/25/2021
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: Penicillin, sulfa

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

Symptoms: Extreme muscle and joint pain lasting over 7 days, including but not limited to difficulty walking and standing, extreme fatigue lasting over 5 days, migraine headaches,

Other Meds: Sertraline, spironolactome

Current Illness:

ID: 1689092
Sex: F
Age: 30
State: WI

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

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

Symptoms: Second dose administered less than 24 days from initial dose.

Other Meds:

Current Illness:

ID: 1689093
Sex: F
Age: 42
State:

Vax Date: 05/10/2021
Onset Date:
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: CT contrast lungs Brain MRI (have an arachnoid 5 cm cyst) Blood tests every 2 days Referral to hemotologist Ultrasound

Allergies: Sulpha/penicillin

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

Symptoms: Hemolytic Anemia Positive D-dimer Blood transfusion Macrocystic anemia Destruction of RBC hemoglobin 80 On home oxygen

Other Meds: Codeine Percocet Baclofan Cipralex Valume Totadol IM Maxeran Vitamin C Vitamin multi Vitamin D B/12 vitamin

Current Illness: Back disc injury (torn L4/L5) Gerd Depression PTSD

ID: 1689094
Sex: M
Age: 70
State:

Vax Date: 05/21/2021
Onset Date: 05/21/2021
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:

Allergies:

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

Symptoms: vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1689095
Sex: F
Age: 0
State: CO

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

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

Lab Data: None.

Allergies: None.

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

Symptoms: 4 month old infant was given a Hepatitis B vaccine at 4 months and 11 days instead of 6 months old. No adverse reactions, signs or symptoms were noted at time of injection.

Other Meds: None.

Current Illness: None.

ID: 1689096
Sex: F
Age: 66
State: FL

Vax Date: 04/10/2021
Onset Date: 08/16/2021
Rec V Date: 09/10/2021
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: Breakthrough COVID-19 case. 66 year old female presents to ED with worsening shortness of breath. Patient tested COVID positive on 8/16/21 at a Care Center. She was started on Prednisone, Tessalon Perles and antihistamine. She previously received Johnson&Johnson COVID-19 vaccine on 4/10/21. Patient hypoxic with SpO2 90% on room air which improved to 96% on 3L NC. 8/22/21. admitted. Diagnosed and treated for viral sepsis secondary to covid-19, COVID-19 pneumonia. 8/26/21: discharged

Other Meds: atorvastatin, levothyroxine, meclizine, metformin, triamterene, hydrochlorothiazide

Current Illness:

ID: 1689097
Sex: F
Age: 35
State: CO

Vax Date: 01/21/2021
Onset Date: 01/21/2021
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:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Throat swelling and itchy.

Other Meds: n/a

Current Illness:

ID: 1689098
Sex: F
Age: 38
State: NC

Vax Date: 06/22/2021
Onset Date: 06/22/2021
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:

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

Symptoms: Pt reported receiving first dose as Pfizer and gave a different name and came to us for a second dose. We found a match in database for the same person under a different name later showing the first dose was of Moderna on 4.21 at another facility I put a ticket into the help desk to combine the two accounts. I cannot find the record showing the Moderna dose. I was advised to put a VEARS report in for the administration error.

Other Meds:

Current Illness:

ID: 1689099
Sex: M
Age: 44
State:

Vax Date: 05/21/2021
Onset Date: 05/21/2021
Rec V Date: 09/10/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1689100
Sex: F
Age: 59
State: MA

Vax Date: 05/02/2021
Onset Date: 05/02/2021
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: None.

Symptom List: Unevaluable event

Symptoms: After sitting in the waiting area for 15 minutes (I had absolutely no reaction to the first shot) I started heading back to my car. About half way across the parking lot I started to feel my throat tightening and I started to cough uncontrollably to the point of gagging and I was having trouble breathing. I had my Albuterol inhaler with me, so I used that and started to feel an immediate reduction in symptoms. I sat in my car for a half hour until I felt that the worst had passed. I coughed more than usual for the next several days.

Other Meds: Valsartan/HCTZ 80mg/12.5mg tablets once daily; Sertraline 50mg once daily; Flovent HFA 110 mcg oral inhaler 2 puffs AM/PM; ProAir HFA as needed; multi vitamin, calcium tablets.

Current Illness: None.

ID: 1689101
Sex: F
Age: 56
State:

Vax Date: 05/21/2021
Onset Date: 05/21/2021
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: LA

Lab Data:

Allergies:

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

Symptoms: vaccine expired in fridge

Other Meds:

Current Illness:

Date Died: 08/27/2021

ID: 1689102
Sex: F
Age: 96
State: GA

Vax Date: 02/04/2021
Onset Date: 08/27/2021
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: 08/27/2021 Antigen+ COVID-19 test

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Breakthrough COVID-19 case, death. Vital records cause of death: CARDIOPULMONARY FAILURE, FAILURE TO THRIVE, END STAGE DEMENTIA. Per vital records, COD ICD Codes include: Not yet coded ; Other Significant Conditions include: COVID-19

Other Meds:

Current Illness:

ID: 1689103
Sex: F
Age: 64
State:

Vax Date: 01/27/2021
Onset Date: 07/19/2021
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: LUMIRADX SARS-COV-2 AG TEST (7/14/2021) = positive COVID 19 IGG (7/19/2021) = positive

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: The patient was admitted on 7/19/21 with acute hypoxemic respiratory failure secondary to COVID19. The patient claimed she received her second dose of the COVID vaccine on 1/27/2021. She was started on oxygen, remdesivir and decadron. She initially was on 2L O2, went up to 3L and was on 1-2L at the time of discharge on 7/22/2021.

Other Meds:

Current Illness:

ID: 1689104
Sex: M
Age: 37
State: NY

Vax Date: 08/24/2021
Onset Date: 08/24/2021
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: hypersensitivity NSAIDS

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

Symptoms: Ear fullness and tinnitus in both ears. headache, loss of balance, hearing fluctuation, dizziness, exhaustion, confusion, and body aches.

Other Meds: none

Current Illness: none

ID: 1689105
Sex: F
Age: 59
State:

Vax Date: 05/21/2021
Onset Date: 05/21/2021
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: LA

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1689106
Sex: F
Age: 32
State:

Vax Date: 05/21/2021
Onset Date: 05/21/2021
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:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1689107
Sex: F
Age: 43
State: IA

Vax Date: 08/07/2021
Onset Date: 08/08/2021
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: None, have not sought medical care

Allergies: Eggs

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

Symptoms: One day after vaccine #1, muscle twitching/fasciculation under left eye for 48 hours then resolved, 72 hours after vaccine number 1, muscle twitching to left inner anterior knee for approximately 48 hours, that area of knee now has decreased sensation /mild numbness to touch. Following vaccine #2, arm has been having intermittent muscle twitching at site of injection. Twitching lasts up its minute, resolves and recurs several times throughout day, this symptom continues. Few muscle twitches to right lateral neck noted a few days following second vaccine, resolved within one week of vaccine #2.

Other Meds: Multivitamin Vitamin D3

Current Illness: None

ID: 1689108
Sex: F
Age: 57
State: NV

Vax Date: 05/04/2021
Onset Date: 05/04/2021
Rec V Date: 09/10/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Nausea

Symptoms: Four hours after vaccination experienced extreme fatigue followed lay fever, diarrhea and vomiting that lasted 12- 16 hours, felt like having the flue for 3 days, then had rash beginning on legs then the total torso, used Advil and Benadryl along with dexamethasone took a week to clear up in addition right upper arm at site of injection was bruised and extremely sensitive to touch for eight weeks

Other Meds: none

Current Illness: none

ID: 1689109
Sex: F
Age: 38
State:

Vax Date: 05/21/2021
Onset Date: 05/21/2021
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:

Symptom List: Injection site pain

Symptoms: vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1689110
Sex: M
Age: 69
State: TX

Vax Date: 04/29/2021
Onset Date: 04/30/2021
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: None

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

Symptoms: My kidneys swelled and blocked - my stomach became extremely bloated and swollen = acute pain. Went to emergency and was told to sit and wait. Hurting so bad that I could not do that and left. Never saw a doctor afterwards.

Other Meds: Too many to list

Current Illness: None

ID: 1689111
Sex: F
Age: 43
State:

Vax Date: 05/21/2021
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: RA

Lab Data:

Allergies:

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

Symptoms: vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1689112
Sex: M
Age: 62
State: IA

Vax Date: 04/07/2021
Onset Date: 07/16/2021
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: Heart attack 07/16/2021 and 07/29/21

Allergies: N/A

Symptom List: Tremor

Symptoms: Severe chest pain for about 2 hours.

Other Meds: Aubagio

Current Illness: N/A

ID: 1689113
Sex: F
Age: 39
State: OR

Vax Date: 08/17/2021
Onset Date: 08/17/2021
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: Seasonal allergies

Symptom List: Erythema, Pruritus

Symptoms: It felt like the flu shot, tender but not bothersome. Close to the 15 minutes I started feeling like a pulling string feeling from my upper shoulder going up towards my neck. I let them know about it and they said to move it around. I was already moving it and massaging my arm. They told me to apply ice on it. They checked on me later and I stayed there for a little over an hour. Then I don't know if its because I was nervous or what but I felt hyper. The whole time before getting the vaccine I was talking a lot and after getting the vaccine I continued to talk a lot instead of feeling down. I continued to ice it. It felt like I was on caffeine. Finally I felt fine. I did not really have any pain or discomfort for the rest of the day. At 3 am in the morning I noticed the pain but I thought it was a dream. I was moaning and turning until I realized it was not a dream. I was having really severe aches and pain deep in my armpit. I did not take any medication so I went back to sleep. The first day I took Tylenol. After the 3 am episode I was good for pretty much until early afternoon. When I got home I was eating my food and it felt like I was starting to get the pain again. I just iced it again and I was fine. Then, when the vsafe check in came in at around 2:30 that's when things changed. I went to the bathroom and I looked in the mirror and I noticed a little bulge in between my chest and arm. As I raised my arm I noticed a pulling sensation and it was hard to stretch. At this point I would be on the 24 hour mark. I freaked out. Its kind of a significant swelling. Earlier that day I did not notice any swelling. There was some discoloration in my skin. It was like an oval rectangular shape. The tissue was really soft and squishy. At that point I did take Ibuprofen. I just continued to iced it because I continued with the discomfort. The second day, the injection site did feel tender and sore as well. By the 4th day I did not feel anything. No pain. It was absolutely gone. The discoloration was gone. A week later after getting the vaccine its when I first had an episode when my heart was doing something weird, like palpitations and I had an anxiety attack. I breathe through it. I felt like I got through it. My blood pressure and pulse were high. 3 or 4 days after the second week I had another situation, worse than the first time. I was asleep and I woke up out of my sleep and I was feeling weird, my heart was doing the same weird thing. It reminded me when I got Covid. I started feeling shortness of breath. I immediately checked my blood pressure and oxygen. The readings were super high. I was feeling like I was going to go unconscious. I called 911 because I was by myself and my daughter. They came home and they evaluated me. My blood pressure had come down. They said they did not see any heart situation going on but that does not mean there is not something going on. They wanted me to go to the hospital but I could not go because I had to take care of my daughter. I told them I would call if necessary. I tried to calm myself with teas and meditations. Currently I find myself tired and wanting to sleep a lot. I am still dealing with anxiety. A week and a half after I called the doctor because I was outside and I had a feeling of a stabbing needle. I looked at my arm and there was no bump or anything but my vein was bulged out. I felt like all my veins were popping out. They said it was like a spasm.

Other Meds: None

Current Illness: None

ID: 1689114
Sex: F
Age: 31
State: IL

Vax Date: 08/17/2021
Onset Date: 08/31/2021
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: Doctor diagnosed it as labyrinthitis, prescribed oral steroids, Zofran, and Flonase. Took 7 days to recover once medicine was introduced

Allergies:

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

Symptoms: 6 months pregnant, due December 2021. Experienced dizziness, nausea, vomiting, loss of balance, needed help walking.

Other Meds: Pre-Natal

Current Illness:

ID: 1689115
Sex: F
Age: 63
State: TX

Vax Date: 03/06/2021
Onset Date: 08/10/2021
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: Latex, Macrobid

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

Symptoms: I started out with sore throat runny nose and achy. I also had diarrhea, I lost my smell, then I got a horrible cough that went on a few weeks so I went to doctor they diagnosed me with possible RSV. My smell has still not come back.

Other Meds: Metoprolol and eye drops ASTZ

Current Illness:

ID: 1689116
Sex: F
Age: 69
State: FL

Vax Date: 02/22/2021
Onset Date: 07/30/2021
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: Doctor's visit on 8/04./2021 that resulted in a positive Covid test on 8/05/2021 and then tested again on 8/12/2021 with a positive test on 8/13/2021

Allergies: No

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: I contracted covid and had two positive tests even though I was fully vaccinated. I felt exhausted, slight shortness of breath, runny nose, slight headache and then loss of taste and smell around the 3rd day. I still do not completely have my sense of taste and smell back and it has been over a month since I first contracted Covid.

Other Meds: No

Current Illness: No

ID: 1689117
Sex: M
Age: 45
State: AZ

Vax Date: 08/31/2021
Onset Date: 09/02/2021
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: None

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

Symptoms: Ever since I have gotten my first dose I have felt extremely sick, muscle and skin is achy, headache, foggy brain, cough has developed. I have taken to COVID tests and both came back negative. I am on day 10 of these symptoms.

Other Meds: None

Current Illness: None

ID: 1689118
Sex: M
Age: 64
State: OH

Vax Date: 02/17/2021
Onset Date: 06/09/2021
Rec V Date: 09/10/2021
Hospital: Y

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: none

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

Symptoms: I had open heart quadruple bypass surgery on 06/11/2021. However, I don't think this had anything to do with vaccination

Other Meds: Paroxetine 40mg tablet; buPROPion XL 300 mg 24 hr tablet; levothyroxine 175 mcg tablet; atorvastatin 80 mg tablet; metFORMIN 1,00 mg tablet 2x daily; FERROUS SULFATE ORAL; acetaminophen 650 mg tablet 2x daily; empagliflozin 10 mg tablet; gl

Current Illness: none

ID: 1689119
Sex: F
Age: 67
State: FL

Vax Date: 04/14/2021
Onset Date: 08/18/2021
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: Tested positive for covid on 8/19/21.

Allergies: Toradol

Symptom List: Pain in extremity

Symptoms: COVID-19 breakthrough case. patient with 4 days of shortness of breath progressively worsening presented initially on 8/19 at the time was not hypoxic, was discharged with monitoring system. however shortness of breath has progressively worsened to severe, worse on attempted ambulation, associated with fevers, cough, generalized weakness, so came back to ER, noted to be requiring oxygen supplementation, and also short of breath on talking, so being admitted. Admitted 8/22/21. Pfizer Covid-19 vaccine given on 3/24/21 & 4/14/21. Tested positive for covid on 8/19/21. Diagnosed and treated for acute hypoxic respiratory failure and covid viral pneumonia. Improved and discharged on 8/24/21.

Other Meds: albuterol, amiodarone, apixaban, atorvastatin, azelastine ophthalmic, cholecalciferol, clonidine, escitalopram, famotidine, hydrochlorothiazide, ipratropium nasal spray, lisinopril, meclizine, nitroglycerin sublingual, sucralfate

Current Illness:

ID: 1689120
Sex: F
Age: 21
State: OR

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

Allergies: None

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

Symptoms: Patient inadvertently given mixed doses of COVID19 vaccine. She received Moderna for her 1st dose and was given Pfizer for her 2nd dose. There were no visible reactions and patient tolerated well.

Other Meds: None needed

Current Illness: None

ID: 1689121
Sex: M
Age: 52
State:

Vax Date: 05/21/2021
Onset Date: 05/21/2021
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:

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

Symptoms: vaccine expired in fridge

Other Meds:

Current Illness:

ID: 1689122
Sex: M
Age: 60
State: CA

Vax Date: 06/06/2021
Onset Date: 09/05/2021
Rec V Date: 09/10/2021
Hospital: Y

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

Lab Data: + COVID serology test

Allergies:

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

Symptoms: Breakthrough infection

Other Meds:

Current Illness:

ID: 1689123
Sex: M
Age: 57
State: NC

Vax Date: 06/22/2021
Onset Date: 06/22/2021
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:

Symptom List: Vomiting

Symptoms: Administration Error: Pt sated he had not received a covid vaccination prior. He received Pfizer on 6/22 and received an incentive. When data was entered, it was discovered he received a Janssen Vacccine on 3/27/21.

Other Meds:

Current Illness:

ID: 1689124
Sex: F
Age: 50
State: GA

Vax Date: 04/20/2021
Onset Date: 09/06/2021
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: 09/06/2021 PCR+ COVID-19 test at Health System

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Breakthrough COVID-19 case with Muscle or body aches, Cough (new onset or worsening of chronic cough), Nausea or vomiting, Abdominal pain. Patient presented with nausea and vomiting of 2 days duration. She developed generalized abdominal pain nausea loss of appetite and vomiting of ingested material since 2 days back. She denies fever but has been having cough. She has chronic respiratory failure she is on 4 L of oxygen at home and has not noticed any change in shortness of breath denies any palpitation or chest pain. She states she is fully vaccinated against COVID-19. She continues to take her insulin and her last dose was this morning. Her last dialysis was on Saturday. Investigations in the ED revealed hyperglycemia with blood glucose level of 1296, sodium level of 117 and potassium level of 5.7. Bicarb level was 13 and anion gap was 22. WBC count was within normal range. Chest x-ray showed bilateral opacities suggestive of volume overload vers

Other Meds:

Current Illness:

ID: 1689125
Sex: F
Age: 51
State: OH

Vax Date: 08/26/2021
Onset Date: 08/28/2021
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: Clinic refused

Allergies: na

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

Symptoms: skin bumps on arm after first shot. Sore throat, white blisters on gums and lips. Numb tongue and very white

Other Meds: na

Current Illness: na

ID: 1689126
Sex: M
Age: 26
State: SD

Vax Date: 02/11/2021
Onset Date: 07/27/2021
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: Note: I haven't had the follow-up in regards to the results, so these assessments are my own. CBC w/ Diff -RDW: 11.3% Marked *LOW* (doesn't seem indicative of anything) - Everything else normal Comp Metabolic Panel - All in normal range Rheumatoid Factor - < 10 IU/mL (Normal) - Potentially Seronegative RA? Sedimentation Rate - 12 (Normal) Hand X-rays - PA and ball-catcher's view of the hands - Normal radiographs

Allergies: Zithromycin, pollen-food allergy syndrome

Symptom List: Injection site swelling, Limb discomfort

Symptoms: - Provisional diagnosis of Polyarthritis. Symptoms consistent with Rheumatoid Arthritis, however, labs appear normal. - Symptoms consist of pain and swelling in the joints of the hands, wrists, and feet. Symmetrical. Worse in the mornings and after use. - Onset occurred over two days at the end of July2021 and are still present. - Treatment includes Voltaren Gel (effective), and NSAIDs (partially effective)

Other Meds: Effexor XR 75mg, Adderall XR 20mg, Adderall IR 5mg, Ibuprofen 400mg, Vitamin D3 2000IU (50mcg)

Current Illness:

ID: 1689127
Sex: F
Age: 61
State: ME

Vax Date: 08/27/2021
Onset Date: 09/02/2021
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: Several antibiotics including amoxicillin, penicillin, sulfur, erothyomicin and some others. Several environmental allergies including several grasses, trees, ragweed, dust, pollens, dogs, cats.

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

Symptoms: Experienced intense hives peppered over multiple areas of body. Intense itchy and spread of hives required seeking and getting medical treatment. Steroid injection given at walk-in care facility followed with a prescription for oral steroids along with taking Benadryl and eventually Loratadine. Had to take tylenol and ibuprofen due to side effects from steroids. Immediately started experiencing headaches with steroids while receiving steroids by injection and orally. Light headedness, dizziness, headaches and nausea were all side effects of the steroids. The Physician Assistant that saw patient was extremely concerned for anaphylactic shock and questioned multiple times and caused should I experience any shortness of breath, any numbness or tingling in the mouth, lips or airways to seek immediate medical attention at the Emergency Department of the local hospital. I was until 9/9 before I felt as though all the side effects of the vaccine and the adverse reaction appear to have gone away for the time being.

Other Meds: None

Current Illness: None

ID: 1689128
Sex: F
Age: 63
State: MD

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

Lab Data:

Allergies:

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

Symptoms: Patient was mistakenly scheduled for, and received her second dose of the Moderna vaccine series 22 days following her first dose, earlier than the recommended 28 days and 4 day grace period per CDC. Called patient 9/9/21 immediately after mistake was realized and explained situation. Per CDC, patient does not need to repeat dose or series.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am