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: 1689233
Sex: F
Age: 57
State: CA

Vax Date: 08/10/2021
Onset Date: 08/10/2021
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:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: I felt a sensation in the back of my brain shortly after receiving it. It felt like a sort of zipping. Is it supposed to feel like that?

Other Meds:

Current Illness:

ID: 1689234
Sex: F
Age: 42
State:

Vax Date: 09/09/2021
Onset Date: 09/10/2021
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: Urinalysis was negative

Allergies: Darvocet, Morphine, Percocet, and Vicodin all with reported anaphylaxis reactions

Symptom List: Anxiety, Dyspnoea

Symptoms: Patient presented to the Emergency Department at our facility with approximately 4 hours of vomiting and nausea after receiving the second vaccination for Covid yesterday. She was monitored and treated with Phenergan, Toradol, and Benadryl prior to discharge back home.

Other Meds: Gabapentin, ibuprofen, omeprazole

Current Illness:

ID: 1689235
Sex: F
Age: 21
State: NY

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

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

Symptoms: There was no adverse health effect. The HPV vaccine was given in error. A Hepatitis vaccine was supposed to be given. The error was caught when it was determined that patient did not have a titer for Hep B. Upon investigation at the office it was determined that the HPV virus was given in error.

Other Meds:

Current Illness:

ID: 1689236
Sex: M
Age: 67
State: MN

Vax Date: 03/31/2021
Onset Date: 09/08/2021
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:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Hospitalized dexamethasone, remdesivir

Other Meds:

Current Illness:

ID: 1689237
Sex: F
Age: 55
State: OK

Vax Date: 09/10/2021
Onset Date: 09/10/2021
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: None: Reports that she had previous anaphylaxis reaction to medication in past but doesn't know what it was.

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

Symptoms: Approx. 15min. after injection (08:45 am) client started complaining of trouble swallowing, tongue, lips and cheeks itching. Complained of extreme fatigue, and syncope. Approx. (9:03am) Obtained vital signs. Still complaining of worsening symptoms about 2 min. later. Called 911, administered 0.5mg Epi, IM to Rt. Deltoid, 50mg Benadryl to Rt Deltoid. Ambulance arrived approx 5 min later, client was transported to hospital via ambulance at approx. (09:16 am). She was alert and oriented, verbal when transported.

Other Meds: Unknown - Reports taking a medication for BP but doesn't know what the name is.

Current Illness: None

ID: 1689238
Sex: M
Age: 77
State: GA

Vax Date: 04/02/2021
Onset Date: 07/12/2021
Rec V Date: 09/10/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: the patient is currently hospitalized at Hospital. The patient became symptomatic a few days before being teste which he experienced a low grade fever, body aches, loss of taste and smell, loss of appetite, congestion, cough, shortness of breath, headache, and diarrhea. Patient's wife stated the patient has alot of medical conditions which she believes has caused some symptoms and not just covid. Patient has cancer, high cholesterol, and arthritis.

Other Meds:

Current Illness:

ID: 1689239
Sex: F
Age: 57
State: NY

Vax Date: 09/01/2021
Onset Date: 09/08/2021
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: Fragrance and Beef

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Fever, severe chills for hours, severe headaches and nausea

Other Meds: Vitamin C

Current Illness: None

ID: 1689240
Sex: F
Age: 63
State: NC

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

Symptoms: Hospitalization due to COVID 19 on 9/8/2021. Reported per Janssen vaccine EUA.

Other Meds:

Current Illness:

ID: 1689241
Sex: F
Age: 60
State: VA

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

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Patient complained of numbness and tingling sensations aroung mouth and lips and cheeks 3 hours after vaccination. Patient also felt dizziness. She took diphenhydramine and symptoms resolves in 30 minutes

Other Meds:

Current Illness:

ID: 1689242
Sex: F
Age: 54
State: NM

Vax Date: 03/12/2021
Onset Date: 09/02/2021
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: Sept 2, 2021@15:42 FLU A (CEPHEID) NEGATIVE, FLU B (CEPHEID) NEGATIVE, RSV (CEPHEID) NEGATIVE _COVID-19 (CEPHEID) POSITIVEA

Allergies: Neurontin capsule

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Pt reports "head cold" w/ h/a, some rhinits, some prod cough- pressure is most bothersome.

Other Meds: Cetirizine, cyanocobalamin, diclofenac, ergocalciferol, Furosemide, guaifenesin, levothyroxine, oxymetazoline, phenylephrine, potassium chloride. ascorbic acid, duloxetine, llidocaine patch

Current Illness: None

ID: 1689243
Sex: F
Age: 27
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:
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data: no

Allergies: no

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

Symptoms: Patient reported that she had a headache and has a lump under left arm that has gotten bigger

Other Meds: no

Current Illness: no

ID: 1689244
Sex: F
Age: 26
State: MN

Vax Date: 02/11/2021
Onset Date: 09/08/2021
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:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: Hospitalization

Other Meds:

Current Illness:

ID: 1689245
Sex: F
Age: 60
State: IL

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

Lab Data: None

Allergies: Penicillin and other family of medications

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

Symptoms: Mother states that her daughter suffered five staring seizures at about 8:00 pm on 9-2-2021 and three seizures the next day on 9-3-2021.

Other Meds: Phenobarbital, Keppra, Carbamazepine, Lorazepam, Lamictal, Vitamin D, One a Day vitamin,

Current Illness: None

ID: 1689246
Sex: M
Age: 36
State: NV

Vax Date: 08/27/2021
Onset Date: 08/27/2021
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: SYR
Vax Site: LA

Lab Data: On 9/10/2021 I saw a cardiologist. Had a 12 lead EKG and Echocardiogram done. The echo showed pericarditis.

Allergies: allergic to phenergan (promethazine)

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

Symptoms: I tested positive for COVID 19 in January of 2021 (I think I had it the first time in March, but never tested). On August 27 2021 at 6pm I received my first Pfizer shot. Immediately after the shot I felt the pressure and pain in my chest. The chest pain/ pressure are still persisting. The cardiologist I saw on 9/10/2021 suggested 600mg Motrin every 3 hrs. The outcome remains unknown My body had already fought off COVID 19 naturally and with exposure to it again from the first shot the physician I saw suggested he thinks because I already had COVID-19 my body became hyper reactive from post viral and the autoimmune response was inflammation of the sac around my heart.

Other Meds:

Current Illness:

ID: 1689247
Sex: F
Age: 76
State: WI

Vax Date: 02/22/2021
Onset Date: 09/06/2021
Rec V Date: 09/10/2021
Hospital: Y

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

Lab Data: COVID PCR positive 8/31/21 Chest Xray 9/6/21 ET tube tip lies at the level the mid trachea. The heart size and vascularity are within normal limits. Bilateral patchy airspace disease is present, most pronounced in the lung bases. This had an organizing pneumonia pattern on prior CT. There is no pneumothorax or pleural effusion.

Allergies: Penicillins, Hydrocodone

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

Symptoms: Patient was fully vaccinated with Pfizer COVID-19 vaccine on 1/29/21 and 2/22/21. Patient admitted to reporting hospital on 9/6/21 as a transfer from Hospital. Admitting diagnosis is worsening COVID pneumonia requiring intubation. Patient was reported to arrive at ER after having 10-14 days of symptoms relating to cough. Over the last 5 to 6 days she then began having progressive difficulty breathing. Pt is still currently admitting at another hospital.

Other Meds: Aspirin 81mg, Lasix 20 mg, ruxolitinib phosphate (Jakafi), tessalon

Current Illness: Polycythemia Vera, OSA on CPAP, H. pylori, HTN, Microscopic ischemic colitis

ID: 1689248
Sex: F
Age: 36
State: CA

Vax Date: 09/03/2021
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: IM
Vax Site: LA

Lab Data: HAPPENED LAST NIGHT HAVE NOT CONTACTED DR IN REGARDS TO THIS EVENT

Allergies: LAMICTAL, TEGETROL, MELOXICAM

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

Symptoms: RANDOM NOSE BLEED AND HUGE BLOOD CLOT CAME OUT, HEADACHES, FATIGUE AND TIREDNESS.

Other Meds: TRILEPTAL, ABILIFY, KLONOPIN, AMLODIPINE BESYLATE, ASPIRIN, PROZAC, OMEPRAZOLE, METOPROLOL, MINIPRESS, LIPITOR

Current Illness: NO ILLNESSES

ID: 1689249
Sex: M
Age: 72
State: IN

Vax Date: 03/08/2021
Onset Date: 03/10/2021
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:

Allergies:

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

Symptoms: Blood pressure went up.

Other Meds: Heart; High cholesterol; and Diabetes; Vitamins

Current Illness:

ID: 1689250
Sex: F
Age: 59
State: KS

Vax Date: 03/08/2021
Onset Date: 03/30/2021
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: Urinalysis, CT scan, Lab work

Allergies: Augmentin; Aleve

Symptom List: Ear pain, Hypoaesthesia

Symptoms: I had abdominal pain and mucus in my stool. I went to the doctor on April 1st; I thought I had a UTI, and they took a urine sample and prescribed antibiotics. They sent me to have a CT of my abdomen on April 5th, which showed a bowel infection and advised me to get another CT in 3-4 months. I had another bout of abdominal pain on July 12th and was told I had to wait for another 3 months for another CT scan. I had the CT scan on Sept. 9th and waiting for results.

Other Meds: Metformin; Simvastatin; Pantoprazole Sodium; Estradiol; Zolpidem Tartrate; Levothyroxine Sodium; Vitamin D3 5000 UI daily; Multivitamin daily; Fish Oil

Current Illness: None

ID: 1689251
Sex: F
Age: 64
State: TX

Vax Date: 03/01/2021
Onset Date: 07/26/2021
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: Colonoscopy

Allergies: Latex Iodine

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: When I went for my routine colonoscopy, I was diagnosed with ulcerative colitis. I have never had any prior colon issues, not do colon issues run in my family. I believe something in the vaccine triggered my immune system to attack the colon. With an autoimmune disorder, you have to be so careful.

Other Meds: Levothyroxin Tramedol ER

Current Illness: Sjogrens Hypothyroidism

ID: 1689252
Sex: M
Age: 47
State: TN

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

Allergies: None

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

Symptoms: None

Other Meds: None

Current Illness: None

ID: 1689253
Sex: F
Age: 60
State: FL

Vax Date: 04/20/2021
Onset Date: 04/24/2021
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: CXR, covid test.

Allergies: Diovan, shellfish, soy, sulfa drugs

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

Symptoms: Pt came to ER c/o respiratory problem onset 1 day prior.

Other Meds:

Current Illness:

ID: 1689254
Sex: M
Age: 67
State: FL

Vax Date: 03/02/2021
Onset Date: 03/16/2021
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: Innumerable.

Allergies: NKA

Symptom List: Unevaluable event

Symptoms: Patient developed neuropsychiatric symptoms starting 2 weeks after the 2nd shot of the Moderna COVID vaccine. He was subsequently diagnosed with Hashimoto's Encephalopathy after extensive diagnostic workup.

Other Meds: No prescriptions or over-the-counter medications. Was taking supplements: 1. Umzu Redwood, 2. Psyllium husk, 3. Traumeel, as well as 5-hour energy drinks.

Current Illness: None others than the AE from the vaccine.

ID: 1689255
Sex: M
Age: 65
State: PA

Vax Date: 03/18/2021
Onset Date: 04/23/2021
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: Duplex Ultrasound and Ct Chest 4.23.2021

Allergies:

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

Symptoms: Patient developed cramping in his legs after his first COVID vaccine which was given 2.25.2021. in Hospital. After his second vaccine which was given 3.18.2021, he developed a cough and left leg pain and edema which prompted medical attention about 3 weeks after his second dose. He was diagnosed with a left lower extremity deep vein thrombosis and pulmonary embolism 4.23.2021 and was placed on blood thinenrs, Eliquis.

Other Meds:

Current Illness:

ID: 1689256
Sex: M
Age: 28
State: IL

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

Lab Data:

Allergies: Penicillin

Symptom List: Injection site pain, Pain

Symptoms: Nausea, coldness, headache

Other Meds:

Current Illness:

ID: 1689257
Sex: M
Age: 56
State: TN

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

Lab Data: X-RAY, WAS ORDERED AN MRI TO LOOK FURTHER INTO DIAGNOSING BUT WAS DENIED BY INSURANCE

Allergies: no allergies

Symptom List: Injection site pain, Menorrhagia

Symptoms: PATIENT STATES HE HAS HAD PAIN , LOSS OF MUSCLE AND NUMBNESS IN HIS LEFT ARM THAT WORKS DOWN TO HIS RING AND PINKY FINGER UPON RAISING HAND TO FACE SINCE RECEIVING THE SHOT. HE SAYS THERE HAS NOT BEEN ANY IMPROVEMENT WITH ADDITION OF STEROID PACK AND IBUPROFEN 800MG AND GABAPENTIN (MEDICATIONS WERE TRIED AS SEPARATE THERAPIES NOT AT THE SAME TIME) 3 DAYS OF THERAPY WITH HOT AND COLD

Other Meds: Lisinopril 20mg 2 tablets twice a day , Atorvastatin 40mg 1 tablet qd, Amlodipine 10mg 1 tablet daily, Metoprolol 50mg one-half tablet twice a day, Aspirin 325mg 1 tablet once a day,

Current Illness: none

ID: 1689258
Sex: F
Age: 39
State: IA

Vax Date: 08/15/2021
Onset Date: 08/22/2021
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: CBC w/ dif, CMP, TSH, folate, Vit b12 & B1, ANA, CRP, ESR, ferritin, LDH, on 9/9 Strep PCR, COVID PCR on 8/22.

Allergies: Penicillin

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

Symptoms: Mucositis with ulcers to tongue, inside cheeks, roof of mouth, inner and outer lips, body aches, cervical lymphadenopathy, ongoing fatigue (still present). On 9/4 developed pain to left side of scalp that is sharp when touched.

Other Meds: 3 Advocare supplements which she has taken for years.

Current Illness: none

ID: 1689259
Sex: F
Age: 83
State: MN

Vax Date: 02/25/2021
Onset Date: 09/09/2021
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: POSITIVE COVID TEST 9/9/21

Allergies: ADHESIVE TAPE-SILICONES ISOPROPLY NICOTINATE LATEX MACROBID MEPROBBAMATE METFORMIN NIASPAN

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: NAUSEA. GENERALIZED WEKNESS, COUGH WITH PHLEGM, ABDOMINAL PAIN, HEADACHE AND JOINT PAIN

Other Meds: aspirin 81 mg oral enteric coated tablet bimatoprost (LUMIGAN) 0.01 % Opht ophthalmic (EYE) solution calcium carbonate (TUMS) 200 mg calcium (500 mg) oral chew tab docusate sodium (COLACE) 100 mg oral capsule insulin as

Current Illness:

Date Died: 08/24/2021

ID: 1689261
Sex: F
Age: 63
State: CA

Vax Date: 08/20/2021
Onset Date: 08/21/2021
Rec V Date: 09/10/2021
Hospital: Y

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

Lab Data: patient had a CT scan of the abdomen and pelvis showing emphysematous gastritis and duodenitis. She also had pancreatitis. Patient had marked elevation in liver enzymes that continued to worsen throughout her hospital stay. She had no previous liver problems. She also had acute kidney failure. There is suspicion that the patient developed an arterial occlusion in the abdominal vasculature that could have precipitated this event. Unfortunately this is not proven and only clinical suspicion. An autopsy was not done.

Allergies: none

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Patient had her 1st dose of the vaccine on Friday 8/20. Over the next day the patient developed nausea, vomiting and abdominal pain. The pain continued until the patient presented to the emergency department on 08/22. Patient was found to have emphysematous gastritis. She was started on antibiotics and admitted to the intensive care unit. The patient also had significant elevation in liver enzymes. She developed altered mental status and eventually respiratory failure and was unable to protect her airway. Further radiologic examinations showed perforated viscus and diffuse pneumoperitoneum. Patient died on 08/24.

Other Meds: Estrogen for male to female transition.

Current Illness: none

ID: 1689262
Sex: M
Age: 35
State: WV

Vax Date: 03/10/2021
Onset Date: 03/10/2021
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. Advised to not get 2nd vaccine dose.

Allergies: Nkda

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

Symptoms: Edema in the left shoulder and stiffness. Pain the shoulder and arm that lasted for several weeks , along with numbness and tingling in the arm and fingers. I also had decreased range of motion due to pain in the shoulder after the injection for several weeks.

Other Meds: Vyvanse, Lisinopril, Lexapri, Zetia, Tricor, Fish Oil, Cinnamon, Clonidine, ASA 81, Metforamin.

Current Illness: No

ID: 1689263
Sex: M
Age: 44
State: TX

Vax Date: 09/06/2021
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: RA

Lab Data: None

Allergies: None

Symptom List: Nausea

Symptoms: Patient was given first dose of Moderna on 9/6 after previously receiving J&J Vaccine on 7/16

Other Meds: None

Current Illness: None

ID: 1689264
Sex: F
Age: 72
State: PA

Vax Date: 04/08/2021
Onset Date: 04/11/2021
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: HNL lab 7/23, US Abdomen Complete, 8/20/21 Mycardial Perfusionk, 8/22/21 Lab 254 hour urine test.8/23/21 lab tests

Allergies: Singulair seasonal allergies and strong smells

Symptom List: Injection site pain

Symptoms: 4 days after shot I got shingles stabbing pain in right leg. Went to emergeny twice, clinic, and family doctor talked to on phone 3 times for horrible pain. Lasted 6 weeks. Day after pain subsided I got a rash over my whole body. Doctor prescribed more antibiotics. When that went away my lets started swelling. Had many tests and utra sound on lets stomach and many blood tests. My legs still swell at times.

Other Meds: ATorvastatin 5mg Amlodipine 10mg cetirizine 10mg bioitin 250 citracal plus D3

Current Illness: Osteoporosis

ID: 1689265
Sex: F
Age: 59
State: WI

Vax Date: 02/03/2021
Onset Date: 02/10/2021
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: Multiple lab test cmp, cbc . One episode was transferred to Emergency room for nose bleed and critical blood pressure level.

Allergies: Hydromorphone

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

Symptoms: Spontaneous Nose bleeds and critical Hypertension

Other Meds: Crestor, Nexium, Vitamin D, Calcium

Current Illness: Hyperlipidemia, Osteoporosis

ID: 1689266
Sex: F
Age: 16
State: KY

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

Lab Data:

Allergies: none listed

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

Symptoms: COVID-19 Vaccine administered to under-age patient. This error may have involved not using two patient identifiers to confirm the patient was of-age to receive the vaccine. Patient, first dose of moderna was requested by mother. Immunization was given curbside in left deltoid (8/17/2021 around 12:10 pm) by pharmacist. After administering the vaccine, the staff member realized that the moderna vaccine has not yet been approved under EUA to be given to children 17 years or younger. Patient's parent/guardian was then contacted and updated on what happened. Based on all information available, there is no reason to suspect any harm.

Other Meds: none listed

Current Illness:

ID: 1689267
Sex: M
Age: 55
State: CA

Vax Date: 07/21/2021
Onset Date: 07/21/2021
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: transferred to ER

Allergies: none

Symptom List: Tremor

Symptoms: within 24 hours develop significant lymphadenopathy right groin that got worse after 2nd dose and now presents to clinic with large firm lymph node rt groin with obstruction of venous system in rt lower leg with entire rt lower leg edema and redness. patients transferred to local Emergency department.

Other Meds: none

Current Illness: none

ID: 1689268
Sex: M
Age: 51
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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: N/A

Allergies: None

Symptom List: Erythema, Pruritus

Symptoms: Headache Fatigue Nausea Diarrhea Arm pain

Other Meds: None

Current Illness: None

ID: 1689269
Sex: M
Age: 82
State: OH

Vax Date: 06/14/2021
Onset Date: 06/14/2021
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: 8/9/21 - Podiatrist - Dr. examined feet and confirmed numbness. 8/17/21 - Consulted with Dr. spine specialist. 8/27/21 - Received and MRI ordered by Dr. 9/9/21 - Follow up consultation with Dr.

Allergies: Hydrochlorothiazide (HCTZ) - severe heart irregularity Doxepin - buzzing in feet Ramipril - elevated blood pressure Zoloft - elevated blood pressure Atenolol - irregular heart rate

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

Symptoms: On June 14th, 2021, I got my first Covid-19 Moderna Vaccination. Within a few hours of receiving the vaccination, I developed a significant itch on my left hand. The itching continued on into the night with no relief. Upon arising the next morning I developed a severe outbreak of the hives. I called the doctor and he prescribed Benadryl which gave me some relief. The severity of the hives continued over the next two weeks without significant change. It took me a month before I was completely free of the outbreaks. On August 12th I had another outbreak in three locations, but it lasted only one day without treatment. In addition, I experienced numbness in my feet following the shot, but I was so focused on ridding myself of the hives the numbness did not concern me until it became so prominent that my feet began to feel like they were weighted down and felt very heavy. I consulted with three doctors over the next three months to determine if there could be any other explanation other than the Moderna Vaccine. Unfortunately, none of the doctors could give me an alternative explanation for the numbness. Although the numbness continues as I complete this report, I have sensed that there has been a slight improvement over the past week.

Other Meds: Prescription Drugs Zestril (Lisinopril) 20mg tablet ? one per day Atorvastatin 10mg - one per day Over-the-counter Medicines Vitamin D3 2000 I.U. ? one per day Magnesium Citrate 250mg ? one per day Prilosec (Omeprazole) 20mg capsule - on

Current Illness: None

ID: 1689270
Sex: F
Age: 68
State: NC

Vax Date: 04/12/2021
Onset Date: 09/07/2021
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:

Allergies:

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

Symptoms: Hospitalization on 9/7/2021 due to COVID19. Reported per Janssen COVID vaccine EUA.

Other Meds:

Current Illness:

ID: 1689271
Sex: F
Age: 21
State: VA

Vax Date: 09/04/2021
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: penicillin, mold, dust, seasonal allergies

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: rash and hives in the arm of shot, chest, and legs for a few hours, benadryl was taken twice before it went away

Other Meds: none

Current Illness: none

ID: 1689272
Sex: F
Age: 82
State: MN

Vax Date: 02/22/2021
Onset Date: 09/08/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Hospitalization

Other Meds:

Current Illness:

ID: 1689273
Sex: F
Age: 32
State: IL

Vax Date: 05/11/2021
Onset Date: 06/11/2021
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:

Allergies:

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

Symptoms: I got lip filler 1 month after second vaccine shot and it dissolved in 2 months. The last 5 years it takes over a year to dissolve.

Other Meds: Birth control, spirolactone, seratone

Current Illness:

ID: 1689274
Sex: F
Age: 31
State: NM

Vax Date: 03/12/2021
Onset Date: 09/03/2021
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: Sept 3, 2021@07:40 FLU A (CEPHEID) NEGATIVE, FLU B (CEPHEID) NEGATIVE, RSV (CEPHEID) NEGATIVE _COVID-19 (CEPHEID) POSITIVEA

Allergies: None

Symptom List: Pain in extremity

Symptoms: Screening, contact with positive covid 19 case

Other Meds: None

Current Illness: None

ID: 1689275
Sex: F
Age: 64
State: AZ

Vax Date: 09/08/2021
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:
Dose Series: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: Grass

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

Symptoms: Patient stated that the left side of her shoulder blade. It is up by her neck. It is tender to the touch, It feels like there is a knot in the middle.

Other Meds:

Current Illness:

ID: 1689276
Sex: M
Age: 26
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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Patient was waiting the 15-20 minutes after the shot. He was sitting down and passed out. He fell out of his chair and hit the floor. Patient was sweating and pale. Patient regained consciousness. He drink a soda and we gave him a cold compress.

Other Meds:

Current Illness:

ID: 1689277
Sex: M
Age: 69
State: FL

Vax Date: 04/06/2021
Onset Date: 04/23/2021
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: CXR, covid test.

Allergies: NKA

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

Symptoms: Pt came to ER c/o weakness and fever for 1 week, SOB.

Other Meds:

Current Illness:

ID: 1689278
Sex: M
Age: 55
State: KY

Vax Date: 06/22/2021
Onset Date: 08/26/2021
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: blood vessel burst in back of eye and an ophthamologist did surgery to stop the hemorrhaging. Still recovering. Some sight has returned to the eye.

Other Meds:

Current Illness:

ID: 1689279
Sex: F
Age: 51
State: VA

Vax Date: 05/04/2021
Onset Date: 05/08/2021
Rec V Date: 09/10/2021
Hospital:

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

Lab Data: none

Allergies: latex, nickel

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Had a very heavy menstrual period 4 days after receiving 2nd vaccination (received 2nd dose on May 4, cycle started on May 8, which would have been the expected date that was normal for me). My next cycle came very early on May 21, just 13 days after the prior cycle. That period was also unusually heavy. After that May 21 menstrual cycle, my periods have returned to regular intervals (normal for me) and of normal flow. So I had 2 abnormally heavy periods after vaccination, and one cycle post 2nd vaccination that came 2+ weeks early.

Other Meds: Xanax prn, betahistine 16mg daily

Current Illness: none other than immune response to first vaccination on April 12

ID: 1689280
Sex: M
Age: 21
State: WI

Vax Date: 05/08/2021
Onset Date: 05/10/2021
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: Troponin 3.82 ng/mL (normal < 0.03) CRP 3.6 mg/dL (normal <1.0). ESR 7 mm/hr (normal <15) Negative Nasopharyngeal COVID-19 PCR CMR: Nonischemic pattern of myocardial late gadolinium enhancement , small pericardial effusion, consistent with myopericarditis

Allergies:

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

Symptoms: myocarditis treated with NSAIDs, colchicine

Other Meds:

Current Illness:

ID: 1689281
Sex: F
Age: 60
State: KY

Vax Date: 09/02/2021
Onset Date: 09/05/2021
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

Allergies: Not to my knowledge

Symptom List: Injection site swelling, Limb discomfort

Symptoms: I'm a general contractor I went out of town to visit a friend and lost my voice. I went to the hospital and they prescribed me prednisone and sent me on my way. Went home a 1.5 days later and it got worse and completely lost my voice. I went to the hospital and the Dr. prescribed me Flonase, antibiotics and more prednisone.

Other Meds: None

Current Illness: No

ID: 1689282
Sex: M
Age: 48
State: PA

Vax Date: 08/14/2021
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: EKG CVC blood work panel Chest X-ray Troponin blood work

Allergies: None

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

Symptoms: Shortness of breath Chest pain Pain in my jaw Pain at the roof of my mouth Hive on my right forearm, which was raised & red

Other Meds: Lemtrada 12mg Trokendi 100mg Lexapro 10mg Lipodrene once a day

Current Illness: None

ID: 1689283
Sex: F
Age: 42
State: ID

Vax Date: 09/03/2021
Onset Date: 09/07/2021
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: Pt reported that her labs had been indicative of a heart attack. She didn't have any other risk factors- she is thin, cholesterol normal, bp normal and no sign of any other clots, etc.

Allergies: no known

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

Symptoms: Patient woke Tuesday, 4 days after her second dose of Pfizer, and had terrible arm and back pain and what felt like really bad heart burn in her chest. Her mother called Wednesday and told me about her symptoms and I suggested getting to a doctor and getting an EKG. The patient came in today and was feeling much better but she was getting nitrogylcerin SL tabs and baby aspirin because cardiologist said she had minor heart attack.

Other Meds: NP Thyroid, Multivitamin

Current Illness: Hypothyroidism

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am