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: 1689992
Sex: M
Age: 64
State: IL

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

Lab Data: n/a

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Red, peeling skin rash on left side of face/forehead/neck. Pt states it is getting worse and that it stings and itches. It started the next day following the vaccination. So far, the peeling rash is localized on the left face. It is not on the trunk or extremities. Patient has not tried any treatments or sought medical attention. He tried making an appointment with his primary care provider, but the earliest he could get in is on 9/24/21. I advised him to see a provider at an immediate care facility for further evaluation, due to the reaction not improving and getting worse.

Other Meds:

Current Illness:

ID: 1689993
Sex: F
Age: 47
State: TN

Vax Date: 08/23/2021
Onset Date: 08/31/2021
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: PCN

Symptom List: Anxiety, Dyspnoea

Symptoms: Red, itchy, sore rash at site of injection that lasted about a week.

Other Meds: None

Current Illness: None

ID: 1689994
Sex: F
Age: 58
State: ID

Vax Date: 08/23/2021
Onset Date: 08/24/2021
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: None

Allergies: Sensitivity to Epinephrine. No other allergies known.

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

Symptoms: The following day of the 1st vaccine, I noticed feeling shortness of breath, chest discomfort and feeling emotional, feeling like something is wrong/feelings of doom. I felt that way all that day on 8/24/21 & 8/25/21. On 8/26/21 it started to ease a little in the afternoon and by day 8/27/21, I felt better and shortness of breath was pretty much gone. I didn't realize that this may be an adverse side effect until my daughter (who works for a hospital) told me to get a hold of my doctor and let her know. I found the paperwork and read the normal possible side effects and more serious symptoms. I was a week away from getting my 2nd vaccine so I called my physician. She advised me that the shortness of breath was an adverse event and recommended that I don't get the 2nd vaccine and to report it to CDC. I did use my Albuterol during the time I had shortness of breath and chest discomfort. I was going to go to the ER or call my physician if I felt worse but I started feeling better by 4th day. I usually try to ride thru things and not go to the ER or doctor unless it's serious. I didn't realize what I was experiencing was not part of "normal" side effects.

Other Meds: Celexa, atenelol, simvistatin, armour thyroid, Flovent, abuterol (as needed), estrodial patch, compound progesterone/DHEA, flonase, xanax, marine collagen peptides, multivitamin, D3+K2, CQ10, Tylenol sinus when needed, Started prescription

Current Illness: Thrush in mouth from asthma inhaler.

ID: 1690129
Sex: F
Age: 47
State: DC

Vax Date: 08/26/2021
Onset Date: 08/28/2021
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: None

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Bone pain throughout the body, no treatment sought. Resolved after a few days. Pain in upper left chest (heart?), ongoing more painful with certain movements. No treatment sought yet.

Other Meds: Vitamin C, Vitamin D, Fish oil

Current Illness: None

ID: 1690130
Sex: F
Age: 15
State: MD

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: Nothing yet

Allergies: None

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

Symptoms: Extreme chills, migraine, fever,and nausea. We gave her ibuprofen and have her under a heating blanket. She is sipping water.

Other Meds: None

Current Illness: None

ID: 1690131
Sex: F
Age: 25
State: IL

Vax Date: 09/10/2021
Onset Date: 09/10/2021
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: The event actually occurred at the mixing of the vaccine Pfizer vaccine was diluted with 1.8ml of Moderna vaccine instead of sodium chloride vaccine patient due in November

Other Meds:

Current Illness:

ID: 1690132
Sex: F
Age: 13
State: FL

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

Lab Data: na

Allergies: none

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Dizziness, blurred vision Paramedics took to ER

Other Meds: none

Current Illness: none

ID: 1690133
Sex: F
Age: 48
State: TX

Vax Date: 09/01/2021
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: UNK
Vax Route: IM
Vax Site: LA

Lab Data: Positive COVID rapid test 9/7/2021

Allergies: Penicillin

Symptom List: Pharyngeal swelling

Symptoms: COVID positive 9/7/2021

Other Meds: Anxiety and antidepressant Blood pressure and cholesterol

Current Illness: None

ID: 1690134
Sex: F
Age: 37
State: OH

Vax Date: 08/20/2021
Onset Date: 08/21/2021
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: None.

Allergies: None

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Approximately 5 hours after receiving vaccine, patient's right arm (NOT the vaccine arm) had red itchy rash that lasted for 1 week. She did not seek treatment and the rash resolved on its own.

Other Meds: None

Current Illness: None

ID: 1690135
Sex: F
Age: 46
State: KY

Vax Date: 08/30/2021
Onset Date: 08/30/2021
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:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Patient fainted after receiving vaccine. She reported feeling hot and very nervous prior to receiving vaccination.

Other Meds:

Current Illness:

ID: 1690136
Sex: F
Age: 28
State: MN

Vax Date: 03/08/2021
Onset Date: 08/30/2021
Rec V Date: 09/10/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Fully vaccinated employee became symptomatic and tested positive for Covid-19

Other Meds:

Current Illness:

ID: 1690137
Sex: F
Age: 46
State: OH

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: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: Patient described left arm pain, the arm that received the vaccination, and reported discomfort in the left leg as well. Routinely checked her blood pressure and it was elevated 180/118mmHg. Waited a few minutes and checked again with similar results. She denied any other symptoms. She was advised to have her blood pressure checked out. She refused the offer of EMS, and stated she would have it checked today. She left and it is unknown at this time if she was seen in the ER as advised.

Other Meds:

Current Illness:

ID: 1690138
Sex: F
Age: 55
State: FL

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

Lab Data: None

Allergies: None

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

Symptoms: Headache, muscle aches, nausea, back pain, sore arm, chills, fever - began approx 20 hrs after injection, persisting into evening of day two.

Other Meds: 10 mg Adderol

Current Illness: None

ID: 1690139
Sex: M
Age: 53
State: CA

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: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data: EKG was normal 9/6/21 Covid-19 test was negative 9/6/21

Allergies:

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

Symptoms: headache, burning on chest and pain on sides.

Other Meds: B-Complex supplement

Current Illness:

ID: 1690140
Sex: M
Age: 58
State: CA

Vax Date: 04/26/2021
Onset Date: 04/27/2021
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: 1.) Primary Care Doctor, appointment re: Tinnitus on 5/13/21. 2.) ENT Doctor appointment with Dr. on 5/18/21. Dr. conducted a hearing test.

Allergies: None

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

Symptoms: After getting the Pfizer Covid 19 shot, I started getting tinnitus primarily in my left ear. It is a quite noticible high pitched ringing that is present all the time. It is particularly hard to deal with at night since the ringing becomes quite loud when the noise of the day goes down.

Other Meds: None

Current Illness: None

ID: 1690141
Sex: M
Age: 81
State: VA

Vax Date: 08/20/2021
Onset Date: 08/25/2021
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: went to primary care 8/26 (EKG had pvc's) , cardio 9/6 (being wear vest) returns 9/15

Allergies: shell fish -severe anaphylastic reaction

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

Symptoms: stated involuntary movements in shoulders, neck, face, perspire profusely on skin, arms, shirt cold and wet, bp 180/100pulse 84, irregular pulse, look of fright on face, felt being pulled toward ceiling, skin was ashen, no apparent sob, no nausea or pain radiation, pain localized in chest and abdomnial area, tingling all over, took cetirizine 10mg (due to allergy and had received 2nd dose) within 15 mins got up then reclined bp was still 148/90 pulse still irregular but no distress, did not go to er, went through night with no further episodes,

Other Meds: none known

Current Illness: none known

ID: 1690143
Sex: F
Age: 65
State: IL

Vax Date: 09/09/2021
Onset Date: 09/09/2021
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: Patient stated had a hurt arm about one hour after the vaccination; within a 24 hour period started to develop red blotches going down arms, experienced chills and headache, shoulder and neck pain and stiffness.

Other Meds:

Current Illness:

ID: 1690145
Sex: M
Age: 77
State: FL

Vax Date: 08/28/2021
Onset Date: 09/01/2021
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: Nol

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Left arm muscle location pain Muscle from left shoulder to neck pain

Other Meds: Metoprolol er succinate100 mg Atorvaststin 10mg Lisinopril 40;mg

Current Illness: None

ID: 1690146
Sex: M
Age: 63
State: CA

Vax Date: 05/07/2021
Onset Date: 05/01/2021
Rec V Date: 09/10/2021
Hospital: Y

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

Lab Data: EKG, Echo

Allergies: Ampicillin Rash

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Developed 30%, Heart PVCs. Dr. performed a Cardiac Ablation. The problem was resolved but then recurred after 10 days. Current condition, 30% of heartbeats are PVCs

Other Meds: Zolpidem

Current Illness: none

ID: 1690147
Sex: F
Age: 16
State: FL

Vax Date: 09/10/2021
Onset Date: 09/10/2021
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: paramedic checked he vials and they were fine.

Allergies: peanuts only

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

Symptoms: patient fainted 3 minutes after the vaccine , dizzy, problem breathing, headache. heavy chest. patient was given benadryl and epipen 5 minutes after. patient improved after paramedic came, patient was able to walk out of the store with her father, father stated the will go to the hospital to further check her.

Other Meds:

Current Illness:

ID: 1690148
Sex: M
Age: 36
State:

Vax Date: 07/17/2021
Onset Date: 07/17/2021
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: I won't see a doctor about this, as I have no expectation a doctor would 1) know what to do 2) be able to do anything about it to make it better rather than worse.

Allergies: grains intolerance; chemical sensitivities

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

Symptoms: 7/17/2021: No pain during injection, injection rate was a bit too fast, probably about 1.2 seconds. Slight stinging around 30 minutes after, but for only about 5 seconds. Slightly sore arm. By 8:30pm, the core at the base of my tongue had a bit of tingle radiating toward the full surface of the tongue. By about 9:30, the back left of my knee felt a pain or soreness (vaccine would be the only cause for this type of pain). 9/10/2021: Since 7/18/2021 I have had burning sensations occuring most every day, and which is occuring right now. Similar to what would happen if one were to eat very spicy food and then never return to a normal state after eating the spicy food.

Other Meds: Herbal remedies taken prior to and after vaccination: honey; Astragalus extract from the root of Certified Organic Astragalus mongholicus plants; Balanced B Complex -700 mg of 8-in-1 Mushroom Defense Mix (organic king trumpet, turkey tail,

Current Illness: none

ID: 1690149
Sex: F
Age: 35
State: KY

Vax Date: 09/08/2021
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: none

Allergies: sulpha drugs

Symptom List: Unevaluable event

Symptoms: Redness and warm to the touch at the vaccine site two days after the vaccine was given. The patient is using a cold compress.

Other Meds: unknown

Current Illness: unknown

ID: 1690150
Sex: F
Age: 40
State:

Vax Date: 03/24/2021
Onset Date: 05/05/2021
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: None

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

Symptoms: Crazy heavy and painful periods since 2nd vaccine. Period did not stop for 25 days.

Other Meds: Birth control: portia

Current Illness: None

ID: 1690151
Sex: M
Age: 20
State: GA

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Patient lost consciousness and appeared to seize. He came back to in approximately 10-15 seconds. EMS came and did not think he had a full seizure.

Other Meds:

Current Illness:

ID: 1690152
Sex: F
Age: 64
State: CA

Vax Date: 03/17/2021
Onset Date: 03/17/2021
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: cardiologist but did not complete.

Allergies: none

Symptom List: Injection site pain, Menorrhagia

Symptoms: At 10 pm I started getting uncontrollably shaky. I could not calm down - teeth chattering - full body shaking. My husband covered me with an extra blanket until I could stop... which did happen within 20 minutes and I was able to sleep. ... until around 2 am. I looked because I did not want to get out of bed because I felt weak...but I thought I had to vomit... so I tried to get up to make it to the bathroom. I stood up and fell on the ground. My legs could not support me. I started moaning. I told my husband I had to vomit and he encouraged me to crawl to the bathroom on scoot and fall at a time. When what seemed like forever I got to the tile floor, I laid my head on the tile and it felt so good that I crawled the rest of my unclothed body on the tile. And stayed there sweating profusely for what my hubby said was 40 minutes. I can't recall that much time. But when I woke up I was in a puddle of liquid. My chest was dripping wet and my back was in a puddle. My husband thinks I peed, but it's unknown if I could actually sweat that much or if I had an involuntary pee that I can't recall. But when I got up I made it back to the bed without vomiting (the urge passed) and slept until morning. In morning I felt weak but ok. Able to eat and function, etc. I felt good enough by afternoon to strip bed and wash towels that hubby used to dry floor. It was a huge scare. In retrospect maybe I had a 24 hour covid? I had gone to jury duty that morning with 400 other masked people in a big room.... In the weeks that followed I had more heart palpitations than usual. I call them heart murmurs but not sure what they are. I got a checkup and went to cardiologist but by the time I got in to see him, the heartbeat went back to normal so I didn't do all the tests.

Other Meds: none

Current Illness: none

ID: 1690153
Sex: M
Age: 62
State: CO

Vax Date: 03/18/2021
Onset Date: 09/07/2021
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: Urine test 09/07/2021

Allergies: Hay fever, hardwood trees, grass Pfizer 3.16. And. 4.8.21. LotER8729

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

Symptoms: High proteins and blood in urine. Caught during annual physical

Other Meds: B12. biotin. C. D. cats claw. Ubiqinal, DHEA,

Current Illness: None

ID: 1690154
Sex: F
Age: 45
State: CA

Vax Date: 09/09/2021
Onset Date: 09/10/2021
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: LA

Lab Data: N/A

Allergies: No

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: I received the injection the evening of 9/9/2021 my arm felt sore and the next day I had a headache 9/10/2021. I took 500 mg Tylenol at 12:00 p.m., at 5:30 p.m. I noticed a lump on the left side of my neck above my collarbone it is sensitive to the touch. I do not have any bump or lump on the other side opposite. This is new. My neck also feels sore going towards my shoulder on the left side same side as the injection sight.

Other Meds: B12, D3

Current Illness: No

ID: 1690156
Sex: F
Age: 46
State: UT

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: UNK
Vax Route: IM
Vax Site: RA

Lab Data: None

Allergies: Sulfa, Ceclore, Keflex, Pennicillin

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Rapid resting heartrate (108 average) beginning 3 hours after injection (1 pm) and lasting 4-5 hours then slowly returned to normal (65-70) over the next 3 hours (by 9 pm). There were also accompanying heart palpitations. No shortness of breath or chest pain. I had already been experiencing some palpitations and raised heartrate on occasion, and suspected my thyroid medication is too high. I had contacted my doctor to lower my dose. But never had my heart raced that fast for that long and while resting. I also read that Cayenne can increase heartrate and I did drink some added to my juice that morning.

Other Meds: Levothyroxine 50 mcg Immucalm Cayenne Vitamin D Digestive enzymes

Current Illness: None

ID: 1690157
Sex: F
Age: 43
State: GA

Vax Date: 09/10/2021
Onset Date: 09/10/2021
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:

Allergies: no known allergies

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

Symptoms: Numbness in face, pain (ache) in arms, low grade fever, nausea

Other Meds: moderna immunization

Current Illness: none

ID: 1690158
Sex: M
Age: 33
State: MN

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: RA

Lab Data: Vitals taken

Allergies: NONE

Symptom List: Nausea

Symptoms: Shortly after receiving the vaccine, the patient reported feeling nauseous (he was sitting in the waiting area). I asked if he felt dizzy and he said no. He asked for a bag in case he threw up so I walked back into the pharmacy to get one. When I left he was leaning against the wall and when I came back he was on the ground with his eyes very dilated and a blank stare. He appeared to have slouched down the wall (didn't fall over or hit his head). I started tapping his shoulders and loudly saying his name to try to arouse him. He then began mildly convulsing. I yelled for my technician to call ED and to get the store manager. I tried to move him into a recovery position but was unable to. I kept an eye on his breathing and pulse and after about 1 minute he came to. After the initial shock wore off of me telling him he had a seizure, he said he felt better. We waited for the paramedics to arrive, at which point they took his vitals and did a work up. They determined he did not need to go to the hospital but they were going to go wait in the ambulance with him until someone could come pick him up from the store. At that point the patient and the paramedics departed the pharmacy. As far as I know, he did not go to the doctor or hospital to be evaluated further.

Other Meds: NONE THAT PT REPORTED

Current Illness: NONE

ID: 1690159
Sex: M
Age: 12
State: WA

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

Lab Data:

Allergies: Tree nuts

Symptom List: Injection site pain

Symptoms: In the day after getting the shot, Headache and body ache all day. Nausea off and on. Vomiting in the evening

Other Meds: Melatonin

Current Illness: None

ID: 1690160
Sex: F
Age: 13
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:
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: allergic reaction--1 week hives, covid shot then 22 hours later developed abdominal pain, facial swelling, eye swelling, and lip swelling.

Other Meds:

Current Illness:

Date Died: 05/06/2021

ID: 1690161
Sex: M
Age: 34
State: NY

Vax Date: 04/20/2021
Onset Date: 05/06/2021
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: 1) Genomic Sequencing and Deletion/Duplication Analysis of Genes Associated with Arterial Aneuryms and Dissections: No abnormailty identified in genes tested Toxicology Report: Examination of the specimen(s) submitted did not reveal any positive findings of toxicological significance by procedures outlined in the Analysis Summary.

Allergies:

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

Symptoms: Patient passed away on 05/06/2021, 16 days after the first Pfizer injection. He was a healthy 34 year old. Autopsy report showed no organ or other physical abnormalities. The autopsy report stated his cause of death was an hemopericardium (acute dissection of proximal thoracic aorta / fatal cardiac tamponade / rupture into pericardial sac).

Other Meds:

Current Illness:

ID: 1690162
Sex: M
Age: 39
State: OR

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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: PATIENT EXPERIENCED SYNCOPE ABOUT 5 MINUTES FOLLOWING ADMINISTRATION OF THE J&J VACCINE ON 9/10/21. HE FELL FACE FORWARD ON THE FLOOR RESULTING IN A CONTUSION ABOVE HIS RIGHT EYEBROW, RIGHT CHEEK BONE AND RIGHT KNEE. PATIENT WAS PLACED IN A PRONE POSITION ON HIS BACK WITH HIS FEET LEVATED. BP WAS 117/81 PULSE 84. WOUNDS WERE BANDAGED. PATIENT WAS RESPONSIVE TO QUESTIONS AND DID NOT APPEAR TO HAVE ANY DISORIENTATION DURING CARE OF INJURIES. PATIENT WAS ABLE TO MOVE TO A SITTING POSITION AFTER 15 MINUTES AND ABLE TO STAND AND WALK AFTER 20 MINUTES

Other Meds:

Current Illness:

ID: 1690163
Sex: F
Age: 23
State: NM

Vax Date: 07/01/2021
Onset Date: 07/01/2021
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: None

Symptom List: Erythema, Pruritus

Symptoms: Complete loss of menstrual cycle and severe period like cramps daily. Confirmed not pregnant. Onset at the time of vaccine.

Other Meds: None

Current Illness: None

ID: 1690164
Sex: F
Age: 37
State: IN

Vax Date: 09/08/2021
Onset Date: 09/08/2021
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: Did not go to hospital or doctor because did not feel short of breath and had some relief from Benadryl

Allergies: Penicillin

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

Symptoms: A few hours after receiving vaccine L arm and neck began to ache, then headache, dizziness, and tightness in my ears, throat, and chest. Did not feel short of breath. Took Benadryl and went to bed. Awakened the next day with headache, tightness in neck and ears, sore throat, loss of appetite, nausea and diarrhea. Went to work began to have tightness in chest, pain in left arm and neck, was sent home. Took Benadryl went to bed. Awakened today with headache, sore throat, and fatigue. Took severe sinus tablets and feeling better.

Other Meds: none

Current Illness: none

ID: 1690165
Sex: M
Age: 31
State: MN

Vax Date: 12/30/2020
Onset Date: 09/07/2021
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:

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

Symptoms: tested positive after vaccination

Other Meds:

Current Illness:

ID: 1690166
Sex: F
Age: 29
State: NH

Vax Date: 08/25/2021
Onset Date: 08/28/2021
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: None

Allergies: Demerol. Reglan, CT Barium, strawberries, gluten

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Started noticing chest pain a few days after injection. At first the pain was controlled by taking Aleve, but eventually that stopped helping. The chest pain started getting more consistent about 7-10 days after injection and around that time I also started to have episodes of shortness of breath and the feeling of my heart pounding. The pain gets worse when laying down. On 9/9/21 my doctor put me on diclofenac.

Other Meds: Synthroid, jolessa, vitamins D3 and C, zinc, melatonin, bentyl, zofran, aleve, Benadryl, Allegra

Current Illness:

ID: 1690167
Sex: F
Age: 61
State: DC

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

Lab Data: N/A

Allergies: N/A

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

Symptoms: Patient got High dose rather than regular dose

Other Meds: N/A

Current Illness: N/A

ID: 1690168
Sex: F
Age: 49
State: GA

Vax Date: 09/10/2021
Onset Date: 09/10/2021
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: Milk allergy (causes breathing problems) Lisinopril (causes cough)

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

Symptoms: Since about 10 minutes following the shot, I began having tingling in my feet that has continued. I also have tingling in my hands. Additionally, initially, I had a scratchy throat and itched, but that lasted less than 5 minutes. However, the foot and hand tingling, which is bilateral on both but worse on the right of each, has continued and it is now about 9 hours since the vaccine shot. I did not report this to the pharmacy as I thought it would stop. I did call back a few hours later asking if I could take Benedryl in case I was having an allergic reaction. I was told I could but I have not taken anything as the tingling is not severe at this moment, just present. It was NOT present prior to getting the shot.

Other Meds: Metoprolol Succinate, Metformin, Amlodipine, Vitamin D, Iron, Nexium(Generic), Losartan, Tagment(Over the counter), Atorvastatin, multi vitamin

Current Illness:

ID: 1690169
Sex: F
Age: 67
State: WA

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: None at this time, patient advised to monitor for side effects.

Allergies: penicillins, sulfa antibiotics

Symptom List: Pain in extremity

Symptoms: On 9/10/2021 patient came to the pharmacy seeking her flu shot. Flu shot was prepared for the patient. The vaccine administrator called out a different patients name to which the patient responded and confirmed she was the other patient verbally. When asked if she was here for her second dose of pfizer covid vaccine she again responded yes. The patient received the pfizer vaccine that was intended for a different patient. The incident was discovered when the intended patient asked on the status of her vaccine.

Other Meds: unknown

Current Illness: unknown

ID: 1690170
Sex: M
Age: 26
State: CA

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:

Allergies:

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

Symptoms: Patient does not report any adverse events after vaccination, but the vaccine was given too soon. The second dose was due on 9/18/21 but he was mistakenly given the second dose on 9/8/21 instead

Other Meds:

Current Illness:

ID: 1690171
Sex: F
Age: 42
State: VA

Vax Date: 02/05/2021
Onset Date: 03/08/2021
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: gluten

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

Symptoms: In both legs numbness, tingling shooting pain. Unable to control left more so than left foot while running. Unable to exercise for a month, even walking, without increased tingling or numbness. Continued fatigue in both legs noted. Occasional tingling around mouth or right hand.

Other Meds: Aspirin, prenatal vitamin

Current Illness:

ID: 1690172
Sex: F
Age: 46
State: OH

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

Lab Data:

Allergies: NDKA

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

Symptoms: Patient broke out in hives on face on forehead above eye. Extreme itching . Advised call 911 or visit ER if symptoms worsen or if new symptoms arise.

Other Meds: benadryl, tylenol

Current Illness: Unknown

ID: 1690173
Sex: F
Age: 58
State: TX

Vax Date: 08/14/2021
Onset Date: 08/29/2021
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: Visual exam

Allergies: Gabapentin

Symptom List: Vomiting

Symptoms: Rash on torso 15 days after 1st vaccine. 20 days after 1st vaccine diagnosed with Shingles.

Other Meds: Women's Multivitamin; Vitamin D; Calcium; Baby Aspirin (1 per day)

Current Illness: None

ID: 1690312
Sex: F
Age: 79
State: PA

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: 037K20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data: none

Allergies: No known drug allergy

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: The patient received her first vaccine on 08/13/21. She received the Moderna vaccine. When she returned on 09/10/21, she received the Pfizer vaccine. No adverse effects documented.

Other Meds: lisinopril 10 mg tablet mesalamine 1.2 GM tablet

Current Illness: unknown

ID: 1690313
Sex: F
Age: 25
State: NC

Vax Date: 05/05/2021
Onset Date: 05/05/2021
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: N/a

Allergies: None

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

Symptoms: Fever 102.1 for 2 days Migraine for 24 hours

Other Meds: None

Current Illness: None

ID: 1690314
Sex: F
Age: 72
State: LA

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: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: RX: Morphine, Zofran, Iron IV, Tetracyclines, Plendel, Tagamet, Aspirin, Celebrex, Ultram, Topral, Sulfa Drugs, Naproxen, Xiidra, I uptophen

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Right arm had severe pain and I was unable to move or lift my arm for approximately 48 hours. Sluggishness, low grade fever, no appetite for food or drink for 72 hours

Other Meds: Leaxapro, Wellbutrin, Prevastatin, Benicar, Norco, Ozempic, Prevacid, Norvasc, Tylenol Arthritis, Melatonin

Current Illness: Diabetes Type 2

ID: 1690315
Sex: F
Age: 40
State: GA

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: levaquin wellbutrin thimerasol

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

Symptoms: Fever, body aches, fatigue, weakness, chills starting 9/8/21 around 8:30am continuing until 9/10/21 around 4:00pm. diarrhea starting 9/9/21 about 2:00pm and continuing through 9/10/21 at current time. Large hives surrounding injection site starting 9/10/21. Hives and entire upper arm are hot to the touch. Had a telemed visit 9/9/21 doctor said it sounds to be side effects from vaccine. Have not discussed hives with a doctor yet.

Other Meds: lamotrigene dexillant folic acid

Current Illness:

ID: 1690316
Sex: F
Age: 20
State: WA

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

Lab Data:

Allergies: NKDA

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

Symptoms: Patient fainted after she stood up to wait for her mother to get her vaccine

Other Meds: unknown

Current Illness: unknown

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am