VAERS 2021 Database www.vaers.hhs.gov

Main Page | All 2021 Deaths | Videos
VAERS Updated: 11/12/2021
** VAERS DATABASE Last updated: November 12, 2021**
PLEASE CHECK BACK SOON
Download the files above while you wait.







Manufacturers

Total Manufacturer
199,106MODERNA
36,710JANSSEN
5,381PFIZER\BIONTECH
2,555GLAXOSMITHKLINE BIOLOGICALS
1,469UNKNOWN MANUFACTURER
897MERCK & CO. INC.
627SEQIRUS, INC.
112DYNAVAX TECHNOLOGIES CORPORATION
91SANOFI PASTEUR
75NOVARTIS VACCINES AND DIAGNOSTICS
40EMERGENT BIOSOLUTIONS
14PAXVAX
12TEVA PHARMACEUTICALS
12PROTEIN SCIENCES CORPORATION
9PFIZER\WYETH
4BERNA BIOTECH, LTD.
4SMITHKLINE BEECHAM
3INTERCELL AG
1MEDIMMUNE VACCINES, INC.
1CSL LIMITED

COVID19 Lot Number

VAX LOT Total
2S9CL7,949
7,473
2,547
1,506
1,187
1,051
1,049
s0294561,043
866
IMM209861
816
UT7065MA766
657
579
U62828AA563
557
538
U6737AA516
515
S034636506
4F472471
458
P100253275449
444
276563436
429
418
4BH32414
MENVEO404
PP9L5362
UJ446AA337
319
306
290
271
49TM3270
R1B252M253
4F472179
933622147
C5763AA144
CW3116134
3Y7NL126
UNK114
113
ARBA141A105
104
103
96
300057A90
79
1F4EB73
R1B743M62
56
UJ090AA55
51
UH894AB46
45
UNK44
UNK42
42
EJ168638
Unknown36
35
34
32
32
26
el128424
24
A115A22
22
EN620222
21
UNK20
20
19
Z127A19
19
17
JEV18K95E15
12
111798PI12
10
A739088
No batch number8
3333324181078
6
6
TAR356
5
5
U6935AA5
UNK5
4
unknown4
3
2
55RB72
2
2
2
2
2
U7124AA2
JEV18A68E2
2
ABYB05BA1
1
1
1
1
AMVA436A1
1
1
TJ3521
A130A; VIS give1
1
U7140BB1
1
1
SP UP016AA1
1
1808P08802/ESV01
037K20A300,947
EL1284288,578
57,766
1,432

Incidents per State

State Total
82,750
CA62,821
FL38,209
TX36,512
NY34,921
PA23,646
IN23,622
IL20,597
MI19,590
OH19,426
NJ18,413
NC16,769
GA15,932
WA15,351
VA15,234
MA14,876
AZ14,206
MN12,940
MD12,656
CO11,908
WI11,425
MO10,240
TN9,685
OR8,768
KY8,437
CT8,300
SC6,700
OK6,293
AL5,692
LA5,025
IA4,825
KS4,821
UT4,637
NV4,374
NM3,967
AR3,807
ME3,161
NH3,096
NE2,918
MS2,859
ID2,785
WV2,469
HI2,459
PR2,417
MT2,414
RI2,076
DE1,868
AK1,830
VT1,734
DC1,715
ND1,388
SD1,269
WY866
GU118
VI69
AS47
MP29
MH8
XB6
FM4
QM3
XV2
XL1

ID: 1694148
Sex: M
Age: 11
State: PR

Vax Date: 06/12/2021
Onset Date: 06/12/2021
Rec V Date: 09/13/2021
Hospital:

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

Lab Data: UNKNOWN

Allergies: UNKNOWN

Symptom List: Dysphagia, Epiglottitis

Symptoms: INADVERTENTLY VACCINATED BEFORE 12 YRS OF AGE

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1694149
Sex: F
Age: 34
State: PA

Vax Date: 08/27/2021
Onset Date: 09/11/2021
Rec V Date: 09/13/2021
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: none

Symptom List: Anxiety, Dyspnoea

Symptoms: dull pain at injection site 2 weeks later

Other Meds: Lexapro

Current Illness: none

ID: 1694150
Sex: F
Age: 52
State: MI

Vax Date: 08/10/2021
Onset Date: 08/11/2021
Rec V Date: 09/13/2021
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: Going to get a PEG allergy test in Oct @ Dr. office

Allergies: prior allergy/hives/rash to seroquel i now believe this to be PEG allergy and am getting allergy tested in Oct

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

Symptoms: Itchy skin all the time Hives, blisters, flares up Has been continuing since I got the shot Tried Prednisone, and steroid shot, and Benedryl, and Claritin Nothing is helping

Other Meds: zoloft, yaz, mobic, neupro, daily vitamin

Current Illness: n/a

ID: 1694151
Sex: F
Age: 54
State: NY

Vax Date: 09/11/2021
Onset Date: 09/11/2021
Rec V Date: 09/13/2021
Hospital:

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

Lab Data:

Allergies: NONE LISTED

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: PATIENT WAS WAITING THE 20 MINUTES POST VACCINATION . WITHIN 10 MINUTES OF SHOT, PATIENT FELT LIGHT HEADED, HAD HER EYES CLOSED. PARTIALLY RESPONSIVE. AFTER LYING ON FLOOR WITH LEG ELEVATED, PT FELT A LITTLE BETTER BUT ALSO COMPLAINED OF LEFT LEG NUMBNESS. ON STROKING HER FOOT, PT HAD SENSATION. EMS WAS CALLED. PATIENTS VITALS WERE BP 80/60 AND BS 127 . PT WAS TAKEN TO HOSPITAL AS SHE STILL FELT LIGHTHEADED STANDING UP.

Other Meds: NOT KNOWN

Current Illness: NONE REPORTED

ID: 1694152
Sex: M
Age: 12
State: RI

Vax Date: 05/18/2021
Onset Date: 05/18/2021
Rec V Date: 09/13/2021
Hospital:

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

Lab Data: UNKNOWN

Allergies: UNKNOWN

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

Symptoms: VACCINATED AT CORRECT AGE OF 12 YEARS, REPORTED BY MISTAKE.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1694153
Sex: F
Age: 36
State:

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 09/13/2021
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: None.

Allergies: none

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

Symptoms: Heart palpitations and muscle weakness, no treatment.

Other Meds: none

Current Illness: none

ID: 1694154
Sex: F
Age: 68
State: OH

Vax Date: 07/12/2021
Onset Date: 09/02/2021
Rec V Date: 09/13/2021
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 9/2/21

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Patient was fully Vaccinated with Moderna (6/14/21 & 7/12/21) and was admitted to the hospital with COVID. Patient tested positive 9/2/21 with high flow nasal cannula and SOB. Was finally admitted 9/12/21 and is currently still admitted

Other Meds:

Current Illness:

ID: 1694155
Sex: F
Age: 36
State: IL

Vax Date: 09/09/2021
Onset Date: 09/11/2021
Rec V Date: 09/13/2021
Hospital:

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

Lab Data: na

Allergies: Gluten allergy, cipro, amoxicillin

Symptom List: Pharyngeal swelling

Symptoms: I broke out in a cyst like rash all over my left side shoulder, neck and back on Saturday morning following the shot. I have also had severe bloating and stomach issues since Saturday.

Other Meds: Tylenol

Current Illness:

ID: 1694156
Sex: F
Age: 30
State: KS

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

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: pain at injection site same day of jab. The next day I had a low grade fever all day, all of my joints and muscles ached to the point it hurt to walk. I had a horrendous headache. Fatigue was really bad, I slept all day. Although I don't feel as bad as I did this weekend, I am still very fatigued with joint paint and a slight headache ongoing.

Other Meds: levothyroxin and Triiodothyronine Thyroid Support multivitamin vitamin d3

Current Illness: none

ID: 1694157
Sex: M
Age: 87
State: KY

Vax Date: 03/21/2021
Onset Date: 09/10/2021
Rec V Date: 09/13/2021
Hospital: Y

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

Lab Data:

Allergies: NKA

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Covid postive; admitted to hospital; treated with remdesivir, oxygen and dexamethasone

Other Meds: unknown

Current Illness: unknown

ID: 1694158
Sex: F
Age: 90
State:

Vax Date: 02/15/2021
Onset Date: 09/07/2021
Rec V Date: 09/13/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: Vaccine breakthrough, symptomatic. Inpatient admit 9/7-9/12.

Other Meds:

Current Illness:

ID: 1694159
Sex: F
Age: 48
State: TX

Vax Date: 05/06/2021
Onset Date: 05/08/2021
Rec V Date: 09/13/2021
Hospital:

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

Lab Data: May 15th bloodwork- no findings. May 10th Brain and Lower Lumber MRI's- no findings. May 30th Cervical MRI- no findings

Allergies: Sulfa and milk

Symptom List: Rash, Urticaria

Symptoms: On Saturday, May 8th, I had sharp pains in the back of my left calf; it hurt to walk and was painful to the touch. This lasted about three hours and then became shooting prickly and warm sensations from my foot to my hip. This lasted a couple of days and was rarely constant sensations that varied between shooting pain, prickly, warm, and cold sensations. It then went to my right leg and I had a video appointment with Dr. on May 13th and she advised me to take Advil and to watch for the symptoms to move upward as it could be Guillain barre. On Saturday, May 15th early morning, my left arm was tingly and numb and my left face felt puffy and numb. I went to the ER on May 15th and the ER doctor ruled out Guillain barre and stated it was a reaction to the vaccine and it would need to run its course. They took blood work. My symptoms continued and worsened so Dr. order two MRIs, one of the brains and lower lumbar, and referred me to Dr. reviewed the MRIs and stated that there were no concerns related to the MRI results but that the vaccine attacked my nerves and it would need to run its course. He prescribed Lyrica to help the nerves and ordered a cervical MRI. I returned to Dr. on 7/12/21. I reported that my symptoms were still there but no longer worsening and improving. He stated that was good and it need to continue to run its course.

Other Meds: Venlafaxine 75 mg, Trazodone 100 mg, Vitamin C, D3, B12, Fish Oil and probiotic

Current Illness: none

ID: 1694160
Sex: M
Age: 15
State: FL

Vax Date: 08/24/2021
Onset Date: 08/26/2021
Rec V Date: 09/13/2021
Hospital: Y

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

Lab Data: Troponin I: 8/27: 0.16, 0.31, 0.39, 0.67; 8/28: 0.89, 0.21 Echo obtained on 8/27 showing overall normal ventricular function, but a small apical pericardial effusion without hemodynamic significance. EKG obtained and showed diffuse ST elevation consistent with pericarditis. Repeat EKG was normal sinus rhythm with no evidence of ST elevations.

Allergies: None

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

Symptoms: Transferred from outside ED and admitted to the pediatric step down ICU on 8/26 for chest pain and abnormal EKG. CV/RESP: Chest pain resolved with ibuprofen given at outside ED and was not required during admission. EKG obtained and showed diffuse ST elevation consistent with pericarditis. Initial troponin <0.02 but increased to 0.39 on 8/27. Cardiology consulted. Echo obtained on 8/27 showing overall normal ventricular function, but a small apical pericardial effusion without hemodynamic significance. Started on ibuprofen 400mg tid and Pepcid 20mg bid on 8/27. Troponin increased to 0.81 overnight 8/27. Repeat troponin on 8/28 was 0.21. Repeat EKG was normal sinus rhythm with no evidence of ST elevations. Patient remains without chest pain and denies dyspnea.

Other Meds: None

Current Illness: None

ID: 1694161
Sex: M
Age: 11
State:

Vax Date: 06/02/2021
Onset Date: 06/02/2021
Rec V Date: 09/13/2021
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: UNKNOWN

Allergies: UNKNOWN

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

Symptoms: INADVERTENTLY VACCINATED BEFORE 12 YEARS OF AGE.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1694162
Sex: F
Age: 50
State: VA

Vax Date: 09/11/2021
Onset Date: 09/12/2021
Rec V Date: 09/13/2021
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: None

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

Symptoms: Severe stomach pain Nausea Vomiting

Other Meds: None

Current Illness: None

ID: 1694163
Sex: F
Age: 67
State: MA

Vax Date: 03/04/2021
Onset Date: 04/29/2021
Rec V Date: 09/13/2021
Hospital:

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

Lab Data: Ultrasound of the leg- Immediate treatment

Allergies: none

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

Symptoms: I had no symptoms at all. I went in for a routine ultrasound and they found a deep vein thrombosis. As the radiologist was working on my leg. She was taking photos of the dvt leaving my leg and becoming a pulmonary embolism. I was immediately placed on Xarelto 20mg within the hour. As a result I did not have to visit the hospital. The Xarelto annihilated the blood clot and as a result I no longer have to take the medication. All of this happened and was resolved within a 2 hour period. My ultrasounds have been reviewed by various radiologist and the clot that I experienced that day in unlike any other I have had for the past 31 years off and on. Everything has cleared up at this time.

Other Meds: Daily Vitamin-1xdaily Calcium Supplement-1xdaily Vitamin D -1xdaily Full Aspirin -1xdaily

Current Illness: none

ID: 1694164
Sex: M
Age: 81
State: FL

Vax Date: 08/20/2021
Onset Date: 09/08/2021
Rec V Date: 09/13/2021
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: 3 weeks after injection and after taking Amoxicillin test negative for anti bodies

Other Meds: Amoxicillin. Test for anti bodies came in negative for a second time after using drug for second time because of teeth and gum problems. Each time after drug, I tested negative. Never before was I tested so I do not know if I had no antibod

Current Illness:

ID: 1694165
Sex: F
Age: 64
State: MA

Vax Date: 02/17/2021
Onset Date: 03/03/2021
Rec V Date: 09/13/2021
Hospital:

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

Lab Data: X-ray- fluid in knees autoimmune testing- negative for everything blood work- ESR sedimentation, inflammation high

Allergies: Sulfa, penicillin, cats

Symptom List: Ear pain, Hypoaesthesia

Symptoms: About 2 weeks after the vaccine, my knees started feeling tight. I thought it was from exercise, This was in March and I thought it would just go away. In April I started having pain in my knees. In June I went to my primary care doctor who sent me to do an x-ray where they found fluids in my joints. I did physical therapy but got to a point where I could barely walk. In June I went to the doctor and they found inflammation. Since June, they've noticed the inflammation getting worse. I am ANA negative, my blood work is all normal except for my ESR sedimentation rate, inflammation is very high. These both kept going higher every couple of months. I went to a rheumatologist who took the fluid out of my knees. I have been put on Plaquenil for the inflammation for 2 months which did nothing. I am now on methotrexate but have only been on it for 2 days so I cannot draw any conclusions. They are calling it rheumatoid arthritis even though my blood work does not show this. They are treating it as rheumatoid arthritis. This has affected my quality of life as I have had to stop doing a lot of things.

Other Meds: Levothyroxine, Vitamin D, vitamins

Current Illness: No

ID: 1694166
Sex: F
Age: 39
State: NC

Vax Date: 09/11/2021
Onset Date: 09/11/2021
Rec V Date: 09/13/2021
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: Tachycardia

Other Meds: Lamotrigine

Current Illness:

ID: 1694167
Sex: F
Age: 11
State: PR

Vax Date: 06/17/2021
Onset Date: 06/17/2021
Rec V Date: 09/13/2021
Hospital:

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

Lab Data: UNKNOWN

Allergies: UNKNOWN

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

Symptoms: INADVERTENTLY VACCINATED BEFORE 12 YEARS OF AFE.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1694168
Sex: F
Age: 34
State: WI

Vax Date: 08/25/2021
Onset Date: 08/26/2021
Rec V Date: 09/13/2021
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: Patient developed marked neck and thoracic back pain 1 day following injection. She has required treatment with muscle relaxer, IM ketorolac, and narcotics

Other Meds:

Current Illness:

ID: 1694169
Sex: F
Age: 62
State: CT

Vax Date: 08/25/2021
Onset Date: 08/31/2021
Rec V Date: 09/13/2021
Hospital:

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

Lab Data:

Allergies: Not known

Symptom List: Unevaluable event

Symptoms: Stomach ache ranging from mild to acute, pain in upper hand and sometimes full hand

Other Meds: Blood pressure medicine: Aslo 2.5

Current Illness: No

ID: 1694170
Sex: M
Age: 11
State: PR

Vax Date: 06/14/2021
Onset Date: 06/14/2021
Rec V Date: 09/13/2021
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: UNKNOWN

Allergies: UNKNOWN

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

Symptoms: INADVERTENTLY VACCINATED BEFORE 12 YRS OF AGE.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1694171
Sex: F
Age: 59
State: OH

Vax Date: 05/17/2021
Onset Date: 09/11/2021
Rec V Date: 09/13/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: + COVID

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Patient was fully vaccinated with J&J on 5/17/21 and tested positive for COVID on 9/8/21. Patient was admitted 9/11/21 with SOB and oxygen requirements needed. Patient remains admitted at this time

Other Meds:

Current Illness:

ID: 1694172
Sex: F
Age: 40
State:

Vax Date: 09/10/2021
Onset Date: 09/12/2021
Rec V Date: 09/13/2021
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: Injection site pain, Menorrhagia

Symptoms: Early menstruation (10 days ahead of schedule)

Other Meds:

Current Illness:

ID: 1694173
Sex: M
Age: 46
State: NC

Vax Date: 08/27/2021
Onset Date:
Rec V Date: 09/13/2021
Hospital:

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

Lab Data: None

Allergies: None

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

Symptoms: Moderna COVID-19 Vaccine EUA Client requested and received 1st dose of the Moderna vaccine. It was found out after the 1st dose of Moderna was administered on 8/27/21 that the client had received the J & J Janssen vaccine 5/8/2021.. No adverse reaction reported or noted.

Other Meds: None

Current Illness: None

ID: 1694174
Sex: F
Age: 88
State:

Vax Date: 03/05/2021
Onset Date: 09/11/2021
Rec V Date: 09/13/2021
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: Patient tested positive for covid 19 s/p vaccination

Other Meds:

Current Illness:

ID: 1694175
Sex: F
Age: 47
State: AZ

Vax Date: 09/11/2021
Onset Date: 09/11/2021
Rec V Date: 09/13/2021
Hospital:

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

Lab Data: I have not been to a doctor since I just lost my insurance. I have only taken Benadryl and Tylenol.

Allergies: Citrus

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: I took the shot and about 5 mins after, I became dizzy, nauseous, really weak and sweaty. I then felt a strong urge to diarrhea. I started drinking a lot of water because I couldn?t get cool inside my body. I sat at the pharmacy about 30 mins and eventually I gathered strength to go home. About 30 mins after being gone, I got a massive headache, itching all over my body, and my left arm became numb. It?s been 3 days so far and the itching has not stopped.

Other Meds: None

Current Illness: Diabetes

ID: 1694176
Sex: F
Age: 41
State:

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

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

Symptoms: Numbness (feeling of pins and needles) on the right side of the face. Started about 12 hrs after receiving the vaccine and is still continuing today 3 days later. No loss of motion is occurring with the first vaccine. I am concerned about the second vaccine.

Other Meds:

Current Illness:

ID: 1694177
Sex: F
Age: 22
State: VA

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

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Patient experienced some blurred vision, and started to loss a bit of consciousness. Despite the fact of losing a bit of consciousness but alert and oriented times 3. Blood pressure was 101/69, Oxygen sat was sitting at 100 and the pulse rate was 78.

Other Meds:

Current Illness:

ID: 1694178
Sex: F
Age: 34
State: IN

Vax Date: 09/11/2021
Onset Date: 09/12/2021
Rec V Date: 09/13/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Injection site pain

Symptoms: Sore arm, body aches, headache, sweating, weakness 14 hours after shot.

Other Meds: Paxil

Current Illness: None

ID: 1694179
Sex: M
Age: 11
State: PR

Vax Date: 06/15/2021
Onset Date: 06/15/2021
Rec V Date: 09/13/2021
Hospital:

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

Lab Data: UNKNOWN

Allergies: UNKNOWN

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

Symptoms: INADVERTENTLY VACCINATED BEFORE AGE 12 YEARS.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1694180
Sex: F
Age: 68
State: SD

Vax Date: 09/10/2021
Onset Date: 09/10/1921
Rec V Date: 09/13/2021
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: Codeine

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

Symptoms: Patient was very anxious prior to administration. Spent considerable time with physician, and then the nurse. Consented to receiving the vaccine. Ten minutes post administration "blacked out". She was conscious immediately, and then became nausiated and began to retch. Retching and vomiting continued so transferred by ambulance to the hospital

Other Meds: Vitamin D3 Eliquis Metoprolol Ondansetron Levothyroxine

Current Illness:

ID: 1694181
Sex: F
Age: 81
State: KY

Vax Date: 02/24/2021
Onset Date: 09/12/2021
Rec V Date: 09/13/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: Moderna on 1/29 and 2/24. Positive on 9/12

Other Meds:

Current Illness:

ID: 1694182
Sex: F
Age: 11
State: PR

Vax Date: 06/15/2021
Onset Date: 06/15/2021
Rec V Date: 09/13/2021
Hospital:

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

Lab Data: UNKNOWN

Allergies: UNKNOWN

Symptom List: Erythema, Pruritus

Symptoms: INADVERTNTLY VACCINATED BEFORE 12 YEARS OF AGE.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1694183
Sex: M
Age: 49
State: PA

Vax Date: 07/23/2021
Onset Date: 08/30/2021
Rec V Date: 09/13/2021
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: General examination given 9/2/21

Allergies: none

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

Symptoms: Noticed facial drooping on 8/30/21 and got progressively worse until i was able to be seen by family doctor on 9/2/21 to which he diagnosed me with Bells Palsy as a result of possible vaccination from Johnson and Johnson Vaccine.

Other Meds: valsartan

Current Illness: none

ID: 1694184
Sex: F
Age: 49
State: NY

Vax Date: 04/04/2021
Onset Date: 05/04/2021
Rec V Date: 09/13/2021
Hospital:

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

Lab Data: I notified my primary care of this approximately one month ago and she said that I should report it to VAERS myself. I have followed up with her to ask if I should be seen by her or by a specialist.

Allergies: Penicillin Latex, plastics, gold, insect bites, heat and cold allergic responses.

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

Symptoms: Tinnitus in left ear. I cannot state with certainty when it began. I have never experienced tinnitus before. When I had the first dose of Pfizer, I experience some temporary symptoms in the few days following including tinnitus in both ears, but it resolved itself. At some point in the weeks following the second dose, I began to notice a very high pitched ringing only in my left ear. It is intermittent, but it is still ongoing.

Other Meds: Natural desiccated thyroid Generic Allegra

Current Illness: Considered hypothyroid following complete thyroidectomy in 2012 Currently under evaluation for Mast Cell Activation Syndrome

ID: 1694185
Sex: F
Age: 43
State: NC

Vax Date: 09/13/2021
Onset Date: 09/13/2021
Rec V Date: 09/13/2021
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: Pennicillin and NSAIDs

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Just as the first dose had done, I began developing numbness and tingling (just on the left side of injection) that began in my ear and spread toward the midline of my face and down my left arm. It was an immediate exacerbation of my small fiber neuropathy that flared for 1-2 weeks and then returned to baseline. (But when I had my first shot, it was on the right side, and it did the exact same thing, but the exacerbation never went away on that side). In the next few days after the shot, I did also have an enlarged lymph node under my left armpit and felt sick for two days and then fatigue for several more days.

Other Meds: Lamotrigine, Nortriptyline, Metroprolol, Digestive Enzymes, Probiotics, Ubiquinol, Multi-vitamin, B-12, Vitamin D

Current Illness: None

ID: 1694186
Sex: M
Age: 88
State: IL

Vax Date: 05/01/2021
Onset Date: 09/08/2021
Rec V Date: 09/13/2021
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: Positive COVID 9/12/21

Allergies:

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

Symptoms: Patient received dose 1 (4/3/21) and 2 (5/1/21), patient admitted to Hospital, positive COVID on 9/12/21

Other Meds:

Current Illness: COPD

ID: 1694187
Sex: F
Age: 60
State: PA

Vax Date: 03/05/2021
Onset Date: 04/09/2021
Rec V Date: 09/13/2021
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: 7/14/21- Ultrasound Musculoskeletal -hands 8/24/21 EMG Blood work 4/28/2021- 8/21 CBC, D-Dimer, Comprehensive Metabolic Panel, Vit D, Cobalamin, A1C, C-reactive Protein, Sedimentation Rate, Parathyroid, 3 hr glucose, Vit. B6, Paraneoplastic autobeval, Methylmalonic acid, Protein immunification electrophoresis, HIV, Hepatitis C, TSH

Allergies: none

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

Symptoms: small nerve neuropathy numbness and tingling in both toes and fingers. 24/7. Constant tingling and numbness. keeps me up at night. No treatment is available. This started 5 weeks after the 2nd vaccine and has been constant for the past 5 months. This started in my toes then spread to my fingers.

Other Meds: Cholestyramine, Zrytec, Sudafed, Multi-Vitamins, Vit C, Vit D, Bone health Vitamin, Probiotic

Current Illness: none

ID: 1694188
Sex: M
Age: 58
State: MI

Vax Date: 12/30/2020
Onset Date: 09/08/2021
Rec V Date: 09/13/2021
Hospital: Y

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

Lab Data: SARS-COV-2 by NAA positive on 09/08/21

Allergies: no know allergies

Symptom List: Pain in extremity

Symptoms: PT received COVID-19 Moderna vaccines in December 2020 and January 2021. Pt presented to the ED with complaints of right hip pain. Pt found to be COVID positive on 09/08/21. CXR on 09/08/21 consistent with COVID pneumonia. Pt noted to be hypoxic and was placed on supplemental oxygen. Pt was started on Remdesivir

Other Meds: Symmetrel, norvasc, aspirin, Lipitor, Celexa, Plavix, Colace, Folate, Nizoral A-D, Nizoral, Normodyne, zyprexa, prilosec, Vitamin B, depakene

Current Illness:

ID: 1694189
Sex: F
Age: 61
State: NJ

Vax Date: 05/12/2021
Onset Date: 05/12/2021
Rec V Date: 09/13/2021
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: Sulfa, quinolines, ofloxacin

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

Symptoms: Within hours are the shot, the migraine aurora started which is a clear indication that I am about to have a migraine attack I had heard we were not supposed to take aspirin or similar products so I was concerned I would not be able to take my migraine medication (sumatriptan) to prevent a full on migraine., Since I need to take my Sumatriptan within 30 minutes after the aurora stops, I needed to get advice quickly. I knew my primary physician would not be able to meet the time constraints so I called the Emergency Department. I spoke with a Physician's Assistant, I do not remember her name. I explained what was happening and that I do, from time to time, get migraines, she advised me to go ahead and administer the Sumatriptan Nasal Spray as I would normally. Which I did immediately after I hung up the telephone, which was approximately 2:15 PM. While I never got a full blown migraine, I did get the migraine funk, brain fog, sore arm and was totally fatigued . I was completely wiped out for about 2 days. I stayed in bed for those 2 days,

Other Meds: b-12 injection

Current Illness: None

ID: 1694190
Sex: F
Age: 41
State: MA

Vax Date: 08/28/2021
Onset Date: 08/28/2021
Rec V Date: 09/13/2021
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 was scheduled by doctor

Allergies: none

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

Symptoms: Received 1st dose of COVID-19 Moderna vaccine 08/28/21 aprox. time 11:20 AM, right arm. Onset of reactions occurred within first 1-4 hours after injection: numbing/tingling of left side of face, eye, neck, back of head and bottom lip, dizziness, headache, brain fog (unable to make out words or focus), blurry vision, weak. This continued for first 3-4 days after injection, started to subside a little but lingering for first 2 weeks after injection. Drank water, rested for the weekend and spoke with nurse doctors office over the phone on Monday 08/30/21. Scheduled telehealth appt to speak with doctor on 09/10/21. Informed doctor of reactions still lingering at time of doctors appt.

Other Meds: Mirena 20/mcg/24hours 52 mg intrauterine device

Current Illness: none

ID: 1694191
Sex: F
Age: 50
State: OH

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

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

Lab Data: CBC, BMP, TSH normal on 09/13/2021

Allergies: none

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

Symptoms: Generalized, intensely pruritic urticaria

Other Meds: neurontin, ditropan xl

Current Illness:

ID: 1694192
Sex: U
Age: 30
State: RI

Vax Date: 08/05/2021
Onset Date: 08/05/2021
Rec V Date: 09/13/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data: No adverse event

Allergies: none

Symptom List: Vomiting

Symptoms: No physical adverse event-- pt previously vaccinated with Janssen Covid-19 vaccine; amidst cancer workup and anticipating need for surgery and chemotherapy. Requested subsequent vaccination with Pfizer vaccine, agreed with propriety given anticipated immune suppression. Dose #1 administered 8/5/21; dose #2 planned for 9/16/21 (two weeks s/p surgery and before chemo initiation)

Other Meds: N/A

Current Illness:

ID: 1694193
Sex: F
Age: 36
State:

Vax Date: 04/02/2021
Onset Date: 04/02/2021
Rec V Date: 09/13/2021
Hospital:

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

Lab Data:

Allergies: Anaphylaxis reactions to bee stings.

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Pt with h/o anaphylactic reactions in the past with bee stings. Within five to ten minutes of receiving vaccine, felt an uncomfortable sensation in her throat, felt mildly short of breath, and developed pruritic hives on chest. Nausea, but no emesis. No swelling was observed. Administered IM epi by medical staff at the vaccine site, and transferred to ED. ED gave famotidine 20 mg IV, diphenhydramine 25 mg IV, and methylprednisolone 125 mg IV. Patient discharged home w/ instructions to take famotidine 20 mg PO BID x 4 days, Prednisone 60 mg PO daily x 4 days, and diphenhydramine 25-50 mg PO QID x 4 days.

Other Meds:

Current Illness:

ID: 1694194
Sex: M
Age: 45
State: KY

Vax Date: 08/19/2021
Onset Date: 09/05/2021
Rec V Date: 09/13/2021
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:

Allergies: Erythromycin

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

Symptoms: Second vaccine dose not given. Admitted to hospital; given remdesivir, on oxygen, on dexamethasone

Other Meds: unknown

Current Illness: unknown

ID: 1694195
Sex: F
Age: 85
State: KY

Vax Date: 03/04/2021
Onset Date: 09/12/2021
Rec V Date: 09/13/2021
Hospital: Y

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:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Moderna on 2/4 and 3/4. Positive on 9/12

Other Meds:

Current Illness:

ID: 1694196
Sex: F
Age: 34
State: IL

Vax Date: 09/12/2021
Onset Date: 09/12/2021
Rec V Date: 09/13/2021
Hospital:

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

Lab Data:

Allergies: Lysol, Clorox

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

Symptoms: Severe Lip swelling, body aches, cough, headache, eye pain

Other Meds: Wellbutrin 150mg

Current Illness: none

ID: 1694197
Sex: M
Age: 20
State:

Vax Date: 08/11/2021
Onset Date: 09/10/2021
Rec V Date: 09/13/2021
Hospital: Y

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: Approx one month after vaccination, member found down in room. He was couple days post op from wisdom teeth extraction surgery. He was taken to local hospital and found to be in DKA (no prior dx of diabetes), Acute renal failure, COVID-19 positive. He remains in ICU in critical condition.

Other Meds: None known

Current Illness: None

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am