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: 1694302
Sex: F
Age: 11
State: PR

Vax Date: 06/03/2021
Onset Date: 06/03/2021
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 VACCINATE BEFORE 12 YRS OF AGE.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1694303
Sex: M
Age: 53
State: CA

Vax Date: 05/07/2021
Onset Date: 05/07/2021
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: None

Allergies: Codine

Symptom List: Anxiety, Dyspnoea

Symptoms: Head and neck aches that forced me to bed with dizziness and nausea Blurred vision and became light adverse and unable to focus Arm became incredibly black and blue over next three days and was unable to lift arm above head for days 4 mos post injection 1 i am still feeling as if in a bit of a daze and have headaches which I have never felt before. Feels almost like have water or fluid on brain...neck always stiff

Other Meds: None

Current Illness: None

ID: 1694304
Sex: F
Age: 64
State: FL

Vax Date: 08/01/2021
Onset Date: 08/12/2021
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:

Allergies: Bleach and pineapples

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

Symptoms: Sudden weakness both legs

Other Meds: MVI, Lisinopril 20mg

Current Illness: Bp

ID: 1694305
Sex: F
Age: 60
State: KY

Vax Date: 04/19/2021
Onset Date: 09/03/2021
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:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Covid positive...contact unknown

Other Meds:

Current Illness:

ID: 1694306
Sex: M
Age: 28
State: OH

Vax Date: 09/08/2021
Onset Date: 09/08/2021
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: Patient declined squad ride to local hospital, but did go by private car and was driven by a friend on 9/8/2021. Patient went to ED and was discharged after CT cleared him with no concerning injuries from fall.

Allergies: NKDA

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

Symptoms: Patient received J & J vaccine in the clinic and approximately 3 mins after administration of vaccine, patient fell to the floor from a sitting position and was unresponsive. Smelling salt was used, patient then became alert but stated "Im dizzy". Patient was clammy, pale and diaphoretic. VS obtained at 1459 BP-122/92, HR-56, SPO2-RA 98%, Left patient on the floor for approximately 20 mins until he was in no acute distress. VS obtained at 1505 BP 130/92, HR-64, SP02- RA 99%, VS obtained AT 1515 BP-136/92, HR-56. When patient fell to the floor he was twisted to the left of his body. Bump noted to left temple region approximately 15mins after fall. Face mask was on patient and staff.

Other Meds: NA

Current Illness: NA

ID: 1694307
Sex: F
Age: 23
State: MA

Vax Date: 08/04/2021
Onset Date: 08/04/2021
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:

Allergies:

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

Symptoms: Patient reports soreness and weakness in arm after getting vaccination that she still had when she got her 2nd vaccination more than a month later. Also reports a burning sensation but is not sure if that is from 2nd dose vaccination received today.

Other Meds:

Current Illness:

Date Died: 05/20/2021

ID: 1694308
Sex: F
Age: 71
State: PA

Vax Date: 03/20/2021
Onset Date: 05/19/2021
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 don?t know what test they did at the hospital.

Allergies: Old style iodine dye

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Surgery was done at on 5/19/21 to replace her aortic valve. While other complications came up, all of the fixes worked. Everything was repaired. My Mother?s blood would not clot. They were unable to close her following surgery. They tried again over night to stop the bleeding but her blood would still not clot. She had stopped all of her blood thinning medications days earlier than suggested prior to surgery. She died the next morning. Had her blood clotted I believe she would be here today. I believe her blood did not clot because of her two doses of this vaccine.

Other Meds: Januvia, metformin, ibesartan, atorvastatin, levothyroxin, ferrous sulfate, iron, potassium, centrum, super b complex, fish oil, low dose aspirin, cinnamon, vitamin c, cranberry, calcium- magnesium-zinc tab Flexeral, as needed

Current Illness: Leaky heart valve

ID: 1694309
Sex: F
Age: 40
State: IL

Vax Date: 02/26/2021
Onset Date: 03/01/2021
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: Amoxycyllin

Symptom List: Pharyngeal swelling

Symptoms: In March my period was a month and a half long. I have a period for three weeks. I have a PMDD. My period has been erratic since the vaccine. My period has been strange menstrual cycle and the timing been strange, my menstrual cycle has been heavy flow. I used to have regular menstrual cycles and light cycles. After my vaccine I also felt tired. My menstrual cycle has not been regular since the vaccine.

Other Meds: Humira(shot for ulcerative colitis), Venlafaxine (anti depression), Alprazolam

Current Illness:

ID: 1694310
Sex: M
Age: 61
State: CA

Vax Date: 09/09/2021
Onset Date: 09/09/2021
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: none

Allergies: none stated

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Medication error in which the vial of vaccine was diluted with 0.18 ml instead of 1.8 ml of normal saline. Resulting in the employee receiving a higher dose of the vaccine.

Other Meds: none stated

Current Illness: none stated

ID: 1694311
Sex: F
Age: 26
State: NY

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

Lab Data: none applicable

Allergies: none known

Symptom List: Diarrhoea, Nasal congestion

Symptoms: vasovagal syncope. Occurred shortly after vaccine administration. Patient was faint, nauseous, and in a cold sweat for about 15 minutes after receiving the shot. Supplied water to the patient as requested. Patient recovered after 15 minutes and was fine with no remaining symptoms.

Other Meds: none

Current Illness: none

ID: 1694312
Sex: F
Age: 43
State: KY

Vax Date: 05/25/2021
Onset Date: 09/05/2021
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: Vaccination site erythema, Vaccination site pruritus, Vaccination site swelling

Symptoms: Covid positive..household contact

Other Meds:

Current Illness:

ID: 1694313
Sex: F
Age: 39
State: NC

Vax Date: 04/02/2021
Onset Date: 08/04/2021
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: 7/13/21- Euroimmun: Equivical Covid Antibody test. 8/2/21- Euroimmun: Equivical Covid Antibody test. 8/4/21- SARS Covid 2 Antibodies IgG and IgM- negative 9/1/21- Euroimmin: Negative covid antibodies

Allergies: sulfa, penicillin, CT contrast iodine, Bees

Symptom List: Rash, Urticaria

Symptoms: NO covid antigens 4 months after vaccine.

Other Meds: Vit D, Norditropin injection, Metformin, spironolactone, Cabergobulin, Zyrtec

Current Illness: n/a

ID: 1694314
Sex: F
Age: 56
State: NY

Vax Date: 04/26/2021
Onset Date: 05/17/2021
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: Seasonal allergies in fall

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

Symptoms: Next day I was a little sore, 3 weeks later I started to get hives, it started on my left leg on the thigh and started traveling up and to the other side went all the way to my head, the hives were all over my body and the right side became more severe. It took about 3 months to travel all over my body and heal. Once I removed avocado from my diet and it started to heal.

Other Meds: LIPITOR

Current Illness:

ID: 1694315
Sex: M
Age: 56
State: KY

Vax Date: 04/09/2021
Onset Date: 09/03/2021
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:

Allergies:

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

Symptoms: Covid positive due to household members

Other Meds:

Current Illness:

ID: 1694316
Sex: M
Age: 73
State: FL

Vax Date: 03/10/2021
Onset Date: 06/10/2021
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: CAT Scan.

Allergies: None.

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

Symptoms: Double pneumonia.

Other Meds: Atorvastatin; Hydrochlorothiazide; Valacyclovir; Lisinopril; Aspirin; Vitamin D; Fish Oil.

Current Illness: None.

ID: 1694317
Sex: F
Age: 41
State:

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

Allergies:

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

Symptoms: Upper lip swelling with reported pain when swallowing. Able to swallow own secretions, no tongue swelling noted, no respiratory distress. Is positive for hives. Was treated with diphenhydramine, famotidine, dexamethasone, and intramuscular epinephrine.

Other Meds:

Current Illness:

ID: 1694318
Sex: M
Age: 53
State: NM

Vax Date: 09/08/2021
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: None

Allergies: Amoxicillin Neosporin

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

Symptoms: Pain scale used for this report: Mild (easy to ignore) Moderate (impossible to ignore, interferes with normal activities) Severe (disabled) First adverse effect: Sore left deltoid (moderate, throbbing and could not sleep on left side) from ~ 1400 Sept 8 to ~1400 Sept 9 when pain transitioned to mild. Pain essentially gone by ~ 1000 Sept 11. Second adverse effect: Neck pain (moderate, constant and distracting) from base of head down left side to shoulder ~ 2000 Sept 8 to ~ 1200 Sept 9 when pain transitioned to mild. Pain essentially gone by ~ 1200 Sept 10.

Other Meds: Generic multivitamin 1000 IU D3 25 mg Zinc 500 mg C 3 mg melatonin Generic claritin 10 mg

Current Illness: None

ID: 1694319
Sex: F
Age: 35
State: SC

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

Allergies: Aspirin

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Within couple of hours after the vaccine, I started to have tingling/itching all over. Later than night I had a fever, tremors, swelling and warmth at injection site, headache, weakness, and shoulder, neck and breast pain on the same side as the injection.

Other Meds: Wellbutrin, Xyzal, HCTZ

Current Illness:

ID: 1694320
Sex: F
Age: 73
State: KY

Vax Date: 06/09/2021
Onset Date: 09/07/2021
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: Covid positive contact unknown.

Other Meds:

Current Illness:

ID: 1694321
Sex: M
Age: 54
State: MI

Vax Date: 01/21/2021
Onset Date: 02/26/2021
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:

Allergies:

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

Symptoms: neuropathy in the feet been to the doctor a few time no solution

Other Meds: Lansoprazole 30 mg and Lisinopril 10mg

Current Illness:

ID: 1694322
Sex: M
Age: 37
State: GA

Vax Date: 04/19/2021
Onset Date: 04/26/2021
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: I got sick for 48 hours after vaccine (headache, chills, aches, primarily) but then got better for several days later. A week later I started getting severe headaches (never had headache issues before in my life). It go so bad I could not open my eyes for basically a day. Went to the ER after I developed a fever. They tested me for covid and it came back negative. They gave me an IV and sent me on my way. Said I was just having a bad cold. Symptoms did not get better and in fact got worse. I couldn't open my eyes again because of the headaches and I noticed a rash. Went back to the ER, they tested me for covid (negative) and said it was a virus. Sent me on my way again. Symptoms didn't get better... went to Urgent Care and they tested for covid (negative) and strept. Strept test came back positive. Got me medication and I went home. Headaches still would not go away and my rash had gotten worse. I went back to the same Urgent Care and they said you are having a bad reaction to the vaccine and have shingles because of it. Gave me more medication... eventually I got better. I still have headaches to this day (which again, never had before). Very frustrating but it is what it is at this point.

Allergies: None

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

Symptoms: I got sick for 48 hours after vaccine (headache, chills, aches, primarily) but then got better for several days later. A week later I started getting severe headaches (never had headache issues before in my life). It go so bad I could not open my eyes for basically a day. Went to the ER after I developed a fever. They tested me for covid and it came back negative. They gave me an IV and sent me on my way. Said I was just having a bad cold. Symptoms did not get better and in fact got worse. I couldn't open my eyes again because of the headaches and I noticed a rash. Went back to the ER, they tested me for covid (negative) and said it was a virus. Sent me on my way again. Symptoms didn't get better... went to Urgent Care and they tested for covid (negative) and strept. Strept test came back positive. Got me medication and I went home. Headaches still would not go away and my rash had gotten worse. I went back to the same Urgent Care and they said you are having a bad reaction to the vaccine and have shingles because of it. Gave me more medication... eventually I got better. I still have headaches to this day (which again, never had before). Very frustrating but it is what it is at this point.

Other Meds: None

Current Illness: None

ID: 1694323
Sex: M
Age: 14
State: GA

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: LA

Lab Data:

Allergies: N/A

Symptom List: Unevaluable event

Symptoms: Vomiting, low SP and red itchy arms and neck

Other Meds: N/A

Current Illness:

ID: 1694324
Sex: F
Age: 48
State: VA

Vax Date: 09/07/2021
Onset Date: 09/08/2021
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: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

Symptoms: whole body ached and right arm, the arm injection was given, now goes numb when i lay down

Other Meds: BP meds

Current Illness:

ID: 1694325
Sex: F
Age: 70
State: NY

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

Lab Data:

Allergies: Lactose

Symptom List: Injection site pain, Pain

Symptoms: Headache, chills, lethargic, stomach pain and bloating, foggy brain, body aches.

Other Meds: MultiVitamin, probiotic, Amlodipine, triamterine hctz, levoceterizine

Current Illness: None

ID: 1694326
Sex: F
Age: 76
State: MN

Vax Date: 03/31/2021
Onset Date: 09/03/2021
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: Positive SARS-CoV-2 BY PCR 9/3/21

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Note that this case meets vaccine breakthrough criteria. Patient presented with ~10 days of nausea, vomiting, decreased appetite. Hx gallstones, now with intermittent diarrhea and abdominal pain.

Other Meds:

Current Illness:

ID: 1694327
Sex: M
Age: 77
State: NY

Vax Date: 09/03/2021
Onset Date: 09/08/2021
Rec V Date: 09/13/2021
Hospital:

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

Lab Data: none

Allergies: none

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

Symptoms: Extreme fatigue beginning about 12 hours after vaccine and lasting about 20 hours. 72 hours later sudden onset of left auricular canal pain, left sided sore throat and hair tenderness in the left temporal region. (Suggesting neuropathy). No medical care given

Other Meds: regular insulin, Levamir, metoprolol, rosuvastatin, Vit D, ASA (81 mg), valsartan, tamsulosin, turmeric

Current Illness: none

ID: 1694328
Sex: F
Age: 64
State: MI

Vax Date: 03/08/2021
Onset Date: 05/20/2021
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: none

Allergies: amoxicillin; erythromycin; keflex, cipro, artificial sugar substitute

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: About 8 to 10 weeks after the 2nd dose vaccine, I started to get a bullseye rash on my chest. I was prescribed doxycycline since my doctor thought it could be Lyme's disease. The rash continue to spread so I went back to the doctor. I was diagnosed with pityriasis rosea. I followed up with dermatologist for a confirmation. There is no treatment for this diagnosed and takes 8 to 10 weeks for it to run its course and resolve on it own. As of now, I still have a faded area of where the rash used to be.

Other Meds: Synthroid; Boniva; Simvastatin; Plavix, Plaquenil; Vitamin D3, Calcium, Iron; Omeprazole

Current Illness: none

ID: 1694329
Sex: F
Age: 41
State: IN

Vax Date: 09/09/2021
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: UNK
Vax Route: IM
Vax Site: RA

Lab Data: None

Allergies: None

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Most started around 11am 9/10/21. Headache, severe fatigue, painful urination (this only lasted a couple hours on 9/10), dizzy/not feeling like I'm "in my body" floating maybe?, runny/stuffy nose, severe body aches (previous injuries hurting as if they were healing all over again), arm is sore of course but as of 9/13, there is now a red lump approximately one inch lower than injection site. Had low grade fever on 9/11/21 Currently have not seen or spoken to a HCP about symptoms. Taking 200mg ibuprofen every 6 hours as needed. It has only slightly relieved symptoms.

Other Meds: Esomeprazole 40mg once daily Famotidine 40mg once at bedtime Quetiapine 25mg once at bedtime Pregabalin 200mg twice daily Montelukast 10mg at bedtime Vyvanse 60mg once daily Cetirizine 10mg once daily Ethynodiol diacetate and ethinyl estr

Current Illness: None

ID: 1694330
Sex: F
Age: 70
State: SC

Vax Date: 02/08/2021
Onset Date: 02/10/2021
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: had a sigmoidoscopy on April 15th - showed distal active ulcerative colitis with bleeding.

Allergies: none

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

Symptoms: I started having rectal bleeding - sign of an UC flare. Had been in remission for ten plus years. This began 2 days after my #2 Covid Vaccine. I continue with the rectal bleeding and urgency today after several courses of both oral and rectal medications.

Other Meds: azathioprine balsalazide simvastatin zyrtec HCTZ colace tumeric b12 multivitamin

Current Illness: none

ID: 1694331
Sex: M
Age: 62
State:

Vax Date: 04/21/2021
Onset Date: 06/06/2021
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: Diagnosed and repaired via emergency Laser surgery on 6/8/2021

Allergies: none

Symptom List: Nausea

Symptoms: Spontaneous Tear in Retina

Other Meds: none

Current Illness: stomach ache

ID: 1694332
Sex: F
Age: 52
State: KY

Vax Date: 04/13/2021
Onset Date: 08/07/2021
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:

Symptom List: Injection site pain

Symptoms: Covid positive due to household

Other Meds:

Current Illness:

ID: 1694333
Sex: M
Age: 48
State: CA

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

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

Symptoms: Since vaccine I feel dizzy and upper abdominal discomfort. Today the dizziness is worst. I am never dizzy.

Other Meds:

Current Illness:

ID: 1694334
Sex: F
Age: 49
State: MA

Vax Date: 05/21/2021
Onset Date: 06/01/2021
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: RA

Lab Data: 6/18/2021 - an ENT doctor put a camera up each nostril (I looked online and I think it is called nasal endoscopy) and he said everything looked normal 6/28/2021 - Hearing Test which showed hearing loss (Sounds were sent directly to the nerve and also through the ears. My hearing was better when sounds were sent directly to the nerve so the hearing test confirmed that the feeling of blocked ears was causing hearing loss) 8/20/2021 - an ENT doctor put a camera up each nostril (nasal endoscopy) and said everything looked normal. I had a second hearing test which still showed hearing loss. 9/1/2021 - CAT Scan at Hospital and results were normal

Allergies: No allergies. I am lactose intolerant.

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

Symptoms: May 21-May 23 I had fatigue, chills, I was hot/cold, upset stomach, dry mouth. June 1 my left ear started fluttering when I lay on my right side in bed. Noise/Sensation is so bothersome I can only sleep on my left side. June 6 my ears started feeling blocked and I cannot hear as well and the dry mouth came back. August 30 at night I started hearing ringing in my right ear. This has happened a couple times over the last 2 weeks

Other Meds: 1. Multivitamin - 1 per day 2. Calcium Supplement - 1 per day 3. Flaxseed Oil 1000 mg - 1 per day 4. Iron 65 mg - 1 per day

Current Illness: None

ID: 1694335
Sex: F
Age: 54
State: MN

Vax Date: 09/02/2021
Onset Date: 09/07/2021
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: C-REACTIVE PROTEIN (INFLAMMATION) COMPREHENSIVE METABOLIC PANEL LAB ONLY-COMPLETE BLOOD COUNT WITH DIFFERENTIAL LIPASE MAGNESIUM SARS-COV-2, INFLUENZA A+B, AND/OR RSV NUCLEIC ACID TESTING PANEL URINE DIP, REFLEX TO MICROSCOPIC, REFLEX TO CULTURE EKG

Allergies:

Symptom List: Tremor

Symptoms: Gastroenteritis due to COVID-19 virus Hypokalemia Diarrhea, unspecified type Nausea

Other Meds:

Current Illness:

ID: 1694336
Sex: M
Age: 21
State: PA

Vax Date: 02/10/2021
Onset Date: 05/30/2021
Rec V Date: 09/13/2021
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:

Allergies: None

Symptom List: Erythema, Pruritus

Symptoms: Not sure if related to vaccine but I just wanted to inform the CDC in case it is an adverse event from the Pfizer vaccine. I received my second dose on Feb. 10th, 2021 and began showing elevated blood glucose levels later in February. By the end of May, I was showing symptoms of diabetes, including frequent urination, extreme thirst, and neuropathy. I went to the hospital on June 21st, 2021 after passing out at work and was diagnosed with diabetic ketoacidosis and Type 1 Diabetes.

Other Meds: Daily multivitamin

Current Illness: None

ID: 1694337
Sex: M
Age: 48
State: MN

Vax Date: 01/28/2021
Onset Date: 09/10/2021
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:

Allergies:

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

Symptoms: Patient vaccinated and then tested positive for COVID-19

Other Meds:

Current Illness:

ID: 1694338
Sex: F
Age: 34
State: SC

Vax Date: 09/10/2021
Onset Date: 09/11/2021
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: Latex; Tree nuts; Tree fruit; Grass and tree pollen; Neomycin; Garamycin; Reglan ; Lorabid ; Ceclor; Bactrim

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

Symptoms: At 2:00 am following injection, could not move injected arm without intense pain. Hand was tingling and would go numb. Shoulder and armpit hurt. 10:00 am I started icing arm. Began feeling nauseas, weak and tired. My chest would hurt and my heart would pound on occasion. Joint pain started a few hours later, mostly in knees, hips, and lower back. By 4:00 pm, mild fever started (100.4?). I could barely get out of bed all day. My legs would shake when walking to the bathroom. The area above my left breast under my collarbone became puffy and extremely sore. Left armpit also hurt. Fever broke late at night on 9/11. On 9/12, most symptoms improved except left breast/armpit pain, fatigue/weakness, and heart pounding. I got a stomach ache later on 9/12. I?d feel very weak if I tried to move around too much, so I stayed in bed. Through the night of 9/12, I woke up either freezing or sweating several times. The morning of 9/13 (today) I still felt weak. Left breast/armpit still hurt, and I could feel an almond sized swollen, tender lymph node above my left collar bone. I still feel weak and fatigued as I write this, and my heart continues to pound on and off.

Other Meds: Zoloft 50 mg; Seasonique; Xyzal; Nortriptyline 50 mg; Magnesium Oxide; Vitamin D

Current Illness:

ID: 1694339
Sex: M
Age: 55
State: MI

Vax Date: 04/06/2021
Onset Date: 04/20/2021
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:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Cataract in right eye. Had an eye doctor appointment previous year and there was no sign of any cataract in either eye. Cataract is getting worse every month. Also, floaters in both eyes have increased in numbers and size making my vision worse in both eyes.

Other Meds:

Current Illness:

ID: 1694340
Sex: M
Age: 72
State: KY

Vax Date: 02/11/2021
Onset Date: 02/19/2021
Rec V Date: 09/13/2021
Hospital:

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

Lab Data: EKG Mar 9, 2021 , EKG Mar 25, 2021 , treadmill stress test Apr 13, 2021 , heart catheter Apr 22, 2021.

Allergies: None

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

Symptoms: Felt tired and short of breath about 2 weeks after last vaccination along with swollen ankles. Had strong chest pain and lower jaw pain 3 weeks after vaccination. Saw a cardiologist and had stress test and heart catherization. No significant problems found and have had with no symptoms ever since.

Other Meds: Benicar, Rosuvastatin

Current Illness: None

ID: 1694341
Sex: F
Age: 50
State: PR

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

Allergies: Previous allergies to Penicillin, ASA, Sulfa, Iodine, Oxycodone

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

Symptoms: Itchy throat and cough.

Other Meds: None

Current Illness: None

ID: 1694342
Sex: F
Age: 51
State: OH

Vax Date: 04/16/2021
Onset Date: 05/07/2021
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: hospital ER

Allergies: ambian amox pen codine latex adhesives/surgical glue/steri-strips

Symptom List: Pain in extremity

Symptoms: uterus hemorrhage 2 days after 2nd dose; hysterotomy

Other Meds: don't remember

Current Illness: none

ID: 1694343
Sex: F
Age: 63
State: KY

Vax Date: 04/14/2021
Onset Date: 09/02/2021
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:

Allergies:

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

Symptoms: Covid positive...contact with grandbabies

Other Meds:

Current Illness:

ID: 1694344
Sex: M
Age: 55
State: MN

Vax Date: 05/07/2021
Onset Date: 09/09/2021
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:

Allergies: Patient swabbed at our offsite testing location. Please contact primary care provider, Dr. for further questions.

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

Symptoms: Patient vaccinated for and then tested positive for COVID-19

Other Meds: Patient swabbed at our offsite testing location. Please contact primary care provider, Dr. for further questions.

Current Illness: Patient swabbed at our offsite testing location. Please contact primary care provider, Dr. for further questions.

ID: 1694345
Sex: F
Age: 57
State: MO

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

Allergies: zofran, oxycontin

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

Symptoms: chills, 101 fever, could not move arm very painful, armpits are swollen, pain going up neck and side of her head, pain in stomach

Other Meds: topamax, cored, lorsartan, lasix, potassium, xanax, cymbalta

Current Illness: no

ID: 1694346
Sex: F
Age: 54
State: TX

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: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: codeine, penicillin

Symptom List: Vomiting

Symptoms: My throat feels like it is closing up, headaches, my face is achy, runny nose, congestion

Other Meds: none

Current Illness: none

ID: 1694347
Sex: F
Age: 36
State: CO

Vax Date: 08/30/2021
Onset Date: 08/31/2021
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:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: I have an autoimmune flare up, GI flare up. Two days after my vaccine, my symptoms got worse. My auto immune flared up really bad and intensified on 08-31-2021. I had body aches, joint pain, redness and swelling in my fingers. I also get tongue pain and lip pain and lip swelling. I also got eye lid swelling. My auto immune flare is still present.

Other Meds:

Current Illness:

ID: 1694348
Sex: F
Age: 58
State:

Vax Date: 03/25/2021
Onset Date: 09/06/2021
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: Back pain, Cold sweat, Headache, Nausea, Vomiting

Symptoms: Breakthrough case. Positive PCR test on 9/6/2021

Other Meds:

Current Illness:

ID: 1694349
Sex: F
Age: 65
State: NM

Vax Date: 09/07/2021
Onset Date: 09/08/2021
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: IM
Vax Site: LA

Lab Data: NA

Allergies: Penicillin

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Redness, swelling, heat and pain at injection site x 4 days - still slightly reddened at 6 days post-vaccination Body aches, headaches, low grade fever, chest congestion x 3 days

Other Meds: Nexium, atorvastatin, Voltaren gel, Ca, Mg, Vit A, B Complex

Current Illness: NA

ID: 1694350
Sex: F
Age: 45
State: UT

Vax Date: 01/28/2021
Onset Date: 03/05/2021
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: CT Scans, Ultrasounds, Xrays, Brian MRI, Knee MRI,

Allergies: None

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

Symptoms: Started with leg pain in the left calf. Episodes of dizziness, vertigo, ear pressure, headaches. I now have low ferratin levels and take iron daily. Low vitamin D, fatigue, swollen lymph nodes, heartburn, kidney pain, UTI symptoms, muscle twitches, hands and arms go numb, heart palpitations and Tachycardia, severe anxiety attacks (i believe is due to cortisone levels). I also developed a lump on my right knee which no one can confirm what it is from.

Other Meds: Krill oil

Current Illness: Kidney Stones, Melanoma Removed in December of 2020

ID: 1694351
Sex: F
Age: 60
State: KS

Vax Date: 01/20/2021
Onset Date: 09/05/2021
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: RA

Lab Data:

Allergies:

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

Symptoms: Covid positive contact unknown

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am