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: 1705895
Sex: M
Age: 23
State: NY

Vax Date: 08/21/2021
Onset Date: 08/21/2021
Rec V Date: 09/16/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Systemic: Chills-Mild, Systemic: Dizziness / Lightheadness-Mild, Systemic: Numbness (specify: facial area, extremities)-Mild, Additional Details: Patient stated history of anxiety but did not elaborate. Started to feel very nervous right after the vaccine and called his sister to come get him. After his sister arrived he said his arms felt numb. I asked him if he would like me to call 911 and he said yes. His arms started to feel better but he was very nervous and said he felt dizzy and wanted to go to the hospital to be further checked. emt took vitals which were normal. Pt did not loose consciousness and was very alert and responsive.

Other Meds:

Current Illness:

ID: 1705896
Sex: F
Age: 63
State: PA

Vax Date: 08/10/2021
Onset Date: 09/07/2021
Rec V Date: 09/17/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Site: Pain at Injection Site-Severe, Systemic: Numbness (specify: facial area, extremities)-Medium, Additional Details: Patient reported pain and tingling in immunization arm one month after shot - another healthcare provider called it 'covid arm'

Other Meds:

Current Illness:

ID: 1705897
Sex: M
Age: 53
State: KY

Vax Date: 07/26/2021
Onset Date: 07/26/2021
Rec V Date: 09/17/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Error: Wrong Vaccine Formulation (ex. different manufact. initial and booster)-

Other Meds:

Current Illness:

ID: 1705899
Sex: F
Age: 44
State: CA

Vax Date: 08/05/2021
Onset Date: 08/23/2021
Rec V Date: 09/17/2021
Hospital:

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

Lab Data: Blood work 9/14/2021, scheduling for MRI and EMG

Allergies: Penicillin

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Bilateral leg pain, tingling, and weakness, abnormal period- one week early, heavy, and painful

Other Meds: Vit C, B complex, vit D, probiotics

Current Illness: A cold on 7/10/21

ID: 1705900
Sex: F
Age: 51
State: CA

Vax Date: 09/14/2021
Onset Date: 09/15/2021
Rec V Date: 09/17/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: redness,pain, fluid filled blister and pus at the injection site

Other Meds:

Current Illness:

ID: 1705901
Sex: M
Age: 55
State: CA

Vax Date: 09/09/2021
Onset Date: 09/09/2021
Rec V Date: 09/17/2021
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: Error: Wrong Vaccine Formulation (ex. different Manu fact. initial and booster)-

Other Meds:

Current Illness:

ID: 1705902
Sex: F
Age: 54
State: KY

Vax Date: 08/10/2021
Onset Date: 08/10/2021
Rec V Date: 09/17/2021
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: Pyrexia, White blood cell count decreased

Symptoms: Error: Wrong Vaccine Formulation (ex. different manufact. initial and booster)-

Other Meds:

Current Illness:

ID: 1705903
Sex: M
Age: 70
State: KY

Vax Date: 07/08/2021
Onset Date: 07/08/2021
Rec V Date: 09/17/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Error: Wrong Vaccine Formulation (ex. different manufact. initial and booster)-

Other Meds:

Current Illness:

ID: 1705904
Sex: F
Age: 45
State: WA

Vax Date: 08/20/2021
Onset Date: 08/21/2021
Rec V Date: 09/17/2021
Hospital:

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

Lab Data:

Allergies: Sulfa drugs

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Swollen left lymph node near collarbone

Other Meds: Fenofibrate

Current Illness:

ID: 1705905
Sex: M
Age: 63
State: KY

Vax Date: 08/15/2021
Onset Date: 09/05/2021
Rec V Date: 09/17/2021
Hospital:

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

Lab Data: CBC,CMP, Covid screen, Respiratory Virul Screen CXR, Ct of Chest ECG

Allergies: None

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Chills, Fever, Pulmonary Infiltrate , elevated D Dimer and ESR ONE WEEK LATER- Hypotension Aflutter N and vomiting Weakness

Other Meds: Flecainide,Acyclovir,Candesartan,clonidine Amlodipine Spironolactone

Current Illness: Multiple Myeloma,AL Amyloidosis,HTN,GERD

ID: 1705906
Sex: F
Age: 37
State: AR

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

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

Lab Data: none

Allergies: none

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

Symptoms: Adverse event - began about 6hrs after vaccination and lasted for 24 hrs; extreme fatigue; body aches, started mild then worsened; fever (100.6); headache; very very sore arm at injection site (right arm unable to bear weight or lift more than a few inches) Pregnancy history: 34 weeks pregnant at time of vaccination; estimated date of delivery: 10/21/21; had several painful contractions during this time but no known complications to pregnancy due to adverse event; birth weight: n/a, have not delivered yet.

Other Meds: prenatal vitamin; probiotic; magnesium

Current Illness: none

ID: 1705907
Sex: M
Age: 69
State: KY

Vax Date: 08/02/2021
Onset Date: 08/02/2021
Rec V Date: 09/17/2021
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: Error: Wrong Vaccine Formulation (ex. different manufact. initial and booster)-

Other Meds:

Current Illness:

ID: 1705908
Sex: F
Age: 47
State: IL

Vax Date: 03/14/2021
Onset Date: 07/01/2021
Rec V Date: 09/17/2021
Hospital:

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

Lab Data:

Allergies: Bentyl, Sulfa drugs

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

Symptoms: Noticed a lump in my left arm about 3-4 months after the vaccine 3-4 inches below where the vaccine was administered. There's no pain associated with the lump, but it is noticeable, and I will be going to the doctor for an exam.

Other Meds: Magnesium, Zrytec, Vitamin D, Tagamet, Multi-vitamin

Current Illness: None

ID: 1705909
Sex: F
Age: 29
State: TN

Vax Date: 09/09/2021
Onset Date: 09/09/2021
Rec V Date: 09/17/2021
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: Systemic: Allergic: Difficulty Breathing-Mild, Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Mild, Systemic: Flushed / Sweating-Medium, Systemic: Tingling (specify: facial area, extemities)-Medium, Additional Details: After immuniztion was given. Patient stated that she was not feeling well. She was experiencing some difficulty breathing, lightheadness, tingling all over, sweating. Patient never lost consciousness or fainted; however, there were moments were she couldn't keep eyes open but upon stimulation she would open them up. Due to difficulty breathing 911 was called. She was transported to ER.

Other Meds:

Current Illness:

ID: 1705910
Sex: M
Age: 29
State: TN

Vax Date: 08/24/2021
Onset Date: 08/24/2021
Rec V Date: 09/17/2021
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: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: Systemic: Dizziness / Lightheadness-Mild, Systemic: Flushed / Sweating-Severe, Systemic: Tingling (specify: facial area, extemities)-Mild, Additional Details: Pt experienced profuse sweating and some lightheadednes. Also had some tingling in the fingers. After sitting for awhile with fan and ice pack on back of neck patient recovered and was able to leave on his on accord.

Other Meds:

Current Illness:

ID: 1705911
Sex: F
Age: 52
State: CA

Vax Date: 07/13/2021
Onset Date: 09/01/2021
Rec V Date: 09/17/2021
Hospital:

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

Lab Data: sep. 1 2021, sep 4 2021

Allergies: none

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

Symptoms: Started having seizures during the day/ as opposed to the nocturnal epilepsy I have had for 52 years. Have started blacking out/fainting for no reason.

Other Meds: Lamotrigine, Keppra

Current Illness: none

ID: 1705912
Sex: F
Age: 25
State: CA

Vax Date: 07/29/2021
Onset Date: 07/30/2021
Rec V Date: 09/17/2021
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: none

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

Symptoms: dizziness, vomiting, nauseousness

Other Meds: none

Current Illness: none

ID: 1705913
Sex: M
Age: 43
State: TX

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

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

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Medium, Systemic: Hypertension-Medium, Systemic: Weakness-Medium, Additional Details: Pt fainted within three seconds of receiving J&J vaccine. Slouched down in chair where bowls and urine was released. Guided pt to floor but in that process, pt fell forward hitting his forehead on the bottom of rolling chair. Pt was unresponsive for a total of 10 seconds. Once he came to, feet where elevated on chair and pt layed supine on floor for about 8 minutes. Pt obtained a quarter sized bump on his forehead from fall. once pt left.

Other Meds:

Current Illness:

ID: 1705914
Sex: F
Age: 45
State: WA

Vax Date: 09/10/2021
Onset Date: 09/11/2021
Rec V Date: 09/17/2021
Hospital:

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

Lab Data:

Allergies: Sulfa drugs

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Extremely enlarged/swollen left lymph node near collarbone. Did not want injection in right arm because I had a nerve conduction test of my right arm/hand scheduled for 09/16/21.

Other Meds: Fenofibrate

Current Illness:

ID: 1705915
Sex: M
Age: 16
State: FL

Vax Date: 09/01/2021
Onset Date: 09/01/2021
Rec V Date: 09/17/2021
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: Error: Booster Given Too Early-

Other Meds:

Current Illness:

ID: 1705916
Sex: M
Age: 65
State: FL

Vax Date: 09/09/2021
Onset Date: 09/09/2021
Rec V Date: 09/17/2021
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: Error: Booster Given Too Early-

Other Meds:

Current Illness:

ID: 1705917
Sex: F
Age: 22
State: MA

Vax Date: 09/09/2021
Onset Date: 09/09/2021
Rec V Date: 09/17/2021
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: Unevaluable event

Symptoms: Site: Pain at Injection Site-Mild, Systemic: Arm tingling/numb-Mild, Systemic: Numbness (specify: facial area, extremities)-Mild, Systemic: Tingling (specify: facial area, extemities)-Mild, Additional Details: Patient appeared extremely anxious when going to admit the vaccine. After 115 minutes of monitoring the patient explained she was feeling tingling down her arm. She said she has covid in the past and claimed that "any side effects that occur she was bound to get." She insisted on us calling 911 and was put on a stretcher in an ambulance

Other Meds:

Current Illness:

ID: 1705918
Sex: F
Age: 19
State: CA

Vax Date: 09/09/2021
Onset Date: 09/09/2021
Rec V Date: 09/17/2021
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: Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Medium, Systemic: Hyperventilation-Medium, Systemic: Hypotension-Medium, Systemic: Shakiness-Medium, Systemic: Weakness-Severe, Additional Details: PER PATIENTS SISTER, THE PATIENT HAS BEEN DIAGNOSED WITH PANIC DISORDER AND SUFFERS FROM PANIC ATTACKS.

Other Meds:

Current Illness:

ID: 1705919
Sex: M
Age: 74
State: TX

Vax Date: 08/20/2021
Onset Date: 08/20/2021
Rec V Date: 09/17/2021
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: Error: Wrong Vaccine Formulation (ex. different manufact. initial and booster)-

Other Meds:

Current Illness:

ID: 1705920
Sex: F
Age: 50
State: NJ

Vax Date: 09/07/2021
Onset Date: 09/08/2021
Rec V Date: 09/17/2021
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: Site: Itching at Injection Site-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium

Other Meds:

Current Illness:

ID: 1705921
Sex: F
Age: 13
State: MA

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

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

Lab Data:

Allergies:

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

Symptoms: Systemic: anxiety pt stated they were very hot and had rapid breathing-Mild, Additional Details: patient was given an ice pack and water and calmed down and had few issues

Other Meds:

Current Illness:

ID: 1705922
Sex: F
Age: 80
State: NY

Vax Date: 09/08/2021
Onset Date: 09/09/2021
Rec V Date: 09/17/2021
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: Site: Bruising at Injection Site-Medium, Site: Itching at Injection Site-Medium, Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium

Other Meds:

Current Illness:

ID: 1705923
Sex: M
Age: 16
State: OH

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

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Systemic: Flushed / Sweating-Severe, Systemic: Nausea-Medium, Additional Details: Patient got nauseous and sweaty while in post vaccination area. I had him lay down and put his feet up for about 15 minutes. After a few minutes of laying down he drank some orange juice he had with him. Felt better/back to normal after.

Other Meds:

Current Illness:

ID: 1705924
Sex: F
Age: 31
State: WA

Vax Date: 09/11/2021
Onset Date: 09/11/2021
Rec V Date: 09/17/2021
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: Systemic: Allergic: Difficulty Swallowing, Throat Tightness-Mild, Systemic: Confusion-Severe, Systemic: Dizziness / Lightheadness-Severe, Systemic: Exhaustion / Lethargy-Mild, Systemic: Fainting / Unresponsive-Severe, Systemic: Flushed / Sweating-Medium, Systemic: Hyperventilation-Severe, Systemic: Seizure-Mild, Systemic: Shakiness-Medium, Systemic: Visual Changes/Disturbances-Medium, Additional Details: Pt didn't feel good, 5 mins post vaccine. She was talking on the phone when we overheard her not feeling well. She passed out and woke up after 10 seconds. Juice and water was provided. She felt visual distrubances that recovered after 5 mins. Pt reported tightness of her throat with NO difficulty breathing, 2 tabs of benadryl was given. Pt was okay after 20 mins. Pt smelled strongly of marijuana.

Other Meds:

Current Illness:

ID: 1705925
Sex: F
Age: 22
State: NC

Vax Date: 09/11/2021
Onset Date: 09/11/2021
Rec V Date: 09/17/2021
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: Systemic: Fainting / Unresponsive-Mild, Systemic: had slight panic attack-Mild, Systemic: Flushed / Sweating-Mild

Other Meds:

Current Illness:

ID: 1705926
Sex: F
Age: 52
State: NY

Vax Date: 08/20/2021
Onset Date: 08/20/2021
Rec V Date: 09/17/2021
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: Error: Wrong Patient (documentation in EMR)-

Other Meds:

Current Illness:

ID: 1705927
Sex: F
Age: 34
State: FL

Vax Date: 09/11/2021
Onset Date: 09/11/2021
Rec V Date: 09/17/2021
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: Systemic: Allergic: Difficulty Breathing-Severe, Systemic: Allergic: Itch (specify: facial area, extremeties)-Medium, Systemic: Allergic: Itch Generalized-Medium, Systemic: Allergic: Rash Generalized-Medium, Systemic: Chest Tightness / Heaviness / Pain-Severe, Additional Details: Pt states that she has blotches all over her body, experiencing neck pain and chest felt heavy.

Other Meds:

Current Illness:

ID: 1705928
Sex: M
Age: 46
State: TN

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data: none

Allergies: none

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

Symptoms: patient denied having previous vaccine however it was discovered when reporting 09/10/2021 vaccine that the patient had received a previous janssen vaccine on 03/19/2021 at another facility

Other Meds: none

Current Illness: none

ID: 1705929
Sex: F
Age: 71
State: PA

Vax Date: 09/14/2021
Onset Date: 09/14/2021
Rec V Date: 09/17/2021
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: Penicillin

Symptom List: Tremor

Symptoms: Mild pain at injection site Mild fever Moderate Chills Severe joint pain Mild fatigue

Other Meds: Jardiance, levothyroxine, omeprazole, rosuvastatin, gabapentin, vitamin D, alpha lipoic acid, vitamin B complex, probiotics

Current Illness: Diabetes, long lasting side effects from Moderna Covid 19 vaccine, hypothyroidism, sinus issues,

ID: 1705930
Sex: F
Age: 43
State: FL

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

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: Systemic: Dizziness / Lightheadness-Severe, Systemic: Hypotension-Severe, Systemic: Nausea-Severe, Systemic: Weakness-Severe

Other Meds:

Current Illness:

ID: 1705931
Sex: M
Age: 72
State: NC

Vax Date: 09/10/2021
Onset Date: 09/10/2021
Rec V Date: 09/17/2021
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: Site: Redness at Injection Site-Mild, Site: Swelling at Injection Site-Mild, Systemic: Numbness (specify: facial area, extremities)-Medium, Additional Details: States left arm and hand were numb and getting better 1 day after vaccine given. States also had stiffness behind both knees and floaters in his eyes (both of which have went away 1 day later).

Other Meds:

Current Illness:

ID: 1705932
Sex: F
Age: 49
State: GA

Vax Date: 09/01/2021
Onset Date: 09/02/2021
Rec V Date: 09/17/2021
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: Systemic: swelling/knot on wrist of injection arm and ankle of right side-Mild

Other Meds:

Current Illness:

ID: 1705933
Sex: F
Age: 20
State: CA

Vax Date: 09/11/2021
Onset Date: 09/11/2021
Rec V Date: 09/17/2021
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: Systemic: Allergic: Difficulty Breathing-Severe, Systemic: Dizziness / Lightheadness-Medium, Systemic: Flushed / Sweating-Mild, Additional Details: Lasted a few minutes and then patient felt normal

Other Meds:

Current Illness:

ID: 1705934
Sex: M
Age: 12
State: FL

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

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

Lab Data:

Allergies:

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

Symptoms: Systemic: Vomiting-Mild

Other Meds:

Current Illness:

ID: 1705935
Sex: F
Age: 29
State: CA

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

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Systemic: Chills-Mild, Systemic: Dizziness / Lightheadness-Mild, Systemic: Fainting / Unresponsive-Mild, Systemic: Headache-Mild, Systemic: Nausea-Mild, Systemic: Seizure-Mild, Systemic: Weakness-Mild, Additional Details: patient had a seizure about 10 minutes after receiving the moderna vaccine. the seizure episode lasted 30-60 seconds. the patient regained consciousness, but experienced lightheadedness, weakness, nausea, headache, and chills. patient was provided with a benadryl 25 mg, orange juice, and a cookie. patient felt better afterward. patient will follow up with a physician at an urgent care.

Other Meds:

Current Illness:

ID: 1705936
Sex: M
Age: 42
State: HI

Vax Date: 08/19/2021
Onset Date: 08/19/2021
Rec V Date: 09/17/2021
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: Pain in extremity

Symptoms: Error: Wrong Vaccine Formulation (ex. different manufacture. initial and booster)-

Other Meds:

Current Illness:

ID: 1705937
Sex: F
Age: 26
State: GA

Vax Date: 09/10/2021
Onset Date: 09/10/2021
Rec V Date: 09/17/2021
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: Systemic: Fainting / Unresponsive-Medium, Systemic: Nausea-Mild, Additional Details: Fainted, but came to within approx 1 min. Had upset stomach afterward. Remained in the pharmacy for approx 30 minutes after. Was able to walk out of pharmacy. Called pt next day and pt stated she was ok, her stomach was still a litle upset

Other Meds:

Current Illness:

ID: 1705938
Sex: F
Age: 39
State: MA

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

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

Lab Data:

Allergies:

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

Symptoms: Systemic: Headache-Mild, Systemic: Tingling (specify: facial area, extemities)-Mild, Additional Details: Patient during her waiting period that she felt some tingling throughout her arm. Nothing she was concerned about. After approximately 1-2 hours, I contacted her to see how she was feeling. She stated the tingling was now throughout her left side arm and leg. She also stated she felt some head pressure, but nothing she found to be alarming. She has had prior vaccines that give similar responses, that have all resolved.

Other Meds:

Current Illness:

ID: 1705939
Sex: F
Age: 42
State: CA

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

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

Lab Data:

Allergies:

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

Symptoms: Site: Pain at Injection Site-Severe, Systemic: Numbness (specify: facial area, extremities)-Medium, Systemic: Tingling (specify: facial area, extemities)-Medium, Additional Details: Patient suspects vaccine was given too high and thinks its shoulder injury related to vaccine administration. She has a doctor's appointment on Wed 9/15 for evaluation. Limited range of motion. Some finger numbness/tingling running down her arm and into her armpit/left breast area.

Other Meds:

Current Illness:

ID: 1705940
Sex: F
Age: 0
State: WA

Vax Date: 09/16/2021
Onset Date: 09/16/2021
Rec V Date: 09/17/2021
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 tests at this time

Allergies: None

Symptom List: Vomiting

Symptoms: Arm is sore with a rash and it?s hot and swollen.

Other Meds: None

Current Illness: None

ID: 1705941
Sex: M
Age: 14
State: TX

Vax Date: 09/11/2021
Onset Date: 09/11/2021
Rec V Date: 09/17/2021
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: Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Medium, Systemic: Flushed / Sweating-Mild, Systemic: Hypotension-Medium, Additional Details: Patient lost consciousness after vaccine administered. Temp was measured at 95.9 F before injection and 97.5 F after reaction. Patient lost conciousness for a couple of minutes and was very sweaty. Blood pressure was measured 90/71 mmHg at time of event. Blood pressure 30 minutes later was 120/79 mmHg.

Other Meds:

Current Illness:

ID: 1705942
Sex: F
Age: 36
State: CA

Vax Date: 06/08/2021
Onset Date: 06/08/2021
Rec V Date: 09/17/2021
Hospital:

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

Lab Data: None

Allergies: None

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

Symptoms: Within an hour and a half I became dizzy and had pain in the back of my head near neck. My tongue felt swollen. I had body aches over night. With second dose within 4 hours my legs and arms were sore and I was dizzy(vertigo) it?s been 3 months and I still have sore muscles and vertigo.

Other Meds: None

Current Illness: None

ID: 1705943
Sex: F
Age: 36
State: OH

Vax Date: 08/13/2021
Onset Date: 08/13/2021
Rec V Date: 09/17/2021
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:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Error: Wrong Vaccine Formulation (ex. different manufact. initial and booster)-

Other Meds:

Current Illness:

ID: 1705944
Sex: M
Age: 54
State: PA

Vax Date: 08/23/2021
Onset Date: 09/02/2021
Rec V Date: 09/17/2021
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: Chills, Diarrhoea, Fatigue, Feeling abnormal, Headache

Symptoms: Systemic: sudden sensorineural hearing loss-Severe, Systemic: Tinnitus-Severe

Other Meds:

Current Illness:

ID: 1705945
Sex: M
Age: 48
State: AZ

Vax Date: 08/18/2021
Onset Date: 09/13/2021
Rec V Date: 09/17/2021
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: NSAIDS

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

Symptoms: Sciatic nerve pain, both legs

Other Meds: Tylenol, testosterone, cabergoline, anastrasol

Current Illness: None

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am