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: 1709627
Sex: M
Age: 32
State: MN

Vax Date: 01/14/2021
Onset Date:
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: LA

Lab Data: tested positive for Covid 19 9/13

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: tested positive for Covid 19 9/13

Other Meds:

Current Illness:

ID: 1709628
Sex: F
Age: 65
State: TX

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

Allergies: Amoxicillin

Symptom List: Anxiety, Dyspnoea

Symptoms: High fever 101F started around 8:00 p.m. on 08/23/2021 and broke around 6:00 a.m. on 08/24/2021. When the fever broke I got a splitting headache and took 800 mg of ibuprofen and the headache subsided and never returned. For the rest of 08/24 and all of 08/25, I was very tired. On 08/26 I felt well enough to return to work.

Other Meds: Multivitamins & minerals supplements

Current Illness: None

ID: 1709629
Sex: M
Age: 58
State: HI

Vax Date: 02/18/2021
Onset Date: 04/19/2021
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: A blood test was performed and did not show anything.

Allergies: Sulfamethoxazole Cephalexin

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

Symptoms: Rash all over body. Started with the legs and then worked up to the back, chest and arms. Strong itching all over body. Rash would produce sores and scabs. Scabs seem to have a root that went into the body and could not be pulled off. I have photos of the outbreak.

Other Meds: Whey Protein Powder

Current Illness:

ID: 1709630
Sex: F
Age: 30
State: AZ

Vax Date: 06/24/2021
Onset Date: 07/03/2021
Rec V Date: 09/17/2021
Hospital: Y

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

Lab Data: hospitalised 7/7 and 7/20/21

Allergies: Tuna

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: tachycardia to 170, orthostatic hypotension, chest pain, SOB, headache, seizure like episode. Over 1 month progressed to demylinating disease with loss ability to ambulate, use hands c/w Guillian-Barre Syndrome; autonomic dystonia; recurrent non-epileptic seizure like events.

Other Meds: Modafinil 200 mg/d

Current Illness:

ID: 1709631
Sex: M
Age: 48
State:

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: none

Allergies: none

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

Symptoms: Numbness in both hands continuously

Other Meds:

Current Illness: none

ID: 1709632
Sex: M
Age: 64
State:

Vax Date: 09/12/2021
Onset Date: 09/12/2021
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: vaccine was administered after being improperly. the should have been moved for the freezer on 9/2, but was not removed until 9/8 and was administered to the patient

Other Meds:

Current Illness:

ID: 1709633
Sex: M
Age: 17
State: VA

Vax Date: 09/17/2021
Onset Date: 09/17/2021
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: NONE

Allergies: NKDA

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: AFTER WAITING 15 MINS PATIENT WAS WALKING AROUND THE STORE AND ALMOST FAINTED. HE CAME BACK TO THE PHARMACY FULLY ALERT AND STATED THAT IT WAS JUST THAT MOMMENT WHERE HE FELT LIGHT HEADEDNESS AND NOW HE IS FINE. BLOOD PRESSURE AND HR WAS CHECKED. ALL IN NORMAL RANGES.

Other Meds: NONE

Current Illness: NONE

ID: 1709634
Sex: F
Age: 59
State: IN

Vax Date: 09/15/2021
Onset Date: 09/16/2021
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: D-dimer 8,833. PT, INR, APTT normal, UA neg, Chemistry Na 134, Cl 97, clucose 114, AST 52, Troponin <0.012, CBC Hgb 9.2, Neutrophil 94, lymphocytes 2.0, monocytes 2.0

Allergies: NKA

Symptom List: Pharyngeal swelling

Symptoms: at 0300 the patient developed rigors/chills. She got up from bed to find Tylenol and Aleve in her kitchen and when she looked up, she became syncopal and fainted, fell on R side, injured R rib and had a black eye. Felt better at 0600. At about 0900 she got up to the restroom only a few steps away from her bed and she had another syncopal incident where she hit the back of her head. She went to the hospital ER for sutures to the back of her head.

Other Meds: unknown

Current Illness:

ID: 1709635
Sex: M
Age: 34
State: CA

Vax Date: 09/17/2021
Onset Date: 09/17/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: Patient passed out about 5-10min after the vaccine, then found consciousness. Pt was shaking, sweating, and looked pale.

Other Meds:

Current Illness:

ID: 1709636
Sex: M
Age: 61
State: IA

Vax Date: 08/19/2021
Onset Date: 08/23/2021
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: None

Allergies: NSAIDS

Symptom List: Diarrhoea, Nasal congestion

Symptoms: 3 or 4 days after Mr second shot I awoke to a sharp pain on the right side of my chest and underarm that I can only liken to a broken rib. It was excruciating and made breathing very painful for about five days. I could not stay out of bed and had to have my right arm raised over my head when I was not laying in bed. Only lying on my right side somewhat eased the pain. I could not lay in any other position without extreme pain. After about five days of this, the pain began to travel to the right side of my back, finally I was able to breathe without involuntary yelps of pain escaping from me. As more days passed, this severe pain slowly worked its way down my right side and then slowly down to my right thigh, then painfully behind the knee, eventually encompassing my entire leg. Now almost a month later, there are still remnants in my shin. But it's almost gone now, a month later. It never went into my foot.

Other Meds: Methadone; Aspirin; Benedryl

Current Illness: None

ID: 1709637
Sex: M
Age: 33
State: VA

Vax Date: 03/01/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: Soy

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

Symptoms: Sharp intermittent pain in lymph nodes. Not swelling or discoloration observed.

Other Meds: Serlatrin

Current Illness: N/A

ID: 1709638
Sex: F
Age: 23
State: NY

Vax Date: 05/13/2021
Onset Date: 07/05/2021
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: None

Symptom List: Rash, Urticaria

Symptoms: Dry patch where the shot was injected. Lighter and rougher than the rest of my skin. Also peels and flakes.

Other Meds: None

Current Illness: None

ID: 1709639
Sex: M
Age: 30
State:

Vax Date: 09/07/2021
Onset Date: 09/07/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: vaccine was administered after being improperly. the should have been moved for the freezer on 9/2, but was not removed until 9/8 and was administered to the patient

Other Meds:

Current Illness:

ID: 1709640
Sex: F
Age: 30
State: CA

Vax Date: 09/05/2021
Onset Date: 09/10/2021
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: Vertigo, inner ear pressure, nausea, constant dizziness even when laying down, pressure headaches that I?ve never experienced before, severe anxiety paired with unprovoked rage which is exceptionally abnormal for me, unusually heavy period with at least double my normal amount of clotting

Other Meds:

Current Illness:

ID: 1709641
Sex: M
Age: 23
State: CO

Vax Date: 09/07/2021
Onset Date: 09/07/2021
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: vaccine was administered after being improperly. the should have been moved for the freezer on 9/2, but was not removed until 9/8 and was administered to the patient

Other Meds:

Current Illness:

ID: 1709642
Sex: M
Age: 51
State:

Vax Date: 07/01/2021
Onset Date: 07/08/2021
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: Future eye appointment

Allergies: codeine

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

Symptoms: Definite vision changes and need to get prescription redone as had exam with prescription done two weeks prior to shot. Also constant tearing and redness in both eyes.

Other Meds:

Current Illness: none

ID: 1709643
Sex: F
Age: 72
State: CO

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

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

Symptoms: vaccine was administered after being improperly. the should have been moved for the freezer on 9/2, but was not removed until 9/8 and was administered to the patient

Other Meds:

Current Illness:

ID: 1709644
Sex: F
Age: 16
State: SC

Vax Date: 09/17/2021
Onset Date: 09/17/2021
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: none

Allergies: none

Symptom List: Ear pain, Hypoaesthesia

Symptoms: patient fainted about 30 seconds after receiving the vaccine

Other Meds: none

Current Illness: none

ID: 1709645
Sex: F
Age: 38
State: TX

Vax Date: 09/05/2021
Onset Date: 09/05/2021
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: Anaphylactic pine nut allergy

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Fever, severe muscle aches, chills, sweats, nausea

Other Meds: Adderall 20mg bid, multi vitamin, vitamin c, b-12 complex, vitamin d, biotin, baby aspirin

Current Illness: None

ID: 1709646
Sex: M
Age: 21
State:

Vax Date: 09/17/2021
Onset Date: 09/17/2021
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: NKA to food or medications

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

Symptoms: Patient without adverse symptoms. Patient tolerated vaccine well and departed after 15minute observation time. Instructed to submit VAERS due to patient reporting receiving Pfizer vaccine on 24Aug2021 on screening form during mass vaccination event. During post vaccine administration documentation patient found to have received Moderna not Pfizer on 24Aug2021. Patient received Pfizer on 17Sep21 instead of receiving Moderna. Patient aware informed of findings.

Other Meds:

Current Illness: none reported

ID: 1709647
Sex: F
Age: 23
State: CO

Vax Date: 09/07/2021
Onset Date: 09/07/2021
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: vaccine was administered after being improperly. the should have been moved for the freezer on 9/2, but was not removed until 9/8 and was administered to the patient

Other Meds:

Current Illness:

ID: 1709648
Sex: M
Age: 67
State: CA

Vax Date: 09/17/2021
Onset Date: 09/17/2021
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: Client received 1st dose of Pfizer vaccine on 4/20/21 and 2nd dose of Pfizer vaccine on 5/14/21. Client received 3rd dose of Moderna vaccine 9/17/21. Monitored client and educated patient on possible side effects.

Other Meds:

Current Illness:

ID: 1709649
Sex: F
Age: 31
State:

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

Lab Data:

Allergies:

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

Symptoms: vaccine was administered after being improperly. the should have been moved for the freezer on 9/2, but was not removed until 9/8 and was administered to the patient

Other Meds:

Current Illness:

ID: 1709650
Sex: F
Age: 43
State: GA

Vax Date: 08/14/2021
Onset Date: 08/15/2021
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: Ct scan, blood work, dental x-rays

Allergies: Sulfa drugs Mastisol (skin adhesive)

Symptom List: Injection site pain, Pain

Symptoms: Approximately 13 hours after receiving vaccine I began to feel sick (headache, slightly nauseous, feverish). I went to get ibuprofen at 5:30 am. Without any indication it was coming on, I passed out. I hit my face on our kitchen counter and then fell face first into the floor. I fractured my nose, split open the skin on my nose, completely ripped apart my upper lip, and damaged all four upper front teeth. This resulted in a trip to the emergency room, a CT scan, multiple stitches, root canals, and possible dental implants. I will also most likely need speech therapy because the muscle around my mouth was torn in two and I will need orthodontic devices to reposition my teeth. I have never passed out from a vaccine before . I have undergone many surgeries without passing out. I continued to feel flu like symptoms for 3-4 days after receiving the vaccine.

Other Meds: None

Current Illness: None

ID: 1709651
Sex: F
Age: 51
State: NY

Vax Date: 04/16/2021
Onset Date: 09/17/2021
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: X-ray

Allergies: allergic to amoxicillin, augmenting

Symptom List: Injection site pain, Menorrhagia

Symptoms: SIRVA: shoulder pain began right away and never went away. Bruise at injection site high up on arm, almost in shoulder. 2 30-day courses of Meloxicam and now physical therapy 2x per week

Other Meds: Cymbalta, Calcium, Vitamin D, Vitamin B Complex

Current Illness: none

ID: 1709652
Sex: M
Age: 31
State:

Vax Date: 01/08/2021
Onset Date: 09/14/2021
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: Fully vaccinated test positive- asymptomatic.

Other Meds:

Current Illness:

ID: 1709653
Sex: F
Age: 45
State: AZ

Vax Date: 05/04/2021
Onset Date: 05/04/2021
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: Requested a visit with an allergist. Still waiting.

Allergies: erythromycin and related meds; tussy - D; citalopram

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Almost immediately I got a sharp pain in my right hip that persisted for a while. Then a generalized ache. A numb, novicaine-like sensation from my eyes, through my face, neck, and arms; down to my hands. my list first became shriveled and then swelled up to triple the size. I had taken claritin previous to the shot as a prevention, & benedryl when I went home at the direction of the on-site nurses. Saw my PCP shortly after.

Other Meds: claritin, vitamin c, vitamin d, 80 mg aspirin

Current Illness: none

ID: 1709654
Sex: M
Age: 15
State: MD

Vax Date: 09/17/2021
Onset Date: 09/17/2021
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: BLOOD PRESSURE 106/60 AT FIRST, THEN 110/70 ABOUT 10 MINS LATER. O2 SAT LEVEL 100%. HEART RATE APPROXIMATELY 90. BLOOD GLUCOSE 81.

Allergies: NONE

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: PATIENT FELT FAINT APPROXIMATELY 3-5 MINUTES FOLLOWING 2ND DOSE OF PFIZER COVID VACCINE. PATIENT BEGAN TO FAINT AND FATHER LOWERED HIM TO THE FLOOR. PATIENT QUICKLY REGAINED CONSCIOUSNESS, BUT FELT FAINT AFTER GETTING BACK IN A CHAIR. PATIENT WAS LOWERED TO FLOOR AGAIN AND WAITED FOR EMS TO ARRIVE. EMS ARRIVED A FEW MOMENTS LATER (3:15PM) AND ASSESSED THE PATIENT.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1709655
Sex: F
Age: 40
State: CO

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

Allergies:

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

Symptoms: vaccine was administered after being improperly. the should have been moved for the freezer on 9/2, but was not removed until 9/8 and was administered to the patient

Other Meds:

Current Illness:

ID: 1709656
Sex: M
Age: 12
State: CO

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: vaccine was administered after being improperly. the should have been moved for the freezer on 9/2, but was not removed until 9/8 and was administered to the patient

Other Meds:

Current Illness:

ID: 1709657
Sex: F
Age: 30
State: TX

Vax Date: 09/14/2021
Onset Date: 09/16/2021
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: None

Symptom List: Injection site pain

Symptoms: I?ve had an IUD - Mirena for 3.5 years which has caused my menstrual cycles to stop completely. I no longer get periods. 2 days after the shot I started a heavy period and am still on it. I didn?t think it had anything to do with the vaccine but I was worried something was wrong and needed to see a doctor until someone told me it could be from the shot. After some research I was told by the pharmacist that it?s an adverse reaction and suggested I report it.

Other Meds: Zoloft

Current Illness: None

ID: 1709658
Sex: M
Age: 20
State: MO

Vax Date: 05/05/2021
Onset Date: 05/01/2021
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:

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

Symptoms: Over the next week to week and a half after my vaccine, I experienced a rather sharp chest pain. It would go away for short periods of time but kept coming back with no obvious trigger.

Other Meds:

Current Illness:

ID: 1709659
Sex: F
Age: 47
State:

Vax Date: 04/01/2021
Onset Date: 04/01/2021
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: N/a

Allergies: Shellfish

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

Symptoms: Evening of injection, one week later and 6 months later face became extremely red and burning and felt like it was going to blister Since injection felt muscle ache at injection and in specific part of bicep near crease of arm off and on

Other Meds: Prilosec

Current Illness: N/a

ID: 1709660
Sex: F
Age: 12
State: CO

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

Symptoms: vaccine was administered after being improperly. the should have been moved for the freezer on 9/2, but was not removed until 9/8 and was administered to the patient

Other Meds:

Current Illness:

ID: 1709661
Sex: F
Age: 0
State: FL

Vax Date: 09/17/2021
Onset Date: 09/17/2021
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: Patient came to pharmacy seeking flu vaccine. Vaccination was processed correctly. Vaccinating pharmacy technician administered moderna covid vaccine by mistake.

Other Meds:

Current Illness:

ID: 1709662
Sex: M
Age: 38
State: PA

Vax Date: 09/13/2021
Onset Date: 09/14/2021
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: Ceclor

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

Symptoms: Right shoulder pain. Feeling of Pinched nerve and loss of mobility. Doctor appointment Monday.

Other Meds: Vitamin C, D, Quercitin, Omega 3

Current Illness:

ID: 1709663
Sex: F
Age: 28
State: CA

Vax Date: 09/03/2021
Onset Date: 09/04/2021
Rec V Date: 09/17/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: At 33 5/7 weeks, less than 24 hours after receiving the Janssen Covid 19 Vaccine, patient experienced a plancental abruption that resulted in an emergency cesarean delivery of a premature infant, who has had to be in the NICU since delivery.

Other Meds:

Current Illness:

ID: 1709664
Sex: M
Age: 63
State: CO

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

Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: vaccine was administered after being improperly. the should have been moved for the freezer on 9/2, but was not removed until 9/8 and was administered to the patient

Other Meds:

Current Illness:

ID: 1709665
Sex: F
Age: 52
State: OH

Vax Date: 08/27/2021
Onset Date: 08/29/2021
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: she said she developed a red rash around her neck...like she had been strangled...she went to the doctor and he thought it looked like a fungal rash but wasn't sure.

Other Meds:

Current Illness:

ID: 1709666
Sex: F
Age: 39
State: OH

Vax Date: 08/31/2021
Onset Date: 09/01/2021
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: I went to the ER on day 3 and ER doctor thought I probably had a pinched nerve and prescribed muscle relaxers which did nothing.

Allergies:

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

Symptoms: Immediately following the shot I had pain up my neck and across my chest. That night I had horrible cold sweats and woke up with a kink in my back and neck which I assumed that?s all it was and now still 2+ weeks later it?s still causing me pain. I also started my period the day after the shot which was 10 days early. That has never happened my entire life. I had warm sensation in my arms and legs and numbness.

Other Meds:

Current Illness:

ID: 1709667
Sex: F
Age: 51
State: CA

Vax Date: 04/14/2021
Onset Date: 04/15/2021
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: Blood tests

Allergies: None

Symptom List: Pain in extremity

Symptoms: Dramatic decrease in concentration, ability to comprehend information; loss of concentration; severe fatigue; difficulty complete daily routine tasks; forgetfulness; constant feeling of tiredness while.

Other Meds: None

Current Illness: None

ID: 1709668
Sex: F
Age: 52
State: KY

Vax Date: 09/01/2021
Onset Date: 09/08/2021
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: Rash with itching, pain, burning on palms of both hands ,fingers,and between toes. Treatment was a steroid shot .followed 5 days later by a steroid pack of pills and a steroid cream. Total time of rash was 11 days.

Other Meds:

Current Illness:

ID: 1709669
Sex: F
Age: 46
State: NJ

Vax Date: 09/08/2021
Onset Date: 09/08/2021
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 reported by patient

Allergies: aspirin, codeine, penicillins, PEG, and possibly more per patient. Patient reported allergies to Benadryl thereafter, having used it after the allergic reaction to Moderna

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

Symptoms: Arm swelled up 2 hours after shot. Sense of taste lost, metallic taste in the evening of the day of vaccination. Fingertips and throat swollen a day after. Patient also reports felt itchy all over. Patient reports having used Benadryl which helped but was allergic to that also as she experienced a feeling of welling in the throat. Patient reports has EpiPen but expired but didn't need to use it. Patient also reports has consulted with multiple doctors to see what the issue is and felt that it might have been PEG polyethylene glycol

Other Meds: None reported by patient and none filled at pharmacy

Current Illness:

ID: 1709670
Sex: M
Age: 45
State: CA

Vax Date: 08/20/2021
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: no

Allergies: no

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

Symptoms: Runny nose/stuffy nose, congestion, intermitten cough, itchy throat.

Other Meds: no

Current Illness: no

ID: 1709671
Sex: F
Age: 31
State: TN

Vax Date: 08/07/2021
Onset Date: 08/12/2021
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:

Allergies:

Symptom List: Vomiting

Symptoms: My wife had a miscarriage 6 days after she received the first dose. She was 9 weeks pregnant. My wife was 142 lbs. healthy. Baby had a normal ultrasound 3 weeks prior.

Other Meds:

Current Illness:

ID: 1709672
Sex: M
Age: 49
State: UT

Vax Date: 01/15/2021
Onset Date: 09/14/2021
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: 9/10 - Blood work done in office with PA including urine sample 9/13 - Some tests re-run then sent to local outpatient clinic for a CT scan 9/14 - Additional symptoms of Bell's Palsy appear. In the ER, ran EKG, an MRI and some more blood work.

Allergies: seafood

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Patient has developed Bell's Palsy as of 9/14/2021. He had also been experiencing random swelling around his wrist bone and then both knees swelled up causing severe pain when he walked. Bedrest helped the swelling. This started approximately 9/3/2021. Within the same week he started having severe back and neck pain causing him to not be able to sleep for more than an hour. The following week on the 14th we ended up taking him to the ER for stroke symptoms and that's when he was diagnosed with Bell's. Palsy.

Other Meds: Ibuprofen and tylenol

Current Illness: none

ID: 1709673
Sex: M
Age: 21
State: KS

Vax Date: 09/17/2021
Onset Date: 09/17/2021
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: Not known

Allergies: none on file

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

Symptoms: Patient received vaccination and went out front to wait for the recommended 15 minutes. A few minutes later they fainted. 911 was called and they were attended to by a Pharmacist. Patient was conscious. Waited for Paramedics. They ended up taking him away. I was not told anything by Paramedics.

Other Meds: Not known

Current Illness: none known

ID: 1709674
Sex: M
Age: 34
State: WA

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

Lab Data: None reported

Allergies: Latex

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Patient reports feeling nerve pain, tingling, weakness, and shaking in the arm he received the vaccine. This started the day of the vaccine and continued through today.

Other Meds: None Reported

Current Illness: None Reported

ID: 1709675
Sex: F
Age: 49
State: CA

Vax Date: 05/07/2021
Onset Date: 06/02/2021
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: Severe swelling in one foot progressed to disabling pain and stiffness in multiple joints. I also developed swaying vertigo and neurological symptoms including nystagmus, tremors and twitching. Diagnosed with seronegative rheumatoid arthritis on August 5, 2021. Vertigo/neurological symptoms have not resolved; I'm awaiting an appointment with a neurologist to address them.

Other Meds:

Current Illness:

ID: 1709676
Sex: M
Age:
State: AZ

Vax Date: 07/01/2021
Onset Date: 07/29/2021
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: None

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

Symptoms: diaherra muscle spasms tinnitus Old illnesses and injuries activated randomly, sudden onset.

Other Meds: Motrin, Multi-vitamin

Current Illness: None

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am