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: 1713311
Sex: F
Age: 49
State: OH

Vax Date: 08/11/2021
Onset Date: 08/21/2021
Rec V Date: 09/18/2021
Hospital:

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

Lab Data: Covid 19 test on 8/23/2021.

Allergies: Penicillin

Symptom List: Dysphagia, Epiglottitis

Symptoms: Headache, pain and pressure behind eyes - blood shot eyes, nausea, fatigue for first few days after vaccine. Then, had headache, nausea and fatigue for several days. On 8/21/2021 had sweating, headache, congestion, body aches, nausea, fatigue which then progressed to low grade fever, difficulty breathing and coughing. Had telehealth visit with Dr. on 8/23/21 who prescribed medrol dose pack and Covid test. Tested positive for Covid on 8/24/2021. Symptoms progressed with difficulty breathing, coughing and decrease pulse oxygen level to 94%. also loss of taste and smell for 4 days. Doctor began Dulera inhaler and Z-pack. Have gradually improved since.

Other Meds: Norethindrone tablets - 0.35mg 1x/day, Aspirin - 81mg 1x/day, IBgard - 2 capsules 1x/day

Current Illness: None.

ID: 1713312
Sex: F
Age: 37
State: WI

Vax Date: 09/16/2021
Onset Date: 09/16/2021
Rec V Date: 09/18/2021
Hospital:

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

Lab Data: Results came back from ER on 09/16/21 for running blood work twice and there was no evidence of blood clot or heart attack. EKG was performed twice and I was told it was normal. Follow up with primary care doctor is scheduled for 09/20/21.

Allergies: animal dander (dogs being the biggest one); environmental/seasonal; hay

Symptom List: Anxiety, Dyspnoea

Symptoms: At 4:30 PM on 09/16/21 I began to feel short of breath and easily winded with some chest discomfort. By about 5 PM I used my rescue inhaler. Around 5:30 PM I called for a ride to the ER because chest pain was getting worse. At the ER they ran a number of tests including blood work and EKGs. Chest pain got worse while at the ER. Fever spiked while in ER. I was given Tylenol and ibuprofen. Results came back from running blood work twice and there was no evidence of blood clot or heart attack. EKG was performed twice and I was told it was normal. I will follow up with my primary care provider on 09/20/21 for more information. As of today (09/18/21), I continue to have some chest discomfort and tire extremely easily. Breathing is still more labored also.

Other Meds: Levothyroxine (low dose for low thyroid); Vitamins/minerals: D3, zinc, C, iron, biotin (hair, nails, skin supplement)

Current Illness: None

ID: 1713313
Sex: M
Age: 62
State: KS

Vax Date: 04/27/2021
Onset Date: 04/29/2021
Rec V Date: 09/18/2021
Hospital: Y

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: Full labs on 4/27 wnl

Allergies: Penicillin

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

Symptoms: Chest pain and hypertension, ER visit, cardiac cath showed clotted vessle off the LAD that was stented. Symptoms resolved without elevation in Cardiac enzymes

Other Meds: Atorvastatin and Clopidogrel

Current Illness: none.

ID: 1713314
Sex: F
Age: 78
State: FL

Vax Date: 05/06/2021
Onset Date: 05/01/2021
Rec V Date: 09/18/2021
Hospital:

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

Lab Data: MRA brain 8/3/21: normal MRI brain w/wo contrast 8/20/21: Atrophy and small vessel ischemic change. Focal encephalomalacia anterior left temporal lobe most suggestive of sequela of old brain injury. No acute/subacute abnormalities. Swallow study 8/17/21: Laryngeal penetration without aspiration with thin barium

Allergies: erythromycin, sulfa

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Approx 10 days after vaccine administration (May 2021), patient experienced acute onset significant vomiting and diarrhea. 2 days later had acute onset of significant dysarthria with some dysphagia that have persisted without significant change since that time. No other reported neurologic symptoms. Neuro exam with hyperreflexia in lower extremities, 2 beats of clonus RLE, noted dysarthria. Normal CN exam otherwise with no weakness or deviation of tongue. patient denies any prior head injury. Normal neuro exam otherwise. She has been undergoing speech/swallow therapy and occupational therapy with some mild improvement.

Other Meds: Atorvastatin, clonazepam, Lexapro, fluconazole, Amitiza, polyethylene glycol, urosodiol

Current Illness: N/A

ID: 1713315
Sex: F
Age: 15
State: TX

Vax Date: 09/06/2021
Onset Date: 09/06/2021
Rec V Date: 09/18/2021
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: None

Other Meds: None

Current Illness: None

ID: 1713316
Sex: F
Age: 44
State: MN

Vax Date: 04/07/2021
Onset Date: 09/15/2021
Rec V Date: 09/18/2021
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: Nexium

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

Symptoms: Headache, sore throat, pressure neck, shoulders, runny nose, congestion, fatigue starting on 9/15/21. Daughter tested positive for COVID on 9/12/21, unclear if daughter vaccinated

Other Meds: Vitamin D; Micrette

Current Illness: none

ID: 1713317
Sex: F
Age: 34
State: NV

Vax Date: 09/16/2021
Onset Date: 09/17/2021
Rec V Date: 09/18/2021
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: N/a

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Immediately my face and leg and arm on the left side started tingling. The next morning my left leg was weak. Today which is two days later I feel pins and needles in my left foot, leg, arm, fingers. The muscles in my left leg are very fatigued and week. The muscles in my left leg are very fatigued and week.

Other Meds: Zoloft 100mg

Current Illness: N/a

ID: 1713318
Sex: F
Age: 38
State: VA

Vax Date: 08/20/2021
Onset Date: 09/14/2021
Rec V Date: 09/18/2021
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: After receiving the second vaccine, my last period started a week late and now I?m heavily spotting even though my next period isn?t supposed to start for another 12 days. I never have abnormal menstrual issues. I have an iud and everything is like clockwork and has been for years. So I?m reporting: *Late period *Breakthrough Bleeding when I shouldn?t be bleeding at all right now. I?d just like to stress again than my menstrual cycle has been like clockwork for decades. This is absolutely unusual.

Other Meds: Fluoxetine

Current Illness:

ID: 1713319
Sex: M
Age: 16
State: TX

Vax Date: 09/06/2021
Onset Date: 09/06/2021
Rec V Date: 09/18/2021
Hospital:

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

Lab Data: None

Allergies: None

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: None

Other Meds: None

Current Illness: None

ID: 1713320
Sex: F
Age: 43
State: CA

Vax Date: 06/26/2021
Onset Date: 07/10/2021
Rec V Date: 09/18/2021
Hospital:

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

Lab Data: cervical spine xray negative nerve conduction study has been ordered neurology referral

Allergies: no known allergies

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Left hand numbness, pain, and weakness starting 2 weeks after first dose of Moderna COVID vaccine; symptoms have persisted to the present; mild true weakness of left hand/wrist/forearm muscles on exam 9/9/21 Bilateral lower extremity weakness starting same day after second dose of Moderna COVID vaccine; resolved the same day or next day

Other Meds: Bupropion Cetirizine Has Mirena IUD

Current Illness: no acute illnesses

ID: 1713321
Sex: F
Age: 39
State: OR

Vax Date: 02/17/2021
Onset Date: 02/18/2021
Rec V Date: 09/18/2021
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: Hydrocodone, cucurbita, latex, whey, yeast, sumatriptan, adhesives & tapes.

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

Symptoms: Brain fog, dementia like. Tremor in fingers and wrist. Abnormal

Other Meds: Sprintec, topamax, 800mg ibuprofen, multivitamins.spironolactone.

Current Illness: None

ID: 1713322
Sex: F
Age: 68
State: KS

Vax Date: 03/06/2021
Onset Date: 03/06/2021
Rec V Date: 09/18/2021
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: Lidocaine-tingling, itching

Symptom List: Rash, Urticaria

Symptoms: 1213-patient receives vaccine 1225-tingling in mouth and lips 1230-itching Patient reports she takes many meds; has allergies which cause stomach aches and headaches 1240-No visible swelling of lips or face; no cough; no agitation; pulse strong, steady 70s; no breathing problems; no nausea; no redness visible. Possible mild hypertension vs. anxiety. Lotion applied to skin. Benedryl offered to patient 25mg; patient prefers to take benedryl at home 1250-Patient ready to go home; offered to call EMS to check her; declined EMS, benedryl, water. Was given nurse's phone number, RN, and asked to call as soon as patient arrived there. 1255-Walked patient to her car. 1425-Patient called RN, after running errand and is now home and reports feeling better.

Other Meds:

Current Illness:

ID: 1713323
Sex: F
Age: 49
State: FL

Vax Date: 09/16/2021
Onset Date: 09/16/2021
Rec V Date: 09/18/2021
Hospital:

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

Lab Data: EKG was normal and routine labs normal and chest x ray normal

Allergies: Sulfa

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

Symptoms: Stabbing chest pain 10 hours after vaccine. Pain worse when lying down and deep breathing. Doctor believed that symptoms were pericarditis and gave antii-inflammatory and pain meds. Also started menstrating. I am in menopause and have not had a period in 5 years and I started a period the day I got the vaccine. Do not know outcome as I?ve just started meds and rest today and just left the ER

Other Meds: Kepra

Current Illness: Central core myopathy

ID: 1713324
Sex: M
Age: 73
State: WA

Vax Date: 08/23/2021
Onset Date: 09/14/2021
Rec V Date: 09/18/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data: 1) Troponinemia to 0.22, seven (7) hours after anginal chest pain; 2) Cardiac MR revealing "Small 1.1 cm mid-wall located LGE (late gadolinium enhancement) consistent with non-ischemic focal myocardial fibrosis"; 3) EKG revealing no ST-changes, RBBB which was present on previous EKGs, 4) Cardiac catheterization revealing "Non-obstructive coronary artery disease of the large epicardial vessels."; 5) ECHO revealing "Normal left ventricular size and systolic function. No regional wall motion abnormalities."

Allergies: NONE

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

Symptoms: Presented on 9/14 to ER with anginal chest pain lasting 30 minutes (substernal pressure, radiating to L neck, arm) which self-resolved. On admission, patient was treated with 36 hours of heparin drip d/t suspected ACS (later discontinued). Later treated with 4mg IV Mg2+ for relative hypomagnesemia (1.3), and 2L LR for orthostatic hypotension. Labs/imaging revealed cardiac stress (troponinemia) in absence of obstructive coronary artery disease on cardiac cath, and "non-ischemic focal myocardial fibrosis" on MRI. Over the course of the hospitalization, anginal chest pain did not recur, and troponin trended back to within normal range. Patient was discharged with a low-dose beta-blocker (metoprolol XL 12.5 QD) in addition to optimized stain (atorvastatin rather than simvastatin) and optimized alpha-blocker (tamsulosin rather than alfuzosin). Per Cardiology consult: "Etiology of myocarditis is unclear, he has somewhat focal LGE. No HF, normotensive, no heart block. DDx is broad including sarcoid, viral infection and COVID vaccination (got three doses)."

Other Meds: Simvastatin Metformin Losartan Alfuzosin

Current Illness: NONE

ID: 1713325
Sex: F
Age: 38
State: FL

Vax Date: 09/16/2021
Onset Date: 09/17/2021
Rec V Date: 09/18/2021
Hospital:

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

Lab Data: N/A

Allergies: N/A

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

Symptoms: A node under my right armpit has swollen. It is about the size of a golf ball. It makes it hard to raise or use my right arm. The pain is in the side of my breast up my armpit and down to my elbow. I am using Ibuprofen and Acetaminophen, Hot compress and resting. Ive also alerted my care team. I am also keeping track of the size to make sure it does not get bigger.

Other Meds: 10 MG Montelukast, 0.5 MG Clonazepam, 900MG Gabapentin, 25 MG Sumatriptan, 90 MG Duloxetine, 10 MG Cetirizine, 300MG Bupropion HCL XL

Current Illness: N/A

ID: 1713326
Sex: M
Age: 22
State:

Vax Date: 09/04/2021
Onset Date: 09/13/2021
Rec V Date: 09/18/2021
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: delayed rash, swelling, itchy

Other Meds:

Current Illness:

ID: 1713327
Sex: M
Age: 72
State: MN

Vax Date: 02/26/2021
Onset Date: 09/15/2021
Rec V Date: 09/18/2021
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: Patient had Virtual visit and at that time was asymptomatic and interested in COVID 19 PCR testing. His partner tested positive for COVID-19 on 9/14/21). Patient had PCR testing on 9/15/21, which was positive. Unclear if partner vaccinated

Other Meds: Atenolo; Adult aspirin low strength; Gabapentin; Pantoprazole; Metformin; Clopidogrel; Simvastatin

Current Illness: none

ID: 1713328
Sex: F
Age: 36
State: NC

Vax Date: 01/07/2021
Onset Date: 01/09/2021
Rec V Date: 09/18/2021
Hospital:

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

Lab Data:

Allergies: Keflex, progesterone injections, processed/aged foods

Symptom List: Ear pain, Hypoaesthesia

Symptoms: 2 days after vaccine developed inability to sleep, anxiety that increased over days into being unable to function. Reality was distorted, unable to eat for 3 days. On day 10 had sudden projectile vomiting and diarrhea with throat closure.

Other Meds: Zyrtec, vit d, singular, zyrem, xolair, famotadine

Current Illness: Narcolepsy, physical urticaria

ID: 1713329
Sex: F
Age: 58
State: GA

Vax Date: 04/10/2021
Onset Date: 04/14/2021
Rec V Date: 09/18/2021
Hospital:

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

Lab Data: Labs done to rule out other possible causes; April 26,2021,- SED RATE, VitB12, CMP, CBC, Hemoglobin, ANA, CRP, TSH May 18,2021 - Urinalysis, RA Factor, Covid Antibody

Allergies: None

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: 4 days after I received 1st shot of the Moderna Covid 19 Vaccine in April. I had sticking, stinging and burning pains in my skin and my fingers and toes joints hurt. My skin felt like it was on fire. No rash,however my hands and sole of my feet became became excessively dry with several painful cracks. Water burned and felt like gasoline on my skin.

Other Meds: None

Current Illness: None

ID: 1713330
Sex: F
Age: 37
State: NY

Vax Date: 09/03/2021
Onset Date: 09/08/2021
Rec V Date: 09/18/2021
Hospital:

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

Lab Data:

Allergies: Mild PCN Cantaloupe

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

Symptoms: 24 hrs headache nausea, fever, chills. (Took Motrin 400mg) 5 days later severe itchiness from head to toe. (Took antihistamine xyzal)

Other Meds: No

Current Illness:

Date Died: 09/12/2021

ID: 1713331
Sex: M
Age: 59
State: GA

Vax Date: 03/29/2021
Onset Date: 09/12/2021
Rec V Date: 09/18/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Patient death

Other Meds:

Current Illness:

ID: 1713332
Sex: F
Age: 22
State: TN

Vax Date: 06/01/2021
Onset Date: 08/01/2021
Rec V Date: 09/18/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Unevaluable event

Symptoms: I have started having bad headaches & it have altered my menstrual cycle to a complete stop. I haven?t had 2 month of period since I had my 2nd dose

Other Meds: None

Current Illness: Headache

ID: 1713333
Sex: M
Age: 50
State: AZ

Vax Date: 06/01/2021
Onset Date: 07/01/2021
Rec V Date: 09/18/2021
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: MRI, #2 CT scans

Allergies: None

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

Symptoms: My hearing is loss.. Head pressure

Other Meds: None

Current Illness: None

ID: 1713334
Sex: M
Age: 55
State: SC

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

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

Lab Data: none reported

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Pt had J and J at different pharmacy back in May, didnt find out until after giving the shot that he already had received it before. Talked to him and he said his doctor recommended booster. Will follow up in future with the pt but he did not have any advese reaction. I just wanted to report invalid dose for admin error as a pharmacist. thank you!

Other Meds:

Current Illness:

ID: 1713335
Sex: M
Age: 33
State: OH

Vax Date: 08/04/2021
Onset Date: 08/26/2021
Rec V Date: 09/18/2021
Hospital:

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

Lab Data: Multiple nodules in lungs and clavicle(s).

Allergies: Shellfish

Symptom List: Injection site pain, Menorrhagia

Symptoms: Pain in chest, soreness in arm. Pain when moving right arm across the chest.

Other Meds: Vitamin C, Vitamin D3 and Zinc

Current Illness: None

ID: 1713336
Sex: F
Age: 34
State: OR

Vax Date: 09/17/2021
Onset Date: 09/17/2021
Rec V Date: 09/18/2021
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: Sulfa meds, latex, Vicadone, chocolate, gelatin, coconut

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

Symptoms: Dizzy, nauseous, massive headache,

Other Meds: Basaglar insulin, prenatal vitamins

Current Illness:

ID: 1713337
Sex: F
Age: 36
State: WI

Vax Date: 09/18/2021
Onset Date: 09/18/2021
Rec V Date: 09/18/2021
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: nkda

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: about 5 minutes after receiving vaccine, she notified me she was not feeling good, and she wanted to lay down , she laid down gently i sat with her about 10 min she carried on conversation pulse steady , was nauseous at one point wth dry heave said she had not eaten ' eventually took some water m0 symptoms resolved, seemed consistent with vagal reaction

Other Meds: not known

Current Illness: none

ID: 1713338
Sex: M
Age: 52
State: IL

Vax Date: 04/15/2021
Onset Date: 05/03/2021
Rec V Date: 09/18/2021
Hospital:

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

Lab Data: May 23 Pcp visit, may 24 PCP & ER, june 14, july 7 PCP & ER, july 16 PCP, august 10 liver specialist, august 16 liver specialist, September 10th dermatologist. Multiple blood tests, xrays, cat scans, ascites drain etc. no body know what it is and keeps passing me to next doctor or specialist

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Hives, swelling, ascites, blisters, non stop itch, pruritus, puffy eyes, eyelid bump infection, dry skin

Other Meds:

Current Illness: Covid infection

ID: 1713339
Sex: F
Age: 42
State: KS

Vax Date: 03/26/2021
Onset Date: 03/26/2021
Rec V Date: 09/18/2021
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: Patient had vaccine and 15 minutes later at 1445 started experiencing mild hives, discomfort. Patient has history of auto-immune disorder/celiac. Given benadryl 50mg IM on RT side. Patient color has improved; 02 stats improved. Pepcid 20mg. Advised patient to consult provider and front load benadryl prior to next appointment.

Other Meds:

Current Illness:

ID: 1713340
Sex: M
Age: 25
State: PA

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

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

Lab Data: About 5-10 minutes after vaccine, pt started saying they didn't feel right and was dizzy, heart was racing a bit, feeling anxious, sweating. 911 called and Manager on duty notified. Gave patient 4 tsp of liquid benadryl. EMS came and examined the patient. Pt signed refusal form to go to hospital and stated he thought it could have been anxiety bc he was feeling better

Allergies: none

Symptom List: Nausea

Symptoms: About 5-10 minutes after vaccine, pt started saying they didn't feel right and was dizzy, heart was racing a bit, feeling anxious, sweating. 911 called and Manager on duty notified. Gave patient 4 tsp of liquid benadryl. EMS came and examined the patient. Pt signed refusal form to go to hospital and stated he thought it could have been anxiety bc he was feeling better

Other Meds: unknown

Current Illness: none

ID: 1713341
Sex: M
Age: 13
State: WA

Vax Date: 09/11/2021
Onset Date: 09/12/2021
Rec V Date: 09/18/2021
Hospital: Y

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

Lab Data: Troponin levels decreased over course of hospitalization from 1.33 to 1.15 to 0.54 over pt's 3 day observation and cardiac ECHO and EKG's were normal

Allergies: NKA

Symptom List: Injection site pain

Symptoms: Pt. had chest pain and shortness of breath.

Other Meds: None

Current Illness: None

ID: 1713342
Sex: M
Age: 37
State: FL

Vax Date: 05/17/2012
Onset Date: 05/17/2012
Rec V Date: 09/18/2021
Hospital:

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

Lab Data: after several months of trying to figure out what was causing problems I underwent allergy testing at the recommendation of my family doctor, resulting in allergic reactions to 76 different substances. No allergies prior to receiving this vaccination.

Allergies: none at the time

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

Symptoms: burning at injection site, hard lump approximately the size of a marble for several weeks, chronic fatigue, suddenly developed allergies to 76 different substances (environmental as well as food and pet), onset of migraines

Other Meds: none

Current Illness: none

ID: 1713343
Sex: M
Age: 23
State: TN

Vax Date: 08/04/2021
Onset Date: 08/11/2021
Rec V Date: 09/18/2021
Hospital:

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

Lab Data: blood pressure check, temperature check, and heart rate check.

Allergies: fish & soy

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

Symptoms: Radiating pain in my shoulder moving down my left arm and towards my back, and now my left leg. This started occurring after my first dose of moderna on 8/4/21, but I expected the pain to go away. it is now 40+ days past my first vaccine and I am still experiencing this pain along with a slight tension headache on the back of my head towards my neck. My doctor said that it the area may be inflamed an prescribed me methylprednisolone to reduce inflammation. It has been 1 day, I have taken 8 tablets (6 yesterday, and 2 today), and I still have the headache and radiating pain in my thigh shoulder, and back.

Other Meds: Methylprednisolone

Current Illness: n/a

ID: 1713344
Sex: F
Age: 42
State: IL

Vax Date: 09/17/2021
Onset Date: 09/18/2021
Rec V Date: 09/18/2021
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: Meloxicam

Symptom List: Tremor

Symptoms: Passed out in my kitchen and hit the hardwood floor. This was within 24 hours of the shot.

Other Meds: Aspirin, multi vitamin. Ashwaghanda. Apple cider vinegar gummy. Iwi cholesterol. Probiotics. Curcumin.

Current Illness: None

ID: 1713345
Sex: F
Age: 76
State: PA

Vax Date: 09/10/2021
Onset Date: 09/16/2021
Rec V Date: 09/18/2021
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 started developing a red itchy rash around the injection site and down her arm to her elbow beginning 5 days post immunization.

Other Meds:

Current Illness:

ID: 1713346
Sex: M
Age: 35
State: AZ

Vax Date: 09/16/2021
Onset Date: 09/17/2021
Rec V Date: 09/18/2021
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: None

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

Symptoms: I suddenly experienced increased heart rate. I then felt like my heart was beating out of my chest. I had my fianc? check my blood pressure, which is typically in the normal range. I had a 160 over 108 with a resting heartrate of 120. That night I also experienced severe sweating.

Other Meds: None

Current Illness: None

ID: 1713347
Sex: F
Age: 65
State: MO

Vax Date: 09/16/2021
Onset Date: 09/16/2021
Rec V Date: 09/18/2021
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: Began swelling a couple hours after injection in two spots on left arm, became red as well, swelling and redness went down but has now begun again, 4" by 4" red, swollen, itchy, warm area around injection, painful if pushed on

Other Meds:

Current Illness:

ID: 1713348
Sex: F
Age: 57
State: SC

Vax Date: 09/18/2021
Onset Date: 09/18/2021
Rec V Date: 09/18/2021
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: Patient had J&J at different pharmacy back in May; didn't find out until after giving the shot she already received it before. Talked to her and she said her doctor recommended booster. Will follow-up in future with the patient. She did not have any adverse reaction. I just wanted to report invalid dose for admin error as a pharmacist. Thank you!

Other Meds:

Current Illness:

ID: 1713349
Sex: F
Age: 61
State: ND

Vax Date: 09/16/2021
Onset Date: 09/17/2021
Rec V Date: 09/18/2021
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: Penicillin, Bee sting

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

Symptoms: Extreme presyncope and lightheadedness for approximately 18 hours

Other Meds: Buspirone 30mg, pramipexole 6mg, furosemide 40mg, metoprolol 50mg, levothyroxine 100mcg

Current Illness: No emergent illness, only symptoms of chronic conditions

ID: 1713351
Sex: F
Age: 18
State: KS

Vax Date: 04/14/2021
Onset Date: 04/14/2021
Rec V Date: 09/18/2021
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: Patient started to fall when she just reached observation. Patient was in the process of sitting down when she became weak and lost function of her legs and consciousness. Patient has a history of fainting. Patient stated she did not eat prior. After 10 minutes and consuming a snack and water the patient regained full alertness and conversation/movement.

Other Meds:

Current Illness:

ID: 1713352
Sex: F
Age: 54
State: OR

Vax Date: 09/15/2021
Onset Date: 09/16/2021
Rec V Date: 09/18/2021
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: Low grade fever, chills, extreme body aches, headache, nausea, and diarrhea

Other Meds: Lisinopril, Acid Reducer, Claritin, Vitamin D

Current Illness:

ID: 1713353
Sex: F
Age: 44
State: CA

Vax Date: 09/17/2021
Onset Date: 09/17/2021
Rec V Date: 09/18/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 2
Vax Route:
Vax Site:

Lab Data: Doctor office is closed today.

Allergies: None

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

Symptoms: Extreme dizziness 5 min post injection Extreme dizziness that lead to fainting 26 hours post injection. Continues dizziness Unable to perform normal daily functions

Other Meds: Lexapro

Current Illness: None

ID: 1713354
Sex: F
Age: 73
State: MN

Vax Date: 02/15/2021
Onset Date: 09/15/2021
Rec V Date: 09/18/2021
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: Lisinopril; Bactrim

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

Symptoms: Cough, runny nose, congestion, fatigue starting 9/15/21 ln additiion, right eye is red and has been gritty and has had discharge the past couple of days

Other Meds: MiraLax; Benefiber; Synthroid; HCTZ; hyralazine; Klor-Con; Albuterol

Current Illness: none

ID: 1713355
Sex: F
Age: 40
State: NY

Vax Date: 09/03/2021
Onset Date: 09/04/2021
Rec V Date: 09/18/2021
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: Rapid heart beat, headache, nausea, heavy breathing,

Other Meds:

Current Illness:

ID: 1713356
Sex: F
Age: 42
State: OK

Vax Date: 04/01/2021
Onset Date: 05/16/2021
Rec V Date: 09/18/2021
Hospital:

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

Lab Data: None

Allergies: None

Symptom List: Vomiting

Symptoms: Heavy menstrual cycles and clotting

Other Meds: Birth control, Calcium, magnesium, probiotics

Current Illness: None

ID: 1713357
Sex: F
Age: 42
State: NH

Vax Date: 01/25/2021
Onset Date: 04/01/2021
Rec V Date: 09/18/2021
Hospital:

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

Lab Data: Overnight sleep study in July 2021

Allergies: Aspirin Codeine morphine

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Since the vaccine I have experienced increasing hypersomnia and had to seek medical care. I visited PCP then had a sleep study and was diagnosed with idiopathic hypersomnia (rule/out narcolepsy). I am now taking armodafanil daily so that I can complete routine day to day activities without falling asleep.

Other Meds: None

Current Illness: None

ID: 1713358
Sex: F
Age: 13
State: TX

Vax Date: 09/18/2021
Onset Date: 09/18/2021
Rec V Date: 09/18/2021
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: No adverse events reported. Error of age was discovered after the vaccine was administered. Patient's mother was made aware of the incident.

Other Meds:

Current Illness:

ID: 1713359
Sex: F
Age: 42
State: OR

Vax Date: 08/28/2021
Onset Date: 09/03/2021
Rec V Date: 09/18/2021
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 yet....I just reported it to my doctor

Allergies: Amoxicillin, Azithromycin, Benadryl, Doxycline, levofloxacin, Penicillin, sulfamethoxazole, sumatriptan, sumatriptan

Symptom List: Injection site swelling, Limb discomfort

Symptoms: After having that 1st pfizer vaccine I have experienced changes in my period (very dark brown blood with clotting in the beginning) , twitching & trimmers in both of my arms, and grinding my teeth.

Other Meds: Vitamins

Current Illness: None

ID: 1713360
Sex: F
Age: 67
State: KY

Vax Date: 03/17/2021
Onset Date: 09/07/2021
Rec V Date: 09/18/2021
Hospital:

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

Lab Data: covid-19 viral testing antigen

Allergies: Amox-clav

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

Symptoms: Fever, loss taste and smell, congestion, fatigue, nausea

Other Meds: Multivitamin, omeprazole, bisoprolol fumarate, Xanax,

Current Illness: None

ID: 1713361
Sex: F
Age: 76
State: NY

Vax Date: 04/01/2021
Onset Date: 04/07/2021
Rec V Date: 09/18/2021
Hospital: Y

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

Lab Data: ct scan, ultrasound

Allergies: mercury in red snapper and grouper.

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

Symptoms: whole body ached, couldn't walk, both arms were hurting, knees hurting, then the following month hospitalized for high potassium levels. Prednisone, Hydroxychloroquine 200mg, Veltassa 8.4g, Acetami/Codein 300-30mg tab. 1 tablet every six hours

Other Meds: Clopidogrel tablets 75 mg 1 tablet per day Resuvastatin 20mg 1 tablet per day Isosorbide MN ER 120mg tablet take two tablets per day Verapamil ER240mg tab GLE 1 tablet per day Acetylcysteine solution 3x30 ml vials three times a day Zolpidem

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am