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: 1713412
Sex: F
Age: 13
State: OR

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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: none indicated

Allergies: no known

Symptom List: Dysphagia, Epiglottitis

Symptoms: The patient is a 13 y.o. female presents to the office for influenza vaccination. Vaccine Information Sheet given to patient. Vaccine screening questionnaire completed and reviewed Patient had emesis episode about 30-60 seconds post vaccine with pallor, no diaphoresis, no rash, no urticaria, no facial swelling or angioedema, no respiratory distress. Updated Dr. on patient's condition. No previous issues with vaccines and no known allergies. Patient's symptoms resolved with no continual emesis- waited in clinic for observation period. Patient stable on discharge with no complaints.

Other Meds: no known

Current Illness: no known

ID: 1713413
Sex: U
Age: 25
State: KS

Vax Date: 04/21/2021
Onset Date: 04/21/2021
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:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Patient stated redness, slight SOA with first vaccine dose. Hesitant about 2nd dose. 2nd dose given in observation area. Supervisor notified. Fluids provided to patient. Patient was observed 30 minutes per protocol for allergies. At 11:20 c/o slight dizziness, crackers and water provided. At 1130 patient states heart is racing; P88. Patient states this also happens when taking effexor. Refused ambulance; taken to car by EMS personnel. Patient's mother was present in observation area.

Other Meds:

Current Illness:

ID: 1713414
Sex: M
Age: 55
State: AZ

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: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: penicillin

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

Symptoms: Tiredness, fatigue, Body aches, Headache, soreness at injection site

Other Meds: over the counter allergy medication

Current Illness: allergies

ID: 1713415
Sex: M
Age: 70
State: GA

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: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data:

Allergies: NKA

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Patient attempted to get up after 10 minutes of receiving the Moderna vaccine. Apparently patient got dizzy and fell to the ground hitting his head on the floor resulting in head laceration. The paramedics were called. Attended to him and took him to the ER.

Other Meds: Plavix

Current Illness: Diabetes mellitus

ID: 1713416
Sex: F
Age: 33
State: MN

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

Lab Data:

Allergies: Sulfa

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

Symptoms: Hard, painful, red, hot to the touch lump at injection site. Also cery itchy

Other Meds: Ambien, ibuprofen, alive, Benadryl, vitamin c, vitamin d3, probiotic, fish oil

Current Illness:

ID: 1713417
Sex: M
Age: 45
State:

Vax Date: 06/10/2021
Onset Date: 06/16/2021
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: None

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

Symptoms: Headache, coughing, flue

Other Meds: None

Current Illness: None

ID: 1713418
Sex: F
Age: 37
State: MA

Vax Date: 02/01/2021
Onset Date: 03/01/2021
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: Zertec authtrycycling one inslin

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: After receiving my shots I started to get brain fog my arms were hurting like somebody was squeezing down on them I had trouble sleeping I would wake up in the middle of the night and be in pain and for the last 6 weeks I have had the pain in my arms all day and all night with no relief there are times I forget what I'm going to say and sometimes even mid-sentence I forget what I'm going to say

Other Meds: Metformin vitiman d atorvastatin sertraline baby aspirin alpraolam prn probiotics levothyroxine clonidine loraatadine triamcinolone Victoria lantis

Current Illness:

ID: 1713419
Sex: M
Age: 37
State: CT

Vax Date: 07/30/2021
Onset Date: 07/30/2021
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: None

Allergies: None

Symptom List: Pharyngeal swelling

Symptoms: Right arm sore. Left arm sore at previous injection site from April 12th. No other symptoms.

Other Meds: None

Current Illness: None

ID: 1713420
Sex: M
Age: 24
State: OH

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

Lab Data: none

Allergies: unknown

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: patient stated while in process of getting second shot. He had experienced an occasional heart flutter but he was also under quite a bit of stress the last 3 weeks also. he got his second shot today.

Other Meds: unknown

Current Illness: unknown

ID: 1713421
Sex: M
Age: 21
State: NH

Vax Date: 08/18/2021
Onset Date: 08/21/2021
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: unknown- pt has physical after vaccine on an unknown date

Allergies: no known allergies

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Patient came in for 2nd moderna covid 19 vaccine appointment. I was asking him if he had experienced any issues with the first shot. He stated he had intermittent chest pain starting a few days after the vaccine that was accompanied with mild shortness of breath which was not normal for him. The intermittent chest pain and SOB lasted about a week and has since resolved. Patient stated he had a physical after the vaccine. He mentioned the symptoms and his vaccination status to the doctor. He said the doctor listened to his heart and said he thought it was allergies. Patient stated he does not have allergies and didn't think it was allergies. We decided to hold off on the 2nd vaccine until we could talk to the doctor (patient came in for 2nd vaccine on a saturday when md office was closed).

Other Meds: unknown

Current Illness: unknown

ID: 1713422
Sex: F
Age: 33
State: MN

Vax Date: 08/20/2021
Onset Date: 08/27/2021
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:

Allergies: Sulfa

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

Symptoms: One week following Covid shot (08/27/2021) injection site became hot, itchy, red , hard lump, slightly painful, it would constantly change in appearance and lasted for a week. Became bigger in size every day for the entire week. It would fade in color and border would become raised.

Other Meds: Ambien, ibuprofen pm, ibuprofen, vitamin c, vitamins d3, calcium, fish oil, probiotics

Current Illness:

Date Died: 08/05/2021

ID: 1713423
Sex: F
Age: 73
State: WI

Vax Date: 06/09/2021
Onset Date: 08/05/2021
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:

Symptom List: Rash, Urticaria

Symptoms: Back of heart collapsed.

Other Meds:

Current Illness:

ID: 1713424
Sex: F
Age: 31
State: NY

Vax Date: 09/11/2021
Onset Date: 09/11/2021
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: nuts, amoxicillin

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

Symptoms: hives to face 3 hours after 2nd vaccine

Other Meds: none

Current Illness: none

ID: 1713425
Sex: F
Age: 60
State: KS

Vax Date: 04/02/2021
Onset Date: 04/02/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: Antibiotics/codeine-anaphylaxis

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

Symptoms: Patient requested to have vaccine given to her in the EMS room due to a past anaphylaxis reaction to antibiotics and codeine. Patient was given 50mg benadryl PO at 0910 and vaccine was given at 0925.

Other Meds:

Current Illness:

ID: 1713426
Sex: F
Age: 17
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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: None

Allergies: None

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

Symptoms: None

Other Meds: None

Current Illness: None

ID: 1713427
Sex: M
Age: 61
State: AZ

Vax Date: 08/26/2021
Onset Date: 08/26/2021
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: NKDA

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

Symptoms: A few hours after the vaccine, Pt's left shoulder symptoms began: extreme pain in the shoulder joint and immobility. These symptoms continued for several days to the degree that he was not able to use his arm at all, and required help with dressing. It has gradually improved, but he remains with quite limited range range of motion and some pain. I left a few messages on MyChart and the nurse called Pt on August 31. Pt followed up with PA on Sept 1 with an in-person visit. She and Pt discussed that the injection was most likely given too high in the deltoid, and is affecting the soft tissues around his shoulder joint. We are giving more time for recovery, but at this point he has not regained full function of his left arm, making it difficult to answer the question below about whether permanent damage has occurred.

Other Meds: Losartan 25mg QD QD Rosuvastatin 10mg HS Janumet 50-500mg BID Pepcid 10mg HS Zytrec PRN Triamcinolone nasal spray PRN

Current Illness: seasonal allergies

ID: 1713428
Sex: F
Age: 35
State: WI

Vax Date: 09/02/2021
Onset Date: 09/10/2021
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: Rash and itching on right arm approximately 2 inches below injection site. Started 8 days after vaccine and lasted 4 days. No treatment needed. Rash self-resolved

Other Meds: Multivitamin, vitamin D

Current Illness:

ID: 1713429
Sex: F
Age: 33
State: GA

Vax Date: 09/09/2021
Onset Date: 09/18/2021
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: Kale/walnuts

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Swollen left eye, open sore on eyebrow- eyelid closing over eye. 4-5 fever blisters active on mouth and surrounding area. Began with first vaccination- two weeks after and same with second dose 09 days after. Swollen eyelid is new.

Other Meds: Spironolactone 200mg

Current Illness:

ID: 1713430
Sex: F
Age: 51
State:

Vax Date: 09/17/2021
Onset Date: 09/17/2021
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:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Headache, muscle ache, sore arm, tiredness

Other Meds:

Current Illness:

ID: 1713431
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: RV1
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: ROTAVIRUS (ROTARIX)
Lot:
Dose Series: 1
Vax Route: PO
Vax Site: MO

Lab Data: None

Allergies: None

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

Symptoms: None

Other Meds: None

Current Illness: None

ID: 1713432
Sex: F
Age: 48
State: PA

Vax Date: 04/15/2021
Onset Date: 04/16/2021
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: 48 halter monitor Echocardiogram Audiogram Vestibular Rehab therapy Blood work for thyroid Prednisone for possible inflammation

Allergies: None

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

Symptoms: Heart palpitations Menstrual cycle started and last 3 weeks Dizziness Blurred vision Tinnitus Vestibular neuontitus Extreme head pressure Nystagmus

Other Meds: 10 mg Lisinopril Vitamin D3 Iron

Current Illness: None

ID: 1713433
Sex: F
Age: 39
State: PR

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: LA

Lab Data:

Allergies: SEAFOOD

Symptom List: Unevaluable event

Symptoms: The patient verbalizes that at the moment she arrived at the observation area she was dizzy and palpitations with shortness of breath.

Other Meds: SYNTHROID

Current Illness:

ID: 1713434
Sex: F
Age: 37
State: NY

Vax Date: 03/28/2021
Onset Date: 03/28/2021
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:

Allergies: influenza vaccine, milk,

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

Symptoms: Dizziness, elevated heart rate, hives and difficulty swollowing. given prendisone, benedyl for 2 weeks. rushed to er after shot.

Other Meds:

Current Illness:

ID: 1713435
Sex: F
Age: 28
State: KS

Vax Date: 07/31/2021
Onset Date: 07/31/2021
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: Vitals: BP 130/80, P67, T 98.6 1929-P72

Allergies: Penicillin, Latex

Symptom List: Injection site pain, Pain

Symptoms: After patient received vaccination, she stated she felt a little dizzy. Patient became semi-conscious and was put in a wheelchair and placed on EMS cot. Ice pack applied to head; vitals taken. Patient became alert, awake, weak. EMS called; transported to Hospital. Patient reported she has been in heat all day with hadly anything to drink; patient has chronic dehydration.

Other Meds: N/A

Current Illness:

ID: 1713436
Sex: M
Age: 27
State:

Vax Date: 08/31/2021
Onset Date: 09/03/2021
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:

Allergies: None

Symptom List: Injection site pain, Menorrhagia

Symptoms: Pains in the left arm

Other Meds: None

Current Illness: Pains in left arm

ID: 1713437
Sex: F
Age: 13
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: 025J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data: None

Allergies: None

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

Symptoms: Vaccinated with expired vaccine by 6 days

Other Meds: None

Current Illness: None

ID: 1713438
Sex: F
Age: 0
State:

Vax Date: 09/12/2021
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: ECG

Allergies: None

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Difficulties breathing, rapid heart beat, headache

Other Meds: None

Current Illness: None

ID: 1713439
Sex: M
Age: 35
State: MD

Vax Date: 09/10/2021
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: UNK
Vax Route: IM
Vax Site: RA

Lab Data: N/A, scheduling appointment for 9/23

Allergies: N/A

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Sore arm, started immediately, lasted one week Pain in armpit, started next morning, lasted one week Fever, started that evening, lasted 4 days Tightness in chest, started that evening, feel periodically

Other Meds: N/A

Current Illness: N/A

ID: 1713440
Sex: F
Age: 44
State: TX

Vax Date: 04/01/2021
Onset Date: 09/14/2021
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: 2/27/2021 - CMP, CBC, A1C ALL normal 5/11/2021 - CMP, CBC, A1C, Lipase, Amylase: Not normal (low MCHC, TSH 8) 7/5/2021 - CMP, CBC, other tests: Low MCHC, elevated TSH 8/22/2021 - CMP, CBC, A1C, DSDNA, IgG levels, COVID-19 Antibody test: TSH normal, low MCHC, antibody test showed high number of spike proteins.

Allergies:

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

Symptoms: 4/14 - Fatigue, extreme muscle pain at injection site; 4/24 - Pancreatitis, continued pain at injection site (steroids, low fat diet); 5/14 - Hair loss; 6/5 - TSH 8, Hypothyroidism, hair loss, anemia (125mcg Synthroid, iron supplementation); 9/5 - Hair loss (TSH normal, MCHC low, continued thyroid hormone and dietary supplementation); Present - Physicians do NOT recommend booster or further vaccination at present, will monitor CBC with Diff, CMP, and other labs for further treatment needs.

Other Meds:

Current Illness:

ID: 1713441
Sex: F
Age: 31
State: MI

Vax Date: 08/18/2021
Onset Date: 08/19/2021
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: None

Allergies: Penicillin

Symptom List: Nausea

Symptoms: Fatigue, fever, headache, chills, and muscle aches for about 24 hours

Other Meds: Pre-natal vitamin (still being taken during breaatfeeding), Claritin

Current Illness: None

ID: 1713442
Sex: F
Age: 36
State: NY

Vax Date: 08/28/2021
Onset Date: 08/28/2021
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: Did not went to primary care or vaccine clinic for medical update.

Allergies: N/A

Symptom List: Injection site pain

Symptoms: At initial injection Feeling chills in both legs, then warm all over. Lasted less than 15 minutes. Feeling chills in legs or other parts of the body as though outside in the cold of winter. No other side effects that I recognize. Still feel chills 20 days after vaccination.

Other Meds: Singulair Albuterol

Current Illness: N/A

ID: 1713443
Sex: F
Age: 43
State: NY

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: None

Allergies: Aspirin, Naproxen, Ibuprofen, Pepto Bismol, Hydromorphone, Gabapentin, Excedrin Migraine, Cipro, Flagyl, Carmen lip balm, Vibramycin, Meclizine, Pertussis, Latex, Adhesive tape, Bee stings

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

Symptoms: Hives, rash, itching tight feeling in throat, trouble swallowing( Anaphylactic reaction) 340pm vaccine given, 740pm woke up with symptoms went to emergency room arrived approximately 810pm MD ordered IV Solu-Medrol, 1 L normal saline, famotidine, PO Benadryl, with good effects and complete resolution of symptoms monitor for couple hrs released

Other Meds: Claritin, Famotidine, Protonix, Magnesium, Imitrex, Benadryl

Current Illness: None

ID: 1713444
Sex: F
Age: 51
State: FL

Vax Date: 09/13/2021
Onset Date: 09/18/2021
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:

Allergies: Citrus, tomatoes, strawberries, honey, soy, and. Red peppers

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

Symptoms: 5 days later, suddenly developed large red, very itchy, burning spot on arm around injection spot

Other Meds: Hyaluronic acid, B complex, saw palmetto

Current Illness: None

ID: 1713445
Sex: F
Age: 66
State: AZ

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

Lab Data: none

Allergies: none

Symptom List: Tremor

Symptoms: Within 24 hours of receiving this vaccine, the area below and to the side of the injection site became very red and swollen and painful. The dimensions of the red area are 6 inches by 3 inches. I will continue to monitor this reaction and contact my doctor if it does not go away within a week.

Other Meds: multi vitamin and vitamin D

Current Illness: none

ID: 1713446
Sex: M
Age: 74
State: CT

Vax Date: 03/14/2021
Onset Date: 04/01/2021
Rec V Date: 09/18/2021
Hospital: Y

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

Lab Data:

Allergies: Moxifloxacin, Pilocarpine

Symptom List: Erythema, Pruritus

Symptoms: Trouble breathing, extreme fatigue,

Other Meds: Zetia, Cholestoff, Vitamins B-12, C, D-3.

Current Illness: Nne

Date Died: 08/01/2021

ID: 1713447
Sex: F
Age: 33
State: PA

Vax Date: 08/22/2021
Onset Date: 08/01/2021
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: Unknown

Allergies: NKDA

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

Symptoms: Patients boyfriend came into the pharmacy on 09/18/21 asking when she received her 2nd dose of the vaccine. I asked if it was because she lost her card and he said "No, she died a few days after and I'm trying to figure out if it was from the vaccine". Date of death/causes/symptoms of death unknown.

Other Meds: Unknown, came in for second vaccine with no known drug history

Current Illness: Unknown

ID: 1713448
Sex: F
Age: 59
State: HI

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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: none

Allergies: none

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

Symptoms: Fever, pain in the left arm, itching back of the hands and legs

Other Meds: Norco, Ambien, zocor, synthroid, omeprazole, flonase,

Current Illness: Cervical arthritis and Primary insomnia

ID: 1713449
Sex: F
Age: 35
State: FL

Vax Date: 08/26/2021
Onset Date: 09/07/2021
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: Iodine

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Cramps in feet and hands, burning and shooting pain in arms, legs and back.

Other Meds: Ointment nifedipine/dilated an/lidocaine

Current Illness: Anal fissure

ID: 1713450
Sex: M
Age: 13
State: NY

Vax Date: 06/22/2021
Onset Date: 06/28/2021
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: EKG, echocardiogram, stress EKG (9/7/21)

Allergies:

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

Symptoms: Chest pain and shortness of breath with sports decreased endurance for athletics.

Other Meds: Guanfacine 3mg ER

Current Illness:

ID: 1713451
Sex: F
Age: 55
State: PA

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

Allergies: Amoxicillin Bactrim Bystolic Ceftriaxone Doxycycline Effient Flagyl Iodine and Iodine contrast Levaquin Metoclopramide Morphine Nebicalol Nitrofurantoin Suffamethoxazole Tobramycin Vancomycin Can take with 75mg of IV Benadryl

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

Symptoms: Dose 1 my face and lips became tingly the back of my tongue swelled but sideways like it was in my teeth other then that nothing Dose 2 same as dose 1 but a bit more of my face then about 5 hours later my chest became red with bumps went to the ER received Benadryl went home Booster shot : my lips were tingly my tongue swelled the back of my throat felt itchy I could not swallow due to my Achalasia so they called a Rapid Response on me took me to the ER gave me IV Benadryl and Epranehrim got discharged after awhile and took Benadryl.

Other Meds:

Current Illness: listed below

ID: 1713452
Sex: F
Age: 42
State: IL

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

Lab Data:

Allergies: Gluten, dairy, soy, coconut Penicillin & clindmyacin

Symptom List: Pain in extremity

Symptoms: Migraine spiked to 10 Whole body muscle & joint pain making it difficult to move about & severe pain w/ limited mobility at injection site Stomach cramping Nausea Significantly increased Brain Fog & trouble verbally communicating Emotional - did not experience any symptoms after 1st injection FC3181 from Walgreens though was diagnosed with Hashimotos since 1st dose which also results in similar side effects though I?m 99% worse since getting 2nd dose yesterday

Other Meds: Unithroid, Iodine, Selenium, Zinc, Vitamin D, B12, C, Beef protein, Adaptecrine

Current Illness: Autoimmune diseases: Breast cancer remission Lymphodema Lupus - maybe false positive though ??? Hashimotos - new diagnosis since 1st vaccine 8/27/21 (9/16/21 diagnosed) Hypothyroid Possibly Breast Implant Illness Migraines Arthritis

ID: 1713453
Sex: M
Age: 36
State: KS

Vax Date: 09/02/2021
Onset Date: 09/02/2021
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: Vitals: BP 120/80, P85, 02 98%, RR 20

Allergies: NKA

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

Symptoms: While in observation, patient felt flush w/ hot/cold sweats. Patient had not had any food yet so a snack was given with water. Patient taken to EMS room where he was laid supine and cold pack applied to forehead; vitals taken. 1158 patient ambulated without difficulty.

Other Meds: Rosuvastatin

Current Illness:

ID: 1713454
Sex: F
Age: 65
State: OK

Vax Date: 08/27/2021
Onset Date: 08/29/2021
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: NA

Allergies: NA

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

Symptoms: 08/28-2:00Am woke up with sore arm, fever of 100 and chills.10:00am still feverish off and on, weak feeling, dizzy, brain fog, tired with radiating prickly pain in arm around the injection site. 08/29- 09/18, Still having some days feeling very tired with brain fog, 2-days I slept all day and 3 days I've had chills, feeling very cold. Still having having the prickly pain in the left arm that travels down and up the arm over to the upper chest area making arm feel weak. This usually only last a few seconds off and on throughout the days. 08/31, my heart started feeling like it is skipping beats making me feel light headed, this is intermittent.

Other Meds: NA

Current Illness: NA

ID: 1713455
Sex: M
Age: 9
State: TX

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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Patient received his annual flu vaccine, shortly afterwards (about 15 minutes), mom reported patient had fainted outside on way to their vehicle. Emergency action initiated, 911/ems called, RPh (myself) arrived on scene outside with emergency kit (children epipen, bp meter), pt found awake and responsive and sitting, patient reported feeling weak/dizzy (like in a dream), Pulse found elevated, no signs of rash/swelling/trouble breathing, EMS/Firefighters arrived at this point (post 20 minutes from time of vaccination), found everything WNL except BP showed being low (upper 80s/60s), Ambulance arrived 5 min later, found everything WNL (Blood sugar 95, oxygen 96), determined episode due to anxiousness, child okayed to release/parents denied visit to hospital, said they would follow-up with pediatrician.

Other Meds:

Current Illness:

ID: 1713456
Sex: F
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: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data: None

Allergies: None

Symptom List: Vomiting

Symptoms: Vaccinated with expired vaccine by 6 days

Other Meds: None

Current Illness: None

ID: 1713457
Sex: F
Age: 56
State: NC

Vax Date: 05/27/2021
Onset Date: 08/08/2021
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: DO NOT HAVE A DR. NO VISIT

Allergies: penicillin

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: RINGING IN LEFT EAR. LEFT EAR AND SIDE OF FACE NUMB. MY HEAD FEELS LIKE A BAD SINUS INFECTION BUT WITHOUT ANY MUCOUS IN THE NOSE. DRY SCRATCHY THROAT AND CONTINUED COUGH.

Other Meds: none

Current Illness: none

ID: 1713458
Sex: M
Age: 22
State: CA

Vax Date: 03/21/2021
Onset Date: 03/21/2021
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: None.

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

Symptoms: Had a seizure within the 15 minutes after the shot was given. Recovered almost immediately after the vaccine was given. No effects after the fact.

Other Meds: None.

Current Illness: None.

ID: 1713459
Sex: F
Age: 46
State: CA

Vax Date: 09/16/2021
Onset Date: 09/18/2021
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: With the second one, (which I had two days ago) my right armpit is tender with swollen lymph nodes the size of a golf ball. No shoulder or upper arm pain this time. The pain and swelling is all under my arm.

Allergies: none

Symptom List: Injection site swelling, Limb discomfort

Symptoms: With the first vaccine, I had 8/10 pain in my upper left arm and shoulder accompanied with slight lymph node swelling and tenderness in my arm pit for 2 weeks

Other Meds: Synthroid 25 mcg per day

Current Illness: none

ID: 1713460
Sex: M
Age: 34
State: NC

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:

Allergies:

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

Symptoms: No adverse reaction to report. Patient obtained a complete moderna COVID19 series after receiving Janssen from another provider.

Other Meds:

Current Illness:

ID: 1713461
Sex: F
Age: 44
State: MN

Vax Date: 09/12/2021
Onset Date: 09/12/2021
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: RA

Lab Data: First time reporting, no follow up yet

Allergies: None known

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

Symptoms: Numbness, tingling, aching in left arm following vaccine Administration and still present.

Other Meds: Multivitamin

Current Illness: None

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am