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: 1713928
Sex: F
Age: 38
State: CA

Vax Date: 09/08/2021
Onset Date: 09/14/2021
Rec V Date: 09/19/2021
Hospital:

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

Lab Data: Ultrasound, blood tests 9.14.2021

Allergies: nka

Symptom List: Dysphagia, Epiglottitis

Symptoms: Started bleeding the morning of 9.14.2021 - miscarriage occurred. Approximately 5 weeks and 4 days pregnant. Due date 5.13.2022?

Other Meds: Prenatal vitamin

Current Illness:

ID: 1713929
Sex: M
Age: 52
State: CA

Vax Date: 09/17/2021
Onset Date: 09/18/2021
Rec V Date: 09/19/2021
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. Pre Existing condition.

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Triggered a HSV-1 outbreak.

Other Meds:

Current Illness:

ID: 1713930
Sex: F
Age: 22
State: MD

Vax Date: 06/08/2021
Onset Date: 06/11/2021
Rec V Date: 09/19/2021
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: CBC (multiple times), Mono titers, EKG, full metabolic panel, spleen assessment, liver assessment, urine analysis, strep test, lyme disease test, covid tests

Allergies: None

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

Symptoms: Development of acute mononucleosis that resulted in a trip to the emergency room, and subsequently 6 doctor?s appointments for treatment and follow up. Recovery is not fully complete and is still ongoing at this time (09/19/2021)

Other Meds: None

Current Illness: None

ID: 1713931
Sex: F
Age: 37
State: NY

Vax Date: 04/01/2021
Onset Date: 07/01/2021
Rec V Date: 09/19/2021
Hospital:

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

Lab Data: Labs and ultrasound pending

Allergies: Zomig

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: I began vaginal bleeding late July. Consistency, and flow started as light pink in varying degrees of amount but it was always flowing. Then, I began seeing what looked like clots and it was very thick. First appointment with the provider and he chalked it up to my cervix healing from a recent pap. I continued to bleed through all of August. Late August/early September I began experiencing mild cramping and spurts of area specific pain. I was seen again and this time the provider decided to order labs and an ultrasound. A day before the ultrasound I ended up in the ER because I was in so much pelvic pain and I felt extremely weak and lightheaded. I felt so much pressure in my uterine region I felt like it was going to fall out.

Other Meds: Levothyroxine Duloxetine

Current Illness: None

ID: 1713932
Sex: F
Age: 37
State: WA

Vax Date: 09/14/2021
Onset Date: 09/14/2021
Rec V Date: 09/19/2021
Hospital:

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

Lab Data:

Allergies: Toradol

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

Symptoms: 72 hours immediately following injection: Headache, nausea, inability to stay awake, debilitating muscle pain, severe kidney/back/flank pain, heart/chest pain. Severe, sharp joint/nerve pain in both knees, left an cle, both elbows, and hips.

Other Meds: 40 mg Adderal 24hr release, spironolactone, birth control

Current Illness: None

ID: 1713933
Sex: F
Age: 41
State: CO

Vax Date: 08/12/2021
Onset Date: 08/14/2021
Rec V Date: 09/19/2021
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: After my first dose of the Pfizer COVID vaccine I had hemorrhage level vaginal bleeding for four days after the vaccine. It was a distinct alteration of my normal menstrual cycle and menstrual bleeding. It was not normal for my body or my menstrual cycle.

Other Meds:

Current Illness:

ID: 1713934
Sex: F
Age: 29
State: OR

Vax Date: 09/02/2021
Onset Date: 09/03/2021
Rec V Date: 09/19/2021
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: Sulfa

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Inflammation of sciatica, or something in left leg/hip. Painful to stand up and walk/stretch. Otherwise, reactions included 101 degree fever, chills, etc.

Other Meds: Supplements: Magnesium. Herbs: Valarian root, Avena Sativa, Yarrow, Mugwort, Dandelion Root

Current Illness:

ID: 1713935
Sex: M
Age: 18
State: GA

Vax Date: 08/22/2021
Onset Date: 08/24/2021
Rec V Date: 09/19/2021
Hospital:

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

Lab Data: UNKNOWN

Allergies: NONE

Symptom List: Pharyngeal swelling

Symptoms: Patient reported that he had inflammation of the chest. Patient and mother went to the hospital and they said the reaction should subside in a few days. The patient was told to take tylenol and advil. Unknown if the patient stayed in hospital or had further tests or medications provided.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1713936
Sex: M
Age: 61
State: IL

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 09/19/2021
Hospital:

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

Lab Data: Cat scan 2/5/21

Allergies: None

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: At 8:00 PM I started having lower abdominal pain. It didn't go away and I suspected it could be an appendicitis so around 1:00 AM that night I called my internist and they said to go to hospital. I checked in to emergency room at Hospital and they did a cat scan and confirmed it was an appendicitis. They transferred me to Hospital and I had my appendix removed around 11:00 AM

Other Meds: Metformin, Jardience, Sertraline, Low Dose Aspirin, B-12

Current Illness: None

ID: 1713938
Sex: M
Age: 48
State: IA

Vax Date: 03/18/2021
Onset Date: 06/12/2021
Rec V Date: 09/19/2021
Hospital:

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

Lab Data: Can't attach sheets

Allergies: zpack

Symptom List: Diarrhoea, Nasal congestion

Symptoms: 3/19/2021-3/22/2021 sore stiff shoulder. I was constantly stretching my arm (frozen shoulder) daily Cant attach sheets

Other Meds: allegra

Current Illness: none

ID: 1713939
Sex: F
Age: 54
State: FL

Vax Date: 09/17/2021
Onset Date: 09/19/2021
Rec V Date: 09/19/2021
Hospital:

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

Lab Data:

Allergies: Wasps

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

Symptoms: ?Covid Arm? Raised Rash size of whole hand Redness Very warm and painful to touch No puritus Same reaction reported after 1st dose in same left arm which noted appeared 2 weeks post vaccine and lasted for 2 days. Advised to take Antihistamine prior to 2nd vaccine, in which I took Claritin. Other: ?Covid Arm? with injection site tenderness was the only reaction to 1st dose. 2nd dose felt ?off?/brain fog? about 1hr post. 16 hours post 2nd dose experienced flu like symptoms; chills, fatigue, aches

Other Meds: Claritin Omeprazole Burpropion D3 Zinc C B12 Multivitamin

Current Illness:

ID: 1713940
Sex: F
Age: 26
State: MN

Vax Date: 12/22/2020
Onset Date: 09/16/2021
Rec V Date: 09/19/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data: Antigen test positive on 9/13/21

Allergies: unk

Symptom List: Rash, Urticaria

Symptoms: Employee was tested positive for COVID-19 on 9/13/21. Employee was removed from work 9/13-9/22.

Other Meds: unknown

Current Illness: unk

ID: 1713942
Sex: F
Age: 63
State: WA

Vax Date: 09/17/2021
Onset Date: 09/17/2021
Rec V Date: 09/19/2021
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: Animals, codeine

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

Symptoms: Extreme pain and swelling at injection site, chest pain and hard time breathing , extremely bad headacheit'sdizzy, body aches, I thought I was going to die.

Other Meds: None

Current Illness: None

ID: 1713943
Sex: M
Age: 17
State:

Vax Date: 09/19/2021
Onset Date: 09/19/2021
Rec V Date: 09/19/2021
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: 0915) Patient received his first Pfizer COVID vaccine in Left arm. 0918) Brother states that patient just passed out. Patient is checked and is responsive, alert and oriented X3, pale, and diaphoretic. He is lowered to the floor, feet elevated, ice pack behind his neck. BP:116/68 P: 66 O2 Sat: 98%. 0921) BP: 116/73 P: 73 O2 Sat: 98%. 0925) BP: 128/75 P: 81 O2 Sat: 98% Patient got up and sitting in a recliner chair. Patient drinking water and eating crackers. States he is feeling better. Color is no longer pale. 0927) BP: 118/75 P: 82 O2 Sat: 98%. 0935) BP: 113/71 P: 82 O2 Sat: 98%. 0942) BP: 112/74 P: 81 O2 Sat: 98%. 1000) Patient stood up, feeling back to normal, and was discharged to home with his Mother.

Other Meds:

Current Illness:

ID: 1713944
Sex: M
Age: 24
State: TX

Vax Date: 09/15/2021
Onset Date: 09/18/2021
Rec V Date: 09/19/2021
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: ECHO, Labs testing, elevated troponin, CKMB, CRP, ESR

Allergies: No known allergies

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

Symptoms: Myocarditis - abnormal EKG and elevated troponin- treated with ASA and toradol for pain

Other Meds: lexapro 10 mg daily

Current Illness: none

ID: 1713945
Sex: F
Age: 23
State: CO

Vax Date: 08/01/2021
Onset Date: 08/01/2021
Rec V Date: 09/19/2021
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: None

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

Symptoms: Menstrual bleeding starting 3 days after 1st vaccination, has not stopped.

Other Meds: None

Current Illness: None

ID: 1713946
Sex: F
Age: 49
State: TX

Vax Date: 02/24/2021
Onset Date: 06/17/2021
Rec V Date: 09/19/2021
Hospital: Y

Vax Type: DTAPHEPBIP
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: DTAP + HEPB + IPV (PEDIARIX)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies: penicillin

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

Symptoms: 6/17/21 Sudden onset segment elevated myocardial infarction. Required double bypass. Calcium score from 2017 was 0%. Per surgeon, cause was unique as all other arteries were pristine.

Other Meds: straterra; prozac; estring; valsartan hctz 12.5; fish oil; vit d; vit b12; probiotic

Current Illness: n/a

ID: 1713947
Sex: M
Age: 55
State:

Vax Date: 09/13/2021
Onset Date: 09/15/2021
Rec V Date: 09/19/2021
Hospital:

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

Lab Data: None , went back to the facility to ask about the side effects and to see if mine were normal and was told that those were some of them .

Allergies: None

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Fevers. chills, Lymphatic swelling under arm pit ( huge lump looked like I grew a third boob !! ) coughing shortness of breath swollen around the collar bone.

Other Meds: None

Current Illness: None

ID: 1713949
Sex: M
Age: 81
State: MD

Vax Date: 09/17/2021
Onset Date: 09/17/2021
Rec V Date: 09/19/2021
Hospital:

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

Lab Data: None

Allergies: Codeine

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Chills, Fever (101 degrees). Treated with rest and hydration and cold compresses at home. Patient was fine by next morning.

Other Meds: Plavix, metropolol, levothyroxine, aricept, Paroxitene, Biotin, Fish oil, stool softener, fiber gummies, vitamin c gummies

Current Illness: None

ID: 1713950
Sex: F
Age: 72
State: CA

Vax Date: 08/18/2021
Onset Date: 08/20/2021
Rec V Date: 09/19/2021
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:

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

Symptoms: I have rheumatoid arthritis that was controlled by methotrexate. Following my booster shot I began to have rather severe pain in multiple joints. One month later the symptoms are still occurring.

Other Meds: Methotrexate

Current Illness:

ID: 1713951
Sex: M
Age: 24
State: WI

Vax Date: 09/11/2021
Onset Date: 09/12/2021
Rec V Date: 09/19/2021
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: N/a

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

Symptoms: The night I received the vaccine I was awake at 3 am and felt the chills crawl from my toes to my forehead in which I had flu like symptoms (fever, chills, aches, intense headache) for the whole day the next day. Those symptoms subsided but I've felt very lethargic every day since and the passed few days I've been having chest pains and pressure near my heart.

Other Meds: Hemp Products

Current Illness: N/a

ID: 1713953
Sex: F
Age: 30
State: FL

Vax Date: 07/28/2021
Onset Date: 07/30/2021
Rec V Date: 09/19/2021
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: Severe chest pain, tightness, and shortness of breath. Heavy heart palpitations.

Other Meds: None

Current Illness: None

ID: 1713954
Sex: F
Age: 31
State: TX

Vax Date: 09/13/2021
Onset Date: 09/18/2021
Rec V Date: 09/19/2021
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: n/a

Allergies: n/a

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

Symptoms: Ecchymosis on the lower extremities

Other Meds: n/a

Current Illness: n/a

ID: 1713955
Sex: F
Age: 44
State: CA

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 09/19/2021
Hospital:

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

Lab Data: Diagnosed with SIBO, going to acupuncture and headaches have went away, improved with energy, now taking Chinese herbs to help with body inflammation

Allergies: Erythramiacin

Symptom List: Injection site pain, Pain

Symptoms: Extremely high temperature, projectile vomiting, diarrhea, fainting, full body pain. Over the next few months I experienced chronic fatigue, daily headaches, loss of appetite, increased feeling of SOB, since vaccinations I have had a herpes flare up monthly with swelling of lymph nodes in my left groin

Other Meds: Vitamin D3K2, fish oil, B complex, B12, vitamin C, magnesium

Current Illness: None

ID: 1713956
Sex: F
Age: 29
State:

Vax Date: 09/15/2021
Onset Date: 09/15/2021
Rec V Date: 09/19/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Medication error, patient came in to get 2nd vaccine, was administered the Pfizer as a second dose, and later noted that she had already had her Janssen in March 2021. Asymptomatic from any effects.

Other Meds:

Current Illness:

ID: 1713957
Sex: F
Age: 48
State: PA

Vax Date: 09/01/2021
Onset Date: 09/03/2021
Rec V Date: 09/19/2021
Hospital:

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

Lab Data: Currently scheduling a ultrasound by doctors' orders.

Allergies: Floroquinilone Allergy Lavender Allergy Shellfish Allergy

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

Symptoms: Lump (i.e. hive) present on arm. Stiff neck on left side. Chest pain presented that same night and concerned her enough to take a Bayer aspirin tablet.

Other Meds: Singulair daily Zyrtec daily

Current Illness: None

ID: 1713958
Sex: M
Age: 79
State: FL

Vax Date: 09/17/2021
Onset Date: 09/18/2021
Rec V Date: 09/19/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: PATIENT STATES HE WOKE UP AROUND 5 AM THE NEXT MORNING FEELING SEVERE DIZZINESS, TO THE POINT WHERE HE STATES HE "COULD NOT AMBULATE" OR GET OUT OF BED FOR A COUPLE HOURS. HE ALSO SAID HE WAS NAUSEOUS. THESE SIDE/ADVERSE EFFECTS LASTED FOR 5 HOURS. PATIENT ASKED THAT I REPORT.

Other Meds:

Current Illness:

ID: 1713961
Sex: M
Age: 20
State: FL

Vax Date: 09/19/2021
Onset Date: 09/19/2021
Rec V Date: 09/19/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Patient came in for second shot of Moderna and recieved Pfizer vaccine instead.

Other Meds:

Current Illness:

ID: 1713962
Sex: F
Age: 64
State: IL

Vax Date: 05/04/2021
Onset Date: 05/31/2021
Rec V Date: 09/19/2021
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: Chest X-Ray; normal.

Allergies:

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

Symptoms: I had a respiratory cough, since two weeks after shot. It is now almost 5 months later and cough (bronchitis) is still present. Wondering if the vaccine shot lessened my ability to recover. I have taken prescription cough syrup, nasal sprays, and finally an antibiotic; nothing has worked. I am under the care of a pulmonologist.

Other Meds: Multivitamin; Biotin; Estrogen cream (estradiol)

Current Illness:

ID: 1713963
Sex: M
Age: 79
State: NC

Vax Date: 07/01/2021
Onset Date: 07/07/2021
Rec V Date: 09/19/2021
Hospital: Y

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

Lab Data: CT Scan: Clear; MRI: Clear; Neuclear stress test: Clear; Ultrasound: clear. July 7-8 2021 in ER Heart monitor worn for two weeks beginning July 15 ordered by cardiologist.Perfect

Allergies: None

Symptom List: Nausea

Symptoms: Six days following the vaccination, I experienced AFIB at 11:15 AM, with a heart rate of 143 that persisted for several hours. At 4 PM, with no reduction in heart rate, I went to the emergency room and was immediately treated with an IV to lower my heart rate. I remained in the ER for two days and was given a CT Scan, Neuclear Stress test, and ultrasound. None of the tests could explain the AFIB. Heart and arteries are perfectly healthy. Cardiologist had me wear a heart monitor for two weeks with no further episodes. I have been placed on a blood thinner, Eliquis and a calcium blocker, Cardizem. My Cardiologist says I will be taking these for the rest of my life.

Other Meds: Atorvastatin, Tamsulosin, Vitamin C, Vitamin D3,Zinc,Glicosomi Condroitin and Centrum Silver Multi Vitamin

Current Illness: None

ID: 1713964
Sex: F
Age: 21
State: NY

Vax Date: 05/12/2021
Onset Date: 05/12/2021
Rec V Date: 09/19/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: Skipped period (still having irregular cycles, which has never happened) Heart burn Loss of sex drive Depression

Other Meds:

Current Illness:

ID: 1713965
Sex: M
Age: 14
State: UT

Vax Date: 08/31/2021
Onset Date: 09/01/2021
Rec V Date: 09/19/2021
Hospital: Y

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

Lab Data:

Allergies: None known

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

Symptoms: dx = myocarditis Briefly, pt is an active male who is currently playing football and began complaining of chest pain around 1 prior to admission ago, shortly after COVID-19 vaccine on 8/31. Several episodes of vomiting and diarrhea the last 3 days. Initially grandmother (guardian) thought chest pain was related to football injury; however, following increased complaints of chest pain, accompanied by shortness of breath and fatigue, pt was taken to the ED at hospital. Troponin in the ED was 16 and ST segment elevation consistent with myocarditis. Pt was admitted to the floor. Follow-up troponin this afternoon was increased to 63. Additionally, telemetry while on the floor was reviewed and 2 6-beat runs of ventricular tachycardia were noted. For these reasons, the patient was transferred to the CICU for further monitoring and management. Viral panel resulted as rhinovirus positive, but asymptomatic. He was in the cardiac ICU for 3 days. Had 2 runs of VT treated with metoprolol. Received IVIG and was placed on NC to maintain saturations above 90%. He was febrile after transfer to the floor but cultures were negative. Troponins downtrended. CRP initially uptrended. Cardiac MRI showed fibrosis. Cardiology determined they were less confident in COVID vaccine as the cause for his myocarditis given this, fever, and uptrending CRP. Rheumatology and ID were consulted, work up for MISC was negative (had covid in Feb). Troponin, BNP, CRP all continued to downtrend until he was deemed safe for discharge on 9/17. Enalapril and spirinolactone were started without complications and given resolving AKI. A TTE was obtained day prior to discharge, and was read as normal.

Other Meds: None known

Current Illness: Cough, sneezing end of August after returning from summer vacation in Location. COVID test negative 8/28. Improved Presented with vomiting, diarrhea. Rinovirus + Mentioned intermittent chest pain before vaccination, had attributed to obesity, lack of exercise.

ID: 1713966
Sex: M
Age: 60
State: WA

Vax Date: 09/10/2021
Onset Date: 09/11/2021
Rec V Date: 09/19/2021
Hospital:

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

Lab Data: nothing yet

Allergies: Peanuts and other nuts.

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

Symptoms: Chills followed by sweats have continued off and on for over a week. Very tired headache very thirsty body aches

Other Meds: None

Current Illness: I have had periods of excessive tiredness a week earlier.

ID: 1713967
Sex: M
Age: 26
State: TX

Vax Date: 08/27/2021
Onset Date: 08/28/2021
Rec V Date: 09/19/2021
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: None

Symptom List: Tremor

Symptoms: 1) Patient awoke at 0400 with severe chills, and body aches. Patient wasn't able to get warm until using around 4 blankets, sweat clothes, and wife holding him. He was likely running a high fever at the time, but was not confirmed. Patient was shivering uncontrollably. Recovered by the next morning. Had a slight temp elevation the next day. <100. 2) Patient had severe body aches. Moving around and walking around was uncomfortable. Injection sight was especially sore and painful. Lasted about 4 days before fully recovered. 3) Headaches. Patient reported headaches for approximately 7 days. Typically the headache came on around 1700 every night and lasted until they went to bed. After about 7 days the headaches stopped. 4) Fatigue. Patient reported General fatigue for about 5 days after the vaccination. 5) Joint pain. Patient complained of joint pain for approximately 3 days, and then it subsided. Patient recovered from all this on his own. He self medicated with Ibuprofen for all symptoms for the first 2 days until most symptoms started to reduce. He did not seek any medical attention. Complained that his symptoms were worse than the symptoms he experienced when he contracted COVID 19 in July 2020.

Other Meds: None

Current Illness: None

ID: 1713968
Sex: M
Age: 29
State:

Vax Date: 09/17/2021
Onset Date: 09/18/2021
Rec V Date: 09/19/2021
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: None

Symptom List: Erythema, Pruritus

Symptoms: Fever (101 degrees F for ~6 hours) Tachycardia (greater than 120 beats per minute for ~6 hours) Confusion and Headache for ~6 hours

Other Meds: None

Current Illness: None

ID: 1713969
Sex: F
Age: 77
State: NC

Vax Date: 09/19/2021
Onset Date: 09/19/2021
Rec V Date: 09/19/2021
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: Doxycycline

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

Symptoms: Patient received her Fluad vaccine and walked to the registers to pay for her groceries. She stated that she did not feel well and two front store employees assisted her in sitting on a bench and getting her drink of water with a straw. The pharmacist came to assist and checked her blood pressure. It was 170/88. Patient stated that she did eat breakfast. We did give her a sip of orange juice with a straw. Her face had a light sweat. She was extremely drowsy and in and out of coherence. She could state her name. She asked us to call her boyfriend and he did arrive to help. She did not want us to call 911, but we did. The first responders checked her blood sugar and it was 120. They analyzed her heart with an AED and no shock was advised. She was then transported to the local hospital by the EMS.

Other Meds: Clopidigrel 75mg daily, Vitamin D 50,000 units twice weekly

Current Illness: not known

ID: 1713970
Sex: F
Age: 61
State: NY

Vax Date: 03/05/2021
Onset Date: 04/02/2021
Rec V Date: 09/19/2021
Hospital:

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

Lab Data: No

Allergies: N/A

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

Symptoms: None stated.

Other Meds: N/A

Current Illness: N/A

ID: 1713971
Sex: F
Age: 84
State: CA

Vax Date: 01/28/2021
Onset Date: 02/03/2021
Rec V Date: 09/19/2021
Hospital:

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

Lab Data: pulmonaire function test in July, shows very poor oxigen dissemination in lungs done at hospital. very high d-dimmer test at hospital in February Heart test done at CPMC showing atrial febrillation

Allergies: th?ophylline, /cipro/ sulfa antibiotics

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: low grade Fever for weeks Acute Breathlessness, loss of voice, ongoing since vaccination in January newly discovered atrial fibrillation

Other Meds: Losartan/amlodipine/ metoprolol

Current Illness: n /a

ID: 1713972
Sex: M
Age: 66
State: FL

Vax Date: 02/23/2021
Onset Date: 02/24/2021
Rec V Date: 09/19/2021
Hospital:

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

Lab Data: none

Allergies:

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

Symptoms: Severe chills, Fever - Both doses the same effect. Chills and fever started in the middle of the night after no symptoms on the day of the shots. Fever lasted about 3 days. Chills and fever were reduced with OTC Acetometaphin

Other Meds:

Current Illness: Only Psoriasis.

ID: 1713973
Sex: F
Age: 20
State: CT

Vax Date: 09/08/2021
Onset Date: 09/08/2021
Rec V Date: 09/19/2021
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: Per patient she had pre-medicated with an anti-histamine and as soon as the anithistamine wore off she experience itching all over her body. Upon taking another anti-histamine itching subsided. Then, while asleep the night of the vaccination, patient experienced profound chest pain while having a dream someone was stepping on her chest - after getting up and eating patient felt fine and has not had any other chest pain. Patient also complains of mild headache every evening after receiving vaccine.

Other Meds:

Current Illness:

ID: 1713974
Sex: F
Age: 27
State: WI

Vax Date: 09/19/2021
Onset Date: 09/19/2021
Rec V Date: 09/19/2021
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: Mold, aspirin and caffeine when combined, environmental asthma

Symptom List: Pain in extremity

Symptoms: 20 minutes into observation period, patient stated her lips were numb, she had chills and was not feeling well.

Other Meds: None

Current Illness: None

ID: 1713975
Sex: M
Age: 34
State: FL

Vax Date: 08/01/2021
Onset Date: 08/08/2021
Rec V Date: 09/19/2021
Hospital:

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

Lab Data: 9/6/2021 primary care visit where ear drum retraction was detected.

Allergies: None.

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

Symptoms: Received single dose in left arm as stated on form. Next day noticed some light headedness. The day after - 2 days after first dose - dizzy and light headedness continued. Dizziness and light headedness has persisted since day 2 after the shot. Earlier on in the symptoms the dizziness sensation would come and go, sometimes a few hours a day or as little as 15 minutes. Accompanied by ear fullness in either ear, random, sometimes light pain in either ear as well. Sinus congestion with clear diagnosis. Started a course of high dosage amoxicilian(?) For 7 days. Felt better for a day or two but has regressed back to previous conditions noted above. Currently (9/19/2021) on day 3 of all day dizziness. With 2 days prior 9/17/2021 being more severe. Since the start, roughly 8/7/2021, have also had cases of ringing in the ears, and light muffled hearing. No ear infection according to a recent doctor visit but they did notice some ear drum retraction. Diagnosed with possibly euchastian tube dysfunction, despite being perfectly fine as an adult in allergy season and with absolutely zero changes in environmental factors or lifestyle. Pending visit with an ENT for full diagnosis.

Other Meds: Metaprolol 50mg succ.

Current Illness: None.

ID: 1713976
Sex: F
Age: 44
State:

Vax Date: 09/15/2021
Onset Date: 09/16/2021
Rec V Date: 09/19/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Overall body aches headache memory issues brain fog

Other Meds:

Current Illness:

ID: 1713977
Sex: F
Age: 47
State:

Vax Date: 09/10/2021
Onset Date: 09/11/2021
Rec V Date: 09/19/2021
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: MODERNA COVID-19 VACCINE EUA Large red, itchy rash area around injection site that increased in size a couple of days before started looking better.

Other Meds:

Current Illness:

ID: 1713978
Sex: F
Age: 30
State: CA

Vax Date: 09/03/2021
Onset Date: 09/07/2021
Rec V Date: 09/19/2021
Hospital:

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

Lab Data: Pending lab tests.

Allergies: None

Symptom List: Vomiting

Symptoms: 3 days post vaccine fatigue started. 4 days post vaccine my legs started getting tingling/burning and some numbness in lower legs and feet. I also started getting constant muscle twitches in legs and sometimes in arms. Headaches also started after one week. Ear pressure also began 9 days post vaccine. I spoke to my primary doctor 12 days post vaccine and she suggested taking in electrolytes in the form of gatorade or Liquid IV packets. She ordered lab work which was drawn on 9/16/21 and she ordered a B12 shot. I will follow up with her on Monday 9/20/21. I continue to have muscle twitches in legs and arms, headaches on and off, fatigue, low energy, numbness and tingling in legs and feet.

Other Meds: Post-natal vitamin, iron supplement, probiotic, magnesium/calcium supplement, birth control

Current Illness: Seasonal allergies

ID: 1713979
Sex: F
Age: 18
State: IA

Vax Date: 09/03/2021
Onset Date: 09/03/2021
Rec V Date: 09/19/2021
Hospital:

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

Lab Data: Getting a brain scan sometime in the next week

Allergies: Strawberries

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Headache hours after getting the shot that has been constant for 3 weeks and no medicine is helping. Dizziness and shakiness after getting the shot that hasn't gone away. High blood pressure after getting the shot.

Other Meds: None

Current Illness: None

ID: 1713980
Sex: F
Age: 44
State: NY

Vax Date: 09/09/2021
Onset Date: 09/09/2021
Rec V Date: 09/19/2021
Hospital:

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

Lab Data: None.

Allergies: None

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

Symptoms: Full body pain (muscles, joints, skin, ears, eyes, gums) began around 9:00 pm on 9/9/21 and increased in severity over the next 24 hours. By the morning of 9/10/21, a fever of 103 degrees accompanied the severe body pain. Cried from the pain. Needed assistance to get out of bed. Pain and fever gradually lessened throughout the day on 9/11/21 and into 9/12/22.

Other Meds: None

Current Illness: None

ID: 1713981
Sex: M
Age: 30
State:

Vax Date: 09/16/2021
Onset Date: 09/17/2021
Rec V Date: 09/19/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Allergic to penicillin/amoxicilin

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Extreme fever, chills, fatigue, sore muscles lasting.(day after). Extreme neck soreness, cough, migraine, poor ability for clot blood from cuts(two days after)

Other Meds: None

Current Illness: None

ID: 1713982
Sex: F
Age: 71
State: WA

Vax Date: 09/17/2021
Onset Date: 09/17/2021
Rec V Date: 09/19/2021
Hospital:

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

Lab Data: no tests were done

Allergies: Erythromycin causes me to vomit Epinephrine works too well at making my heart race when given with Novocain, for dental work

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

Symptoms: About 4 hours after the flu shot I began shaking as if having chills and felt warm but didn?t register a fever. I was very tired. About 5 hours after the shot I began vomiting, grew weaker, and developed a headache About 12 hours after the shot the shaking stopped as well as the vomiting. 46 hours after the shot most of the symptoms are gone.

Other Meds: None

Current Illness: None

ID: 1713983
Sex: F
Age: 40
State: WI

Vax Date: 12/29/2020
Onset Date: 09/17/2021
Rec V Date: 09/19/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Employee became symptomatic and tested COVID-19 positive on 9/18/21. She is recovering due back at work on 9/28.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am