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: 1714715
Sex: M
Age: 74
State: RI

Vax Date: 09/16/2021
Onset Date: 09/16/2021
Rec V Date: 09/20/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1714716
Sex: M
Age: 27
State: RI

Vax Date: 09/16/2021
Onset Date: 09/16/2021
Rec V Date: 09/20/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1714717
Sex: M
Age: 58
State: RI

Vax Date: 09/16/2021
Onset Date: 09/16/2021
Rec V Date: 09/20/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1714718
Sex: M
Age: 28
State: RI

Vax Date: 09/16/2021
Onset Date: 09/16/2021
Rec V Date: 09/20/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1714719
Sex: F
Age: 32
State: NM

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

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

Lab Data:

Allergies:

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

Symptoms: Site: Redness at Injection Site-Mild, Systemic: Allergic: Itch Generalized-Medium, Systemic: Allergic: Rash Generalized-Medium, Systemic: Flushed / Sweating-Medium, Systemic: Hypertension-Mild, Additional Details: PATIENT DEVELOPED RASH ON CHEST AREA AFTER VACCINATION WAS GIVEN 2 CAPS OF BENADRYL 25 MG AND A DOSE 50 MG IM INJECTION WAS GIVEN AT INTERVALS RASH BECAME LESS SEVERE PARAMEDICS WERE CALLED AND OBSERVED THE PATIENT SHE WAS TOLD TO CONTINUE BENADRYL AND MONITOR HERSELF IF RASH BECAME SEVERE AND BREATHING BECOMES DIFFICULT SHE HAS TO REPORT TO ER /URGENT CARE

Other Meds:

Current Illness:

ID: 1714720
Sex: F
Age: 81
State: TX

Vax Date: 07/16/2021
Onset Date: 07/16/2021
Rec V Date: 09/20/2021
Hospital:

Vax Type: FLUC4
Manufacturer: SEQIRUS, INC.
Vax Name: INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT)
Lot: 276563
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

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

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

Other Meds:

Current Illness:

ID: 1714721
Sex: M
Age: 10
State: CO

Vax Date: 06/09/2021
Onset Date: 06/09/2021
Rec V Date: 09/20/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Error: Patient Too Young for Vaccine Administered-

Other Meds:

Current Illness:

ID: 1714722
Sex: M
Age: 14
State: HI

Vax Date: 09/01/2021
Onset Date: 09/01/2021
Rec V Date: 09/20/2021
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: Systemic: Dizziness / Lightheadness-Mild, Systemic: Fainting / Unresponsive-Mild, Systemic: Flushed / Sweating-Mild

Other Meds:

Current Illness:

ID: 1714723
Sex: M
Age: 30
State:

Vax Date: 09/01/2021
Onset Date: 09/17/2021
Rec V Date: 09/20/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Stincky feet

Other Meds:

Current Illness:

ID: 1714724
Sex: F
Age: 60
State: OH

Vax Date: 01/14/2021
Onset Date: 03/17/2021
Rec V Date: 09/20/2021
Hospital:

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

Lab Data: mammogram of right breast; ultrasound of right breast, biopsy of right breast, 3 rounds of antibiotics

Allergies: N/A.

Symptom List: Diarrhoea, Nasal congestion

Symptoms: On March 17 I developed cellulitis and infection with a sudden change in my right breast such as engorgement redness swelling purulent drainage from breast tissue but only see in localized to the radiation area only. I have had right breast cancer with a lumpectomy, radiation and tamoxifen daily. The only abnormal that would of made this sudden inflammatory response would be the vaccine. No trauma event occurred prior to or leading up to this event. In addition I was placed on multiple rounds of antibiotics. I have developed from this reaction a large are of fat necrosis to my right breast. This is being monitored. I have met 3 other random women breast cancer patients who have developed similar reactions from their covid vaccine at least a month to 2 months after. No previous trauma to breast which may of caused the same reaction. It has taken 4-5 months for the redness and engorgement to subside. Large area of fat necrosis remains within right breast

Other Meds: Atenolol; Ambien; Omeprazole; Tamoxifen.

Current Illness: Cholelithiasis.

ID: 1714725
Sex: F
Age: 12
State: NY

Vax Date: 05/22/2021
Onset Date: 05/30/2021
Rec V Date: 09/20/2021
Hospital:

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

Lab Data: Blood work, MRI, clinical visit, resistance to treatment.

Allergies: n/a

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

Symptoms: One week following the first vaccination, Patient started experiencing swelling in her right knee which has progressed to both knees and accompanied by fatigue, stiffness, and pain. . In the several months that have followed, she has been diagnosed with Juvenile Idiopathic Arthritis. While we do have data to support the presence of this autoimmune disease prior to the vaccinations, the recent significant flair occurred right after the shots and has had significant impact. We still have not been able to control the symptoms months later.

Other Meds: Methylphenidate

Current Illness: n/a

ID: 1714726
Sex: M
Age: 44
State: FL

Vax Date: 09/10/2021
Onset Date: 09/16/2021
Rec V Date: 09/20/2021
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: Shingles/Herpes Zoster

Other Meds: Lortab

Current Illness: None

Date Died: 05/17/2021

ID: 1714727
Sex: F
Age: 84
State:

Vax Date: 01/12/2020
Onset Date: 01/04/2021
Rec V Date: 09/20/2021
Hospital: Y

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

Lab Data: A CT scan revealed cancer (myothelioma) which normally takes several months following diagnosis. Patient died within weeks, from being perfectly healthy prior to her first vaccination.

Allergies: None

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

Symptoms: Death following severe breathing difficulties starting shortly after vaccination. Patient had a second vaccination but this was not reported on her vaccine card.

Other Meds: Medication for low bone density - unknown name

Current Illness: None

ID: 1714864
Sex: M
Age: 70
State: MD

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 09/20/2021
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: none

Allergies: none

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

Symptoms: Starting the day after the shot and continuing to today, there is pain, stiffness and difficult movement at site of injection

Other Meds: Statin

Current Illness: none

ID: 1714866
Sex: F
Age: 16
State: NH

Vax Date: 09/15/2021
Onset Date: 09/15/2021
Rec V Date: 09/20/2021
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: peppermint

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

Symptoms: After injecting Dilutent into vial - waited 15 minutes and injected 1.8cc into right arm of student. Realized it was a multidose vial.

Other Meds: N/A

Current Illness:

ID: 1714867
Sex: F
Age: 39
State: PR

Vax Date: 08/22/2021
Onset Date: 08/22/2021
Rec V Date: 09/20/2021
Hospital:

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

Lab Data: None

Allergies: None

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

Symptoms: Numbness and inflammation of the right side, face, eye and neck. Temperature increased.

Other Meds: None

Current Illness: None

ID: 1714868
Sex: M
Age: 47
State: PA

Vax Date: 05/04/2021
Onset Date: 06/03/2021
Rec V Date: 09/20/2021
Hospital:

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

Lab Data: none

Allergies: seasonal allergies

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

Symptoms: multiple neurological events

Other Meds: escitalopram 10 mg daily

Current Illness: none

ID: 1714869
Sex: M
Age: 65
State: TX

Vax Date: 01/08/2021
Onset Date: 01/11/2021
Rec V Date: 09/20/2021
Hospital:

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

Lab Data: Dermatologist biopsied it and termed it granulae anulum or something like that which meant skin sensitivity reaction commonly resulting from vaccines.

Allergies: hay fever, antibiotic allergy experienced Oct. 2019 cephlaxin or something like that was a scabbing rash over my back and was beginning to reach around my stomach area before I discontinued. Similar to my vaccine reaction except vaccine scabbing less severe but rash was more abundant, did get to my stomach and limited chest area, but never went away, it has diminished but still see it lightly. Went to dematologist in July 2021? was biopsied and told it was granulae anulum or something like that-when I looked up on line it is a skin sensitivity reaction commonly seen in vaccinations.

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Described earlier-rash, that I still have although diminished.

Other Meds: Meds and supplements had been taken long term with no reactions-Nexium, liadal, tamulosin, various vit and minerals and a probiotic.

Current Illness: gastric reflux, irritable bowel, undiscovered at the time abnormal EKG with athersclerosis, past TURP, various injuries 2019 broken wrist with CRPS with follow up surgery to repair feb 2020, CRPS still active but by mid 2020, off pain meds.

ID: 1714870
Sex: M
Age: 28
State:

Vax Date: 08/24/2021
Onset Date: 09/09/2021
Rec V Date: 09/20/2021
Hospital:

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

Lab Data: The night of 13 and 14 in the facility, and the night of the 18 and 19 in the facility.

Allergies: None

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Thursday 09/09 after a year of being diagnosed and without any crisis. 12 days after the vaccination, I have a crisis like the previous ones, and I have a continuous beeping and dazed that does not stop after modifying the treatment as I was in the emergency twice.

Other Meds: Zebinix 800Mg (0-0-1)

Current Illness: Epilepsy

ID: 1714871
Sex: M
Age: 52
State: NY

Vax Date: 08/24/2021
Onset Date: 08/24/2021
Rec V Date: 09/20/2021
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: no

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

Symptoms: Pfizer vaccine was diluted with NS 0.9% Bacteriostatic which is not recommended for use with this vaccines. Reported to Pfizer and CDC. As per recommendation from CDC, affected dose should be repeated. Pt was notified and all questions answered. Pt repeated dose on 9/15/21.

Other Meds: unk

Current Illness: unk

ID: 1714873
Sex: F
Age: 34
State: TN

Vax Date: 09/16/2021
Onset Date: 09/17/2021
Rec V Date: 09/20/2021
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: None

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

Symptoms: Severe Headache - on and off for 4 days Chills - 2 days Body aches - 3 days Sore throat - 4 days Loss of feeling in left arm, numbness, tingling and moderate pain radiating into my armpit and down to my fingers with any movement - lasted 1 day All were treated with acetaminophen, ibuprofen and excedrine migraine

Other Meds: Probiotic supplement, prenatal vitamins (breastfeeding) and mini pill oral contraceptive

Current Illness: None

ID: 1714875
Sex: F
Age: 48
State: TX

Vax Date: 09/16/2021
Onset Date: 09/17/2021
Rec V Date: 09/20/2021
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 muscles aches, headache and pressure behind eyes

Other Meds: bariatric multivitamins

Current Illness: none

ID: 1714876
Sex: F
Age: 13
State: NY

Vax Date: 08/24/2021
Onset Date: 08/24/2021
Rec V Date: 09/20/2021
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: no

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

Symptoms: Pfizer vaccine was diluted with NS 0.9% Bacteriostatic which is not recommended for use with this vaccines. Reported to Pfizer and CDC. As per recommendation from CDC, affected dose should be repeated. Pt was notified and all questions answered. Pt repeated dose on 9/15/21.

Other Meds: unk

Current Illness: unk

ID: 1714877
Sex: M
Age: 46
State: NY

Vax Date: 08/24/2021
Onset Date: 08/24/2021
Rec V Date: 09/20/2021
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

Allergies: no

Symptom List: Injection site pain, Pain

Symptoms: Pfizer vaccine was diluted with NS 0.9% Bacteriostatic which is not recommended for use with this vaccines. Reported to Pfizer and CDC. As per recommendation from CDC, affected dose should be repeated. Pt was notified and all questions answered. Pt repeated dose on 9/15/21.

Other Meds: unk

Current Illness: unk

ID: 1714878
Sex: F
Age: 51
State: OH

Vax Date: 05/19/2021
Onset Date: 09/18/2021
Rec V Date: 09/20/2021
Hospital: Y

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: Patient developed breakthrough COVID-19 post-vaccination requiring hospitalization.

Other Meds:

Current Illness:

ID: 1714879
Sex: M
Age: 13
State: NY

Vax Date: 08/24/2021
Onset Date: 08/24/2021
Rec V Date: 09/20/2021
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: no

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

Symptoms: Pfizer vaccine was diluted with NS 0.9% Bacteriostatic which is not recommended for use with this vaccines. Reported to Pfizer and CDC. As per recommendation from CDC, affected dose should be repeated. Pt was notified and all questions answered. Pt repeated dose on 9/15/21.

Other Meds: unk

Current Illness: unk

ID: 1714880
Sex: M
Age: 84
State: FL

Vax Date: 09/09/2021
Onset Date: 09/09/2021
Rec V Date: 09/20/2021
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: None

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: *Was given a Flu vaccination. He is unaware of the type given. I selected a type to move forward. Face feels frozen with a pinching feeling that moves throughout body.

Other Meds: CQ10 Vitamin D B12 Alpha Lipoic Acid

Current Illness: None

ID: 1714881
Sex: M
Age: 40
State: ID

Vax Date: 09/19/2021
Onset Date: 09/19/2021
Rec V Date: 09/20/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Tightness in chest hard to breathe, tingling similar to a foot falling asleep in the left side of my face arm and fingers. Dizziness and a headache. Occurred 15 minutes after shot and went away an hour later. Same symptoms returned 13 hours after shot.

Other Meds: None

Current Illness: None

ID: 1714882
Sex: F
Age: 72
State: NJ

Vax Date: 09/19/2021
Onset Date: 09/19/2021
Rec V Date: 09/20/2021
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: sulfonamides, codeine, cortisone, amoxicillin, and meloxicam

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

Symptoms: Vagal response- turned very red, hand tremor, nausea, dizziness, clammy/sweating and started to fade out of consciousness. I had pt lie down and elevated her feet. She started to feel better and eventually sat up. She was given water and observed until she said that she felt fine. Total event was about 30 minutes

Other Meds: Unknown

Current Illness: Unknown

ID: 1714883
Sex: M
Age: 12
State: NY

Vax Date: 08/24/2021
Onset Date: 08/24/2021
Rec V Date: 09/20/2021
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: no

Symptom List: Nausea

Symptoms: Pfizer vaccine was diluted with NS 0.9% Bacteriostatic which is not recommended for use with this vaccines. Reported to Pfizer and CDC. As per recommendation from CDC, affected dose should be repeated. Pt was notified and all questions answered. Pt repeated dose on 9/15/21.

Other Meds: unk

Current Illness: unk

ID: 1714884
Sex: F
Age: 53
State: MI

Vax Date: 09/08/2021
Onset Date: 09/10/2021
Rec V Date: 09/20/2021
Hospital:

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

Lab Data: 9/14/2021 ED visit with labs and CXR

Allergies:

Symptom List: Injection site pain

Symptoms: Reported nausea on 2nd day post vaccine. Worked 3 twelve hour shifts in the days following vaccination. Began to get worse. On wednesday last week she was weak, dizzy, nausea, back pain, shortness of breath. All seem to be worsening. Was seen in ED with negative labs and CXR. Rested at home the next several days. Still having sx as of today. Advised to seek out COVID testing to rule this out and contact her PCP..

Other Meds:

Current Illness:

ID: 1714886
Sex: F
Age: 39
State: IN

Vax Date: 09/18/2021
Onset Date: 09/19/2021
Rec V Date: 09/20/2021
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: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Severe cramping in lower abdomen and lower back pain the entire 2nd day after vaccine

Other Meds: None

Current Illness: None

ID: 1714887
Sex: M
Age: 56
State: OH

Vax Date: 08/23/2021
Onset Date: 08/24/2021
Rec V Date: 09/20/2021
Hospital:

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

Lab Data: None

Allergies: None

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

Symptoms: Body aches, headache, fatigue. Lasted 2 days. 10 days later raised welts at injection site.

Other Meds: None

Current Illness: None

ID: 1714888
Sex: F
Age: 40
State: KY

Vax Date: 05/28/2021
Onset Date: 09/06/2021
Rec V Date: 09/20/2021
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: NKDA

Symptom List: Tremor

Symptoms: COVID

Other Meds: NONE

Current Illness: NONE

ID: 1714889
Sex: F
Age: 38
State: OH

Vax Date: 08/30/2021
Onset Date: 09/13/2021
Rec V Date: 09/20/2021
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: Intolerance to dairy and gluten

Symptom List: Erythema, Pruritus

Symptoms: 1st dose: 08/09/21. 2nd dose: 08/30/21. My monthly cycle is always the same. On time, flow, etc does not change. Since receiving the 1st vaccine, my period was a week early and the flow was spotty, then heavier than usual. This started August 20th, expected to start Aug 27th. My cycle after the second dose, started 4 days early and was just spots of blood for 3-4 days. I still have not had a full period this month. Expected start date: Sept 17. Spotting began: Sept 13. I also have been waking up with minor headaches off and on since vaccination (I rarely ever get headaches).

Other Meds: Zyrtec. Albuterol. Probiotic.

Current Illness: No

ID: 1714890
Sex: F
Age: 80
State: OH

Vax Date: 03/04/2021
Onset Date: 09/17/2021
Rec V Date: 09/20/2021
Hospital: Y

Vax Type: UNK
Manufacturer: UNKNOWN MANUFACTURER
Vax Name: VACCINE NOT SPECIFIED (NO BRAND NAME)
Lot:
Dose Series: UNK
Vax Route: SYR
Vax Site: UN

Lab Data:

Allergies:

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

Symptoms: Patient developed breakthrough COVID-19 post-vaccination requiring hospitalization.

Other Meds:

Current Illness:

ID: 1714891
Sex: M
Age: 43
State: TX

Vax Date: 06/18/2021
Onset Date: 06/25/2021
Rec V Date: 09/20/2021
Hospital:

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

Lab Data: Physical Exam - July 16, 2021 - Reported tinnitus to my GP AUD Hearing Test - Sept. 17, 2021 - No indications of hearing loss due to damage, tumors, or abnormalities in the ears.

Allergies: None

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

Symptoms: Shortly after my second dose of the vaccine, I began having continuous tinnitus. It has persisted since July without getting worse or better.

Other Meds: None

Current Illness: None

ID: 1714892
Sex: F
Age: 32
State: NC

Vax Date: 08/30/2021
Onset Date: 09/16/2021
Rec V Date: 09/20/2021
Hospital:

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

Lab Data: n/a

Allergies: none

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Heavy period, painful cramps, headache, on and off bleeding

Other Meds: none

Current Illness: none

ID: 1714893
Sex: F
Age: 19
State: OH

Vax Date: 09/16/2021
Onset Date: 09/16/2021
Rec V Date: 09/20/2021
Hospital:

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

Lab Data: N/A

Allergies: none

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

Symptoms: Client originally received Moderna COVID-19 vaccine

Other Meds: none

Current Illness:

ID: 1714894
Sex: M
Age: 55
State: NY

Vax Date: 09/15/2021
Onset Date: 09/15/2021
Rec V Date: 09/20/2021
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: Zero, I stayed at home. I'd been examined for mind-fog-related conditions about a decade ago with nothing found.

Allergies: coedine meds and certain nuts, none of which factor into this episode

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

Symptoms: Obviously this is anecdotal, I have not received medical treatment and am relating as best as I can. I got a first Moderna vaccine on the morning of Wednesday, September 15. I have a history of experiencing headaches and "brain fog" but nothing crippling. Starting in the evening and continuing for Thursday, Friday, and Saturday I had a pounding headache on the right side and in the middle of my head - this was qualitatively different than my usual chronic headaches. it was constant but the pressure kept changing, I felt as though I might have been sensitive to circulation in my head. I was ready to check into a hospital and was reading and rereading vaccine side-effects out of concern. I spent Thursday and Friday flat on my back, and tried to do as little as possible on Saturday, and Saturday night when I tried to participate in a dinner conversation I experienced such brain-fog that I'm amazed that I could function at all. Yesterday (Sunday) I was mostly back to normal. At some times during my headache my pulse was about 100 to 105. My arm was sore but not red or swollen. I understand that the reaction to a second dose is often worse. Since I have do experience chronic headaches and mind fog (though not anything like what I experienced the past several days), and since I'm in otherwise OK health, and since I've already received a dose of the Moderna vaccine, I wonder if a second presents more risk for me than the advantages it offers? Of course I don't want to get COVID and COVID can be crippling even to a healthy person, but since I don't have underlying conditions and I've I've already received one dose, perhaps I should not get a second dose? I'm extremely concerned about undergoing any similar crippling headache. Please advise if a second dose is contraindicated.

Other Meds: none at all

Current Illness: none

ID: 1714895
Sex: M
Age: 61
State: OH

Vax Date: 01/22/2021
Onset Date: 09/16/2021
Rec V Date: 09/20/2021
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:

Symptom List: Pain in extremity

Symptoms: Patient developed COVID-19 post-vaccination requiring hospitalization.

Other Meds:

Current Illness:

ID: 1714896
Sex: F
Age: 71
State: KY

Vax Date: 03/11/2021
Onset Date: 03/01/2021
Rec V Date: 09/20/2021
Hospital:

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

Lab Data: EKG, Prostate Check

Allergies: None

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

Symptoms: After I took the second vaccine I went to the doctor for my follow up office visit and the doctor discovered I had AFIB, following the AFIB I had another doctors appointment and later discovered I developed prostate cancer.

Other Meds: Metformin, Glipboride, Losartan, Atorvastatin, Carvedilol, baby aspirin, Centrium Mens, and garlic tablet.

Current Illness: None

ID: 1714897
Sex: F
Age: 31
State: FL

Vax Date: 08/04/2021
Onset Date: 08/12/2021
Rec V Date: 09/20/2021
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: Grand Mal Seizure

Other Meds: Topiramate (100mg x2 daily), Briviact (50mg x2 daily), Sertraline (100mg x1 daily)

Current Illness:

ID: 1714898
Sex: F
Age: 71
State: GA

Vax Date: 08/23/2021
Onset Date: 08/23/2021
Rec V Date: 09/20/2021
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: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: Swollen area in the lower lip.

Other Meds: None.

Current Illness:

ID: 1714899
Sex: F
Age: 49
State: OH

Vax Date: 09/04/2021
Onset Date: 09/05/2021
Rec V Date: 09/20/2021
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: Seasonal allergies only

Symptom List: Vomiting

Symptoms: Patient states that the morning after she was vaccinated she woke up with numbness and tingling on the left side of her face. This numbness and tingling was above the baseline of the regular level of numbness and tingling she has on the left side of her face due to Bell's Palsy from 20 years ago. She indicates that the original occurrence of Bell's Palsy was not the result of a previous vaccination but of a traumatic stressful event. She has been under the care of a neurologist since that time. The new numbness and tingling on the left side of her face lasted for a day and by the next day she had returned to her previous level of sensation on the left side of her face. Patient notified her physician of her reaction to the vaccination and they suggested she call the Health Department to see if she should have the second Pfizer vaccination. RN encouraged patient to call physician to discuss whether a second dose of the Pfizer vaccine should be given due to the physician's greater knowledge of the patients complex medical history. Patient verbalized understanding and said that she would follow up with her physician to discuss.

Other Meds: Synthroid, Dostinex, MVI-Flintstone, Zyrtec, Vitamin D, Collagen, Baby ASA

Current Illness: Sinuses

ID: 1714900
Sex: M
Age: 36
State: NC

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

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

Lab Data: Self administered temperature checks. 100.1 F on 09/17/2021 at 2100 98.9 F on 09/18/2021 1000 98.5 F on 09/18/2021 at 1500

Allergies: None

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: My arm was painful at the injection site all day on the date it occurred 0900 09/17/2021. Within 10 hours the arm pain began to increase, along with body aches all over and a strong headache. By 2100 on 09/17/2021 I had horrible body aches, chills, headache and was completely exhausted and also had a fever of 100.1 degrees. Difficulty sleeping due to the hot/cold cycle of fever and chills. Symptoms continued into the next day 09/18/2021 in which I continued to feel exhausted, felt body aches, seemed to have a fever still and arm pain persisted. By 09/19/2021 I felt less tired and less body pain and no fever but still had reduced amount of energy, and still continued pain at injection site and still sporadic headache. Today 09/20/2021 as of 0900, I still have pain in arm at injection site, low energy but better than over the weekend, no fever or chills today.

Other Meds: Vitamin C supplement

Current Illness: None

ID: 1714901
Sex: F
Age: 37
State: PA

Vax Date: 03/16/2021
Onset Date: 08/21/2021
Rec V Date: 09/20/2021
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: Binax at-home test 8/24/21 Binax at-home test 8/26/21 RiteAid (ProjectBaseline) test 8/28/21

Allergies: N/A

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

Symptoms: Breakthrough positive COVID case (tested positive 8/24/21 after being contacted that a coworker I had been in contact with had tested positive on 8/23/21)

Other Meds: Probiotics Women's Multivitamin

Current Illness: N/A

ID: 1714902
Sex: F
Age: 48
State: GA

Vax Date: 09/12/2021
Onset Date: 09/15/2021
Rec V Date: 09/20/2021
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

Allergies: Gluten, NSAIDS

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Large, red area with swelling and fever on right deltoid and bicep about 2 inches below injection site. Medium, painful knots along right clavicle. Both starting 4 days after vaccine.

Other Meds: Losartin 50mg qd, Metoprolol 50 mg qd, Lexapro 20 mg qd, Allegra 180mg, Prilosec 40 mg qd, Probiotics, Vitamin D 2,000 mg qd, Tylenol 650mg/Tramadol 50mg PRN.

Current Illness: N/A

ID: 1714903
Sex: F
Age: 80
State: OH

Vax Date: 01/22/2021
Onset Date: 09/19/2021
Rec V Date: 09/20/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: Patient developed COVID-19 post-vaccination requiring hospitalization.

Other Meds:

Current Illness:

ID: 1714904
Sex: F
Age: 64
State: MS

Vax Date: 07/27/2021
Onset Date: 07/27/2021
Rec V Date: 09/20/2021
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: NKDA

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

Symptoms: Pt c/o burning in chest after administration of the vaccine. 143/82 BO 72P 16R denies any pain! s,s2 Heart sounds. Pt monitored for 40 more minutes in the clinic prior to departure.

Other Meds: Nitroglycerin, Lisinopril/20-12 HCTZ

Current Illness: NONE

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am