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: 1715171
Sex: F
Age: 62
State: CA

Vax Date: 09/02/2021
Onset Date: 09/03/2021
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: None

Allergies: Codeine

Symptom List: Dysphagia, Epiglottitis

Symptoms: I developed swollen lymph glands on my left side. My husband is a RN and noticed it immediately. I also had a low fever, chills, body aches and tired for 3 days. I slept a day and a half off and on.

Other Meds: Jardiance for diabetes, Lisinopril for Hypertension

Current Illness: None

ID: 1715172
Sex: F
Age: 69
State: KY

Vax Date: 07/30/2021
Onset Date: 09/21/2021
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: Covid positive contact unknown

Other Meds:

Current Illness:

ID: 1715173
Sex: F
Age: 39
State: NJ

Vax Date: 09/17/2021
Onset Date: 09/18/2021
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: Dizziness

Other Meds:

Current Illness:

ID: 1715174
Sex: M
Age: 32
State: TN

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

Lab Data: n/a

Allergies: n/a

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: this is to report of COVID vaccination errors. Patient received his 1st dose of Moderma COVID vaccine on 8/20/2021, On 9/17/2021, when nurse was administering the 2nd dose to him, failed to ask him what type of COVID vaccine he received for as first dose, therefore, he received his 2nd dose of COVID vaccine as the Pfizer one. no an advise reaction occurred to him so far as I am submit this report

Other Meds: n/a

Current Illness: n/a

ID: 1715175
Sex: M
Age: 45
State: MN

Vax Date: 09/09/2021
Onset Date: 09/16/2021
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: Patient swabbed at our offsite collection site. No primary care provider listed.

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

Symptoms: Patient vaccinated for and then tested positive for COVID-19

Other Meds: Patient swabbed at our offsite collection site. No primary care provider listed.

Current Illness: Patient swabbed at our offsite collection site. No primary care provider listed.

ID: 1715176
Sex: F
Age: 21
State: IL

Vax Date: 09/15/2021
Onset Date: 09/15/2021
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: chest xray, decadron prescription on discharge

Allergies: milk, soy, wheat

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

Symptoms: general malaise, dizziness, & chest tightness

Other Meds: none

Current Illness: unknown

ID: 1715177
Sex: F
Age: 25
State: TX

Vax Date: 09/14/2021
Onset Date: 09/14/2021
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: No

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: I started getting pain in the arm type 10 at night I already had body discomfort, fever, nausea, muscle pain, chills, strong pain in the head, by the second day the pains became stronger and I was very tired and discomfort. By the third day, Saturday, I had a convulsion attach where I could only stay home since I am in the country as a tourist. On the sixth day, I woke up with a headache and nausea, seventh day, Monday September 20, I still have a lot of head pain and nausea with certain numbness in the body as if I were going to start a convulsive attack but they go away and then they come back. Honestly it scares me a lot to be like this.

Other Meds: Keppra (levetiracetam) 1000 mg Lamotrigina 100 mg Levotiroxina 125 mcg Acetaminof?n 500 mg Salbutamol inhalator

Current Illness:

ID: 1715178
Sex: F
Age: 41
State: CA

Vax Date: 02/03/2021
Onset Date: 08/01/2021
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: None

Symptom List: Pharyngeal swelling

Symptoms: I have had pain in my lower legs and twitching around my right eye, with some tingling and numbness around the right side of my face.

Other Meds: Tylenol, Hair and Skin Vitamins

Current Illness: None

ID: 1715180
Sex: M
Age: 72
State: NC

Vax Date: 05/12/2021
Onset Date: 05/31/2021
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: No known

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: recurrent urticaria

Other Meds: Asprin

Current Illness: No known

ID: 1715181
Sex: F
Age: 65
State: MN

Vax Date: 08/30/2021
Onset Date: 08/30/2021
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:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Diffuse arthralgias x 3 weeks

Other Meds: amitriptyline, aspirin, zyrtec, flonase

Current Illness: none

ID: 1715182
Sex: F
Age: 72
State: MO

Vax Date: 02/16/2021
Onset Date: 09/10/2021
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: Celecoxib - itching Ibuprofen - not specified

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

Symptoms: Patient admitted to hospital with COVID-19 symptoms on 9/10/2021 after receiving vaccination second dose in February. Patient ultimately discharged from hospital on 9/16/2021, never needing to be intubated during stay.

Other Meds: Calcium carbonate 1200 mg daily Clobetasol 0.05% cream topically BID PRN (rash) Cyanocobalamin 1000 mcg daily Estriol powder vaginally MWF Lactobacillus acidophilus 1 capsule daily Meloxicam 15 mg daily Metformin 1000 mg ER daily Rabeprazol

Current Illness: Frontal lobe dysfunction. Anger outbursts, problems with attention, concentration, easy agitation

ID: 1715183
Sex: F
Age: 50
State: TX

Vax Date: 08/25/2021
Onset Date: 08/25/2021
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: CT scan, CT with Contrast - which showed aneurism, waited 2.5hrs for MRI and MRA of neck to find out it was NOT aneurism. CBC, a ton of other blood work. MRA of Brain ordered Dates - see above

Allergies: environmental allergies, flu vaccine

Symptom List: Rash, Urticaria

Symptoms: *Dizziness *Nausea *vomitting Chronic Migraine - 12 hours later at 0300 *headache *Fever (100.2 to 101.8) *EXTREME fatigue *Blurred vision *loss of appetite *Injection site felt like it was hit by sledge hammer *Injection site swollen aphasia brain fog Hair loss ER Visit on 8/31 after I Maxed out all triptans and other chronic migraine meds and all of the other symptoms Migraine PCP 9/7 wrote exemption and advised to follow with neuro and rest Neuro 9/8 who started infusions and ordered an MRA 9/9 1st infusion 9/15 2nd infusion 9/16 3rd infusion 9/21 eye dr to check pressure in eyes for the blurred vision

Other Meds: Hydroxychloroquine, sereteline

Current Illness: None

ID: 1715184
Sex: M
Age: 29
State: SD

Vax Date: 09/14/2021
Onset Date: 09/14/2021
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: Random glucose.

Allergies: Banana, Penicillin

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

Symptoms: Within 15 minutes of receiving vaccination patient experienced low BP and dizziness. Patient was then transferred over to the ER for further management of symptoms. In the ER patient received normal saline bolus with normalization of BPs.

Other Meds: Tylenol, ascorbic acid, DM/PE/ acteaminophen/doxylamine, echinacea, multivitamin, zinc

Current Illness: None

ID: 1715185
Sex: F
Age: 45
State: KY

Vax Date: 05/21/2021
Onset Date: 09/08/2021
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:

Allergies:

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

Symptoms: Covid positive household member

Other Meds:

Current Illness:

ID: 1715186
Sex: F
Age: 35
State: IL

Vax Date: 08/20/2021
Onset Date: 09/18/2021
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: chest x-ray, contrast chest CT, leg ultrasound, saline

Allergies: N/A

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

Symptoms: Tachycardia (resting pulse 140 bpm, walking pulse 180 bmp); stage 2 hypertension (157/96)

Other Meds: Gemfibrozil, multivitamin, vitamin D

Current Illness: N/A

ID: 1715187
Sex: F
Age: 54
State: MI

Vax Date: 09/07/2021
Onset Date: 09/09/2021
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: lipton tea, codine

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

Symptoms: hives and itching like similar allergic reactions, self treated with benadryl

Other Meds: prilosec

Current Illness: none

ID: 1715188
Sex: F
Age: 17
State: UT

Vax Date: 09/16/2021
Onset Date: 09/17/2021
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: Listed in description.

Allergies: Nuts, sunflower seeds, some fresh produce.

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

Symptoms: Patient got the shot last Thursday and on Friday, the next day, she came down with a sore throat. Then on Saturday she was sick and slept after work. On Sunday around 4:00 or so she had a tightening of the throat and lungs requiring an ER visit. Patient was given albuterol, Benedryl, an anti anxiety and a steroid. No improvement . Suspected viral. Sent home. At 7:15 am Monday morning, retuned to ER with worsening symptoms of tightening of chest. Gave epinephrine breathing treatment, MRI to check blood clots, blood work, dexmethasone. Outcome not determined yet. In ER at present.

Other Meds: Amitrytaline

Current Illness: None

ID: 1715189
Sex: M
Age: 16
State: VA

Vax Date: 02/17/2021
Onset Date:
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:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Patient was 16 at the time of his vaccination. He recvd Moderna which is not indicated for those under 18.

Other Meds:

Current Illness:

ID: 1715190
Sex: F
Age: 65
State: CA

Vax Date: 03/04/2021
Onset Date: 03/04/2021
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: ECG CT scan Ultrasound

Allergies: Cephalexin Amoxicillin Antihistamine

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: I would experience blackouts, collapse to the floor, and break out into a cold sweat. My other symptoms include lightheadedness, leg weakness, shortness of breath, fatigue, and upper abdominal pain.

Other Meds: Aspirin Vitamin D

Current Illness: N/A

ID: 1715191
Sex: F
Age: 75
State: MO

Vax Date: 02/13/2021
Onset Date: 04/13/2021
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: Second mammogram on April 23, 2021 indicated the same cyst in my left breast. Dr. asked if I had received the Covid vaccine. Yes I did. A third mammogram is scheduled for late October to see if the cyst has changed or disappeared.

Allergies: Penicillin Sulfa Tetanus

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

Symptoms: Routine mammogram on April 13, 2021 indicated a cyst in my left breast.

Other Meds: Atorvastatin 20mg Citalopram 20 mg Lisinopril 5 mg

Current Illness: None

ID: 1715192
Sex: M
Age: 16
State: MN

Vax Date: 08/17/2021
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: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Patient swabbed at our offsite collection site. Please contact their primary care provider for further questions.

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

Symptoms: Patient vaccinated for and then tested positive for COVID-19

Other Meds: Patient swabbed at our offsite collection site. Please contact their primary care provider for further questions.

Current Illness: Patient swabbed at our offsite collection site. Please contact their primary care provider for further questions.

ID: 1715193
Sex: F
Age: 35
State: GA

Vax Date: 08/03/2021
Onset Date: 08/11/2021
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: I did not report this to my doctor as this was recorded as possible side effects of this vaccine.

Allergies: Allergies to medications: Sulfur, Sulpha, Codeine, Tramadol Allergies to food: Corn or any corn derived products. Allergies to products: Latex

Symptom List: Unevaluable event

Symptoms: Covid Arm - Slight Discomfort when using arm and Red/swollen at site immediately after getting, 8 days later the pain set in and the area became more swollen and red, and was hot to touch. Pain when used arm. I had a lot of fatigue and cold chills during the first week of receiving and Some confusion. Second week I had bad vertigo for 4 days, which intensity did decreased day over day. Headaches followed after the Vertigo for about 3 days with some dizziness. I continued to have serious fatigue until about 2nd week in Sept. I was taking about 4-5 naps a day and didn't have the energy to do much of anything. My legs and arms felt heavy during the fatigue.

Other Meds: Benadryl 25mg 2x a day, Adderall 30 mg 1x a day, Zyrtec as needed.

Current Illness: None

ID: 1715194
Sex: M
Age: 47
State: KY

Vax Date: 06/25/2021
Onset Date: 09/10/2021
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:

Allergies:

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

Symptoms: Covid positive household member

Other Meds:

Current Illness:

ID: 1715195
Sex: M
Age: 40
State: MS

Vax Date: 09/20/2021
Onset Date: 09/20/2021
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:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: No adverse effects reported

Other Meds:

Current Illness:

ID: 1715196
Sex: M
Age: 41
State: DE

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

Lab Data: Sept 16, 2021 - xrays of chest and soft tissue neck xray; low lung volumes reported

Allergies: ciproflaxzcin, acetaminophen, amitizia

Symptom List: Injection site pain, Menorrhagia

Symptoms: left jaw stiffness and swelling; tongue tingling; mild difficulty swallowing mild soft tissue swelling over left TMJ/parotid/angle of mandible/ submandibular area; mild fullness some radicular area, no mass or lymph node palpated. mildy tender there treatment: adminster H2 blocker, H1 blocker, solu-medrol, and IV fluids; Diphenhydramine hcl, methyprendenisolone na succ, prednisone (5 days)

Other Meds: Hydroxyzine hcl, Pantoprazole, Miratapine

Current Illness:

ID: 1715197
Sex: F
Age: 71
State: CA

Vax Date: 03/15/2021
Onset Date: 08/15/2021
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:

Allergies: adhesive tape

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

Symptoms: High fever, chills, pain in right calf and knee, swelling in right calf and knee

Other Meds: allopurinol, atorvastatin, hydrochlorothiazide, losartan, vitsmin c, del immune, probiotic, calcium

Current Illness: none

ID: 1715198
Sex: M
Age: 52
State: WA

Vax Date: 09/17/2021
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: N/A

Allergies: No known

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: I had a pt who got his 2nd Covid vaccine 7days earlier than the expected date by an error because he did not have his vaccination card with him. He got his first shot on 09/03/21 and the 2nd one on 09/17/21

Other Meds: The 2nd dose of Covid shot was given 7 days earlier than the scheduled date

Current Illness: N/A

ID: 1715199
Sex: M
Age: 0
State:

Vax Date: 09/20/2021
Onset Date: 09/20/2021
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:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Patient was vaccinated with Pfizer vaccine after previously completing the J&J vaccine. J&J vaccination was completed on 03/10/21 and Pfizer first dose was administered on 08/08/21. The patient experienced no adverse reaction. He came back for 2nd dose of pfizer 21 days later when we found the error.

Other Meds:

Current Illness:

ID: 1715200
Sex: M
Age: 53
State: SD

Vax Date: 05/06/2021
Onset Date: 05/07/2021
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: UA 5/12/2021; CT urogram 9/20/2021; cystoscopy 9/20/2021

Allergies: None

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

Symptoms: Patient had Gross hematuria after BOTH his first and second vaccination. Onset was 24 hours. Hematuria was confirmed in lab. Patient underwent a complete hematuria work-up including CT with and without Contrast abdomen and pelvis and cystoscopy without other cause found

Other Meds: None

Current Illness: None

ID: 1715201
Sex: F
Age: 0
State: WA

Vax Date: 03/01/2001
Onset Date: 03/01/2001
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: Multiple

Allergies: None

Symptom List: Nausea

Symptoms: Hospitalized numerous times due to parotitis

Other Meds: None

Current Illness: None

ID: 1715202
Sex: F
Age: 45
State: CA

Vax Date: 09/04/2021
Onset Date: 09/04/2021
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: None known

Symptom List: Injection site pain

Symptoms: Fainted 2+ hours after receiving vaccine.

Other Meds: Paroxetine - 5 mg (1/2 of 10 mg) daily

Current Illness:

ID: 1715203
Sex: M
Age: 67
State: IL

Vax Date: 03/15/2021
Onset Date: 03/01/2021
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: Echogram, Endoscope

Allergies:

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

Symptoms: I had fatigue for several day. I started getting pain in my stomach that is ongoing. On July 30th, to see the doctor. He set up an endoscopy, nothing found. They also found that I had a heart morrow, So, he set up on Echogram on Sept 8th. I also have an appointment with the cardiologist on the Nov. 29th.

Other Meds: Omeprazole; lisinopril

Current Illness:

ID: 1715204
Sex: F
Age: 32
State: CA

Vax Date: 08/17/2021
Onset Date: 08/17/2021
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:

Allergies:

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

Symptoms: My menstrual cycle never came in august. I received my swings dose in September and started the very next day but with a vengeance. I have very regular menstrual cycles and even thought I could have been pregnant, took 2 pregnancy tests to confirm I wasn?t, even tho I had a tubal ligation a few years ago. After I received my second dose and my period came two week earlier than normal, I was in an immense amount of pain from really bad cramping and experienced huge blood clots. It was very strange.

Other Meds:

Current Illness:

ID: 1715205
Sex: M
Age: 59
State: MN

Vax Date: 07/12/2021
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:

Allergies: Patient swabbed at our offsite collection site. Please contact their primary care provider, for further questions.

Symptom List: Tremor

Symptoms: Patient vaccinated for and then tested positive for COVID-19

Other Meds: Patient swabbed at our offsite collection site. Please contact their primary care provider, PA for further questions.

Current Illness: Patient swabbed at our offsite collection site. Please contact their primary care provider for further questions.

ID: 1715206
Sex: F
Age: 60
State: OH

Vax Date: 05/07/2021
Onset Date: 05/09/2021
Rec V Date: 09/20/2021
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: Cat-Scan 05/25/2021 EKG 05/25/2021 Ultrasound 05/25/2021

Allergies: Pennicillin, Sulfa-Drugs

Symptom List: Erythema, Pruritus

Symptoms: Pt. states that after receiving the 1st dose of J&J 05/07/2021, started experiencing symptoms 05/09/2021 of sharp pains throughout the left legs, ER visit 05/25/2021 . 05/25/2021 suffered a Brainstem Left Ponds Stroke. Hospitalized 2 weeks, In-Patient for PT. Out-Patient Neuro Therapy for 6 Weeks.

Other Meds: Losartin 50mg, Acyclovir 200mg

Current Illness: N/A

ID: 1715207
Sex: F
Age: 66
State: WA

Vax Date: 09/16/2021
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: NKDA

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

Symptoms: Aortic dissection seen Medical center

Other Meds: lisinopril

Current Illness: none

ID: 1715208
Sex: F
Age: 28
State: PA

Vax Date: 09/17/2021
Onset Date: 09/18/2021
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: Dilatin, via IV

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

Symptoms: Tingling in the lateral right foot, discomfort in the right heel, pins and needles in peroneal muscles of right leg, weakness in calf.

Other Meds: 500mc B12 5000IU D3 28mg Iron 1000mg Folate

Current Illness: N/A

ID: 1715209
Sex: F
Age: 22
State: MN

Vax Date: 02/19/2021
Onset Date: 09/18/2021
Rec V Date: 09/20/2021
Hospital: Y

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

Lab Data: POSITIVE COVID TEST 9/18/21

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: ASYMPTOMATIC. PATIENT ADMITTED FOR CARDIAC ARREST / OVERDOSE

Other Meds:

Current Illness:

ID: 1715210
Sex: F
Age: 47
State: OH

Vax Date: 03/18/2021
Onset Date: 03/20/2021
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: No

Allergies: Bactrim

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

Symptoms: Severe migraine nauseated stiff neck

Other Meds: No

Current Illness: No

ID: 1715211
Sex: M
Age: 62
State: MI

Vax Date: 05/08/2021
Onset Date: 09/13/2021
Rec V Date: 09/20/2021
Hospital: Y

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: history of coronary artery disease, diabetes, renal failure status post kidney transplant to the emergency department with shortness of breath. He also has a history of heart failure. States he's had a cough and been congested. Admits bilateral lower extremity swelling; patient started with fever and was tested

Other Meds:

Current Illness:

ID: 1715212
Sex: M
Age: 32
State: WI

Vax Date: 07/23/2021
Onset Date: 07/24/2021
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: LA

Lab Data: None - swelling resolved on its own.

Allergies: None

Symptom List: Pain in extremity

Symptoms: Left testicular swelling - moderate. Started after both injections, approximately 12 hours later. Patient noticed while in the shower. Was concerned enough to ask his wife (me) to look and see. Redness, swelling, heat evident in the left testicle. Patient thought that he maybe had a hernia, but hernia check was done and negative. Swelling subsided both times after a week. Only change in health history both times was getting vaccinated.

Other Meds: Atenolol - 1x/day - 25 mg

Current Illness: None

ID: 1715213
Sex: F
Age: 49
State: IN

Vax Date: 08/29/2021
Onset Date: 08/30/2021
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: 9/4/21 Ct angiogram normal Labs relatively normal - no ddimer done at year visit 9/13- dr visit - more labs - negative covid antibodies

Allergies: Sulfa

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

Symptoms: Severe headache and nausea Tachycardia , chest tightness, difficulty breathing , sever pain in upper back between scapula Trip to ER, CT angiogram , EKG , blooodwork Follow up with family dr - additional testing done

Other Meds: Synthroid Wellbutrin Gabapentin

Current Illness: None

ID: 1715214
Sex: F
Age: 4
State: NY

Vax Date: 09/18/2021
Onset Date: 09/18/2021
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: Patient was sitting on Mom's lap, and I was injecting the needle, she jerked back and the needle came out and scratched her arm. The vaccine itself had not been injected. I was able to clean her up with a tissue and put a bandaid on it. The patient was very upset, but Mom and Dad were ok. Mom admitted she didn't have a good grasp on her. We went ahead and gave her the shot in the other arm (left arm) with Dad holding her and she did fine.

Other Meds:

Current Illness:

ID: 1715215
Sex: M
Age: 37
State: MT

Vax Date: 08/10/2021
Onset Date: 08/15/2021
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: Ringing in the ear. At least one episode per day. Mainly left ear, but occasionally right ear. Prior to vaccine, ear would seldomly ring - once per year or so.

Other Meds: Pine Pollen tincture

Current Illness: None

ID: 1715217
Sex: F
Age: 33
State: NY

Vax Date: 08/25/2021
Onset Date: 08/25/2021
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:

Allergies: NA

Symptom List: Vomiting

Symptoms: 1ST Shot, I hade muscle twitching in the L arm (vaccinated arm). 2ND Shot, I have extreme arm pain in R arm ( injected arm) Not only at injection site from radiating pain down arm. I had muscle twitching in injected arm again. Headache, Fever 102.7 with chills and diaphoresis and body aches.

Other Meds: NA

Current Illness: NA

ID: 1715218
Sex: M
Age: 36
State: FL

Vax Date: 09/17/2021
Onset Date: 09/18/2021
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: None

Allergies: None

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Has congestion Fatigue Chills Headache

Other Meds: None

Current Illness: None

ID: 1715219
Sex: F
Age: 58
State: KY

Vax Date: 01/20/2021
Onset Date: 09/14/2021
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:

Allergies:

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

Symptoms: Covid positive worker

Other Meds:

Current Illness:

ID: 1715220
Sex: F
Age: 29
State: FL

Vax Date: 09/05/2021
Onset Date: 09/07/2021
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: I have annual blood work on file with Dr. (she's my primary). Since my reactions started I haven't been able to get an appointment with my primary or any other doctor in the office. I have an appointment with a cardiologist on Thursday 9/23 to hopefully get some answers.

Allergies: none

Symptom List: Injection site swelling, Limb discomfort

Symptoms: I have difficulty catching my breath from simple tasks such as vacuuming and cleaning. I first noticed it when I walked up my attic stairs to put something in storage and my heart felt like it was beating out of my chest. My heart rate was over 150 bpm from walking up 5 stairs. My resting heart rate is around 60 and now when I stand it shoots to over 100 and my blood pressure drops. My blood pressure is all over the place throughout the day. I am light headed when standing, dizzy, blurry vision, constant headaches, my arms get tingly feeling- especially when laying down and brain fog. My period started 10 days early and only lasted for 1 day. I have been monitoring by side effects and keeping a journal so when I can speak to my primary we can review in detail.

Other Meds: No medication take day of vaccine

Current Illness: none

ID: 1715221
Sex: F
Age: 18
State: MI

Vax Date: 09/11/2021
Onset Date: 09/14/2021
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: N/a

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

Symptoms: Dose 2 was given at day 14 ( 1st dose 08/28 2nd 09/11). Patient parent called on 09/14 to report the error and stated patient was hospitalized with concussion like symptoms. Unclear weather vaccine error resulted in symptoms or if patient had some other concurrent medical problem.

Other Meds: N/a

Current Illness: Concussion

ID: 1715222
Sex: M
Age: 74
State: FL

Vax Date: 03/16/2021
Onset Date: 08/13/2021
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: Xray, D-dimer

Allergies: Fosamax

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

Symptoms: Around August 13th I Started feeling sharp shooting pain on my right side of my breast it lasted a couple of days and it moved to the left breast it felt like a stabbing pain there was nothing I could do to make it happed it lasted and moved around from side to side. I went to an urgent care on Aug 23rd. because my family doctor had no appointment openings the Urgent care doctor took an X-ray and D-dimer was concern for blood clots but it came out ok. He said it could've been muscular or a virus there's was no definite answer. It has gotten better but it still feels tender.

Other Meds: Doxazosin, Colestipol, Inhaler

Current Illness: None

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am