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: 1715642
Sex: M
Age: 36
State: OR

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

Lab Data: unknown

Allergies: unknown

Symptom List: Dysphagia, Epiglottitis

Symptoms: Patient came into the pharmacy to receive his second dose of the Pfizer Covid-19 vaccine, and he said that he has had persistent dull pain in left arm that he is currently dealing with since his first vaccination. He will seek out a doctor to evaluate his arm.

Other Meds: unknown

Current Illness: unknown

ID: 1715643
Sex: M
Age: 69
State:

Vax Date: 02/04/2021
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: Patient had positive COVID test on 9/16/2021

Other Meds:

Current Illness:

ID: 1715644
Sex: F
Age: 81
State: IL

Vax Date: 03/16/2021
Onset Date: 09/16/2021
Rec V Date: 09/20/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: Pt received Pfizer x2. Pt was tested COVID + on 9/16 and hospitalized on 9/17/21. Pt was hypoxic and received remdesivir and dexamethasone.

Other Meds:

Current Illness:

ID: 1715645
Sex: F
Age: 20
State: KY

Vax Date: 04/14/2021
Onset Date: 09/15/2021
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: Tested positive for COVID 19 on 09/17/2021

Other Meds:

Current Illness:

ID: 1715646
Sex: M
Age: 81
State: MI

Vax Date: 02/23/2021
Onset Date: 09/06/2021
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: COVID positive PCR on 09/06/2021.

Allergies: Lisinopril, statin-hmg-coa reductase inihbitors, codiene, diovan.

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

Symptoms: Fully COVID vaccinated patient admitted to hospital through ED for shortness of breath with COVID positive test on 09/06/21. Ambulatory PO2 at 82%. D/C home on 2L/NC and additional 5 day course of decadron.

Other Meds: Allopurinol, Norvasc, Eliquis, Aspirin, Cymbalta, Lasix, Neurontin, Lantus, Novolog, Lopressor, Pravachol, Flomax.

Current Illness:

ID: 1715647
Sex: M
Age: 77
State: MN

Vax Date: 09/07/2021
Onset Date: 09/07/2021
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: amoxicillin, bacitracin, gleevec, triple antibiotic,penicillin

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

Symptoms: patient came 9/19 to report symptoms after receiving 3rd dose of Pfizer. Symptoms: aching joints, chills, fever 101 for 3 days, low grade fever 2 days (99), Per pt, after symptoms gone (5 days), cant breathe without coughing and acting lungs.

Other Meds: celecoxib, lisinopril., nifedipine, pantoprazole,pravastatin, tamsuolin, zolpidem

Current Illness:

ID: 1715648
Sex: F
Age: 25
State: SC

Vax Date: 09/14/2021
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: IM
Vax Site: LA

Lab Data: Hives starting on the left side of my face on Thursday 9/16/2021 and progressing across the bottom half of my face and neck.

Allergies: Silversuladiozine

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: 206A21A

Other Meds: Niacin, b3

Current Illness: No

ID: 1715649
Sex: F
Age: 61
State: MA

Vax Date: 03/19/2021
Onset Date: 05/01/2021
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: Covid Test positive August 3, 2021

Allergies: Seafood; bee stings; Percocet; any "statin" drugs

Symptom List: Pharyngeal swelling

Symptoms: I had a routine mammogram in May 2021 and I am now undergoing chemotherapy. I am at treatment number four. I had to postpone my treatment as well due to testing positive for Covid on August 3rd 2021 as well. I was asymptomatic though.

Other Meds: Amlodipine; losartan; lorazepam; insulin

Current Illness: N/A

ID: 1715650
Sex: F
Age: 25
State: CT

Vax Date: 09/13/2021
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:

Allergies: Nonexistent

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: My period came the day after I got the second Covid vaccine which was 2 weeks early.

Other Meds: Nonexistent

Current Illness: Nonexistent

ID: 1715651
Sex: F
Age: 25
State: UT

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: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: None

Allergies: No

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Currently pregnant Estimated date of delivery is October 19th, 2021 -Headache, still have now has been two days since injection -Muffled hearing , still have now has been two days since injection -Pain at injection site, lasted about 24 hours -Muscle pain, lasted about 36 hours -Joint pain, lasted about 36 hours -Tired, still have now has been two days since injection -Fever, lasted about 24 hours -Hot flashes with sweating, lasted about 24 hours -Nausea, lasted about 12 hours -Diarrhea, lasted about 12 hours

Other Meds: Nature Made Prenatal Multi + DHA Tylenol Extra Strength

Current Illness: None

ID: 1715652
Sex: M
Age: 38
State: WA

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

Lab Data:

Allergies: None

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

Symptoms: About an 1.5 hours after receiving the vaccine, I started feeling dizzy and would randomly start leaning/falling over at random. It felt as if the ground wasn't even and my sense of balance has been affected since I received the vaccine. Along with this came a loud ringing in my ears that persists to today. I have difficulty hearing certain frequencies because of the loud ring sound. I have notified my provider of these issues from the vaccine and have not received a response yet as to what to expect and if treatment is available.

Other Meds: None

Current Illness: None

ID: 1715653
Sex: F
Age: 52
State:

Vax Date: 01/29/2021
Onset Date: 09/17/2021
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: Patient had a positive COVID test on 9/17/2021

Other Meds:

Current Illness:

ID: 1715654
Sex: M
Age: 63
State: MI

Vax Date: 03/17/2021
Onset Date: 04/01/2021
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: EMG

Allergies:

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

Symptoms: I had tingling and numbness in my feet. I also had a little bit of tingling and numbness in my hands. It also had a burning feeling. I went to see my doctor about this. She referred me to the neurologist. They did an EMG. They diagnosed my stocking type small fiber modality lost.

Other Meds: Tamsin; fluorine; lisinopril; losartan; oxybutynin; Cinder silver; vitamin B; fish oil; aspirin; vitamin D; Alpha Acid

Current Illness:

ID: 1715655
Sex: F
Age: 63
State: NY

Vax Date: 09/02/2021
Onset Date: 09/02/2021
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: Went to Urgent Care, then ER, then follow up w primary doctor then Cardiologist. Had 4 EKGs appeared normal, chest x Ray normal, blood work electrolytes were off.

Allergies: Sulfa

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

Symptoms: Heart pounding and heart palpitations. Fever 99.8.

Other Meds: Lisiniprol 10 mg and Allegra. Vitamins and supplements vitamin C, B12, B3, Biotin, D, magnesium, flax seed oil, tumeric, zinc, milk thistle.

Current Illness: None

ID: 1715656
Sex: M
Age: 26
State: CA

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

Lab Data: N/a

Allergies: N/a

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

Symptoms: N/a

Other Meds: Albuterol

Current Illness: N/a

ID: 1715657
Sex: M
Age: 57
State: WV

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: 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: Long Standing Tinnitus to left ear. Suddenly increased in intensity next day. Remains significantly louder.

Other Meds: Vitamin D

Current Illness: None

ID: 1715658
Sex: F
Age: 19
State: NE

Vax Date: 09/18/2021
Onset Date: 09/18/2021
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: Lower extremity ultrasound, performed POCUS today. No DVT.

Allergies: None known

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

Symptoms: Malaise starting in the vending of 9/18/2021 around 8PM central time. Awoke with fever and chills at 4AM central time on 9/19/2021. Fatigue/malaise all day 9/19/2021. Malaise/fatigue improved through morning classwork. Mild tingling in extremities and face beginning 1407 hours 9/20/2021.

Other Meds: ProImmune 200/CA2963131 Fish oil supplement Vitamin D3

Current Illness: Mild road rash from scooter accident in the week prior, no other illnesses/co-morbidities.

ID: 1715659
Sex: F
Age: 65
State: IL

Vax Date: 04/03/2021
Onset Date: 09/16/2021
Rec V Date: 09/20/2021
Hospital: Y

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: Pt received Pfizer x2. Pt tested COVID + on 9/9/21 and admitted to hospital for COVID on 9/16/2021. Pt receiving remdesivir and dexamethasone.

Other Meds:

Current Illness:

ID: 1715660
Sex: F
Age: 23
State: WA

Vax Date: 09/09/2021
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:

Allergies: Dust, dust mites

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Erythema multifore, diffuse erthematic pinpoint papular rash on hands, arms, legs, thighs, trunk, back. Erythematic plaques bilateral cheeks, right ear lobe. 8 cm circular erythematic wheal with central clearing on left deltoid at site of injection. Erythematic plaque on left elbow.

Other Meds: Albuterol, bupropion HCL, cetirizine, levonorgestrel-ethinyl estradiol

Current Illness:

ID: 1715661
Sex: F
Age: 48
State: IL

Vax Date: 04/15/2021
Onset Date: 04/15/2021
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: Not Applicable

Allergies: Anaphylaxis-Medications: Sumitriptans, Polysporin, Neosporin; Food: Dairy (whey), Chocolate Hives-Medications: Vicodin, Valium; Tomato, Kiwi, Pineapple, Eggplant, CNS reaction/muscle spasms-Medications: Dilaudid, Anesthesia

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

Symptoms: Difficulty breathing, fast heartbeat, dizziness, faintness, and muscle weakness. The dizziness, faintness, and muscle weakness were immediate and passed within a couple minutes. The difficulty breathing and fast heartbeat began immediately and increased rapidly over next 5 minutes. I sought medical assistance, took 50mg of Benadryl and used my rescue inhaler. Remained under monitoring for an hour but did not use EpiPen. Over the next 48hrs I experienced continued but less severe difficulty breathing and occasional periods of muscle weakness.

Other Meds: Prescriptions: Daily-Sunosi, Ritalin, Topomax; PRN-Rescue Inhaler, EpiPen Supplements: Multivitamin, Vitamin D, Vitamin B-Complex, Probiotics, Digestive Enzymes, Calc-Mag (1000/500mg) OTC: Allegra

Current Illness: Family hx of cancer: multiple 1st and 2nd degree relatives; and, See below

ID: 1715662
Sex: M
Age: 69
State: TX

Vax Date: 04/02/2021
Onset Date: 04/16/2021
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: None

Allergies: None

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

Symptoms: In the weeks following the second Covid shot, I became painfully stiff in the low back and upper legs. Also, balance was badly affected.

Other Meds: Xarelto 75mg Areds 2 Vitamin D3 5000 iu Magnesium Potassium

Current Illness: None

ID: 1715663
Sex: M
Age: 56
State: MN

Vax Date: 04/05/2021
Onset Date: 09/15/2021
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: sore throat; nonproductive cough; fever; chills; body aches, diarreha starting on 9/15/21

Other Meds: AMLODIPINE; fLUTICASONE;ATORVASTATIN, FISH OIL; VITAMIN C

Current Illness: none

ID: 1715665
Sex: F
Age: 12
State: WI

Vax Date: 09/06/2021
Onset Date: 09/06/2021
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: None

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

Symptoms: Patient was out of the age range for the Moderna Emergency use vaccine. She is 12 years old.

Other Meds: None

Current Illness: None

ID: 1715667
Sex: F
Age: 53
State: AR

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: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: N/A

Symptom List: Injection site pain, Pain

Symptoms: PT STATED SHE FELT WEAK. SKIN TURNED RED. A KNOT FORMED ABOVE HER RIGHT EYEBROW. ARM PAIN

Other Meds: N/A

Current Illness: N/A

ID: 1715668
Sex: F
Age: 11
State: OK

Vax Date: 06/25/2021
Onset Date: 06/25/2021
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: NOne

Allergies: none

Symptom List: Injection site pain, Menorrhagia

Symptoms: Clients parent put down the incorrect date of birth and age on consent form, making her eligible for the Pfizer vaccine . 09/20/2021 spoke with clients mother, she reports no known adverse events after either doese

Other Meds: none

Current Illness: none

ID: 1715669
Sex: M
Age: 59
State: IN

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

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

Lab Data:

Allergies:

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

Symptoms: fatigue, soreness, cold chills, cold symptoms, chest tight, fever, severe muscle spasms

Other Meds:

Current Illness:

ID: 1715670
Sex: M
Age: 89
State: IL

Vax Date: 03/06/2021
Onset Date: 08/11/2021
Rec V Date: 09/20/2021
Hospital: Y

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: Pt received Pfizer x2. Pt tested COVID + on 8/11/21 and admitted to hospital for COVID on 8/11/2021, but did not require COVID treatments.

Other Meds:

Current Illness:

ID: 1715671
Sex: F
Age: 53
State: MI

Vax Date: 04/10/2021
Onset Date: 09/03/2021
Rec V Date: 09/20/2021
Hospital: Y

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

Lab Data: COVID positive PCR on 09/03/2021.

Allergies: Celexa/Citalopram

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Fully vaccinated for COVID patient who tested positive COVID test on 09/03/21 during routine screening for admission. Patient asymptomatic. Repeat testing on 09/03/21, 09/07/21, 09/09/21, and 09/10/21 all resulted as "Not Detected." No symptoms of COVID during admission.

Other Meds: Abilify, folic acid, apresoline, vistaril, labetalol, L. acidophilus, Mag-Ox, Mobic, Revia, protonix, zoloft, B1, desyrel, vancomycin, verapamil

Current Illness: C difficile infection

ID: 1715672
Sex: F
Age: 53
State: CA

Vax Date: 05/15/2021
Onset Date: 07/01/2021
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: Penicillin; Neosporin; nickel

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

Symptoms: After approximately a month after 2nd dose, have been having memory issues that have persisted to this day.

Other Meds:

Current Illness: None

ID: 1715673
Sex: M
Age: 52
State: WA

Vax Date: 08/10/2021
Onset Date: 08/10/2021
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:

Allergies: Possibly penicillin

Symptom List: Nausea

Symptoms: I had a variety of symptoms after receiving the first dose of the Pfizer vaccine. In total, these lasted for three weeks, and I was unable to work for one week. Most seriously, I felt a very irregular heartbeat the evening after the vaccine injection. This started about four hours after the injection, and lasted two hours. Although I fortunately did not need to go to the hospital, I was considering it and I would have had to do so urgently if it had become any worse. The other symptoms included: Numb and tingling feet, which started almost immediately after the injection and lasted for three days. Mental confusion, which made driving difficult and somewhat dangerous. This started about 30 minutes after the injection, and it lasted on and off for two weeks. It became somewhat difficult to get food, because I was avoiding driving. Fatigue. This lasted about three weeks, and it was especially bad for the first 10 days. On two days, I was so tired that I had to stay in bed most of the day and slept. In conclusion, before having the Pfizer vaccine, I felt fine and I had no illnesses. I am in otherwise good health and I do not take any prescriptions. After the vaccine, I was really quite sick for two weeks.

Other Meds: None

Current Illness: None

ID: 1715674
Sex: F
Age: 29
State: PA

Vax Date: 02/05/2021
Onset Date: 04/24/2021
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: None

Allergies: Soy, various fruits and vegetables, springtime allergens

Symptom List: Injection site pain

Symptoms: Irregular menses for 5 months now (as of 9/20/21). Menses were regular, every 28-30 days, until 4/24/21. Periods are now intermittently two weeks late (roughly 3/4 of menstrual cycles). IUD had been in place for 5 years and is still in place. Menses are carefully tracked monthly.

Other Meds: Lexapro 10mg

Current Illness: None

ID: 1715675
Sex: F
Age: 64
State: IL

Vax Date: 02/26/2021
Onset Date: 09/09/2021
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: over the counter COVID test at home = Positive nasal swab test = Positive

Allergies: Flexeril, soma, Lodine

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

Symptoms: 9/9/2021 Sore throat, headache, nasal congestion, loss of smell & taste. Used over the counter cold liquid and ibuprofen. Symptoms subsided about 6 days later

Other Meds: hydrochlorothiazide, estrace, multi vitamins, Vit C & E, calcium, lansoprazole, omega-3, probiotics, turmeric

Current Illness: none

ID: 1715676
Sex: F
Age: 50
State: WI

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: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data: None

Allergies: none

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

Symptoms: Received shot at 10:15am, the following morning at 3:30am I had a seizure.

Other Meds: Trazadone 50mg at bedtime

Current Illness: None

ID: 1715677
Sex: F
Age: 48
State: WA

Vax Date: 09/03/2021
Onset Date: 09/04/2021
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: Covid test, I am waiting for imaging to call me to set up a CT scan of the blood vessels in my brain. Waiting on my Dr. to consult with other colleagues for a treatment plan.

Allergies: Pineapple, latex

Symptom List: Tremor

Symptoms: Since the day after the shot I woke with a headache that as of this date has yet to go away, I have severe dizzy spells, I have had an episode where I have seen different color floating dots when I close my eyes and silver what looks likes glitter was thrown up in front of me, upset stomach, pain on and off in the lower left leg above my ankle bone, running nose and slight cough.

Other Meds: Bayer aspirin, Aleve

Current Illness:

ID: 1715678
Sex: F
Age: 24
State:

Vax Date: 09/13/2021
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: no

Symptom List: Erythema, Pruritus

Symptoms: Approximately 7:30 pm started noticing a large red, swollen, warm bump at injection site. Painful to touch and move arm. Persisted over the next 3 days. Still painful to touch and large bruise noted at injection site a week later.

Other Meds: no

Current Illness: no

ID: 1715679
Sex: M
Age: 16
State: WI

Vax Date: 09/06/2021
Onset Date: 09/06/2021
Rec V Date: 09/20/2021
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: None

Allergies: none

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

Symptoms: Not age approved for Moderna emergency use vaccine. Patient is 16 years of age

Other Meds: none

Current Illness: none

ID: 1715680
Sex: F
Age: 29
State:

Vax Date: 08/10/2021
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: LA

Lab Data:

Allergies:

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

Symptoms: two weeks post vaccine pt had heavy menstral bleeding and clotting

Other Meds:

Current Illness:

ID: 1715681
Sex: F
Age: 21
State: ND

Vax Date: 09/13/2021
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: None

Allergies: None

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Patient developed a head to toe body rash and facial swelling approximately 48-72 hrs after she received the vaccine. Began on bilateral legs on 15 Sep and progressed to full body by 16 Sep along with facial swelling.

Other Meds: Patient was taking Amoxicillin.

Current Illness: Patient was diagnosed with streptococcal pharyngitis on 09 Sep 21 and also began treatment with Amoxicillin same day.

ID: 1715682
Sex: M
Age: 31
State: CA

Vax Date: 08/19/2021
Onset Date: 08/19/2021
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:

Allergies:

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

Symptoms: PT CAME IN FOR 2ND DOSE ON 9/20/21. DURING SCREENIGN QUESTIONS, PATIENT STATED HE HAD INCREASE IN HEART RATE AND HEART RATE WAS CONTINOUSLY FAST POST VACCINATION.

Other Meds:

Current Illness:

ID: 1715683
Sex: F
Age: 81
State: MT

Vax Date: 09/07/2021
Onset Date: 09/08/2021
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: CT scan and Labs and Fluids

Allergies: None

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

Symptoms: Fluids and monitoring

Other Meds: Lamital lipitor Eliquest Prilosec Zoloft Vitamin B12 Vitamin D3 Magnesium

Current Illness: No

ID: 1715684
Sex: F
Age: 62
State: MA

Vax Date: 09/01/2021
Onset Date: 09/18/2021
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: Bloodwork MRI brain , cat scan of head and neck

Allergies: Chantex, Lipitor, vicodin

Symptom List: Pain in extremity

Symptoms: Severe dizziness could not stand or walk, went to ER and tested for stroke MRI of the Brain, CAT Scan of the head and neck admitted into the hospital for observation was perfectly in good health until after receiving the vaccine

Other Meds: Levothyroxine

Current Illness: None

ID: 1715685
Sex: F
Age: 31
State: IA

Vax Date: 09/13/2021
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:
Dose Series: 2
Vax Route:
Vax Site:

Lab Data: none

Allergies: lactose

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

Symptoms: within 48 hours developed sinus congestion and pain, fever 100.5 and severe flare on neuralgia in her LUE

Other Meds: gapaentin, apap, Kurvelo

Current Illness: old traumatic injury to LUE from trauma occasional pain flares uses 7 tramdol at the most in one month

ID: 1715686
Sex: M
Age: 87
State: IL

Vax Date: 03/11/2021
Onset Date: 08/09/2021
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:

Allergies:

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

Symptoms: Pt received Pfizer x2. Pt tested COVID + on 8/9/21 and admitted to hospital for COVID on 8/9/2021. Pt receiving remdesivir and dexamethasone.

Other Meds:

Current Illness:

ID: 1715687
Sex: F
Age: 62
State: TX

Vax Date: 02/27/2021
Onset Date: 02/27/2021
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: I felt lightheaded and my arm was immediately very sore. I stayed on site for 1/2 an hour and then drove home. While driving, I had a very strong sensation of intense heat internally, mostly in my chest area and a tingling sensation down my left arm. I flagged down a driver who called an ambulance to my location. I stayed in the ambulance about 20 minutes till my family came. During that time, I felt slightly nauseous but the sensation of internal heat ceased. I had no further discomfort.

Other Meds: Celexa 20mg. Once daily at 8am.

Current Illness: None.

ID: 1715688
Sex: M
Age: 79
State: OH

Vax Date: 01/27/2021
Onset Date: 09/19/2021
Rec V Date: 09/20/2021
Hospital: Y

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

Lab Data: COVID swab, 9.19.21

Allergies: neosporin

Symptom List: Vomiting

Symptoms: patient acquired COVID after immunization

Other Meds:

Current Illness:

ID: 1715689
Sex: F
Age: 91
State: MI

Vax Date: 02/02/2021
Onset Date: 09/07/2021
Rec V Date: 09/20/2021
Hospital: Y

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

Lab Data: "Detected" COVID swab reported to the BCHD on 08/19/2021.

Allergies: Claritin (dizziness), gabapentin (sedation/confusion), lipitor (muscle symptoms), Penicillins (rash), sulfas (rash)

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Patient fully vaccinated for COVID admitted inpatient with original COVID positive test on 08/19/21. Patient with hypoxia (80's) and shortness of breath on 09/07/21 and presented to ED, she admitted to receive remdesivir, O2, dexamethasone. Respiratory needs maintained in mid to high 90's on 1L O2. Discharged home on 09/09/2021 with Homecare support and O2 at 1L/NC.

Other Meds: Abatacept, tylenol, fosamax, prozac, lasix, norco, lisinopril, mothotrexate, toprol XL, multivitamin, zanaflex.

Current Illness:

ID: 1715690
Sex: M
Age: 12
State: OR

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: RA

Lab Data:

Allergies: NKA

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

Symptoms: No adverse event noted. Patient too young to receive Janssen and RN administered in error.

Other Meds:

Current Illness:

ID: 1715691
Sex: F
Age: 30
State: WA

Vax Date: 09/14/2021
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: None

Symptom List: Injection site swelling, Limb discomfort

Symptoms: I have muscle aches, headaches, it felt like i had the flu

Other Meds: None

Current Illness: None

ID: 1715692
Sex: F
Age: 44
State: IN

Vax Date: 03/22/2021
Onset Date: 03/22/2021
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: yes ekg and blood draws

Allergies: cascn

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

Symptoms: fever, chills, tiredness. fatigue, nausea, diarrhea, headaches, blood pressure became high

Other Meds: Tylenol

Current Illness: -no

ID: 1715693
Sex: M
Age: 58
State: FL

Vax Date: 09/06/2021
Onset Date: 09/08/2021
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: none

Allergies: None

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

Symptoms: I got the injection in upper left sholder. The next day I had a bit of pain. The second day the pain was down my arm. At the same time the second day I had a feeling of Fatigue and a bad headache. I felt like I had the flu. The forth and fifth day I was feeling very Lethargic and slept a bunch. I also had pain in my somach. I started to feel better about day 6.

Other Meds: Testosterone CYP 200 MG/ML .5ml every two weeks Tadafafil 5mg Carvedilol 12 .5 MG 2 X per day Mil Thistle 275 mg Vitamin C 1000 Mg per day Vitamin D 500 Mg per day

Current Illness: none

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am