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: 1719334
Sex: F
Age:
State: NY

Vax Date:
Onset Date: 03/13/2021
Rec V Date: 09/21/2021
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: No

Symptom List: Dysphagia, Epiglottitis

Symptoms: Hearing loss

Other Meds:

Current Illness: no

ID: 1719336
Sex: F
Age: 47
State: CA

Vax Date: 09/21/2021
Onset Date: 09/21/2021
Rec V Date: 09/21/2021
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: Sulfamethoxazole with Trimethoprim

Symptom List: Anxiety, Dyspnoea

Symptoms: I started to feel nauseous and tingling left side of my throat, followed by an itchy sensation on my face and arms, heaviness in the back of my head and shortness of breath. I immediately felt my blood pressure drop, but I did not check my actual blood pressure at the moment. The sensation lasted approximately 20 minutes

Other Meds: Omeprazol

Current Illness:

ID: 1719337
Sex: F
Age: 52
State: FL

Vax Date: 03/31/2021
Onset Date: 09/13/2021
Rec V Date: 09/21/2021
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: Employee tested positive during outbreak testing and now has loss of smell.

Other Meds:

Current Illness:

ID: 1719338
Sex: M
Age: 41
State: TX

Vax Date: 01/26/2021
Onset Date: 01/28/2021
Rec V Date: 09/21/2021
Hospital: Y

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

Lab Data:

Allergies: none

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Heart Attack

Other Meds: Mycophenolic Acid 360mg, SMX/TMP 400mg-80mg, Pantoprazole 40mg, Carvedilol 3.125mg, Valganciclovir 450mg, Prednisone 5mg, Envarsus XR 1mg,

Current Illness: none

ID: 1719339
Sex: M
Age: 62
State: IL

Vax Date: 09/21/2021
Onset Date: 09/21/2021
Rec V Date: 09/21/2021
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: Client was given 3rd dose of Pfizer after initial 2 dose series with Moderna vaccine

Other Meds:

Current Illness:

ID: 1719340
Sex: F
Age: 48
State: AL

Vax Date: 03/27/2021
Onset Date: 03/27/2021
Rec V Date: 09/21/2021
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: I went to eye dr. on 4/2/21 & again about a week later when my eyes weren't better and my other eye was also bothering me.

Allergies: Cow's milk, eggs, coffee beans, mozerella cheese, wheat

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

Symptoms: Immediately after shot my eyes started feeling wierd, and blurry. Over the next couple days I noticed my left eye wasn't centered. It was turned in toward right corner. My eye also began having spasms. In the next couple weeks my right eye also moved toward center, but not as bad as left eye. I went to eye dr. and she said I had swelling in eyes and gave me steroid eye drops. They helped but I had to go back a 2nd time for more drops. My eyes are better, but never compltely the same. I still need the drops. (Also note a nurse suggested I take an allergy medication after my 2nd shot. I did for about 10 days and my eyes didn't react as bad as with 1st shot.)

Other Meds: Atenylol Pantoprolol

Current Illness:

ID: 1719341
Sex: F
Age: 63
State:

Vax Date: 02/07/2021
Onset Date: 09/20/2021
Rec V Date: 09/21/2021
Hospital: Y

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

Lab Data: Cycle threshold 16.4.

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Hospitalization due to COVID 19. Reported per Moderna COVID vaccine EUA.

Other Meds:

Current Illness:

ID: 1719342
Sex: M
Age: 74
State: AZ

Vax Date: 03/16/2021
Onset Date: 05/15/2021
Rec V Date: 09/21/2021
Hospital:

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

Lab Data: Blood work 4th week of May.

Allergies: None

Symptom List: Pharyngeal swelling

Symptoms: No adverse reactions after the initial injection. The day after the 2nd injection I felt a mild ache in my joints (knees, hips, shoulders and elbows) and a feeling of tiredness. I napped on that day, as well as the 2nd full day after the 2nd injection. My joint ache was gone ny the 2nd day. 3rd day I was fine. About 7 weeks later my joints started to mildly ache, and within a week they were bad enough to keep me from sleeping more than 30 minutes at a time. It would take me about 5 minutes to get out of bed to stand up. I was very aware my symptoms were just about the same the same as after my 2nd. Covid injection, except much much more intense. I couldn?t stand or sit more than 5 Mins. It hurt to lie down. Went to the doctor and he diagnosed PMR and treated with 30 mg of prednisone the 1st day, then 15 mg a day after that. The 1st night after that I slept very well. My Naturapathic Doctor took a blood sample and verified the PMR finding. I followed this with Physical Theropy starting about a month later.

Other Meds: None

Current Illness: None

ID: 1719343
Sex: M
Age: 44
State: WA

Vax Date: 09/21/2021
Onset Date: 09/21/2021
Rec V Date: 09/21/2021
Hospital:

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

Lab Data:

Allergies: Doxycycline

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Approximately 20 minutes after receiving 2nd pfizer dose, I started feeling lightheaded/dizziness without vertigo. Feeling of head tightness. Still have the feeling while reporting this event.

Other Meds: none

Current Illness: none

ID: 1719344
Sex: M
Age: 16
State:

Vax Date: 09/16/2021
Onset Date: 09/16/2021
Rec V Date: 09/21/2021
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: None

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Pt w/ PMH significant for positive PPD in 2019. 13mins post vaccination pt c/o Dizziness. Vitals: @17:42 BP103/47, HR 67, RR 21, O2 Sat 100% -- > @17:52 110/69, 63, 18, 100% PT given H2O and taken to Med Room via WC to lay down. VS taken and WDL. Apple juice given. Dr and family at bedside. PT reported no dizziness and denied other symptoms and stated he was feeling better. PT educated, ambulated independently with steady gait. Left building accompanied by family. NAD.

Other Meds: None

Current Illness:

ID: 1719345
Sex: M
Age: 48
State: CA

Vax Date: 09/21/2021
Onset Date: 09/21/2021
Rec V Date: 09/21/2021
Hospital:

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

Lab Data:

Allergies: Nkda

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

Symptoms: Patient lost consciousness 10 minutes after receiving first dose of covid vaccine. He collapsed on the floor while seating in the monitoring area. Emergency number was called and paramedics arrived at the scene 5 minutes later. BP and glucose level was within normal limit but he was taken to the hospital.

Other Meds: None

Current Illness: None

ID: 1719346
Sex: F
Age: 0
State: IL

Vax Date: 09/21/2021
Onset Date: 09/21/2021
Rec V Date: 09/21/2021
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: Client received 3rd dose of Pfizer after initial 2 dose series with Moderna

Other Meds:

Current Illness:

Date Died: 09/15/2021

ID: 1719347
Sex: M
Age: 88
State: CA

Vax Date: 03/04/2021
Onset Date: 09/12/2021
Rec V Date: 09/21/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: severe shortness of breath

Other Meds:

Current Illness:

ID: 1719348
Sex: M
Age: 66
State: MI

Vax Date: 03/11/2021
Onset Date: 04/25/2021
Rec V Date: 09/21/2021
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 Not sure if related, just sent as a follow up.

Allergies: Drugs Allergic Reactions 1. Celestone 2. Flexeril 3. Zoloft

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

Symptoms: None

Other Meds: 1. Metformin HCL 1,000mg (Generic for Glucophage) 2X Daily 2. Potassium Citrate ER 15 MEQ TB - 1620mg (Generic for Urocit-K) 2X Daily 3. Januvia 100mg - Morning 4. Propafenone HCI 225mg (Generic for Rythmol) 2X Daily 5. Pentoxifylline ER 40

Current Illness: Turbinate Resection ? March 15, 2021

Date Died: 09/10/2021

ID: 1719349
Sex: F
Age: 88
State: VA

Vax Date: 07/27/2021
Onset Date: 08/01/2021
Rec V Date: 09/21/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: Patient experienced severe elevated blood pressure and a hemorrhagic stroke a few days post receiving 2nd dose of Moderna Covid vaccine. Patient was hospitalized and then moved to care facility. In care facility, patient experienced UTI and sepsis, which led to re-hospitalization. Due to issues swallowing, patient suffered aspiration pneumonia. Patient could not swallow properly post stroke, and directive was no feeding tubes. Thus, patient moved to hospice and subsequently passed away on 9/10/21.

Other Meds:

Current Illness:

ID: 1719350
Sex: F
Age: 39
State: FL

Vax Date: 05/19/2021
Onset Date: 07/16/2021
Rec V Date: 09/21/2021
Hospital:

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

Lab Data: blood work

Allergies:

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

Symptoms: I got cramps in my stomach. I got right arm and right leg pain. I could not move right arm and right leg for 16 hours. I went to ER. They did blood work, that my blood count was high.

Other Meds:

Current Illness:

ID: 1719351
Sex: F
Age: 55
State: AZ

Vax Date: 08/04/2021
Onset Date: 08/05/2021
Rec V Date: 09/21/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: skin burning, broke out with something that seemed like chicken pots , tired and nausea, upset stomach and fever

Other Meds:

Current Illness:

ID: 1719352
Sex: F
Age: 51
State: IL

Vax Date: 03/23/2021
Onset Date: 09/16/2021
Rec V Date: 09/21/2021
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: None

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Admitted for dizziness and hypotension

Other Meds: N/A

Current Illness: N/A

ID: 1719353
Sex: F
Age: 71
State: PA

Vax Date: 09/17/2021
Onset Date: 09/18/2021
Rec V Date: 09/21/2021
Hospital:

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

Lab Data:

Allergies: pine

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: severe diarrhea, fever, nausea, weak, numb legs

Other Meds: asthma blood pressure meds

Current Illness:

ID: 1719354
Sex: M
Age: 68
State: TX

Vax Date: 03/19/2021
Onset Date: 09/17/2021
Rec V Date: 09/21/2021
Hospital: Y

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

Lab Data: CBC, CMP, CXR, EKG, COVID, Cardiac profile

Allergies: NKA

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

Symptoms: SOB, cough

Other Meds: clopidegrel, atorvastatin, tamulosin, olmesartan, carvedilol

Current Illness:

ID: 1719355
Sex: F
Age: 32
State: SC

Vax Date: 08/25/2021
Onset Date: 08/28/2021
Rec V Date: 09/21/2021
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: Stomach scans, blood test, urine test

Allergies: None

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

Symptoms: The day after the shots I had a bad headache. The next day I was extremely sick with vomiting and diarrhea. I went to the emergency room 3 times and to several doctors. They can't seem to figure out what's wrong other than the shots. It's the only thing that was different.

Other Meds: Cymbalta, Lamictal. Multivitamin

Current Illness: None

ID: 1719356
Sex: F
Age: 35
State: IL

Vax Date: 09/16/2021
Onset Date: 09/16/2021
Rec V Date: 09/21/2021
Hospital:

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

Lab Data: none; was advised to call my physician if pain persists into the the next week

Allergies: latex

Symptom List: Unevaluable event

Symptoms: I am 9 weeks pregnant. First evening after receiving 1st dose of Pfizer, I felt sharp discomfort in my heart lasting 1-3 minutes, medially and inferiorly, while at work and resting at home, no exercise, no sob. That same night, I had heart flutters that woke me up from my sleep, it felt like my heart went out of rhythm and was trying to get back into normal rhythm. The next day (Day 2, 9/17/2021), I had sharp pains again with duration unchanged but occurred ~ ~4 times, at work and at home; no exercise, no sob. The 3rd day (Saturday 9/18/21), I woke up at 6am with sharp pains again and paged by OBGYN right away; was advised to call my physician if pain persists into the the next week. Day 4 (9/19/21), frequency had lessened. Day 5 (9/20/21) and Day 6 (9/21/21) sharp discomfort occurred less duration and frequency.

Other Meds: prenatal

Current Illness: none.

ID: 1719357
Sex: F
Age: 41
State: WA

Vax Date: 09/17/2021
Onset Date: 09/21/2021
Rec V Date: 09/21/2021
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: None

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

Symptoms: Left side of lower lip trembling

Other Meds: None

Current Illness: None

ID: 1719358
Sex: M
Age: 58
State: FL

Vax Date: 07/26/2021
Onset Date: 08/03/2021
Rec V Date: 09/21/2021
Hospital:

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

Lab Data: Covid test, cxr, lab work.

Allergies: Relafen

Symptom List: Injection site pain, Pain

Symptoms: Pt came to ER c/o cough, onset was several days.

Other Meds:

Current Illness:

ID: 1719359
Sex: F
Age: 35
State: TN

Vax Date: 09/10/2021
Onset Date: 09/11/2021
Rec V Date: 09/21/2021
Hospital:

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

Lab Data: She went to her primary care physician office where a CRP was ran and came back positive with a value of 1.36.

Allergies: None

Symptom List: Injection site pain, Menorrhagia

Symptoms: Around 24 hours after receiving second Moderna shot, the patient started experiencing shooting chest pain on left side that radiated to her back and had shortness of breath.

Other Meds: None

Current Illness: n/a

ID: 1719360
Sex: F
Age: 60
State: FL

Vax Date: 05/12/2021
Onset Date: 09/20/2021
Rec V Date: 09/21/2021
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: Patient tested positive for COVID-19 on 9/20/2021; patient has symptoms of chills, headache, coughing, body aches, loss of smell

Other Meds:

Current Illness:

ID: 1719361
Sex: F
Age: 63
State:

Vax Date: 02/15/2021
Onset Date: 09/20/2021
Rec V Date: 09/21/2021
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: Reported diagnosed with COVID 6 days before admission. Not confirmed. Cycle threshold on admission 33.8.

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Hospitalization due to COVID 19. Reported per Moderna COVID vaccine EUA.

Other Meds:

Current Illness:

ID: 1719362
Sex: F
Age: 78
State: HI

Vax Date: 09/20/2021
Onset Date: 09/20/2021
Rec V Date: 09/21/2021
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 received 2 doses of pfizer for primary series and received 1 dose of Johnson & Johnson vaccine. Vaccinator failed to check vams system if patient had received previous COVID-19 doses and patient checked "NO" on questionnaire for the following question: Have you ever received a COVID-19 vaccine.

Other Meds:

Current Illness:

ID: 1719363
Sex: M
Age: 48
State: CA

Vax Date: 05/04/2021
Onset Date: 07/17/2021
Rec V Date: 09/21/2021
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: All my blood work/lab results came back normal in August. Thyroid, iron, etc. were normal. My primary care doctor suspected maybe it was the recent upping of my lisinopril dosage but the hair loss continued and worsened weeks after I was switched to a different high blood pressure medicine. My hair was absolutely full and fine in June. This all just started in late July and has worsened until now mid-Sept.).

Allergies: penicillin (as a child)

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

Symptoms: Sudden, rapid hair loss and thinning of hair beginning in late July through to September 2021 across the crown of my head. The same thing also happened to my sister who got her Pfizer shots on the same day, roughly the same time, and the same location as me. Within a matter of weeks, my hair rapidly shed. I was under no more stress than I normally am and my father wasn't bald. My sister, who I was staying with from January to May, tested positive for Covid in January while I tested negative (but it came back positive for strep throat in Jan. after she tested positive for Covid). While it's not clear that the Pfizer vaccine triggered my hair loss, it's the only major shock to my system that my body received in the last four months leading up to this sudden hair loss. The possibility of hair loss as a side effect should at least be looked into, please. Thanks.

Other Meds: Lisinopril, Lexapro, Claritin, vitamins C and D

Current Illness:

ID: 1719364
Sex: F
Age: 95
State: ME

Vax Date: 02/26/2021
Onset Date: 04/20/2021
Rec V Date: 09/21/2021
Hospital: Y

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

Lab Data: Workup at the hospital

Allergies: no

Symptom List: Nausea

Symptoms: CVA several weeks after 2nd shot . Ambulated to Hospital ED on 4/20/21

Other Meds: Valsartan 40mg, furosemide 20mg, albuterol sulfate, Anoro ellipta 62.5 mcg-25mcg, lorazapam .5mg, escitalopram oxalate 5mg, atorvastatin calcium 80mg, amlodipine besylate 10mg, Vit D3 1,000 unit tab, multi vitamin, asprin

Current Illness: no

ID: 1719365
Sex: M
Age: 51
State: AZ

Vax Date: 09/10/2021
Onset Date: 09/12/2021
Rec V Date: 09/21/2021
Hospital:

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

Lab Data: SARS-CoV-2 rapid test (-) 2021-09-21; patient sent for chest x-ray, not yet available

Allergies: NKDA

Symptom List: Injection site pain

Symptoms: Patient has nonproductive cough without other symptoms, and without any history of respiratory problems. Patient tested negative for SARS-CoV-2 today in the office

Other Meds: Chlorthalidone 25 mg daily, lisinopril 10 mg daily, Metformin 1 g twice daily, Actos 30 mg daily, atorvastatin 20 mg daily

Current Illness: None

ID: 1719366
Sex: F
Age: 62
State: WY

Vax Date: 09/15/2021
Onset Date: 09/16/2021
Rec V Date: 09/21/2021
Hospital:

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

Lab Data: None

Allergies: Bee stings

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

Symptoms: After receiving the 3rd dose, I noticed the next day that I could not taste properly. Food tastes bland or no taste at all. Very spicy food can be tasted. It has been going on for 7 days now.

Other Meds: Xarelto Venlofaxine Nortryptoline Xydra drops

Current Illness: None

ID: 1719367
Sex: M
Age: 40
State: CA

Vax Date: 08/13/2021
Onset Date: 08/14/2021
Rec V Date: 09/21/2021
Hospital:

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

Lab Data: 9.20.21 - Bloodwork on vitamin levels I an have upcoming nerve conduction test.

Allergies: None

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

Symptoms: Intense right side of head headache, loss of hearing for about two minutes, persistent right eye twitch, num in right arm, leg and occasionally cheek, left leg numbness to point of losing strength to walk, ringing in right ear

Other Meds: Multivitamin

Current Illness: None

ID: 1719368
Sex: F
Age: 73
State: CO

Vax Date: 09/01/2021
Onset Date: 09/18/2021
Rec V Date: 09/21/2021
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: sulfa, dairy

Symptom List: Tremor

Symptoms: Nausea, vomiting, diarrhea, chills and fever, fainting and falling resulting in head injury

Other Meds: levothyroxine

Current Illness: none

ID: 1719369
Sex: F
Age: 50
State: MI

Vax Date: 09/21/2021
Onset Date: 09/21/2021
Rec V Date: 09/21/2021
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: NKA

Symptom List: Erythema, Pruritus

Symptoms: Patient stated she needed a first time Pfizer Vaccine. After administration, found in MICR that patient had been vaccinated with Moderna on 5/13/21 and 6/10/21. Patient states never received vaccines.

Other Meds: "blood pressure pills" unknown to patient type or dose

Current Illness: Unknown, denies illness at time of vaccination

ID: 1719370
Sex: F
Age: 32
State: FL

Vax Date: 04/08/2021
Onset Date: 08/03/2021
Rec V Date: 09/21/2021
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: Covid test.

Allergies: NKA

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

Symptoms: Pt came to ER c/o loss of sense of taste, mild sore throat, onset 3 days ago.

Other Meds:

Current Illness:

ID: 1719371
Sex: F
Age: 44
State: NC

Vax Date: 09/07/2021
Onset Date: 09/01/2021
Rec V Date: 09/21/2021
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: SWOLLEN, ABCESSED GUMS

Other Meds:

Current Illness:

ID: 1719372
Sex: F
Age: 68
State: CA

Vax Date: 04/18/2021
Onset Date: 05/02/2021
Rec V Date: 09/21/2021
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 - won't have results until Friday

Allergies: no

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Have a rash on my right shoulder area in my back now - it is raised and has little bumps. I don't have any treatment for it. I showed it to my doctor and she said to watch it. Back of my neck and the right part of my back shoulder is where it's at. I went to Urgent Care at - yesterday because I'm having symptoms relating to COVID. I have a headache, runny nose, sore throat and fever. No treatment for it yet.

Other Meds: Losartan 100 mg; Clintiapine (Seroquel) 400 mg; Citrulline - 100 mg; Atorvastatin - 80 mg; Pioglitazone - 45 mg; Glipizide 10 mg

Current Illness: no

ID: 1719373
Sex: F
Age: 45
State: SC

Vax Date: 06/23/2021
Onset Date: 06/24/2021
Rec V Date: 09/21/2021
Hospital:

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

Lab Data: None

Allergies: None

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

Symptoms: Broke out in a red rash that itched profusely.

Other Meds: None

Current Illness: None

ID: 1719374
Sex: M
Age: 26
State: FL

Vax Date: 09/21/2021
Onset Date: 09/21/2021
Rec V Date: 09/21/2021
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: n/a

Allergies: pcn

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

Symptoms: patient got pale and felt like he was going to faint. vomited. gave water felt better

Other Meds:

Current Illness: unknown

ID: 1719375
Sex: F
Age: 67
State: WI

Vax Date: 03/26/2021
Onset Date: 09/20/2021
Rec V Date: 09/21/2021
Hospital: Y

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

Lab Data: 9/5/2021 SARS CoV-2, PCR, Rapid, V positive

Allergies:

Symptom List: Pain in extremity

Symptoms: tested positive for COVID 9/5/21, was admitted to the hospital 9/20/21

Other Meds:

Current Illness:

ID: 1719376
Sex: F
Age: 92
State: FL

Vax Date: 02/04/2021
Onset Date: 08/04/2021
Rec V Date: 09/21/2021
Hospital: Y

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

Lab Data: Lab, cxr, covid test.

Allergies: NKA

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

Symptoms: Pt came to ER after fall with right side leg and hip pain.

Other Meds:

Current Illness:

ID: 1719377
Sex: F
Age: 57
State: WA

Vax Date: 03/01/2021
Onset Date: 03/01/2021
Rec V Date: 09/21/2021
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: I am allergic to Nickle sulfate based product.

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

Symptoms: After the vaccine 5 minutes after my voice cut in and out and continue to do it randomly. My arm was bleeding right after, the symptoms went on for 18 days then it improve. My voice still randomly cuts in and out. I had a blood vessel in my eye as well.

Other Meds: The only prescription I was on was thyroid medication.

Current Illness: None.

ID: 1719378
Sex: F
Age: 22
State: FL

Vax Date: 09/17/2021
Onset Date: 09/19/2021
Rec V Date: 09/21/2021
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: N/A

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

Symptoms: Multiple blood clots in urine each urination since 09/19/2021 following second Pfizer vaccination on 09/17/2021. No pain or discomfort associated.

Other Meds: N/A

Current Illness: N/A

ID: 1719379
Sex: F
Age: 32
State: AZ

Vax Date: 08/22/2021
Onset Date: 09/11/2021
Rec V Date: 09/21/2021
Hospital:

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

Lab Data: None

Allergies: none

Symptom List: Vomiting

Symptoms: Swollen armpit on the same arm as injection. Vaginal bleeding for 9 continuous days (not related to menstrual cycle as I am have been regular my whole life and was not within the normal time frame).

Other Meds: Larin Fe (Birth Control)

Current Illness: none

ID: 1719380
Sex: F
Age: 37
State: NC

Vax Date: 04/19/2021
Onset Date: 04/30/2021
Rec V Date: 09/21/2021
Hospital:

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

Lab Data:

Allergies: n/a

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: heavy menstrual bleeding, passing of clots during period, irregular bleeding during middle of cycle even after having a period 10 days prior, this has happened for 3 months and I'm not sure if my period has returned to normal. I was previously on birth control and often did not have a period but was consistently regular when I did have a period - it would be at end of birth control pack/placebo pills. Even on birth control I had this irregularity. I have since taken myself off birth control to try and get my body back to normal.

Other Meds: birth control

Current Illness: n/a

ID: 1719381
Sex: F
Age: 63
State: NC

Vax Date: 09/07/2021
Onset Date: 09/08/2021
Rec V Date: 09/21/2021
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: RED,SWOLLEN, SORE "SPLOTCHES", PRIMARILY ON OPPOSITE SIDE OF BODY THAN VACCINE ADMINISTRATION

Other Meds:

Current Illness:

ID: 1719382
Sex: M
Age: 36
State: NC

Vax Date: 08/26/2021
Onset Date: 08/26/2021
Rec V Date: 09/21/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: This patient unknowingly was given a second dose of Janssen. The patient reported he had not received a covid vaccine prior. When internet was back up and his data was entered it was discovered he had previously received a Janssen vaccine

Other Meds:

Current Illness:

ID: 1719383
Sex: F
Age: 58
State: AZ

Vax Date: 12/01/2020
Onset Date: 05/24/2021
Rec V Date: 09/21/2021
Hospital:

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

Lab Data: 12 x rays of joints showed calcium pyrophosphate and elevated WBC lab test. Colchicine and Hydroxychloroquin prescribed along with a reduction to 20 mg, then 10mg of prednisone.

Allergies:

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

Symptoms: Severe stiffness, pain developed in neck, bilateral shoulders, arms, hips, legs, ankles including muscles associated with those areas. Increasing g in severity to the point of being unable to move. This followed a right shoulder rotator cuff tear on 05/23/2021. Shoulder surgery scheduled for 07/02/2021 which was cancelled the day of surgery due to my severe autoimmune type symptoms. Emergency MRI showed negative to pinched cervical spine. Treatment was in ER of 60 mg Prednisone and follow up with rheumatologist Dr. is now evaluating my care and making recommendations to see how I respond.

Other Meds: Multivitamin, cinnamon, fish oil, calcium/vitamin D

Current Illness:

ID: 1719384
Sex: F
Age: 45
State: SC

Vax Date: 07/21/2021
Onset Date: 07/22/2021
Rec V Date: 09/21/2021
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: Broke out in a red rash that itched profusely.

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am