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: 1720521
Sex: F
Age: 25
State: AZ

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

Lab Data: None - sent home from work due to fever

Allergies: Fructose, melon, sweet potato, red pepper, cherry

Symptom List: Dysphagia, Epiglottitis

Symptoms: Shortness of breath/trouble breathing - took multiple puffs of albuterol (prescribed for mild-moderate asthma). 5 puffs taken total - 9/21/21 @ 0200, 0430, 0715 Headache/migraine - tylenol taken - 09/20/21 & 09/21/21 Fever 09/20/21 & 09/21/21 Muscle aches - muscle relaxer taken - 09/20/21 & 09/21/21 Nausea - 09/20/21 & 09/21/21 Runny nose - 09/21/21

Other Meds: None

Current Illness: None

ID: 1720522
Sex: F
Age: 42
State: TX

Vax Date: 07/17/2021
Onset Date: 07/17/2021
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: Cane sugar corn eggs Cow milk Wheat

Symptom List: Anxiety, Dyspnoea

Symptoms: Extreme exhaustion (lasting 2 months, getting better over time) Cold ?brain freeze? headaches on left side of head, 2 months(again, lessening over time) Cold shocks in calves, lasted about 3 weeks Hot then cold in entire left side of body, started one hour after injection, lasted about an hour Sore left arm for about 24 hours Dizziness

Other Meds:

Current Illness:

ID: 1720523
Sex: F
Age: 54
State: CA

Vax Date: 09/18/2021
Onset Date: 09/18/2021
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: NONE

Allergies: NKA

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

Symptoms: 9/18 HEADACHE, LIGHT MENSTRUAL BLEEDING 9/19 HEADACHE, LIGHT TO MODERATE MENSTRUAL BLEEDING Rx Paracetamol 1 GRAM + IBUPROFEN 200 MG 9/20 MODERATE TO HEAVY MENSTRUAL BLEEDING 9/21 HEAVY MENSTRUAL BLEEDING

Other Meds: LOSARTAN 50 MG OD, SIMVASTATIN 20 MG OD, ELDERBERRY 2000 MG OD, ZINC 35 MG OD, CALCIUM 500 MG OD, VITAMIN D 50,000 IU EVERY WEEK

Current Illness: NONE

ID: 1720524
Sex: M
Age: 42
State: MN

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

Lab Data:

Allergies: None

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Lightheaded and hives all over

Other Meds: Temazepam, ibuprofen, vitamin d, fish oil, Buspar, diazepam, sulfatrimethozone, adderall, diflucan

Current Illness: Tooth abcess, hidrenatis supervia, yeast infection

ID: 1720525
Sex: F
Age: 29
State: CA

Vax Date: 07/22/2021
Onset Date: 07/01/2021
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: None

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

Symptoms: Missing period since July after the covid shot

Other Meds: Prenatals, vitamin d, myo chiro d insitol

Current Illness: None

ID: 1720526
Sex: F
Age: 67
State: MN

Vax Date: 03/01/2021
Onset Date: 07/15/2021
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: Aug 27 of 2021: complete blood labs were taken and doctor visit on that same day.

Allergies: No known allergies

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

Symptoms: I started having leg and foot cramps nightly. The cramps occur every night and are quite severe so that I cannot sleep. There is residual pain from some of the cramps for days afterward. I also am experiencing all over body aches in both arms and legs. I also am suffering unusual fatigue where I cannot keep my eyes open even during the day. I am also experiencing occasional headaches. I never had these issues previously except for occasional cramps related to unusual amount of activity but never every day and night. I have tried massage, stretching, high dosages of Magnesium, drinking more water, etc. Nothing seems to help. Am currently taking Hylands leg cramps PM pills at bedtime and they dont work either. I visited my Primary Care doctor on August 27th. He ran blood tests to see if anything abnormal and all came back in normal ranges. He referred me to rheumatologist but I cannot get an appt til late Nov.

Other Meds: Vitamin D, calcium, turmeric supplements, No prescriptions

Current Illness: No illnesses; Received a cortisone shot in knee around that time

ID: 1720527
Sex: M
Age: 72
State: OH

Vax Date: 09/07/2021
Onset Date: 09/10/2021
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: none

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: 3 days after I had the shot, a fairly mobile lump developed in my left armpit. I thought is was perhaps a swollen lymph node but I haven't noticed this before with flu shots that I take regularly. After a couple of days the lump became painful and inflamed but generally I felt fine. I mentioned this irritant when I was seeing a rheumatologist (first time about my painful hands) early in the morning 7 days after the vaccination . He looked at the armpit area and said it looked like a cyst that had not come to a head yet but to monitor it. That night it started to drain onto the armpit skin with a clear fluid that was not smelly. Now two weeks after the original flu shot it has almost totally disappeared. I have no idea if this is typical for a swollen lymph node or if this is just coincidental with the shot but I am not aware of having a cyst in either armpit previously

Other Meds: Metformin (2x 1000 mg), Glimepiride, Lisinopril, Hydrochlorothiazide 25 mg, Atorvastatin 40 mg, Multivitamin, MgO (400 mg), Vitamin D3 (50 mcg), Turmeric (1500 mg x2), Glucosamine MSM (1500 mg x 2)

Current Illness: Arthritis in hands and foot

ID: 1720528
Sex: F
Age: 25
State: MA

Vax Date: 04/17/2021
Onset Date: 05/18/2021
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: During the second episode of heavy bleeding, I visited Urgent Care on 6/19/21. They took a test that showed I was anemic due to the blood loss.

Allergies: Penicillin

Symptom List: Pharyngeal swelling

Symptoms: Following my second dose of the vaccine on 5/8/21 (Lot #EW0183) I had an irregularly long and heavy period for 3 months. This included extremely heavy bleeding (going through a pad + tampon every hour) for 11-15 days each month, with blood clots the size of my fist for 6-8 of those days each months. This is far heavier than my regular period that I've had for over a decade. I also had the Nexplanon implant at the time of vaccination and symptoms.

Other Meds:

Current Illness:

ID: 1720530
Sex: F
Age: 25
State: TN

Vax Date: 09/19/2021
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: None

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Dizziness, ringing in ears, trouble focusing

Other Meds: Ibuprofen

Current Illness: None

ID: 1720531
Sex: F
Age: 47
State: AZ

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

Lab Data: N/A

Allergies: none

Symptom List: Diarrhoea, Nasal congestion

Symptoms: pain and coldness in wrist and hand

Other Meds: protonix, flu vaccination

Current Illness: unknown

ID: 1720532
Sex: F
Age: 50
State: GA

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

Lab Data: None

Allergies: Latex

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

Symptoms: Developed a low grade temperature starting in the early evening, and then it increased to a high of 103.5 ?F by 10:30pm. I was cold, but I did not have the normal chills associated with a flu. I did not experience any upper respiratory symptoms except for chest tightness. I had a headache (mid-range) and also muscle aches. I took ibuprofen just before midnight so that I could sleep. I woke up with a temperature the following morning, and it was consistently between 102 and 102.5 ?F for much of the day. I did not take any fever reducers until 10pm. The next morning, I was still running a temperature, but it was low grade. All other symptoms had dissipated. By Sunday I was fine. I did note shooting pains in my right leg around 2 weeks after the injection.

Other Meds: None

Current Illness: None

ID: 1720533
Sex: F
Age: 25
State: MI

Vax Date: 06/08/2021
Onset Date: 06/28/2021
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: Blood work: two weeks after onset: 07/12/2021. No remarkable findings EMG: 08/19/2021: no remarkable findings MRI of brain: 09/11/2021. No remarkable findings

Allergies: Bactrim

Symptom List: Rash, Urticaria

Symptoms: Initially: Parathesia in right leg. Other altered sensations progressed to right and left legs, some in arms/back.

Other Meds: Apri birth control, lexapro

Current Illness:

ID: 1720534
Sex: F
Age: 49
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: IM
Vax Site: LA

Lab Data:

Allergies: no

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

Symptoms: Patient with history of fainting fainted 2 minutes after receiving the J&J COVID vaccine while still siting on the vaccination chair. Patient was carefully lowed to the floor. She regained consciousness while reached floor. She denies any medical history. Her last annual check up was Jan, 2021. Her VS was checked. Her initial VS at 12:49: BP 114/68; P 68, Res 16; O2 sat 100%. She was given water and snack and she rested on the floor mat for approx 30 mins. Her VS has been checked several times and has been stable. She left the vaccination site symptom free.

Other Meds: no

Current Illness: no

ID: 1720535
Sex: M
Age: 48
State: AZ

Vax Date: 05/03/2021
Onset Date: 05/03/2021
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: Glucose Urea Nitrogen (BUN) Creatinine GFR Estimated (Non-African American) GFR Estimated (African American) BUN/Creatinine Ratio Sodium Potassium Chloride Carbon Dioxide (CO2) Anion Gap Protein, Total Albumin Globulin Albumin/Globulin Ratio Calcium Alkaline Phosphatase Alanine Aminotransferase Aspartate Aminotransferase Bilirubin, Total Cholesterol Triglyceride Cholesterol/HDL Ratio HDLCholesterol Non-HDL Cholesterol LDL Cholesterol, Calculated VLDL Cholesterol

Allergies: NKA

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

Symptoms: SEVER SWELLING. COULD NOT WALK FOR THREE DAYS DUE TO SWELLING AFFECTING LOWER BACK. LEFT SIDE OF BODY IS STILL SWOLLEN. SEVERE CHRONIC FATIGUE STILL AFFECTING ME. I NOW HAVE DIABETES. LAST 5 YEARS OF PHYSICALS SHOW BLOOD SUGAR NORMAL. DAILY HEADACHES.

Other Meds: Escitalopram 20mg daily Losartan/Hctz 100/12.5mg once a day Esomeprazole 40mg daily Metformin Hcl Er 500mg two tabs BID Turmeric Curcumin 500mg daily Alprazolam .5mg PRN Flonase once a day Benadryl PRN Metamucil once a day Tylenol PRN Ibupr

Current Illness: NONE

ID: 1720536
Sex: F
Age: 33
State: CA

Vax Date: 09/18/2021
Onset Date: 09/21/2021
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: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: a higher dose which was withdrawn straight out without mixing with the sodium chloride 0.9% was given to the patient. The patient has not experienced side effects so far. Her primary doctor was informed.

Other Meds:

Current Illness:

ID: 1720537
Sex: F
Age: 77
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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Pt received expired dose. It was reconstituted at 11 AM and pt was given dose at 7:15PM. Pt chose not to get an addition dose at this time.

Other Meds:

Current Illness:

ID: 1720538
Sex: F
Age: 38
State: CA

Vax Date: 08/22/2021
Onset Date: 08/23/2021
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: Physical exam showed myositis, muscle spasms, tendonitis and muscle spasms. Labs showed an increase in sedimentation rate and TSH levels are doubled.

Allergies: none

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

Symptoms: 1st day very sore left arm applied ice and took tylenol. Pain started radiating up my neck and had shooting pain in my shoulder down to my shoulder blade. No one could even touch my arm it hurt so much. 2nd day- Soreness increased around my shoulder joint up my neck and down my shoulder blade. My injection site was still very sore. Felt like I was in a car accident not given a safe shot. 3rd day- Injection site soreness started to calm down. Pain increased around my shoulder joint, up my neck and down my shoulder blade. 4th day until now- it hasn't changed, I have to ice my arm several times a day, complete stretches/physical therapy. My doctor increased my celebrex from 200 mb twice a day to 400 mg twice a day.

Other Meds: Toprol XL 50 mg, Prilosec 25mg, 200 mg celebrex twice a day, Keppra 750 mg, multivitamin, vitamin D, calcium/magnesium complex.

Current Illness: none

ID: 1720539
Sex: M
Age: 52
State: FL

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

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

Lab Data:

Allergies: Pencillin

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Fever, chills, sweats, headache, irritability. Events were cyclical and repeating. Days later, extreme fatigue, labored breathing, elevated heart rate to point of being painful. Accustomed to working outside. 3 days after second injection, just walking outside to inspect building led to needing 45 minutes in full fan AC in truck and 30 oz water. Not normal.

Other Meds: Cymbalta

Current Illness: None

ID: 1720540
Sex: F
Age: 59
State: OR

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

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Chills, muscle aches, headache, fatigue, low grade fever, sore arm

Other Meds: None

Current Illness: None

ID: 1720541
Sex: F
Age: 44
State: CA

Vax Date: 08/22/2021
Onset Date: 09/17/2021
Rec V Date: 09/21/2021
Hospital:

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

Lab Data: None

Allergies: penicillin

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

Symptoms: Severe pain and limited movement of middle finger on right hand after first shot. Pain became even more severe after second short and this time included my thumb on left hand with the same type of pain and limited movement.

Other Meds: none

Current Illness: none

ID: 1720542
Sex: M
Age: 32
State: CA

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: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Diarrhea, Left arm pain, Left side rib cage and armpit pain.

Other Meds:

Current Illness:

ID: 1720543
Sex: M
Age: 15
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: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Unevaluable event

Symptoms: None, but gave moderna to a 15 year old, which was not approved for that age

Other Meds: None

Current Illness: None

ID: 1720667
Sex: M
Age: 48
State: AZ

Vax Date: 07/15/2021
Onset Date: 07/18/2021
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: 8/4/2021-ER visit 8/14/2021- seen by cardiologist 8/29/2021- admitted to the hospital with respiratory failure 9/1/2021-Troponin 1800 and 1200, changes on EKG that were not present previously,

Allergies: Percocet

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

Symptoms: Chest pain that required emergency room visits, referral and visit with cardiology, and resulted in an MI

Other Meds: Lyrica

Current Illness: None

ID: 1720668
Sex: M
Age: 26
State: CA

Vax Date: 09/20/2021
Onset Date: 09/21/2021
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:

Allergies: None

Symptom List: Injection site pain, Pain

Symptoms: 102 fever, body ache, Diarrhea, nausea, head ache.

Other Meds: None

Current Illness: Covid 1 month prior

ID: 1720669
Sex: M
Age: 17
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: SYR
Vax Site: LA

Lab Data: na

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: patient was given a Moderna COVID-19 vaccine on in Aug 2021. After giving realized patient was less than 18. Reported as a VAERS previously. Today pt presents for 2nd vaccine. I administered a 2nd Moderna vaccine to complete the series. Patient and guardian aware of the Moderna vaccine being administered and acknowledged and gave permission for second.

Other Meds:

Current Illness:

ID: 1720670
Sex: M
Age: 36
State: TN

Vax Date: 09/13/2021
Onset Date: 09/17/2021
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: CBC, CMP, vitamin D, sed rate, CRP. Only abnormality was low vitamin D

Allergies: None

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

Symptoms: Patient experienced expected fatigue, body aches, fever, chills for 4 days. On day 4 Patient started having intense intrusive suicidal thoughts which made him tearful because he reportedly said he did not want to commit suicide but could not get the thoughts out of his head. Suicidal ideation, agitation, crying and inability to complete ADL's continued until patient was able to receive a ketamine infusion on late evening 9/18/21. He was seen by his PCP on 9/20/21

Other Meds: Pristiq 40mg, Buspar 15mg BID, modafiil 200mg BID

Current Illness:

ID: 1720671
Sex: F
Age: 64
State:

Vax Date: 09/01/2021
Onset Date: 09/18/2021
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: Blood work pending.

Allergies: Latex-sensitivity.

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Prolonged headache, back/neck ache, nausea, dizziness.

Other Meds: Supplements only.

Current Illness: None.

ID: 1720672
Sex: F
Age: 58
State: AK

Vax Date: 09/14/2021
Onset Date: 09/15/2021
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: RA

Lab Data: No

Allergies: No

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Achy body, fever, chills.

Other Meds: Levothyroxine, fish oil, collagen pills.

Current Illness: No

ID: 1720673
Sex: F
Age: 23
State: CO

Vax Date: 09/20/2021
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: RA

Lab Data:

Allergies: Sulfa drugs and Rocephin

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

Symptoms: Extreme bloating/stomach distended (i look 6 month pregnant) and bad cramping in my uterine region and my upper abdomen

Other Meds: Phentermine 37.5 MG Symbalta 60 MG

Current Illness:

ID: 1720674
Sex: M
Age: 53
State: ME

Vax Date: 04/21/2021
Onset Date: 05/05/2021
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: First date I could get to see Ear/Nose/Throat doctor is not until December 2021.

Allergies: none

Symptom List: Nausea

Symptoms: Tinnitus. Volume is really loud and has not diminished over time. I now live with it every day and it is debilitating, painful, and creates hearing loss

Other Meds: none

Current Illness: none

ID: 1720675
Sex: F
Age: 54
State: NC

Vax Date: 09/20/2021
Onset Date: 09/20/2021
Rec V Date: 09/22/2021
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 at this time

Symptom List: Injection site pain

Symptoms: low fever, left arm pain, swollen arm , very tired, nausea, neck pain, heavy body ache, headache .

Other Meds: coconut oil 1.000 mg, magnesium 400mg, melatonin 10mg , Gaba 750 mg , focus factor . did not take for 2 days before received the vaccine.

Current Illness: none

ID: 1720676
Sex: F
Age: 32
State: TX

Vax Date: 08/12/2021
Onset Date: 08/01/2021
Rec V Date: 09/22/2021
Hospital: Y

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

Lab Data: Several tests 9/11-9/13 at hospital. Blood work, mri, ct, lumbar puncture

Allergies: No

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

Symptoms: Fingers began to go numb and tingly, then 2 and a half weeks later both legs became tingly and numb, then other arm. Went to hospital, could barely move legs for about 2 days, had no reflexes in extremities, severe weakness. Sedation to hands/arms has come back but legs are still severely weak. I can walk with assistance of a walker.

Other Meds: Adderall, birth control

Current Illness: None

ID: 1720677
Sex: M
Age: 40
State: MS

Vax Date: 09/20/2021
Onset Date: 09/21/2021
Rec V Date: 09/22/2021
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: Chills, sweats, headache, body ache, restless legs, dizziness, fatigue, low grade fever, shortness of breath, difficulty walking or performing any type of physical activity. Telephones physician. Used Tylenol and ibuprofen. After 12 hours, muscle aches and headache diminished. Dizziness and chills persist. No fever 24 hours after vaccine.

Other Meds:

Current Illness:

ID: 1720678
Sex: F
Age: 58
State: NJ

Vax Date: 09/17/2021
Onset Date: 09/18/2021
Rec V Date: 09/22/2021
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: Tremor

Symptoms: Patient stated on the phone she was nauseous right after the vaccine. On Saturday, the day after the vaccine, she states her top lip was tight and red. It was slightly evident Friday, but more apparent on Saturday as it bothered her more.

Other Meds:

Current Illness:

ID: 1720679
Sex: M
Age: 55
State: MO

Vax Date: 05/01/2021
Onset Date: 08/01/2021
Rec V Date: 09/22/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: Low T effecting strength and stamina

Other Meds:

Current Illness:

ID: 1720681
Sex: F
Age: 57
State: VA

Vax Date: 09/18/2021
Onset Date: 09/19/2021
Rec V Date: 09/22/2021
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 at this point. 9/21/21

Allergies: Flecanide

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

Symptoms: Prolonged, continuous cardiac arrhythmias, approximately 12-15 hours duration despite normal medication that usually controls them. Began about 30 hours after injection, resolved at about 48 hours after injection. Swelling, redness below injection site, warm to touch approximately 6?x 3? area. Began about 30 hours after injection. Swelling has lasted at least 36 hours at current date. No signs of improvement to this point despite repeated application of steroid cream, oral antihistamines and h2 blockers.

Other Meds: Humira injection q 2 weeks Atenolol Zyrtec Vit b12 Calcium supplement Vit c Vit D Multi vitamin for women Azo probiotic

Current Illness: None

ID: 1720682
Sex: M
Age: 50
State: WA

Vax Date: 04/28/2021
Onset Date: 06/02/2021
Rec V Date: 09/22/2021
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: None

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

Symptoms: Heart attack

Other Meds: Losartan

Current Illness: None

ID: 1720683
Sex: M
Age: 29
State:

Vax Date: 07/27/2021
Onset Date: 07/28/2021
Rec V Date: 09/22/2021
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: Poison Oak

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Chest pain centered at the heart. Pain was both consistent (at a level 3/10) and would at times spike in pain level (to 7/10). No chest pain has ever been felt as severe as this before. The pain started earlier the day after the vaccine and became worse at night. Throughout the rest of that week it took at least 4-5 days before I felt comfortable enough to run and continue my usual physical activities.

Other Meds:

Current Illness:

ID: 1720684
Sex: F
Age: 39
State: CA

Vax Date: 09/17/2021
Onset Date: 09/17/2021
Rec V Date: 09/22/2021
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: Beginning a few hours after injection I had left arm pain. Then began a fever of 101.4. Then sever body aches and joint pain to the point of near immobility. Swollen lymph nodes. Extreme fatigue. Was prescribed dexamethasone and Toradol for symptoms the day after as I was incapacitated and in tears.

Other Meds:

Current Illness:

ID: 1720685
Sex: M
Age: 62
State: MD

Vax Date: 05/06/2021
Onset Date: 05/21/2021
Rec V Date: 09/22/2021
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: 1. Facial Numbness-CT Scan of Sinuses 6/21/2021, MRI of Head 8/27/2021 both unremarkable. 2. Atrial Flutter-EKG 8/3/2021. 3-day heart monitor 8/3/2021-8/6/2021.

Allergies: Aspirin

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

Symptoms: 1. Numbness on right side of nose and under right eye. Amoxicillin followed by Clavulanate starting 5/28/2021. Clindamycin starting 6/23/2021. Condition still exists. 2. Atrial Flutter. First detected on 7/27/2021. Condition still exists. Ablation scheduled for 10/15/2021. Atrial Flutter-Echocardiogram 8/9/2021.

Other Meds: Janumet 50/1000mg, Jardiance 25mg, Glimeperide 4mg, Singulair 10mg, Allegra 180mg, HCTZ 25mg, Trililpix 135mg, Vyvanse 70mg.

Current Illness: None

ID: 1720686
Sex: F
Age: 72
State: WA

Vax Date: 09/17/2021
Onset Date: 09/17/2021
Rec V Date: 09/22/2021
Hospital:

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

Lab Data:

Allergies: Bee stings Chronic Pathogenic Urticaria

Symptom List: Pain in extremity

Symptoms: Swollen shoulder & arm down into armpit Redness around arm at shoulder Trouble lifting arm, cannot lay on it Headache and fuzzy headed

Other Meds: Vitamin & mineral supplements Levothyroxine Estrodiol

Current Illness: None

ID: 1720687
Sex: F
Age: 55
State: ID

Vax Date: 08/31/2021
Onset Date: 09/03/2021
Rec V Date: 09/22/2021
Hospital:

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

Lab Data: None yet. Appointment scheduled with doctor for November 28, 2021

Allergies: None

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

Symptoms: Fever and chills, muscle pain began after 12 hours and lasted until 72 hours after injection. Used ibuprofen to control symptoms, but was confined to bed for two days. Noticable hair loss began on day 4. I have lost about 30-40% of my hair and it is still falling out 17 days later! My scalp is now showing through my hair! Also, joint pain in my fingers began about the same time and continued for about one week. (This is no longer a problem.). My only guess is that I received the vaccine too soon after recovering from Covid-19. I was sick with Covid symptoms from June 28-July 11th

Other Meds: Atorvastatin 40, CoQ10, multivitamin, fish oil

Current Illness: None

ID: 1720688
Sex: F
Age: 37
State: GA

Vax Date: 05/22/2021
Onset Date: 05/22/2021
Rec V Date: 09/22/2021
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: Going to a cardiologist/ have a neurologist app set can?t get in until nov /

Allergies: Eggs Dairy Adhesives

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

Symptoms: Seizures almost everyday, Weak, nauseous, lethargic everyday, appetite has changed / can?t eat or smell the same foods I use to enjoy, motion sickness, can?t stand long, Very low energy. Tried immune suppressant worked for a short period of time went through physical therapy couldn?t walk by myself after getting out of the hospital. I?m still sick but not as bad and it?s September. Currently experiencing irregular heart beats.

Other Meds: Wellbutrin Lyrica Buspirone Oxycodone

Current Illness: N/A

ID: 1720689
Sex: F
Age: 43
State: IL

Vax Date: 09/14/2021
Onset Date: 09/15/2021
Rec V Date: 09/22/2021
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: latex

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

Symptoms: muscles aches, chills, severe headache, dizziness, nauseous, sore throat

Other Meds: Was told by Primary Care Physician Nurse to take Tylenol every 4 hours and drink lots of fluids

Current Illness: None

ID: 1720691
Sex: M
Age: 48
State: GA

Vax Date: 09/17/2021
Onset Date: 09/18/2021
Rec V Date: 09/22/2021
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: Elbow swollen 3x normal size within a 10 minute period. Hot and painful to the touch. Red rash reaction between half of bicep and halfway down forearm

Other Meds: None

Current Illness: None

ID: 1720692
Sex: M
Age: 43
State: CA

Vax Date: 04/29/2021
Onset Date: 04/30/2021
Rec V Date: 09/22/2021
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: CK 2,760 IU/L (6/24/21) CK-MB 41.8 ng/mL (6/24/21) Aldolase: 16.5 U/L (6/24/21)

Allergies: None

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Rhabdomyolisis and Myocarditis

Other Meds: Aspirin 81 mg daily

Current Illness: None

ID: 1720693
Sex: M
Age: 31
State:

Vax Date: 09/16/2021
Onset Date: 09/16/2021
Rec V Date: 09/22/2021
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: EKG with Global ST elevation with PR depression also positive x-rays demonstrating pericarditis.

Allergies: Amoxicillin

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

Symptoms: Pericarditis demonstrated within 15 mins of vaccine

Other Meds: Multivitamin, Fish oil, N-acetyliene-Crystalline (per patient), CO-Q10,

Current Illness: None

ID: 1720694
Sex: F
Age: 34
State: NH

Vax Date: 08/01/2021
Onset Date: 09/02/2021
Rec V Date: 09/22/2021
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: 9/6 seen at PRH- Dover Walk in ED Dover NH 03820, EKG, chest XRAY, laboratory testing

Allergies: imitrex,

Symptom List: Injection site swelling, Limb discomfort

Symptoms: chest pain, shortness of breath, body aches, fatigue and malaise

Other Meds: Adderall IR, Vyvanse, Celebrex, Celexa, Colchicine if needed

Current Illness: NONE

ID: 1720695
Sex: F
Age: 14
State: IL

Vax Date: 08/01/2021
Onset Date: 09/02/2021
Rec V Date: 09/22/2021
Hospital:

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

Lab Data: Electrocardiogram- Sept 4, 2021, Echocardiogram- Sept 6 2021, COVID and Dengue Test, Hematic biometry- Thursday August 29, September 6- Hematic biometry, c-reactive protein, ferritin, D-dimer, amylase, lipase, troponin I.

Allergies: None

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

Symptoms: Reaction occurred 3 days after vaccination. presenting high fever, pain muscle, accelerated heart rate, very severe pain in joints, rash and very red eyes.

Other Meds: None

Current Illness: No

ID: 1720696
Sex: F
Age: 36
State: NC

Vax Date: 09/07/2021
Onset Date: 09/07/2021
Rec V Date: 09/22/2021
Hospital:

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

Lab Data:

Allergies: Pertussis Vaccine, TB test, Penicillin, cockroach, pecan tree pollen.

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

Symptoms: Urticaria and rash to trunk within 2 hours of receiving injection. Rash continued to spread throughout trunk and to extremities over the following 3 days; even with continued use of regular daily antihistamines and added oral diphenhydramine and topic hydrocortisone 1%.

Other Meds: Zyrtec, omeprazole, Flonase, Adderall IR, Adderall XR, Naprosyn, Prozac

Current Illness: None

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am