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: 1726668
Sex: M
Age: 37
State:

Vax Date: 09/22/2021
Onset Date: 09/22/2021
Rec V Date: 09/23/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Administration error mixed series mRNA vaccine Pfizer and Moderna.

Other Meds:

Current Illness:

ID: 1726669
Sex: F
Age: 34
State: CA

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data: None

Allergies: Peanuts, tree nuts, shell fish, tramadol, cats

Symptom List: Anxiety, Dyspnoea

Symptoms: Dizziness, off balance, really bad headaches, unable to stand without feeling like i will fall, one episode of vomiting, tired and low energy.

Other Meds: No

Current Illness: No

ID: 1726670
Sex: F
Age: 65
State:

Vax Date: 09/22/2021
Onset Date:
Rec V Date: 09/23/2021
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: Administration error mixed series mRNA vaccine Pfizer and Moderna.

Other Meds:

Current Illness:

ID: 1726671
Sex: F
Age: 31
State: NY

Vax Date: 01/10/2021
Onset Date: 09/13/2021
Rec V Date: 09/23/2021
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: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose12/20/21 2nd dose01/10/21 Diagnosed covid positive:09/15/21 Symptom onset:09/13/21 Exposure:home Symptoms:cough,fatigue,muscleaches

Other Meds:

Current Illness:

ID: 1726672
Sex: F
Age: 47
State: NC

Vax Date: 09/22/2021
Onset Date: 09/23/2021
Rec V Date: 09/23/2021
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: PCN

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

Symptoms: Muscle weakness, fatigue, fever, cough

Other Meds: None

Current Illness: Cold like symptoms but covid negative

ID: 1726673
Sex: F
Age: 35
State: FL

Vax Date: 09/23/2021
Onset Date: 09/23/2021
Rec V Date: 09/23/2021
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: none at this time.

Allergies: denied.

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

Symptoms: 5 minutes after vaccine was administered. Pt. was seen crying and complained of anxiety, chest pain/tightness, dizziness, and light headedness. Pt. was provided water, more closely observed. Pt. denied respiratory distress, nausea, diaphoresis. BP was taken: 159/114, HR: 79 at 4:05pm. BP taken at 4:14pm: 137/99, HR: 75. EMS was contacted. EMS vital signs: O2: 100%, BP: 136/80, HR: 70. Pt. denied wanting to go to hospital. Pt. reported sx improvement. Pt. was able to stand and walk without incident.

Other Meds: denied taking medications on 9/23/21. denied being on blood pressure medications.

Current Illness: reported 1 month ago hx of chest pain that prompted doctors visit and reported having high blood pressure. Pt. was unsure last BP reading.

ID: 1726674
Sex: F
Age: 24
State: NY

Vax Date: 01/10/2021
Onset Date: 09/14/2021
Rec V Date: 09/23/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose12/20/21 2nd dose01/10/21 Diagnosed covid positive:09/15/21 Symptom onset:09/14/21 Exposure:community Symptoms:loss of smell/taste,sore throat,runny nose

Other Meds:

Current Illness:

ID: 1726675
Sex: F
Age: 22
State: NJ

Vax Date: 01/28/2021
Onset Date: 09/14/2021
Rec V Date: 09/23/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose01/07/21 2nd dose01/28/21 Diagnosed covid positive:09/15/21 Symptom onset:09/14/21 Exposure: Symptoms:cough,fatigue,muscle aches,sore throat,runny nose, HA

Other Meds:

Current Illness:

ID: 1726676
Sex: F
Age: 46
State: MN

Vax Date: 08/29/2021
Onset Date: 08/31/2021
Rec V Date: 09/23/2021
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: After the side effects that were anticipated [chills, sweats, body aches], a very bad case of vertigo set in. I have struggled with vertigo from time to time in the past. It's been 3 1/2 weeks of on/off symptoms which are sometimes debilitating because of the dizziness and nausea.

Other Meds: Nuva Ring, Magnesium Glycinate

Current Illness: None

ID: 1726677
Sex: F
Age: 27
State: NY

Vax Date: 02/26/2021
Onset Date: 09/07/2021
Rec V Date: 09/23/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose02/05/21 2nd dose02/26/21 Diagnosed covid positive:09/14/21 Symptom onset:09/07/21 Exposure:travel Symptoms:fever,cough,fatigue,muscle aches,sore throat,chills

Other Meds:

Current Illness:

ID: 1726678
Sex: M
Age: 23
State: CA

Vax Date: 09/22/2021
Onset Date: 09/22/2021
Rec V Date: 09/23/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Pt received second dose 14 days after first dose instead of 21 days.

Other Meds:

Current Illness:

ID: 1726679
Sex: M
Age: 88
State:

Vax Date: 09/22/2021
Onset Date: 09/22/2021
Rec V Date: 09/23/2021
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: Administration error mixed series mRNA vaccine Pfizer and Moderna.

Other Meds:

Current Illness:

ID: 1726680
Sex: M
Age: 81
State: GA

Vax Date: 09/14/2021
Onset Date: 09/18/2021
Rec V Date: 09/23/2021
Hospital:

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

Lab Data: CAT scan , and lab work

Allergies: No

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

Symptoms: 09/18/2021 abdominal issues Pain around the belly button then next day belly pain back pain and nausea. 04:00 AM 09/20/201 ER - hospital CAT scan , and lab work. Liter of 1 liter of Fluids and 8 hours of observation cracker and juice to see if he could maintain on his stomach and sent home Was diagnosis with Mild Pancreatitis no history no gallstone, alcohol and he did not fit the profile.

Other Meds: Sythriod 100micrograms once daily, Geneuvia 50mg twice daily, Propathanone 225 twice daily, Metoplol extended 25mg once daily Nicogram 500mg twice daily, Lipitor 10mg once daily, Novat 5mg once daily

Current Illness: No

ID: 1726681
Sex: M
Age: 59
State: WI

Vax Date: 04/13/2021
Onset Date: 08/09/2021
Rec V Date: 09/23/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data: To many to list

Allergies: None

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

Symptoms: Presented as a head cold, several days into the Covid had difficulty breathing, hence the reason for the admission to the hospital.

Other Meds: Atorvastatin, Doxycycline Hyclate, Baby Aprin

Current Illness: No

ID: 1726682
Sex: M
Age: 14
State: GA

Vax Date: 07/19/2021
Onset Date: 07/19/2021
Rec V Date: 09/23/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1726683
Sex: M
Age: 48
State: GA

Vax Date: 07/19/2021
Onset Date: 07/19/2021
Rec V Date: 09/23/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1726684
Sex: F
Age: 52
State: IN

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

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

Lab Data: Na

Allergies: Na

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

Symptoms: Fever 101.5, headache, nausea.

Other Meds: Effexor, metoprolol, progesterone

Current Illness: Na

ID: 1726685
Sex: M
Age: 55
State: NC

Vax Date: 08/06/2021
Onset Date: 08/10/2021
Rec V Date: 09/23/2021
Hospital:

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

Lab Data:

Allergies: NA

Symptom List: Ear pain, Hypoaesthesia

Symptoms: PATIENT RECEIVED 1 DOSE OF PFIZER ON 08/06/2021 AT ONE LOCATION AND RECIEVED ANOTHER DOSE OF PFIZER ON 08/10/2021 at another location,

Other Meds: NA

Current Illness: NA

ID: 1726686
Sex: M
Age: 12
State: GA

Vax Date: 07/19/2021
Onset Date: 07/19/2021
Rec V Date: 09/23/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1726687
Sex: M
Age: 11
State: PR

Vax Date: 06/28/2021
Onset Date: 06/28/2021
Rec V Date: 09/23/2021
Hospital:

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

Lab Data: UNKNOWN

Allergies: UNKNOWN

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

Symptoms: INADVERTENTLY VACCINATED BEFORE AGE 12 YRS. INFO COULD NOT BE CLARIFIED. SUSPECTED WRONG DATA ENTRY.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1726688
Sex: F
Age: 51
State: SC

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 09/23/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Arm started to hurt right away. Pain went down to hands and wrist. The burning pain went away a couple of weeks later but I still have pain and soreness in my arm and shoulder 6 months after the shot. I had nothing wrong before the shot.

Other Meds: None

Current Illness: None

ID: 1726689
Sex: M
Age: 26
State: GA

Vax Date: 07/19/2021
Onset Date: 07/19/2021
Rec V Date: 09/23/2021
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: Unevaluable event

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1726690
Sex: F
Age: 42
State: CA

Vax Date: 09/05/2021
Onset Date: 09/16/2021
Rec V Date: 09/23/2021
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: Tetracycline

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

Symptoms: Shingles

Other Meds: Multi Vitamin, E, A, Biotin, Turmeric, Zyrtec

Current Illness: None

ID: 1726691
Sex: F
Age: 14
State: GA

Vax Date: 07/19/2021
Onset Date: 07/19/2021
Rec V Date: 09/23/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1726692
Sex: F
Age: 72
State: IL

Vax Date: 09/21/2021
Onset Date: 09/22/2021
Rec V Date: 09/23/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: low grade fever, arm redness and swelling at injection site, slept on and off all day

Other Meds: metaformin, hydrochlorthiazide,,nifedipine,omeprazole, nadolol

Current Illness:

ID: 1726693
Sex: M
Age: 58
State: MN

Vax Date: 05/15/2021
Onset Date: 09/21/2021
Rec V Date: 09/23/2021
Hospital: Y

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: Uncertain of anything right after vaccine. Admitted to hospital with hyponatremia and alcohol abuse. Was dx with COVID after admitted to hospital during this admit.

Other Meds:

Current Illness:

ID: 1726694
Sex: F
Age: 14
State: GA

Vax Date: 07/19/2021
Onset Date: 07/19/2021
Rec V Date: 09/23/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1726695
Sex: M
Age: 62
State: CA

Vax Date: 09/15/2021
Onset Date: 09/21/2021
Rec V Date: 09/23/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Tinnitus Both ears

Other Meds: None

Current Illness: None

ID: 1726696
Sex: M
Age: 11
State: KY

Vax Date: 09/23/2021
Onset Date: 09/23/2021
Rec V Date: 09/23/2021
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: N/A

Allergies: No known allergies

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

Symptoms: The wrong patient was given the vaccine during a school vaccine clinic. Patient did not have any adverse reactions.

Other Meds: Focalin XR 10mg, Fluoxetine 10mg, Carbamazepine 200 mg, Guanfacine 1mg, Risperidone 1 mg, Loratadine 10 mg, Brompheniramine-pseudoephendrine-DM 2-30-10 mg/5mL, Melatonin 10mg

Current Illness:

ID: 1726697
Sex: F
Age: 13
State: GA

Vax Date: 07/19/2021
Onset Date: 07/19/2021
Rec V Date: 09/23/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1726698
Sex: M
Age: 11
State: PR

Vax Date: 06/04/2021
Onset Date: 06/04/2021
Rec V Date: 09/23/2021
Hospital:

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

Lab Data: UNKNOWN

Allergies: UNKNOWN

Symptom List: Injection site pain

Symptoms: INADVERTENTLY VACCINATED BEFORE AGE 12 YRS. INFO COULD NOT BE CLARIFIED. SUSPECTED WRONG DATA ENTRY.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1726699
Sex: F
Age: 69
State: FL

Vax Date: 07/21/2021
Onset Date: 08/15/2021
Rec V Date: 09/23/2021
Hospital:

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

Lab Data: X-Rays (Unknown)

Allergies: N/A

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

Symptoms: Pt. states that after receiving the 1st dose of J&J 07/21/2021, started experiencing symptoms 08/15/2021 of extreme pain in the knees (both), *Both knees replacement '18 & 04/13/2021. Left hand joint pain difficulty closing. Scheduled MRI 09/22/2021. Prior X-Rays preformed and no indications of injury (unknown source). Still continuing to experience symptoms.

Other Meds: Wellbutrin

Current Illness: N/A

ID: 1726700
Sex: M
Age: 46
State: NC

Vax Date: 07/13/2021
Onset Date: 07/20/2021
Rec V Date: 09/23/2021
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: NA

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

Symptoms: PATIENT RECEIVED 1 DOSE OF MODERNA ON 07/13/2021 AT ONE LOCATION AND RECIEVED ANOTHER DOSE OF MODERNA ON 07/20/2021 AT DEPARTMENT OF PUBLIC HEALTH.

Other Meds: NA

Current Illness: NA

ID: 1726701
Sex: F
Age: 40
State: WV

Vax Date: 09/15/2021
Onset Date: 09/16/2021
Rec V Date: 09/23/2021
Hospital:

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

Lab Data: See by the Doctor about 6 hours later; performed blood work indicated low iron and high ferritin had previously had bloodwork 3 months prior with no issues at all. Also, showed cardiac concerns referral to cardiologist.

Allergies: NSAIDs

Symptom List: Tremor

Symptoms: Normal sore arm; but the following day about 16 hours later I woke up and passed out and fell and hit my head. This is not normal behavior for me.

Other Meds: OTC Multi Vitamin Birth Control Pill atorvastatin

Current Illness: None

ID: 1726703
Sex: F
Age: 20
State: GA

Vax Date: 07/20/2021
Onset Date: 07/20/2021
Rec V Date: 09/23/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1726704
Sex: F
Age: 35
State: TN

Vax Date: 09/16/2021
Onset Date: 09/21/2021
Rec V Date: 09/23/2021
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:

Allergies: NA

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

Symptoms: PFIZER COVID-19 VACCINE (EUA Rash and itchiness all over my body. it started around neck but gradually spread all over the body with little round spots.

Other Meds: NA

Current Illness: NA

ID: 1726705
Sex: F
Age: 51
State: SC

Vax Date: 03/29/2021
Onset Date: 03/29/2021
Rec V Date: 09/23/2021
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: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: Had pain in arm , shoulder, wrist and hand right away. The burning pain went away in about 2 weeks however I still have constant pain in my shoulder upper arm six months later. The pain has not gone away.

Other Meds: None

Current Illness: None

ID: 1726706
Sex: F
Age: 79
State: MI

Vax Date: 03/03/2021
Onset Date: 09/22/2021
Rec V Date: 09/23/2021
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: Asthenia, Chills, Headache, Myalgia

Symptoms: breakthrough case, hospitalization

Other Meds:

Current Illness:

ID: 1726707
Sex: F
Age: 64
State: PA

Vax Date: 09/03/2021
Onset Date: 09/03/2021
Rec V Date: 09/23/2021
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: Codeine, Morphine, Penicillin, Most mycins

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

Symptoms: Initially - injection site soreness - expected - had this with first 2 doses in the series Muscle aches, Body aches, Fatigue Day 1-5 - expected - had this with the first doses in the series but this time it lasted longer. Headache - starting about 8 hours after injection and continuing until about 5 days later - had this with first two doses of series but the length of time it lasted this time was unexpected Sudden, Violent Vomiting lasting about 6 hours - Day 4 - unexpected Diarrhea, Stomach cramps lasting about 24 hours - Day 4 - unexpected Dizziness & Chills, NO Fever - Starting Day 2 and lasting until Day 5 - unexpected. As noted in Box #18 All Covid 19 Vaccines were Moderna - #1) 2/19/2021 0011M20A, #2) 3/19/2021 011M20A.

Other Meds: Omeprazole, cyclobenzaprine, ASA, metoprolol, Lorazepam, Nabumatone, Tramadol, furosemide, cetirizine, fluticasone, hydroxychloroquine, gabapentin, albuterol, vitamin D, Calcium, losartan, montelukast, Restasis

Current Illness: None

ID: 1726708
Sex: M
Age: 15
State: GA

Vax Date: 07/20/2021
Onset Date: 07/20/2021
Rec V Date: 09/23/2021
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:

Allergies:

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

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1726709
Sex: F
Age: 15
State: CO

Vax Date: 09/22/2021
Onset Date: 09/22/2021
Rec V Date: 09/23/2021
Hospital:

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

Lab Data:

Allergies: NKA

Symptom List: Pain in extremity

Symptoms: Patient received vaccine on 9/22 at 10:31 am. Per patient, started having chest pain reported as "pressure" that night, and feeling "hot all over" without taking temperature. When asked if she had heart racing, palpating, or difficulty breathing- she felt there was some difficulty breathing when "trying to breathe deep." Patient did not call PCP or seek medical attention. Patient was returning to vaccine clinic on 9/23 at 0900 for family members' appointments and waited, thinking clinic could treat/advise. Temp 39.1, HR 136, Heart rate regular. Patient also had not eaten or drank this am and feeling unwell. Advised patient and father to call PCP today for appointment/medical advice or go to ED for eval. Assistant manager on floor at this time and in agreement.

Other Meds:

Current Illness:

ID: 1726710
Sex: M
Age: 60
State: NC

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

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

Lab Data:

Allergies: NA

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

Symptoms: PATIENT RECEIVED 1 DOSE OF JANSSEN ON 08/020/2021 AT ONE LOCATION AND RECIEVED ANOTHER DOSE OF JANSSEN ON 08/23/2021.

Other Meds: NA

Current Illness: NA

ID: 1726711
Sex: M
Age: 79
State: KY

Vax Date: 03/30/2021
Onset Date: 09/19/2021
Rec V Date: 09/23/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Patient was fully vaccinated as of 3/31/21. patient is symptomatic as of 9/19 and lab confirmed as of 9/22

Other Meds:

Current Illness:

ID: 1726712
Sex: F
Age: 35
State: KS

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

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

Lab Data: None at this time

Allergies: None

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

Symptoms: Initally, later that day my left arm became so sore i had limited range of motion and would almost cry to use it or (later that night) to sleep on it. Directly after the immunization i started having a subtle feeling of nausea that went away about 5pm. Over night i started having fever and chills. The morning of 9/22 i woke up with a severe migrane to my right temple, extream fatigue and extream joint/bone pain. The headache- treated all day with alternating tylenol and ibuprofen was somewhat manageable. The fatigue and the bone/joint pain was terrible and dibilitating for my day to day life. The fatigue and joint/bone pain continued through the night of 9/22/2021. Upon waking up on 9/2/2021 i had a slight headache (took tylenol with much relief) and still substantial fatigue. It is 1040 on 9/23/2021 and i am fatigued and have not been able to drive or do more than light simple quick tasks with out long periods of rest.

Other Meds: Birth control- yaz

Current Illness: None

ID: 1726713
Sex: M
Age: 42
State: FL

Vax Date: 09/23/2021
Onset Date: 09/23/2021
Rec V Date: 09/23/2021
Hospital:

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

Lab Data: BP

Allergies: None

Symptom List: Vomiting

Symptoms: Fainted and urinated self immediately after vaccinated. Sweating profusely and dizziness

Other Meds: None

Current Illness: None

ID: 1726714
Sex: F
Age: 35
State: SC

Vax Date: 09/22/2021
Onset Date: 09/22/2021
Rec V Date: 09/23/2021
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: None

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: A few hours after receiving my second shot my arm got very red and developed a hot, painful rash. I also have a fever of 102 along with chills and fatigue.

Other Meds: Prenatals, zofran

Current Illness: None

ID: 1726715
Sex: M
Age: 15
State: GA

Vax Date: 07/20/2021
Onset Date: 07/20/2021
Rec V Date: 09/23/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1726716
Sex: M
Age: 28
State: IL

Vax Date: 08/16/2021
Onset Date: 09/05/2021
Rec V Date: 09/23/2021
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: Began feeling fuzziness/discomfort in my head on 9/5/21. This was not a headache or a migraine. This feeling lasted 5 days on and off and caused me to have trouble sleeping for fear of not waking up. On 9/9/21 the feeling in my head worsened as I tried to fall asleep. I got out of bed and told my girlfriend I needed to go to the ER. Almost immediately the feeling in my head became so severe that I thought I was going to die at any moment and went into a full-blown panic attack. At the ER I had 3 more panic attacks. I had a CT scan and bloodwork completed and they showed nothing was wrong. It is now 9/23/21 and for the past 2 weeks, I have continued to have the same feeling in my head followed by panic attacks ranging in severity from mild to quite severe. I have been prescribed Atarax and Xanax to help with anxiety and panic attacks. My entire life I have never had any mental health issues and am a very relaxed person. There has been no major life events or stressors in my life to cause the anxiety and panic attacks. The only thing that has changed in my life is receiving the Pfizer vaccine leading me to believe it is the cause of the head discomfort leading to panic attacks.

Other Meds:

Current Illness:

ID: 1726717
Sex: M
Age: 71
State: MI

Vax Date: 05/18/2021
Onset Date: 09/22/2021
Rec V Date: 09/23/2021
Hospital: Y

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

Lab Data:

Allergies: Pentothal

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

Symptoms: COVID-19, SOB, increased oxygen needs

Other Meds: amLODIPine, 10 mg, PO (oral) aspirin, 324 mg, PO (oral), qDay atorvastatin 80 mg oral tablet, 80 mg, PO (oral), qDay docusate-senna, 1, PO (oral), bid gabapentin, 300 mg, PO (oral), bid metFORMIN 500 mg oral tablet, 500 mg= 1 tab(s), P

Current Illness: Type 2 diabetes, obesity, hyperlipidemia, hypertension, stented coronary artery

ID: 1726718
Sex: F
Age: 55
State: MT

Vax Date: 02/12/2021
Onset Date: 09/10/2021
Rec V Date: 09/23/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: Diagnosed and admitted to hospital while fully vaccinated

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am