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: 1727240
Sex: M
Age: 67
State: WV

Vax Date: 02/22/2021
Onset Date: 09/13/2021
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: Penicillin

Symptom List: Dysphagia, Epiglottitis

Symptoms: Shingles outbreak, right abdomen and back.

Other Meds: Levothyroxine, propranolol, Omeprazole, Ezetimbe, sildenafil.

Current Illness: None.

ID: 1727241
Sex: F
Age: 57
State: PA

Vax Date: 06/03/2021
Onset Date: 06/24/2021
Rec V Date: 09/23/2021
Hospital: Y

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

Lab Data: Venous Duplex Chest CT multiple lab studies

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Vaccination - 6.3.2021 Pfizer Patient developed right leg pain chest pain and shortness of breath about 2.5 weeks after vaccination and was admitted to the hospital 6.24.2021 for a RLE DVT and PE exactly 3 weeks after her vaccine.

Other Meds:

Current Illness: Patient had been admitted 4.2021 for respiratory failure due to COPD and pneumonia.

ID: 1727243
Sex: F
Age: 30
State: MN

Vax Date: 08/24/2021
Onset Date: 09/07/2021
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: NA

Allergies: NA

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

Symptoms: Missed menstrual cycle after 1st dose of Pfizer vaccine. 1st day of previous menstrual cycle was 8/10/2021, received 1st dose of Pfizer on 8/24/2021 and was supposed to get menstrual cycle on 9/7/2021 and completely missed.

Other Meds: Nortrel birth control.

Current Illness: NA

ID: 1727244
Sex: F
Age: 75
State: NC

Vax Date: 03/19/2021
Onset Date: 03/25/2021
Rec V Date: 09/23/2021
Hospital: Y

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

Lab Data: unknown, but many tests were run

Allergies: none

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Stroke which has left her with left side paralysis

Other Meds: levothyroxine 125 MCG tablet lorazepam 0.5 MG tablet mirtazapine 30 MG tablet omeprazole 20 MG EC tablet ascorbate calcium/bioflavonoid (ESTER-C ORAL) polyethylene glycol powder vitamin D3 5000 IU

Current Illness: none

ID: 1727245
Sex: M
Age: 17
State: GA

Vax Date: 07/31/2021
Onset Date: 07/31/2021
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:

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

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1727246
Sex: F
Age: 57
State: MI

Vax Date: 08/26/2021
Onset Date: 08/27/2021
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: CBC PLATELETS,XRAY LUMBAR SPINE 0N 09-08-2021

Allergies: none

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

Symptoms: NUMBNESS AND TINGLING OF LEGS,GENERALIZED BRUISES ON LEGS ,PAIN TO BILATERAL LOWER EXTEMITIES ,HEADACHE,EXTREME FATIGUE STILL PERSISTENT AFTER A MONTH

Other Meds: none

Current Illness: none

ID: 1727247
Sex: M
Age: 63
State: NY

Vax Date: 04/28/2021
Onset Date: 04/29/2021
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: 1. EKG, 2. 2 COVID tests ( neg), 3. cardio blood work up, 4. TEE, 5. Electro-cardioversion, 6. Echocardiogram, 7. EKG, 8. Full blood and urine work up, 9. TEE, 10. Electro-cardio version.

Allergies: Pradaxa

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Began suffering heart arrhythmia within 8 hours which lasted the entire time until going into A-Fib within 72 hours. First time in A-fib in 4 years. After being cardioverted on 21 May 2021, remained in normal rhythm until 6 September 2021. Went back into A-fib on 6 September 2021. Was cardioverted again, on 17 September 2021. Have been excessively tired since receiving second COVID shot on 28 April 2021. Also experiencing muscle fatigue and headaches continuously since 28 April 2021.

Other Meds: Multaq, Crestor, Coreg, Zyrtec, Azor, Glimipride, Metformin, Zinc, Vitamin D, Vitamin C, Multi- Vitamin.

Current Illness: None

ID: 1727248
Sex: F
Age: 63
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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1727249
Sex: M
Age: 82
State: FL

Vax Date: 03/15/2021
Onset Date: 09/02/2021
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: LA

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Hospitalization 9/2-9/9 for COVID PNA, hypoxemia, COPD. Treated with dexamethasone 6 mg IV daily and REMDESIVIR.

Other Meds:

Current Illness:

ID: 1727250
Sex: F
Age: 37
State: TX

Vax Date: 09/08/2021
Onset Date: 09/08/2021
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: N/A

Allergies: artifical cinnamine: throat burn and rash around mouth

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Patient notes that on 9/8 she had her first dose of Pfizer COVID vaccine. Two hours later she felt totally drained and it lasted 48 hours. She couldn't stand up for long periods because she was exhausted. Within the first 4 hours she had brief heart racing that lasted for 30 minutes off and on and then it resolved and hasn't returned. The patient states she started with SOB right after the vaccine and this has persisted. She has a history of asthma that is controlled except for seasonal changes. The SOB is sometimes at rest, but mostly with exertion. Going up stairs she feels SOB. The first week after the vaccine she was having to use her albuterol inhaler. She is not having to use the inhaler as much now. She last used the inhaler on Friday. No wheezing or coughing. She hasn't noticed any change in her allergies since before the vaccine. She also notes she has R upper arm itching and heat where she had the injection. She had a lump in her R upper arm a few days ago along with redness. She took benadryl.

Other Meds: ?Nexplanon(Etonogestrel) 68 MG Implant Subcutaneous ?Albuterol Sulfate HFA 108 (90 Base) MCG/ACT Aerosol Solution 2 puffs as needed Inhalation every 4 hrs as needed for coughing, wheezing, Notes: prn ?Ibuprofen 800 MG Tablet 1 tablet with

Current Illness: none

ID: 1727251
Sex: F
Age: 87
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: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1727252
Sex: M
Age: 19
State: UT

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: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data: none

Allergies: none

Symptom List: Rash, Urticaria

Symptoms: While in our observation area, 3-5 minutes after vaccine given the patient passed out and voided bladder, gave patient water to drink, took two blood pressure measurements 84/49 with HR 44 at 11:41am and then 108/61 with HR 59 at 11:45. He laid down in our counseling room for about 10 minutes under his mother's supervision and walked out on his own.

Other Meds: vitamin c supplement

Current Illness: none

Date Died: 09/14/2021

ID: 1727253
Sex: M
Age: 27
State: KY

Vax Date: 09/14/2021
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: 1
Vax Route: IM
Vax Site: LA

Lab Data: none.

Allergies: NKDA

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

Symptoms: Patient's grandmother found him dead in the bathroom 4 to 4:30 hours after his vaccine. She was not aware of him having complaints. He had vomited in the commode -that was the only comment that she had.

Other Meds: Biktarvy, Albuterol, Advair, Lopressor, Sublocade - (last dose 7/30/21).

Current Illness: HIV and Opioid DO,Tricuspid Prosthetic valve endocarditis. His grandmother found him dead on 9/14 8 to 8:30 pm. She said it looked like he had vomited in the commode. She did not use Narcan on him and denied that she saw evidence of drug use. She called 911 and EMS /coroner did not think an autopsy was appropriate and said "he had heart disease ".

ID: 1727254
Sex: F
Age: 45
State: IN

Vax Date: 04/08/2021
Onset Date: 09/17/2021
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: SYR
Vax Site: LA

Lab Data: Sofia Antigen COVID-19 test with a positive result

Allergies:

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

Symptoms: Patient received the Pfizer vaccine on 3/18/21 and 4/8/21 so was fully vaccinated when they tested positive for COVID-19 on 9/17/21.

Other Meds:

Current Illness:

ID: 1727255
Sex: F
Age: 52
State: GA

Vax Date: 07/26/2021
Onset Date: 07/26/2021
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: 1727256
Sex: M
Age: 70
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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1727257
Sex: F
Age: 52
State: WA

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

Allergies:

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

Symptoms: Bruising at injection site of the Adacel vaccine, and reduced mobility in the left shoulder due to pain

Other Meds:

Current Illness:

ID: 1727258
Sex: F
Age: 68
State: CA

Vax Date: 09/22/2021
Onset Date: 09/22/2021
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:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1727259
Sex: F
Age: 56
State: ME

Vax Date: 08/24/2021
Onset Date: 08/24/2021
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: 9/21/2021 Labs no results yet

Allergies: penicillin

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Severe headache and fever of 99 and took off work that day. I started itching and pain on my arm at the injection site. Numbness and tingling in my arm and progressively got worse and went down to my fingers. Now this is radiating to my left arm. Bruising on back of my right knee and a large hematoma on Sept. 17th. I did take pictures. I just was able to get in to provider on 9/21/21. I had blood work drawn, and I am scheduled for a MRI of my cervical area to find out why I have numbness and tingling. I have had some weakness and lose of strength. I have joint pain now all over and it's more so than normal. I go to Physical Therapy (Rehab) weekly and I have missed two appointments now due to my pain and joint swelling. I have constant itching of my skin all over my body so badly that I break open my skin from itching.

Other Meds: multivitamin, tramadol, ibuprofen, B12, Vitamin D

Current Illness: none

ID: 1727260
Sex: F
Age: 49
State: VA

Vax Date: 08/01/2021
Onset Date: 08/03/2021
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:

Allergies: None

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

Symptoms: Arm became soar and has gotten worse over time. Has not gotten any better since last injection. Became very sick after second dose and was so for 3 days. Have continued to be extremely fatigued since.

Other Meds: Zoloft

Current Illness: None

ID: 1727261
Sex: F
Age: 51
State: OR

Vax Date: 02/12/2021
Onset Date: 03/16/2021
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: none

Allergies: None

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

Symptoms: Approximately one month after second dose, I had Shingles

Other Meds: Allegra, Lexapro, hydrOXYzine, Lipitor

Current Illness: None

ID: 1727262
Sex: F
Age: 40
State: UT

Vax Date: 07/20/2021
Onset Date: 07/21/2021
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: I have not been to the doctor. I don't feel like my doctor would be open to discussing anything negative about the vaccination because they are pushing so hard for everyone to get it.

Allergies: None

Symptom List: Unevaluable event

Symptoms: Chest pains and headaches that lasted for 3 weeks after first Pfizer Covid-19 vaccination. Chose not to receive second dose due to the unusual chest pains and headaches that occurred.

Other Meds: Armour thyroid and progesterone

Current Illness: None

ID: 1727263
Sex: M
Age: 24
State: CA

Vax Date: 07/08/2021
Onset Date: 09/05/2021
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: lumbar puncture with CSF analysis CT head non-contrast

Allergies: none

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

Symptoms: The patient presented with weakness and numbness of lower extremities, consistent with Guillain Barre syndrome

Other Meds: none

Current Illness: none

ID: 1727264
Sex: F
Age: 51
State: MN

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

Lab Data: none

Allergies: none

Symptom List: Injection site pain, Pain

Symptoms: Vaccine was given past BUD time. Vaccine was diluent and BUD time was 9/22/2-21 1635 and vaccine was given 9/23/21 0813

Other Meds: unknown

Current Illness: not ill

ID: 1727265
Sex: M
Age: 59
State:

Vax Date: 06/14/2021
Onset Date: 09/05/2021
Rec V Date: 09/23/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Hospitalization 9/5-9/11 for COVID. Treated with dexamethasone 6 mg IV daily and Remdesivir

Other Meds:

Current Illness:

ID: 1727266
Sex: M
Age: 71
State: UT

Vax Date: 03/18/2021
Onset Date: 09/16/2021
Rec V Date: 09/23/2021
Hospital:

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

Lab Data: 3 COVID test- all negative, chest x-ray clear, EKG- normal.

Allergies: None

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

Symptoms: On 09/16/2021 I started having coughs and chest congestion. Then I started running a fever. I took some medication for the fever, and it went down. The congestion and coughs got worse. We went to the emergency room, and they did a COVID test, chest x-ray, and EKG. The chest x-ray was clear, and the EKG was normal. The COVID test came back negative. They did not prescribe any medications. The following Sunday 09/19/2021 I got 2 COVID tests, one short and one long term, which both came back negative as well. The following week we went out on vacation. 3 of us tested positive for COVID and 3 are still waiting for the results. I should know by tomorrow my results. I am still congested a little bit and I still have a cough. I received the flu vaccination this fall.

Other Meds: CENTRUM multi-vitamin; Simvastatin; Finasteride; Tamsulosin; Olmesartan; Amlodipine Besylate

Current Illness: None

ID: 1727267
Sex: M
Age: 63
State: CA

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

Other Meds:

Current Illness:

ID: 1727268
Sex: F
Age: 82
State: IN

Vax Date: 03/03/2021
Onset Date: 09/20/2021
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: Sofia Antigen COVID-19 test with a positive result

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Patient received the Pfizer vaccine on 2/10/21 and 3/3/21 so was fully vaccinated when they tested positive for COVID-19 on 9/20/21.

Other Meds:

Current Illness:

ID: 1727269
Sex: F
Age: 58
State: FL

Vax Date: 09/16/2021
Onset Date: 09/18/2021
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: Bactrim

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

Symptoms: After the first dose on August 26, 2021, I have become very tired throughout the day. After the second dose on September 16, 2021, I have become even more tired throughout the day and have muscle and joint pain continuously, especially when I wake up in the morning. I have also had intermittent headaches since my second dose. This morning, , September 23, 2021, I feel as if I am coming down with a flu. I have taken over the counter cold/flu/sinus tablets, but the symptoms continue with a headache, stiff neck, exhaustion, a shivers. I have a normal temperature of 98 ,.

Other Meds: Trazadone

Current Illness: None

ID: 1727270
Sex: F
Age: 67
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: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1727271
Sex: F
Age: 52
State: GA

Vax Date: 07/26/2021
Onset Date: 07/26/2021
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: Injection site pain

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1727272
Sex: F
Age: 67
State: CO

Vax Date: 03/17/2021
Onset Date: 06/10/2021
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: Had a CT Scan of Lungs: Mucus plugs and blockages (causing oxygen not to get through).

Allergies: Sulfa Antibiotics, Pitted Fruits, Full Anaphylactic Reactions

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

Symptoms: About 3 Months after vaccine, had treatment for lung issues, given nebulizer and aerobika and prescription for albuterol inhaler by the lung specialist. Diagnosed with bronchiectasis. Coughing, shortness of breath, fatigue, repeated infections. Have been living in unspecified location, while there is lots of wildfire smoke in the summer could be a contributing factor. Still in treatment.

Other Meds: Hormone Replacement Therapy, Daily Multivitamin

Current Illness: N/A

ID: 1727273
Sex: F
Age: 70
State: MN

Vax Date: 03/05/2021
Onset Date: 09/21/2021
Rec V Date: 09/23/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: Admitted to hospital on: 9/21/21

Other Meds:

Current Illness:

ID: 1727274
Sex: M
Age: 62
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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1727275
Sex: F
Age: 67
State: GA

Vax Date: 07/26/2021
Onset Date: 07/26/2021
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: 1727276
Sex: M
Age: 55
State: MO

Vax Date: 09/23/2021
Onset Date: 09/23/2021
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: n/a, I referred the patient to see their primary care provider if symptoms do not resolve in 12-24 hours.

Allergies: n/a

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

Symptoms: Tinnitus, pt reported ringing in the ears after about 12 minutes post vaccination time.

Other Meds: n/a

Current Illness: unknown

ID: 1727277
Sex: F
Age: 46
State: GA

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: 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: SEVERE INFLAMMATION WITH CIRCULAR DEMARCATION AT INJECTION SITE

Other Meds:

Current Illness:

ID: 1727278
Sex: M
Age: 51
State: TX

Vax Date: 07/16/2021
Onset Date: 09/01/2021
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: none

Allergies: Not known

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: I feel my blood pressure has gone up after vaccination because I used to take 1 Amlodipine per day for my blood pressure, now I have to take 3 times a day to keep my blood pressure level normal It seems my heart is heavy most of the time.

Other Meds: Amlodipine for blood presure metformin diabetic

Current Illness: blood pressure diabetic

ID: 1727279
Sex: M
Age: 81
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: 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: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1727280
Sex: F
Age: 37
State: GA

Vax Date: 09/16/2021
Onset Date: 09/18/2021
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: None.

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

Symptoms: Menstrual cycle came early.

Other Meds: None.

Current Illness:

ID: 1727281
Sex: F
Age: 73
State: IN

Vax Date: 02/19/2021
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: 1
Vax Route: IM
Vax Site: LA

Lab Data: Sofia Antigen COVID-19 test with a positive result

Allergies:

Symptom List: Pain in extremity

Symptoms: Patient received the Moderna vaccine on 1/22/21 and 2/19/21 so was fully vaccinated when they tested positive for COVID-19 on 9/21/21

Other Meds:

Current Illness:

ID: 1727282
Sex: M
Age: 82
State: CA

Vax Date: 09/22/2021
Onset Date: 09/22/2021
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:

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

Symptoms: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1727283
Sex: F
Age: 12
State: GA

Vax Date: 08/02/2021
Onset Date: 08/02/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1727284
Sex: F
Age: 71
State: IL

Vax Date: 07/05/2021
Onset Date: 07/15/2021
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: Urgent Care visit on 7/24/2021 with reported normal CBC and CMP

Allergies: Latex

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

Symptoms: Within 10 days pt describes intermittent severe burning type pain across the middle of her back lasting hours.

Other Meds: Omeprazole

Current Illness: None

ID: 1727285
Sex: M
Age: 72
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: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1727286
Sex: F
Age: 26
State: CA

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

Lab Data: NONE

Allergies: NKA

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: STAT RN called at covid vaccine clinic. Patient identified x 2. RN present, patient alert and oriented x 4. Patient got Covid pfizer vaccine and 15 minutes after patient felt dizzy and nauseous . Blood pressure 145/75 HR 103 stable O2 sat 96%. Patient remains alert and oriented x 4, responding well. Patient assisted in laying down. Dr came and assessed patient. No further orders given. Continue to monitor patient. Patient complained of breathing feels tight with heavy pressure on chest. Dizziness resolving, nausea clear. Denies any headache. Assisted patient in standing up.Patient stated chest pressure got worse when standing up. Patient sat back and conversing appropriately. VS stable. Dr came and assessed pt. Advised pt to take her inhaler at home and rest. Denies any dizziness nor nausea nor vomiting. Denies any throat swelling. Patient remains stable. Okay to send patient home. Pt left clinic in stable condition.

Other Meds: Took Diflucan 150 mg x 1

Current Illness: Candida Vulvovaginitis, Tonsillitis

ID: 1727287
Sex: M
Age: 20
State: GA

Vax Date: 07/26/2021
Onset Date: 07/26/2021
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: 1727288
Sex: M
Age: 72
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: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1727289
Sex: F
Age: 39
State: OH

Vax Date: 02/27/2021
Onset Date: 03/01/2021
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: None

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

Symptoms: No menstrual period since vaccine

Other Meds: Levothyroxene, famotidine

Current Illness: None

ID: 1727290
Sex: M
Age: 53
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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am