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: 1727291
Sex: F
Age: 29
State: TX

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: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Dysphagia, Epiglottitis

Symptoms: Patient c/o feeling dizzy after getting the vaccine. Patient is currently pregnant and estimate due date is 4/8/2022. Vital was taken BP: 108/62. HR: 91. Resp: 16. O2: 99%. Patient was recovered after 5 minutes. Left the site in stable condition.

Other Meds: Prenatal, Aspirin, Estrace, and doxylamine

Current Illness: None

ID: 1727293
Sex: M
Age: 29
State: NM

Vax Date: 09/21/2021
Onset Date: 09/23/2021
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:

Allergies: unknown

Symptom List: Anxiety, Dyspnoea

Symptoms: rash on forearms and chest areas, chest pain, joint pain, muscle pain, chills, heat flashes, headache, shortness of breath

Other Meds: Multi-vitamin,.

Current Illness: Covid ( early/mid Aug) with mild cough symptoms.

ID: 1727294
Sex: M
Age: 40
State:

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: 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: 1727295
Sex: M
Age: 89
State: CA

Vax Date: 02/25/2021
Onset Date: 09/06/2021
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: Results for patient as of 9/23/2021 11:13 9/6/2021 16:15 CRP, SER QL: 3.1 (H) 9/7/2021 00:37 CRP, SER QL: 3.6 (H) 9/11/2021 06:13 CRP, SER QL: 1.2 (H) 9/13/2021 05:53 CRP, SER QL: 0.8 9/15/2021 05:51 CRP, SER QL: 0.3 9/17/2021 05:45 CRP, SER QL: 0.3 9/19/2021 05:40 CRP, SER QL: 2.7 (H) 9/21/2021 05:50 CRP, SER QL: 2.0 (H) 9/23/2021 07:06 CRP, SER QL: 1.4 (H)

Allergies: nkda

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: 89 YO male w/ PMHx of HTN, HLD, DM2, Gout, CVA, smoking hx, covid vaccinated, p/w sob/dyspnea found with COVID pneumonia and multiple PEs. #AHRF 2/2 COVID PNA, c/b provoked PE Vaccinated patient, afebrile with progressive shortness of breath, fatigue, productive cough (yellow phlegm COVID, presented w/ 9d hx of prog starting 8/29). Initially treated for CAP prescribed course of doxycycline after d/w clinic MDs. Found COVID positive on 9/6; initially requiring 15L NRB on admission, now on 3L NC s/p 10d course decadron and 5d course remdesivir. CT chest showed PE on 9/6, on xarelto for anticoagulation. Per Dr., isolation precautions d/c'ed on 9/21 given >20 days since symptom onset. CRP downtrending, no cough or fever. Currently satting well on 2LNC, requiring 4LNC on ambulation. - Goal SpO2 >92%. Self proning as tolerated - Continue to wean O2 as tolerated. - Continue with Xarelto 15 mg BID for PE - Xarelto loading 15 mg BID for 21 days (until 9/28) then 20 mg QD (staring 9/29) for at least 3 months - S/p Decadron 6mg qD IV/PO for 10 days (9/6/21 - 9/16) - S/p Remdesivir 100 IV qD (9/7 - 9/10), s/p 200mg IV x1 (9/6) for total 5 days - Trend daily inflammatory marker labs (CRP every other AM) - Continue Remeron 7.5 mg qhs for appetite stimulant #HYPERKALEMIA - RESOLVED AM K 5.5 that resolved without intervention on repeat chemistry to 4.7. Will continue to monitor potassium levels on daily chemistries. Pt is not on any medications that can contribute to elevated K. Started patient on low K diet. #NORMOCYTIC ANEMIA #Iron deficiency Anemia #MELENA Hx of IDA. On admission Hgb 11.6 with downtrending to 6.8 as of 9/21 2/2 GI bleed (guaiac positive, black stools noted). Recent EGD/colo on 11/4/20 showed - gastritis, diverticulosis (sigmoid), hemorrhoids. Pt s/p 1 unit pRBC on 9/17, required 2nd unit pRBC on 9/21 for hgb 6.8. Black stool noted 9/20. Discussed case with GI on 9/21; no scope given 2L O2 req still high for gen anesthesia; also prior EGD shows nothing that would benefit from direct intervention - has hernia which can be easily upset by inflammation. Overall not actively bleeding, just oozing. CTM on protonix BID and should improve. No need to change anticoagulation given no scope. Hgb stable at 8.8 on 9/22. - Daily CBC - Transfuse if Hgb<7 - Outpatient GI follow-up on discharge - Continue Protonix 40 mg BID - Continue Xarelto for PE #New onset Afib New finding on EKG 9/6. CHA2Ds2-VaSc score of 4 (Age, HTN, DM) - S/p heparin gtt. Continue with Xarelto 15 mg BID until 9/28 then 20 mg QD - Will need echo for further evaluation, after isolation #DM2 with peripheral neuropathy Hgb A1c 5.4% 3/2021. Not on PTA anti-glycemic meds. - Continue with PTA gabapentin 300 mg QHS #HTN - Continue with PTA hydralazine #HLD Daily LFTs WNL. S/p remdesivir, resume statin - Continue with Simvastatin 20 mg qhs #GERD - Cont PTA protonix #Gout No active issues. Not on meds. - CTM #BPH - Continue with PTA Tamsulosin and Finasteride. FEN: replete lytes PRN Diet: DIET, CARDIAC DVT Prophylaxis: Xarelto GI Prophylaxis: PO pantoprazole daily Activity: As tolerated Foley indication: Patient does not have a urinary catheter Central line: Not present Bowel: Senna, Miralax, Colace Code: Partial Code DNR, okay for pressors okay for intubation Dispo: ALF pending

Other Meds: Medications Prior to Admission: Prior to Admission Medications Outpatient Home Medications Taking? Albuterol (PROAIR/PROVENTIL/VENTOLIN) 90 mcg/actuation Inhl HFAA Stopped Taking Sig: Inhale 2 Puffs by mouth every 4 hours as needed for quic

Current Illness: Urinary retention

ID: 1727296
Sex: F
Age: 25
State: NC

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:
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: 1727297
Sex: M
Age: 70
State: IN

Vax Date: 02/15/2021
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: Sofia Antigen COVID-19 test with a positive result

Allergies:

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

Symptoms: Patient received the Pfizer vaccine on 1/25/21 and 2/15/21 so was fully vaccinated when they tested positive for COVID-19 on 9/23/21

Other Meds:

Current Illness:

ID: 1727298
Sex: M
Age: 75
State:

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

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

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

Other Meds:

Current Illness:

ID: 1727299
Sex: F
Age: 39
State: TX

Vax Date: 12/22/2020
Onset Date: 12/25/2020
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: Reglan

Symptom List: Pharyngeal swelling

Symptoms: Irregular heavy menstrual cycle

Other Meds: Trintellix Lunesta Propranolol Hydroxyzine

Current Illness: None

ID: 1727300
Sex: F
Age: 77
State: WA

Vax Date: 08/31/2021
Onset Date: 09/02/2021
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: epinephrine, oxycodone

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: About 2 days after the vaccine, I developed a very large bright red circle around the injection site. It was about 4 inched in diameter. It started to itch badly. I also started to ache all over my body and got progressively worse as the day continue. By nightfall, the ache would worsen and I could not sleep. I can feel the ache and pain in my joints and soft tissue. I did consult my doctor and he mentioned the vaccine could have trigger my fibromyalgia to flare. I have a history of fibromyalgia in my 50s which has layed dormant for 20 years. I do have to take Tylenol and a muscle relaxant to help me sleep. The fibromyalgia has improved but not completely resolved.

Other Meds: none

Current Illness: none

ID: 1727301
Sex: F
Age: 31
State: TX

Vax Date: 09/09/2021
Onset Date: 09/10/2021
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: PATIENT HAS NOT SEEN A DOCTOR

Allergies: NKDA

Symptom List: Diarrhoea, Nasal congestion

Symptoms: PATIENT STATES THAT AFTER HER 2ND DOSE OF PFIZER COVID VACCINE STARTING ON 9/10/21 SHE STARTED TO EXPERIENCE MORE NOTICEABLE HAIRLOSS. SHE SAID HER SCALP IS ITCHY AND HER HAIR HAS BEEN SHEDDING MOST NOTICEABLY WHEN SHE TAKES A SHOWER. SHE SHED A LARGE AMOUNT OF HAIR ON 9/19/21 AND SHOWED US DOCUMENTED PICTURES.

Other Meds: NO

Current Illness: NO

ID: 1727302
Sex: M
Age: 84
State:

Vax Date: 03/19/2021
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: Vaccination site erythema, Vaccination site pruritus, Vaccination site swelling

Symptoms: Patient hospitalized 9/5/21-9/8/21 for COVID Pneumonia/AMS, Treated with dexamethasone IV and Remdesivir.

Other Meds:

Current Illness:

ID: 1727303
Sex: F
Age: 69
State: NY

Vax Date: 01/01/2021
Onset Date: 04/15/2021
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: SYR
Vax Site: RA

Lab Data: A covid test was done which was negative but was had I tested positive for antibodies and was told at one point I had covid. I cannot recall having any symptoms for covid but I did have a temperature for one day possibly back in December. I have never had any history of any heart issues or high blood pressure. Up until I had the vaccine I was in excellent health. I have now lost one of my kidneys due to this blood clotting issue and have been taking coumadin daily.

Allergies: NKA

Symptom List: Rash, Urticaria

Symptoms: Acute aortic thrombus that extended to the left renal artery with occlusion of the left renal artery. I had an aortic thrombectomy at local medical center. I went to the ER with left flank pain at which time a ct scan was done and the clot was found.

Other Meds: Levothyroxin, Vitamin D, Advil

Current Illness: None

ID: 1727304
Sex: F
Age: 15
State: CA

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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1727305
Sex: M
Age: 14
State: GA

Vax Date: 08/02/2021
Onset Date: 08/15/2021
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: hospital records

Allergies: NKA

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

Symptoms: Parotitis

Other Meds: Zoloft, Vit D, ASA, Atenolol, Zyrtec

Current Illness: none

ID: 1727306
Sex: M
Age: 66
State:

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

Other Meds:

Current Illness:

ID: 1727307
Sex: M
Age: 80
State: TN

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: Individual was at the hospital at the time of report.

Allergies: NKA

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

Symptoms: Onset of weakness approximately 4 hrs post vaccination. Unable to stand. Fell to the floor on 4 different occasion over 2 days time. This required calling EMS and neighbors for assistance. Weakness has continued through today. Ordinarily this individual has no problems standing or walking. To ER today for evaluation.

Other Meds: BP med (unknown name)

Current Illness: None

ID: 1727308
Sex: M
Age: 57
State:

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

Other Meds:

Current Illness:

ID: 1727309
Sex: F
Age: 36
State: GA

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

Other Meds:

Current Illness:

ID: 1727310
Sex: M
Age: 83
State:

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

Other Meds:

Current Illness:

ID: 1727311
Sex: F
Age: 45
State: IN

Vax Date: 04/21/2021
Onset Date: 09/23/2021
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: Sofia Antigen COVID-19 test with a positive result

Allergies:

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

Symptoms: Patient received the Pfizer vaccine on 3/31/21 and 4/21/21 so was fully vaccinated when they tested positive for COVID-19 on 9/23/21.

Other Meds:

Current Illness:

ID: 1727312
Sex: F
Age: 74
State:

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

Other Meds:

Current Illness:

ID: 1727313
Sex: M
Age: 12
State: TX

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:
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: 1727314
Sex: F
Age: 66
State: MA

Vax Date: 09/19/2021
Onset Date: 09/20/2021
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: LA

Lab Data: None.

Allergies: Sulfa based drugs.

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

Symptoms: She got her vaccine, no problems at the vaccine site other than soreness. Went to sleep, had liquid draining out of her eyes, nose. Really couldn't sleep, up the entire night. She started getting tired, which she felt was normal, but not this tired. She has been sleeping during the day about 6 hours at a time. She has had no appetite. She just feels like the wind has been kicked out of her. She tried to do something and she falls asleep. Nothing is really helping the symptoms. Tuesday she had fever of 101. Her husband called the 24-hour nursing line who instructed her to take Tylenol every 8 hours. The fever went down to 100, and then would go back up to 102. she has been having intermittent chills and sweating. Her temp went to 98.6, then 99.7, hard for her to breath. Feels like she has run a marathon, and cannot even do the simpleist things around her house, and just got the energy to take a shower and finally went outside as it is a beautiful day. Any activity is very tiring . She ate breakfast and it went through her. It's been a horrible and it's been 4 days, and did not have a problem with the 1st 2 vaccines, and it really scare her.

Other Meds: Centrum silver 50+, vitamin B12, Vitamin D.

Current Illness: None.

ID: 1727315
Sex: M
Age: 70
State: KY

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

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: POSITIVE COVID

Other Meds:

Current Illness:

ID: 1727316
Sex: M
Age: 16
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:
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1727317
Sex: M
Age: 17
State: PR

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: 025J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: The adverse event is that the patient was vaccinated 3 months before he turned 18 years old.

Other Meds:

Current Illness:

ID: 1727318
Sex: F
Age: 71
State: VA

Vax Date: 03/19/2021
Onset Date: 03/19/2021
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: sulfa drugs

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: I had muscle aches, joint aches and a fever that went to 101.8, I had a headache, dizziness, nausea,I did not vomit. I had loose stools. I had a skin rash from breast level all the way down to my knees, and my arms. i tend to get like this with a protein based vaccine.

Other Meds: Lipitor 20 mg qd, pantoprazole 40 mg qd, calcium 1200 mg, vit d 2000 IU, flax seed oil,

Current Illness:

ID: 1727319
Sex: F
Age: 15
State: GA

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

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1727320
Sex: F
Age: 58
State: NY

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: RA

Lab Data:

Allergies: None Known

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

Symptoms: It appears that the entire contents of a vial of Pfizer Covid vaccine was administered to the patient in a volume of 0.3ml. The patient was contacted by Dr as the event occurred in the Emergency Department, prior to discharge. The patient experienced vomiting overnight. It is unclear whether this was related to the event since this is the reason she sought care on the day of the event.

Other Meds:

Current Illness: Flank Pain

ID: 1727321
Sex: F
Age: 46
State: CA

Vax Date: 07/19/2021
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: 1
Vax Route: IM
Vax Site: RA

Lab Data: Antibody test taken on 8/31/21 which said I was NEGATIVE for antibodies. This doesn't make sense as antibodies are supposed to be created in the 1st shot & even more in the 2nd shot.

Allergies: none

Symptom List: Nausea

Symptoms: After my first shot on July 19, 2021, I felt extremely tired and had a lot of brain fog. I had my antibodies tested 6 weeks later which resulted in no antibodies being detected. I received my second shot on September 20, 2021 & a few hours later, I felt a sudden heat wave come over my whole body. About 2 days later, I was achey and extremely tired & am now falling asleep rapidly like no other time before in my life & reported this to my doctor on July 22, 2021. On July 22, 2021, in the evening, I started to have pain in under my arm (perhaps in my lymphnodes) in my armpit on the same arm where I was given the shot. This morning, the pain has increased & very tender to the touch.

Other Meds: Multi-Vitamins Losartan Dymista Cozaar Symbicort

Current Illness: none

ID: 1727322
Sex: F
Age: 70
State:

Vax Date: 02/27/2021
Onset Date: 09/20/2021
Rec V Date: 09/23/2021
Hospital: Y

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: Admitted to Hospital on Date of Adverse Event [recorded in VAERS] for treatment of Covid-19 Positive following completion of Covid Vaccine Series

Other Meds:

Current Illness:

ID: 1727323
Sex: F
Age: 23
State: PR

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

Lab Data: N/A

Allergies: No known drug allergies

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

Symptoms: Administration error. During vaccine administration, PFIZER's COVID-19 vaccine was administered instead of the influenza vaccine (FLUCELVAX QUAD PF INJ) Two doses of MODERNA had previously been administered. PFIZER's vaccine would be the third in the series of COVID-19.

Other Meds:

Current Illness: No known health conditions

ID: 1727324
Sex: F
Age: 42
State: NC

Vax Date: 02/03/2021
Onset Date: 03/08/2021
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: PT, vestibular clinic, brain and spine MRI, Botox injections, EEG, mold testing, heavy metal testing, lyme. All results negative for underlying cause of symptoms. Possible Meige syndrome per neuro. Has upcoming eval with neuro at Hospital 11/2021

Allergies: Keflex, Sudafed, cats, dogs, wheat, milk, mold, trees, weeds

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

Symptoms: About 1 month after dose 2, presented to urgent care March 8, 2021. (Also had acupuncture treatment 1 week before symptoms began). Unclear if related to vaccine but no other provider was willing to submit for patient. Symptoms include lower extremity weakness, dystonia of face, blepharospasm, memory loss, nausea, vertigo, tremor, vision change, fatigue, muscle spasms/cramps, and headache. Has been evaluated by numerous specialties including eye, rheum, cardio, neuro, psych, ENT, PT. No change in the symptoms since onset in March. Pt is now unable to drive or work due to this.

Other Meds: Birth control, other meds used at that time unknown to provider submitting this

Current Illness: No known acute illness in the month prior or at time of vaccine

ID: 1727325
Sex: M
Age: 14
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: Tremor

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1727326
Sex: F
Age: 41
State: WA

Vax Date: 09/14/2021
Onset Date: 09/15/2021
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: Blood work.

Allergies: Sulfa; DILAUDID; sage; lavender

Symptom List: Erythema, Pruritus

Symptoms: On 9/14/21 150/100 blood pressure which gave me a migraine. I went to the ER on 9/15 and was given an IV and other medications. I was sent home and had to go back to the ER on the 18th. I went back because I still had a migraine. I was given steroids on top of the regular medicine. I was able to get my sumatriptan refilled. My blood pressure has went down since then but it is still a little bit high.

Other Meds: Sumatriptan

Current Illness: No

ID: 1727327
Sex: M
Age: 42
State: AZ

Vax Date: 04/22/2021
Onset Date: 05/10/2021
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: CT Scan- clear, no plaque EKG Urine Blood Heart Monitor

Allergies: None.

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

Symptoms: Begin to experience heart palpitations during moderate exercise on a Monday, lasted duration of exercise. Heart palpitations occurred two additional times throughout the week. The next week, on Monday, May 22, I was on a rowing machine, experienced palpitations, tightness in chest, left arm discomfort, and slight numbness in left hand fingers. Went to the ER and went through a EKG, urine, blood test, and x-ray. Nothing found and no blockages noted. Referred to a cardiologist where I was prescribed a heart monitor and CT scan with dye contrast. Heart monitor observed several readings of palpitations and CT scan showed no blockages/stenosis. Continue to experience palpitations to this day and have a follow up with my primary care physican next week.

Other Meds: None.

Current Illness: None.

ID: 1727328
Sex: M
Age: 61
State: CA

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

Lab Data:

Allergies: No known allergies

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

Symptoms: "Moderna COVID-19 Vaccine EUA"

Other Meds: Lisinopril Zocor Prilosec

Current Illness: Hyperlipidemia and Hypertension

ID: 1727329
Sex: F
Age: 29
State: TX

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: IM
Vax Site: LA

Lab Data: N/A

Allergies: None

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Light headed, heart fluttering, anxiety, hyperventilating. EMS evaluated and cleared patient.

Other Meds: None

Current Illness: None

ID: 1727330
Sex: M
Age: 21
State: CA

Vax Date: 09/07/2021
Onset Date: 09/09/2021
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: NKDA

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

Symptoms: The patient is a 21yo acdu usmc HM who scheduled this appointment to discuss adverse effect of the Pfizer covid-19 vaccine on 9/16/21. I called and spoke with the patient. He states he received the first dose of the Pfizer vaccine on 9/7/21. On 9/9/21, he started having a metallic taste in his mouth when he ate an egg or meat, now he has that taste with all protein and fatty foods but not with carbohydrates. He states he s chewing gum with mint after meals. He denies fevers, angioedema or aphthous ulcers in the mouth. He has no other concerns.

Other Meds: Cyclobenzaprine, Melatonin, Mobic

Current Illness: None

ID: 1727331
Sex: F
Age: 17
State: GA

Vax Date: 08/02/2021
Onset Date: 08/02/2021
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: 1727333
Sex: F
Age: 50
State: WI

Vax Date: 01/29/2021
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: 1
Vax Route: IM
Vax Site: LA

Lab Data: POS ABBOTT RAPID COVID

Allergies: HYDROXYCHLOROQUIN

Symptom List: Pain in extremity

Symptoms: COVID INFECTION/BREAKTHROUGH

Other Meds: TRULICITY 1.5 MG FLONASE NASAL INHALER MONTELUKAST 10 MG ALBUTEROL INHALER 8.5 MG DULOXETINE 30 MG, FLOVENT 110 MCG

Current Illness: NONE LISTED

ID: 1727334
Sex: F
Age: 46
State: WI

Vax Date: 06/10/2021
Onset Date: 06/11/2021
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: Approx one day after the injection, L arm became inflamed at the injection site and moved to lower arm. The arm remained dark red (similar to a severe sunburn), was warm to the touch, and itchy. After a couple days, it went away. However, it occasionally reappears. Most recently 9/22/21 (four months after the second vaccine); arm again was red, warm, inflamed and itchy.

Other Meds:

Current Illness:

ID: 1727335
Sex: M
Age: 14
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: 1727336
Sex: F
Age: 58
State: GA

Vax Date: 03/03/2021
Onset Date: 09/14/2021
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: Positive Covid test

Allergies: None

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

Symptoms: I got Covid

Other Meds: None

Current Illness: None

ID: 1727337
Sex: M
Age: 72
State: IL

Vax Date: 08/26/2021
Onset Date: 08/27/2021
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: Has started having tremors in both hands since 3rd dose of Moderna, which was given due to immunocompromised condition. Is also having vertigo now. Seen at dr office and nurse said to let the health department know. Instructed to let Dr know at next appointment on October 5, 2021.

Other Meds:

Current Illness:

ID: 1727338
Sex: F
Age: 43
State: OH

Vax Date: 01/08/2021
Onset Date: 01/20/2021
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: when expressed concern I was told that it's Just in my head.

Allergies: Codiene

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Foggy brain, cognition has decreased. I have a lot of times I will stop a conversation mid stream due to my mind "going blank, " or the words just will not formulate. This has been happening since the 1st shot but has gotten worse and worse. After my 2nd shot it seems to have worsened alot and did not take as long to see symptoms. Has gotten so bad it is causing me issues at work

Other Meds: Lamictal effexor Seroquel

Current Illness: na

ID: 1727339
Sex: M
Age: 29
State: AZ

Vax Date: 08/02/2021
Onset Date: 08/02/2021
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: 1727340
Sex: M
Age: 62
State: PA

Vax Date: 04/30/2021
Onset Date: 05/15/2021
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: IM
Vax Site: LA

Lab Data: Venous Duplex CT CHest multiple labs

Allergies: NKA

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Patient developed shortness of breath about 2 weeks after his second Moderna vaccine which was given 04.30.2021. His symptoms progressed and then he was admitted to the hospital with a submassive PE and BLE DVT June 15.2021-June 21.2021

Other Meds: trulicity, vitamin D 3, metformin, MVI

Current Illness: none

ID: 1727341
Sex: M
Age: 57
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:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1727342
Sex: M
Age: 81
State: CA

Vax Date: 02/26/2021
Onset Date: 02/28/2021
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: No

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

Symptoms: On Sunday after the vaccine, he woke up and was peeing blood. We took him to the ER on Sunday. They put a catheter in and observed. There was no blood infection. We brought him home thinking he was better. He was still peeing blood with clots stuck in his canal. He had to be rushed to the ER again. They did an intervention to see what was going on in his bladder. There was nothing going on. Eventually, the blood ceased and after 7 days he was released. He received transfusions. His cirrhosis situation also got worse. All preexisting conditions he had were flared up. He had to receive more injections for his cancer as well. After the hospitalization, he saw PCP who referred him to specialists. The specialists had no history on my dad so they were not able to tell if anything was abnormal or new. Also, prior to these events, my father was able to walk independently. Now, he requires assistance via a cane or walker. He is now going to different Hospital.

Other Meds: diabetes medication, aspirin, heart medication, diuretic

Current Illness: No

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am