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: 1729284
Sex: F
Age: 70
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: 1729286
Sex: F
Age: 52
State: MO

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

Symptom List: Anxiety, Dyspnoea

Symptoms: Employee given expired flu vaccination. Expiration date of 06/30/21. No signs or symptoms reported thus far.

Other Meds:

Current Illness:

ID: 1729287
Sex: F
Age: 56
State: CA

Vax Date: 09/21/2021
Onset Date: 09/21/2021
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: Shellfish, Feathers, cat hair, pollen

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

Symptoms: A large amount of redness, swelling and pain on the upper arm where I got the shot. THe reaction has worsened each day.

Other Meds: Daily vitamins

Current Illness:

ID: 1729288
Sex: F
Age: 50
State: MI

Vax Date: 05/12/2021
Onset Date: 08/31/2021
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: Patient presents to ED with COVID symptoms and positive test. Chest pain as well. Fully vaccinated May 2021.

Other Meds:

Current Illness:

ID: 1729289
Sex: F
Age: 72
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:
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: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1729290
Sex: F
Age: 44
State: MI

Vax Date: 09/01/2021
Onset Date: 09/17/2021
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:

Allergies:

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

Symptoms: I started bleeding vaginally 10 days after the vaccine and still bleeding 9/23/21. 13 days of bleeding. My menstrual cycle is normal and predictable because I am on oral contraceptives. This is bleeding outside of my normal cycle. During my normal cycle I only bled for 3-4 days.

Other Meds:

Current Illness:

ID: 1729291
Sex: M
Age: 73
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: 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: 1729292
Sex: F
Age: 23
State: LA

Vax Date: 07/17/2021
Onset Date: 09/17/2021
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: iodine, msg, seafood

Symptom List: Pharyngeal swelling

Symptoms: joints burning, skin burning, chills, fatigue, escalated heart rate, headache, nausea

Other Meds:

Current Illness:

ID: 1729293
Sex: M
Age: 54
State: MO

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

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Employee given expired flu vaccination. Expiration date of 06/30/21. No signs or symptoms reported thus far.

Other Meds:

Current Illness:

ID: 1729295
Sex: F
Age: 63
State: MI

Vax Date: 07/15/2021
Onset Date: 09/10/2021
Rec V Date: 09/23/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Patient admitted for acute encephalopathy and COIVD positive. Vaccinated July 2021.

Other Meds:

Current Illness:

ID: 1729297
Sex: F
Age: 67
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:
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: 1729298
Sex: F
Age: 45
State: MO

Vax Date: 09/15/2021
Onset Date: 09/15/2021
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: Employee given expired flu vaccination. Expiration date of 06/30/21. No signs or symptoms reported thus far.

Other Meds:

Current Illness:

ID: 1729299
Sex: M
Age: 39
State: KS

Vax Date: 04/10/2021
Onset Date: 04/12/2021
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: Penicillin

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

Symptoms: In the days following my first dose of the Pfizer vaccine, I had nerve pain in both of my hands when I bent my wrists forward. This pain continued in my left hand for a couple months, although my left hand now feels fine. My right hand continues to have nerve pain though when I extend my arm and bend my wrist forward even slightly. This has prevented me from doing certain activities that I'm accustomed to doing. The pain in my right hand is still as severe as it was when it initially started in April.

Other Meds: NONE

Current Illness: NONE

ID: 1729300
Sex: M
Age: 53
State: NY

Vax Date: 07/30/2021
Onset Date: 07/30/2021
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: None

Allergies: None

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

Symptoms: I was given the vaccine at 1pm. That night I woke up with an extremely hard erection that was very uncomfortable. The erection lasted about 2 hours or so. This was not due to some arousal. I woke up this way. This happened the entire week.

Other Meds: Vitamin D, zinc, melatonin

Current Illness: None just borderline high cholesterol

ID: 1729301
Sex: M
Age: 60
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: 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: 1729302
Sex: M
Age: 32
State:

Vax Date: 09/15/2021
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:

Allergies: N/A

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

Symptoms: Heart inflammation (extreme chest pain)

Other Meds: N/A

Current Illness: N/A

ID: 1729303
Sex: M
Age: 48
State:

Vax Date: 04/01/2021
Onset Date: 04/01/2021
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: EKG, hearth catheterization, Chest CT, echocardiogram.

Allergies: None

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

Symptoms: Initial side effects were six hours after the injection. I had severe headache, diffuse myalgia, nausea, photophobia, chills, and fever. About a month after the injection, I have had vague intermittent cheat palpitations for the last 4 months. Most recently, I had acute chest pain and went to the ER. My troponins were elevated but my hearth catheterization was normal. I am have daily palpitations and fluttering. After my heart catheterization I went into Atrial fibrillation. I was cardioverted 3x. I am currently following up with a Cardiologist for further evaluation.

Other Meds: None

Current Illness: None

ID: 1729304
Sex: M
Age: 51
State: MI

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

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

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Patient admitted for COVID pneumonia. Vaccinated August 2021

Other Meds:

Current Illness:

ID: 1729305
Sex: M
Age: 61
State:

Vax Date: 09/22/2021
Onset Date: 09/22/2021
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: 1729306
Sex: F
Age: 56
State: AR

Vax Date: 09/23/2021
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:

Allergies:

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

Symptoms: Headache, nausea,chills,fever,heartbeat hard and fast in chest and head

Other Meds:

Current Illness:

ID: 1729307
Sex: F
Age: 15
State: SC

Vax Date: 08/18/2021
Onset Date: 09/09/2021
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: 2 days after vaccine, ulcers appeared in her mouth and vulva

Other Meds: None

Current Illness: None

ID: 1729308
Sex: F
Age: 76
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1729309
Sex: F
Age: 48
State: FL

Vax Date: 09/16/2021
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: On 9/22 the ER ran numerous blood tests and performed a CT without contrast. Nothing revealed anything to explain the spike in my blood pressure

Allergies: Seasonal Allergies

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

Symptoms: Pfizer Vaccine - caused blood pressure to spike to 180/100 and it is still high. I have no history of high blood pressure. I visited the ER and my blood pressure went down to 154/90. my normal blood pressure range is 120/70 to 120/175.

Other Meds: Adderrall XR Goli Daily Vitamins

Current Illness: None

ID: 1729310
Sex: F
Age: 48
State: MD

Vax Date: 01/22/2021
Onset Date: 01/22/2021
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: The doctor felt pretty confident in his diagnosis and reported no tests necessary.

Allergies: None

Symptom List: Injection site pain, Pain

Symptoms: My arm felt swollen or like it was filled with liquid. I checked my arm and it appeared normal but it didn't feel normal. Days passed and I thought it would subside but it started to hurt in one spot on my elbow. It never went away. I finally went to my primary doctor and she prescribed 2 weeks of Ibuprofen. The medicine did not help. It became increasing worse. I couldn't do anything with my left arm or pick up anything. The pain stayed localized to the one area but eventually moved around the same location. I went to a doctor at the clinic and was treated for lateral epicondylitis. I received PT 2x a week and wear a brace on my left arm.

Other Meds: Lexapro 5mg Amlodipine 2.5 mg One a day women's Vitamin C & Vitamin D Probiotic

Current Illness: None

ID: 1729311
Sex: F
Age: 65
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:
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1729312
Sex: F
Age: 50
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: 025J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1729313
Sex: M
Age: 54
State:

Vax Date: 09/22/2021
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: LA

Lab Data:

Allergies: none.

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Persistent muscle ache at the site of injection. Chills beginning about 12 hrs. after injection. Fever with some sweating. Temperature above 38C for at least 3 hrs. Nausea but no vomiting. Lethargy.

Other Meds: none.

Current Illness: none.

ID: 1729314
Sex: F
Age: 32
State: MO

Vax Date: 09/15/2021
Onset Date: 09/15/2021
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: Employee given expired flu vaccination. Expiration date of 06/30/21. No signs or symptoms reported thus far.

Other Meds:

Current Illness:

ID: 1729315
Sex: F
Age: 74
State:

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:

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

Symptoms: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1729316
Sex: F
Age: 22
State: AZ

Vax Date: 08/11/2021
Onset Date: 08/16/2021
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: Blood culture 8/25/2021 Complete blood count 8/25/2021 Metabolic/Electrolyte panel 8/25/2021 C reactive protein level 8/25/2021 Lactic Acid Level 8/25/2021 Nucleated RBC 8/25/2021 COCCI, IGM, IGG 8/25/2021 Strep Test 9/12/2021 POSITIVE Chest XRay - 9/22/21 I have been to the hospital, dermatology specialists, multiple urgent cares, multiple telehealth doctors, and multiple doctors at my primary care facility.

Allergies: NONE

Symptom List: Nausea

Symptoms: About five days after I received my shot, I developed what has now been diagnosed as erythema nodosum in my leg. As of the date of this submission, my leg is still red, swollen and painful. Since my shot, I have also been generally unwell. I have had strep throat, pink eye, and a persistent cough and fever that will not go away. I have been treated with doxycycline, cephalexin, penicillinxpotassium 500, zpack, and painkillers. Before my covid shot I was a healthy law student who worked out almost daily.

Other Meds: Oral birth control (been on it for many years)

Current Illness: NONE

ID: 1729317
Sex: M
Age: 67
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:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1729318
Sex: M
Age: 56
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1729319
Sex: F
Age: 26
State: MO

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

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

Symptoms: Employee given expired flu vaccination. Expiration date of 06/30/21. No signs or symptoms reported thus far.

Other Meds:

Current Illness:

ID: 1729320
Sex: M
Age: 66
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: 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: 1729321
Sex: M
Age: 27
State: CA

Vax Date: 09/15/2021
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: None

Allergies: None

Symptom List: Erythema, Pruritus

Symptoms: On the 15th of September at 7:30 pm, i started to feel chills followed by shivering. About 5 minutes later, the chills disappeared and were replaced with uncontrollable shaking all over my entire body. Unable to find a position that stopped the shaking, I resorted to hugging my knees and the fetal position as I thought I was going to go into shock, or worse. My legs, lower back, upper back, shoulders, and hands were all shaking so badly that I could hardly speak a sentence clearly. This uncontrollable shaking lasted until about 08:50 pm. Immediately following the shaking, I broke out into a fever that lasted until the middle of the night, peaking at 102.8 degrees for multiple temperature checks. I was unable to sleep until after midnight at a time which is unknown due to my body being so incredibly hot, and was worried that a trip to the ER was going to be necessary. I also had concerns about the temperature of my testicles and scrotum, and resorted to taking my clothes off to try and keep as cool as possible. At one point, I had to have my wife check my skin for burns because I felt as if my limbs were physically burning each other from prolonged contact, making laying in one position for more than a couple of minutes nearly unbearable. The following day i woke with a terrible headache, body aches, a slight fever, and intense fatigue. I spent the entire day in bed, sleeping on and off with absolutely no appetite for two days to follow. Being active duty military, I have received over a dozen vaccines in the last 8 years, and not only have I never felt symptoms such as these or so intensely, but I have never been nearly as afraid as I was following this vaccination.

Other Meds: Mens multivitamin, Fish oil, Magnesium, Vitamin C, Glutamine, Multi Greens

Current Illness: Tested positive for Corona Virus on 04AUG2021

ID: 1729322
Sex: M
Age: 52
State: IL

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: Patient was advised to go to an ER or urgent care for evaluation and possible bloodwork.

Allergies:

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

Symptoms: 10 minutes after receiving the vaccine, the patient noticed he was developing red dots all over his body. They were not itchy, and they looked like petechiae.

Other Meds:

Current Illness: Patient states that he has multiple medical issues.

ID: 1729323
Sex: F
Age: 78
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: 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: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1729324
Sex: F
Age: 43
State: TN

Vax Date: 09/13/2021
Onset Date: 09/13/2021
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: CBC and flu test 9-14-2021

Allergies: Sulfa

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Shortness of breath, elevated pulse, dizziness, fever, and body aches

Other Meds: Amlodipine 2.5 mg, Paxil 20 mg, Celebrex 200 mg, Omeprazile 40 mg, Ferrous Sulfate 325 mg

Current Illness: None

ID: 1729325
Sex: F
Age: 39
State: IL

Vax Date: 01/11/2021
Onset Date: 01/21/2021
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: Primary care appt 1/26/21 Urgent care visit 1/28/21 Primary care visit 2/8/21

Allergies: None

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

Symptoms: January 21 hemifacial spasms started on left side of face and continued for a week, progressed to tingling on left side of body. Was evaluated January 28th in urgent care. Tingling and numbness on left side of face, left arm, left leg and foot continued most days for approximately 3-4 months and then was more occasional for another 3 months.

Other Meds: Vitamin B complex Fish oil Vitamin D Iron complex

Current Illness: Assumed long haul COVID symptoms that had recently cleared. Assumed COVID infection March 2020 before testing was available for mild cases

ID: 1729326
Sex: F
Age: 46
State: IL

Vax Date: 04/30/2021
Onset Date: 05/21/2021
Rec V Date: 09/23/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: Underwent blood tests, Urine tests, X-rays, Angiogram, EKG's, MRI ANGIOGRAM

Allergies: Corn, Soy, Peanut Butter,

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

Symptoms: The patient had the headache after the 1st dose starting May 1st, 2021. The headache lasted for 8 days after the 1st dose. From May 1st, 2021 the patient had experienced pain in the chest area, left(leg) knee pain , was unable to bend the knee. On June 29th, 7:05 AM, there was squeezing pain in the chest area including the back pain and left upper arm Pain. In the evening, the back pain was very severe, unable to lie down flat. In the night around 10:00 PM, the patient felt dizzy while standing and went to bed. On June 30th, recurrence of Chest tightness, headache was there. During the call with Insurance provider to identify the nearest ER/Urgent care, Insurance carrier contacted the 911 and the paramedics arrived at the residence at 12:55 PM. Paramedics stated that the blood pressure and pulse was abnormal. Transported by Ambulance to the hospital. ER medical care team took Couple of blood tests, X-RAY and EKG in ER room from 1:40 PM to 09:40 PM, was shifted to Cardiac Surveillance Unit at 9:40 PM. Medical Staff & Nurses got the Cardiology team's opinion over the phone and treatment started around 1:10 AM on July 1st, 2021. Cardiac catheterization (Angiogram) was done on July 1st 2021 in the afternoon. No intervention needed. The patient was discharged from the hospital on July 2nd 2021 at 7:30 PM. The patient had experienced chest pain again on July 5th, 2021 and paramedics came to the residence and was transported by ambulance to the Hospital, with High BP and abnormal pulse. The patient was treated in Emergency Room in the Hospital from 11:30 AM to 5:00 PM and was released from the hospital. Recommended for Blood thinner Clopidogrel (Plavix) and rehabilitation. Underwent Cardiac MRI for continued intermittent Chest Pain on September 15th, 2021. as per the MRI results , there is one tiny area of scar.

Other Meds: Vitamin-d3 2000 mg,Magnesium 250 mg, Vitamin b12

Current Illness: None

ID: 1729327
Sex: F
Age: 34
State: MO

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

Allergies:

Symptom List: Pain in extremity

Symptoms: Employee given expired flu vaccination. Expiration date of 06/30/21. No signs or symptoms reported thus far.

Other Meds:

Current Illness:

ID: 1729328
Sex: F
Age: 60
State: KY

Vax Date: 09/01/2021
Onset Date: 09/19/2021
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: I have not tested other than a week prior to shot had Covid test that was negative.

Allergies: Imetrix, bananas, watermelon, cantaloupe, Augmentin

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

Symptoms: 9/19/21 Exhausted, nausea,weak, headache, body aches, shortness of breath worse with exertion , headache 9/20-9/21 Missed work due to weakness, muscle aches, loss of voice, wheezing, shortness of breath worse with exertion , headaches 9/22-9/23 hoarse voice, tired, wheezing, shortness of breath continues especially with exertion , headaches - now evening sore throat with burning in chest and left ear burn/pain/hurting No sign 9/22-9/23 symptoms will ease. Instructed by co-workers (I am a Registered Nurse) to report these issues to you

Other Meds: Synthroid, Singulair, Omeprazole, potassium, losartan, Centrum Vitamin, Vit D3, Wellbutrin Claritin

Current Illness: Asthma, hypertension, hypothyroid

ID: 1729329
Sex: M
Age: 30
State: MO

Vax Date: 09/15/2021
Onset Date: 09/15/2021
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: Employee given expired flu vaccination. Expiration date of 06/30/21. No signs or symptoms reported thus far.

Other Meds:

Current Illness:

ID: 1729330
Sex: M
Age: 29
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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Nausea, tunnel vision, profuse sweating

Other Meds:

Current Illness:

ID: 1729331
Sex: F
Age: 52
State: MO

Vax Date: 09/15/2021
Onset Date: 09/15/2021
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: Employee given expired flu vaccination. Expiration date of 06/30/21. No signs or symptoms reported thus far.

Other Meds:

Current Illness:

ID: 1729440
Sex: F
Age: 52
State: MO

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

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Employee given expired flu vaccination. Expiration date of 06/30/21. No signs or symptoms reported thus far.

Other Meds:

Current Illness:

ID: 1729441
Sex: M
Age: 25
State: MO

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:

Allergies: none

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

Symptoms: only 14 days between 1st and 2nd dose. 1st dose given 9/9/2021. Patient had denied having first dose until discharge, then retrieved card from car showing 1st dose 9/9/2021. No adverse event noted.

Other Meds: none stated

Current Illness: none

ID: 1729442
Sex: M
Age: 40
State: MO

Vax Date: 09/15/2021
Onset Date: 09/15/2021
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: Employee given expired flu vaccination. Expiration date of 06/30/21. No signs or symptoms reported thus far.

Other Meds:

Current Illness:

ID: 1729443
Sex: F
Age: 38
State: OR

Vax Date: 09/13/2021
Onset Date: 09/16/2021
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: 09/18/2021- toxicology - marijuana positive CMP/CBC- WDL

Allergies: NKA

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

Symptoms: 3 days post vacc.- began mild Bilateral upper extremitie shaking/tremors 5 days post vacc.- seizure like activity lasting approximately 30minutes before medications were given in the Emergency Department 10 days post vacc- continuing upper extremity shakiness and began mild full body tremors with weakness to bilateral lower extremities

Other Meds: Zoloft; Wellbutrin; Vitamin D; Tapazole; marijuana

Current Illness:

Date Died: 08/01/2021

ID: 1729444
Sex: F
Age: 65
State: WA

Vax Date: 05/12/2021
Onset Date: 07/01/2021
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: N/A - Patient told these were temporary and non-life threatening. Take Tylenol and relax

Allergies: N/A

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

Symptoms: Patient began having severe headaches within 24 hours of second dose of Moderna vaccine. The following day patient became light headed and dizzy, unable to stand up straight with blinding headaches. Called the clinic where she received the vaccine and told to relax as these were temporary side effects and that is how she knows it's working. Headaches did not subside, patient died 2 and a half months after second dose of Moderna vaccine that was administered at the Hospital/clinic

Other Meds: N/A

Current Illness: Survived lung cancer in 2001, stroke in 2016.

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am