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: 1731572
Sex: M
Age: 83
State: CA

Vax Date: 09/23/2021
Onset Date: 09/23/2021
Rec V Date: 09/24/2021
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: 1731573
Sex: F
Age: 58
State: OK

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

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

Lab Data: NO

Allergies: PENICILLIN SULFA

Symptom List: Anxiety, Dyspnoea

Symptoms: PATIENT WAS GIVEN A COVID VACCINE ON 09/23/2021 AND COVID EXPIRED ON 09/17/2021

Other Meds: clotrimazole-betamethasone neomycin-polymyxin-HC lisinopril

Current Illness: NONE

ID: 1731574
Sex: F
Age: 52
State: WI

Vax Date: 09/15/2021
Onset Date: 09/15/2021
Rec V Date: 09/24/2021
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: Patient had work up of chest X-ray, EKG, and blood work in the Emergency Room. COVID-19 test came back negative.

Allergies:

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

Symptoms: Patient reports nausea, migraine, chills, and fever immediately post vaccination. The following day the patient experience fever and chest tightness radiating to the left arm. Patient went to the Emergency Room.

Other Meds:

Current Illness:

ID: 1731575
Sex: F
Age: 84
State: MT

Vax Date: 01/25/2021
Onset Date: 09/21/2021
Rec V Date: 09/24/2021
Hospital: Y

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: Diagnosed and hospitalized with covid

Other Meds:

Current Illness:

ID: 1731576
Sex: F
Age: 92
State: MI

Vax Date: 02/05/2021
Onset Date: 09/22/2021
Rec V Date: 09/24/2021
Hospital: Y

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

Lab Data: Unknown

Allergies: Bactrim DS, codeine, oxycodone

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

Symptoms: Patient was asymptomatic the ECF would not keep patient as she tested positive for COVID.

Other Meds: Unknown

Current Illness: Unknown

ID: 1731577
Sex: F
Age: 40
State: CA

Vax Date: 04/01/2021
Onset Date: 04/22/2021
Rec V Date: 09/24/2021
Hospital: Y

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: CAT scan 4/29 to diagnose the pulmonary embolism. BP tests to diagnose that issue.

Allergies:

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

Symptoms: I was pregnant (due May 5th). I received my first Covid shot (Pfizer) on April 1st. On April 16th, I developed high blood pressure. I delivered the baby on April 20th. I had severe high blood pressure, diagnosed as postpartum severe preeclampsia, starting on April 22nd. I was readmitted to the hospital and am still on blood pressure medication currently. On April 29th, I developed a pulmonary embolism and did a 3 month treatment of Pradaxa.

Other Meds: Prenatal vitamins, fish oil

Current Illness:

ID: 1731578
Sex: M
Age: 64
State: CA

Vax Date: 09/23/2021
Onset Date: 09/23/2021
Rec V Date: 09/24/2021
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: 1731579
Sex: U
Age: 86
State:

Vax Date: 09/23/2021
Onset Date: 09/23/2021
Rec V Date: 09/24/2021
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: 1731580
Sex: F
Age: 60
State: CA

Vax Date: 09/23/2021
Onset Date: 09/23/2021
Rec V Date: 09/24/2021
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: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1731581
Sex: F
Age: 59
State: TX

Vax Date: 03/23/2021
Onset Date: 08/20/2021
Rec V Date: 09/24/2021
Hospital:

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

Lab Data: COVID-19 test, results positive 8/26/2021.

Allergies: None.

Symptom List: Diarrhoea, Nasal congestion

Symptoms: 8/20/2021 I started feeling the symptoms of fatigue, and I thought my allergies were going on. No, Sunday I started feeling worse got a cough and still more fatigued and felt just yucky. I lost my taste on 8/26/2021 but I could still smell. I took cold Tylenol. I went to the pharmacy and had a COVID test done and results came back positive on 8/26/2021. On 8/27/2021 I had a virtual visit with my doctor, the doctor wanted me to get an infusion but no appointments were available. She prescribed a cough medicine for me to take. I did not have a fever. She did recommend that I take zinc and so I did start to take that.

Other Meds: Low-Dose Aspirin; Citracal; Nexium; Farxiga; Simvastatin; Metformin; Losartan.

Current Illness: None.

ID: 1731582
Sex: M
Age: 46
State: MO

Vax Date: 09/24/2021
Onset Date: 09/24/2021
Rec V Date: 09/24/2021
Hospital:

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

Lab Data: Patient will have a titer run 90 days from vaccine date in order to know the efficacy of the Janssen vaccine.

Allergies: Hydrocodone

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

Symptoms: The above lot expired on 9-21-2021 and the Janssen vaccine was give on 9-24-2021. No other symptoms beside an expired dose.

Other Meds: Unknown

Current Illness: Unknown

ID: 1731583
Sex: M
Age: 78
State: GA

Vax Date: 01/19/2021
Onset Date: 08/27/2021
Rec V Date: 09/24/2021
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:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: PUI's symptoms developed on 9/4/21 including an inconsistent fever and brain fog. PUI was hospitalized due to severe fatigue and confusion. His oxygen level remains normal. PUI is retired and hasn't had any additional contacts. Prior history of afib and diabetes.

Other Meds:

Current Illness:

ID: 1731584
Sex: M
Age: 38
State: CA

Vax Date: 09/23/2021
Onset Date: 09/23/2021
Rec V Date: 09/24/2021
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: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1731585
Sex: F
Age: 65
State: NH

Vax Date: 03/23/2021
Onset Date: 04/12/2021
Rec V Date: 09/24/2021
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: CBC, CMP

Allergies: Doxycycline, Sulfa Drugs, Keflex, Singulair, Neomycin, Bacitracin, Lisinopril, Losartan, tetracycline.

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

Symptoms: Unexplained rash, non-responsive to treatment

Other Meds: Actos, Omeprazole, Atorvastatin, Gabapentin, Duloxetine, Trazodone

Current Illness: None

ID: 1731586
Sex: F
Age: 56
State: CA

Vax Date: 09/23/2021
Onset Date: 09/23/2021
Rec V Date: 09/24/2021
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: 1731587
Sex: F
Age: 51
State: KY

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

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

Lab Data: Rapid strep and rapid influenza

Allergies: Codeine and Aminophylline

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

Symptoms: Fever 104.9, chills, and nausea.

Other Meds: Alternating Acetaminophen and Ibuprofen.

Current Illness: None

ID: 1731588
Sex: F
Age: 48
State: NJ

Vax Date: 09/16/2021
Onset Date: 09/18/2021
Rec V Date: 09/24/2021
Hospital:

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

Lab Data: I?ve got an appt with an allergist on 9/28

Allergies: Lisinopril. Propanalol. Bactrim. Macrodantin.

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

Symptoms: I have developed hives on my hands and feet. My face looked like it had been pricked by pins. The hives have dried out and are flattened out. I have pics. I had a fever but not outrageous. I felt good on Wednesday, but then developed a fever again that night on 9/22. Felt like the flu. Body aches. Tired.

Other Meds: Alprazolam 0.25 mg tablets

Current Illness: None

ID: 1731589
Sex: U
Age: 73
State:

Vax Date: 09/22/2021
Onset Date: 09/22/2021
Rec V Date: 09/24/2021
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: 1731590
Sex: F
Age: 66
State: NY

Vax Date: 02/19/2021
Onset Date: 04/02/2021
Rec V Date: 09/24/2021
Hospital:

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

Lab Data: Catt scan. ECG & labs done 4/9/2021 Carotid Doppler 7/14/21 Cardiac 30 day event monitor. Completed 4/24/21 Echocardiogram 9/7/21 MRI scheduled for 10/15/21

Allergies: None

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Unable to read words in a book or verbalize those words for several minutes. Accompanied & followed by a headache.

Other Meds: Multivitamins

Current Illness: None

ID: 1731591
Sex: F
Age: 43
State: WI

Vax Date: 03/17/2021
Onset Date: 09/16/2021
Rec V Date: 09/24/2021
Hospital:

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

Lab Data:

Allergies: Lidocaine - Hives

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

Symptoms: Patient contracted COVID after being fully vaccinated

Other Meds: aspirin 81mg Cholecalciferol 1,000IU Daily hydroxychloroquine levothyroxine 75mcg daily

Current Illness: None documented

ID: 1731592
Sex: F
Age: 79
State: CA

Vax Date: 03/19/2021
Onset Date: 07/01/2021
Rec V Date: 09/24/2021
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: MRI CT scan blood work

Allergies: gabapentin

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

Symptoms: I got a CT scan, it showed that I had a lung. My spot on my lungs increased in size a lot in a few months. They are unsure that the vaccine had increase the speed for the spot. I also development cancer in my thyroid as well.

Other Meds: Lovastatin, Lisinopril

Current Illness:

ID: 1731593
Sex: M
Age: 70
State: KY

Vax Date: 02/24/2021
Onset Date: 09/21/2021
Rec V Date: 09/24/2021
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: COVID 19

Other Meds:

Current Illness:

ID: 1731594
Sex: M
Age: 20
State: PA

Vax Date: 09/23/2021
Onset Date: 09/23/2021
Rec V Date: 09/24/2021
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: Shrimp

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

Symptoms: At 6:35pm on 9/24/2021 employee reported by telephone that he believed he was having a reaction to the vaccine he had been given earlier that day. He reported that he was experiencing a fever, nausea, and vomiting. Employee was advised to seek medical care from his own HCP if he felt the need to, or if symptoms persisted.

Other Meds: None

Current Illness: None

ID: 1731595
Sex: F
Age: 41
State: WI

Vax Date: 08/19/2021
Onset Date: 08/20/2021
Rec V Date: 09/24/2021
Hospital:

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

Lab Data:

Allergies: AMMOXICILLIAN

Symptom List: Injection site pain, Pain

Symptoms: THE DAY AFTER THE SHOT, I HAD SEVERE FATIGUE AND WEAKNESS AND BODY ACHES. THAT LASTED FOR 24 HOURS. THE DAY AFTER THE SHOT I ALSO DEVELOPED A HEADACHE. I HAD THE HEADACHE FOR 8 STRAIGHT DAYS. NOW, I GET HEADACHES 3-5 DAYS PER WEEK. I ALSO FEEL FOGGY. LIKE I CANT THINK STRAIGHT OR CONCENTRATE.

Other Meds: BENAZEPRIL, ZYRTEK, VITAMIN D, CALCIUM, MULTI VITAMIN, VITAMIN C

Current Illness: NONE

ID: 1731596
Sex: U
Age: 53
State:

Vax Date: 09/22/2021
Onset Date: 09/22/2021
Rec V Date: 09/24/2021
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: 1731597
Sex: F
Age: 38
State: CO

Vax Date: 09/09/2021
Onset Date: 09/12/2021
Rec V Date: 09/24/2021
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: Codeine

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

Symptoms: Both hands and finger tips go numb

Other Meds: Amitriptyline

Current Illness:

Date Died: 08/27/2021

ID: 1731598
Sex: M
Age: 72
State:

Vax Date: 03/27/2021
Onset Date: 08/24/2021
Rec V Date: 09/24/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: pt presented to ED with SOB x 1wk, worsening; morbidly obese; cough, hypoxic; hx of CHF, chronic A Fib, DM2; positive for COVID; intubated on mechanical ventilation; condition worsened, pt died in the hospital

Other Meds:

Current Illness:

ID: 1731599
Sex: F
Age: 43
State:

Vax Date: 04/30/2021
Onset Date: 05/01/2021
Rec V Date: 09/24/2021
Hospital: Y

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

Lab Data: MRI - 3 strokes and effected your right side.

Allergies: no

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: In May 2021, I had vision, pherifical vision and could see colour for my right eye. 3 strokes since 16 Apr 2021 and 10 Jul 2021 and hospitalized. 7 Jul 2021 I was rushed by ambulance to hospital. Had 3 strokes. I can't drive and live on my own now.

Other Meds: no

Current Illness: no

ID: 1731600
Sex: F
Age: 29
State: FL

Vax Date: 04/01/2021
Onset Date: 09/19/2021
Rec V Date: 09/24/2021
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: Dairy, penicillin

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

Symptoms: Sudden ear drainage of yellow fluid, no concurrent or preceding sinus infection

Other Meds: None

Current Illness: Postpartum hypertension

ID: 1731601
Sex: M
Age: 60
State: KY

Vax Date: 03/09/2021
Onset Date: 08/27/2021
Rec V Date: 09/24/2021
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: COVID 19

Other Meds:

Current Illness:

ID: 1731602
Sex: U
Age: 70
State:

Vax Date: 09/22/2021
Onset Date: 09/22/2021
Rec V Date: 09/24/2021
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: 1731603
Sex: F
Age: 29
State: TX

Vax Date: 09/23/2021
Onset Date: 09/24/2021
Rec V Date: 09/24/2021
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: Biaxin

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

Symptoms: Experienced 103? F fever with shaking chills, lightheadedness and nausea. 400mg Ibuprofen was self administered and resolved the issues within 30-45 minutes. Fever started at 5:15am and broke (started sweating) around 6am.

Other Meds: None

Current Illness: None

ID: 1731604
Sex: F
Age: 50
State:

Vax Date: 03/22/2021
Onset Date: 09/14/2021
Rec V Date: 09/24/2021
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: Vaccine breakthrough, asymptomatic. 9/14 Inpatient admit 9/22 to present, non COVID reason

Other Meds:

Current Illness:

ID: 1731605
Sex: F
Age: 41
State: OK

Vax Date: 09/22/2021
Onset Date: 09/24/2021
Rec V Date: 09/24/2021
Hospital:

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

Lab Data: NO

Allergies: AMOXOCILLIN ibuprofen Flonase Allergy Relief

Symptom List: Tremor

Symptoms: PATIENT WAS ADMINISTERED A COVID VACCINE ON 09/22/2021 AND VACCINE EXPIRED 09/17/2021

Other Meds: Adderall

Current Illness: NO

ID: 1731606
Sex: F
Age: 51
State: FL

Vax Date: 09/19/2021
Onset Date: 09/19/2021
Rec V Date: 09/24/2021
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: Penicillin; Morphine; Levaquin; Sulfa (not sure)

Symptom List: Erythema, Pruritus

Symptoms: The evening of 9/19/2021 I had pain at the injection site. From my neck down to my fingers there was discomfort and a heavy feeling. I had muscle and joint pain that was moderate. When I woke up on Monday morning 9/20/2021 I had a scratchy throat and dry cough, and I was still experiencing the arm pain from the night before. I felt a little fatigued as the day went on and started having mild chills. I didn't check my temperature so I don't know if I had a fever. I'm still having muscle and joint pain. The morning 9/21/2021 when I woke up I noticed I was having significant soreness and tenderness in my right clavicle area. I felt a dime size lump in that area. In a couple of hours it was the size of a golf ball. I contacted Walgreens pharmacy where I had received the 2nd dose and asked if that was a normal reaction. The pharmacist said that that was not a common reaction. They told me if it got worse to contact my PCP or go to urgent care. I started to have the same type of swelling on the left side above my clavicle. At that point I contacted my new PCP, but because I wasn't an established patient yet they wouldn't see me for the issues and referred me to urgent care or the ER. Then I consulted with a pharmacist. They told me they had never seen or heard of the reaction I was having before and told me I need to make sure again to let them know so they can report it. I did that and called back. The pharmacist called me through out that day to check in to see if they were any changes. They suggested if there were changes to go to an urgent care or the ER and to also self report. The following day on 9/22/2021 I started to have swelling in my lymph nodes in my groin area and in my right armpit. I was also having some tightness in my throat on 9/21/2021 and 9/22/2021 but it wasn't significant. Since then the swelling in the groin and right armpit area has completely subsided. The swelling in my clavicle area is more noticeable on the right side but has reduced from a golf ball size to the size of a half dollar or quarter. I don't have any tightness in my throat now and the swelling has gone down. I haven't went to an urgent care or the ER. I'm still having swelling on clavicle right side area which is more noticeable than the left side.

Other Meds: 2 Advil pills after vaccine

Current Illness:

ID: 1731607
Sex: F
Age: 58
State: MN

Vax Date: 01/07/2021
Onset Date: 09/20/2021
Rec V Date: 09/24/2021
Hospital:

Vax Type: UNK
Manufacturer: UNKNOWN MANUFACTURER
Vax Name: VACCINE NOT SPECIFIED (NO BRAND NAME)
Lot:
Dose Series: UNK
Vax Route: SYR
Vax Site: UN

Lab Data:

Allergies:

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

Symptoms: Positive results

Other Meds:

Current Illness:

ID: 1731608
Sex: F
Age: 58
State: UT

Vax Date: 09/08/2021
Onset Date: 09/10/2021
Rec V Date: 09/24/2021
Hospital:

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

Lab Data: No labs done

Allergies: Wheat, corn, soy

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

Symptoms: Difficulty breathing, pain with inspiration, tight chest, heart palpitations, cough, headache, body aches, fatigue, brain fog. Symptoms ongoing to this day.

Other Meds: None

Current Illness: None

ID: 1731609
Sex: U
Age: 49
State:

Vax Date: 09/22/2021
Onset Date: 09/22/2021
Rec V Date: 09/24/2021
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: Asthenia, Chills, Headache, Myalgia

Symptoms: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1731610
Sex: F
Age: 20
State: PR

Vax Date: 05/11/2021
Onset Date: 05/11/2021
Rec V Date: 09/24/2021
Hospital:

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

Lab Data: UNKNOWN

Allergies: UNKNOWN

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

Symptoms: INFO CLARIFIED. SUSPECTED WRONG DATA ENTRY.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1731611
Sex: F
Age: 47
State: NM

Vax Date: 05/20/2021
Onset Date: 06/18/2021
Rec V Date: 09/24/2021
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: Elevated d-dimer

Allergies:

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

Symptoms: Heart palpitations, pvcs, angina, further hypertension, all requiring new medications. Elevated d-dimer.

Other Meds: Lisinopril, naproxen, montelukast, cetirizine

Current Illness: Degenerative joint disease, Ehlers Danlos Syndrome, hypertension

ID: 1731612
Sex: F
Age: 33
State: CA

Vax Date: 09/01/2021
Onset Date: 09/15/2021
Rec V Date: 09/24/2021
Hospital:

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

Lab Data:

Allergies: Allergies to Penicillin and Sulfa, plastic band-aids.

Symptom List: Pain in extremity

Symptoms: My menstrual period has changed. I am on Nexplanon birth control implant, I hardly bled before these vaccines doses, and now I am bleeding a lot, I actually bled through my pants. This is not normal and I would like it documented. Also, three weeks after my second dose, my left upper arm where I got both doses of this vaccine, it is sore still. The soreness went after after a week and now it is back, this is also not normal. I also have a red rash that comes and goes in the same area. Both doses required me to take Benadryl afterwards because it causes my throat to itch.

Other Meds:

Current Illness:

ID: 1731613
Sex: F
Age: 29
State: KY

Vax Date: 08/12/2021
Onset Date: 08/31/2021
Rec V Date: 09/24/2021
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: COVID 19

Other Meds:

Current Illness:

ID: 1731614
Sex: F
Age: 26
State: NC

Vax Date: 09/22/2021
Onset Date: 09/23/2021
Rec V Date: 09/24/2021
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: Sulfa

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

Symptoms: Diarrhea Redness-tender to touch at injection site

Other Meds: Zyrtec

Current Illness:

ID: 1731615
Sex: M
Age: 80
State:

Vax Date: 02/23/2021
Onset Date: 09/23/2021
Rec V Date: 09/24/2021
Hospital: Y

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: 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: 1731616
Sex: F
Age: 57
State: NC

Vax Date: 08/20/2021
Onset Date: 08/20/2021
Rec V Date: 09/24/2021
Hospital:

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

Lab Data: ECG in office on 9/24/21 showed sinus rhythm and left ventricular hypertrophy. I am referring her for an echocardiogram and 48 hr holter monitor. The following labs were drawn in office today, results pending (Iron and TIBC, Vitamin B12 and Folate; CMP; TSH Rfx on Abnormal to Free T4; CBC With Differential/Platelet; Sedimentation Rate-Westergren; CRP; Rheumatoid Factor (RF); Anti-CCP Ab, IgG/IgA; Antinuclear Antibodies Direct; Anti-dsDNA Antibodies; Calcium, Ionized, Serum; CK+Aldolase. I am also referring her to neurology. She is currently seeing physical therapy.

Allergies: Mild allergy to prednisone and Avelox (reaction unknown).

Symptom List: Vomiting

Symptoms: Paresthesias Bilateral Feet, Muscle Spasms in back, Back Pain, Leg Weakness, "Brain Fog," "weird sensation in arms," Nausea, Abdominal Spasms, Palpitations, Vision Changes (wears glasses)

Other Meds: SUMAtriptan Succinate 25 MG Oral Tablet Take 1 tablet (25 mg) by mouth 2 times per day at least 2 hours between doses as needed Lomotil 2.5-0.025 MG Oral Tablet take 1 po qday prn Meclizine HCl 25 MG Oral Tablet Take 1 tablet (25 mg) by mou

Current Illness:

ID: 1731617
Sex: F
Age: 71
State: WI

Vax Date: 03/28/2021
Onset Date: 09/13/2021
Rec V Date: 09/24/2021
Hospital: Y

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

Lab Data:

Allergies: Sulfa abx

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Pt fully vaccinated with the Pfizer vaccine against COVID 19, on 3/7/2021 and 3/28/2021. Pt tested positive for covid on 9/13/2021. Presented to our ED on 9/20/2021 and admitted to the hospital. Found to have COVID-19 bilateral pneumonia, and sepsis. Still hospitalized.

Other Meds: alendronate, atorvastatin, calcium, cartia, lisinopril, metformin, metoprolol, multivitamin, trazodone, venlafaxine, warfarin.

Current Illness:

ID: 1731618
Sex: M
Age: 76
State: IL

Vax Date: 09/20/2021
Onset Date: 09/20/2021
Rec V Date: 09/24/2021
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: None

Allergies: Atorvastatin, Cephalosporins

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

Symptoms: "About 60 -90 minutes after my flu vaccine I became very vertiginous with a mild headache, with the environment whirling, staggering gait possible only holding on. I went to bed, had vomiting from the vertigo. I used a walker the rest of the day. This persisted even after a 3 hr nap. I was queezy the next day. I'm still less stable but it's manageable. Today I has a raspy voice, mild headache."

Other Meds: albuterol (PROVENTIL HFA) 90 mcg/actuation inhaler 1-2 Puffs inhalation, QID, PRN asthma amLODIPine 10 mg tablet Take 1 tablet by mouth daily. aspirin 81 mg Tablet, Delayed Release (E.C.) 1 TABLET DAILY Cholecalciferol, Vitamin D3, (VITAMIN

Current Illness: None

ID: 1731619
Sex: U
Age: 84
State:

Vax Date: 09/22/2021
Onset Date: 09/22/2021
Rec V Date: 09/24/2021
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: 1731620
Sex: F
Age: 28
State:

Vax Date: 09/22/2021
Onset Date: 09/22/2021
Rec V Date: 09/24/2021
Hospital:

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

Lab Data: N/A

Allergies: na

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

Symptoms: 5 minutes after administering vaccine. Staff member complained of tingling, hot flushed face and nausea. Benadryl 50mg given. After 45 minutes staff member had no symptoms and was sent home with a friend. Instructed to contact her medical doctor.

Other Meds: na

Current Illness: na

ID: 1731621
Sex: M
Age: 56
State: KY

Vax Date: 04/14/2021
Onset Date: 08/22/2021
Rec V Date: 09/24/2021
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: COVID 19

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am