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: 1731929
Sex: F
Age: 41
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: 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: 1731930
Sex: F
Age: 34
State: ME

Vax Date: 03/22/2021
Onset Date: 03/01/2021
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: Functional audiogram -- unremarkable; Brain MRI -- unremarkable aside from an incidental finding of a Rathke Cyst

Allergies: Seasonal allergies

Symptom List: Anxiety, Dyspnoea

Symptoms: After receiving my second injection I began having dizziness, ear pressure, pulsatile tinnitus and migraine headaches with a visual aura about 4-5 times per week. I followed up with my rheumatologist in April who referred me to ENT. ENT ordered a functional audiogram which was normal. They also ordered a brain MRI which was unremarkable aside from an incidental finding of a Rathke Cyst. I was then referred to a neuratologist who diagnosed me with inner ear and ocular migraines likely secondary to an autoimmune dysfunction. Prior to the vaccine I was seeing a rheumatologist for autoimmune symptoms, however, the abovementioned symptoms were new onset following the vaccine.

Other Meds: OTC omeprazole 20mg daily OTC Zyrtec 10mg daily OTC ibuprofen 400-600mg PRN pain OTC acetaminophen 500-1000mg PRN pain

Current Illness: None

ID: 1731931
Sex: F
Age: 42
State: NY

Vax Date: 03/15/2021
Onset Date: 03/15/2021
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: CBC

Allergies: Tylenol, lactose intolerant

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

Symptoms: A few hours after the vaccine I developed a severe headache, really bad fatigued so I took an Aleve and went to bed. When I woke up the next morning my entire body ached causing me to have to stay in bed. 3/17 the symptoms seemed to be getting a little better but all of the sudden my immune system seemed as if it begin attacking all my joints resulting in me not being able to walk for several days. My knees, ankles and shoulders area were severely swollen. I reached out to my Rheumatologist after about a week because the symptoms were getting worse. Because I had just gotten my Remicade Infusion a few weeks prior there was no treatment that could be performed and advised I take OTC pain meds until the vaccine reached full strength first other treatments could be performing. I did later get the infusion which did improve the symptoms a little and on 4/9 I visit the Rheumatologist in office and my infusions injections were then readjusted from every 8 weeks to now every 6 weeks.

Other Meds: Multivitamin, 400 mg Vit D., HCTZ, Remicade Infusion

Current Illness: no

ID: 1731932
Sex: F
Age: 54
State: TN

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

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

Lab Data: Contact pharmacy no results, contact primary provider no results, emergency room visit no results except to tell primary provider test that needed run. As for now no results

Allergies: Sulfa drugs, Erythromycin

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: The first vaccine I got covid arm after 7 days it went away in 4 days and I did fine. Second vaccine It was sore a few days warm to touch and a knot then next few weeks kept getting more sore and I called the pharmacy who said it might have triggered a autoimmune flair up that I was not aware I had. Few more months went by and the arm became more sore snd I was having trouble moving it or using it with having excruciating pain. I told my primary doctor who did blood work that showed normal but was basic blood work. I ended up at the ER in excruciating pain in arm who told me I needed different blood work or possible test done to take the paper to my provider to do because they didn?t bathe capabilities to do it at the emergency room. I have no insurance and I am a self pay do I can?t afford to have the test done. In the meantime I?m in severe pain.The test the ER recommended was blood first consisting of Ana, c3,c4,(send rate),crp, antiphospholipid antibodies , and cadiolipin antibodies . I can?t afford to do this right now because I?m self pay at doctors and we only have my husbands income of 1280. Month I?m off work taking care of him because he has chronic illnesses With COPD, Emphysema, heart failure, kidney failure and diabetes. Please help me get tested to get well or point me in the right direction to get this cured.

Other Meds: (diclofenac sodium enteric-coated tablets) - 75 mg 2 x day, lyrica 75 mg 1xday, flexeril 10 mg 1xday, Dexilant 60 mg 1xday , vitD 50,000 units once week

Current Illness: Neuropathy, Degenerative disc disease, muscle spasms

ID: 1731933
Sex: F
Age: 64
State: MI

Vax Date: 09/21/2021
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: PT SOUGHT MEDICAL ATTENTION AND RECEIVED PRESCRIPTION FOR PREDNISONE 9/24/21

Allergies: NKDA

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

Symptoms: RED RASH WITH ITCHING ON FACE (EAR, EYE, NOSE), THROAT/NECK, CHEST, B/L ARMS AND LEGS. NO WEEPING/OPEN SORES, NOT PAINFUL JUST ITCHY. NO SHORTNESS OF BREATH. PT STATES ONSET ABOUT 1HR AFTER ADMINISTRATION OF VACCINE WITH SYMPTOMS SPREADING/WORSENING EACH DAY. PT SOUGHT MEDICAL ATTENTION AND RECEIVED PRESCRIPTION FOR PREDNISONE 9/24/21

Other Meds:

Current Illness:

ID: 1731934
Sex: M
Age: 88
State:

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

Other Meds:

Current Illness:

ID: 1731935
Sex: M
Age: 27
State: CT

Vax Date: 08/26/2021
Onset Date: 08/26/2021
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: no known

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: patient presented for 2nd dose. stated that following 1st dose there was a noticeable bump. this started to decrease up until about a week ago when it began to enlarge then exude a pus like substance. patient does not have a PCP but referred to Urgent care for f/u for potential infection.

Other Meds: no known

Current Illness: no known

ID: 1731936
Sex: M
Age: 70
State: MO

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 of mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1731938
Sex: F
Age: 67
State: WI

Vax Date: 03/17/2021
Onset Date: 09/18/2021
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: Penicillins - Hives Triple antibiotic - redness

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Patient contracted COVID after being fully vaccinated Cough and Headache

Other Meds: albuterol PRN for wheezing Vitamin C 1000mg daily aspirin 81mg daily Symbicort BID Calcium 600 + D 600mg-200IU daily Zyrtec 10mg daily clonazepam 0.5mg daily duloxetine 60mg daily hydrochlorothiazide 25mg daily multivitamin daily Fish Oil d

Current Illness: None documented

ID: 1731939
Sex: F
Age: 70
State: FL

Vax Date: 03/30/2021
Onset Date: 09/22/2021
Rec V Date: 09/24/2021
Hospital: Y

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

Lab Data:

Allergies: NKA

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Vaccinated patient hospitalized with COVID-19

Other Meds:

Current Illness:

ID: 1731940
Sex: F
Age: 33
State: NC

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: Vaccination site erythema, Vaccination site pruritus, Vaccination site swelling

Symptoms: Vaccine expired 9/21/2021 at 11:59pm. Vaccine administered 9/22/2021 at 8:20am

Other Meds:

Current Illness:

ID: 1731941
Sex: F
Age: 71
State: KY

Vax Date: 02/16/2021
Onset Date: 02/16/2021
Rec V Date: 09/24/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data: Lab work CT-scan

Allergies: Versed Codeine

Symptom List: Rash, Urticaria

Symptoms: On April 22, 2021 I had lab work done in relation to abdominal pain that I was having. The lab work showed my platelet count was high at 490,000 when the normal count is 130,000-400,000. It also showed that my red blood cells was high at 5.37M-UL when the normal range is 3.80-5.20M-UL. The doctors treated me for diverticulitis and gave me antibiotics for it. I have been fine since taking the medicine and haven't had any more abdominal pain.

Other Meds: Lisinopril 10mg 1xday Protonic 20mg 1xday Pepcid 20mg 1xday Tylenol as needed Motrin as needed Flexural 10mg as needed Calcium Multivitamin Vitamin C Vitamin D

Current Illness:

ID: 1731942
Sex: M
Age: 37
State: AZ

Vax Date: 09/12/2021
Onset Date: 09/13/2021
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: No

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

Symptoms: Hives around heat starting the following day, lasted about 6 days Back and muscle pain starting about day 4 that's still ongoing. Same as stomach and gastrointestinal issues

Other Meds: Lansoprazole

Current Illness: No

ID: 1731943
Sex: M
Age: 67
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: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1731944
Sex: M
Age: 68
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: 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: 1731945
Sex: M
Age: 33
State: IL

Vax Date: 03/11/2021
Onset Date: 08/13/2021
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: None

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

Symptoms: Sharp pains in heart, becoming more frequent today.

Other Meds: None

Current Illness: None

ID: 1731946
Sex: M
Age: 57
State: OR

Vax Date: 09/23/2021
Onset Date: 09/24/2021
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:

Allergies: none

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

Symptoms: Chills, shivers, fever of 100-101, muscle aches, skin sensitivity

Other Meds: None

Current Illness: none

ID: 1731947
Sex: M
Age: 77
State: TN

Vax Date: 09/15/2021
Onset Date: 09/16/2021
Rec V Date: 09/24/2021
Hospital: Y

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

Lab Data: CT head was done on AM of 09/20/21 showed acute/subacute ischemic stroke in right posterior parietal lobe.

Allergies: NKA

Symptom List: Ear pain, Hypoaesthesia

Symptoms: The day after the 2nd dose of Moderna (9/16/21), the patient experienced confusion. A head CT performed on 9/20/21 which showed an acute/subacute ischemic stroke in right posterior parietal lobe.

Other Meds: Naproxen 220 mg Q8H PRN pain

Current Illness: Hypertension

ID: 1731948
Sex: F
Age: 21
State: MO

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

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Was given an expired dose, no reactions

Other Meds:

Current Illness:

ID: 1731949
Sex: F
Age: 88
State: FL

Vax Date: 04/02/2021
Onset Date: 09/12/2021
Rec V Date: 09/24/2021
Hospital: Y

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

Lab Data:

Allergies: NKA

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

Symptoms: Vaccinated patient hospitalized with COVID-19

Other Meds:

Current Illness:

ID: 1731950
Sex: F
Age: 28
State: PR

Vax Date: 09/02/2021
Onset Date: 09/02/2021
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:

Allergies: NONE

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

Symptoms: 28 year old female is received in the area of vaccination COVID-19 Hospital to administer the second dose vaccine PFIZER. After collecting all data patient informs having an allergic reaction to the first dose vaccine against COVID-19 PFIZER. She refers "After having administered the first dose of PFIZER vaccine, I started with heavy bleeding with clots. The same night I was administered the vaccine until the next day, it was not time for my period, and usually I bleed very little" It is recommended to visit her primary doctor before administering second dose. She expresses and authorizes the administration of the second dose and signs the consent. She is advised to visit the nearest emergency room in the event of bleeding. The second dose is administered with aseptic measures, the patient had no adverse reaction during the 15 minute wait.

Other Meds: NONE

Current Illness: NONE

ID: 1731951
Sex: M
Age: 59
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: 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: 1731952
Sex: F
Age: 42
State: NY

Vax Date: 08/19/2021
Onset Date: 08/19/2021
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: LA

Lab Data: No

Allergies: Tylenol; lactose intolerant

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

Symptoms: Pharmacy I was advised to drink 16oz of water 1hr before the shot which I noticed prevented the headache this time. And the arm at the injection site got sore for a few hours but nothing else was associated.

Other Meds: Multivitamin; vit D; HCTZ; Avsola infusion

Current Illness: AE carryover from dose 2

ID: 1731953
Sex: F
Age: 64
State: MN

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

Lab Data: Awaiting recommendations from Moderna

Allergies: Iodine, Nalbuphine, Doxycycline, Codeine, Latex, Sulfa Prednisone

Symptom List: Injection site pain, Pain

Symptoms: Moderna removed from freezer on 7/29/21 - stored in refrigerator starting on 7/29/21 - expiration date changed to 8/28/21 once stored in refrigerator. Dose given on 9/22/21 - product expired 8/28/21. Contacted Moderna, awaiting response.

Other Meds: Cimzia, Vit D, B12, Potassium Chloride, Sodium bicarb

Current Illness: NA

ID: 1731954
Sex: F
Age: 76
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: 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: 1731955
Sex: F
Age: 35
State: CA

Vax Date: 02/12/2021
Onset Date: 02/12/2021
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: COIVD test, negative, 2/17/2021. EKG, abnormal but I cannot remember what it was I have a follow up, 2/17/2021.

Allergies: n/a

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

Symptoms: At first I had a headache right after I got the second dose. It was an extreme headache. I started walking to my car and started to feel like I was getting a cold and then I was very tired. The second day I had a headache which wouldn't go away with any medication. I also had chest pain and swollen lymph nodes under my arms. I started feeling sharp, needle like pains going from my arm to my breast which wasn't constant but just randomly happened. So after still feeling like that for a few days, my doctor advised me to go to ER. I went there and explained what I was feeling. I got some tests and now have an appointment with the cardiologist.

Other Meds: n/a

Current Illness: n/a

ID: 1731956
Sex: M
Age: 63
State:

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:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1731957
Sex: F
Age: 61
State: SC

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: RA

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: The vaccine was administered one day post expiration date. The expiration date is dynamic and is not printed on the vial. J&J has been updating the expiration date and has been extended the date multiple times over the last 6 months. The company was contacted and they do not recommend a repeat dose. The patient experienced no adverse reaction.

Other Meds:

Current Illness:

ID: 1731958
Sex: F
Age: 56
State: WI

Vax Date: 09/01/2021
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: RA

Lab Data: No

Allergies: Compazine, gabapentin

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

Symptoms: Vertigo started at 8pm day after vaccine and worsened. Increased restless leg,severe headache

Other Meds: Savella,wellbutrin,synthroid,toprol XL,ropinrole,buspar,

Current Illness: No

ID: 1731959
Sex: F
Age: 53
State: MA

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:

Allergies: penecillian

Symptom List: Nausea

Symptoms: severe headache and muscle aches, runny nose, watery eyes and signifigant swelling in lips. headache, runny nose, and body aches 24 hours, swollen lips 48 hours and counting. Benedryl helped.

Other Meds: lexapro 10 mg

Current Illness: none

ID: 1731960
Sex: F
Age: 64
State: FL

Vax Date: 05/14/2021
Onset Date: 08/30/2021
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: LA

Lab Data:

Allergies: Codeine

Symptom List: Injection site pain

Symptoms: Vaccinated patient hospitalized with COVID-19

Other Meds:

Current Illness:

ID: 1731961
Sex: F
Age: 44
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: 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: 1731962
Sex: M
Age: 44
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: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1731963
Sex: F
Age: 84
State: MO

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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Tremor

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

Other Meds:

Current Illness:

ID: 1731964
Sex: M
Age: 84
State: MO

Vax Date: 03/23/2021
Onset Date: 07/19/2021
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: SARS-CoV-2 PCR positive 7/19/2021

Allergies: NKDA

Symptom List: Erythema, Pruritus

Symptoms: Presented to emergency department 7/19 w/ syncope, vomiting. Had abnormal chest X-ray and started on antibiotics for pneumonia. Hospitalized for 3 days and discharged in usual state of health on 7/22/2021.

Other Meds: albuterol, aspirin, buproprion, buspirone, fluticasone, guafenesin, Norco, memantine, fish oil, pantoprazole, simvastatin, tolterodine, vitamin D

Current Illness: none

ID: 1731965
Sex: F
Age: 33
State:

Vax Date: 09/10/2021
Onset Date: 09/10/2021
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: 3 negative pregnancy tests 9/15 9/18 9/20

Allergies:

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

Symptoms: Menstrual cycle 2 weeks late after vaccine.

Other Meds: Levothyroxine Prenatal vitamin Cetirizine

Current Illness:

ID: 1731967
Sex: F
Age: 32
State: FL

Vax Date: 08/19/2021
Onset Date: 08/29/2021
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: LA

Lab Data: Lumbar puncture did not reveal evidence of elevated protein. This was done at outside hospital and I do not have the date available to me. She had MRI of the brain, cervical spine, thoracic spine, lumbar spine. EMG is pending.

Allergies: sulfa

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

Symptoms: 32-year-old woman who at approximately 9 weeks pregnant receive the first shot of Materna COVID-19 vaccine on August 19. 10 days later she developed numbness, tingling, weakness, balance difficulties to the point that she was not able to walk. She was admitted to hospital, diagnosed with Guillain-Barr? syndrome, received IVIG. She is improving. She still has neurologic deficits based upon my evaluation as of 9/23/2021.

Other Meds: zoloft 25, PNV, albuterol MDI

Current Illness: none

ID: 1731968
Sex: F
Age: 48
State: CA

Vax Date: 05/25/2021
Onset Date: 06/06/2021
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: Biopsy on foot and back, both spots came back confirming it is Lichon Planus.

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Severe rash outbreak on feet, wrist, legs, arms, and back along with itching. Was prescribed corticoid steroid creams to treat, which eased up a bit.

Other Meds:

Current Illness:

ID: 1731969
Sex: F
Age: 75
State: MO

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: SYR
Vax Site: LA

Lab Data:

Allergies:

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

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

Other Meds:

Current Illness:

ID: 1731970
Sex: M
Age: 53
State:

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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

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

Other Meds:

Current Illness:

ID: 1731971
Sex: F
Age: 61
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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1731972
Sex: F
Age: 27
State: MO

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: 2
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

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

Other Meds:

Current Illness:

ID: 1731973
Sex: M
Age: 55
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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

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

Other Meds:

Current Illness:

ID: 1731974
Sex: F
Age: 41
State: FL

Vax Date: 01/13/2021
Onset Date: 08/31/2021
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: Sulfa

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

Symptoms: Vaccinated patient hospitalized with COVID-19

Other Meds:

Current Illness:

ID: 1731975
Sex: F
Age: 41
State: MN

Vax Date: 04/28/2021
Onset Date: 04/28/2021
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: 5/19/21: Labs (normal) 6/17/21: Neurologist exam (normal) 7/30/21: EMG (normal) 8/31/21: MRI (normal)

Allergies: None

Symptom List: Vomiting

Symptoms: Within 30 minutes of getting the 2nd dose of Moderna, I started to feel tingling in my hands and feet. This tingling has continued since then, although it has seemed to dull a bit. I visited with my primary case doctor on 5/19/21. She took some labs and referred me to a Neurologist at the Clinic. I saw Dr. at the Clinic on 6/17/21. She did an exam and didn't notice anything concerning. She told me that her recommendation would be to get an EMG, but I decided to wait a couple weeks to see if anything improved. I then scheduled the EMG for 7/30/21. I had a follow up with Dr on 8/16/21 where she told me the EMG was normal. She then recommended an MRI of my cervical spine. I had the MRI on 8/31/21. I had another follow up with Dr. on 9/3/21 where she told me that the MRI was normal. I now have an appointment for second opinion on 9/29/21 with the Neurology Clinic .

Other Meds: Fiber Gummies; Prenatal Vitamins; Azelastine; QNSAL; Spironolactone

Current Illness: I was being seen by an allergist for mucus/post nasal drip issues.

ID: 1731976
Sex: F
Age: 63
State: WV

Vax Date: 09/17/2021
Onset Date: 09/18/2021
Rec V Date: 09/24/2021
Hospital:

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

Lab Data: none

Allergies: none listed

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Pt first developed a fever of 102 on Sat 9/18 and treated with Tylenol. On Sun 9/19, she had a nose bleed, treated with compression until symptoms resolved. On Mon 9/20 pt had itching that progressed to hives on Tues 9/21 and a very "cold feeling to the touch". This was not treated to the best of my knowledge other than the initial Tylenol. Pt called me on Wed 9/22 to report this but did say she was beginning to feel better. I followed up with pt today, 9/24 and pt claims that all symptoms have resolved

Other Meds: unsure

Current Illness: unsure

ID: 1731977
Sex: F
Age: 59
State: MO

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: RA

Lab Data:

Allergies:

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

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

Other Meds:

Current Illness:

ID: 1731978
Sex: M
Age: 61
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: 1731980
Sex: M
Age: 50
State: FL

Vax Date: 06/05/2021
Onset Date: 06/01/2021
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: RA

Lab Data: Pulmonary embolism

Allergies: No

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

Symptoms: Pulmonary embolism Blood clot in lung

Other Meds: Alprazolam Methadone Cypionate

Current Illness: None

ID: 1731981
Sex: F
Age: 48
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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

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

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am