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: 1732577
Sex: M
Age: 56
State: CA

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: 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: 1732578
Sex: M
Age: 30
State: CA

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: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1732579
Sex: F
Age: 66
State: CA

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

Allergies:

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

Symptoms: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1732580
Sex: M
Age: 45
State: TX

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: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data: none

Allergies: none

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Patient did not have card. He stated that his first shot was Phizer. Was discovered later that his first shot was Moderna. Patient waited 30 minutes in the pharmacy and reported that he felt well and had no side effects.

Other Meds: unknown

Current Illness: none

ID: 1732582
Sex: F
Age: 59
State: TX

Vax Date: 06/03/2021
Onset Date: 06/07/2021
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: thyroiglobulin antbodiy, 25.4, high; thyroid peroxidase, 549, high; thyroid imaging w/uptake, 4 hr is 44.9% and 24 hr is 71.6%; no focal abnomalities and findings compatible with thyroiditis and Grave's disease on 8-18-2021

Allergies: none

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

Symptoms: Approximately 2-3 days after second dose of Moderna vaccine, I developed severe stomach pain. I thought I was just having an attack of some sort and that it would pass; sadly it did not, so I scheduled an appointment with the doctor. On 6/23/2021 I saw Dr. who prescribed Protonix and scheduled lab work. On 7/8/2021, I was advised my lab work indicated hyperthyroidism. Subsequent tests indicated Graves disease.

Other Meds: climara patch; omeprazole

Current Illness: none

ID: 1732583
Sex: M
Age: 22
State:

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

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

Symptoms: PMH Unknown, Medications Unknown, Allergies: NKA 1min post vaccination pt reported flushing/sweating, vomiting, dizziness. Patient observed pale, skin clammy to touch. Patient transferred to observation room via wheelchair. Patient vomitted 1x, clear liquid. Pt reports similar adverse effects after first dose. Pt denies reporting adverse effects prior to 2nd dose vacciantion. Vitals: @12:10 BP 118/77, HR 86, RR 18, 02 98% -- > @12:20 113/73, 73, 16, 100%. Juice and cracker snack provided. Patient reports relief of adverse symptoms. Patient gait is steady, directed to return to POD4. Patient stable at discharge (12:35)

Other Meds: Unknown

Current Illness:

ID: 1732584
Sex: F
Age: 75
State: CA

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: 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: 1732585
Sex: M
Age: 79
State: KY

Vax Date: 03/18/2021
Onset Date: 08/20/2021
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: Chest xray and CT of the abdomen were consistent with very small right lower lobe infiltrate and bloody secretions in the colon were consistent with diarrhea. Acute kidney injury due to increase in creatinine 1.9, secondary to the diarrhea for last several days. Positive COVID-19 test Sent home with oxygen

Allergies: Diclofenac

Symptom List: Pharyngeal swelling

Symptoms: Pneumonia due to COVID-19 Acute kidney injury 8/20/21-Came to ED for not feeling well for 3-4 days, mild cough, no fever or chills. No shortness of breath or chest pain. Did have some watery diarrhea. Shortness of breath noted

Other Meds: Apixaban 5 MG TAKE ONE TABLET BY MOUTH TWICE A DAY Azithromycin 250 MG Take 2 tablets by mouth once for 1 dose on day 1, then take 1 tablet daily on days 2-5. Ergocalciferol 50,000 Units Oral Every 7 days Loperamide HCl 2 mg Oral 4 time

Current Illness: Persistent atrial fibrillation, acute kidney injury, pneumonia due to COVID-19

ID: 1732586
Sex: M
Age: 57
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: Abdominal pain, Chills, Sleep disorder

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

Other Meds:

Current Illness:

ID: 1732587
Sex: F
Age: 32
State: IN

Vax Date: 01/10/2021
Onset Date: 08/10/2021
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: 8/10/21- US showing demise, fetal demise lab panel. 8/11/21- fetal chromosomes, placental cultures

Allergies: none

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Pregnancy related outcome. EDD 9/12/21. Single umbilical artery found at 20 week US. IUFD at 35w 2d on 8/10/21. Delivered 8/11/21. weight 5 lbs 6.7 oz.

Other Meds: Pre-natal vitamin

Current Illness: none

ID: 1732588
Sex: M
Age: 33
State: MO

Vax Date: 08/27/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: lymph nodes swelled up; prescribed an antiinflammatory; doctor did not want patient to get second dose at 4 weeks but to check on him in 6 weeks

Other Meds:

Current Illness:

ID: 1732589
Sex: F
Age: 25
State: NY

Vax Date: 09/18/2021
Onset Date: 09/19/2021
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:

Allergies: None

Symptom List: Rash, Urticaria

Symptoms: Can?t lay flat have chest pains and pooling mucus in my throat since vaccine, and horrible headaches every day. I barely ever got headaches my period dramatically stopped after 2 days.

Other Meds: Synthroid

Current Illness: None

ID: 1732590
Sex: M
Age: 52
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: 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: 1732591
Sex: M
Age: 12
State: TX

Vax Date: 09/17/2021
Onset Date: 09/21/2021
Rec V Date: 09/24/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data: Troponin peak: 5.6

Allergies: NKA

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

Symptoms: Chest pain, palpitations, troponin leak -- diagnosed with Myocarditis, Admitted to hospital for 2 days. Received supportive therapies with NSAIDS. No intervention or immunomodulors. Echo wnl with normal EF.

Other Meds: None

Current Illness: None

ID: 1732592
Sex: M
Age: 28
State: MO

Vax Date: 09/06/2021
Onset Date: 09/06/2021
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: N/A

Allergies: NKDA

Symptom List: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: 2nd Dose of Moderna Vaccine administered on 9/6/21 from Lot #011A21A expired 8/16/21. *Site leadership consulted with the Moderna Medical Safety Department and received the below confirmation: * If the dose given in error is the first dose, a second dose should be administered 28 days later. If this dose is the second dose, the series is complete and no additional doses are needed.

Other Meds: APAP

Current Illness: No

ID: 1732593
Sex: M
Age: 52
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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

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

Other Meds:

Current Illness:

ID: 1732594
Sex: F
Age: 73
State: MO

Vax Date: 09/21/2021
Onset Date: 09/21/2021
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: None

Allergies: Unknown

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

Symptoms: Patient received Pfizer vaccine as her 3rd booster dose instead of Moderna, which was the original series that she completed.

Other Meds: Unknown

Current Illness: Unknown

ID: 1732596
Sex: F
Age: 35
State: NJ

Vax Date: 09/22/2021
Onset Date: 09/23/2021
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: None

Allergies: Cipro

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Fatigue, chills, fever, +2 pedal edema, joint pain, chest pain

Other Meds: Lyrica, belbuca, flexeril, klonipin, lunesta, cyanocobalamin injections

Current Illness: None

ID: 1732597
Sex: F
Age: 58
State: CA

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

Other Meds:

Current Illness:

ID: 1732598
Sex: M
Age: 66
State:

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

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

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

Other Meds:

Current Illness:

ID: 1732599
Sex: F
Age: 46
State:

Vax Date: 08/27/2021
Onset Date: 08/27/2021
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:

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

Symptoms: pt received first dose of moderna on 8/27/21. pt experienced headache, fever, and chills that were gone within 3 days. pt then experienced itching at injection site that did not go away and would come and go. pt does not think anything else is related to the itching. pt says itching comes and goes but stopped about 5 days ago. Pt will f/u with md

Other Meds:

Current Illness:

ID: 1732600
Sex: F
Age: 68
State: CA

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: 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: 1732601
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: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

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

Other Meds:

Current Illness:

ID: 1732602
Sex: M
Age: 28
State:

Vax Date: 09/06/2021
Onset Date: 09/06/2021
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: N/A

Allergies: N/A

Symptom List: Injection site pain, Pain

Symptoms: 2nd Dose of Moderna Vaccine administered on 9/6/21 from Lot #011A21A expired 8/16/21. *Site leadership consulted with the Moderna Medical Safety Department and received the below confirmation: * If the dose given in error is the first dose, a second dose should be administered 28 days later. If this dose is the second dose, the series is complete and no additional doses are needed.

Other Meds: N/A

Current Illness: No

ID: 1732603
Sex: F
Age: 44
State: CA

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:

Allergies: Cipro Crab Shrimp

Symptom List: Injection site pain, Menorrhagia

Symptoms: Pt reports of "itching" to L lower back and bilateral ear "warmth" following J&J vaccine. RN noted 2 inch redness with blotchy hives to L lower back that pt had been scratching. Bilateral ears also red with warmth to touch. No other symptoms or complaints. Contact made with on call ER MD who gave verbal orders for Benadryl 50mg po in which pt tolerated very well. Within 10 mins of medication, pt reported "subsiding" of her reported symptoms and continued to remain free of any respiratory distress. At 30 minutes post medication, pt's itching with redness/blotchy hives to L lower back completely resolved.

Other Meds: Aspirin 81 mg po daily Kenalog 0.1% ointment

Current Illness: none

ID: 1732604
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: 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: 1732605
Sex: M
Age: 69
State: CA

Vax Date: 03/24/2021
Onset Date: 07/02/2021
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: Hematology Oncology Cancer Center - two offices together in the same building - Radiation Oncology Center Dr. for radiation and the doctor for Oncology

Allergies: no

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: So on the 2nd of July - after routine testing, I had a pre-diagnosis for colorectal cancer; that was confirmed with a biopsy - it took almost two weeks - they had to do a confirming - on the 16th. After that I started chemotherapy and radiation therapy for the tumor. Those are done. That was for 5 1/2 weeks. Started on August 3rd and It finished on Sept 13th. Follow up - will see Dr on October 12th to see what the radiation did. And then maybe another four weeks until surgery. Still to be determined if I'm recovered from the cancer - most likely it will require surgery.

Other Meds: no

Current Illness: no

ID: 1732606
Sex: M
Age: 44
State: AZ

Vax Date: 08/17/2021
Onset Date: 08/17/2021
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: Sulfa drugs

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: I have experienced nerve pain since the shot was administered. At over a month post-injection, I still have intermittent nerve pain in my limbs, hands, and feet. So far the nerve pain has not improved. My sleep began to worsen as time went on post-injection. I have developed insomnia for the first time in my life after never having sleep problems before. This has not improved. I had pain in my left eyeball. I have had joint and muscle pain. I have experienced intense PVC?s and an elevated pulse. I had no preexisting conditions before taking the COVID vaccine.

Other Meds: None

Current Illness: None

ID: 1732607
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:
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: 1732608
Sex: F
Age: 71
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: RA

Lab Data:

Allergies:

Symptom List: Nausea

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

Other Meds:

Current Illness:

ID: 1732609
Sex: F
Age: 28
State: AZ

Vax Date: 05/25/2021
Onset Date: 05/31/2021
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: Blood tests performed on MTHFR, uric acid, homocysteine, TSH, T4, T3, vitamin B12, DHEA sulfate, cortisol, vitamin D, magnesium, microsomal TPO antibody, thyroglobulin antibodies, intact PTH, and calcium (performed on 31-Jul-2021). All came back within normal range, except slightly high cortisol levels. I have since started EEG neurofeedback therapy for my panic attacks.

Allergies: N/A

Symptom List: Injection site pain

Symptoms: 6 days after my first Pfizer vaccine shot, my panic disorder increased tremendously out of nowhere. I originally developed panic disorder after contracting COVID-19 in December of 2020, but medication helped tremendously to subside them. After receiving the vaccine, my medication isn't too helpful anymore, as they seem to be getting progressively worse starting from day 6 post vaccination. I have also become progressively worse in regards to my dizziness, balance, eyesight ("wonky" eyesight), energy, heart rate and blood pressure (increase noticed in both), muscle numbness in arms/legs/feet/hands

Other Meds: Lorazepam, 0.5mg twice daily. Tri-sprintec, once daily.

Current Illness: N/A

ID: 1732610
Sex: M
Age: 49
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: 1732611
Sex: M
Age: 27
State: MO

Vax Date: 09/06/2021
Onset Date: 09/06/2021
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: N/A

Allergies: NKDA

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

Symptoms: 2nd Dose of Moderna Vaccine administered on 9/6/21 from Lot #011A21A expired 8/16/21. *Site leadership consulted with the Moderna Medical Safety Department and received the below confirmation: * If the dose given in error is the first dose, a second dose should be administered 28 days later. If this dose is the second dose, the series is complete and no additional doses are needed.

Other Meds: APAP, Analgesic Balm

Current Illness: No

ID: 1732612
Sex: F
Age: 51
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: Tremor

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

Other Meds:

Current Illness:

ID: 1732613
Sex: M
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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

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

Other Meds:

Current Illness:

ID: 1732614
Sex: M
Age: 64
State:

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

Other Meds:

Current Illness:

ID: 1732615
Sex: M
Age: 36
State: VA

Vax Date: 09/03/2021
Onset Date: 09/15/2021
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: Penicillin

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

Symptoms: I have a couple of autoimmune issues and because of this I recieved the booster shot. Almost 2 weeks after my lichen planus flared up worse than ever and now it has spread to place I've never experienced. With my first two Pfizer shot I did not experience this. I am seeing a dermatologist and explained my current issue. We have increased my steroids so what effect does that have on the vaccine? I got the booster on September 3rd and started noticing the first flare up around September 13th. Still dealing with lichen planus and the increase of prednisone is not helping.

Other Meds: Prednisone 2.5mg for lichen planus, skyrizi first year of doses completed next dose is October 7th

Current Illness:

ID: 1732616
Sex: M
Age: 57
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: Asthenia, Chills, Headache, Myalgia

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

Other Meds:

Current Illness:

ID: 1732617
Sex: M
Age: 34
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: SYR
Vax Site: LA

Lab Data:

Allergies:

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

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

Other Meds:

Current Illness:

ID: 1732618
Sex: F
Age: 55
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: 1732619
Sex: F
Age: 41
State: KS

Vax Date: 09/21/2021
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: LA

Lab Data: none

Allergies: Sulfacetamide Aspirin clindamycin tetracycline tetanus-diptheria toxoids - locked arm, swelling shellfish

Symptom List: Pain in extremity

Symptoms: Right arm pain, right neck pain, right axillary pain, right hand tingling, onset 1 day after vaccine administration. Seen at clinic 3 days after vaccine administration.

Other Meds: hydroxyzine 25 mg cetirizine omeprazole escitalopram cholecalciferol

Current Illness:

ID: 1732620
Sex: M
Age: 73
State: WV

Vax Date: 09/24/2021
Onset Date: 09/24/2021
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: None

Allergies: No known allergies

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

Symptoms: Patient had a vasovagal response. He became pale and felt nearly fainted. With the assistance of his wife, he laid down in the floor and put his feet up in a chair. His wife wiped his face with a cool paper towel until he felt better. After about 10 minutes, he sat up against the wall for another 10 minutes until he felt completely fine. The entire event lasted approximately 30 minutes. He states that this often happens when he gets immunizations.

Other Meds: Irbesartan

Current Illness: None

ID: 1732621
Sex: M
Age: 32
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: 1732622
Sex: F
Age: 32
State: WA

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

Lab Data:

Allergies:

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

Symptoms: After IM administration in the left deltoid, Pt exhibited a racing pulse. We attempted several times to capture an accurate blood pressure reading; the reading was in error a few times, but we also got a readings of 232/127, 185/131, 169/112,71/55, 180/110, and 179/93, BP was clearly elevated. Pt was also nauseated. 25mg diphenhydramine was administered. 911 wasn't called per Pt request as she was awake and aware and could breathe properly. She contacted her sister to pick her up to go to the hospital. Pt was mobile and was taken to the hospital for evaluation by her sister.

Other Meds:

Current Illness:

ID: 1732623
Sex: F
Age: 57
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: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Vomiting

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

Other Meds:

Current Illness:

ID: 1732624
Sex: M
Age: 29
State: CA

Vax Date: 09/10/2021
Onset Date: 09/10/2021
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 noted; pt waiting for referral into cardiologist for tests.

Allergies: did not discuss

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Pt described having heart palpitations, starting about 4 hours after vaccine the same evening of administration. Pt complained that even had palpitations continuing for 4 days after, also complained of shortness of breath when laying down and feeling winded quickly. Pt said he spoke with his primary care provider; PCP is referring pt to see a cardiologist. Pt said that no longer having palpitations but still having shortness of breath and easily winded; pt inquired if pharmacy could give him a faster referral to get him in for cardiology referral; told him pharmacy does not have that kind of authorization and to continue to follow up with his PCP if still have additional symptoms. Advised pt to hold on getting a 2nd Pfizer vaccine until have approval from either his PCP or the cardiologist.

Other Meds: did not discuss

Current Illness: did not mention

ID: 1732625
Sex: M
Age: 46
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: RA

Lab Data:

Allergies:

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

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

Other Meds:

Current Illness:

ID: 1732626
Sex: M
Age: 20
State: WV

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: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: syncope, sweating, light headed, temporary sight disruption/ low heart rate, dizzy, nausea, flushing

Other Meds:

Current Illness:

ID: 1732627
Sex: F
Age: 42
State: FL

Vax Date: 09/24/2021
Onset Date: 09/01/2021
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: none ordered at this time.

Allergies: none

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

Symptoms: Individual was given 0.3ml of undiluted pfizer-Biotech. Patient was observed and had no abnormal signs or symptoms of adverse event two hours post vaccination administration. Vitals with in normal limits for patient.

Other Meds:

Current Illness: Patient had the flu one month ago.

ID: 1732628
Sex: M
Age: 45
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