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: 1734935
Sex: F
Age: 24
State: NC

Vax Date: 08/26/2021
Onset Date: 08/26/2021
Rec V Date: 09/25/2021
Hospital:

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

Lab Data: (8/29, 9/18) Multiple CXRs, (8/29, 9/18) EKGs, (9/18) Blood work

Allergies: Peanuts

Symptom List: Dysphagia, Epiglottitis

Symptoms: Following administration of dose 1, the night of, chest pain and acid reflux occurred. (Pt has no history of acid reflux) Total doctor visits after due to discomfort: 3. Medications given: Prilosec and Pepsid. Symptoms did subside. Following administration of dose 2, the next morning, pain level 8 chest pain and acid reflux, epigastic pain. ER visit. Given GI cocktail. Symptoms subsided days after for the most part...currently comes and goes.

Other Meds: Multi-vitamin

Current Illness: N/A

ID: 1734936
Sex: M
Age: 76
State:

Vax Date: 09/24/2021
Onset Date:
Rec V Date: 09/25/2021
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: 1734937
Sex: F
Age: 24
State: TX

Vax Date: 09/25/2021
Onset Date: 09/25/2021
Rec V Date: 09/25/2021
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: NKA

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

Symptoms: During an injection, the needle came apart from the syring. Additional dose was then given after.

Other Meds: Unknown

Current Illness: None

ID: 1734938
Sex: F
Age: 31
State: GA

Vax Date: 09/02/2021
Onset Date: 09/02/2021
Rec V Date: 09/25/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1734939
Sex: M
Age: 70
State:

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

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

Lab Data:

Allergies:

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

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

Other Meds:

Current Illness:

ID: 1734940
Sex: F
Age: 65
State:

Vax Date: 09/24/2021
Onset Date:
Rec V Date: 09/25/2021
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: Administration error mixed series mRNA vaccine Pfizer and Moderna.

Other Meds:

Current Illness:

ID: 1734941
Sex: M
Age: 12
State: GA

Vax Date: 08/06/2021
Onset Date: 08/06/2021
Rec V Date: 09/25/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1734942
Sex: F
Age: 60
State:

Vax Date: 09/24/2021
Onset Date: 09/24/2021
Rec V Date: 09/25/2021
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: 1734943
Sex: U
Age: 15
State: GA

Vax Date: 09/02/2021
Onset Date: 09/02/2021
Rec V Date: 09/25/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1734944
Sex: M
Age: 80
State:

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

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

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

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

Other Meds:

Current Illness:

ID: 1734945
Sex: M
Age: 13
State: GA

Vax Date: 08/06/2021
Onset Date: 08/06/2021
Rec V Date: 09/25/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1734946
Sex: F
Age: 13
State: UT

Vax Date: 07/15/2021
Onset Date: 07/15/2021
Rec V Date: 09/25/2021
Hospital:

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

Lab Data: None

Allergies: Penicillin

Symptom List: Rash, Urticaria

Symptoms: The adverse event is the duration (8 days) of the symptoms experienced following the vaccine. Symptoms included fatigue, low fever (99.2 at the hightest; her regular temperature is 97.6), significantly reduced appetite, and nausea. No medical treatment was needed. Paitent spent a significant amount of time in bed resting. By the ninth day following the vaccine (7/23/21), all symptoms subsided.

Other Meds: Calcium, Vitamin D3

Current Illness: None

ID: 1734947
Sex: M
Age: 70
State: CA

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 09/25/2021
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: None

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

Symptoms: High Fever

Other Meds: Niacin, Aspirin

Current Illness: None

ID: 1734948
Sex: F
Age: 16
State: FL

Vax Date: 08/21/2021
Onset Date: 08/21/2021
Rec V Date: 09/25/2021
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: N/A

Allergies: NONE

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

Symptoms: PATIENT IS 16 YEAR OLD AT THE TIME OF ADMINISTRATION

Other Meds: ONLY VACCINE

Current Illness: N/A

ID: 1734949
Sex: M
Age: 77
State: CA

Vax Date: 09/25/2021
Onset Date: 09/25/2021
Rec V Date: 09/25/2021
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: we had a vaccine event in our pharmacy today, and pt stopped by that table in the front of the store and received the flu hd shot there, then came to the pharmacy asking for a pneuomonia vaccine, our hand held programmer showed pt was pending both vaccines and he was inadvertently given the flu hd vaccine again.

Other Meds:

Current Illness:

ID: 1734950
Sex: M
Age: 47
State: GA

Vax Date: 09/02/2021
Onset Date: 09/02/2021
Rec V Date: 09/25/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1734951
Sex: F
Age: 22
State: GA

Vax Date: 09/02/2021
Onset Date: 09/02/2021
Rec V Date: 09/25/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1734952
Sex: F
Age: 63
State: CA

Vax Date: 03/01/2021
Onset Date: 04/25/2021
Rec V Date: 09/25/2021
Hospital:

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

Lab Data: Had right breast examined on April 14 and no lump was detected at that time. No other tests done at that time.

Allergies: Amoxicillin Cephalexin Doxycycline Erythromycin Oxycodone Oxycodone Hcl?Oxycodone?Asa Some white and red vinegars

Symptom List: Ear pain, Hypoaesthesia

Symptoms: About 4-6 weeks after 2nd dose, noticed small lump in right breast. Had it checked at HCF and it was benign--the NP suggested it may have been caused by Covid-19 vaccine (I had also had a bi-lateral mammogram performed about 2-3 weeks before noticing lump and it was normal).

Other Meds: Trader Joe's Vit. D-1000 I.U.; Citracal Calcium Citrate-650 mg w/ Vit D3 -1000 I.U, Zinc 5.5 mg, Copper 0.45 mg, Manganese 1.15 mg, Sodium 5 mg.; Centrum Silver multi Vit

Current Illness: N/A

ID: 1734953
Sex: M
Age: 86
State:

Vax Date: 09/24/2021
Onset Date: 09/24/2021
Rec V Date: 09/25/2021
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: 1734954
Sex: M
Age: 42
State: GA

Vax Date: 09/02/2021
Onset Date: 09/02/2021
Rec V Date: 09/25/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1734955
Sex: F
Age: 53
State: TX

Vax Date: 01/01/2021
Onset Date: 02/03/2021
Rec V Date: 09/25/2021
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: Labs EkG Xray CT

Allergies: None

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

Symptoms: Stomach pain , fever, headaches , Heart rate went up i was in the ER 2 days in a row with IV medications.

Other Meds: Women Vitamins , Elderberry vitamin

Current Illness: None

ID: 1734956
Sex: F
Age: 47
State: GA

Vax Date: 08/06/2021
Onset Date: 08/06/2021
Rec V Date: 09/25/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1734957
Sex: F
Age: 37
State:

Vax Date: 09/24/2021
Onset Date: 09/24/2021
Rec V Date: 09/25/2021
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: 1734958
Sex: F
Age: 49
State: MN

Vax Date: 01/11/2021
Onset Date: 09/11/2021
Rec V Date: 09/25/2021
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:

Symptom List: Injection site pain, Pain

Symptoms: Pain in shoulder/deltoid in left arm that persisted weeks after shot. Pain with movement and at rest. Did Active PT with physical therapist for 3 months. Now resolved.

Other Meds: VtD/E/B/zinc

Current Illness:

ID: 1734959
Sex: F
Age: 72
State:

Vax Date: 09/25/2021
Onset Date: 09/25/2021
Rec V Date: 09/25/2021
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: Patient complained of flushing after vaccination. Patient denied chest pain, headache, dizziness and no shortness of breath. Cold pack applied.

Other Meds:

Current Illness:

ID: 1734960
Sex: M
Age: 71
State: GA

Vax Date: 09/02/2021
Onset Date: 09/02/2021
Rec V Date: 09/25/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1734961
Sex: M
Age: 63
State:

Vax Date: 09/24/2021
Onset Date: 09/24/2021
Rec V Date: 09/25/2021
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: 1734962
Sex: M
Age: 20
State: GA

Vax Date: 09/02/2021
Onset Date: 09/02/2021
Rec V Date: 09/25/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1734963
Sex: M
Age: 53
State:

Vax Date: 09/24/2021
Onset Date: 09/24/2021
Rec V Date: 09/25/2021
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: 1734964
Sex: M
Age: 53
State: GA

Vax Date: 09/02/2021
Onset Date: 09/02/2021
Rec V Date: 09/25/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1734965
Sex: F
Age: 15
State: NY

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 09/25/2021
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: There were no symptoms

Other Meds:

Current Illness:

ID: 1734966
Sex: F
Age: 87
State:

Vax Date: 09/24/2021
Onset Date: 09/24/2021
Rec V Date: 09/25/2021
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: 1734967
Sex: F
Age: 49
State: GA

Vax Date: 08/05/2021
Onset Date: 08/05/2021
Rec V Date: 09/25/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1734968
Sex: F
Age: 38
State: CA

Vax Date: 08/08/2021
Onset Date: 09/07/2021
Rec V Date: 09/25/2021
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: No

Symptom List: Tremor

Symptoms: I was 3 weeks pregnant when I received my first dose of Pfizer vaccine. At my first ultrasound they could not detect a heartbeat and I had a miscarriage. I had undergone alot of testing before I got pregnant and all my tests showed that I was perfectly healthy.

Other Meds: Pre-natal pills

Current Illness: No

ID: 1734969
Sex: F
Age: 36
State: GA

Vax Date: 09/25/2021
Onset Date: 09/25/2021
Rec V Date: 09/25/2021
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: Latex

Symptom List: Erythema, Pruritus

Symptoms: Within 5 minutes of receiving the first COVID vaccine, Patient felt swelling and tingling in her tongue. She did not have any issues with her breathing, but her tongue felt heavy, swollen, and tingly for roughly an hour. She did not take any medication after this reaction. Within 5 minutes of receiving her second COVID vaccine, she felt swelling, tingling, and numbness in her tongue. She also felt a flash of heat in her head that went away quickly. Following the flash of heat, her arms, legs, and fingers were ice cold and she had an internal tremble. I gave her 12.5mg of liquid diphenhydramine at 9:21am. This was 8 minutes after her vaccine. After several minutes, she started to feel better. Her tongue still felt heavy and she was still cold, but she could tell the reaction was going away.

Other Meds: Daily multivitamin, garcinia, apple cider vinegar

Current Illness: None

ID: 1734970
Sex: U
Age: 18
State: GA

Vax Date: 08/03/2021
Onset Date: 08/03/2021
Rec V Date: 09/25/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1734971
Sex: M
Age: 13
State: GA

Vax Date: 08/06/2021
Onset Date: 08/06/2021
Rec V Date: 09/25/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1734972
Sex: M
Age: 17
State: NY

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 09/25/2021
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: There were no symptoms.

Other Meds:

Current Illness:

ID: 1734973
Sex: U
Age: 32
State: GA

Vax Date: 09/02/2021
Onset Date: 09/02/2021
Rec V Date: 09/25/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1734974
Sex: M
Age: 76
State: OH

Vax Date: 09/21/2021
Onset Date: 09/24/2021
Rec V Date: 09/25/2021
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: CBC Ddimer BMP Troponin EKG CXR

Allergies: None known

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

Symptoms: Angioedema of the upper lip and hands bilaterally

Other Meds: Latanoprost 0.005% eye drops Carvedilol Pravastatin Tamsulosin Losartan potassium Vitamin C Zinc Vitamin D3 Fish oil Baby aspirin

Current Illness: Cardiac stent 8/21

ID: 1734975
Sex: F
Age: 25
State: TX

Vax Date: 09/22/2021
Onset Date: 09/22/2021
Rec V Date: 09/25/2021
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: NKA

Symptom List: Pain in extremity

Symptoms: 10MINUTES AFTER SHOT-CLENT STARTED COMPLAINING ABOUT FEELING HOT- BECAME PALE IN HER FACALSO SHE STARTED HAVING SPME NAUSEA- B/P 121/91-103-PULSE O2-99(11:10)- OFFERED WATER AND SNACKS-UNAB;E TO EAT SNACKS- 11:15 B/P-148/106 -PULSE-87 O2-99- DR. ASSESSED CLIENT AMD ASSURED SHE WAS DID NOT NEEDED TP BE TRANSPORTED.= AFTER ADDITIONAL 15 MINUTES C;IENT B/P- 134/88- 82= OFFFERED A RIDE HOME-CLIENT DECIDED TO DRIVE HERSELF

Other Meds: PRENATAL VITIAMS

Current Illness: NONE

ID: 1734976
Sex: F
Age: 50
State:

Vax Date: 04/08/2021
Onset Date: 08/06/2021
Rec V Date: 09/25/2021
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: Woke up blind in left eye on August 6th, 2021. Diagnosed with a massive cataract. Had cataract surgery on August 24th 2021, which led to a detached retina on September 3rd. Vitrectomy on September 10th. Diagnosed with subfoveal prefluroroncarbon fluid on September 21st.

Other Meds:

Current Illness:

ID: 1734977
Sex: M
Age: 43
State: NM

Vax Date: 01/01/2021
Onset Date: 08/01/2021
Rec V Date: 09/25/2021
Hospital:

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

Lab Data: 08/2021 TUMOR IDENTIFIED 08/2021 CK BLOOD LEVELS EXTREMELY ELEVATED ANEMIA IDENTIFIED

Allergies: NA

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

Symptoms: Identified tumor on right side of head . Tingling facial sensations . Anemia as well

Other Meds: Plant based protein

Current Illness: Na

ID: 1734978
Sex: M
Age: 70
State:

Vax Date: 09/24/2021
Onset Date: 09/24/2021
Rec V Date: 09/25/2021
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: Administration error mixed series mRNA vaccine Pfizer and Moderna.

Other Meds:

Current Illness:

ID: 1734979
Sex: M
Age: 29
State: NY

Vax Date: 09/25/2021
Onset Date: 09/25/2021
Rec V Date: 09/25/2021
Hospital:

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

Lab Data: n/a

Allergies: unkown

Symptom List: Vomiting

Symptoms: Patient reported feeling dizzy and numbness in the right arm. EMS was called , he was able to walk away with EMS out of the pharmacy / store.

Other Meds: unknown

Current Illness: unknown

ID: 1734980
Sex: F
Age: 36
State: MN

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

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

Lab Data:

Allergies: None

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Lots of bleeding and it wasn't time for her period. Severe back pain, pelvic abdominal pain and headache. Severe fatigue. Not able to get out of bed.

Other Meds: None

Current Illness: None

ID: 1734981
Sex: M
Age: 12
State: GA

Vax Date: 08/06/2021
Onset Date: 08/06/2021
Rec V Date: 09/25/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1734982
Sex: M
Age: 65
State: FL

Vax Date: 02/12/2021
Onset Date: 02/23/2021
Rec V Date: 09/25/2021
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: None.

Allergies: None.

Symptom List: Injection site swelling, Limb discomfort

Symptoms: After both doses of vaccine, I had soreness and swelling in left vas at site of vasectomy. Pain lasted about one week after each shot. Two weeks after second vaccination, I noticed I could no longer sleep on my left side without pressure in my chest. Pressure increased to pain in right side of chest. Pain would drop away throughout the day, but return at night about an hour and a half after going to bed. Pain continued to get worse over the course of about two months. Exercising with weights made the problem worse. Aerobic exercise did not effect the problem. I was an avid runner before getting vaccinated, but have since reduced my runs to about 3 times a week running about 2-3 miles at a time. At this time after about 7 months, I still have minor pain, but it is very minor. It can still occasionally be a problem lying on my right side. I continue to improve very slowly. I tried using aspirin at the peak of the pain and felt it might have helped a little bit. I have not seen a physician or taken any other medication.

Other Meds: None.

Current Illness: None.

ID: 1734983
Sex: M
Age: 60
State: RI

Vax Date: 09/25/2021
Onset Date: 09/25/2021
Rec V Date: 09/25/2021
Hospital:

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

Lab Data:

Allergies: No known allergies

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

Symptoms: Patient had noted on consent forms that he had previously fainted after getting blood drawn. We spoke about this and he stated that he gets nervous with needles. After giving him his vaccine, he moved into our waiting area and within 2 minutes he fainted. His head was snapped back and his legs were out straight. I tapped him on the shoulder and shouted his name. He was unresponsive for approximately 30-45 seconds and in that time the ambulance was called. He came to and didn't have memory of what had happened, but stated that he was warm and began profusely sweating. The front store manager got him a bottle of water and when the paramedics arrived they took him on the stretcher to get vital laying down in the ambulance. I called the patient approximately 4 hours after the incident and he stated that the paramedics allowed him to leave on his own and he wasn't transported to the hospital. He noted a sore neck from when he head snapped back in the chair, but he was otherwise feeling fine.

Other Meds: None noted on his consent form

Current Illness: N/A

ID: 1734984
Sex: M
Age: 17
State: NY

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 09/25/2021
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: There were no symptoms.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am