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: 1735489
Sex: M
Age: 90
State: AZ

Vax Date: 09/25/2021
Onset Date: 09/25/2021
Rec V Date: 09/26/2021
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: Error: Wrong Dose of Vaccine - Too High-

Other Meds:

Current Illness:

ID: 1735490
Sex: F
Age: 79
State: AZ

Vax Date: 09/25/2021
Onset Date: 09/25/2021
Rec V Date: 09/26/2021
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: Error: Wrong Dose of Vaccine - Too High-

Other Meds:

Current Illness:

ID: 1735491
Sex: M
Age: 52
State: FL

Vax Date: 09/04/2021
Onset Date: 09/07/2021
Rec V Date: 09/26/2021
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: Site: Pain at Injection Site-Mild, Additional Details: PATIENT CAN'T LIFT UP RIGHT ARM 3 DAYS AFTER HE RECEIVED THE VACCINE. COMPLAINS OF "HEAVY ARM"

Other Meds:

Current Illness:

ID: 1735492
Sex: F
Age: 24
State: TX

Vax Date: 09/24/2021
Onset Date: 09/24/2021
Rec V Date: 09/26/2021
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: Wrong Vaccine Formulation (ex. different manufact. initial and booster)-

Other Meds:

Current Illness:

ID: 1735493
Sex: F
Age: 85
State: CA

Vax Date: 09/18/2021
Onset Date: 09/18/2021
Rec V Date: 09/26/2021
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: Error: Wrong Vaccine Formulation (ex. different manufact. initial and booster)-

Other Meds:

Current Illness:

ID: 1735494
Sex: F
Age: 67
State: NJ

Vax Date: 09/22/2021
Onset Date: 09/23/2021
Rec V Date: 09/26/2021
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: Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium, Systemic: Dizziness / Lightheadness-Medium, Systemic: Exhaustion / Lethargy-Medium, Systemic: Fever-Medium, Systemic: Nausea-Medium, Additional Details: Arm is red and swollen and warm to touch

Other Meds:

Current Illness:

ID: 1735495
Sex: M
Age: 72
State: MS

Vax Date: 09/25/2021
Onset Date: 09/25/2021
Rec V Date: 09/26/2021
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: Site: Pain at Injection Site-Medium, Site: Swelling at Injection Site-Medium, Additional Details: Patient's arm "puffed" up and became warm to the touch about 10-15 minutes after he received it. Patient said he felt fine otherwise and went home.

Other Meds:

Current Illness:

ID: 1735496
Sex: F
Age: 39
State: AZ

Vax Date: 08/27/2021
Onset Date: 08/29/2021
Rec V Date: 09/26/2021
Hospital:

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

Lab Data: Lung x-ray- clear, covid test- neg

Allergies: None

Symptom List: Pharyngeal swelling

Symptoms: 4 months pregnant due Feb 19th 2022, not breathing while sleeping, shortness of breath, dry cough

Other Meds: Propranolol, quetiapine, oxcarbazepine, citalopram, levothyroxine, prenatal, d3

Current Illness: None

ID: 1735497
Sex: F
Age: 75
State: CA

Vax Date: 09/25/2021
Onset Date: 09/25/2021
Rec V Date: 09/26/2021
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: Wrong Vaccine Formulation (ex. different manufact. initial and booster)-

Other Meds:

Current Illness:

ID: 1735498
Sex: M
Age: 50
State: NY

Vax Date: 01/01/2021
Onset Date: 02/01/2021
Rec V Date: 09/26/2021
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: None

Symptom List: Diarrhoea, Nasal congestion

Symptoms: When I look in the mirror, my left ball appears to hang a couple of inches lower than my right ball. Given that I got the shot in my left arm, I?m convinced that it was either the shot or else my mirror is playing tricks on me and might need to be replaced.

Other Meds: None

Current Illness: None

ID: 1735499
Sex: M
Age: 53
State: WI

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

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

Lab Data:

Allergies: None

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

Symptoms: Wrist joint pain (both wrists), neck pain, shoulder joint pain, TINNITUS.

Other Meds: Finasteride, aspirin, prilosec otc

Current Illness: None

ID: 1735500
Sex: M
Age: 54
State: WI

Vax Date: 08/19/2021
Onset Date: 08/24/2021
Rec V Date: 09/26/2021
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 at this point. I will be returning to ether dermatology or to my primary physician this week due to the symptoms progressing.

Allergies: None

Symptom List: Rash, Urticaria

Symptoms: Headache for 3 days after vaccination, sore arm for a few days theses symptoms started the next day. approximately 5 days I later notice a rash in the abdominal area. Rash slowly spread to chest, arm pits, groin and now next and shoulders. The rash has been getting progressively worse. I went to urgent care on 9/13/21. I was told to wait on getting the second dose unitl can see my primary physicians and/or to set an appointment with dermatology. I was seen by dermatology on 9/21/21 and given a Diagnosis of Pityriasis Rosea. The doctor indicated that this is a rare finding however there are reports of this post vaccine. Ias of today the symptoms or rash continue to worsen. The rash is now very itchy and covers most of my body with the exception of my lower legs and lower arms.

Other Meds: Multi vitamins, Vit, D, Vit. C, Zinc, Probiotic,

Current Illness: None

ID: 1735501
Sex: F
Age: 36
State: TX

Vax Date: 09/23/2021
Onset Date: 09/24/2021
Rec V Date: 09/26/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Severe migraine for 36+ hours, nausea, vomiting, low grade fever. Headache so debilitating could not get out of bed. When I did, I would get dizzy and vomit. BP normal, heart rate still elevated.

Other Meds: None

Current Illness: Elevated heart rate from covid, obesity

ID: 1735502
Sex: F
Age: 52
State: PA

Vax Date: 09/24/2021
Onset Date: 09/24/2021
Rec V Date: 09/26/2021
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: Macrobid Sulfa drugs Benlysta Linsopril Hyzaar Metoprolol

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

Symptoms: Ringing in ears, bi-laterally Started about 7:00pm. Still happening two days later getting louder

Other Meds:

Current Illness: None

ID: 1735503
Sex: F
Age: 36
State: OH

Vax Date: 01/14/2021
Onset Date: 02/16/2021
Rec V Date: 09/26/2021
Hospital:

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

Lab Data: None

Allergies: NKA

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

Symptoms: 5 days after second dose of vaccine I broke out in hives on random areas of my body. This went on for the next five days and then seemed to resolve itself.

Other Meds: Multivitamin

Current Illness: Positive for COVID 12/20/20

ID: 1735504
Sex: F
Age: 47
State: NY

Vax Date: 03/01/2021
Onset Date: 03/15/2021
Rec V Date: 09/26/2021
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: I have a wonderful feeling of euphoria, joy and gratitude, and was happy to the point of tears. Feelings of relief overwhelmed me knowing that if I am exposed to Covid, my chances of disability and death are greatly reduced. Warm feelings towards scientists and health officials for creating this amazing and innovative vaccine have remained with me to this day.

Other Meds:

Current Illness:

ID: 1735505
Sex: F
Age: 35
State: FL

Vax Date: 09/11/2021
Onset Date: 09/12/2021
Rec V Date: 09/26/2021
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: Penicillin, Codeine

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

Symptoms: 9/12/21 6:00am vomiting began 7:30am diarrhea began 7:30am severe exhaustion began Slept through the night 9/11/21-9/12/21. Napped from 10:00am to 1:00pm. Then again napped 3:00pm to 6:00pm. 6:00pm headache began Slept again through the night. Severe fatigue and headache continued through 09/13/21

Other Meds: None

Current Illness: None

ID: 1735506
Sex: F
Age: 52
State: OR

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

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

Lab Data:

Allergies: SULFA medication allergy Grass & tree pollen allergies Bad reaction to solarcaine

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Not sure flushot name. Within 3 hours my bottom lip began to tingle like a cold sore (but I don?t get cold sores) and the bottom lip began to swell. I took 50mg of Benedryl and was fine within a few hours.

Other Meds: Citalopram, progesterone and regular birth control, omeprazole

Current Illness: headache for a few days prior, have sjogrens, heavy bleeding from fibroids, moderate anemia, high blood pressure

ID: 1735507
Sex: F
Age: 30
State: TX

Vax Date: 09/23/2021
Onset Date: 09/24/2021
Rec V Date: 09/26/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Syncope, vomiting, bowel incontinence

Other Meds: None

Current Illness: None

ID: 1735508
Sex: F
Age: 38
State: TN

Vax Date: 06/09/2021
Onset Date: 07/01/2021
Rec V Date: 09/26/2021
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: Flu like symptoms, extreme fatigue, headache, body aches, neck/shoulder pain.

Other Meds: Adderall, Buproprion, Gabapentin, valacyclovir, azelastin spray, clariton

Current Illness: Chronic Reactivated epstein Barr, Fibromyalgia, HSV1, anxiety, depression

ID: 1735509
Sex: F
Age: 66
State: MD

Vax Date: 09/24/2021
Onset Date: 09/24/2021
Rec V Date: 09/26/2021
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: none

Allergies: none

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

Symptoms: vertigo, chills, sweating, body aches, headache, fainting, soreness and redness at site of vaccination

Other Meds: Atorvastatin 10ng daily Over the counter Vitamin D

Current Illness: none

ID: 1735510
Sex: F
Age: 30
State: IN

Vax Date: 09/18/2021
Onset Date: 09/18/2021
Rec V Date: 09/26/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Unevaluable event

Symptoms: PT had headaches and dizziness on the first day. Since the second day, she has been suffering from bad dizziness, nausea, loss of appetite, fatigue, and abdominal pain. Her fatigue is so bad that she has to sleep for over 12 hours a day. Her normal body temperature is 36.5 degrees celsius, but it has been between 35.5-36.1 degrees.

Other Meds: Buspar, Pristiq, Diazepam

Current Illness: None

ID: 1735511
Sex: F
Age: 58
State: PA

Vax Date: 09/02/2021
Onset Date: 09/09/2021
Rec V Date: 09/26/2021
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: Humira injection, Mobic , Wellbutrin, Pepcid, Allegra,neutontin,fish oil, aspirin,zinc, vitamin d, magnesium, calcium, seasonal allergy injections

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

Symptoms: Psoriatic arthritis pain returned. The pain was under control with Mobic and Humira injections.

Other Meds:

Current Illness: Psoriatic Arthritis, Seasonal allergies

ID: 1735513
Sex: F
Age: 67
State: IN

Vax Date: 09/23/2021
Onset Date: 09/25/2021
Rec V Date: 09/26/2021
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: Toradol, Codiene

Symptom List: Injection site pain, Pain

Symptoms: Fatigue, body aches, and headache

Other Meds: Protonix, Effexor, Synthroid, and Lipitor

Current Illness: None

ID: 1735514
Sex: M
Age: 37
State: NY

Vax Date: 03/27/2021
Onset Date: 04/04/2021
Rec V Date: 09/26/2021
Hospital:

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

Lab Data: Bloodwork taken, no clear indicators in results

Allergies: None

Symptom List: Injection site pain, Menorrhagia

Symptoms: Heart pain (still persisting 6 months later), sensitivity to sun, not sweating properly

Other Meds: Multivitamin, vitamin b12, melatonin,

Current Illness: Long covid symptoms (fatigue, brain fog)

ID: 1735515
Sex: M
Age: 53
State: CA

Vax Date: 05/29/2021
Onset Date: 05/30/2021
Rec V Date: 09/26/2021
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: Great deal of pain on the joints and the spine

Other Meds: avorstatin

Current Illness: None

ID: 1735516
Sex: M
Age: 42
State: PA

Vax Date: 07/03/2021
Onset Date: 07/04/2021
Rec V Date: 09/26/2021
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: cashews, walnuts, pumpkin seeds, sunflower seeds

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: normal arm pain as expected, while driving home felt pain spreading weakness in left hand, fine after a day. after a few days left testical soreness comes and goes still occurs today even after 3 months. also left hip sorenesses hard to describe like a pinching pain inside depending on how i am sitting or standing never had this before started the same weekend in july when got the shot

Other Meds: none

Current Illness: none

ID: 1735519
Sex: F
Age: 66
State: TX

Vax Date: 09/23/2021
Onset Date: 09/24/2021
Rec V Date: 09/26/2021
Hospital:

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

Lab Data: None

Allergies: None

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Moderate-to-severe swelling of left arm on Day 2 followed by swelling and redness on Day 3. On Day2, fever, disseminated joint pain, fatigue. Swelling and redness still ongoing

Other Meds: Melatonin 10 mg QD

Current Illness: None

ID: 1735520
Sex: F
Age: 30
State: ND

Vax Date: 09/23/2021
Onset Date: 09/23/2021
Rec V Date: 09/26/2021
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 medical tests, just took Benadryl and had someone stay with me.

Allergies: Eggs whites, wheat Sensitivity

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

Symptoms: Related to my flu shot reaction last year they kept me in the clinic for 30 minutes I got itchy during that time, about an hour after the injection I developed a rash, I took two courses of Benadryl throughout the day the rash improved. As well as the itching the following day. I?ve had a pounding headache for three days, now. For 3 days after my injection, my joints hurt excessively bad I developed swollen lymph nodes under my armpit of my left arm. My arm was so sore I couldn?t sleep on it it would wake me up if I rolled on it. I have been extremely fatigued (Friday and Saturday, so far better today, but remains present).

Other Meds: None

Current Illness: None

ID: 1735521
Sex: F
Age: 66
State:

Vax Date: 01/22/2021
Onset Date: 09/12/2021
Rec V Date: 09/26/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Large pontine hemorrhage without hydrocephalus is considered incompatible with meaningful survival. Repeat CT of the head pending. There is no indication for neurosurgical intervention.

Other Meds:

Current Illness:

ID: 1735522
Sex: F
Age: 26
State: NE

Vax Date: 04/05/2021
Onset Date: 04/05/2021
Rec V Date: 09/26/2021
Hospital:

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

Lab Data: None

Allergies: None

Symptom List: Injection site pain

Symptoms: Temporary arm paralysis that has continued off and on since the night of the shot. It usually occurs when driving and occurs for about 4 hours after. There sometimes is also acute pain in the shoulder, area between triceps and biceps, elbow, outside part of the forearm, wrist, middle finger, ring finger, pinkie, hand on side associated with the fingers listed above. So far, I have been trying to squeeze a stress ball, take ibuprofen or Alleve. I have not went to a clinic/doctor/hospital/etc to get it looked at, yet but I plan on going in at some point (appointment is not scheduled).

Other Meds: Allegra (seasonal allergies)

Current Illness: Possibly whiplash - was in car accident 1/11/21, but I think I recovered about 2 months after

ID: 1735523
Sex: M
Age: 74
State: MI

Vax Date: 09/25/2021
Onset Date: 09/25/2021
Rec V Date: 09/26/2021
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: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: pain at injection site, nausea, fever, muscle and joint pain, sleeplessness. and headache

Other Meds: Zetia, plavix, baby aspirin, multi vitamin

Current Illness: none

ID: 1735524
Sex: F
Age: 34
State: SC

Vax Date: 09/16/2021
Onset Date: 09/19/2021
Rec V Date: 09/26/2021
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: Vicodin, laytex, flagil

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

Symptoms: Increase heart rate around 3 days after injection Resting heart rate fluctuates between 60s and low 100s Low activity (moving, waking to the restroom) causes heart rate to increase to 100s- mid 100s 11 weeks pregnant at time of first injection Currently 13 weeks. Had similar issues with higher rates post Covid Early 2021 following positive covid Nov 2020

Other Meds: Valtrex, pepcid

Current Illness: None

ID: 1735525
Sex: M
Age: 78
State: FL

Vax Date: 09/24/2021
Onset Date: 09/25/2021
Rec V Date: 09/26/2021
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: None

Symptom List: Tremor

Symptoms: Tiredness, mild headache, fever (100)

Other Meds: Lisinopril-HTZ 20-12.5, Metoprolol SUCCESS ER 50MG, simvastatin 20mg

Current Illness: None

ID: 1735526
Sex: M
Age: 63
State: FL

Vax Date: 08/25/2021
Onset Date: 08/27/2021
Rec V Date: 09/26/2021
Hospital:

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

Lab Data: MY CARDIOLOGIST

Allergies: NONE

Symptom List: Erythema, Pruritus

Symptoms: I STARTED TO HAVE IRREGULAR HEART BEATS, 4, 5 OR MORE TIMES A DAY. I HAVE NEVER HAD THAT BEFORE. THE IRREGULAR HEART BEATS COME, STAY FOR A WHILE AND THEY GO UNTIL THEY COME BACK HOURS LATER I EVEN WENT TO MY CARDIOLOGIST TO CHECK FOR THIS 2 OR 3 DAYS AFTER THE VACCINE AND HE TOLD ME AFTER A EKG THAT MY HEART WAS FIND AND PROBABLY WILL BE THE EFFECT OF THE VACCINE

Other Meds: ATORVASTATINE 10 MG ASPIRINE 81 MG

Current Illness: NONE

ID: 1735527
Sex: M
Age: 50
State: GA

Vax Date: 08/27/2021
Onset Date: 08/29/2021
Rec V Date: 09/26/2021
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: None

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

Symptoms: Constant ringing in ears. Continuous ringing in ears since 8/29/2021

Other Meds: Valsartan

Current Illness: None

ID: 1735528
Sex: F
Age: 64
State: MA

Vax Date: 02/04/2021
Onset Date: 02/18/2021
Rec V Date: 09/26/2021
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: MRI (2) at hospital and Head CT scan and mulitple blood tests in hopsital - unknown results by this clinician

Allergies: Percodan - swelling

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

Symptoms: patient reports two weeks after vaccine developed numbess abdominal numbess which has progressed to numbess from breasts dowwn to bilateral knees, around left and right flank, left leg primarily affected with numbess and pain. has seen several doctors including PCP dr at hospital.

Other Meds: unknown

Current Illness: None Reported

ID: 1735529
Sex: M
Age: 50
State:

Vax Date: 09/18/2021
Onset Date: 09/21/2021
Rec V Date: 09/26/2021
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: Amoxicillin

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Stiff neck; ringing ears.

Other Meds: Lisinopril, Amlodipine, Pantoprazole

Current Illness:

ID: 1735530
Sex: F
Age: 31
State: KS

Vax Date: 09/13/2021
Onset Date: 09/13/2021
Rec V Date: 09/26/2021
Hospital:

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

Lab Data: Labs 09/13/2021 (ER visit after using EpiPen) Magnesium 1.9mg/dL (range 1.6-2.6 mg/dL) Sodium 141MMOL/L (range 137-147MMOL/L) Potassium 4.1MMOL/L (range 3.5-5.1 MMOL/L) Chloride 105 MMOL/L (range 98-110 MMOL/L) Glucose 105 MMOL/L ( range 10-100 MMOL/L) Blood Urea Nitrogen 16 MG/DL (range 7-25 MG/DL) Creatinine 0.98MG/DL (range 0.4-1.00 MG/Dl) Calcium 9.5 MG/DL (range 8.5-10.6 MG/DL) Total Protein 6.7 G/DL (range 6.0-8.0 G/DL) Total Bilirubin 0.9 mg/DL (range 0.3-1.2 MG/DL) Albumin 4.5 G/DL (range 3.5-5.0 G/DL) Alk Phosphate 45 U/L (range 25-110 U/L) AST (SGOT) 20 U/L (range 7-40 U/L) CO2 24 MMOL/L (range 21-30 MMOL/L) ALT (SGPT) 13 U/L (range 7-56 U/L) Anion Gap 12 (range 3-12) White Blood Cells 15.9 K/UL (range 4.5-11.0 K/UL) RBC 4.19 M/UL (range 4.0-5.0 M/UL) Hemoglobin 12.5 GM/DL (range 12.0-15.0 GM/DL) Hematocrit 36.8% (range 36-45%) MCV 87.9 FL (range 80-100FL) MCH 29.8 PG (range 26-34 PG) MCHC 33.9 G/DL (range 32.0-36.0 G/DL) RDW 13.4% (range 11-15%) Platelet Count 282 K/UL (range 150-400 K/UL) MPV 8.1 FL (range 7-11FL) Neutrophils 84% (range 41-77%) Monocytes 8% (range 24-44%) Eosinophils 1% (range 0-5%) Basophils 1% (0-2%) Absolute Neutrophil Count 13.52 K/UL (range 1.8-7.0 K/UL) Absolute Lymph Count 1.27 K/UL (range 1.0-4.8 K/UL) Absolute Monocyte Count 0.93 K/UL (range 0-0.80 K/UL) Absolute Eosinophil Count 0.08 K/UL (range 0-0.45 K/UL) Absolute Basophil Count 0.08 K/UL (range 0-0.20 k/UL) MDW (Monocyte Distribution Width) 15.3 (range <20.7) Lactic Acid POC 0.3 MMOL/L (range 0.5-2.0 MMOL/L) Creatinine, POC 1.0 MG/DL (range 0.4-1.00 MG/L) D-Dimer 254 ng/mL FEU (range <500 ng/mL FEU) Troponin 0.00 NG/ML (range 0.00-0.05 NG/ML) Multiple EKGs also obtained

Allergies: Acetaminophen, citalopram, lamotrigine, etomidate, zipresidone Hcl, clarithromycin, peanut, cefdinir, doxycycline Hcl, sulfamethoxazole-trimethoprim, rosins, latex, gabapentin, levofloxacin, topiramate, Immune Globulin (human)(IgG), Dermabond, Albuterol

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

Symptoms: Started within 1 hour of vaccine (pt. Has history of delayed anaphylactic reactions) with severe diarrhea, abdominal pain, nausea, tachycardia, tingling in back of throat and cough. Called the on-call physician with the clinic where the vaccine was received. Was instructed to take an extra Zyrtec/take bedtime dose early. Progressed (aver an hour) to worsening cough, body itching, chest redness, SOB (83% O2 saturation?taken @ home), chest pain. Used EpiPen auto-injector and went to the ER. Due to ER being over capacity had to wait in the waiting room for a while. An EKG was obtained and results were abnormal. Was treated/observed in the ED and then discharged home. Symptoms of chest pain, heart palpitations and SOB with exertion in addition to low-grade fever are still unresolved (as of 9/26/2021). Allergic reactions completely resolved over a period of 48 hours.

Other Meds: Montelukast, Tramadol, Rozerem, Vyvanse, Gastrocrom, Motegrity, Zofran, Flovent HFA, Xopenex HFA, Plaquenil, Anaspaz, Midodrine, Claritin, Zyrtec, Voltaren Gel, Corlanor

Current Illness: Sinus Infection

ID: 1735531
Sex: F
Age: 53
State: NY

Vax Date: 08/26/2021
Onset Date: 09/22/2021
Rec V Date: 09/26/2021
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: N/A going to clinic today

Allergies: NKS

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

Symptoms: Formation of Rash bilateral upper and lower extremities. Red itchy, present for 4 days and getting worse. My son who does not live with me also had similar reaction of red raised itchy bumps all over upper extremities after a few weeks after receiving the Janssen Vacine.

Other Meds: N/a

Current Illness: N/A

ID: 1735533
Sex: M
Age: 57
State: MO

Vax Date: 09/24/2021
Onset Date: 09/24/2021
Rec V Date: 09/26/2021
Hospital:

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

Lab Data: pt refused.

Allergies:

Symptom List: Pain in extremity

Symptoms: SX: sweating, pale, unresponsive, conscious, hypothermia. unable to obtain vital signs. symptoms started about 7 min after the administration during a 15-min observation period. Pt was help laying flat on the floor from a chair by two technicians. Epipen was administered after patient is unresponsive and EMS was called to the scene. Pt started to be responsive after the epipen administration and during EMS arrival in approximately 2 min. EMS obtained patient's vital signs and EKG was normal. Pt refused to go to the ER and waited for his wife to pick him up at the pharmacy.

Other Meds:

Current Illness:

ID: 1735534
Sex: M
Age: 70
State: OR

Vax Date: 08/27/2021
Onset Date: 08/27/2021
Rec V Date: 09/26/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 2
Vax Route:
Vax Site:

Lab Data: Chest x-ray showed cardiomegaly, no pleural effusion, no pneumothorax, however he has alveolar edema with hyperinflated lung fields. EKG reviewed showed atrial fibrillation (new onset) at a rate of 106bpm with no ST or T wave changes suggestive of an ischemia heart disease. Acute diastolic Heart Failure: BMP 557. Significantly elevated CVP and severe biatrial enlargement, and moderate pulmonary hypertension per Echo.

Allergies: NKDA

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

Symptoms: Patient had been feeling short of breath for 1 month; the dyspnea is intermittent with no known triggers, better with sitting in an upright position, exacerbated by moving around or talking and has been progressive. He has also been feeling dizzy for 1 month; the dizziness is intermittent, triggered by standing up or sitting down, it makes him feel like he would fall down; the dizziness is nonprogressive and he has had to use a can during these dizzy episodes. He has never tested positive for COVID-19. He received the 2nd dose of Moderna COVID-19 vaccine 1 month ago, which coincided with the start of these symptoms. He has had a little bit of a cough for 1 week; the cough is productive with dark brown phlegm and not associated with chest pain/pleuritic chest pain. He has progressive paroxysmal nocturnal dyspnea for 1 month.

Other Meds: aspirin 81mg daily, ibuprofen 600mg q6h PRN pain

Current Illness: None

ID: 1735535
Sex: F
Age: 37
State: MO

Vax Date: 09/17/2021
Onset Date: 09/18/2021
Rec V Date: 09/26/2021
Hospital:

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

Lab Data: EKG, chest X Ray on 9-25

Allergies: None

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

Symptoms: Chest pains, profuse sweating, low pulse, cold hands and feet, numbness in arms and legs, and fatigue.

Other Meds: Buspar, paxil, propranolol, amlodipine, meloxicam, suboxone, THC, aloe vera capsules, Ashwagandha gummies

Current Illness: None

ID: 1735536
Sex: M
Age: 48
State: IN

Vax Date: 09/24/2021
Onset Date: 09/25/2021
Rec V Date: 09/26/2021
Hospital:

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

Lab Data: N/a

Allergies: N/a

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

Symptoms: Came home rest and feeling a little better.

Other Meds: Dizzy at first the stomach hurt

Current Illness: N/a

ID: 1735537
Sex: F
Age: 75
State: KY

Vax Date: 09/25/2021
Onset Date: 09/25/2021
Rec V Date: 09/26/2021
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: Codeine

Symptom List: Vomiting

Symptoms: Chills, headache, severe muscle/joint pain

Other Meds: Pristiq, Premarin, fenofibrate, alprazolam, Zyrtec, sudafed, Metformin

Current Illness: Allergies

ID: 1735538
Sex: F
Age: 36
State: WV

Vax Date: 09/22/2021
Onset Date: 09/22/2021
Rec V Date: 09/26/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Night flashes, left kidney pain.

Other Meds: Lexapro 10mg, adderall 20mg

Current Illness:

ID: 1735539
Sex: M
Age: 29
State: FL

Vax Date: 08/04/2021
Onset Date: 08/04/2021
Rec V Date: 09/26/2021
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: Aug 17- CAT scan, Sep 20- PFT, tons of blood tests over the last month

Allergies:

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

Symptoms: chest pain, tightness in the chest, shortness of breath, dizziness, clamy hands and feet. Still ongoing

Other Meds:

Current Illness:

ID: 1735540
Sex: F
Age: 45
State: CO

Vax Date: 03/06/2021
Onset Date: 03/10/2021
Rec V Date: 09/26/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: CBC 3/24/2021 CBC 3/25/2021 CERVICAL ULTRASOUND COLPOSCOPY 4/72021 CBC 4/13/2021 CBC 4/21/2021 CBC 4/23/2021

Allergies: No allergies

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Began bleeding vaginally, thought it was my normal period however as days went by my flow increased and I was in the ER on 3/24 getting two units of blood. Was given very high doses of progesterone to stop bleeding which did not work and on 4/23 I under went a hysterectomy.

Other Meds: No medications or supplements of any kid being taken.

Current Illness: None known

ID: 1735541
Sex: M
Age: 62
State: MD

Vax Date: 04/22/2021
Onset Date: 06/04/2021
Rec V Date: 09/26/2021
Hospital:

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

Lab Data: Acupuncture.

Allergies: None

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

Symptoms: I got the Moderna shots, one in each arm, in my center deltoid muscles, The pain from them stayed mildly after each one, but neither ever went away. To this day, the pain has gotten to were I can only lift both of my arms up half way, like in the form of lifting and pouring a pitcher of water, and the pain in both arms today is un-bearable. I have to sleep on my back or front, cannot sleep on my sides, due to pain. I went to an Acupuncturist, last month and his needles brought the pain down in both muscles, about 25 percent at best. They are still painful and effecting my ability to do my job, and as of today, have cut my job back to four days a week, due to the pain.

Other Meds: N.P. Thyroid daily, 60mg. Multi-Vitamin daily

Current Illness: None

ID: 1735542
Sex: M
Age: 31
State: SC

Vax Date: 08/02/2021
Onset Date: 08/04/2021
Rec V Date: 09/26/2021
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: Pertussis vaccine must be removed from DPT

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

Symptoms: On the second day after I received the vaccine, along with other listed side effects I experienced moderate bi-lateral lower back pain. This was accompanied by brown/orange/light red urine progressively in that order for a period of 6 hours and 3 urination cycles. This issue resolved with the same pace as the onset. I have not experienced any other notable symptoms.

Other Meds: Lisinapril, metoprolol, cyclobenzaprine.

Current Illness: None

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am