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: 1735749
Sex: F
Age: 48
State: SC

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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Sulfa Morphine

Symptom List: Dysphagia, Epiglottitis

Symptoms: Woke up aprox 3 am feeling feverish, chills, headache, over all felt sick. Felt like what I remember feeling when I had the flu. It?s been years since I?ve gotten the flu. Rested, and took ibuprofen Felt better and more like myself around 10 am. Short lived, thankfully. Feel fine now.

Other Meds: Zertec Vitamin D B complex Niacinamide

Current Illness:

ID: 1735750
Sex: F
Age: 45
State: GA

Vax Date: 07/22/2021
Onset Date: 08/02/2021
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: N/A

Allergies: N/A

Symptom List: Anxiety, Dyspnoea

Symptoms: Irregular menstrual cycle: spotting 8/2-6, Extremely heavy menstrual cycle and longer than normal duration from 8/15-22, Extremely heavy cycle and longer than normal duration from 9/4-15.

Other Meds: Hydrothiazide

Current Illness: N/A

ID: 1735751
Sex: M
Age: 68
State: FL

Vax Date: 08/13/2021
Onset Date: 08/14/2021
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: Blood tests, and two cranial MRIs. Nothing found. Headache just went away.

Allergies: None

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

Symptoms: Headache for 33 consecutive days. Pain level up to 9 at times. In the last week it dropped to a 3-4 pain level.

Other Meds: AML 10 mg. Fenofibeate 140 mg, aspirin 83mg. All daily

Current Illness: None

ID: 1735752
Sex: M
Age: 59
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: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

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

Other Meds:

Current Illness:

ID: 1735753
Sex: M
Age: 59
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: 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: 1735755
Sex: M
Age: 53
State:

Vax Date: 03/09/2021
Onset Date: 03/09/2021
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: rash to bilateral thighs, took benadryl 25mg po x 1, pepcid 20mg po x 1, dexamethasone 4mg po x 1

Other Meds:

Current Illness:

ID: 1735756
Sex: M
Age: 71
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: 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: 1735757
Sex: F
Age: 33
State: MI

Vax Date: 09/16/2021
Onset Date: 09/16/2021
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: sulfa

Symptom List: Pharyngeal swelling

Symptoms: Itching along the arm in which the vaccination was given. Later blotchy erythema along the upper back and chest; face.

Other Meds: none

Current Illness: none

ID: 1735758
Sex: F
Age: 33
State:

Vax Date: 03/09/2021
Onset Date: 03/09/2021
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: tightness when breathing, pt has history of anxiety and takes xanax. pt denies any other s/sx of ha and dizziness

Other Meds:

Current Illness:

ID: 1735759
Sex: M
Age: 72
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: 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: 1735760
Sex: F
Age: 63
State: IL

Vax Date: 07/28/2021
Onset Date: 08/11/2021
Rec V Date: 09/26/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: Pt received Pfizer x2. Pt tested COVID + on 8/7/21 and admitted to hospital for COVID on 8/11/2021. Pt received remdesivir and dexamethasone.

Other Meds:

Current Illness:

ID: 1735761
Sex: F
Age: 50
State: TX

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: SYR
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Rash, Urticaria

Symptoms: My esophagus has constricted and will not relax. I can still breathe but I have a hard time eating or swallowing. It's painful when food travels down my esophagus to my stomach. I've never had acid reflux or any esophogus problems in the past.

Other Meds: Fluoxetine, Claritin, Diclofenac, Misoprostol, Vitamin D3, Multivitamin, Magnesium, Ibuprofen

Current Illness: None

ID: 1735762
Sex: F
Age: 67
State:

Vax Date: 03/12/2021
Onset Date: 03/12/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: complains of dizziness s/p 2nd dose vaccine. drank 1 cup of water, after 10 minutes patient verbalized relief of dizziness. stayed for 20 extra minutes for monitoring then left

Other Meds:

Current Illness:

ID: 1735763
Sex: F
Age: 27
State: MD

Vax Date: 09/03/2021
Onset Date: 09/03/2021
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: Covid test negative

Allergies: No

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

Symptoms: 2 hours after shot severe migraines next day body aches with migraines and cold like symptoms. Tested for covid negative twice. Talked to doctors and one only gave me medication for headaches another wanted to treat me with antibiotics for inflammation and Lyme disease I was perfectly fine before the shot and started having reactions after the vaccination. I jist want the side effects to go away and no doctor is listening to me instead they are trying to diagnose me with something I dont have

Other Meds: Adderal but not taken every day

Current Illness: No

ID: 1735764
Sex: F
Age: 32
State: NY

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

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

Symptoms: light headness( Mediately )sore-arm. Swelling breast, sore abdomen, wheezing every thing else 1 hour after.

Other Meds: Verapamil, omerprazole, magnesium, topiramate, ubrelvy. Ventlion, Advil, nortiptyline

Current Illness: , hemiplegic migraine

ID: 1735765
Sex: F
Age: 49
State: NY

Vax Date: 09/26/2021
Onset Date: 09/26/2021
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: Fish, eggplant

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

Symptoms: About 10 minutes after administration of Pfizer vaccine, patient started feeling shortness of breath and was hyperventilating. Her face was red and her eyes were swollen. Patient was administered Epipen 0.3mg in her right deltoid. Patient was driven by family member to Hospital to treat allergic reaction since it is 2 blocks away.

Other Meds:

Current Illness:

ID: 1735766
Sex: M
Age: 67
State: CA

Vax Date: 09/25/2021
Onset Date: 09/25/2021
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:

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

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

Other Meds:

Current Illness:

ID: 1735767
Sex: F
Age: 48
State:

Vax Date: 04/13/2021
Onset Date: 04/13/2021
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:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: pt premedicated with benadryl, reported thoat itching and redness at injection site. pt took another benadryl after administration. pt tolerated medication well upon taking second dose

Other Meds:

Current Illness:

ID: 1735768
Sex: F
Age: 35
State: MN

Vax Date: 07/30/2021
Onset Date: 08/02/2021
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: I went to the doctor on 2 occasions in August for checkups. I also had a blood test for antibodies on 09/09/21 which was positive.

Allergies: Penicillin

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: On 08/02/2021 (3 days after I received the first dose), I woke up to pins and needles. I had tingling and numbness in my arms all day. On 08/03/2021, the tingling and numbness moved from my arms to my legs. I also had other reactions including a rash at the injection site that was hot, red, and looked like a raised skin bump, and diarrhea. The reactions mostly subsided within 1 week; however, I have had occasional mild waves of tingling/numbness in my arms.

Other Meds: none

Current Illness: none

ID: 1735769
Sex: M
Age: 35
State: NJ

Vax Date: 03/30/2021
Onset Date: 09/19/2021
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: PCR + for Covid on 9/24

Allergies: none known

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

Symptoms: Client was vaccinated with Pfizer vaccines on 3/30 and 4/30/2021 (dates approximate within a few days per client report). Developed symptoms of Covid on 9/19: vomiting, headache, fatigue, loss of smell. Tested PCR + on 9/24. Reported as a case of breakthrough Covid in a previously vaccinated client.

Other Meds: none known

Current Illness: none known

ID: 1735770
Sex: F
Age: 46
State: FL

Vax Date: 09/14/2021
Onset Date: 09/15/2021
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: NA

Allergies: NKDA

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

Symptoms: Pain in injection site, bruising (hematoma like) for about 2 weeks

Other Meds: Levothyroxine

Current Illness:

ID: 1735771
Sex: M
Age: 77
State: IL

Vax Date: 03/08/2021
Onset Date: 08/20/2021
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: LA

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: Pt received Pfizer x2. Pt tested COVID + on 8/10/21 and admitted to hospital for COVID on 8/11/2021. Pt received remdesivir and dexamethasone.

Other Meds:

Current Illness:

ID: 1735772
Sex: F
Age: 37
State:

Vax Date: 04/12/2021
Onset Date: 04/12/2021
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:

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

Symptoms: face swelling noted 40 minutes after vaccine given. patient took two tylenol and it went away. patient left ~ 1 hour after

Other Meds:

Current Illness:

ID: 1735773
Sex: F
Age: 57
State:

Vax Date: 04/21/2021
Onset Date: 04/21/2021
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:

Symptom List: Injection site pain, Pain

Symptoms: pt experienced episode of vertigo after second dose. pt left 30 minutes later symptom free

Other Meds:

Current Illness:

ID: 1735774
Sex: M
Age: 59
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: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

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

Other Meds:

Current Illness:

ID: 1735775
Sex: M
Age: 42
State: NY

Vax Date: 06/16/2021
Onset Date: 06/16/2021
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: None

Allergies: Sulfa antibiotics; Penicillin

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

Symptoms: Patient came to the pharmacy on 9/26/21 complaining of complications due to his second Moderna COVID-19 vaccine, which he received on 6/16/21. The patient stated that the administrating pharmacist "jabbed and possibly twisted" the needle into his left bicep instead of the deltoid. He said it was very painful and caused so much bleeding that the pharmacist had to get more band aids from the back of the pharmacy. He also said that it was still bleeding when he got home from the pharmacy. Since getting his second dose, he claims that his left arm has been very weak to the point where he has dropped grocery bags he was carrying. He also developed a small/hard bump on his left wrist that he noticed on 9/25/21. He stated that nothing else in his life has changed so he is attributing these complications to an error in administering the second dose. He has not seen a doctor regarding these issues and his PQCF from 6/16/21 says that he does not have PCP. I recommended that he see a doctor and he said he plans on going to a medical clinic at his work tomorrow to get it looked at. He thinks he will need to get a referral to see a specialist because it is affecting his work. The patient also plans to come back tomorrow to speak with the pharmacy manager. He wants the incident documented; I told him that I planned on submitting an SCRT report to Walmart and a report through the CDC's VAERS. I also contacted our PCSM.

Other Meds: N/A

Current Illness: N/A

ID: 1735776
Sex: F
Age: 27
State: WA

Vax Date: 09/08/2021
Onset Date: 09/11/2021
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: Blood tests, ultrasound of thyroid

Allergies: None

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Hyperthyroidism

Other Meds: None

Current Illness: None

ID: 1735777
Sex: M
Age: 56
State: IL

Vax Date: 07/26/2021
Onset Date: 08/11/2021
Rec V Date: 09/26/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Pt received Pfizer x2. Pt tested COVID + on 8/11/21 and admitted to hospital for COVID on 8/11/2021. Pt received remdesivir, tocilizumab and dexamethasone.

Other Meds:

Current Illness:

ID: 1735778
Sex: M
Age: 62
State: AK

Vax Date: 06/02/2021
Onset Date: 06/12/2021
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: None.

Allergies: NKDA

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

Symptoms: Patient notes 10 days after receiving the vaccine he developed extraordinary fatigue and muscle weakness that progressed through the day. He reports lost feeling in both legs, short of breath, and fatigue. He states that he went to sleep (>12 hrs) and then woke the next day feeling much improved. He then developed a purple-blue reticulated rash on his back and non-pruritic. Rash still present but fading as today (22 Sept 2021).

Other Meds: HCTZ, Lisinopril, Rosuvastatin, Janumet, Synthroid

Current Illness: No acute illness.

ID: 1735779
Sex: F
Age: 52
State:

Vax Date: 04/21/2021
Onset Date: 04/21/2021
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:

Allergies:

Symptom List: Nausea

Symptoms: facial flushing, weakness, and fatigue. patient stayed for observation for 2 hours then left without symptoms

Other Meds:

Current Illness:

ID: 1735780
Sex: M
Age: 55
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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain

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

Other Meds:

Current Illness:

ID: 1735781
Sex: M
Age: 54
State: PA

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

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

Symptoms: Pt stated that he developed lightheadedness the next morning and passed out for a few minutes. He did not incur any injuries and felt better shortly after. Pt did not complain of any other adverse effects.

Other Meds: None

Current Illness: None reported

ID: 1735782
Sex: F
Age: 42
State:

Vax Date: 04/21/2021
Onset Date: 04/21/2021
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:

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

Symptoms: Lightheadedness and dizziness resolved within 30 minutes after resting and drinking water.

Other Meds:

Current Illness:

ID: 1735783
Sex: F
Age: 75
State: PA

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: Penicillin

Symptom List: Tremor

Symptoms: Patient complained that 3 days after getting the flu shot she had tightness , red, swollen, and painful right upper arm. There were little flat rashes that were not itchy . Patient took Tylenol for the pain. Her arm is getting better after 3 days and is going back to normal.

Other Meds: Tylenol

Current Illness: None

ID: 1735784
Sex: F
Age: 77
State: IL

Vax Date: 03/10/2021
Onset Date: 08/11/2021
Rec V Date: 09/26/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: Pt received Pfizer x2. Pt tested COVID + on 9/22/21 and admitted to hospital for COVID on 9/22/2021. Pt receiving remdesivir and dexamethasone.

Other Meds:

Current Illness:

ID: 1735785
Sex: F
Age: 26
State: TX

Vax Date: 09/26/2021
Onset Date: 09/26/2021
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: 159/102 157/84 99% 95% 97hr 69hr

Allergies:

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

Symptoms: PT complained of leg pain, chest closing and chest pain. She also had 2 panic attacks and had to be transported to the hospital.

Other Meds:

Current Illness:

ID: 1735786
Sex: M
Age: 67
State: AL

Vax Date: 09/26/2021
Onset Date: 09/26/2021
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: The patient's blood pressure was 186/89, pulse 80. Blood glucose on first check was 51, after eating and waiting about 15 minutes it had increased to 98.

Allergies: No known allergies

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

Symptoms: Within approximately 10 minutes after receiving this vaccination the patient reported feeling lightheaded and weak. He said that he thought his blood glucose was low (he had experienced low glucose levels before and said that the symptoms he was experiencing are typical for him when his glucose is low). I checked his blood pressure and his blood glucose level. His blood pressure was a bit elevated and his glucose was indeed low. I had him sit quietly in our vaccination room and had him eat a cereal bar and drink some orange juice. I rechecked his glucose approximately 15 minutes later and it had increased and the patient said he was feeling much better.

Other Meds: Modafanil, Glimiperide, Desvenlafaxine, Metformin, Lisinopril, Amlodipine, Dicyclomine, Atorvastatin, Tamsulosin, Levothyroxine,

Current Illness: None

ID: 1735787
Sex: F
Age: 56
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: 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: 1735788
Sex: F
Age: 47
State: NJ

Vax Date: 09/18/2021
Onset Date: 09/23/2021
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:

Allergies: Sulfa

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

Symptoms: In addition to my neck continuing to hurt since 1st vaccine, I now have ear pain in my left ear that stated 5 days after second dose.

Other Meds: None

Current Illness: None

ID: 1735789
Sex: F
Age: 44
State: CT

Vax Date: 09/01/2021
Onset Date: 09/12/2021
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:

Allergies: No allergies Sensitive to ephedrine in cold/flu medicine Lactose sensitive

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

Symptoms: Immediately after shot dizzy, rapid heartbeat, chest pressure, shortness of breath, followed by panic attack due to physical symptoms. Up until present: brain fog/unable to concentrate or focus, insomnia, occasional rapid pulse, shortness of breath, off and on dizziness, spatial awareness completely off, short term memory problems, freezing cold feet, strange menstrual period?.

Other Meds: No prescriptions Vitamin C Omega 3 oil with vitamin D

Current Illness: None

ID: 1735790
Sex: F
Age: 54
State: IL

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

Lab Data: blood tests

Allergies:

Symptom List: Pain in extremity

Symptoms: swollen lymph nodes in the neck, chest, left side,. Dizzy, tired , nausea, left arm feels numb, headache that starts in the back of the neck and goes into my head.

Other Meds:

Current Illness:

ID: 1735791
Sex: F
Age: 49
State: FL

Vax Date: 12/15/2020
Onset Date: 12/16/2020
Rec V Date: 09/26/2021
Hospital:

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

Lab Data: I went to the hospital for tests and we know what it isn't..i tried to go 2 more times but each time the hospital was 2 packed wirh cobid patients. The first time was stupid, they didnt even look at it, just wrote me a topical script and thats ut. It didn't work at all.

Allergies: Sulfa

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

Symptoms: It was like my skin fell off 3 times. It started as pinpoints on my legs then in a week spread to my face where my skin geew and fell off 3 times over. I had active infections on my face from December until end of May. The nurse took 2 hours of notes about this all in june 2021. I'm scarred for life on my face besides the fact i couldn't leave the house for 5 months

Other Meds: No

Current Illness: No

ID: 1735792
Sex: F
Age: 70
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: 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: 1735793
Sex: F
Age: 78
State: IL

Vax Date: 03/04/2021
Onset Date: 08/11/2021
Rec V Date: 09/26/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: Pt received Pfizer x2. Pt tested COVID + on 8/11/21 and admitted to hospital for COVID on 8/11/2021. Pt received remdesivir x2 doses and dexamethasone.

Other Meds:

Current Illness:

ID: 1735794
Sex: F
Age: 18
State: VA

Vax Date: 09/19/2021
Onset Date: 09/20/2021
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: none

Allergies: n/a

Symptom List: Vomiting

Symptoms: patient had swelling and bruising, was fevered and red around the vaccination area

Other Meds: n/a

Current Illness: n/a

ID: 1735795
Sex: M
Age: 30
State: TN

Vax Date: 08/29/2021
Onset Date: 08/30/2021
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: Emergency room visit and Covid rapid test

Allergies: None

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Extreme Ringing in ears, tinnitus like symptoms, vertigo and dizziness

Other Meds: None

Current Illness: Non

ID: 1735796
Sex: F
Age: 35
State: TN

Vax Date: 01/02/2021
Onset Date: 01/12/2021
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:

Allergies: Phenergan

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

Symptoms: 10 days after injection, injection site became hot to touch, itchy and slightly red. Within 1 hour left arm became numb and tingly. Soon after left leg also became numb and tingly. Benadryl and Ibuprofen was taken as directed and symptoms resolved within 24 hours.

Other Meds: Vitamin D3, Mirena IUD

Current Illness: None

Date Died: 09/04/2021

ID: 1735797
Sex: M
Age: 85
State: IL

Vax Date: 03/06/2021
Onset Date: 08/10/2021
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:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Pt received Pfizer x2. Pt tested COVID + on 8/9/21 and admitted to hospital for COVID on 8/10/2021. Pt received remdesivir and dexamethasone. Deceased on 9/4/2021

Other Meds:

Current Illness:

ID: 1735798
Sex: F
Age: 16
State: IL

Vax Date: 07/01/2021
Onset Date: 07/23/2021
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: Upper Endoscopy, liver scan, abdominal xray, CBC with diff, CMP, stool samples for occult blood, and Total Bilirubin l level.

Allergies: Pet Dander, Pollen

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

Symptoms: Initial adverse events feeling hot, dizziness, Event resolved 20-30 minutes post vaccination. Later experienced black tarry stools, low WBC, low RBC, high bilirubin levels, and loss of appetite.

Other Meds: Albuteral, Miralax, Famotadine

Current Illness: N/A

ID: 1735799
Sex: F
Age: 24
State: WV

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

Allergies: None

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

Symptoms: The morning after I received my first dose, I experienced vaginal bleeding for 3 days and counting, that resembled a period. In addition to the vaginal bleeding I also experienced stomach cramps like you would during your peeiod. Im on the pill, and I was not due for my period for 2 more weeks.

Other Meds: Birth Control Pills (Tri-Lo-Mili)

Current Illness: None

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am