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: 1735902
Sex: F
Age: 57
State:

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: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1735903
Sex: F
Age: 69
State: CA

Vax Date: 09/24/2021
Onset Date: 09/26/2021
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: None

Symptom List: Anxiety, Dyspnoea

Symptoms: Sore Lt Shoulder with redness and slight swelling then very tender Left arm with swollen lymph nodes and ache with arm movement.

Other Meds: None

Current Illness: None

ID: 1735904
Sex: M
Age: 68
State: FL

Vax Date: 08/27/2021
Onset Date: 08/28/2021
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: None

Allergies: None

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

Symptoms: Patient reported this on 9/26/2021. Patient described that after receiving shot he was very tired and sleeping in bed most of the time. He had fever, changes in vision, tired, did not go to restroom and described and stiffness in leg

Other Meds: N/A

Current Illness: None noted.

ID: 1735905
Sex: M
Age: 55
State:

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: 1735906
Sex: F
Age: 66
State:

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:

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: 1735907
Sex: F
Age: 67
State: CO

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: None

Allergies: Sulfa Bee stings

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

Symptoms: Cutaneus extreme reaction. Rash, swelling, itching.

Other Meds: Zoloft, Trazadone, statin, omeprezol

Current Illness: Had hand surgery 2 weeks before.

ID: 1735908
Sex: F
Age: 89
State:

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: 1735910
Sex: F
Age: 86
State:

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: 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: 1735911
Sex: F
Age: 42
State: NJ

Vax Date: 09/12/2021
Onset Date: 09/12/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: red rash on arm where vaccination given

Other Meds:

Current Illness:

ID: 1735912
Sex: F
Age: 66
State:

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: 1735913
Sex: F
Age: 72
State:

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: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1735914
Sex: F
Age: 82
State:

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: SYR
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1735915
Sex: F
Age: 43
State: MI

Vax Date: 08/18/2021
Onset Date: 08/19/2021
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: 9.3.21 ER received lab work and a Head CT.

Allergies: PCN Sulfa Antibiotic

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

Symptoms: 8.19.21 diaphoretic, nausea, sharp shooting, zapping pain in neck, bilateral wrists, fingers, knees and both ankles. Chills with no fever. Took Motrin at home with no relief. Resolved the following day, 8.20.21. 8.20.21 noticed numbness, tingling in right hand and lack of movement in right pointer finger. The numbness and tingling progressed to lack of movement and pain in the middle, ring and pinky finger of my right hand in the following 3 days. 9.1.21 noticed numbness and tingling in my left hand. Constant, but not painful. 9.3.21 woke up at 9am with intractable headache, pain, numbness, tingling in both hands and still lack of movement in my right fingers from pointer, index, ring and pinky. 9.3.21 went to ER

Other Meds: D-Amphetamine Salt Combo 20mg tabs one tab twice daily Sertraline 100mg tab one tab daily

Current Illness: Diagnosed Wednesday, June 30, 2021 with Acute Bronchitis Diagnosed Monday, July 12, 2021 with Viral/Bacterial upper respiratory infection

ID: 1735916
Sex: M
Age: 66
State:

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:

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

Symptoms: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1735917
Sex: M
Age: 78
State: OH

Vax Date: 02/01/2021
Onset Date: 09/17/2021
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: CT scan

Allergies: none

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

Symptoms: Appendicitis. Onset on Friday Sept 17. Pain continued to increase. Low grade fever. Went to ER on Saturday after speaking with primary care doctor. CT scan showed an enlarged, inflamed appendix. Transferred to a different hospital to have appendix removed on Sunday.

Other Meds: Lisinopril 20 mg 1x a day Simvastatin 20 mg 1x a day allopurinol 100mg 1x a day finasteride 5 mg 1 x a day

Current Illness: none

ID: 1735918
Sex: F
Age: 85
State:

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

Lab Data:

Allergies:

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

Symptoms: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1735919
Sex: F
Age: 37
State: IL

Vax Date: 05/11/2021
Onset Date: 05/18/2021
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: Viable pregnancy with strong symptoms before second covid vax 5/11. Viable pregnancy on ultrasound 5/18. As of 6/14, pregnancy shown to have stopped growing and ended via miscarriage on or around 5/19, about 8 days post covid shot.

Other Meds: Sertraline

Current Illness:

ID: 1735920
Sex: F
Age: 87
State:

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:

Symptom List: Ear pain, Hypoaesthesia

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

Other Meds:

Current Illness:

ID: 1735921
Sex: M
Age: 37
State:

Vax Date: 09/24/2021
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:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

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

Other Meds:

Current Illness:

ID: 1735922
Sex: F
Age: 67
State: NC

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

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

Symptoms: Patient remarked several hours post vaccination arm uncomfortable, inflamed and redness began later. Patient went to urgent care and received antibiotics for infection ( injection site reaction)

Other Meds: pantoprazole, losartan, carvedilol, isosorbide mononitrate, hyoscyamine, rosuvastatin

Current Illness: none

ID: 1735923
Sex: F
Age: 57
State:

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

Allergies:

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

Symptoms: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1735924
Sex: M
Age: 52
State:

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:

Allergies:

Symptom List: Unevaluable event

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

Other Meds:

Current Illness:

ID: 1735925
Sex: F
Age:
State: PA

Vax Date:
Onset Date:
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: Patient called and said her left arm hurts to life, touch, and that it is warm on top. She tried advil 3 times daily, then iced it. Patient advised to follow up with doctor next week.

Other Meds:

Current Illness:

ID: 1735926
Sex: F
Age: 35
State: IL

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

Lab Data:

Allergies: Doyxycline

Symptom List: Injection site pain, Pain

Symptoms: Fatigue, tingling of fingertips, sore L arm, headache

Other Meds:

Current Illness:

ID: 1735927
Sex: M
Age: 67
State:

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: 1735928
Sex: F
Age: 72
State:

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

Lab Data:

Allergies:

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

Symptoms: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1735929
Sex: M
Age: 57
State: MD

Vax Date: 09/24/2021
Onset Date: 09/25/2021
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: None

Allergies: None

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Headache, chills, mild fever

Other Meds: Ibuprofen

Current Illness: None

ID: 1735930
Sex: M
Age: 80
State:

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: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

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

Other Meds:

Current Illness:

ID: 1735931
Sex: F
Age: 64
State:

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

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: 1735932
Sex: M
Age: 16
State: NM

Vax Date: 02/02/2021
Onset Date: 07/01/2021
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: Skin scrape of rash. 09/24/2021

Allergies: Bactrim

Symptom List: Nausea

Symptoms: Shingles rash with multiple dermatomes. Came back twice.

Other Meds: Doxazosin

Current Illness:

ID: 1735933
Sex: M
Age: 72
State:

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: 1735934
Sex: M
Age: 50
State: NY

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

Lab Data:

Allergies: keflex

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

Symptoms: all my teeth hurt. Sensitive to cold and heat. Started after first shot and started to get better. Got worse after second shot

Other Meds: losartan, matoparal, rapatha

Current Illness: none

ID: 1735935
Sex: M
Age: 82
State:

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: RA

Lab Data:

Allergies:

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

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

Other Meds:

Current Illness:

ID: 1735936
Sex: M
Age: 82
State:

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: Tremor

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

Other Meds:

Current Illness:

ID: 1735937
Sex: F
Age: 24
State: NY

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

Lab Data: N/A

Allergies: N/A

Symptom List: Erythema, Pruritus

Symptoms: Fever, malaise, body aches, fatigue, cognitive impairment, and changes in menstruation.

Other Meds: N/A

Current Illness: COVID-19

ID: 1735938
Sex: M
Age: 71
State:

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

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

Symptoms: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1735939
Sex: M
Age: 63
State:

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

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

Other Meds:

Current Illness:

ID: 1735940
Sex: F
Age: 53
State:

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: 1735941
Sex: M
Age: 44
State: IN

Vax Date: 08/22/2021
Onset Date: 08/22/2021
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: Penicillin

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

Symptoms: Adverse Event #1: Immediate burning pain at injection site in left shoulder, followed by acute pain in left should. Pain is deep in shoulder joint or ligament, and also comes with a reduction in strength in that shoulder. Pain still continues today, never goes away. Adverse Event #2: Stiff & sore neck. Pain still continues today. Severity varies day-to-day. Adverse Event #3: Swelling in both big toes. Swelling that turned into blisters near the edge of toe nails on both big toes. Started a couple days after shot. Swelling still occurs on occasion currently, but not as severe.

Other Meds: Amphetamine Salts ER 30mg

Current Illness: None

ID: 1735942
Sex: F
Age: 33
State: PA

Vax Date: 09/25/2021
Onset Date: 09/26/2021
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: None

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

Symptoms: Pain in injection site Nausea 4 hours after vaccination that subsided alone Breastfed 20 month old increased breastfeeding following day, experienced low grade fever and fussiness starting 24 hours after vaccination. Unknown if related to mother's vaccination.

Other Meds: None

Current Illness: None

ID: 1735943
Sex: M
Age: 73
State:

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:

Allergies:

Symptom List: Pain in extremity

Symptoms: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1735944
Sex: F
Age: 22
State: TX

Vax Date: 09/23/2021
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:
Dose Series: 2
Vax Route:
Vax Site:

Lab Data: Blood work done today was normal. Urine analysis was normal as well.

Allergies: No

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

Symptoms: 24 hours after my vaccination I began to run a fever as high as 103. Felt very bad but woke up yesterday feeling back to normal. Fast forward to this morning, I woke up barely conscious and in a pool of sweat. I managed to make it to the fridge and chugged apple juice to give me a tiny bit a strength. I took my temperature and it read 94.1, over and over. I called an ambulance because I was not conscious enough to drive to the ER. Paramedics couldn?t take my temperature because their thermometer didn?t read lower than 95F. I went to the ER and got a diagnosis of hypothermia, and since then have recovered. Dysautonomia can cause low temperature, but I have never experienced anything like this before. I truly thought I was dying I felt so bad. I am just glad I woke up when I did so I could begin the process of warming my body up.

Other Meds: Ritalin

Current Illness: N/a

ID: 1735945
Sex: F
Age: 40
State: CA

Vax Date: 01/04/2021
Onset Date: 02/08/2021
Rec V Date: 09/26/2021
Hospital: Y

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

Lab Data: Had the index cyst removed but now I have a bent finger from it . Arm still having the ache, weak, and numbing in arm.

Allergies: none

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

Symptoms: left a indent where shot was given, developed lumps in wrist and on index finger. Was told they are gangly cyst. Did not have them before I was given vaccine. I get ache, weak, and numbing in arm.

Other Meds: none

Current Illness: none

ID: 1735946
Sex: F
Age: 17
State: NY

Vax Date: 09/04/2021
Onset Date: 09/06/2021
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: None

Allergies: None

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

Symptoms: Bleeding in between periods since the first injection

Other Meds: Aldactone, Norgest/E Triphasic - Ortho Tri Cyclen Tab Pak

Current Illness: none

ID: 1735947
Sex: M
Age: 73
State:

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: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1735948
Sex: F
Age: 85
State:

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: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

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

Other Meds:

Current Illness:

ID: 1735949
Sex: F
Age: 38
State: MI

Vax Date: 09/17/2021
Onset Date: 09/17/2021
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: None

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

Symptoms: When I received my first Covid vaccine, my elbow hurt almost immediately for a weekend. The second dose, my elbow hurt immediately as well. It has been a week and the pain continues with a burning sensation now. It hurts to move my arm and I have no strength due to the pain in the joint.

Other Meds: None

Current Illness: None

ID: 1735950
Sex: M
Age: 68
State:

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

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

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

Other Meds:

Current Illness:

ID: 1735951
Sex: F
Age: 53
State: TN

Vax Date: 01/16/2021
Onset Date: 01/16/2021
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: Labwork at endocrinologist-WNL 4/20/21 MRI of the Brain-WNL, 8/30/2021

Allergies: Codeine, Hydrocodone, Sulfa, Hibiclens

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

Symptoms: About 1.5 hours after the vaccine, I started having a dull aching headache above my eyebrows, behind my eyes & behind my cheek bones. This headache continued for 5 days. It stayed dull and constant, but it wasn't incapacitating. I continued to work with the headache. About 28 hours after the vaccine, I began to feel very tired, achy and just laid on the couch the rest of the day. The tiredness and headaches have continued ever since. I went to my endocrinologist on 4/20/2021 for my regular check up. After lab and USG of my thyroid, there were no changes. I continued having the headaches off and on (about 3-5/week). Nothing would stop them, not Motrin, Tylenol, or Aleve. I tried lying in a dark room, cool compresses, warm compresses, no sound, soothing music, nothing would stop them. Since I have a history of Renal Cell cancer and the headaches were continuing, I was worried that I might have brain metastasis. I saw my oncologist on August 10, 2021. Dr. ordered an MRI of the brain just to check. I had my MRI on August 30, 2021. It was normal. My headaches are continuing. Sometimes, they are painful, and I have to go lie down. They continue to be 3-5 times per week.

Other Meds: Biotin, Turmeric, Multivitamin, Zinc, Vitamin C

Current Illness: none

ID: 1735952
Sex: M
Age: 71
State:

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: RA

Lab Data:

Allergies:

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

Symptoms: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am