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: 1736003
Sex: M
Age: 68
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: 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: 1736004
Sex: F
Age: 23
State: OK

Vax Date: 08/20/2021
Onset Date: 08/23/2021
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: Blood pressure skyrocketting 3 days after receiving vaccine. Started having stabbing sensations and shortness of breathe, hurt to breathe in

Other Meds:

Current Illness:

ID: 1736005
Sex: M
Age: 74
State: GA

Vax Date: 01/21/2021
Onset Date: 01/28/2021
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:

Allergies:

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

Symptoms: Severe pain below the waist

Other Meds:

Current Illness: Lambert Eaton Myasthenic Syndrome (LEMS)

ID: 1736006
Sex: F
Age: 93
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: 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: 1736007
Sex: M
Age: 33
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: 1736008
Sex: M
Age: 52
State:

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

Other Meds:

Current Illness:

ID: 1736009
Sex: F
Age: 81
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: 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: 1736010
Sex: M
Age: 75
State: NE

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data: none

Allergies: Dog and cat dander, arborvitae

Symptom List: Pharyngeal swelling

Symptoms: Headache, nausea, chills, muscle aches and tiredness. Treating it with naproxen, 22o mg tid

Other Meds: Omeprezole, stool softner, zertec

Current Illness: None

ID: 1736011
Sex: F
Age: 81
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: Abdominal pain, Chills, Sleep disorder

Symptoms: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1736012
Sex: F
Age: 28
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: 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: 1736013
Sex: F
Age: 27
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: None

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

Symptoms: Hot flashes within 30 minutes which lasted for approximately 12 hours. Within approximately 4 hours, felt a surge of mental clarity and began hyperfocusing on a subject for approximately 7 hours, which is unusual for me unless I am experiencing a mood episode. I have experienced hypomanic episodes, around 1/year, and I started noticing the signs shortly after the dose which hadn?t been present in the days leading up to the day of the vaccine. I was awake all night and could not sleep. Finally slept for a few hours and woke up feeling okay. I noticed extreme irritability during the whole day and heightened psychomotor agitation (not caused by stimulant use or any other drug) including motor tics which I perform when I?m having a mood episode of hypomania. They don?t occur when I?m in a normal mood. I?m wondering if the immune response caused by the vaccine triggered a hypomanic episode. Also experiencing teariness at minor frustrations and slight muscle pain and fogginess like I cannot focus my energy but at the same time have an excess of it. None of this had started until a few hours after the vaccine dose

Other Meds: Propranolol; acyclovir (both regularly taken)

Current Illness: None

ID: 1736014
Sex: M
Age: 65
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: 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: 1736015
Sex: F
Age: 3
State: MD

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

Lab Data: None

Allergies: None

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

Symptoms: Entire right upper arm became swollen and very itchy.

Other Meds: None

Current Illness: None

ID: 1736016
Sex: M
Age: 33
State: CA

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: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Headache, fever, soreness at injection site, fatigue beginning at 0100. Managed with rest, fluids, and ibuprofen.

Other Meds: None

Current Illness: None

ID: 1736017
Sex: F
Age: 95
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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1736018
Sex: F
Age: 46
State: NC

Vax Date: 04/17/2021
Onset Date: 05/01/2021
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: Abnormal menstral bleeding. I bleed more days per month and heavier.

Other Meds: Armour thyroid 60mg 2x per day, claritin , vitamin d

Current Illness:

ID: 1736019
Sex: F
Age: 14
State: CA

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

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

Symptoms: Client reported that her legs felt "heavy" at 17:55 after completing her 15 minute observation period. The client denied any other s/s of anaphylaxis. The client stated that she spent several hours in the car on the way to the vaccination site. The client stated that her parents were in the vaccination room and that she was waiting for them. RN recommended the client stay in the observation area until her parents arrive. RN asked the client to report any changes in her symptoms or new onset of symptoms. The client voiced understanding of this. RN checked in with the client about 5 minutes later and the client stated the feeling was gone. At 18:30 the client reported itchiness and noticed redness on her thighs and neck. The client ambulated and sat down in the anti-gravity chair. RN responded. The client denied any shortness of breath or throat tightness. Vitals obtained at 18:30 were as follows: BP 137/87, HR 113, and O2 99%. The client stated she was concerned about a "rash on my legs." The client has no known allergies. She has no chronic conditions or medications. RN assessed the client's skin around the vaccination site, over her chest, neck, ankles, and face. RN did not note any urticaria or hives. The client showed RN a picture of her thighs which the client had taken while in the bathroom previously. RN viewed the picture and was unable to discern if there was a rash or redness present. The client's mother viewed the picture and stated that it looked abnormal for the client. The client was wearing jeans and RN was unable to view the client's thighs in person at the time. The client stated the itching was localized to her right knee and described it as intermittent. RN responded. Repeat vitals obtained at 18:35 were as follows: BP 137/97, HR 110, and O2 99%. RN discussed potential administration of Diphenhydramine. The client and her mother stated that she has not taken Diphenhydramine before. The client asked, "What will that help?" RN discussed the risks, benefits, and potential side effects of Diphenhydramine. RN noticed tears in the client's eyes. The client stated, "My throat kind of hurts, but it feels like I'm going to cry." The client denied any difficulty swallowing, shortness of breath, or constriction of her throat. The client requested to go to the restroom to look at her legs and requested RN accompany her. The client, RN, and the client's mother viewed the client's thighs with the client's permission in the restroom. RN noted stretch marks on the client's thigh which the client confirmed were normal for her. The client stated that her legs "look better." The client's mother stated the client's legs appeared normal. RN did not note any other redness or rash on the client's legs. Repeat vitals obtained at 18:45 PM were as follows: BP 133/94, HR 105, O2 99%. RN educated the client's mother in Spanish regarding s/s of anaphylaxis and when to seek EMS. The client's mother voiced understanding of this education. RN provided education to the client regarding s/s of anaphylaxis, when to seek EMS, and V-safe. The client's voiced understanding of this education. Vitals obtained at 18:54 were as follows: BP 127/71, HR 96, O2 98%. The client denied any current symptoms. The client was alert and oriented to person, place, time, and situation. The client stood up at 19:00 and walked unassisted with a steady gait out of the observation area.

Other Meds: None

Current Illness: Unknown

ID: 1736020
Sex: F
Age: 94
State:

Vax Date: 09/24/2021
Onset Date: 09/24/2021
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: 1736021
Sex: F
Age: 22
State: VT

Vax Date: 05/11/2021
Onset Date: 06/01/2021
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: CT chest 7/2021: negative for evidence of sarcoidosis CBC, ESR, CRP, UA, strep, RPR, tick borne illness: Lyme, Babeiosis, Ehrlichiosis,

Allergies: none

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Around June 1st insidious onset of generalized joint pain and swelling associated with stiffness. A week after joint pain developed tender nodules that began on her shins then became generalized. Patient was diagnosed with E. nodusum. Had extensive work up done for etiology, none identified. By 8/2/21 symptoms had essentially resolved and patient was feeling much better.

Other Meds: Mirena

Current Illness: none

ID: 1736022
Sex: M
Age: 23
State:

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:

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

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

Other Meds:

Current Illness:

ID: 1736023
Sex: F
Age: 65
State:

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:

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: 1736024
Sex: M
Age: 19
State: NH

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: Elevated bilirubin High blood pressure Repeat testing in a week

Allergies: None

Symptom List: Unevaluable event

Symptoms: Tachycardia, rapid heart rate, burning sensation in chest, elevated bilirubin, elevated blood pressure

Other Meds: Aspirin, low dose (one that day)

Current Illness: None

ID: 1736025
Sex: F
Age: 41
State: MA

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

Lab Data:

Allergies: NKDA

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

Symptoms: Headache Sore throat Sinus pressure Fatigue Still experiencing

Other Meds: Celexa Probiotic

Current Illness: None

ID: 1736026
Sex: M
Age: 51
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: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1736027
Sex: F
Age: 48
State: OK

Vax Date: 09/15/2021
Onset Date: 09/21/2021
Rec V Date: 09/26/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Injection site pain, Menorrhagia

Symptoms: PVC?s. I have never suffered from them before.

Other Meds: B complex, magnesium citrate , vitamin d

Current Illness: None

ID: 1736028
Sex: M
Age: 47
State: CA

Vax Date: 01/12/2021
Onset Date: 01/25/2021
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: None

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

Symptoms: Bilateral Tinnitus (loud constant ringing in both of my ears)

Other Meds: Lipitor 10mg every other day

Current Illness:

ID: 1736029
Sex: F
Age: 76
State:

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

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1736030
Sex: F
Age: 43
State: NC

Vax Date: 07/30/2021
Onset Date: 07/30/2021
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: Ceftin, adhesive tape, ppd derivative, cymbalta

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Tinnitus starting approximately 20 minutes after the injection. Has not stopped since then.

Other Meds: Synthroid, lipitor, HCTZ, phentermine, finasteride, benadryl, baclofen, Meloxicam, singulair, protonix

Current Illness: None

ID: 1736031
Sex: F
Age: 80
State:

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:
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: 1736032
Sex: F
Age: 38
State: MI

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

Lab Data:

Allergies: sulfa dilaudid penicillin

Symptom List: Nausea

Symptoms: at first I felt foggy like a haze feel... left the store a few hours later and the next day my eyes felt like they were burning sensation. It felt like when you spray bleach and the fumes get in your eyes thats what I felt. now comes and goes

Other Meds: nikki birth control labetalol

Current Illness: sinus infection

ID: 1736033
Sex: M
Age: 53
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: Injection site pain

Symptoms: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1736034
Sex: F
Age: 50
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 induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1736035
Sex: M
Age: 38
State: NY

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: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: NONE

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

Symptoms: Redness of the skin in the inner area of the ankles, they seemed like bites at first, now they have the appearance of a bruise. Then the area became homogenous all red. Then it expanded towards the outside of the ankle. Sometimes there is itching but it is sporadic. I have never had a fever or pain. My ankle is very inflamed when I walk for a long. Being inflamed I lose a little mobility in my ankle. After a lot of walking I have a warm area , but after a short time resting it returns to normal temperate. Even without treatment.

Other Meds: NONE

Current Illness: NONE

ID: 1736036
Sex: M
Age: 33
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: 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: 1736037
Sex: F
Age: 25
State: GA

Vax Date: 08/14/2021
Onset Date: 09/19/2021
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: N/A

Symptom List: Erythema, Pruritus

Symptoms: 3 weeks after second shot I have noticed swollen supraclavical lymph node on the left side. Feels about the size of a grape but could be larger/smaller. Will be going to doctor to get it checked out. I have no other symptoms that I have noticed.

Other Meds: N/A

Current Illness: N/A

ID: 1736038
Sex: F
Age: 81
State: CA

Vax Date: 03/08/2021
Onset Date: 03/12/2021
Rec V Date: 09/26/2021
Hospital: Y

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: blood test, 18 to 20

Allergies: no allergies

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

Symptoms: Within 5 days, fainted, husband called 911, taken to hospital, had to have a blood transfusion. Went on for 4 months, doctors couldn't find the source of internal bleeding. I was ready to quit all treatment, A doctor finally repeated a test that had be done several times, found bleeding in small intestines. At my age I don't want the second shot, I would rather die from the virus than go through that period of time again. What I would like is a letter excusing me from the 2nd shot so I can go on with what life I have left I would appreciate any help, other than a shot, Thank you so much

Other Meds: too many to list

Current Illness: none

ID: 1736039
Sex: M
Age: 45
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: 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: 1736040
Sex: F
Age: 20
State: CA

Vax Date: 07/29/2021
Onset Date: 08/26/2021
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: possibly shrimp, pineapple, mushrooms and pollen

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: The night of my first dose I got really sick and almost went to urgent care. I woke up in the middle of the night with a fever, chills, sweating and migraine. A week after my second dose (8/25/2021), I noticed my right bicep where I got the shot felt swollen and hurt while I was at work. When I got home I noticed a large swollen rash. The next morning it had spread, and urgent care prescribed a steroid and something for the itching. 6 days later (8/31/2021) I was taken by ambulance to the ER. They originally thought I had a seizure but have not performed the proper tests but a followup has determined it was possibly convulsive syncope and not a seizure. Also got a concussion from the accident and how hard I hit my face on the floor. Was advised by a nurse and a family friend with their doctorate to fill this out. I am the only person in my family that had a reaction to the vaccine.

Other Meds: birth control

Current Illness:

ID: 1736041
Sex: F
Age: 65
State: CO

Vax Date: 03/09/2021
Onset Date: 08/12/2021
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: CT scan abdominal showed diverticulitis (this is the first time I had ever had this)

Allergies: Gluten and dairy cause GI distress No drug allergies

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

Symptoms: Acute abdominal pain requiring visit to the ER

Other Meds: Compounded T4/T3 Compounded topical estrogen and progesterone Orenda Multivitamin/Mineral; Orenda EAZE probiotics; Orenda Immune support

Current Illness: None

ID: 1736043
Sex: F
Age: 31
State: AL

Vax Date: 08/21/2021
Onset Date: 08/21/2021
Rec V Date: 09/26/2021
Hospital: Y

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: MRI 9/7/21 Lumbar puncture 9/7/21

Allergies: Penicillin, mycin, sulfa

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

Symptoms: Weakness in arms that moved to legs. Hospitalized and diagnosed with transverse myelitis after 2 weeks. Not leg function.

Other Meds: Progesterone, PMS supplement

Current Illness: None

ID: 1736044
Sex: F
Age: 43
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: 1736045
Sex: F
Age: 25
State: NY

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

Lab Data: EKG demonstrated sinus rhythm with occasional PVCs. CBC with diff, BMP, magnesium level, HS troponin, and ddimer were within normal limits.

Allergies: Amoxicillin (reaction: rash)

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

Symptoms: Healthy, active, and young female developed palpitations 43 hrs after receiving 1st dose of Pfizer-BioNTech vaccine and noted frequent PVCs on her watch and later confirmed with 12-lead EKG at the ER. These symptoms have improved but continue to persist. No history of palpitations or heart problems.

Other Meds: None

Current Illness: None

ID: 1736046
Sex: M
Age: 71
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: 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: 1736047
Sex: M
Age: 71
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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1736048
Sex: M
Age: 63
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: 1736049
Sex: F
Age: 74
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: 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: 1736050
Sex: F
Age: 25
State: WA

Vax Date: 09/09/2021
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: RA

Lab Data:

Allergies: Intolerance to codeine, minocycline and lorazepam

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

Symptoms: Within 10 minutes of vaccination, chest pressure and burning with shortness of breath. This lasted for around 12 hours. I also had extreme fatigue for 2 days

Other Meds: Falmina birth control

Current Illness: None

ID: 1736051
Sex: M
Age: 82
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: 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: 1736053
Sex: M
Age: 31
State: NE

Vax Date: 03/11/2021
Onset Date: 04/30/2021
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: No

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

Symptoms: Loss of hair in the center of the head, gradually until there was a huge circular gap.

Other Meds: None

Current Illness: No

ID: 1736054
Sex: F
Age: 40
State: VT

Vax Date: 01/01/2021
Onset Date: 02/03/2021
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: Full cardiac work up, ekg, echocardiogram, chest Vt, chest X-ray, etc.July, 3021

Allergies: Sulfa

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

Symptoms: First dose: I?d chest pain, palpitations, shortness of breath, Headaches and vertigo symptoms 2nd: dose, I had anaphylactic reaction with associated sxs bronchospasm and severe hypotension, 64/40. Later developed myopericarditis requiring treatment with colchicine.

Other Meds: Multi vitamins Extra calcium, zinc and vitamin c

Current Illness: None

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am