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: 1740786
Sex: F
Age: 62
State: MI

Vax Date: 09/26/2021
Onset Date: 09/26/2021
Rec V Date: 09/28/2021
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: Sulpha, Amoxicillin, Phenergan, Tetracaine, Metoprolol

Symptom List: Dysphagia, Epiglottitis

Symptoms: Injection site swelling, red, hot, painful

Other Meds: Atorvastatin, Estradial, Cartia, Magnesium, Vitamin D

Current Illness: None

ID: 1740787
Sex: F
Age: 38
State: MN

Vax Date: 02/03/2021
Onset Date: 09/27/2021
Rec V Date: 09/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data: 9/27 SARS/COV-2, NAAT positive

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Breakthrough COVID

Other Meds:

Current Illness:

ID: 1740788
Sex: M
Age: 31
State: MN

Vax Date: 09/26/2021
Onset Date: 09/28/2021
Rec V Date: 09/28/2021
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: Penicillin, Beef

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

Symptoms: Severe fatigue and body aches the following day, 2 days following: body aches, fatigue, and swollen lymph node on right arm

Other Meds: Sertraline, Buproprion, Oxybutinin, Fish Oil, Vitamin D, Fexofenadine, Montelukast, Fiber

Current Illness: None

ID: 1740789
Sex: F
Age: 36
State: FL

Vax Date: 09/24/2021
Onset Date: 09/24/2021
Rec V Date: 09/28/2021
Hospital:

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

Lab Data: Doctor visit scheduled.

Allergies: n/a

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: 9/24/21-9/25/21 102 degree fever, chills, numbing of hands and feet. 9/10 pain in Left injection arm with 0 range of motion. The next day- bilateral swollen lymphnodes, 100 degree fever. Unable to touch arm or move it. Swollen bilateral lymphnodes and bilateral rash on both armpits. 9/26/21 Day three- swollen lymphnodes and rash along left side of body, down torso, and hip. 9/27/21- Rash under left armpit, swollen lymphnodes

Other Meds: Probiotic supplement

Current Illness: n/a

ID: 1740790
Sex: F
Age: 45
State: IN

Vax Date: 03/04/2021
Onset Date: 04/01/2021
Rec V Date: 09/28/2021
Hospital:

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

Lab Data: N/A

Allergies: N/A

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

Symptoms: Breathing problems, headaches, running nose Using a inhaler and on medication for headaches

Other Meds: Prenatal vitamins

Current Illness: None

ID: 1740791
Sex: M
Age: 64
State: NY

Vax Date: 09/27/2021
Onset Date: 09/27/2021
Rec V Date: 09/28/2021
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: no

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

Symptoms: Fever on my second shot, first shot was ok.

Other Meds: Synthroid, Valsartan, Amlodipine, Atorvastatin

Current Illness: none

ID: 1740792
Sex: F
Age: 53
State: IN

Vax Date: 09/03/2021
Onset Date: 09/24/2021
Rec V Date: 09/28/2021
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: Sulfer drugs Erythromyacin

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Watery eyes, blurred vision from both vaccines. This second one was worse

Other Meds: Pristiq 100 Omega 3 Bromelain Atenlol 200 mg tumeric probiotics Deplin 15 mg

Current Illness: None

ID: 1740793
Sex: M
Age: 43
State: FL

Vax Date: 07/14/2021
Onset Date: 07/14/2021
Rec V Date: 09/28/2021
Hospital:

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

Lab Data: N/A

Allergies: N/A

Symptom List: Pharyngeal swelling

Symptoms: 1) Tinnitus (2-3 times per day ever since, left or right ear) 2) Attention deficit (I noticed my ability to focus has decreased substantially within a few days after the shot, and it has not come back) 3) Extreme sleepiness (I noticed getting extremely sleepy several times per day; this started about 50 days after the shot)

Other Meds: Finasteride (1 mg) for hair loss.

Current Illness: N/A

ID: 1740794
Sex: F
Age: 38
State: TX

Vax Date: 12/22/2020
Onset Date: 12/23/2020
Rec V Date: 09/28/2021
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: none

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Acute urticaria and angioedemaWith use of systemic steroids and antihistamines including hydroxyzine, Zyrtec and famotidine. Eventually acute urticaria and angioedema continued to progress to chronic urticaria and is currently being treated with monthly injections of 300 mg of Xolair Currently urticaria is ongoing 8 months post vaccination .

Other Meds: pimtrea prenatal vitamins

Current Illness: none

ID: 1740795
Sex: F
Age: 73
State: FL

Vax Date: 08/23/2021
Onset Date: 08/23/2021
Rec V Date: 09/28/2021
Hospital:

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

Lab Data: None yet

Allergies: Morphine

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Cellulitis left upper arm area Body aches, headaches, nausea, fever, fatigue

Other Meds: Tylenol

Current Illness:

ID: 1740796
Sex: F
Age: 38
State: TX

Vax Date: 08/27/2021
Onset Date: 08/28/2021
Rec V Date: 09/28/2021
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: Dizziness, chest pains, shortness of breath, elevated BP that is now not controlled by medication

Other Meds: Benicar

Current Illness: None

ID: 1740797
Sex: M
Age: 43
State: NY

Vax Date: 05/08/2021
Onset Date: 05/08/2021
Rec V Date: 09/28/2021
Hospital:

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

Lab Data: MRI X-Ray

Allergies: None

Symptom List: Rash, Urticaria

Symptoms: Sever muscle and joint pain. Joints and muscles locked up for 2 days. Muscle pain at the sight of injection that has not gone away in 4 months. Tingling and numbness in left arm for the past 4 months. Loss of mobility in left arm for the past 4 months. Loss of strength in left arm for the last 4 months. Tingling and numbness in left hand/fingers for the past 4 months. Loss of sleep for 4 months due to pain.

Other Meds: Trulicity 1.5 ml Metformin 1000mg Simvastatin

Current Illness: None Known

ID: 1740798
Sex: F
Age: 25
State: IL

Vax Date: 08/16/2021
Onset Date: 09/23/2021
Rec V Date: 09/28/2021
Hospital:

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

Lab Data: Pelvic ultrasound 9/23/21 CBC 9/23/21 Hcg 9/23/21 1464 Platelets 426 Hcg 9/27/21 372 Platelets 410 Platelets 271 7/23/21 (for reference prior to receiving vaccine)

Allergies: None

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

Symptoms: On 9/10/21 I had a positive pregnancy test. On 9/23/21 while at work I started passing large blood clots and bleeding. I went to the Emergency Room at Hospital. Platelet count was abnormally high and the pelvic ultrasound showed no viable pregnancy. I was discharged with threatened miscarriage diagnosis and told to repeat hcg levels and CBC on 9/27/21. I passed more clots over the weekend and on 9/27/21 my hcg levels had dropped from 1400?s to 300?s and platelets were still abnormally high. Confirmed miscarriage

Other Meds: None

Current Illness: None

ID: 1740799
Sex: F
Age: 54
State: MI

Vax Date: 01/06/2021
Onset Date: 01/07/2021
Rec V Date: 09/28/2021
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: multiple visits at optometrist and ophthalmologist office, has a referral to neuro-opthalmologist

Allergies: none

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

Symptoms: eye inflammation, decreased vision, headaches - condition lasting months and ongoing at this time (9 months post vaccine)

Other Meds: Estrogen

Current Illness: none

ID: 1740800
Sex: F
Age: 63
State: NC

Vax Date: 09/27/2021
Onset Date: 09/27/2021
Rec V Date: 09/28/2021
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: Latex

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

Symptoms: Sensorineural hearing loss - right ear- muffled hearing. Noticed within approximately 90 minutes of injection. Next day (today)- hearing is still muffled- but seems to be improving.

Other Meds: Metformin, Losartan, Multivitamin, baby aspirin

Current Illness: None

ID: 1740801
Sex: F
Age: 25
State: VA

Vax Date: 09/27/2021
Onset Date: 09/27/2021
Rec V Date: 09/28/2021
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: and per pt: "15 hours after the vaccine I fainted while washing my hands after having been up for several minutes. I became very dizzy and lost my balance and vision while reaching to turn the water off and fell. I recovered quickly. This happened for the first vaccine, as well, about 20 hours after the first Pfizer shot. For that time, I became dizzy while stretching and standing and then collapsing, but quickly recovered."

Other Meds:

Current Illness:

ID: 1740802
Sex: M
Age: 53
State: FL

Vax Date: 08/21/2021
Onset Date: 08/24/2021
Rec V Date: 09/28/2021
Hospital:

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

Lab Data: Blood work, Heart Enzymes, EKG / ECG, Stress test, CT with contrast, chest xrays.

Allergies: None

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

Symptoms: I was out of town for work and on the morning of 8/24 @ 4am I woke up with severe chest pains and high pulse rate with major nerve pain in both legs and entire back. 911 was called and I was transported via ambulance the Clinic ED in city. Arrived with Chest Pains, high pulse rate, legs and back pain. All heart enzymes were normal, CT and stress test was normal but had and abnormal ECG. Monitored me through out the day, could not find any reason for the pain or pulse rate. Was released that afternoon with a diagnosis of polyneuropathy of unknown cause and possible diabetes. Multiple providers examined me and said timing with the vaccine was just coincidence. I continue to have a high pulse rate with back and leg pain. If I get startled or move quickly, nerve pain shoots all through my body. Nobody has any explanation for it.

Other Meds: Levothyroxin and Atorvastatin

Current Illness: None

ID: 1740803
Sex: F
Age: 37
State: IL

Vax Date: 09/17/2021
Onset Date: 09/20/2021
Rec V Date: 09/28/2021
Hospital:

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

Lab Data:

Allergies: n/a

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Diagnosed with HSV 2 two years prior with only 1 initial outbreak. After first shot of vaccine, consistent HSV2 outbreak while on anti viral meds.

Other Meds: Valtrex, Birth Control

Current Illness: HSV2

ID: 1740804
Sex: F
Age: 13
State: TN

Vax Date: 08/20/2021
Onset Date: 08/22/2021
Rec V Date: 09/28/2021
Hospital:

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

Lab Data: none

Allergies: Codeine, polyethylene glycol

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Patient develops migraine headache that is worse than her usual migraine. She describes photophobia and phonophobia. The migraine is refractory to maxalt and ibuprofen. In ER, she is treated with IV fluids, diphenhydramine, ketorolac, ondansetron, and prochlorperazine.

Other Meds: Metformin, Maxalt

Current Illness: none

ID: 1740805
Sex: F
Age: 64
State: NY

Vax Date: 04/21/2021
Onset Date: 04/22/2021
Rec V Date: 09/28/2021
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: Acute Arm pain, treated with Meloxicam & Medrol

Other Meds: Vit B, Vit D

Current Illness: None

ID: 1740806
Sex: M
Age: 36
State: PA

Vax Date: 09/09/2021
Onset Date: 09/10/2021
Rec V Date: 09/28/2021
Hospital: Y

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: chest xray, EKG, lab work, CT scan, ultrasound

Allergies: no known allergies

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

Symptoms: hospitalized with diagnosis of pericarditis after receiving vaccine

Other Meds: Flovent 2 puffs BID, albuterol inhaler prn, Effexor daily

Current Illness: depression, asthma

ID: 1740807
Sex: M
Age:
State: ME

Vax Date: 09/01/2021
Onset Date: 09/27/2021
Rec V Date: 09/28/2021
Hospital:

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

Lab Data: Ct scan

Allergies: None

Symptom List: Unevaluable event

Symptoms: Seizure

Other Meds: None

Current Illness: None

ID: 1740808
Sex: M
Age: 60
State: PA

Vax Date: 02/13/2021
Onset Date: 04/13/2021
Rec V Date: 09/28/2021
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: Anterior and posterior draw test negative. Anterior Lachman test negative, Medial and lateral McMurry test negative. Radiology exam of knee and hip non significant. Mod arthritis in rt hip. labs: CK 91, C-reactive protein <1.0, Sed Rate 3 Referred to orthopedic surgeon - no additional testing or tx.

Allergies: NKA

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

Symptoms: 2 months, Intermittent myalgia and joint pain in knees, legs, and shoulders bilaterally

Other Meds: NSAID

Current Illness: None

ID: 1740809
Sex: F
Age: 27
State: NY

Vax Date: 09/26/2021
Onset Date: 09/26/2021
Rec V Date: 09/28/2021
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: Shellfish, low quality metals, some gluten sensitivity

Symptom List: Injection site pain, Pain

Symptoms: 104 fever, violent chills, severe headache, nausea, diarrhea, body ache, sore arm 9/26 and 9/27 and swollen axillary lymph node on 9/28.

Other Meds: None

Current Illness: None

ID: 1740810
Sex: F
Age: 58
State: NC

Vax Date: 04/26/2021
Onset Date: 05/01/2021
Rec V Date: 09/28/2021
Hospital:

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

Lab Data: Can be obtained from Dr.

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: INR has fluctuated from normal 2.6 down to 1.6 up to critical 6.4 since I received injection. My Dr has changed my warfin dosage several times and taken me off for short periods to try to level it. This has all been since I received the wrong covid shot at the above named pharmacy.

Other Meds: Levothyroxin, warfin, pravstatin metprolol

Current Illness:

ID: 1740811
Sex: M
Age: 57
State: VA

Vax Date: 03/23/2021
Onset Date: 03/24/2021
Rec V Date: 09/28/2021
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: Afib suddenly worse and very difficult to control. Multiple ER visits and cardiology appointments for medication adjustment before Afib was finally able to be controlled.

Other Meds:

Current Illness:

ID: 1740812
Sex: F
Age: 87
State:

Vax Date: 02/18/2021
Onset Date: 09/25/2021
Rec V Date: 09/28/2021
Hospital: Y

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: Admitted to Hospital on Date of Adverse Event [recorded in VAERS] for treatment of Covid-19 Positive following completion of Covid Vaccine Series

Other Meds:

Current Illness:

ID: 1740813
Sex: F
Age: 41
State: IL

Vax Date: 09/26/2021
Onset Date: 09/28/2021
Rec V Date: 09/28/2021
Hospital:

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

Lab Data:

Allergies: Sulfa, Penicillin

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Rash on abdomen/chest

Other Meds: None

Current Illness: None

ID: 1740814
Sex: F
Age: 78
State: WI

Vax Date: 09/25/2021
Onset Date: 09/26/2021
Rec V Date: 09/28/2021
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: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: Received Moderna vaccination the same day, Unable to stand, fatigue.

Other Meds:

Current Illness:

ID: 1740815
Sex: F
Age: 45
State: TX

Vax Date: 09/25/2021
Onset Date: 09/26/2021
Rec V Date: 09/28/2021
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: Employee calling to report a reaction after receiving a COVID-19 vaccine. Vaccine Name - Pfizer Vaccine Date - ? 9/25/2021 Is this your first or second dose- 3rd Booster Date of symptom onset - ? 9/26/2021 Symptoms - ? Headache, body aches, chills fever (101.0, and 100.6) Last day of work and shift - ? NA Home remedies- Employee stated she took Tylenol for the fever Any improvement- The Tylenol seemed to be helping the fever Recommendation- Advised employee to continue taking Tylenol as needed for fever per pack instructions. Employee voiced understanding Employee of information ? Yes Employee voiced any concerns ? No Employee?s questions answered to employee?s satisfaction -Yes

Other Meds:

Current Illness:

ID: 1740816
Sex: F
Age: 39
State: VA

Vax Date: 08/30/2021
Onset Date: 08/30/2021
Rec V Date: 09/28/2021
Hospital:

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

Lab Data: I saw my PCP. She advised that I have testing done by I have an appointment 10/14/2021.

Allergies: Laxtex, alpha gal(mammal products), vicodin, flagyl, gelatin,

Symptom List: Injection site pain

Symptoms: I got hives on my neck, face , and abdomen. My neck became very swollen and was hard to turn. I also had a really large swollen spot under my right arm. The swollen area continued under my right breast.

Other Meds:

Current Illness: None

ID: 1740817
Sex: F
Age: 84
State: MI

Vax Date: 03/15/2021
Onset Date: 09/20/2021
Rec V Date: 09/28/2021
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: Bacitracin Penicillin

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

Symptoms: Hospitalized 09/20/2021; COVID-19 positive 09/20/2021; fully vaccinated DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: a 85 y.o. female with past medical history significant for HTN, HPL, diet controlled DM 2, OA. She presented to the ED due to the above complaints. Patient states she started feeling unwell about 9 days ago. Since that time she has been experiencing generalized weakness, poor appetite, and fevers. More recently she has developed shortness of breath which has been progressing as well as cough. She is vaccinated against COVID. Upon arrival to the ED, patient was AF but hypoxic. She is currently on 2L of supplemental oxygen. Basic labs were obtained and significant for + COVID PCR. CTA thorax was obtained and was negative for PE but did demonstrate scattered groundglass opacities throughout both lungs suggestive of atypical infection. She was treated with Decadron 6 mg daily for 4 days. Which she will continue for 6 more days. She was not a candidate for remdesivir, due to she was symptomatic >10 days. She should stay in isolation until she finish her Decadron. Initially she required oxygen support, but by the time of discharge she was in her home.

Other Meds: acetaminophen (TYLENOL) 500 MG tablet amlodipine (NORVASC) 5 MG tablet Blood Glucose Monitoring Suppl (BLOOD GLUCOSE MONITOR SYSTEM) W/DEVICE KIT CALCIUM + D PO dexamethasone (DECADRON) 6 MG tablet Glucosamine Chondroitin Adv TABS glucose b

Current Illness: Urgent Care visit on 9/4/2021 dx with urinary tract infection-placed on Keflex SUBJECTIVE: a 85 y.o. female who presents to the Urgent Care with her granddaughter with increased frequency, urgency and abdominal pain. Symptom onset has been acute for a time period of 2-3 day(s). Worse overnight last night. Denies: fever, chills, sweats, incontinence, hematuria, nausea/vomiting, bilateral flank pain and back pain. No vaginal symptoms noted.

ID: 1740818
Sex: M
Age: 58
State: GA

Vax Date: 04/18/2021
Onset Date: 04/18/2021
Rec V Date: 09/28/2021
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: Arm pain at injection site has not gone away several months after injection. Red rash and swelling went away several days after injection, but pain continues. Feels like a bruise from being punched in the arm.

Other Meds: Nexium (20 mg), Amlodipine Besylate (2.5 mg), multivitamin, turmeric, fish oil

Current Illness:

ID: 1740819
Sex: F
Age: 45
State: KY

Vax Date: 09/12/2021
Onset Date: 09/27/2021
Rec V Date: 09/28/2021
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:

Allergies:

Symptom List: Tremor

Symptoms: hospitalization (non-ICU)

Other Meds:

Current Illness:

ID: 1740820
Sex: F
Age: 29
State: MA

Vax Date: 05/03/2021
Onset Date: 05/01/2021
Rec V Date: 09/28/2021
Hospital:

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

Lab Data: I was given a hearing test in May/June, and a MRI July 22nd 2021

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: A few days later I noticed a stuffy feeling in my right ear, as well as tinnitus. After visiting an ENT I was told I have hearing loss in my right ear. It's possible the hearing loss was progressive and began pre-vaccination, but the tinnitus didn't begin until after my second COVID vaccine and has not gone away since.

Other Meds: Celexa, Amitriptyline

Current Illness:

ID: 1740821
Sex: F
Age: 34
State: TN

Vax Date: 08/27/2021
Onset Date: 08/27/2021
Rec V Date: 09/28/2021
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: Chest x ray is unremarkable, EKG is WNL. Troponins are undetectable.

Allergies: cefaclor--hives

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

Symptoms: Patient received J & J vaccine in the morning. By 4 pm, patient presented to ER with complaints of chills, lightheadedness, shortness of breath, chest tightness radiating to upper back. Patient is tachycardic (heart rate = 107). Patient has temp of 100.4 F. Patient is treated with IV acetaminophen, ketorolac, and IV fluids. Vital signs normalized and patient is discharged home.

Other Meds: none

Current Illness: none

ID: 1740822
Sex: F
Age: 17
State: NY

Vax Date: 02/17/2021
Onset Date: 02/17/2021
Rec V Date: 09/28/2021
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: Patient was 17 at the time of vaccination

Other Meds:

Current Illness:

ID: 1740823
Sex: M
Age: 62
State: NC

Vax Date: 03/16/2021
Onset Date: 05/27/2021
Rec V Date: 09/28/2021
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:

Allergies: None

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Had blood clot in left lower extremity. Became below knee amputee June 2,2021.

Other Meds: B12 vitamin, Multi vitamin

Current Illness: None

ID: 1740824
Sex: M
Age: 67
State: KY

Vax Date: 03/26/2021
Onset Date: 09/27/2021
Rec V Date: 09/28/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: hospitalization (non-ICU)

Other Meds:

Current Illness:

ID: 1740825
Sex: F
Age: 49
State: TX

Vax Date: 09/25/2021
Onset Date: 09/26/2021
Rec V Date: 09/28/2021
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:

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

Symptoms: EE received Booster Vaccine on 9/25/2021, at TCH Vaccine event in PFW, sides effects were swollen lymph nodes, redness and swollen at injection site, has taken Tylenol/ibuprofen and cols compress to help with pain. Advise to rest and drink fluids

Other Meds:

Current Illness:

ID: 1740826
Sex: M
Age: 80
State: KY

Vax Date: 03/10/2021
Onset Date: 09/27/2021
Rec V Date: 09/28/2021
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: Pain in extremity

Symptoms: Pfizer on 2/17 and 3/10. Positive on 9/22

Other Meds:

Current Illness:

ID: 1740827
Sex: M
Age: 70
State: KY

Vax Date: 03/25/2021
Onset Date: 09/27/2021
Rec V Date: 09/28/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: Pfizer on 3/4 and 3/25. Positive on 9/23

Other Meds:

Current Illness:

ID: 1740828
Sex: M
Age: 58
State: GA

Vax Date: 09/20/2021
Onset Date: 09/21/2021
Rec V Date: 09/28/2021
Hospital:

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

Lab Data: None.

Allergies: None.

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

Symptoms: Persistent, significant joint pain; most significantly in Right hip and left shoulder. Motrin as needed for pain, now nightly. Appointment scheduled for PCP today. Joint pain not present prior to vaccine. Exercise routine involves cycling and walking 4-5 days per week. Cannot walk without gait disturbance due to pain, especially in right hip. Cycling cadence mostly preserved, however right hip range of motion needed to mount and dismount bicycle is significantly reduced and painful, making starting and stopping difficult without stumbling or falling.

Other Meds: None.

Current Illness: None.

ID: 1740829
Sex: M
Age: 73
State: KY

Vax Date: 02/19/2021
Onset Date: 09/23/2021
Rec V Date: 09/28/2021
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: hospitalization (non-ICU)

Other Meds:

Current Illness:

ID: 1740830
Sex: M
Age: 56
State: NY

Vax Date: 09/15/2021
Onset Date: 09/17/2021
Rec V Date: 09/28/2021
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: None

Symptom List: Vomiting

Symptoms: Swollen throughout the body

Other Meds: None

Current Illness: None

ID: 1740831
Sex: M
Age: 81
State: KY

Vax Date: 02/19/2021
Onset Date: 09/27/2021
Rec V Date: 09/28/2021
Hospital: Y

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: Moderna on 1/26 and 2/19. Positive on 9/27

Other Meds:

Current Illness:

ID: 1740832
Sex: M
Age: 66
State: FL

Vax Date: 09/27/2021
Onset Date: 09/27/2021
Rec V Date: 09/28/2021
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: At the point of administration of the vaccine in the left arm the device had a failure, wherein portion of the vaccine leaked out at the needle and the syringe connection. Due to the undetermined amount of the vaccine administered, the pharmacist revaccinated the patient in the right arm (without device failure).

Other Meds: none

Current Illness: none

Date Died: 09/26/2021

ID: 1740833
Sex: M
Age: 77
State: AR

Vax Date: 04/02/2021
Onset Date: 09/25/2021
Rec V Date: 09/28/2021
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: Covid-19 after complete vaccination. Patient expired on 9/26/2021

Other Meds:

Current Illness:

ID: 1740835
Sex: M
Age: 91
State: KY

Vax Date: 02/24/2021
Onset Date: 09/26/2021
Rec V Date: 09/28/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: hospitalization (non-ICU)

Other Meds:

Current Illness:

Date Died: 05/23/2021

ID: 1740836
Sex: F
Age: 79
State: NY

Vax Date: 04/01/2021
Onset Date: 04/13/2021
Rec V Date: 09/28/2021
Hospital: Y

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

Lab Data: The hospital conducted many tests and diagnosed her with MRSA 2times and then reported that both of the tests were contaminated and that she didn't have MRSA. Hospital said that she wasn't getting enough nutrition for her kidneys to function properly. She was too sick to eat and became too fragile to have a feeding tube.

Allergies: penicillin

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

Symptoms: my mother complained of pains all over her body the night of first shot. She continued to have pain. My mother also became very confused after 1st shot and would speak inappropriately and repeat herself often. She stayed in bed all day and had no energy to to do regular routine. She was very itchy and vomited after 2nd dose. the day after second dose she was unable to ambulate and continued throwing up. When I called ambulance she could not even answer basic questions like how old she was.

Other Meds: none

Current Illness: rheumatoid arthritis, diabetes in remission

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am