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: 1741456
Sex: M
Age: 27
State: NY

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

Lab Data: NONE

Allergies: none

Symptom List: Dysphagia, Epiglottitis

Symptoms: PT WAS GIVEN 5TH DOSE OF GARDASIL AFTER RECEIVING 4TH DOSE AT INITIAL APPOINTMENT WITH THE PROVIDER TO ESTABLISH CARE AT CLINIC. AFTER SPEAKING WITH PATIENT, IT WAS DETERMINED HIS PAST IMMUNIZATION HISTORY WAS NOT REVIEWED AT APPOINTMENT AND THAT HE HAD BEEN GIVEN 3 DOSES AT PRIOR PROVIDER.

Other Meds: none

Current Illness: none

ID: 1741457
Sex: M
Age: 39
State: VA

Vax Date: 09/24/2021
Onset Date: 09/25/2021
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:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Site: Pain at Injection Site-Severe, Systemic: Fainting / Unresponsive-Medium

Other Meds:

Current Illness:

ID: 1741458
Sex: F
Age: 31
State: LA

Vax Date: 09/17/2021
Onset Date: 09/20/2021
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:

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

Symptoms: pt presented for chest pain for 7 days. labs and chest xray ordered. elevated ESR. presumptively dx with acute pericarditis treated colchicine and motrin

Other Meds:

Current Illness:

ID: 1741459
Sex: M
Age: 85
State:

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: 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: 1741460
Sex: F
Age: 62
State:

Vax Date: 05/13/2021
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: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Hospitalization due to COVID-19 pneumonia

Other Meds:

Current Illness:

ID: 1741461
Sex: M
Age: 88
State:

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:

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: 1741462
Sex: F
Age: 59
State:

Vax Date: 03/24/2021
Onset Date: 03/24/2021
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:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: none

Other Meds:

Current Illness:

ID: 1741463
Sex: F
Age: 51
State: FL

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Error: Wrong Dose of Vaccine - Too High-

Other Meds:

Current Illness:

ID: 1741464
Sex: F
Age: 32
State: VT

Vax Date: 09/28/2021
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: 1
Vax Route: IM
Vax Site: LA

Lab Data: None

Allergies: None

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Patient was due for her second COVID-19 Moderna vaccination. Patient was given a dose of COVID-19 Moderna vaccination that had been open for approximately one week in the right deltoid. No immediate reaction.

Other Meds: multivitamin Multiple Vitamins tablet 1 tab(s) orally once a day. Nicotine Patch 21 mg/24 hr film, extended release 1 PATCH transdermally once a day. BuPROPion (Eqv-Wellbutrin SR)(buPROPion) 150 mg/12 hours tablet, extended release 1 tab(s

Current Illness: N/A

ID: 1741465
Sex: M
Age: 48
State: IN

Vax Date: 09/27/2021
Onset Date: 09/28/2021
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:

Allergies: None known

Symptom List: Diarrhoea, Nasal congestion

Symptoms: 102 fever. Chills. Aches. Diahrrea vomiting. Cramping. Numbness in big toes and fingers

Other Meds: Omeprazole Fish oil Vitamin d Zinc Multivitamin

Current Illness: None Recovery from Covid April 2021 after 3 week illness

ID: 1741466
Sex: F
Age: 54
State: IN

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

Lab Data:

Allergies: Sulfa

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

Symptoms: Approximately 2 hours after my #3 Covid booster, I began having numbness around my upper lip on L side. Within 15 minutes area became swollen and swelling continued spreading to my upper lip and to the right side of my mouth. Lasted until approx noon the following day. No trouble swallowing or breathing.

Other Meds:

Current Illness: n/a

ID: 1741467
Sex: F
Age: 42
State: TX

Vax Date: 09/28/2021
Onset Date: 09/28/2021
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:

Allergies: Strawberries

Symptom List: Rash, Urticaria

Symptoms: At the 4th hour I started feeling nausea, headache, chills, stiff neck, and dizziness. At the 5.5 hour I am still feeling the same with the headache and dizziness getting worse

Other Meds: Omeprazole, Trazodone, buspirone, famotidine, cetrizine

Current Illness: gastritis, allergies, insomnia, anxiety

ID: 1741468
Sex: M
Age: 81
State:

Vax Date: 09/28/2021
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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: ADMINISTRATION ERROR MIXED SERIES mRNA VACCINE PFIZER AND MODERNA.

Other Meds:

Current Illness:

ID: 1741469
Sex: M
Age: 32
State: FL

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

Lab Data:

Allergies:

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

Symptoms: Error: Wrong Dose of Vaccine - Too High-

Other Meds:

Current Illness:

ID: 1741470
Sex: F
Age: 59
State:

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:

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

Symptoms: none

Other Meds:

Current Illness:

ID: 1741471
Sex: M
Age: 73
State:

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: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1741472
Sex: M
Age: 85
State: KY

Vax Date: 09/10/2021
Onset Date: 09/27/2021
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: COVID Antigen positive on 9/28/2021

Allergies:

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

Symptoms: Breakthrough COVID case after vaccination, had subjective fever and chills onset 9/27/2021

Other Meds:

Current Illness:

ID: 1741473
Sex: M
Age: 46
State:

Vax Date: 09/27/2021
Onset Date: 09/27/2021
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:

Symptom List: Ear pain, Hypoaesthesia

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

Other Meds:

Current Illness:

ID: 1741474
Sex: F
Age: 30
State: FL

Vax Date: 09/26/2021
Onset Date: 09/26/2021
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:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Error: Wrong Dose of Vaccine - Too High-

Other Meds:

Current Illness:

ID: 1741475
Sex: U
Age: 63
State:

Vax Date: 09/28/2021
Onset Date: 09/28/2021
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:

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: 1741476
Sex: F
Age: 78
State: OH

Vax Date: 02/23/2021
Onset Date: 09/14/2021
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: 9/28/21 Sodium: 110; Potassium: 2.7; Chloride: 65; Magnesium: 1.3 ALT: 72; AST: 67; total bilirubin: 1.48 Rapid COVID-19: positive Chest X-ray: chronic changes without acute airspace disease

Allergies: Percocet

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

Symptoms: Patient became ill approximately 2 weeks prior to ED presentation, reporting intermittent headache, nasal congestion, fatigue, nausea, and mild cough. Patient report nausea has been causing her inability to eat and drink. Patient also reports mobility challenges due to fatigue. Patient was found to be hyponatremic, hypomagnesemic, and hypokalemic. Patient will be admitted for management of these electrolyte imbalances. Patient is receiving replacement of magnesium, potassium, and sodium.

Other Meds: allopurinol, aspirin, carvedilol, hydrochlorothiazide, omeprazole, simvastatin

Current Illness:

ID: 1741477
Sex: M
Age: 60
State:

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:
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: 1741478
Sex: F
Age: 25
State: KS

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: LA

Lab Data:

Allergies:

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

Symptoms: Pt came in for Pfizer Covid-19 booster. Pt had indicated on form that pt had received 2 previous doses of Pfizer vaccine. After administering vaccine, realized that pt had actually received 2 doses of Moderna previously (not Pfizer). Explained to pt that she received a pfizer vaccine today (which she was expecting) but that it was not necessary since she received two doses of Moderna, and no booster is approved at this time for Moderna. Pt understood. I also spoke to her Dad, who was also present. They understood and were not upset. They declined my offer to call pt's doctor.

Other Meds:

Current Illness:

ID: 1741479
Sex: F
Age: 38
State:

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: 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: 1741480
Sex: F
Age: 69
State: NE

Vax Date: 03/27/2021
Onset Date: 08/12/2021
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: lab work; normal. biopsy; idiopathic vasculitis

Allergies: Oxycodone

Symptom List: Injection site pain, Menorrhagia

Symptoms: I was diagnosed with petechiae on 08/17/2021. I had blood test which was normal. I went back to the doctors office a week later and I had a biopsy of my leg, diagnosed me idiopathic vasculitis. I was started on Prednisone medication for two weeks. I am still having swelling on my left and right foot.

Other Meds: I am on prescription medications

Current Illness: None

ID: 1741481
Sex: F
Age: 1
State: CA

Vax Date: 09/22/2021
Onset Date: 09/23/2021
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: Dairy, Egg

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

Symptoms: I am the breastfeeding mother of baby. The morning after my second covid dose my daughter got a rash around her mouth. That afternoon she had terrible diarrhea and that night she ran a fever for a few hours. Over the course of the next few days the rash came and went and she had bad gas and more diarrhea.

Other Meds: N/A

Current Illness: N/A

ID: 1741482
Sex: M
Age: 70
State:

Vax Date: 09/28/2021
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:
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: 1741483
Sex: M
Age: 19
State: CO

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Medium

Other Meds:

Current Illness:

ID: 1741484
Sex: M
Age: 70
State:

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:

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: 1741485
Sex: F
Age: 47
State: WV

Vax Date: 08/26/2021
Onset Date: 09/13/2021
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: Blood work, Urine and a CT abdomen Pelvis all on 9/14/2021

Allergies: None

Symptom List: Nausea

Symptoms: Within a day of receiving the first dose, I had fever, chills, leg pains that resolved within 24 hours. However within two weeks, I started experiencing stomach issues and multiple bowel movements per day. Then on 9/14/21 I was admitted to Medical for a seven day stay for moderate sigmoid diverticulitis with perforations.

Other Meds: atorvastatin, baby aspirin

Current Illness: None

ID: 1741486
Sex: F
Age: 66
State: OH

Vax Date: 03/01/2021
Onset Date: 03/02/2021
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: NONE

Allergies: PENICLIN, SULPHA

Symptom List: Injection site pain

Symptoms: JUST TIRED

Other Meds: DOXCYLINW, LOSARTAN AND WATER PILL

Current Illness: NONE

ID: 1741487
Sex: M
Age: 43
State:

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:
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: 1741488
Sex: M
Age: 53
State: WA

Vax Date: 09/27/2021
Onset Date: 09/28/2021
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: Penicillin

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

Symptoms: Fever, nausea vomiting, joint aches, back pain, headache

Other Meds:

Current Illness:

ID: 1741489
Sex: F
Age: 16
State: FL

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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: Error: Wrong Dose of Vaccine - Too High-

Other Meds:

Current Illness:

ID: 1741490
Sex: M
Age: 74
State:

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: Erythema, Pruritus

Symptoms: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1741491
Sex: F
Age: 36
State: NY

Vax Date: 09/23/2021
Onset Date: 09/23/2021
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: EKG, Heart test, Chest x-ray

Allergies: Unknown allergies

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

Symptoms: An hour after the vaccine my mouth area felt weird and my tongue was tingling. My head and arm started feeling weird. I woke up the next day and my heart was racing, so I went to the ER and was told I was in tachycardia and having an allergic reaction to the vaccine. I was given Benadryl and IV fluids. I went home to rest and was told to follow up with my doctor. I went to work and got a sharp pain in my shoulder blade, and my blood pressure and heart rate were elevated. My blood pressure stays elevated and my heart rate is never under 100 BPM.

Other Meds: Metformin

Current Illness: None

ID: 1741492
Sex: M
Age: 79
State:

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: none

Other Meds:

Current Illness:

ID: 1741493
Sex: F
Age: 43
State: PA

Vax Date: 09/07/2021
Onset Date: 09/10/2021
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:

Allergies: none

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Dizziness and brain fog. Brain fog lasted for about 7-8 days. Dizziness lasted about 13 days.

Other Meds: synthroid, vit D, multi vitamin, allegra, vit B12

Current Illness: none

ID: 1741494
Sex: M
Age: 69
State:

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

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

Lab Data:

Allergies:

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

Symptoms: ADMINISTRATION ERROR MIXED SERIES mRNA PFIZER AND MODERNA.

Other Meds:

Current Illness:

ID: 1741495
Sex: M
Age: 56
State:

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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

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

Other Meds:

Current Illness:

ID: 1741496
Sex: F
Age: 14
State: FL

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

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: Error: Wrong Dose of Vaccine - Too High-

Other Meds:

Current Illness:

ID: 1741497
Sex: F
Age: 61
State: AR

Vax Date: 04/27/2021
Onset Date: 05/27/2021
Rec V Date: 09/28/2021
Hospital:

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

Lab Data: None

Allergies: Sulfa drugs, Neomycin, Bacitracin

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

Symptoms: I have a history of Recurrent Idiopathic Pericarditis. On Thursday, 05/27/2021, thirty days after receiving the 2nd COVID-19 vaccine, I started having symptoms of pericarditis which included shortness of breath, pain in center of chest (worse when lying down), fatigue, and fever of 99.8. I started taking Advil and Tylenol, and quit treadmill exercising. On Tuesday, 06/01/2021, symptoms had not improved--I restarted the Recurrent Idiopathic Pericarditis Treatment Protocol--800mg Ibuprofen 3 times daily for 2-4 weeks for recurrence, Colchicine 0.6mg daily for 6 months for recurrence, and a proton pump inhibitor for gastric protection. (See Continuation Page) I visited my Cardiologist on Wednesday, 06/02/2021--no labs were drawn since this was my 7th episode of recurrent idiopathic pericarditis in three years, and the symptoms were not severe compared to my last episode of pericarditis, The symptoms resolved within 2 weeks of treatment. Addendum: I also had swollen lymph nodes under both arms and a very large painful/swollen lymph node under the right arm (the first vaccine dose was given in the right arm). The lymph noted swelling starting approximately 4-5 days after the first COVID vaccine. The lymph nodes were still swollen when I received the second vaccine dose 21 days later--therefore, I decided to receive the second dose in the opposite arm (my left arm). The lymph nodes remained swollen for weeks after the second dose.

Other Meds: Levothyroxine, Lipitor, Centrum Silver MVI, Vitamin D3

Current Illness: None

ID: 1741498
Sex: M
Age: 42
State: IN

Vax Date: 08/05/2021
Onset Date: 08/06/2021
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: TBD

Allergies: NONE

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

Symptoms: sporadic Muscle twitching and numbness in left arm in various spots tremors

Other Meds: NONE

Current Illness: NONE

ID: 1741499
Sex: F
Age: 61
State:

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

Symptoms: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1741500
Sex: F
Age: 68
State:

Vax Date: 09/28/2021
Onset Date: 09/28/2021
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:

Allergies:

Symptom List: Vomiting

Symptoms: ADMINISTRATION ERROR MIXED SERIES mRNA VACCINE PFIZER AND MODERNA.

Other Meds:

Current Illness:

ID: 1741501
Sex: M
Age: 73
State:

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: 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: 1741502
Sex: M
Age: 21
State: PA

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:

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

Symptoms: Error: Incorrect Reconstitution-

Other Meds:

Current Illness:

ID: 1741503
Sex: F
Age: 79
State:

Vax Date: 03/17/2021
Onset Date: 03/17/2021
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: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: none

Other Meds:

Current Illness:

ID: 1741504
Sex: F
Age: 71
State:

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

Lab Data:

Allergies:

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

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

Other Meds:

Current Illness:

ID: 1741505
Sex: M
Age: 81
State:

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: 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