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**
PLEASE CHECK BACK SOON
Download the files above while you wait.







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: 1741812
Sex: F
Age: 26
State: WA

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

Lab Data: N/A

Allergies: Toradol

Symptom List: Dysphagia, Epiglottitis

Symptoms: Patient received Moderna #2 vaccine after getting Pfizer #1 the previous month, and experienced negative side effects in the 15 minute monitoring period. Details as follows: - Patient booked and appointment for Moderna Vaccine #2 with no record of previous #1 vaccine. Upon arrival, we asked to produce their vaccination card, but they did not have it. As such, prior to administering, we verified clinical background and confirmed with them that they were getting the Moderna #2, which they confirmed yes. - After administration, during the 15 minute monitoring period, patient reported having increased heartrate, chest discomfort, and nausea. Stated having history of similar reactions to vaccines/injections and anxiety increasing during these. - Patient was asked to wait 15 more minutes. - After 15 more minutes, patient symptoms had not completely subsided. As a result, we informed the patient they should not drive/leave alone, should have someone with them, and that they should see a medical provider immediately if their symptoms did not subside/worsen. - Afterwards, patient stated that they had actually gotten Pfizer vaccine in the previous month. Explained to them that the difference vaccine is the reason why they reacted more negatively to a difference vaccine. Re-emphasized that patient should not leave alone and to see a medical provider ASAP if symptoms did not go away/worsened. - Patient confirmed they had somebody to drive/monitor them and left after acknowleding that they should go to ED if symptoms remain.

Other Meds: Methylphenidate, Alprazolam,Lorazepam,Paroxetine

Current Illness: N/A

ID: 1741813
Sex: F
Age: 72
State: CA

Vax Date: 03/04/2021
Onset Date: 08/03/2021
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: EKG 07/07/2021

Allergies: Sedative Medications, Ambien, Prednisone

Symptom List: Anxiety, Dyspnoea

Symptoms: Pt. states that after receiving the 2nd dose of Moderna 03/04/2021, started experiencing symptoms 07/07/2021 suffering from a Heart Attack (Stressed Induced Cardiomyopathy).

Other Meds: Thyroxin, Hydroxozein, Gabapentin, Bactophin

Current Illness: N/A

ID: 1741814
Sex: F
Age: 57
State: NC

Vax Date: 03/27/2021
Onset Date: 03/30/2021
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: EKG and bloodwork.

Allergies: Hydrocodone - ended up in the hospital- was throwing up, nausea, dizzy and was constipated Pain medications - Tramadol - was prescribed after I got the shingles - the doctor prescribed it after the vaccine when I got the shingles

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

Symptoms: Three days later, I had some rash in my chest. It would itch when I took a bath. It was nothing to go to hospital with. I had that maybe a week. In July, I had shingles. At first, I thought it was mosquito or spider bites but then it got to be so painful and doctor said they are shingles. Doctor gave me Tramadol (and said I would need a shingles vaccination in 6 months) and I ended up in the ER the whole night - was vomiting nonstop and nauseous and I was given some medication to stop the vomiting and. Also at ER they gave me morphine through the drip. And also gave me the acid reflux medicine. At first they thought I was having a heart attack - they did an EKG and they found that I wasn't having a attack. I dehydrated from vomiting. They gave me IV fluids. Shingles - I ended up just going to buy Tylenol to drink and doing yoga and sitting down and trying not to stress. I didn't take any medication after that. I am healing and recovering - the wounds are gone but they are still painful if I do anything that triggers them. I'm on the road to recovering.

Other Meds: Vitamin C and I was also taking Instaflex Advanced Joint Support for my joints and Claritin for allergies; Iron tablets

Current Illness: no

ID: 1741815
Sex: M
Age: 22
State: CA

Vax Date: 05/10/2021
Onset Date: 05/11/2021
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: none yet

Allergies: unknown

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: The person giving the shot poked my arm and needle did not penatrate.. ..she pushed again really hard and told the people sitting next to us that she had a hard time getting the needle to go through...instantly neck and arm started to hurt ...I thought this was normal but the tingling in my arm down to my fingers really became bothersome..started to think I slept on my arm wrong that night.. then after another day I thought could I be having a mini stroke ..this numbness and tingling has Not stopped ...I started losing feeling in my left pinky and the finger next to the left pinky finger .... I have a hard time grasping things with the hand and to this very day I still have No feeling in those 2 fingers and my arm hurts if I left passed a certain point ...and today I have wierd rash spot that just developed on that arm very small but itchy and strange ..I recently reported to my doctor and he said we will wait and see what happens but my muscle in my arm is not feeling right and I feel something more needs to be looked into before I have no feelings left in this arm..

Other Meds: none

Current Illness: No

ID: 1741816
Sex: M
Age: 87
State: MO

Vax Date: 03/01/2021
Onset Date: 09/28/2021
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: Sep-28-2021 1110 Coagulation PT 11.4INR 1.1 Sep-28-2021 1021 Chemistry GLUCOSE 135BUN 33CREAT 6.4MDRD GFR 8NA 134K 4.8CL 98CALCIUM 7.5CO2 26.7OSMO 277.5ANION GP 14.1BUN/CRE 5.2TROPI 0.186PROBNP 5919 Sep-28-2021 1021 Hematology WBC 6.5RBC 3.71HGB 12.7HCT 37.2MCV 100.3MCH 34.2MCHC 34.1RDW 13.8RDWSD 51.2PLT 105MPV 12.3AUTONEU% 69.6AUTOLYM% 25.3AUTOMON% 4.0AUTOEOS% 0.0AUTOBAS% 0.2AUTONEU# 4.5AUTOLYM# 1.6AUTOMON# 0.3AUTOBAS# 0.0AUTOEOS# 0.0NRBC% 0.0NRBC 0.0HGB/HCT 2.9IG# 0.06IG% 0.9 Sep-28-2021 1021 Serology PROCALC 4.84

Allergies: No Known Allergies

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

Symptoms: Patient hospitalized fully vaccinated with the following diagnosis- - Acute hypoxic respiratory failure secondary to COVID-19 - Acute COVID-19 pneumonia

Other Meds: amlodipine 10 mg tab Dose: 1 TAB ORALLY ONCE A DAY finasteride 5 mg tab Dose: 1 TAB ORALLY ONCE A DAY Levemir U-100 Insulin 100 unit/mL soln Dose: 10 UNT SUBCUTANEOUS TWICE DAILY metoprolol tartrate 100 mg tab Dose: 1 TAB ORALLY TWICE DA

Current Illness: none

ID: 1741817
Sex: F
Age: 89
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: 1741818
Sex: F
Age: 47
State: NC

Vax Date: 08/29/2021
Onset Date: 09/03/2021
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: injection site reaction - pain, redness, swelling, itching

Other Meds:

Current Illness:

ID: 1741819
Sex: F
Age: 37
State:

Vax Date: 01/06/2021
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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: PATIENT HAD PFIZER VACCINE Dose 1 date: 01/6/2021, Dose 2 date: 01/27/2021, AND TESTED POSITIVE TEST RESULTS.

Other Meds:

Current Illness:

ID: 1741820
Sex: M
Age: 31
State: OK

Vax Date: 04/14/2021
Onset Date: 09/25/2021
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: Amlodipine

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: On 09/24/2021 I began showing signs of facial paralysis. I went to the ER the next day 09/25/2021 where they diagnosed me with Bell's Palsy after some basic motor function tests. They prescribed me with Prednisone and sent me home. As of 09/28/2021 I am still experiencing full facial paralysis on the left side.

Other Meds: Losartan, Metoprolol

Current Illness: None

ID: 1741821
Sex: M
Age: 71
State: CA

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: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None known

Symptom List: Diarrhoea, Nasal congestion

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

Other Meds: Acetaminophen Amlodipine Besylate Aranesp (Billable) Aranesp (Billable) Aranesp (Billable) Atorvastatin Calcium Calcitriol Calcium Acetate Covid-19 Pfizer-BioNTech Addl dose Flomax Fluoxetine HCl Furosemide Heparin bolus Keppra Lantus Liqua

Current Illness:

ID: 1741822
Sex: F
Age: 74
State: NC

Vax Date: 09/10/2021
Onset Date: 09/10/2021
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: N/A

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

Symptoms: INJECTION SITE REACTION, LARGE RED/SWOLLEN AREA BIGGER THAN THE SIZE OF A QUARTER, TREATED WITH PREDNISONE AND RESOLVED QUICKLY

Other Meds: OMEPRAZOLE, SERTRALINE, CARISOPRODOL, FAMOTIDINE, PREMARIN

Current Illness: N/A

ID: 1741823
Sex: M
Age: 68
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: 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: 1741824
Sex: F
Age: 40
State: WY

Vax Date: 09/10/2021
Onset Date: 09/10/2021
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: 2nd dose was given 1 week before it was due.

Other Meds:

Current Illness:

ID: 1741825
Sex: M
Age: 54
State: FL

Vax Date: 04/10/2021
Onset Date: 09/02/2021
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: Around September 1, 8. 15.

Allergies:

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

Symptoms: I contracted an Influenza. I do not know which variety of influenza. It was not related to COVID 19 or the vaccine. I had an extreme cough and sore throat. I tested negative for COVID 19 three times.

Other Meds:

Current Illness:

ID: 1741826
Sex: F
Age: 61
State: CA

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: Trazodone Hcl

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: Acetaminophen Aranesp (Billable) Aranesp-Hold Aspirin Atorvastatin Calcium Calcium Acetate Carvedilol Covid-19 Pfizer-BioNTech Addl dose Engerix-B (Hepatitis B Vaccine) Engerix-B (Hepatitis B Vaccine) Gentamicin 320mcg/ml in 4% Citrate Gent

Current Illness:

ID: 1741827
Sex: M
Age: 77
State: NV

Vax Date: 08/14/2021
Onset Date: 08/16/2021
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: none

Allergies: None

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

Symptoms: Severe rash started in bicep of left arm and spread all the way down arm and then started in bicep area of right arm and continued all the way down right arm --still vivid in both arms after six weeks ,has never gone away

Other Meds: Zolpidem, Magnesium Oxide, D3, Glucosamine Chondroitin, Multivitamin, Aspirin

Current Illness: None

ID: 1741828
Sex: F
Age: 72
State: CA

Vax Date: 09/27/2021
Onset Date: 09/28/2021
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: none

Allergies: LATEX, AMOXICILLIN

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

Symptoms: very sore at VAX site on left arm, slight fever and tiredness

Other Meds: metformin, simvastatin, losartan, multivitamin, citracal vitamins c, e d

Current Illness:

ID: 1741829
Sex: F
Age: 83
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: 1741830
Sex: F
Age: 63
State: CA

Vax Date: 09/24/2021
Onset Date: 09/25/2021
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: Reports sore arm that lasted more than a few days that required multiple doses of over the counter acetaminophen. Patient also iced. When pharmacy examined arm, there was a dark, yet fading, bruise ~5" down from injection area. When arriving to pharmacy 9/26/21 the bruise was in healing process and patient wasn't in pain.

Other Meds:

Current Illness:

ID: 1741831
Sex: F
Age: 71
State: FL

Vax Date: 09/18/2021
Onset Date: 09/19/2021
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: none

Allergies: nonw

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

Symptoms: I had breast cancer surgery Dec. 2020 and had my lymph node removed. After booster shot I had a swelling and a lot of soreness in the area the lymph node was taken out. Should have had shot in other arm. Lasted about 5 days.

Other Meds: Losartan

Current Illness: none

ID: 1741832
Sex: M
Age: 40
State: CA

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: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None known

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: Acetaminophen Amlodipine Besylate Aranesp (Billable) Aspir-81 Calcitriol Chlorthalidone Clonidine HCl Covid-19 Pfizer-BioNTech Addl dose Engerix-B (Hepatitis B Vaccine) Engerix-B (Hepatitis B Vaccine) Engerix-B (Hepatitis B Vaccine) Gentami

Current Illness:

ID: 1741833
Sex: F
Age: 70
State: MI

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: Unevaluable event

Symptoms: Patient came into pharmacy for 3rd dose booster. She was confused and thought she had received Pfizer initially. Patient had actually received 2 doses of Moderna.

Other Meds:

Current Illness:

ID: 1741834
Sex: M
Age: 67
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: LA

Lab Data:

Allergies:

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

Symptoms: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1741835
Sex: M
Age: 49
State: MI

Vax Date: 03/01/2021
Onset Date: 03/01/2021
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: Blood test high cholesterol checked rash said it looks like acne but it's not acne

Allergies: Tetnaus shot allergic reaction to!

Symptom List: Injection site pain, Pain

Symptoms: I had cognitive problems, felt sick body aches pain in joints, shoulder, have an unexplained rash on buttocks and back since May 2021 still have rash can't get rid of steroid cream was prescribed antibiotics prescribed sinus infections several of them! Coughing in mornings throwing up in morning after coughing And can't smell still haven't been able to since vaccine

Other Meds: Lryica 150-2 times a day Fish oil vitamin

Current Illness: First shot was sick the next day for 5hrs

ID: 1741836
Sex: M
Age: 67
State: CO

Vax Date: 03/28/2021
Onset Date: 05/21/2021
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: u/s 5/21/21

Allergies: None

Symptom List: Injection site pain, Menorrhagia

Symptoms: femoral dvt, large thrombosis

Other Meds: 8 statin, vitamin B, D, E, zinc, Viagra

Current Illness: Prostate surgery

ID: 1741837
Sex: M
Age: 31
State: CA

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: SYR
Vax Site: LA

Lab Data: Blood Work , chest xray IV

Allergies: no

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

Symptoms: Patient was unable to move . Unaware of surrounding. Was taken to ER at 1 am on 9/28/2021

Other Meds: Vitamin C

Current Illness: no

ID: 1741838
Sex: F
Age: 67
State: MA

Vax Date: 02/10/2021
Onset Date: 04/02/2021
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: 2/5/21 WBC - 25.4 HGB 13.9 4/2/21 WBC - 107.1 HGB 8.1 4/9/21 WBC - 176.7 HGB 7.6 At this point I needed a blood transfusion, and started treatment with a BTK inhibitor, Calquence. I believe the vaccines triggered my lymphoma, which had formerly been stable, to go haywire. When I needed the transfusion it was difficult to find a match due to my having warm antibodies.

Allergies: amoxicillin, morphine, dilaudid, vicodin

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: I have small lymphocytic lymphoma, have had slow, indolent course for 4.5 years. After vaccination my blood levels crashed, as you can see in the lab results below. *please note, I had the vaccine and the following blood tests in another area. (I have since moved back home.) My doctor there is a different Dr.

Other Meds: Exemestane, baby aspirin, vitamins

Current Illness:

ID: 1741839
Sex: M
Age: 80
State: CA

Vax Date: 09/16/2021
Onset Date: 09/25/2021
Rec V Date: 09/28/2021
Hospital: Y

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

Lab Data: Patient is hospitalized with Covid, per Kaiser Zion diagnosis at hospital.

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Patient could not move his legs at all, intermittently; he had moderate nasal congestion; a persistent cough; glassy eyes that he could barely open or not open at all, intermittently; patient complained of "pain all over" on Sunday night; patient would not or could not verbally respond to questions or commands on Sunday (26th) night; patient was intermittently speaking in gibberish and kept repeating the same words over again on Monday (27th).

Other Meds: Carbidopa-Levodopa Atorvastatin Miralax Fiber Ciprofloxacin

Current Illness: N/A

ID: 1741840
Sex: F
Age: 38
State: MN

Vax Date: 01/27/2021
Onset Date: 09/21/2021
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: Covid-19 test

Allergies:

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

Symptoms: Employee tested positive for COVID-19 after being fully vaccinated

Other Meds:

Current Illness:

ID: 1741841
Sex: F
Age: 0
State: AL

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: RA

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Patient described having tingling in the face on the right side of the mouth and tingling in her right arm. Pt did not report any swelling in face or lips or troubled breathing. Pt was given a dose of benadryl at her request. She did not want to go to the hospital and left approximately 3 hours after her vaccine when she started feeling better.

Other Meds:

Current Illness:

ID: 1741842
Sex: F
Age: 49
State:

Vax Date: 08/07/2021
Onset Date: 08/07/2021
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: none

Symptom List: Injection site pain

Symptoms: Within 1 and 1/2 hours, I experienced intense nausea, abdominal pain, and cramping. I lost my appetite for about 2 and 1/2 weeks. I experience tinnitus, beginning the day after receiving the vaccine which continued for about 1 week. My lymph nodes became painful and swollen for about 2 weeks. I had shooting nerve pain from my armpit to my chest the day, starting the day after the vaccination and continuing for 1 day.

Other Meds: none

Current Illness: none

ID: 1741843
Sex: F
Age: 77
State: UT

Vax Date: 02/24/2021
Onset Date: 02/25/2021
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: Emergency room administered EKG, blood tests, nuclear cardiology PET-CT,

Allergies: Hypersensitive to all medications. Allergic to Atenolol, Levaquin, Tramadol

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

Symptoms: Fever, Chills, Aches for seven days. Headache, Fatigue, chest and neck tightness, low oxygen for six weeks. Fatigue and low oxygen continuing up to seven months and longer. . .

Other Meds: Pita-vastatin Calcium, Amlodipine Besylate, Levothyroxine, Ezetimibe, Citalopram, Clonazepam, Aspirin, Vitamin C, Vitamin D, Vitamin E, Omega 3, Glucosamine with MSM, Cranberry tab.

Current Illness: None

ID: 1741844
Sex: F
Age: 81
State: CA

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: IM
Vax Site: RA

Lab Data:

Allergies: Codeine Hydrocodone Penicillin Vicodin

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

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

Other Meds: Acetaminophen Allopurinol Aranesp (Billable)

Current Illness:

ID: 1741845
Sex: F
Age: 67
State: OH

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

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

Lab Data:

Allergies: Penicillin; Sulfa Drugs; Keflex; Belladonna; Dairy

Symptom List: Tremor

Symptoms: That night after receiving the vaccine, when I was getting in bed, I pulled the covers over my left foot and it felt like my left foot has just been sprained. It was painful. My foot was fine the next morning and I was okay. My ankle had been sprained 5 years before but I didn't have pain or anything until now. It had healed up and there was no pain from it so what happened that night after the vaccine was surprising to me.

Other Meds: Acyclovir; Remeron; Lorazepam; Multivitamin; COQ 10; Vitamin D; Theraturmin HP

Current Illness:

ID: 1741846
Sex: M
Age: 57
State: NY

Vax Date: 09/01/2021
Onset Date: 09/02/2021
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: blood pressure monitoring

Allergies: no known allergies

Symptom List: Erythema, Pruritus

Symptoms: elevated blood pressure that has required increasing his blood pressure medication dosage x4 (10mg to 40mg), continues to this date and had to add additional antihypertensive at today's visit. he did not receive vaccination at our facility but did follow us remotely and now in person for the changes to his blood pressure. we are continuing to monitor his blood pressure. he received his second dose 9/22/21 with no significant changes - just continued to have uncontrolled blood pressure resistant to lisinopril that previously controlled his blood pressure

Other Meds: atorvastatin 10mg daily, vitamin B12 1000mcg daily, januvia 100mg daily, levothyroxine 25mcg daily, aspirin 81mg daily, ubiquinol, fish oil, lantus 15u daily

Current Illness: only chronic conditions at time of vaccination

ID: 1741847
Sex: M
Age: 83
State:

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

Allergies:

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

Symptoms: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1741848
Sex: F
Age: 43
State: PA

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: Sulfa, Many Antibiotics, gamma-globulin, Beef, shrimp, vanilla

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

Symptoms: Swollen lip, hives everywhere especially chest area, dizziness, faint feeling, heart racing within under a minute of receiving vaccination. Today I feel heavy and swollen, along with flu type symptoms and an arm that hurts worse than the tetanus shot I received this past July 2021.

Other Meds: Alive Women's Multivitamin

Current Illness: nothing

ID: 1741849
Sex: F
Age: 71
State: IL

Vax Date: 06/04/2021
Onset Date: 06/04/2021
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: ultrasound has been ordered

Allergies: NKA

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: patient has pain at injection site 3 months later, hardened area palpable under skin

Other Meds: anti-hypertensive meds, diabetic medications, statin

Current Illness: none as far as I know

ID: 1741850
Sex: F
Age: 60
State: CA

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: None known

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

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

Other Meds: Acetaminophen Carvedilol Cinacalcet Hcl Covid-19

Current Illness:

ID: 1741851
Sex: F
Age: 66
State: PA

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: Prohibition against NSAIDS due to gastric bypass surgery

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

Symptoms: pain, redness and swollen left arm still 3 days post injection, Arm is hot. WHAT ARE THE POSSIBLE SIDE EFFECTS OF SHINGRIX? The most common side effects of SHINGRIX are: Day after I slept all day, felt feverish, got no relief from Tylenol, had a headache, felt same on 3rd day so took a naproxen. Felt better for a while but headache returned. Day 4 tiredness, feverish resolved but arm is still swollen, red and hot.

Other Meds: Valsartan, amlodopine, paxil, omeprazole, simvastatin, vitamin c, d, multivitamin, calcium, melatonin, extra strength tylenol twice a day, magnesium, symbicort, dymista, patadine

Current Illness: none

ID: 1741852
Sex: F
Age: 44
State: OR

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: sulphide, onion

Symptom List: Pain in extremity

Symptoms: Intense itching and mild hives within 30 minutes

Other Meds: xanax

Current Illness: none

ID: 1741853
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: 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: Administration error: Mixed series mRNA vaccine Pfizer and Moderna.

Other Meds:

Current Illness:

ID: 1741854
Sex: F
Age: 51
State: NY

Vax Date: 09/22/2021
Onset Date: 09/22/2021
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: Latex, Iodine, Sulfites, Seafood

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

Symptoms: Immediately after: Headache Starting at around 4:45 -5:00 pm Shortness of breath Chest pain Swollen eyes Hives and rash on arms and face Dizziness Sleepy/fatigue Headache Pain and redness in left arm Muscle pain Chills Fever Nausea Feeling sick overall

Other Meds:

Current Illness:

ID: 1741855
Sex: M
Age: 41
State: WA

Vax Date: 08/19/2021
Onset Date: 09/24/2021
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: COVID status positive on 9/24/21.

Allergies: NKDA

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

Symptoms: Patient received Janssen COVID vaccine on 8/19/21 at another facility. On 9/24/21, patient tested positive for COVID with 8 days symptoms of SOB and generalized weakness. Patient admitted to our facility from 9/24/21 to 9/27/21 with main indication acute respiratory distress due to COVID pneumonia. Patient received dexamethasone and remdesivir during hospitalization and was discharged home on 9/27/21.

Other Meds: Acetaminophen PRN, ferrous sulfate

Current Illness:

ID: 1741856
Sex: M
Age: 94
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: 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: 1741857
Sex: F
Age: 45
State:

Vax Date: 01/09/2021
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: Asymptomatic. Tested positive.

Other Meds:

Current Illness:

ID: 1741858
Sex: F
Age: 65
State: VT

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: RA

Lab Data: None

Allergies:

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

Symptoms: Nurse drew up one dose of Pfizer vaccine before diluent added, and administered all 6 doses to patient instead of one dose. Patient was informed and will watch for adverse reactions. We are reporting the vaccine administration error, as required in the CDC guidance on vaccine administration errors.

Other Meds:

Current Illness:

ID: 1741859
Sex: F
Age: 47
State: OK

Vax Date: 03/27/2021
Onset Date: 03/01/2021
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: lab work EKG heart echo test

Allergies: Codeine; Aspirin; Latex; Strawberries; Tide Soap; Bactrim

Symptom List: Injection site swelling, Limb discomfort

Symptoms: I continue to experienced chronic fatigue, so tired all the time, heart palpitations, dizzy, have a cough and got memory confusion since I had covid and these symptoms are not going away. I've had labs done, had a heart echo done, sent to a pulmonologist, lung test, EKG done and it all comes back as inconclusive.

Other Meds: only medication my doctor prescribed

Current Illness: None

ID: 1741860
Sex: M
Age: 77
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: 1741861
Sex: F
Age: 48
State: NY

Vax Date: 07/07/2021
Onset Date: 07/07/2021
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: Urgent Care visit on September 16, 2021

Allergies: N/A

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

Symptoms: Left Arm Pain - Severe. Area of numbness in/on arm. Pain increasing. Pain still intense today over 2 months post vaccine. Stinging sensation in arm. Burning sensation in Arm. At times, pain moving upwards to shoulder, lower neck. At times, pain travels down arm towards hand.

Other Meds: Adderall, 20mg 1x daily

Current Illness: None

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am