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: 1744308
Sex: M
Age: 65
State: OH

Vax Date: 02/05/2021
Onset Date: 09/28/2021
Rec V Date: 09/29/2021
Hospital: Y

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

Lab Data: Positive COVID-19 test 9/20/2021.

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Patient received Pfizer vaccination on 1/15/2021 and 2/5/2021. Patient hospitalized for COVID-19 9/28/2021. Patient still currently hospitalized with breakthrough COVID-19.

Other Meds:

Current Illness:

ID: 1744309
Sex: F
Age: 0
State: TN

Vax Date: 12/13/1956
Onset Date: 01/01/2021
Rec V Date: 09/29/2021
Hospital:

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

Lab Data: Skin biopsies, 2/26/2021 and 4/28/2021 and 5/5/2021 and 6/30/2021 Blood work 04/28/2021

Allergies: Sulfa anitibiotics, Penicillin, Doxycycline, Sulfamethoxazole

Symptom List: Anxiety, Dyspnoea

Symptoms: Development of chronic dermatitis affecting multiple body sites with associated lymphadenopathy, no associated fever. She was treated with 2-3 months of oral prednisone and remains on long term therapy with topical steroids and may require a chronic systemic medication for dermatitis (Dupixent). She does not have a prior history of dermatitis prior to vaccination.

Other Meds: Fish Oil, ALbuterol, Singulair, Astelin, Acyclovir, Zyrtec, Syntrhoid, Gabapentin, Quinapril, Januvia, Furosemide, Cyclobenzaprine, Omeprazole, Bystolic, Strattera, Ventolin, Wellbutrin

Current Illness: no known acute illnesses

ID: 1744310
Sex: F
Age: 64
State: VA

Vax Date: 04/30/2021
Onset Date: 09/17/2021
Rec V Date: 09/29/2021
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: n/a

Allergies: none

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

Symptoms: Shortly after receiving the second dose of Moderna, I got shingles first (I have been vaccinated for Shingles) and now after that cleared, I was diagnosed with Bells Palsy in the ER.

Other Meds: hctz, simavastin, escitopram, prolosec.

Current Illness: none

ID: 1744311
Sex: F
Age: 67
State: IL

Vax Date: 07/12/2021
Onset Date: 09/14/2021
Rec V Date: 09/29/2021
Hospital: Y

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

Lab Data:

Allergies: NO KNOWN ALLERGIES

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: MD H&P: Patient with recent exposure then diagnosis of Covid. This started about 10 days ago. Her O2 sats was checked by her daughter yesterday and was found to be under 90. Because of that she was directed to emergency room. She was admitted for further treatment. Since admission patient been treated with Decadron oxygen supplementation and Has needed breathing treatments.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1744312
Sex: F
Age: 51
State: GA

Vax Date: 09/29/2021
Onset Date: 09/29/2021
Rec V Date: 09/29/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: The patient stated that she felt "woozy", had shakes, and nausea/vomiting x1. The patient's vitals 167/108 L arm 92HR at 0759 and 154/99 R arm 87HR at 0802. The patient was given 25mg of Diphenhydramine oral solution at 0805. The patient was also reclined. The blood pressure was rechecked 188/116 L arm 88HR at 0833 and 172/92 R arm at 0835. The patient's supervisor was then notified to come. The patient gave permission for information to be shared with supervisor. The patient voiced understanding that she should go seek medical attention and treatment from hospital or her own personal doctor. The patient also voiced understanding that she cannot drive herself due to Diphenhydramine intake. The patient's supervisor is witness to patient voicing understanding on both occasions.

Other Meds: None

Current Illness: Adverse reaction to second dose of Pfizer

ID: 1744313
Sex: F
Age: 31
State: WA

Vax Date: 09/01/2021
Onset Date: 09/01/2021
Rec V Date: 09/29/2021
Hospital:

Vax Type: FLUC4
Manufacturer: SEQIRUS, INC.
Vax Name: INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT)
Lot: 276563
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data: None

Allergies: No

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

Symptoms: Started period 2 days after shot and stayed on it until my following expected period, 3 weeks later.

Other Meds: Birth control pill

Current Illness: None

ID: 1744314
Sex: F
Age: 43
State: MO

Vax Date: 03/25/2021
Onset Date: 04/05/2021
Rec V Date: 09/29/2021
Hospital: Y

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

Lab Data: Many MRIS, spinal taps, blood tests

Allergies: Erythromycin Penicillin Morphine MSG Nickel

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: I, recipient of shot, was in perfect health prior to shot on March 25, 2022. Eleven days later, on April 5, 2021, I started experiencing short 3-5 minute pockets of odd imbalance, confusion, delirium, no sense of gravity, loss of feeling in legs, and excessive high blood pressure spikes whenever I stood up. Health insurance with new kicked in late. I was finally able to go to my doctor after 90 days of experiencing adverse reactions. Doctor ran many inconclusuve tests. On July 13, at about 11:00am I was proving child care to 4 children. I suddenly lost cognitive ability to read, to see, to understand, and then loss consciousness. I awoke while in ambulance transfer to hospital. I could not speak. I dud not know my name. I didn't know what year it was. After about 12 hours in ER, some speech & cognition came back. Neurologist ran numerous tests. Some limited white matter and lesion evidence was seen. I set up follow up appointments and returned to work. I had another unexpected episode about a month later. Had been feeling fine but out of nowhere lost the ability to read, speak correctly, move correctly, then lost the ability to know who I was and my brain underwent severe crippling pain. All symptoms subsided after about 12 hours. Three other crippling, terrifying, worsening episodes happened by mid September. Multiple Neurologists have run many MRIs, and the spread of white matter and lesions gets rapidly worse. I have lost more and more ability to focus and to hold memories. I was given a brain biopsy on Sept 27, 2021 and am awaiting results. None of these cognitive symptoms existed before the civid shot.

Other Meds: Estradial Vitamin D

Current Illness: None

ID: 1744315
Sex: F
Age: 78
State: OH

Vax Date: 03/10/2021
Onset Date: 09/28/2021
Rec V Date: 09/29/2021
Hospital: Y

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

Lab Data: +9/28/21 COVID

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Patient was fully vaccinated 3/10/21 and was admitted for COVID19 9/28/21. Patient remains admitted hypoxic, on oxygen

Other Meds:

Current Illness:

ID: 1744316
Sex: F
Age: 32
State: NY

Vax Date: 09/26/2021
Onset Date: 09/27/2021
Rec V Date: 09/29/2021
Hospital:

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

Lab Data: covid 19 test pending

Allergies: Vicodin, pineapple, and bacitracin

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Fever, runny nose, sneezing, coughing, chest pain, chills, loss of smell and taste

Other Meds: Elderberry, iron, vitamin c, and chlorophyll

Current Illness: no

ID: 1744317
Sex: F
Age: 28
State: FL

Vax Date: 09/10/2021
Onset Date: 09/10/2021
Rec V Date: 09/29/2021
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

Allergies: No

Symptom List: Diarrhoea, Nasal congestion

Symptoms: After 12 hours, high fever above 103, tremors After 24 hours, dizziness and nausea, body aches After 48 hours, vertigo, fainted and hit head on the floor After I fainted I felt totally back to normal

Other Meds: Oral Contraceptive (Birth control) Magnesium oxide

Current Illness: None

ID: 1744318
Sex: F
Age: 58
State: SC

Vax Date: 09/18/2021
Onset Date: 09/18/2021
Rec V Date: 09/29/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Vaccine was reconstituted with sterile water instead of normal saline.

Other Meds:

Current Illness:

ID: 1744319
Sex: F
Age: 17
State: NJ

Vax Date: 04/23/2021
Onset Date: 05/10/2021
Rec V Date: 09/29/2021
Hospital:

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

Lab Data: Fundus photographs and retinal OCT performed on 5/11/21

Allergies: none

Symptom List: Rash, Urticaria

Symptoms: Pt experienced flashing lights in the right eye as well as a shadow in her vision in the right eye for 3 hours starting 5/10/21 am. In addition she had mild eye pain. She was seen in the ER and dx with ocular migraine and told to f/u with our Ophthalmology practice. We saw pt on 5/11/21 and vision was 20/20. She was diagnosed with a mild Central retinal vein occlusion in the right eye. On exam pt had hyperemia of the right optic nerve and a few small intraretinal hemorrhages in the periphery. She also had engorged and dilated retinal vessels.

Other Meds: Alleve one dose in the am of the vaccination, before the shot

Current Illness: None

ID: 1744320
Sex: F
Age: 63
State: MN

Vax Date: 09/28/2021
Onset Date: 09/28/2021
Rec V Date: 09/29/2021
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: No adverse event, but patient was given high dose flu vaccine (fluad) and is only 63 years old.

Other Meds:

Current Illness:

ID: 1744321
Sex: M
Age: 67
State: KY

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 09/29/2021
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: None

Allergies: Yes, eggs, soy, milk (as a child) seasonal, respiratory allergies (as an adult)

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

Symptoms: About 10 days later I had severe joint pain to a point where it was incapacitating. I called my doctor who advised anti-inflammatory which we followed. For the first 2 weeks I could not walk, it was so painful. It improved after that but took 6 weeks to completely resolve. We took Tylenol to help.

Other Meds: No

Current Illness: No

ID: 1744322
Sex: F
Age: 40
State: IN

Vax Date: 09/28/2021
Onset Date: 09/28/2021
Rec V Date: 09/29/2021
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: Penicillin Other vaccines Dairy

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

Symptoms: Nausea and vomiting immediately, then ceased overnight and resumed at 4am the next morning, ongoing every 30 minutes for hours

Other Meds: Atavan

Current Illness: N/A

ID: 1744323
Sex: F
Age: 39
State: ME

Vax Date: 09/24/2021
Onset Date: 09/24/2021
Rec V Date: 09/29/2021
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 known

Allergies: Unknown

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

Symptoms: From Pharmacy. Pfizer #1 on 09/24/21 @ 3 pm. right arm. Above the injection site there is a round indented area on the skin., She said that she has never had headache in her life. She has had a headache since the vaccine. " In my frontal Lobe, it is on & off. " She said that the first day she felt like there was an elephant sitting on her chest, & since then she has been feeling palpitations in her chest. Her PCP is thru local HCF. She denied fever or 99% HR 73. For the first 24 hours the site was tender and pink, swollen and it has all since resolved, exception of the dimple. She said that about an hour after the vaccine she did the magnet to her arm and it was magnetized. She said that about 36 hours after the vaccine the magnet no longer stuck. I advised her to contact her PCP related to the palpitations she is intermittently experiencing. She cried heavily on the phone saying she got the vaccine or she would lose her job. A VAERS will need to be submitted..

Other Meds: Unknown

Current Illness: none known

ID: 1744324
Sex: F
Age: 68
State: OH

Vax Date: 03/16/2021
Onset Date: 09/11/2021
Rec V Date: 09/29/2021
Hospital:

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

Lab Data: Rapid Test done on 9-15-2021, resulted positive

Allergies:

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

Symptoms: Headache and congestion

Other Meds:

Current Illness:

ID: 1744325
Sex: F
Age: 71
State: SC

Vax Date: 09/27/2021
Onset Date: 09/28/2021
Rec V Date: 09/29/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Ear pain, Hypoaesthesia

Symptoms: I experience pain and swelling at the site of the injection soon after the shot About one day later, I began having a fever (100.4) along with headache, body ache, tiredness, and nausea. 16 hours after that I still have body ache and tiredness but no fever. I did not have any adverse reaction to the other two Phizer vaccinations that I received 7 months ago.

Other Meds: Vitamins: calcium with vitamin d3, zertex allergy med., glucosamine chondroitin

Current Illness: none

ID: 1744326
Sex: F
Age: 65
State: MS

Vax Date: 07/19/2021
Onset Date: 07/22/2021
Rec V Date: 09/29/2021
Hospital:

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

Lab Data: Covid test- negative

Allergies: None

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: I was fine the first and second day. On Sunday morning I was in pain. I had body aches. I could not do anything. I went to the emergency room that morning because I was not feeling well. They did a Covid test, which came back negative. They gave me a shot of steroids for the pain. They did not prescribe any medications. I had the second shot on 08/10/2021 and I just had a swollen arm for about a week.

Other Meds: Only supplements

Current Illness: None

ID: 1744327
Sex: F
Age: 37
State: SC

Vax Date: 09/18/2021
Onset Date: 09/18/2021
Rec V Date: 09/29/2021
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: Vaccine was reconstituted with sterile water instead of normal saline

Other Meds:

Current Illness:

ID: 1744329
Sex: F
Age: 38
State: NM

Vax Date: 09/02/2021
Onset Date: 09/03/2021
Rec V Date: 09/29/2021
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: None

Allergies: Amoxicillin

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

Symptoms: Significant lymph node swelling in armpit of arm that received vaccine. Arm pit so swollen it was no longer a pit. Pain, swelling, difficulty using arm because it felt like tendon and muscles would rip between chest and shoulder Lasted about 4 days Menstrual cycle after vaccine, some spotting and period was much heavier with clots

Other Meds: Nuvaring

Current Illness: None

Date Died: 06/09/2021

ID: 1744331
Sex: M
Age: 77
State: NC

Vax Date: 03/29/2021
Onset Date: 04/01/2021
Rec V Date: 09/29/2021
Hospital: Y

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

Lab Data: Too many test and laboratory results to list as my father had extensive list of health issues.

Allergies: Latex

Symptom List: Unevaluable event

Symptoms: Fatigue, Dizzy, Nausea, Loss of taste, Loss of smell (lasted about a week, then disappeared) Fatigue, Dizzy, Nausea, Loss of taste, Loss of smell, trouble breathing, headaches, loss of appetite(05/09/2021, went to hospital twice, was discharged too early the first time; 11 May 2021; returned to the hospital 21 May 2021 due to shortness of breath, fatigue, dizzy, nausea, loss of appetite, which the trouble breathing and shortness of breath was due to fluid build-up around the heart and his lungs). Admitted approximately late afternoon 21 May 2021 and did not get discharged, died on 9 June 2021 in the Hospice house.

Other Meds: Amiodarone 200 MG Tablet, Atorvastatin 20 MG Tablet, Furosemide 40 MG Tablet, Gabapentin 300 MG Capsule, Glipizide 10 MG Tablet, Magnesium Oxide 400 MG, Metolazone, 2.5 M Tablet, Metoprolol Succinate 100 MG, Nexium 40 MG Capsule, SitaGlipti

Current Illness:

ID: 1744332
Sex: M
Age: 71
State: MI

Vax Date: 03/04/2021
Onset Date: 09/20/2021
Rec V Date: 09/29/2021
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: Unknown

Allergies: No known allergies

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

Symptoms: Dyspnea, cough, bilateral generalized weakness

Other Meds: Unknown

Current Illness: Unknown

ID: 1744333
Sex: F
Age: 31
State: NC

Vax Date: 09/28/2021
Onset Date: 09/29/2021
Rec V Date: 09/29/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: Na

Allergies: Na

Symptom List: Injection site pain, Pain

Symptoms: Nausea migraine

Other Meds: Na

Current Illness: Na

ID: 1744334
Sex: F
Age: 62
State: NY

Vax Date: 09/24/2021
Onset Date: 09/29/2021
Rec V Date: 09/29/2021
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 drugs

Symptom List: Injection site pain, Menorrhagia

Symptoms: 4 and a half days (108 hours) after receiving a first dose of the Pfizer vaccine, I woke up at 12:30 a.m. and upon sitting up in bed experienced vertigo-like dizziness, which continued for about a half hour until I realized I was likely to vomit, though I had no feeling of nausea. I had no fever. In the 4 and a half days leading up to last night?s adverse reaction, I had neither eaten nor done anything whatsoever unusual. The vomit itself was very dark in color. I was able to fall back asleep after a half hour or so, and on awakening around 7 a.m. felt dizzy again upon sitting up in bed and began experiencing tinnitus, which is as yet ongoing as of 7 a.m.

Other Meds: multivitamin plus vitamin D and zinc

Current Illness: none

ID: 1744335
Sex: F
Age: 29
State: SC

Vax Date: 09/18/2021
Onset Date: 09/18/2021
Rec V Date: 09/29/2021
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: Vaccine was reconstituted with sterile water instead of normal saline.

Other Meds:

Current Illness:

ID: 1744336
Sex: F
Age: 27
State: IA

Vax Date: 04/22/2021
Onset Date: 05/26/2021
Rec V Date: 09/29/2021
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: Blood work and urine analysis for pregnancy and STDs. All of which came back negative. I was told to take ibuprofen and come back if it didn't end.

Allergies: Bananas?

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: I had a period that lasted from May 3rd to June 5th. I was concerned and talked to friends who had also had a similar reaction after receiving the vaccine, so I went to the doctor. I feel that this is not being taken seriously enough or investigated thoroughly because of the amount of misinformation about the vaccine. I don't want this to dissuade anyone from getting the vaccine, but I also feel like this is a side effect that is being underreported because it is effecting women and it is difficult to track. I just want to be listened to and taken seriously. Hopefully this will help other women in the future.

Other Meds: Nuvaring

Current Illness: No illnesses

ID: 1744337
Sex: M
Age: 74
State: CA

Vax Date: 02/25/2021
Onset Date: 02/27/2021
Rec V Date: 09/29/2021
Hospital:

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

Lab Data: No

Allergies: I have an allergy to sesame seeds

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: I had 2 reactions, one was swelling which started almost immediately and was like a hard knot in my arm and of course there was pain. 2 days after the shot I started getting a rash and it got bigger and bigger, so maybe 4-5" in diameter. It was itching. I took some Benadryl for it. It lasted about a week. I called a Dermatologist, sent pictures. Both reactions lasted about a week. I just got my 3rd dose last Saturday 9/25/2021 and I'm getting the same rash like the one after my 2nd dose.

Other Meds: Lisinopril

Current Illness: I have an ongoing sinus problem

ID: 1744338
Sex: M
Age: 73
State: FL

Vax Date: 12/22/2020
Onset Date: 08/05/2021
Rec V Date: 09/29/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data: Labs, rapid test.cxr.

Allergies: NKA

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

Symptoms: Pt came to ER c/o difficulty breathing, wheezing, and cough. Onset 3 days prior. Covid positive rapid test completed 8/3/21.

Other Meds:

Current Illness:

ID: 1744339
Sex: M
Age: 57
State: ND

Vax Date: 09/07/2021
Onset Date: 09/17/2021
Rec V Date: 09/29/2021
Hospital: Y

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

Lab Data: troponin 9/17/21- 0.862 troponin 9/17/21-4.748 (about 2 hours after initial troponin) troponin 9/18/21-10.288 (about 2 hours after second troponin) radial coronary angiogram on 9/18/21-minimal core disease EKG 9/18/21-inferior infarct, recent echo 9/18/21-normal cardiac MRI on 9/19/21-non-specific findings suggesting infarct vs non -ischemic cardiomyopathy or possibly myocarditis

Allergies: seasonal allergies

Symptom List: Nausea

Symptoms: Patient developed left-sided chest pain with radiation into throat/neck with some shortness of breath while pedal biking. Patient took (3) 81 mg aspirin at 7 pm and went to ER with dizziness and above symptoms which were improved by the time he presented to ER. ER workup found elevated troponin, received nitroglycerin and heparin IV drip, Cardiology consut for NSTEMI, underwent radial coronary angiogram on 9/18 with minimal core disease found. Found to have hypertension and nonsustained ventricular tachycardia during angiogram. Seen and examined by Cardiac. Cardiac MRI done on 9/19 showing non-specific findings suggesting infarct versus non-ischemic cardiomyopathy or possibly myocarditis. Discharged with diagnosis of NSTEMI likely due to MINOCA (mycardial infarction with nonobstructive coronary arteries) due to cardiac MRI showing inflammation over bottom of heart versus all over as would be suspected with myocarditis as well as troponin that quickly escalated in the ER versus a gradual slow increase as would be expected with myocarditis. Patient had Cardiology f/u on 9/27/21 and is scheduled for additional Cardiology f/u in 1 month with echo. Per Cardiology patient is to hold second dose of Moderna until Cardiology performs additional testing and research on risks vs benefits.

Other Meds: aspirin 81 mg daily, omeprazole 40 mg daily, atorvastatin 40 mg daily,

Current Illness: no illnesses

ID: 1744340
Sex: F
Age: 44
State: VA

Vax Date: 09/28/2021
Onset Date: 09/28/2021
Rec V Date: 09/29/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: chills, body aches, headache

Other Meds: microgestin

Current Illness:

ID: 1744341
Sex: M
Age: 58
State: VA

Vax Date: 09/27/2021
Onset Date: 09/28/2021
Rec V Date: 09/29/2021
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: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: 101 fever within 24 hours of being vaccinate to include muscle aches. Took Tylenol 800mg

Other Meds: None

Current Illness: No illness but currently possess COVID-19 antibodies

ID: 1744342
Sex: M
Age: 15
State: GA

Vax Date: 06/20/2021
Onset Date: 06/23/2021
Rec V Date: 09/29/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data: Lab: Coronavirus-SARS-CoV-2, NAA, Lab results negative

Allergies: NONE

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

Symptoms: Pt lost sense of smell and taste of some foods after a couple days after getting the 2nd dose. He could taste some foods and then no taste eating certain other foods. Has no sense of smell at all. No other symptoms and is feeling fine otherwise

Other Meds: NONE

Current Illness: NONE

ID: 1744343
Sex: U
Age: 12
State: SC

Vax Date: 09/18/2021
Onset Date: 09/18/2021
Rec V Date: 09/29/2021
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: Vaccine reconstituted with sterile water instead of normal saline.

Other Meds:

Current Illness:

ID: 1744344
Sex: M
Age: 83
State:

Vax Date: 02/25/2021
Onset Date: 09/28/2021
Rec V Date: 09/29/2021
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: Erythema, Pruritus

Symptoms: Vaccine breakthrough, asymptomatic. 9/28 Inpatient admit 9/28 to present,

Other Meds:

Current Illness:

ID: 1744345
Sex: M
Age: 51
State: OH

Vax Date: 06/16/2021
Onset Date: 09/10/2021
Rec V Date: 09/29/2021
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: PCR collected 9-12-2021 and resulted positive on 9-13-2021

Allergies:

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

Symptoms: Fever, feverish, body aches, runny nose, sore throat, cough, headache, fatigue, congestion

Other Meds:

Current Illness:

ID: 1744346
Sex: F
Age: 17
State:

Vax Date: 09/24/2021
Onset Date: 09/25/2021
Rec V Date: 09/29/2021
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: None

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

Symptoms: Arm soreness started early morning following vaccine. Pain grew and patient was unable to use left arm. Muscle weakness was noted and she was unable to lift her arm above shoulder level. Ice packs and pain relievers were used which seemed to help a little with the soreness, but arm weakness and pain was still present and at times the pain was excruciating. Patient had bouts of dizziness and slight nausea. These symptoms persisted throughout the day on Saturday (vaccine was given Friday, early afternoon). These symptoms gradually dissipated on Sunday morning and were almost completely gone by Sunday afternoon. No fever was present during this time.

Other Meds: Tylenol/Motrin

Current Illness: None

ID: 1744347
Sex: F
Age: 54
State: GA

Vax Date: 09/28/2021
Onset Date: 09/29/2021
Rec V Date: 09/29/2021
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: Tetracyclines

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Pain at injection site, pain in arm of injection, muscle aches, head ache, malaise/ weakness, chills, fever of 100.8.

Other Meds: None

Current Illness: None

ID: 1744348
Sex: F
Age: 12
State: MD

Vax Date: 09/26/2021
Onset Date: 09/27/2021
Rec V Date: 09/29/2021
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

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

Symptoms: 101F fever for 24 hours. Low grade fever (99.9) for the next 24 hours.

Other Meds: None

Current Illness: None

ID: 1744349
Sex: F
Age: 49
State: SC

Vax Date: 09/18/2021
Onset Date: 09/18/2021
Rec V Date: 09/29/2021
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: Vaccine was reconstituted with sterile water instead of normal saline.

Other Meds:

Current Illness:

ID: 1744350
Sex: F
Age: 85
State: OH

Vax Date: 01/25/2021
Onset Date: 09/28/2021
Rec V Date: 09/29/2021
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: NKDA

Symptom List: Pain in extremity

Symptoms: Patient developed breakthrough COVID-19 requiring hospitalization. This patient received the first dose of the Pfizer 2-dose series on 1/25/2021, and has yet to receive her second dose.

Other Meds:

Current Illness: N/A

ID: 1744351
Sex: F
Age: 29
State: NY

Vax Date: 07/01/2021
Onset Date: 08/01/2021
Rec V Date: 09/29/2021
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: No

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

Symptoms: I had the normal muscle aches and pain at the injection site after my first dose. After my initial dose I also experienced a late period for the first time since being pregnant 10 years ago. I use a period tracker and always get regular periods. After my first injection I was 5 days late and had a heavier than normal period with cramping. After my second dose which was in August, I only experienced pain at the site of the injection and another delayed period. This time it was a week late, with cramping occuring a few days before and during my period and heavy bleeding for two out of the seven days which lead to bleeding through pads. I suspected it was related to the covid vaccine as I have not struggled with late periods, or heavy periods before. Last time I've had severe cramping like I have experienced since getting my covid vaccine was over 10 years ago. I am waiting to see if my period goes back to normal in the next couple of months.

Other Meds: No

Current Illness: Mild cold a week before vaccination

ID: 1744352
Sex: F
Age: 49
State: NY

Vax Date: 09/23/2021
Onset Date: 09/28/2021
Rec V Date: 09/29/2021
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: Gluten

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

Symptoms: Red itchy bumps up and down left arm; White sores in mouth; Seems like an allergic reaction

Other Meds: Synthroid; Telmisartan; Vitamin D

Current Illness: None

ID: 1744353
Sex: F
Age: 36
State: MD

Vax Date: 09/28/2021
Onset Date: 09/28/2021
Rec V Date: 09/29/2021
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: None

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

Symptoms: Around 7pm, broke out in hives/welts throughout entire body. Incredibly itchy throughout. Skin flushed and warm to touch, felt like it was burning. Took 50mg benedryl PO, didn?t work after an hour, took 25mg more of benedryl and the reaction decreased. By next morning, still itchy but most of hives gone.

Other Meds: Adderall

Current Illness: No

ID: 1744354
Sex: F
Age: 59
State: OH

Vax Date: 03/13/2021
Onset Date: 09/06/2021
Rec V Date: 09/29/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data: Rapid test resulted positive on 9-8-2021

Allergies:

Symptom List: Vomiting

Symptoms: Fever, muscle aches, cough, headache, fatigue, congestion

Other Meds:

Current Illness:

ID: 1744355
Sex: F
Age: 65
State: FL

Vax Date: 09/28/2021
Onset Date: 09/29/2021
Rec V Date: 09/29/2021
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: None

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Itching, injection site pain 14 hrs. after injection, tiredness, headache, muscle pain, chills, nausea, feeling unwell, decreased appetite and felt like fainting. Temp 97.7 at 10:00 am 09/29/21.

Other Meds: None

Current Illness: None

ID: 1744356
Sex: F
Age: 62
State: MD

Vax Date: 09/22/2021
Onset Date: 09/23/2021
Rec V Date: 09/29/2021
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 listed

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

Symptoms: Per Patient/Employee has a history of chronic illness and after receiving 2nd dose of Pfizer COVID vaccine on 9/22/2021 at 0830 AM she started feeling heaviness, tingling, numbness of left leg with difficulty walking and unsteady gait that started on 9/23/2021 at 1100 AM.

Other Meds: Unknown

Current Illness: Multiple Sclerosis and Transverse Myelitis

ID: 1744357
Sex: F
Age: 36
State: MN

Vax Date: 02/11/2021
Onset Date: 09/23/2021
Rec V Date: 09/29/2021
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: none

Symptom List: Injection site swelling, Limb discomfort

Symptoms: headache, loss of smell, sinus congestion, nasal congestion, post nasal drainage, chest congestion, sneezing. starting on 9/23/21

Other Meds: Bupropion

Current Illness: none

ID: 1744358
Sex: F
Age: 90
State: GA

Vax Date: 04/08/2021
Onset Date: 08/28/2021
Rec V Date: 09/29/2021
Hospital: Y

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

Lab Data: 08/29/2021 PCR+ COVID-19 test at Hospital

Allergies:

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

Symptoms: Breakthrough COVID-19 case with symptom onset 8/28/2021: Aches, Nausea/Vomiting, Fatigue or tiredness. pt is still hospitalized as of 9/10 for COVID sx @ Hospital since 9/5 when she was admitted to ICU, pt dx covid pneumonia, rx antibiotics, not on oxygen.

Other Meds:

Current Illness:

ID: 1744360
Sex: F
Age: 52
State: GA

Vax Date: 09/27/2021
Onset Date: 09/27/2021
Rec V Date: 09/29/2021
Hospital:

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

Lab Data: none

Allergies: NONE

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

Symptoms: Fever range from 96.9 to 101 in the course of first 12 hours starting around 12 hours after vaccine. The 96.9 drop was after fainting with minimal warning signs. Chills and sweats were worse than any vaccine or actual sickness that I have ever experienced (ten times worse than shot #2 for Covid and I had fever for 2 days with that). Continue to have a manageable low grade fever 100 degrees on day2 , but the low fever was not normal for me.

Other Meds: NONE

Current Illness: NONE

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am