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: 1745617
Sex: M
Age: 78
State: OH

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

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: patient lied and said he wanted a first dose moderna vaccine. he was with his partner who also wanted a first dose . later after billing vaccine it was determined that this patient had already gotten the first and second dose seven months ago

Other Meds:

Current Illness:

ID: 1745618
Sex: F
Age: 56
State: MI

Vax Date: 04/14/2021
Onset Date: 09/05/2021
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: Covid-19 Positive 09/10/2021

Allergies: N/A

Symptom List: Anxiety, Dyspnoea

Symptoms: I was exposed on to Covid-19 on 09/02/2021 when I was flying. The symptoms started on 09/05/2021. I first got a cough and then my nose was running. I thought I had a Sinus infection but my symptoms got worse through the week. I was using my inhalers, but they weren't making me feel better. I then lost my sense of taste and smell and the fact that it started with a cough made me think it was unusual. I visited my doctor and I was given Prednisone and some antibiotics because they thought it was a Sinus infection. I tested positive for Covid-19 and I was bedridden. On 09/21/2021 I was lightheaded and dizzy when I went outside. My Oxygen was very low at 92 and I had a slight fever. I called the doctor and she prescribed Zithromax which really seemed to help as well as more Prednisone. My inhaler helped as well as my C-Pap machine. I improved slightly over time. It has been four weeks and I still have very little energy. I lay down about three times a day and it helps. My cough has improved.

Other Meds: Synthroid; Lexapro; Xanax; Lunesta; Omeprazole; Symbicort; Xopenex

Current Illness: N/A

ID: 1745619
Sex: M
Age: 57
State:

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

Allergies:

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

Symptoms: No adverse symptoms present at vaccine site. No adverse symptoms reported after 15 minute recommended wait time.

Other Meds:

Current Illness:

ID: 1745620
Sex: F
Age: 50
State: NJ

Vax Date: 03/12/2021
Onset Date: 09/28/2021
Rec V Date: 09/29/2021
Hospital:

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

Lab Data: Ultrasound.

Allergies: None

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Fluid near heart; hearing loss.

Other Meds: Lamictal; Wellbutrin; Lexapro

Current Illness: None

ID: 1745621
Sex: F
Age: 38
State: TN

Vax Date: 09/16/2021
Onset Date: 09/25/2021
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: Gluten, potatoes, IV dye (CT scans)

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

Symptoms: Tinnitus in right ear, beginning nine days after second Pfizer shot. Severity increases in the presence of loud environmental noise.

Other Meds: Levothyroxine, prenatal vitamins, cough drops with zinc

Current Illness: Seasonal allergies

ID: 1745622
Sex: F
Age: 38
State: FL

Vax Date: 09/22/2021
Onset Date: 09/22/2021
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: Sulfa abx

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

Symptoms: Patient reported 30 minutes after having COVID J&J Vaccine noted shortness of breath, stomach pain, mouth and throat itchy called 911, patient was able to control shortness of breath as she has a hx of asthma with rescue her rescue inhaler . The next day patient on 09/23/2021 woke with stomach cramps, no diarrhea, no blood in stool, and hives diffuse across body. Patient on 09/24 went to hospital was started on oral steroids and benadryl. Patient was than followed up with my clinic as her PCM on 27 Sep 2021.

Other Meds: Singulair, Flonase, Zyrtec, omeprazole, prozac, buspirone, topamax, albuterol, iron

Current Illness: none

ID: 1745623
Sex: F
Age: 57
State: OR

Vax Date: 04/06/2021
Onset Date: 04/06/2021
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: None just reported the conditon to my primary doctor.

Allergies: Iodine, Zpac, amoxicillan, Shingles vaccine, rabbit hair, dogs, cats, tetnas shot, Cigarette smoke, Marijauna smoke.

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Instantly had involuntary muscle spasms in my legs and arms. The muscle spasms have continued through out my body for months now. Some are painful. within days I had blisters around my knee joints which left scars. They were painful and itched.

Other Meds: Amlodipine 5mm

Current Illness: None

ID: 1745625
Sex: M
Age: 30
State: CA

Vax Date: 08/01/2021
Onset Date: 08/01/2021
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: None

Allergies: None

Symptom List: Pharyngeal swelling

Symptoms: Expected Adverse Event: Day-after vaccine dose injection-site soreness, fever, and muscle/joint aches. Other Adverse Event: Fatigue - Ongoing - Occurs in the Afternoon Description - Post injection a noted increase of daily fatigue. Sleep and caffeine have no effect. No change in activity levels. Significant reduction in waking hours, energy, and attentiveness. Noted signs of exhaustion: drowsiness, twitching eyelid, difficulty focusing, restless sleep, intermittent hypersomnia.

Other Meds: None

Current Illness: None

ID: 1745626
Sex: F
Age: 39
State: TX

Vax Date: 08/15/2021
Onset Date: 08/20/2021
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: N/A

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Five days after receiving my first COVID vaccine I had a headache come on near my temple. I never get headaches and just thought it wasn't anything to be worried about. The headache remained the same and 4 days later I went to an urgent care. The nurse said it was probably a tension headache and gave me prescription Motrin. The headache never seemed to go away so I went to my primary care doctor's practice. She wasn't available so I saw another doctor. This doctor said it was probably some kind of virus and that it would go away in 3 weeks. I asked her about if this was a side effect of the vaccine and she said they don't know all the side effects. How awful! If you are going to tell people to get this vaccine, you need to be prepared for the side effects and not to brush people off. I followed up with my primary care doctor and she gave me an antibiotic because I felt so much inflammation in my face/head. The antibiotic and I switched doctors because she was also pretty unhelpful. My newest doctor has been so incredibly helpful! I'm currently on prednisone and it has eased some of the inflammation after 5 weeks of horrible headaches. I wish I would have never have gotten this vaccine. I know there are risks with everything, but this has been terrible and I wouldn't wish it on anyone.

Other Meds: N/A

Current Illness: N/A

ID: 1745627
Sex: F
Age: 32
State: WA

Vax Date: 09/01/2021
Onset Date: 09/15/2021
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:

Allergies: Sulfa medications

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Itchy with slight burning rash at site of injection.

Other Meds: None

Current Illness: None

ID: 1745628
Sex: F
Age: 67
State: WA

Vax Date: 08/19/2021
Onset Date: 08/19/2021
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: No

Allergies: Sulpha Drugs Nitrafurin e derivatives DPT vaccinations

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

Symptoms: Soreness at injection site Fever 99-100.3 Aches Weakness

Other Meds: Eliquis Sertraline Atorvastatin Olmesaran Cosentyx injections

Current Illness: None

ID: 1745629
Sex: M
Age: 55
State: MN

Vax Date: 03/01/2021
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: SYR
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: Tested positive for COVID 9/29/21

Other Meds:

Current Illness:

ID: 1745630
Sex: M
Age: 44
State: HI

Vax Date: 02/08/2021
Onset Date: 02/08/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: Shortness of breath, developed acute bronchitis, fatigue, numbness in my arms, blurry vision, body aches, nausea and headaches. Treated by ibuprofen, Tylenol, topical pain relievers and rest.

Other Meds: None

Current Illness: None

ID: 1745631
Sex: F
Age: 73
State: PA

Vax Date: 03/28/2021
Onset Date: 09/19/2021
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: Covid-19 test

Allergies: penicillin, Erythromycin

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

Symptoms: I have common cold symptoms. I had stuffy nose, cough, headache, and a low-grade fever. I had server fatigue. I contacted my doctor. I went to hospital to get the antibody fusion on Saturday. I had positive covid-19 test of last week.

Other Meds:

Current Illness:

ID: 1745632
Sex: M
Age: 70
State: VA

Vax Date: 03/30/2021
Onset Date: 05/23/2021
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: Physical (rectal) exam 5/25, CT Scan 5/25

Allergies: Ceftin

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

Symptoms: Rectal or Anal Bleeding.

Other Meds: Warfarin, Bupropion XL, Simvastatin, Fenofibrate, Metformin, Fluoxetine, Ropinirole, Osteo-Biflex, Melatonin, Tylenol, Multi-Vitamin

Current Illness: None

ID: 1745634
Sex: M
Age: 46
State:

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:

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: 1745635
Sex: F
Age: 47
State: NY

Vax Date: 09/27/2021
Onset Date: 09/27/2021
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: On two occasions, I was provided with cipro/flagyl for Hpylori in my stomach. Both times, I developed an adverse reaction, one brought me to the hospital to receive an IV.

Allergies: penicillin, ciprofloaxin, flagyl, nuts (especially peanuts)

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

Symptoms: Upon receiving the vaccination, I was feeling faint. Arrived at home, within two hours, hives developed over my entire body and a rash on my face and neck which was red and burning. My breathing was compromised and I was wheezing. My scalp was itching. I became nauseous and vomited several times. Heart was palpitating.

Other Meds: omeprazole, triamterene, Pepcid AC, albuterol, fish oil, flaxseed oil, folic acid, probiotic, zinc, magnesium, vitamin D, biotin, beta carotene

Current Illness: N/A

ID: 1745636
Sex: F
Age: 54
State: NY

Vax Date: 09/21/2021
Onset Date: 09/23/2021
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: ekg - normal

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: tireness, heart palpitations, fever, joints and muscles very achy

Other Meds:

Current Illness:

ID: 1745637
Sex: F
Age: 60
State: GA

Vax Date: 04/06/2021
Onset Date: 06/01/2021
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: none

Allergies: none

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: sore arm, limited ROM, swollen upper arm

Other Meds: none

Current Illness: none

ID: 1745638
Sex: M
Age: 63
State:

Vax Date: 09/28/2021
Onset Date: 09/28/2021
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: Administration error mixed series mRNA vaccine Pfizer and Moderna.

Other Meds:

Current Illness:

ID: 1745639
Sex: M
Age: 91
State: CA

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

Allergies:

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

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

Other Meds:

Current Illness:

ID: 1745640
Sex: M
Age: 66
State: CA

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: Unevaluable event

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

Other Meds:

Current Illness:

ID: 1745641
Sex: M
Age: 71
State:

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

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: 1745642
Sex: M
Age: 56
State: NJ

Vax Date: 07/24/2021
Onset Date: 07/25/2021
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: n/a

Allergies: none

Symptom List: Injection site pain, Pain

Symptoms: The day after 2nd Moderna vaccine administed at pt reported feeling very lightheaded, to the point where he could not stand for 20mins. He did not loose consciousness but felt that he likely would have if he did not lie down quickly. Then for 2 wks afterwards, he reports pain in chest that was constant and was relieved somewhat by advil. Also reports lung feeling inflamed. These latter symptoms lasted for 6-8 wks.

Other Meds: fish oil supplement vitamin D Vitamin C garlic tablet coQ10

Current Illness: no

ID: 1745643
Sex: F
Age: 32
State: CA

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: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

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

Other Meds:

Current Illness:

ID: 1745644
Sex: M
Age: 72
State: FL

Vax Date: 03/27/2021
Onset Date: 08/25/2021
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: Ultrasound, EKG, Echogram of heart - See above

Allergies: No

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

Symptoms: Follow up report: I had a second Ultrasound on August 24th in legs - things were still not right. I was feeling the same still as the first time as I went to Ultrasound in June. I was told to get it checked out. It was exactly the same - that doctor told me - Dr. (urgent care doctor) - said the blood clots were still there and still the same size as the previous Ultrasound had shown. I also had an EKG at that time and he said that it was basically the same as the previous. Dr. had said that it hadn't been normal (my EKG readings) and saw I saw a NP (8/16/2021) for the cardiologist and took the EKG and they said there was a little abnormality - the top part was beating faster than the lower part of my heart. The best thing to do would be to get an Echogram on my heart. That was done 8th of Sept. I saw a hematologist on the 16th and he didn't really look at or do anything - he said that everything seems okay - when I get to the end of Pradaxa I can stop taking it. I am about 2 weeks away from that. He said everything should be okay. Dr. said to schedule with a real cardiologist - and I saw her (Dr.) on 23rd (last Thursday) and in the meantime, I had had the echogram (8th) and she ordered a CT scan (from neck down to pelvis) (I have a family history of having aortic aneurisms - have had it checked in the past and none of been detected prior) and Echocardiogram at the same time - because my left atrium is a bit enlarged and the bulk of the main veins coming off my heart are enlarged (moderately). And she said that they are at the Aortic Root area. Doing the two tests at the same time would give her a better picture of what was going on with my heart. I will get that this coming Friday and I will see her again on October 28th. I was having palpitations - that was why they were looking at my heart - and they said that is typical to have if I have blood clots. She can find out better what's going on with both of these tests at the same time (October 1st). Palpitations have seemed to mostly have gone away - before they were multiple times a day but now they are mostly gone. Just every now and then I have it - I walk a mile and 1/2 or two miles every morning now. I do worry about the blood clots but the Hematologist isn't too worried about it, it seems. Note: I got the flu shot of 16th of September, 2021; haven't yet had the second shingles shot - wanted to wait until all of this other stuff.

Other Meds: Baby Aspirin; CoQ10 - stopped taking the CoQ10 around the 1st of September

Current Illness: No

ID: 1745645
Sex: M
Age: 61
State: CA

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

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

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

Other Meds:

Current Illness:

ID: 1745646
Sex: F
Age: 34
State: WA

Vax Date: 09/13/2021
Onset Date: 09/13/2021
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:

Allergies: Dicloxacillin, doxycycline

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Immediately after jaw pain and still having jaw pain three weeks later. It?s almost like a jaw tightness. Also shortness of breath which I still have to some extent. No treatment sought.

Other Meds: OCP

Current Illness: None

ID: 1745647
Sex: M
Age: 40
State:

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

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: 1745648
Sex: F
Age: 37
State: KS

Vax Date: 09/15/2021
Onset Date: 09/20/2021
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: RA

Lab Data:

Allergies: no

Symptom List: Nausea

Symptoms: ringing in my ears, which occurs randomly throughout the day. I have never previously had this happen in my life.

Other Meds: Vitamins only

Current Illness: none

ID: 1745650
Sex: M
Age: 92
State: LA

Vax Date: 03/27/2021
Onset Date: 03/30/2021
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: He did not seek medical attention for his arm. He applies ice or heat if the pain gets bad and refrains from lifting the right arm. The pain in his right arm continues when he tries to lift the arm.

Allergies: NKA

Symptom List: Injection site pain

Symptoms: The right upper arm is sore since 3 days after injection. He can not raise his arm over his head. It starts hurting when raised approx. 1/4 of the way up.

Other Meds:

Current Illness: None

ID: 1745651
Sex: M
Age: 51
State:

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: 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:

Date Died: 09/28/2021

ID: 1745652
Sex: M
Age: 64
State: LA

Vax Date: 09/24/2021
Onset Date: 09/27/2021
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: RA

Lab Data:

Allergies:

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

Symptoms: Massive stroke with brain bleed.

Other Meds:

Current Illness:

ID: 1745653
Sex: M
Age: 55
State: OH

Vax Date: 02/03/2021
Onset Date: 03/03/2021
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: CBC with Auto Differential - 3/5/21 Normal Comprehensive metabolic panel - 3/5/21 Normal Sedimentation Rate - 3/5/21 Normal C-reactive protein - 3/5/21 Normal Complement Total - 3/5/21 Normal Cryoglobulin - 3/5/21 Normal Cryoglobulin - 3/23/21 Normal Cold Agglutinins - 3/23/21 Normal Lupus LE Panel with Reflex - 3/23/21 Normal D-Dimmer, Quantitative - 3/23/21 Normal Reticulocytes - 3/23/21 Normal

Allergies: grass pollen and dust.

Symptom List: Tremor

Symptoms: Painful, black discoloration of several of my toes. These appeared during the third week after the vaccination and lasted for approximately two weeks before dissipating and finally disappearing.

Other Meds: Olmesartan (Benicar) 40 mg tablet Pantoprazole Sodium 40mg tablet

Current Illness: None

ID: 1745654
Sex: F
Age: 37
State: WI

Vax Date: 09/01/2021
Onset Date: 09/04/2021
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

Allergies: none

Symptom List: Erythema, Pruritus

Symptoms: For the first 2 days after the shot I had minimal side effects (sore arm, sneezing). The morning of Saturday, Sept 4 I woke up with back pain that progressed into the worst back spasms I've ever had and that didn't subside until noon on Sunday, Sept 5, which at that point the back pain and spasms were intermittent until the evening of Monday, Sept 6. After Sept 6 the pain went away until I received my second COVID shot which will be in another report.

Other Meds: vitamin d, multivitamin

Current Illness: none. Before the shot I had not been this ill for years.

ID: 1745655
Sex: M
Age: 77
State:

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

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: 1745656
Sex: M
Age: 67
State: CA

Vax Date: 03/16/2021
Onset Date: 09/25/2021
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: Results as of 9/29/2021 14:43 3/14/2020 12:06 CRP, SER QL: 20.6 (H) 9/26/2021 06:40 CRP, SER QL: 16.1 (H) 9/27/2021 06:45 CRP, SER QL: 10.3 (H) 9/28/2021 06:22 CRP, SER QL: 4.6 (H)

Allergies: Gabapentin

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

Symptoms: Admitted 9/25 for SOB, sx onset 9/15 Reports fever, body aches, cough; home sats readings 88-89% for 3 days prior to admission 67 Y male with a h/o smoking ( 10 pack years, quit last year), metastatic rectal cancer, claustrophobia, h/o post-polio syndrome admitted for acute hypoxemic respiratory failure 2/2 to COVID-19 PNA. Pt. being treated in the hospital x5 days w/ remdesivir and decadron x10days

Other Meds: Atorvastatin (LIPITOR) 20 mg Oral Tab ; Desipramine (NORPRAMIN) 100 mg Oral Tab; Gas Relief 80 simethicone, 80 mg Oral Chew Tab ; HYDROcodone-Acetaminophen (NORCO) 7.5-325 mg Oral Tab; Ibuprofen (MOTRIN) 600 mg Oral Tab; Lisinopril-hydroCHL

Current Illness: ADENOCARCINOMA, RECTUM (Chronic)

ID: 1745657
Sex: F
Age: 61
State: SC

Vax Date: 03/09/2021
Onset Date: 03/19/2021
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: Labs, MRI

Allergies: None.

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: 10 days after the vaccine, The very first thing was that my hands hurt and they were swollen and in the mornings I couldn't open them up. I started going to the hot tub to get them heated and it lasted for like 3 weeks and I never had anything like that before. They were really hard to move. I had to get my rings cut off my hands and I have never had swelling like that. After 3 weeks it went back to normal and I haven?t had a problem since. I don?t have high blood pressure or anything like that. Then my knees started hurting after that and they were stiff and achy and I couldn?t get my knees comfortable and I have had two knee replacements in 2013 and so they were very stiff and achy and hurt on the outside of the knees and the next thing was my hips mostly on the left side hurt and my muscles were hurting all over, especially my arm and upper thighs. Then I had a headache on July 4 and I?ve never had that before and it lasted for 14 days before I went to ER. It wasn?t like a migraine or sinuses, it was optical neuropathy headache on back side of skull, and then the back problems started. It lasted this whole time and it's just started to improve. I did have two teeth I had to have pulled out that rotted as well.

Other Meds: Thyroid Medication

Current Illness: None.

ID: 1745658
Sex: M
Age: 64
State:

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: SYR
Vax Site: LA

Lab Data:

Allergies:

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

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

Other Meds:

Current Illness:

ID: 1745659
Sex: F
Age: 76
State:

Vax Date: 09/28/2021
Onset Date: 09/28/2021
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: Administration error mixed series mRNA vaccine Pfizer and Moderna.

Other Meds:

Current Illness:

ID: 1745660
Sex: F
Age: 70
State: MD

Vax Date: 03/19/2021
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:

Allergies: sodium pentanol

Symptom List: Pain in extremity

Symptoms: injection site sill panful and left pinky finger numb

Other Meds: alendronate sodium ,amlodipine benefiter betamethasone valerate levothyroxine sodium , meclizine, miralax Mylanta Tylenol viactiv vitamin b12 , vitamin D , hydrocortisone biotin

Current Illness: no

ID: 1745661
Sex: F
Age: 69
State: OR

Vax Date: 09/09/2021
Onset Date: 09/10/2021
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: I did not report the adverse event to my primary physician so no medical testing or lab work was done.

Allergies: None that I know of.

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

Symptoms: Arrived home following the vaccination with a bit of a sore arm. Awoke in the middle of the night with hearing lose in the left ear and muffled hearing in the right ear. Took (1) 500mg Tylenal for achiness. Took another another Tylenal eight hours later. Felt most comfortable spending the day quiet watching TV or reading. My hearing gradually returned through out the day. By 6:00pm hearing in both ears had completely returned. The following morning (September 11, 2021) I felt completely back to my normal self and have no adverse effects since.

Other Meds: Metoprolol Succinate 25mg, Vit B12-2000mcg, Vit D3-50mcg

Current Illness: No

ID: 1745663
Sex: M
Age: 50
State: FL

Vax Date: 03/28/2021
Onset Date: 08/05/2021
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: X-ray, Covid-19 test

Allergies: Peanut; tree nuts

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

Symptoms: I had a fever and chills. I had trouble breathing. I have asthma. I went to the doctor. They did a chest-ray and a Covid-19, which can back positive.

Other Meds: Asthma medicine

Current Illness:

ID: 1745664
Sex: M
Age: 87
State:

Vax Date: 02/26/2021
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: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

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

Other Meds:

Current Illness:

ID: 1745665
Sex: F
Age: 17
State: CA

Vax Date: 09/17/2021
Onset Date: 09/28/2021
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:

Allergies:

Symptom List: Vomiting

Symptoms: On 9/22 my daughter had a rash line from shoulder to wrist. On 9/28 another rash line from groin to ankle. Both rashes are on her left side, same side her Covid vaccine was given. Took her to her doctor (9/28) who diagnosed shingles. Prescribed Acyclovir 200mg 5x a day.

Other Meds: Methyl B12, Flonase, Zyrtec, Jolessa birth control pills, probiotic, multi vitamin

Current Illness:

ID: 1745666
Sex: F
Age: 12
State: OR

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

Lab Data: none

Allergies: none

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: 18:50 Patient receives vaccine 18:51 Patient arrives in the observation area accompanied by her mother and the nurse assigned to the observation area who explains to both the patient and her mother that the patient will be observed for fifteen minutes and explains the common side effects and what to do should any of them occur in the next 24-48 hours. Both the patient and the mother verbalized understanding. 18:53 Patient signs for and receives incentive, also gets a pack of fruit snacks. 18:57 - Patient states she does not feel well and looks pale, patient was also diaphoretic. LPN monitoring the observation area approaches the young lady and she immediately slumps to the right in her chair and appears to lose consciousness.. LPN and another nurse transfer the patient from the chair to the stretcher and use a capsule of spirit of ammonia that is broken and waved under the patient?s nose and she immediately responds. 18:58 Vital signs are taken: BP-90/58, P-80, R-18, O2 sat-99-100%. Patient is verbally responsive and able to state her name and recognize her mother. Patient denies difficulty swallowing, breathing or feeling itchy. On physical observation patient does not have any redness or rash appearing on her face, neck, upper extremities or torso. Her upper extremities are warm and dry to touch. 19:03 Patient placed in an upright/seated position, denies feeling dizzy or lightheaded and is offered some water. Able to follow commands and swallow without difficulty. Monitoring continues by RN on site. Patient offered a granola bar and is able to eat without difficulty 19:06- VS taken: BP-100/60, P-101, O2 sat 100%. Monitoring continued in the observation area by RN. Patient is alert and oriented, denying any discomfort/difficulties. 19:23 ? Patient leaves the observation area/clinic accompanied by her mother after informing and instructing the mother of s/s to observe for throughout the night and when to call 911 or seek medical attention. The mother and daughter verbalize understanding the information. Patient was able to ambulate without difficulty or assistance.

Other Meds: none

Current Illness: none

ID: 1745667
Sex: M
Age: 69
State:

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

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

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

Other Meds:

Current Illness:

ID: 1745668
Sex: M
Age: 36
State: MO

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: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Sore arm Muscle fatigue (legs, arms) Headache Fever Night sweats, inability to sleep

Other Meds:

Current Illness:

Date Died: 08/20/2021

ID: 1745669
Sex: M
Age: 83
State: WI

Vax Date: 03/17/2021
Onset Date: 08/07/2021
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: 8/16/2021 and 8/18/2021 CXR Bilateral pulmonary infiltrates 8/7/2021 RAPID SARS-COV-2 BY PCR - detected

Allergies: Unknown

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

Symptoms: Client diagnosed with Covid-19 on 8/7/2021, hospitalized with intermittent dyspnea on exertion, cough, LE edema. He was discharged on 8/13/2021 after being treated with IV Decadron and a 5 day course of Remdesivir. He was readmitted on 8/16/2021 with SOB, fevers, cough and weakness. During this admission, he was given high-dose IV steroids. He died on 8/20/2021 due to Acute hypoxemic respiratory failure due to severe bilateral COVID pneumonia and suspected superimposed bacterial pneumonia. Submitter does not have access to full medical record. If further information is required, please contact the admitting hospital.

Other Meds: Unknown

Current Illness: Unknown

ID: 1745670
Sex: F
Age: 74
State:

Vax Date: 04/09/2021
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: RA

Lab Data:

Allergies:

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

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

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am