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: 1745723
Sex: M
Age: 3
State: CO

Vax Date: 03/25/2021
Onset Date: 03/26/2021
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: None

Allergies: Eggs and corn

Symptom List: Dysphagia, Epiglottitis

Symptoms: Mother reported that child developed a red, itchy rash on face, chest and back the day after receiving the DTaP vaccine. She was advised to give the child Benadryl 5ml and repeat every 6-8 hours.

Other Meds: None prescribed.

Current Illness: Minor head trauma 3/9/21.

ID: 1745724
Sex: M
Age: 78
State: AK

Vax Date: 09/21/2021
Onset Date: 09/21/2021
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:

Allergies: NKDA

Symptom List: Anxiety, Dyspnoea

Symptoms: WARM, RED, NON-ITCHY RASH ON VACCINATION ARM (FLUZONE AND PNEUMOVAX 23), ER VISIT, PT RECIEVED STEROIDS AND ABX

Other Meds: UNKNOWN

Current Illness: NO KNOWN ILLNESSES

ID: 1745725
Sex: M
Age: 80
State: CA

Vax Date: 09/27/2021
Onset Date: 09/29/2021
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: none

Allergies: no known allergies

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

Symptoms: Patient received a third dose of the Covid vaccine. His first two vaccines were Moderna. On 9/27 he was given a Pfizer additional dose by mistake. He was called and he is having no side effects that are out of the ordinary.

Other Meds: blood thinners, and unknown

Current Illness: none known

ID: 1745726
Sex: F
Age: 73
State: AR

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: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data: NA

Allergies: Sulfa, codeine, penicillin, cephalexin

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: PT DEVELOPED A RASH IN EACH ARMPIT. PT SAID RASH WAS BURNING. THE RASH WAS CIRCULAR WITH THE CENTER NOT INVOLVED. RASH LOOKED DRY A LITTLE SCALY. PT STATED SHE HAD NEVER HAD THIS RASH BEFORE. PT DID NOT SEEK MEDICAL TREATMENT.

Other Meds: Unknown

Current Illness: Unknown

ID: 1745727
Sex: F
Age: 63
State: OH

Vax Date: 03/28/2021
Onset Date: 08/06/2021
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: 08/06/2021 Covid test positive

Allergies: None

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

Symptoms: It started with a slight headache, stuffy nose, and drippy nose. Eventually I got like a sinus infection. Super bad runny nose and headache. Really draggy. I lost my sense of smell, which I still do not have correctly. Little bit of a fever like 100. My husband tested positive for Covid and one my friends called me and told me that a lot of people at the wedding we went to tested positive as well. Out of 20 people I know tested positive, all were vaccinated. On 8/06/2021 I went to urgent care to get tested for Covid and It came back positive.

Other Meds: Lipitor

Current Illness: None

ID: 1745728
Sex: F
Age: 41
State: ID

Vax Date: 09/29/2021
Onset Date: 09/29/2021
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:

Allergies:

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

Symptoms: PATIENT CAME INTO PHARMACY TO GET A FLU SHOT, PRESENTED IMMUNIZING TECHNICIAN WITH HER COVID CARD AND TECHNICIAN GAVE HER A 3RD DOSE OF PFIZER (PATIENT HAD FIRST 2 DOSES OF MODERNA WITH LAST DOSE BEING 5/2021)

Other Meds:

Current Illness:

ID: 1745729
Sex: F
Age: 48
State: FL

Vax Date: 04/10/2021
Onset Date: 04/17/2021
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: n/a

Allergies: N/A

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Constant twitching and pulsing in lower legs and spontaneously throughout the body. Has not stopped since receiving the vaccine.

Other Meds: N/A

Current Illness: N/A

ID: 1745730
Sex: F
Age: 41
State: CA

Vax Date: 03/17/2021
Onset Date: 03/17/2021
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: None reported

Symptom List: Pharyngeal swelling

Symptoms: Approximately 5 hours after vaccine, client reports slight itching of her face. Resolved by the time she woke up the next day.

Other Meds: Trazadone

Current Illness: none reported

ID: 1745731
Sex: F
Age: 57
State: OR

Vax Date: 09/14/2021
Onset Date: 09/15/2021
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: Lisinopril Sulfa antibiotics Morphine Hydrocodone

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Developed right shoulder and left collar bone swelling . Patient also complained of pain to area. Symptoms developed approx. 24 hrs. post 2nd Pfizer dose. A few days later patient reported memory issues that were unlike. Could not remember her husbands birther day, wedding anniversary or the nuts she bought from a Hazelnut stand she frequents. She recalled these things 48 hours later which prompt her to notify her healthcare provider's office.

Other Meds: Vitamin D-3 25 mcg Vitamin B-12 2500 mcg Estradiol 0.1 mg/g vaginal cream Hydroxyzine 50 mg Claritin 10 mg Losartan 100 mg Vitamin B-6 100 mg Synthroid 25 mcg Turmeric

Current Illness:

ID: 1745732
Sex: M
Age: 44
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: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

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

Other Meds:

Current Illness:

ID: 1745733
Sex: M
Age: 26
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: SYR
Vax Site: LA

Lab Data: ekg cbc bnp triponen and chest x ray

Allergies: None

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

Symptoms: acute pericardites

Other Meds: None

Current Illness: None

ID: 1745734
Sex: M
Age: 80
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: 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: 1745735
Sex: F
Age: 65
State: FL

Vax Date: 09/15/2021
Onset Date: 09/15/2021
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: Codeine and Levaquin

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

Symptoms: Abdominal cramps, diarrhea, dry heaves, nausea, fever and chills over 102 degrees

Other Meds: Glimperimide, omeprazole, Ropinerole, estradiol, montelukast, multiple vitamin, magnesium

Current Illness: None

ID: 1745736
Sex: F
Age: 26
State: VA

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

Lab Data:

Allergies: Benzoyl peroxide and witch hazel

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

Symptoms: Muscle pain, chills, body aches, headache, fever? was breastfeeding my baby broke out in a rash and then begin showing symptoms, cough, congestion, screaming, fever, and then a few days later tested positive for Covid. I was Covid negative at the time of my shot. I breastfed him all day and at the time I started to feel sick is when he started developing his rash.. other symptoms soon followed

Other Meds: Prenatal vitamin and magnesium oxide

Current Illness:

ID: 1745737
Sex: F
Age: 55
State:

Vax Date: 04/10/2021
Onset Date: 09/28/2021
Rec V Date: 09/29/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: 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: 1745738
Sex: F
Age: 70
State: NY

Vax Date: 03/31/2021
Onset Date: 04/01/2021
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: Dizziness upon awakening in the morning and lasting several hours. This happened for 4 consecutive days.

Other Meds: Bystolic 20mg. daily

Current Illness: None

ID: 1745739
Sex: M
Age: 82
State: OR

Vax Date: 03/10/2021
Onset Date: 04/27/2021
Rec V Date: 09/29/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: Pluracy, atrial flutter,acidic accumulation

Other Meds: vitamin d3, atorvastatin

Current Illness:

ID: 1745740
Sex: M
Age: 73
State: OH

Vax Date: 03/15/2021
Onset Date: 03/16/2021
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: Exam by my G P three times / xray / cortiszone shot in shoulder by specialist and exam 08/ 26/ 21

Allergies: Penacilin

Symptom List: Ear pain, Hypoaesthesia

Symptoms: woke up the day after shot to pain that feels like a serious sprain. I figured it would go away , but it only got worse. After a couple months i went to my doctor. Tried predniszone which helped while i was on it but pain came back after off two days. after xray showed it was not arthritic condition went to shoulder specialist whogave a shot in shoulder which slightly improved it for about 10 days but then back to i guess i have lost 50% use of my shoulder , mabey forever.

Other Meds:

Current Illness:

ID: 1745741
Sex: F
Age: 57
State: TX

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

Allergies: Minocycline and Sulfa antibiotics

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Severe fatigue, body aches, chills, nausea, headache, decreased appetite.

Other Meds: None

Current Illness: None

ID: 1745742
Sex: M
Age: 30
State: TX

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

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

Symptoms: Tinnitus in ears

Other Meds: None

Current Illness: None

ID: 1745743
Sex: F
Age: 61
State: IL

Vax Date: 03/28/2021
Onset Date: 08/05/2021
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: see above

Allergies: Penicillin; sulfa; codeine; Compazine; Neosporin ointment; adhesive tapes and bandaids; Celebrex

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

Symptoms: Had a regular screening mammogram on August 5 2021 - part of the hospital. it showed a suspicious area on mammogram and so they needed me to come in for additional mammogram scans and an ultrasound. The next date was Friday, Aug. 13th at the same place for those tests. I had a core needle (big one) biopsy (and a mammogram because they inserted a marker to show where cancer area was) on August 19th. They did the pathology from that and the Pathology results showed Breast Cancer - August 19th and results on the 20th. Saw oncologist on 8/24 and he had me do an MRI of breasts on 8/26. Breast surgeon on August 30th and Had a breast reconstruction doctor on Aug 31 and genetic counseling and testing done because two of my sisters tested positive for breast cancer in the last month and a half. Oncologist dr: (unlisted dr information). I met with the radiation oncologist Sept 1st and had an EKG and pre-op surgery before surgery and that was on 7th of September. 14th - had a procedure to insert additional marker in my breast to show where cancer was located. CT Scan - urinary incontinences and flank bank to see if there was a kidney stone - there was not (9/15/2021). Dye injected on my left breast so the dye would go to the sentinel node - Sept 16th and then I had my breast cancer - lumpectomy and breast reconstruction surgery on Sept 17th. Follow up appts since then: with Breast surgeon on Sept 27th and I also saw the plastic surgeon before that date because of some complications from my incision area: I had a rash from adhesive from the sterile drape and I had a little bit of bleeding and draining from the incision and an area of necrotic skin at the t junction. That appt with the plastic surgeon was Sept 22. On the 24th, I had blood on my sputum - coughed up small amt of blood - I went to the Hospital ER - everything was fine. Sept 28th, saw the oncologist. Today, I had a previously scheduled appt with PCP doctor and I had the flu vaccine. The oncologist and breast surgeon went over my surgical pathology report with me - the diagnosis - left breast lumpectomy - invasive carcinoma of no special type. Histological grade and came up with a Nottingham score of 1. Tumor size 11 mm. Invasive carcinoma in that one single site with no lympho-vascular invasion. Lymph node was uninvolved with the tumor. All good news. Cancer is removed but I'm waiting for my test results. Yesterday, they sent my tissue off to see if the cancer will re-occur in my body based on my personal genetics and to see if the chemotherapy will be of benefit to me.Will get results on 10/13. I will have to have radiation.

Other Meds: Losartan - 50 mg tablets; Levothyroxine - 100 mcg tablet; Omeprazole 20 mg capsule; Estradiol - Dotty patch - .1mg a day; Progesterone 100 mg capsule; Estradiol Vaginal Cream .1 mg; Vit D3 - 25 mcgs or 1000 IUs; Mupirocin Ointment; Flutic

Current Illness: no

ID: 1745744
Sex: F
Age: 47
State: WI

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: 1
Vax Route: IM
Vax Site: LA

Lab Data: Went to the doctor on 3/1/21 to have it looked at. Just to return if it doesn't improve in 21 days. It did improve no further appoinment needed. When doing my annual mammogram, will tell them to review it in december.

Allergies: sulfa antiboitic medications

Symptom List: Unevaluable event

Symptoms: The second morning after my second covid vaccination in my left arm, my left arm pit was swollen and very sore. It was painful and warm to the touch. It took a good three weeks post vaccination for the swelling to reduce. The pain and redness went away after 5-7 days. There is still a small amount of swollen tissue in the armpit. About 5 days post vaccination, I also had some rash around my armpit and chest area. It did not itch.

Other Meds: proboitics; multi vitamin

Current Illness: none known

ID: 1745745
Sex: M
Age: 70
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: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

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

Other Meds:

Current Illness:

ID: 1745746
Sex: F
Age: 73
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:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Really bad headache and low grade fever that has lasted all day

Other Meds: Vitamin D , biotin ,probiotic, melatonin methotrexate, beta met ozone

Current Illness:

ID: 1745747
Sex: F
Age: 30
State: FL

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: SYR
Vax Site: LA

Lab Data: None

Allergies: Gluten, lavender, environmental allergies

Symptom List: Injection site pain, Menorrhagia

Symptoms: Extreme fatigue, body aches, joint pain, headache, pain at injection site, swelling at injection site, itching at injection site, loss of appetite, hot flashes I've just used ibuprofen, ice and warm showers for pain.

Other Meds: Zyrtec 10mg, vitamin c 1000, vitamin d supplement 1000, ibuprofen 600mg

Current Illness: Sinus infection 3 weeks prior

ID: 1745748
Sex: F
Age: 45
State: WA

Vax Date: 08/26/2021
Onset Date: 08/28/2021
Rec V Date: 09/29/2021
Hospital:

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

Lab Data: Per pt she was not aware this side effect was from the shot until I asked her how she felt after her first shot, but she remembered having these symptoms a couple of days after her covid 1st shot.

Allergies: PER patient SULFA allergy

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

Symptoms: Patient came on 9/16/21 for her second shot, as I usually do to all patients I asked her how she felt after her 1st shot, she stated that she felt her left side of her face was numb; the symptoms on her neck and face lasted about 3 to 5days; her lips last 1 to 2 days and twiching of the eye still happening. She has appt with an eye doctor on 9/30/21.

Other Meds: PER PT only takes multi-vitamin, Vit D drop, and omeg-3.

Current Illness: No; per patient

Date Died: 09/19/2021

ID: 1745749
Sex: F
Age: 73
State: WA

Vax Date: 03/12/2021
Onset Date: 03/13/2021
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: long history of complications, hundreds of tests, results at hospital, as well as SNf as they often use a different lab than hospital. Died in her sleep suddenly at SNF. Initial and Second Acute care Stay both began within 24 hr after vaccine doses. Sudden unexpected death in September at SNF.

Allergies: none

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: After first dose patient hospitalized for RDS/ pneumonia, complicated hospitalization due to sudden CVA. Then to nursing home for rehab. Second dose done months later and next day, hospitalized- heart failure, RDS. complicated rehabilitation. Two hospitalizations both ocurred within 24 hours of vaccine. Died in her sleep suddenly at SNF. Initial and Second Acute care Stay both began within 24 hr after vaccine doses. Sudden unexpected death in September at SNF. Likely related to patients with Factor V Leiden defect should not receive these vaccines.

Other Meds: warfarin, plavix,isosorbide, lasix, protonix, lisinopril

Current Illness:

ID: 1745750
Sex: F
Age: 46
State: LA

Vax Date: 09/21/2021
Onset Date: 09/22/2021
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: Latex Sulfa

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Bruise to injection site won?t go away

Other Meds: Wellbutrin Buspar Prozac Cyclobenzaprene Levocetirizine

Current Illness:

Date Died: 09/25/2021

ID: 1745752
Sex: F
Age: 89
State: NJ

Vax Date: 09/16/2021
Onset Date: 09/17/2021
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: magnetic scans of brain x 2 / cat scans x 1 / cat scan of chest /

Allergies: none known

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

Symptoms: fever and weakness day after vaccine with increasing weakness at home /admitted to hospital 4 days later with weakness /progressive decline with weakness and paralysis of left arm / stroke suspected but could not be confirmed on 2 magnetic resonance scans /inability to speak and then swallow / treated for possible aspiration pneumonia /progressed to being obtunded and respiratory distress / died 9/25/21

Other Meds: amlodipine /pantoprazole /vit d /vit b 12

Current Illness: none

Date Died: 08/18/2021

ID: 1745753
Sex: F
Age: 71
State: MT

Vax Date: 03/20/2021
Onset Date: 08/18/2021
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: COVID-19 PCR on 8/13/2021

Allergies: oxycodone, sulfa medications, morphine, simvastatin

Symptom List: Nausea

Symptoms: Patient was a breakthrough COVID case and died due to COVID-related causes on 8/18/2021.

Other Meds: amiodarone, furosemide, hydrocodone, levothyroxine, metronidazole, nitroglycerin, omeprazole

Current Illness:

ID: 1745754
Sex: M
Age: 2
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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NKDA

Symptom List: Injection site pain

Symptoms: Red, tender, painful at injection site. Patient was evaluated 09/29/2021 in clinic day after the vaccine was administered.

Other Meds: N/A

Current Illness: N/A

ID: 1745755
Sex: F
Age: 84
State:

Vax Date: 02/23/2021
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:

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

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: 1745756
Sex: F
Age: 59
State:

Vax Date: 04/22/2021
Onset Date: 04/22/2021
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:

Allergies:

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

Symptoms: None

Other Meds:

Current Illness:

ID: 1745757
Sex: F
Age: 35
State: NJ

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

Lab Data:

Allergies: None

Symptom List: Tremor

Symptoms: Currently breastfeeding. 45 min after dose started feeling pain in right breast/nipple. Upon returning home it?s been very painful nursing on right side. Significant pain in left arm at injection site

Other Meds: None

Current Illness: None

ID: 1745758
Sex: F
Age: 45
State: LA

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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: IV fluids and radio graphic studies 9/2021. Exploratory Colonoscopy scheduled 10/1/2021.

Allergies: None

Symptom List: Erythema, Pruritus

Symptoms: New onset Severe colitis and severe malaise requiring IV fluids. Symptoms are still occurring and diagnostic tests still being performed.

Other Meds: None

Current Illness: None

ID: 1745759
Sex: M
Age: 63
State: WI

Vax Date: 08/19/2021
Onset Date: 09/22/2021
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: +covid test on 9/27/21

Allergies: none

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

Symptoms: The patient had a breakthrough covid diagnosis on 9/27/2021 despite having received covid vaccination on 8/19/21 and 9/16/21

Other Meds: flomax and omeprazole

Current Illness: none

ID: 1745760
Sex: F
Age: 60
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: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: NONE

Other Meds:

Current Illness:

ID: 1745761
Sex: F
Age: 81
State: OH

Vax Date: 09/01/2021
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:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Profuse sweating started 8 hours after having injection. Fever, muscle aches, sore arm, weak, fell, an all over sick feeling, no appetite, dry cough, head congestion, elevated heart rate, around 100, highest I detected was 121. Injection was on Monday, Sept 27th, I was down the entire day, the 28th. All the symptoms remained on the 28th. On the 29th, arm soreness was less, no fever, dry cough and head congestion were gone. All over sick feeling was not as intense.

Other Meds: Metropol, Lorsartan, Elavil, Crestor, Levothyroxine, Plavix, insulin lantus and humalog inhalers, albuterol, spriva

Current Illness:

ID: 1745762
Sex: M
Age: 23
State: FL

Vax Date: 02/01/2021
Onset Date: 09/29/2021
Rec V Date: 09/29/2021
Hospital:

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

Lab Data: None

Allergies: None

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

Symptoms: I have a headache. I?m not sure if it?s from the vaccine or bc of u/dsta1997?s idiotic comments.

Other Meds: None

Current Illness: None

ID: 1745763
Sex: M
Age: 52
State: CA

Vax Date: 09/01/2021
Onset Date: 09/29/2021
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: NA

Allergies: NA

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

Symptoms: NA

Other Meds: NA

Current Illness: NA

ID: 1745764
Sex: F
Age: 31
State: GA

Vax Date: 08/30/2021
Onset Date: 09/23/2021
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: Pain in extremity

Symptoms: Extremely heavy period and breakthrough bleeding the week after

Other Meds: none

Current Illness: None

ID: 1745765
Sex: F
Age: 51
State: WA

Vax Date: 06/08/2021
Onset Date: 06/08/2021
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: NA

Allergies: none

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

Symptoms: Had 2.5 weeks of bleeding during menstruation including heavy bleeding. Pain at injection site for 3 days. 16 and 17 days after vaccinne administration had terrible headache, 100 degree fever, vomiting all day, body aches. 17 days after vaccine administration almost fainted and had to lay down for 30 minutes. Thought about going to urgent care. Finally on day 18 was feeling better. Will not be getting a Covid vaccine again because of side effects. Also my 2 boys under age 18 will not be getting vaccine as long as there is a threat of serious side effects.

Other Meds: none

Current Illness: none

ID: 1745766
Sex: F
Age: 79
State:

Vax Date: 03/24/2021
Onset Date: 03/28/2021
Rec V Date: 09/29/2021
Hospital: Y

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

Lab Data:

Allergies:

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

ID: 1745767
Sex: F
Age: 32
State: AZ

Vax Date: 02/23/2021
Onset Date: 03/02/2021
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: (03/02/2021) None. Just a physical by a nurse.

Allergies: NKA

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

Symptoms: (03/02/2021) I notice my arm was swelling in the morning. In 2 hrs. grew to about the size of a grapefruit and was itchy. Used ice, benedryl gel, cortizone cream, and lasted for about 2-3weeks. Resolved and no other issues.

Other Meds: Omeprazole, Iron, Natures Bounty Super B complex, Magnesium, Biotin, L-Theanine, Chamomile, Pre and Probiotics

Current Illness: None

ID: 1745768
Sex: F
Age: 30
State:

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: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: Patient reported tingling feeling in her throat and slight swelling of tongue with similar effect from seafood allergic reaction she had ten years ago. Patient alert and oriented, vital signs 135/83, pulse 64, O2 98%, 1525 administered benadryl 50mg IM to right deltoid. Patient tolerated it well. Patient resting in gurney monitored for 30 minutes she then stated she felt better bp 129/87, pulse 54, o2 100%. No respiratory distress noted. Patient denies swelling of tongue, throat closing and any other symptoms. Advised patient if symptoms worsened contact ER or 911.

Other Meds:

Current Illness:

ID: 1745769
Sex: M
Age: 55
State: FL

Vax Date: 03/26/2021
Onset Date: 09/29/2021
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: SYR
Vax Site: LA

Lab Data: 9/8 thru 9/10 in hospital Eco , Blood work, CT of chest, x raysf

Allergies: Wellbutrin

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: This is a follow up from previous report, I was Hospitalized for 3 days due to joint swelling in both hands and wrists, both knees, and both shoulder blades, Also had fluid in left lung, fluid was removed at Hospital , I have been on prednisone since my release from hospital

Other Meds: Omprazole Atorvastin Levothroxine Metformin

Current Illness: None

ID: 1745770
Sex: F
Age: 81
State:

Vax Date: 03/28/2021
Onset Date: 09/28/2021
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:

Allergies:

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

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: 1745771
Sex: M
Age: 48
State:

Vax Date: 03/25/2021
Onset Date: 03/25/2021
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: NONE

Other Meds:

Current Illness:

ID: 1745772
Sex: M
Age: 56
State: TN

Vax Date: 08/19/2021
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: RA

Lab Data: None.

Allergies: None

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

Symptoms: General malaise day after administration, persisting 1 week. No injection site swelling or soreness. Cognitive changes and "blurry vision" noticed 2.5 days post vaccination. Cognitive deficits involve short term memory which is impaired enough to be noticeable not only to patient, but elicits unprompted comments from friends and family. Vision is has improved to nearly pre-vaccination quality, but short term memory deficits remain and seem to be somewhat stable at 5 weeks post-vaccination. Development of neurological symptoms associated with administration of vaccine.

Other Meds: None

Current Illness: None

ID: 1745773
Sex: M
Age: 38
State: CT

Vax Date: 09/01/2021
Onset Date: 09/06/2021
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:

Allergies: None

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

Symptoms: My first vaccine was no problem. I barley felt anything. When I got my 2nd injection, I immediately felt a burning sensation in my left shoulder. It felt like fire! My shoulder was very sore for a few days and I wasn?t surprised because that?s normal after a shot or vaccine. I took it easy for about a week but there was still pain but not a soar feeling anymore. There is a sharp electric pain that I feel when doing certain movements with my shoulder. Turning the steering wheel driving causes pain. It has been almost a month since I?ve gotten the injection. I am getting very concerned about this. I plan on seeing a doctor as soon as my insurance kicks in for my new job.

Other Meds: Alprazolam

Current Illness: None

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am