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: 1745968
Sex: M
Age: 18
State: OH

Vax Date: 09/09/2021
Onset Date: 09/09/2021
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: Involuntary Reflex Test with Reflex Hammer (9/15/21) Sensation Test on Foot (Choosing Dull vs. Sharp Object) (9/15/21)

Allergies: N/A

Symptom List: Dysphagia, Epiglottitis

Symptoms: 10:00 pm on 9/9/21: Two and a half hours after receiving the Janssen COVID-19 vaccine, my legs started to become increasingly sore and tight. Because I had not done any intense physical activity earlier that day or the day prior, I was quite confused as to why these symptoms were occurring. Since my legs felt sore, I attempted to stretch them to alleviate the soreness. Unfortunately, this did not work; so, I decided to sleep instead. 9:00 am on 9/10/21: The following morning, along with my leg soreness (like feeling nervous before giving a public speech), I felt intense muscle contractions in numerous regions of my legs (particularly, my calves and thighs: anterior and posterior). These muscle contractions would vary in quality (strength of contraction) and quantity (number of contractions per event and frequency of each event occurring). For the most part, the muscle contractions (spurt of two or three contractions) would last two seconds and occur every ten seconds. Regarding where the muscle contractions would occur, it was completely random: no distinct pattern of event location (besides the general regions of my calves and thighs: anterior and posterior). Also, I realized that the muscle contractions only occurred while I remained stationary (i.e., sitting or lying down); in contrast, when I was standing or moving around on my feet, I would not feel any muscle contractions (although, I still felt slight leg soreness while standing). 9/11/21-9/12/21: Symptoms remained the same as 9/10/21 9/13/21: On the thirteenth, my symptoms vastly increased: in terms of overall discomfort. The quality (strength: more intense contractions) and quantity (time span of each event: event length increased (>two seconds) and occurred more frequently (

Other Meds: Amoxicillin

Current Illness: Runny nose, slight cough, sore throat, and diarrhea.

ID: 1745970
Sex: F
Age: 71
State: CA

Vax Date: 03/05/2021
Onset Date: 05/01/2021
Rec V Date: 09/29/2021
Hospital: Y

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

Lab Data: 8/17/21 - Urgent Care: EKG (normal sinus rhythm and ECG); (2) chest x-rays, PA and lateral (lungs look clear, cardiac and mediastinal contours are normal, no abnormal bowel gas in

Allergies: Aggrenox, Ampicillin, Clindaycin Base, Erthymycin Base,

Symptom List: Anxiety, Dyspnoea

Symptoms: I experienced very mild chest pains on both sides of my chest very infrequently (once every few weeks) starting a few months after receiving the second vaccination (around May 2021). I did not see my primary care doctor because the pain was so mild and infrequent. On 8/15/21, the chest pains (still on both sides of my chest) became stronger and more frequent (a few times per day) and worsened when taking deep breaths. On 8/17/21, the chest pains were constant. I went to Urgent Care and after two chest x-rays and an EKG, the doctor told me to go to the ER. In the ER, my blood pressure was 219/77. I had numerous blood tests, EKG, chest x-rays, and chest CT scan, and I was admitted to the hospital

Other Meds: Atorvastatin, Estradiol, Baclofen, Lifepak Nano dietary suppl.

Current Illness: None

ID: 1745971
Sex: M
Age: 40
State:

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

Other Meds:

Current Illness:

ID: 1745972
Sex: F
Age: 35
State: WA

Vax Date: 09/25/2021
Onset Date: 09/27/2021
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:

Allergies: non

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Facial swelling, legs swelling, severe vertigo, irregular heart rhythm problem- too fast and then too slow, irregularly pulse with sharp and steady heart pain), numbness in left shoulder, numbness behind the neck, can't feel the right half of my head, severe headache, chest pain, stomach pain, severe abdominal pain, blurry vision, can't stand on my feet.

Other Meds: non

Current Illness: non

ID: 1745973
Sex: F
Age: 22
State: UT

Vax Date: 08/29/2021
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: 9/17- blood taken at ER- nothing abnormal

Allergies: oral allergy syndrome.

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

Symptoms: 8/29 3rd dose of moderna vaccine 9/8 Itchy began 9/9 Hives began 9/10 Urgent Care visit (prescribed prednisone for 5 days) 9/12 Followed up with personal doctor. Said could take 4-6 weeks has seen these rashes before. (Prescribed Zyrtec and Hydroxyzine) 9/17 Emergency Room. Skin very sensitive, painful/ bruised feeling to touch plus hives and itchy. Bad headache and chills couldn?t sleep. Felt awful. They administered IV Steroid. Prescribed 5 days of additional steroid, said use Zyrtec and Hydroxyzine if needed. 9/23-24 less rash, hives and itch. Skin tenderness gone. Face puffy, red spots on body and face all day. Taking hydroxezine at night 9/25 continued progress flare ups on leg and hands. Red hot spots flare up. Some itchy some not itchy. 9/26. No tenderness of skin. Flare up in late evening on legs and arms. Hot to the touch, itchy but not too itchy. Using cortisone. Felt good all day. No tenderness on body and face less puffy. 9/27 primary care visit 9/29 continuing to take zyrtec- still have Dermatographia but no skin tenderness- feeling less inflamed.

Other Meds: daily birth control pill - sronyx vitamins- vitamin d, c, zinc, probiotic, apple cider vinegar

Current Illness: none

ID: 1745974
Sex: M
Age: 40
State:

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

Other Meds:

Current Illness:

ID: 1745975
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: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: NONE

Other Meds:

Current Illness:

ID: 1745976
Sex: M
Age: 79
State: AZ

Vax Date: 08/25/2021
Onset Date: 08/25/2021
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: Pharyngeal swelling

Symptoms: PATIENT HAS EXPERIENCED NUMBNESS ON THE LEFT ARM THAT PROCEEDS FROM HIS HANDS TO HIS NECK AS WELL AS PAIN SINCE THE VACCINATION. HIS NECK IS ALSO HURTS TO TURN.

Other Meds:

Current Illness:

ID: 1745977
Sex: M
Age: 55
State:

Vax Date: 03/24/2021
Onset Date: 03/24/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: NONE

Other Meds:

Current Illness:

ID: 1745978
Sex: M
Age: 55
State:

Vax Date: 04/21/2021
Onset Date: 04/21/2021
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: none

Other Meds:

Current Illness:

ID: 1745979
Sex: M
Age: 55
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: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: none

Other Meds:

Current Illness:

ID: 1746140
Sex: F
Age: 59
State:

Vax Date: 09/25/2021
Onset Date: 09/26/2021
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: Lymph node swelling & slight pain in right armpit

Other Meds:

Current Illness:

ID: 1746141
Sex: F
Age: 44
State: MN

Vax Date: 06/25/2021
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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

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

Symptoms: Severe hives appearing every day, random times, random place. They disappear on its own after 30 minutes.

Other Meds: none

Current Illness: none

ID: 1746142
Sex: M
Age: 59
State: NC

Vax Date: 08/30/2021
Onset Date: 09/04/2021
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: 28Sep21 Lipase 88 U/L

Allergies: Dairy

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

Symptoms: Second COVID vaccine given 30Aug21 and on 04Sep21 woked up around 130AM with severe abdominal pain. Soon after sever diarrhea and vomiting began (up to 10 times a day) . Also, extreme fatigue and body/muscle aches were experienced. Fatigue/body aches resolved aprox 12Sep but diarrhea and vomiting continued. Vomiting resolved 29Sep and diarrhea continues. HCP visited 22Sep21 , testing done but no diagnosis given. HCP visited again 28Sep21 with testing done and diagnosis of pancreatitis give.

Other Meds: l-Thuroxine Tabs 50 mcg QD Colchicine 0.6 QD Allopurinol 100mg BID

Current Illness: Gout

ID: 1746143
Sex: F
Age: 40
State: AZ

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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: sent to ED

Allergies:

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

Symptoms: itching to face, legs, ears, arms. No hives but getting worse

Other Meds:

Current Illness:

ID: 1746144
Sex: M
Age: 54
State: IA

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: NO ADVERSE EVENTS SO FAR

Allergies: NKA

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

Symptoms: DOSE GIVEN TOO EARLY. PT CAME IN SAYING IT WAS FOR HIS SECOND DOSE BUT HE HAD ALREADY COMPLETED A DOSE OF PFIZER? OUR SYSTEM WAS UNABLE TO CATCH THE PREVIOUS COMPLETED PFIZER VACCINE SERIES

Other Meds: Unknown

Current Illness: UNKNOWN

ID: 1746145
Sex: M
Age: 34
State: CA

Vax Date: 09/28/2021
Onset Date: 09/29/2021
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:

Allergies:

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

Symptoms: Strange taste in mouth, slightly metallic and bitter after vaccination. Continuing into today with nausea starting just after noon on 9/29/2021. Pain at injection site.

Other Meds:

Current Illness:

ID: 1746146
Sex: F
Age: 64
State: IL

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

Symptom List: Ear pain, Hypoaesthesia

Symptoms: no adverse event, we were contacted by local health department, Pt received a Johnson and Johnson. and asked us to submitt a vaers report

Other Meds:

Current Illness:

ID: 1746147
Sex: F
Age: 50
State: FL

Vax Date: 09/26/2021
Onset Date: 09/27/2021
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: Lisinopril

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Pain, swelling, redness in right arm. Fever, chills, fatigue

Other Meds: Laudable, Lamictal, Metformin, Trulicity, Levothyroxine, Gabapentin, Xanax, Glimepride, Pantaprazole, Armodafanil

Current Illness: None

ID: 1746149
Sex: F
Age: 17
State: CO

Vax Date: 09/29/2021
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: BP was take 105/60, and pulse ox (96)

Allergies:

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

Symptoms: Pt was given vaccine, and about 10 minutes, pt passed out. PT was unresponsive for about 60 seconds, breathing strangely. Paramedics were called and pt taken to ER

Other Meds:

Current Illness:

ID: 1746150
Sex: F
Age: 36
State: LA

Vax Date: 08/10/2021
Onset Date: 08/12/2021
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: Stress test, cardiac echo, EKG with new findings of Right bundle branch block and a holter monitor with new findings.

Allergies: Biaxin

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

Symptoms: Chest pain with tachycardia and associated shortness of breath starting the day after vaccination and lasting for 4 weeks. Treated with aspirin and NSAIDS for 1 month. Suspected myocarditis as diagnosis

Other Meds: Metformin 500mg daily Synthroid 50mcg daily

Current Illness: None

ID: 1746151
Sex: F
Age: 29
State: NH

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:

Allergies: Penicillin and sulfa

Symptom List: Unevaluable event

Symptoms: Roughly 30 hours post vaccination, I began to feel pressure in my underarm on the same side I received the shot. My lymph node continued to swell over night and become more tender. This is still persisting 24 hours later as I report this. Additionally, I've started to feel worn down and getting chills but not registering a fever.

Other Meds: Metformin, Zoloft, Ritalin, Allegra, Multivitamin

Current Illness: None

ID: 1746152
Sex: M
Age: 28
State: NJ

Vax Date: 09/29/2021
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: EMS assessed vitals

Allergies: nkda

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

Symptoms: patient received booster dose of Pfizer around 6:50PM. Around 7:00PM he starting having chest pain and nausea. This dissipated a few minutes later. EMS was called.

Other Meds: unknown

Current Illness: none

ID: 1746153
Sex: F
Age: 51
State: AK

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: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: N/A

Allergies: Pt. listed none.

Symptom List: Injection site pain, Pain

Symptoms: Pt. reported over the phone that around 5 hours after receiving the 1st dose of pfizer she had swelling of face and hands w/ some mild breathing distress where she had to "breath from the bottom of the stomach". She called to inquire about taking pain medication for back pain she was having and then brought up her reactions to the vaccination. She later wanted me to not make a note in her profile or report to VAERS as she is now concerned about not being able to get the 2nd dose and she now wants to get moderna instead. I said she would likely have to get either the 2nd pfizer or a moderna at the hospital where they are better equipped to deal with potential severe reactions and her primary care provider can advise her based on her entire medical profile/history. 9/29/21 14:37

Other Meds: Unknown

Current Illness: Pt. listed none.

ID: 1746154
Sex: F
Age: 48
State: IA

Vax Date: 01/07/2021
Onset Date: 01/07/2021
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: Taken to ER for heart and blood pressure monitoring and for allergic reaction Given IV Benadryl, Decadron, Pepcid

Allergies: Latex, Trazadone, Gadolinium, Iodine, Plavix

Symptom List: Injection site pain, Menorrhagia

Symptoms: Immediate tingling in back of throat, tongue, roof of mouth Extremely tachycardic and elevated blood pressure Heaviness in left arm/hand

Other Meds: Lisinopril 10mg, Aspirin 325mg, Amitriptyline 25mg, Vitamin D, Caltrate, Hair Skin and Nails, Magnesium, Tylenol ER 650mg, Probiotic, Zyrtec

Current Illness: None

ID: 1746155
Sex: F
Age: 72
State: OH

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

Lab Data:

Allergies:

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

Symptoms: Patient complained that injection site was warm to the touch. There was no visible redness or swelling at the injection site when she came in this afternoon. I suggested that she apply ice for 15-20 minutes several times a day. If no better or it gets worse, she should call her doctor.

Other Meds:

Current Illness:

ID: 1746156
Sex: M
Age: 66
State: AR

Vax Date: 03/31/2021
Onset Date: 04/02/2021
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: For the last 5 or 6 months I get bad headaches in the afternoon daily. Last one to two hours. I never had this problem before the vaccine. No way am I going to get a third shot.

Other Meds: Metoprolol lisinopril sinthroid aspirin

Current Illness:

ID: 1746157
Sex: F
Age: 68
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: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Patient came in pharmacy and reported swelling from injection site to elbow, red ness in same area and high blood pressure for 4 days. when patient came in pharmacy she had no symptoms and was feeling fine on 09/29/2021. however she said symptoms last her for 4 days from day she get vaccinated.

Other Meds:

Current Illness:

ID: 1746158
Sex: F
Age: 46
State: MA

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

Allergies: None

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

Symptoms: Shoulder pain, muscle soreness next day. Severe migraine next week.

Other Meds: None

Current Illness: None

ID: 1746159
Sex: F
Age: 67
State: AZ

Vax Date: 03/23/2021
Onset Date: 08/24/2021
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: Breast cyst - needle biopsy and ultrasound. Foot mass - I am awaiting for surgery to be scheduled.

Allergies: Codeine

Symptom List: Nausea

Symptoms: When I went for a mammogram , over one month after my 2nd shot, they found a cyst in my left breast. They did a needle biopsy and it was just fluid. Around the middle of August I developed a lump on the bottom of my left foot. I went to a podiatrist on 9/28/21. He said that I had a fibrous mass in my foot. I am also developing a bump on my right middle finger on the left side of my first joint. Right now the bump is slight, but I am going to watch it. Are these cysts, masses due to the Pfizer shots? Is this something you are tracking?

Other Meds: Citalipram 1/day Budesinide 1/week Multiple vitamin Vitamin D

Current Illness: None

ID: 1746160
Sex: F
Age: 57
State: MN

Vax Date: 01/31/2021
Onset Date: 09/26/2021
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: Sulfa; Augmentin; Relafen; Codine; banana; mold and dust

Symptom List: Injection site pain

Symptoms: history of seasonal allergies presents clinic today with acute onset of sore throat, an increased sinus congestion in the last 2-3 days, starting on 9/26/21

Other Meds: Adderall; Aleve; Benadryl; Cymbalta; Botox; Hydroxyzine; Zomig; Lorazepam; Vitamin D3; Triamcinolone

Current Illness: none

ID: 1746161
Sex: F
Age: 48
State: TN

Vax Date: 07/30/2021
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: None

Allergies: None

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

Symptoms: Patient reports having major insomnia lasting one week, and a restless leg -type syndrome (involuntary movement/spasms) affecting the left calf and toes lasting all day for approximately a week and a half. The patient reports the symptoms appeared around a week to 10 days after after receiving the first dose of the Pfizer vaccine.

Other Meds: Zoloft, Xanax, Percocet, Quetiapine

Current Illness: None

ID: 1746162
Sex: F
Age: 24
State: NM

Vax Date: 08/23/2021
Onset Date: 08/23/2021
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: None, virtual visit with PCP on 9/23/21.

Allergies: Zest soap, Irish spring soap, Neo/Poly/Dex antibiotic eye drops.

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

Symptoms: Dizziness, numbness/tingling in both arms and hands for 1 week after injection, severe changes in vision (blurriness/sensitivity to light) for 1 week after injection, extreme muscle weakness for about 5 days after injection to the point of visible shaking when trying to stand/walk up stairs at home. Severe fatigue/sedation to the extent of not being able to stay awake to feed self for 4-5 days after injection, pain in L ribs/flank for about 1 week after injection.

Other Meds: Nuvaring, Phentermine HCL 37.5mg, multivitamin.

Current Illness: None

ID: 1746163
Sex: F
Age: 23
State: MO

Vax Date: 05/18/2021
Onset Date: 06/10/2021
Rec V Date: 09/29/2021
Hospital:

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

Lab Data: Bloodwork was done on July 29th checking if the hives could be related to something like thyroid disease but everything came up clean.

Allergies: None

Symptom List: Tremor

Symptoms: Chronic spontaneous hives, was given antihistamines and Prednisone which only helps relieve the problem not solve it. I now experience angioedema in my hands and feet. The chronic spontaneous hives get worse with my menstrual cycle. The immunologist told me this may be due to the vaccine.

Other Meds: None

Current Illness: None

ID: 1746164
Sex: M
Age: 56
State: MA

Vax Date: 09/22/2021
Onset Date: 09/23/2021
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: Penicillin

Symptom List: Erythema, Pruritus

Symptoms: Chills that have lasted for 1 week- still happening Numb fingers on left hand- happened immediately and lasted 4 days Numb left calf and heel- happened 16 hours after vaccine dose and still numb 1 week later

Other Meds: Lisinipril 10mg 1X per day Multivitamin

Current Illness: None

ID: 1746165
Sex: F
Age: 40
State: MN

Vax Date: 09/20/2021
Onset Date: 09/27/2021
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: PENICILLIN ALLERGY - STATES REACTION SIMILAR TO THIS - BODY ALL FEELS ITCHY

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

Symptoms: THE PATIENT CALLED A WEEK AFTER VACCINATION EXPLAINING SHE HAD EXTREME ITCHINESS OVER HER ENTIRE BODY. SHE PRESENTED TO THE PHARMACY AND WAS VISIBLY RED, BUT NOT SWOLLEN

Other Meds:

Current Illness:

ID: 1746166
Sex: F
Age: 41
State: NY

Vax Date: 09/25/2021
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: N/A

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

Symptoms: 1st shot: Sore arm for 5 days and discoloration in skin at the injection area 2nd shot: Within 12 hours experienced chills, muscle aches and pains, restless legs, stiffness in joint, sore arm, headaches, nausea, loss of appetite, abdominal discomfort. Lasted for 2 days

Other Meds: None

Current Illness: None

ID: 1746167
Sex: M
Age: 62
State: CA

Vax Date: 09/23/2021
Onset Date: 09/23/2021
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: the vaccine was entered as flublok but gave fluzone hd. RPH error

Other Meds:

Current Illness:

ID: 1746168
Sex: F
Age: 36
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: 011J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Ibuprofen, shellfish, corn starch, eggs

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

Symptoms: Per patient: Developed rash; throat/tongue felt swollen. Patient said it took couple of hours for the reactions to calm down. Patient did not seek any medical treatment because the reactions went away.

Other Meds:

Current Illness:

ID: 1746169
Sex: F
Age: 48
State: CA

Vax Date: 08/27/2021
Onset Date: 08/28/2021
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: referral to neurologist-basic labs-

Allergies: Penicillin; Erythromycin; Tetracycline; Iodine (CT dye);

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

Symptoms: The next day woke up with rash at site of injection; one week later developed tremor- right arm; pill rolling motion; stops with intention

Other Meds: Imuran 15 mg bid; Advair; Proair; Omeprazole; Carafate; Singulair; Claritin; Topiramate

Current Illness: No

ID: 1746170
Sex: M
Age: 48
State: TN

Vax Date: 08/05/2021
Onset Date: 08/15/2021
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: CTA 8/15 reveled acute thrombotic stroke to right internal carotid. CT 8/18 reveled worsening cerebral edema. CT of chest for PE 8/20 Multiple labs and ct scans

Allergies: none

Symptom List: Pain in extremity

Symptoms: Pt sustained an acute stroke on 8/15, developed blood clot in right internal carotid. Thrombectomy was performed, irregular intraluminal thrombus along the anterior aspect of the proximal descending thoracic aorta was noted at time of intervention. 8/20 pt developed acute respiratory failure and tachycardia. CT of chest revealed acute bilateral pulmonary embolism. lower extremity venous doppler revealed acute bilateral DVT's. also upper extremity DVT as well. Pt developed pneumonia and cerebral edema post CVA. oncology consult concluded pt had developed VITT vaccine induced thrombotic thrombocytopenia. IVIG was administered twice with patient improvement. platelets at lowest point were at 32. patient has dense Left hemiparesis since 8/15 and requires extensive PT,OT and speech therapy. pt discharged to acute care rehab facility 8/31 and was then transferred to a skilled nursing facility on 9/28 for further rehabilitation. pt currently still has left hemiparesis.

Other Meds: none

Current Illness: none

ID: 1746171
Sex: M
Age: 57
State: WA

Vax Date: 01/26/2021
Onset Date: 01/30/2021
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: Improved with Medrol dosepack. Symptoms returned again in August 2021 and patient was treated with Prednisone in Sept 2021. MRI of C-spine on Sept 01, 2021 showed no signficant change compared to previous MRI done in July 2018.

Allergies: Penicillin. PPD for tuberculosis tests.

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

Symptoms: Flare up of Parsonage-Turner syndrome symptoms. Numbness, parasthesias and weakness in left arm and hand.

Other Meds: Atorvastatin 10 mg per day. Testosterone cypionate injections 200 mg every 2 weeks.

Current Illness: High Cholesterol. Low testosterone. Osteopenia. History of Parsonage-Turner syndrome

ID: 1746172
Sex: M
Age: 66
State: OH

Vax Date: 03/16/2021
Onset Date: 09/27/2021
Rec V Date: 09/29/2021
Hospital: Y

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

Lab Data: Covid positive 9/28/21

Allergies:

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

Symptoms: breakthrough covid - hypoxia requiring oxygen

Other Meds:

Current Illness:

ID: 1746174
Sex: F
Age: 27
State: OK

Vax Date: 09/19/2021
Onset Date: 09/20/2021
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: K-flex

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

Symptoms: I started having miscarriage symptoms 10 hours after the second shot. And miscarried fully the next day.

Other Meds:

Current Illness: No

ID: 1746175
Sex: M
Age: 57
State: CA

Vax Date: 09/25/2021
Onset Date: 09/25/2021
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: At Wellness Event, patient did not have a card with him or have a picture of the vaccine card and he said that he wanted a pfizer booster and double and triple check with him and he said he got the pfizer vaccine. Gave the patient the pfizer booster based on eligibility and pt came back 10 minutes later saying he remembered that he got moderna and not pfizer. Apologized to the patient and told him that he got pfizer and that it should not be any problems and if he would like to let his doctor know about what happened he can. The patient was fine he was not worry.

Other Meds:

Current Illness:

ID: 1746176
Sex: M
Age: 56
State: OH

Vax Date: 02/02/2021
Onset Date: 02/06/2021
Rec V Date: 09/29/2021
Hospital:

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

Lab Data: EMG pending

Allergies: Levofloxacin

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Simultaneous severe bilateral ulnar neuropathy, bilateral hand numbness

Other Meds: Tamsulosin, Pantoprazole

Current Illness:

ID: 1746177
Sex: M
Age: 74
State: MN

Vax Date: 02/11/2021
Onset Date: 09/26/2021
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: RA

Lab Data:

Allergies: procardia

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

Symptoms: congestion and cough that has been present for the past 4 days. Cough is wet and sometimes productive. Started feeling short of breath with exertion and felt like he was wheezing at times with exertion. No SOB at rest. No chest pain or tightness. Attended wedding over the weekend

Other Meds: Aspirin; Amlodipine; HCTZ; Losartan; Simvastatin; Tamsulosin; Sildenafil; Finasteride

Current Illness: none

ID: 1746178
Sex: M
Age: 49
State: TN

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

Lab Data: BP 120/70, O2 SAT 100%, PULSE 90

Allergies: NONE

Symptom List: Injection site swelling, Limb discomfort

Symptoms: APPROX 5 MINUTES AFTER RECEIVING 2ND PFIZER (COVID VACCINE) DOSE, PATIENT GOT VERY NAUSEATED, BROKE OUT INTO A SWEAT, AND FELT DIZZY. I CHECKED PATIENTS BLOOD PRESSURE WHICH WAS NORMAL. I PLACED 2 ICE PACKS ON PATIENTS NECK AND FOREHEAD. PT REQUESTED COLD WATER TO DRINK. AFTER ABOUT 15 MINUTES, PT GOT OVER THIS REACTION AND ALL VITAL SIGNS WERE NORMAL..PT LEFT--PT REFUSED ANY EXTRA CARE

Other Meds: NONE

Current Illness: NONE

ID: 1746179
Sex: M
Age: 19
State: MI

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: RA

Lab Data: BP 97/80.

Allergies: None

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

Symptoms: Patient came up to the counter several minutes after receiving his vaccination and stated he was not feeling well. His face was ashen. I sat down with the patient and asked if he had vomitted. He said No, then stated he was not sure as he thinks he lost consciousness for a minute. He denied any shortness of breath, wheezing, or feelings of numbness or enlargement of his lips or tongue. He then stated he felt like he was going to vomit and did. I took his blood pressure and it was 97/80 with a pulse of 80. He said he did not eat lunch today. He said he has vomitted after having blood drawn before but never after receiving a vaccine, he said he had his seasonal flu shot last year. EMS arrived and checked BP and did an EKG. EKG was normal. Patient did not go with EMS.

Other Meds: None reported

Current Illness: None

ID: 1746180
Sex: M
Age: 73
State: SD

Vax Date: 08/06/2021
Onset Date: 08/11/2021
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: Patient developed bloody stools on the evening of August 11. After several bloody stools pt presented to the ER and was admitted for GI bleed. He underwent serial blood work testing and was treated with several blood transfusions for his anemia. He had 2 colonoscopies, and upper endoscopy and the pill swallow test. None of these test showed the source of his GI bleed. He continued to bleed but lessened over several days. He was discharged after 6 nights in the hospital, 3 of which in the ICU. He was monitered after his dismissal with CBC and his Hgb slowly went up to normal over several weeks time. Pt was advised to have a longer colonoscopy to reach sections of the small bowel and large intestine that their scopes couldn't reach. That is only done as larger facilities. Since pt hasn't had a rebleed since his discharge he hasn't scheduled this test as of yet.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am