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: 1750378
Sex: F
Age: 27
State: MN

Vax Date: 09/29/2021
Onset Date: 09/29/2021
Rec V Date: 09/30/2021
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: None

Symptom List: Dysphagia, Epiglottitis

Symptoms: Fever reaching 103.6 despite antipyretics. Sun opal episode at home 24 hours after injection.

Other Meds: Nuvaring

Current Illness: None

ID: 1750379
Sex: F
Age: 39
State: AZ

Vax Date: 09/21/2021
Onset Date: 09/21/2021
Rec V Date: 09/30/2021
Hospital:

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

Lab Data: none. My dr doenst see the correlation. Here is the my message to my dr and the message I got back: Me: Hello. I had my first covid shot Tuesday. Had a few side effects that went away by the next day. However, my arms and legs still are going numb if I sit or even lay in my bed for 30 min or longer. How long is this supposed to last? Response: Hi, the following is Dr. response ; " Any side effects from COVID vaccine last only 2-3 days at most, usually 1 day. "

Allergies: bactrim

Symptom List: Anxiety, Dyspnoea

Symptoms: Upon receiving the injection my biceps started to tighten. By morning my right side of my whole arm and legs started to go numb when I sat down. When I would change sitting positions my left arm and leg would tingle then go numb. I contacted my drs to be told this was normal and would go away with time. It has been a 8 days and my arms and legs still go numb. I cant sit with my legs crossed as they go numb. Even driving for to long my right arm and leg go numb.

Other Meds:

Current Illness: slow transit, iron deficiency, anxiety, depression

ID: 1750380
Sex: F
Age: 47
State: TX

Vax Date: 09/30/2021
Onset Date: 09/30/2021
Rec V Date: 09/30/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: N/A

Allergies: None

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

Symptoms: Flushed, heart racing, pressure on arm, anxiety. EMS attended and cleared patient.

Other Meds: Vitamins

Current Illness: None

ID: 1750381
Sex: F
Age: 71
State: MA

Vax Date: 09/23/2021
Onset Date: 09/24/2021
Rec V Date: 09/30/2021
Hospital:

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

Lab Data: Unknown

Allergies: Amoxil and Azthromycin

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Patient called and stated she had weakness, nausea, swollen neck and jaw area, chest pressure and tightness with shortness of breath on the Friday evening post administration and finally left leg pain that radiates from hip area to knee on Tuesday post adminstration. She has informed her primary care doctor of side effects as well as our pharmacy.

Other Meds: Unknown

Current Illness: Unknown

ID: 1750382
Sex: F
Age: 45
State: LA

Vax Date: 09/21/2021
Onset Date: 09/28/2021
Rec V Date: 09/30/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: Bell's palsy

Other Meds: none

Current Illness: none

ID: 1750383
Sex: F
Age: 50
State: TX

Vax Date: 09/11/2021
Onset Date: 09/12/2021
Rec V Date: 09/30/2021
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: Labs cameback normal except for colesterol, (9/16/2021)Blood work.

Allergies: Morphine, Statin's, Tramadol

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

Symptoms: Tinnitus and swelling the size of tennis ball. Swelling lasted for 4day and Tinnitus is ongoing. Tiredness, drowsy and is ongoing. Benedryl, Tylenol, B-12 injection once a month. Helped about a week but still tired. 75lbs. lost since April(Gastric Sleeve) and cholesterol was down but after the 3rd shot jumped 75points.

Other Meds: Bariatric Fusion multivitamin capsules, Protonix, Tylenol

Current Illness: None

ID: 1750384
Sex: F
Age: 46
State: CA

Vax Date: 09/27/2021
Onset Date: 09/28/2021
Rec V Date: 09/30/2021
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: walnuts

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Swelling under arm pit .

Other Meds: atenolol 100 mg one a day women's vitamin

Current Illness:

ID: 1750385
Sex: M
Age: 50
State:

Vax Date: 09/30/2021
Onset Date: 09/30/2021
Rec V Date: 09/30/2021
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: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1750386
Sex: F
Age: 15
State: WA

Vax Date: 09/30/2021
Onset Date: 09/30/2021
Rec V Date: 09/30/2021
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: Vaccine was administered when patient is 15 years-old. No adverse event has been reported by the patient.

Other Meds:

Current Illness:

ID: 1750387
Sex: M
Age: 21
State: IN

Vax Date: 09/27/2021
Onset Date: 09/27/2021
Rec V Date: 09/30/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: none were done

Allergies: sulfa drugs

Symptom List: Diarrhoea, Nasal congestion

Symptoms: nausea, vomiting, chills, body aches

Other Meds: prozac, multivitamin

Current Illness: none

ID: 1750388
Sex: F
Age: 36
State: WI

Vax Date: 09/29/2021
Onset Date: 09/29/2021
Rec V Date: 09/30/2021
Hospital:

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

Lab Data:

Allergies: Sunflower Seeds

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

Symptoms: Patient obtained influenza vaccine from outpatient pharmacy. Approximately 4 hours after vaccination, patient developed a red, bumpy rash down both arms. After 24 hours of vaccination, rash extended to trunk of body. Patient took 1 dose of diphenhydramine 25 mg when she initially noticed the rash on the arms. Patient has never experienced an allergic reaction to the influenza vaccine in the past.

Other Meds: Levothyroxine

Current Illness:

ID: 1750389
Sex: M
Age: 40
State: TX

Vax Date: 09/30/2021
Onset Date: 09/30/2021
Rec V Date: 09/30/2021
Hospital:

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

Lab Data: N/A

Allergies: None

Symptom List: Rash, Urticaria

Symptoms: Around 1520, and while in observation, client stated feeling dizzy. EMS came to the scene, assesed, and cleared her.

Other Meds: Aspirin, Omega-3, HBP Rx, and Meclizine

Current Illness: High Blood Pressure

ID: 1750390
Sex: M
Age: 60
State: PA

Vax Date: 04/26/2021
Onset Date: 05/01/2021
Rec V Date: 09/30/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: Pain in thumbs and thumb joints. Loss of grip strength. Pain in ankle.

Other Meds: Levoxyl Fish oil Multi vitamin

Current Illness: None

ID: 1750391
Sex: M
Age: 63
State:

Vax Date: 09/30/2021
Onset Date: 09/30/2021
Rec V Date: 09/30/2021
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:

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

Symptoms: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1750392
Sex: F
Age: 36
State: IL

Vax Date: 09/22/2021
Onset Date: 09/30/2021
Rec V Date: 09/30/2021
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: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: Shingles rash started 8 days after vaccination.

Other Meds:

Current Illness:

ID: 1750393
Sex: F
Age: 34
State: RI

Vax Date: 09/29/2021
Onset Date: 09/29/2021
Rec V Date: 09/30/2021
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: unknown

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

Symptoms: This patient arrived at the vaccination clinic requesting the Janssen vaccine but mistakenly was administered Pfizer.

Other Meds: unknown

Current Illness: unknown

ID: 1750394
Sex: F
Age: 14
State: NH

Vax Date: 06/15/2021
Onset Date: 07/14/2021
Rec V Date: 09/30/2021
Hospital:

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

Lab Data: multiple sets of labs - normal CBC, CMP, TFTs, D Dimer, EKG (tachycardia), brain MRI

Allergies: Bactrim - rash since then has developed Nut allergy

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

Symptoms: onset of dizziness, tachycardia, and neurologic symptoms that started about 4 weeks after 2nd COVID vaccine. Now seen at Hospital for presumed POTS.

Other Meds:

Current Illness:

ID: 1750396
Sex: M
Age: 28
State: CA

Vax Date: 09/30/2021
Onset Date: 09/30/2021
Rec V Date: 09/30/2021
Hospital:

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

Lab Data: 1525 Ambulance transported patient to ER

Allergies: NKDA

Symptom List: Ear pain, Hypoaesthesia

Symptoms: 1505 Patient complaint of dizziness, shortness of breath, and throat tightness after receiving pfizer vaccination. blood pressure taken 78/49 heart rate 56 1510 Benadryl 50 mg IV given times one. 1515 throat tightness, shortness of breath and dizziness still continues. Epipen 0.3 mg given times one in the left lateral thigh. blood pressure 71/38 heart rate 72. Placed patient in a trendelenburg position. 1515called 911 1517 blood pressure retaken 132/79 heart rate 73

Other Meds: Bently 20 mg oral tab Zofran 4 mg tablet

Current Illness: NONE

ID: 1750397
Sex: M
Age: 58
State: AK

Vax Date: 09/02/2021
Onset Date: 09/02/2021
Rec V Date: 09/30/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: first 2-3 days had pain in shoulder, neck, armpit.

Other Meds:

Current Illness:

ID: 1750398
Sex: M
Age: 48
State:

Vax Date: 09/30/2021
Onset Date: 09/30/2021
Rec V Date: 09/30/2021
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: 1750399
Sex: F
Age: 55
State: FL

Vax Date: 09/28/2021
Onset Date: 09/28/2021
Rec V Date: 09/30/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None known

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

Symptoms: Fever, headache, body aches, swollen arm with fever of 101.5, and neck starting to hurt. Presented to ER. Was presented with a Prednisone prescription.

Other Meds: Tylenol/Ibuprofen

Current Illness: None known

ID: 1750400
Sex: F
Age:
State: CA

Vax Date: 03/30/2021
Onset Date: 03/30/2021
Rec V Date: 09/30/2021
Hospital:

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

Lab Data: Covid test- 09/11/2021 positive

Allergies: None

Symptom List: Unevaluable event

Symptoms: Less than 12 hours after getting the vaccine I had fatigue, muscle pain, fever, chills, and headache. They lasted for about 12 hours. I had lingering effects but they were mild. Then I was diagnosed with Covid on 09/11/2021. They did not give me any medications or do any medical tests. We were taking really good care of ourselves but we still got Covid. I still have not recovered my smell and taste. I also developed some stomach issues and brain fog.

Other Meds: Prenatal vitamins

Current Illness: None

ID: 1750401
Sex: F
Age: 62
State: ND

Vax Date: 09/30/2021
Onset Date: 09/30/2021
Rec V Date: 09/30/2021
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: Vaccine administered at 2 weeks rather than 4 weeks, no immediate negative effects noted

Other Meds:

Current Illness:

ID: 1750402
Sex: F
Age: 49
State: MA

Vax Date: 05/04/2021
Onset Date: 05/04/2021
Rec V Date: 09/30/2021
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: peppers, melons, aspirin, sulfa

Symptom List: Injection site pain, Pain

Symptoms: IMMEDIATE major headache following morning extremely swollen & painful lymph nodes under arms, lasted for several (about 4) days

Other Meds: bupropion levothyroxine

Current Illness: none

ID: 1750403
Sex: M
Age: 17
State: TX

Vax Date: 09/30/2021
Onset Date: 09/30/2021
Rec V Date: 09/30/2021
Hospital:

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

Lab Data: N/A

Allergies: None

Symptom List: Injection site pain, Menorrhagia

Symptoms: Tightness in chest, pain in heart. EMS attended and cleared patient.

Other Meds: None

Current Illness: None

ID: 1750404
Sex: M
Age: 45
State:

Vax Date: 09/30/2021
Onset Date: 09/30/2021
Rec V Date: 09/30/2021
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: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1750405
Sex: M
Age: 74
State: WI

Vax Date: 02/09/2021
Onset Date: 08/15/2021
Rec V Date: 09/30/2021
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: no tests or lab results

Allergies: statins, glutten

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: I developed a rash and pimples over arms legs chest and neck eventually it has mostly disappeared but many small hard pimples remain some of which can be scraped off by hand, initially very itchy, When it started it was a lot of blisters rather than pimples and over the fist month changed into a rash and pimples. Vsafe stated that I should report it to vaers. From the very beginning after receiving the first dose the I had sometimes severe fatigue and leg fatigue. This still continues. Doctors comments below along with the treatment received to date.Dr reviewed your message and pictures. She wants you to take cetirizine (Zyrtec) 1-2 times daily. This is an over the counter non-drowsy, allergy medication that can be found at your pharmacy. She also ordered a Medrol dose pack. This is an oral steroid medication. You will want to follow the instructions on the package for dosing instructions. I am sending this to the pharmacy. Let us know if things don't clear up with treatment or if you have any questions. It is not a poisonous reaction an might be erythema multiforme which might be a reaction to either the poisonous plants infection you mentioned or to the vaccine. Not much is known about how this reaction occurs. It is not a common reaction and further investigation would be needed to determine if in fact it is related to the vaccine. It is not contagious.

Other Meds: propranolol, prilosec, exemitibe, one a day, allergy relief,

Current Illness: none

ID: 1750406
Sex: F
Age: 60
State: CA

Vax Date: 08/20/2021
Onset Date: 09/22/2021
Rec V Date: 09/30/2021
Hospital:

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

Lab Data:

Allergies: Sulfa drugs and plaquenil

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Reported face swelling of L side of face on 9/22/21, 9 days after receiving second dose.

Other Meds: Micophenolate 1500 mg bid Gabapentin 800 mg hs Sertraline 100 mg daily Dexamethasone 50 mcg daily

Current Illness: UTI began 8/24/2021

ID: 1750407
Sex: M
Age: 32
State: CA

Vax Date: 09/29/2021
Onset Date: 09/29/2021
Rec V Date: 09/30/2021
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: Suboptimal dose given < 0.5cc. Error due to incorrect dosing when drawing up. Unclear if pt got a full dose. In concern and in an abundance of caution, advise will need to revaccinate, explain at lengths that he is not fully vaccinated and VE may be less and he would be at risk. Discussed options at length along with risk and consequences. Pt questions answered, will decide after to get re-vaccinated. No concerning sx when discussed on phone. Only sx is having flu like sx.

Other Meds:

Current Illness:

ID: 1750408
Sex: F
Age: 64
State: MO

Vax Date: 08/19/2021
Onset Date: 08/24/2021
Rec V Date: 09/30/2021
Hospital:

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

Lab Data: 8/28/2021- X-ray R ankle: bimalleolar right ankle swelling without acute fracture 8/31/2021: ESR:33mm/hr, range 1-30mm/hr ?. : CRP: 33.7mg/L, range <= 10.0

Allergies: Topical benzoin

Symptom List: Nausea

Symptoms: 5 days after covid vaccine, my R ankle became red, hot, swollen and painful to walk on. Saw PCP 2days later who referred me to ortho who thought it was some type of inflammatory condition. Told me to wear brace or boot- could not tolerate either due to pain, edema. Ankle got worse- could not walk on it at all and I became febrile. Ortho told me to go to ER to R/O a blood clot or septic arthritis.

Other Meds: Xarelto 20 mg, atenolol 25 mg, ceterizine, 25 mg tramadol, multivitamin- all daily

Current Illness: After 3rd covid vaccine, I had a fever, chills, headache, muscle aches, fatigue, some nausea- really felt awful for 4-5 days. Adverse event began right after this.

ID: 1750409
Sex: F
Age: 50
State: CA

Vax Date: 01/13/2021
Onset Date: 07/20/2021
Rec V Date: 09/30/2021
Hospital: Y

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

Lab Data: - EKG and troponin - CBC BMP - COVID test - CXR

Allergies: Unknown

Symptom List: Injection site pain

Symptoms: From our ED: 50-year-old female with sarcoidosis presents with right upper chest wall pain and tenderness since this morning, concern for COVID exposure. Initial vitals show elevated blood pressures. Physical exam is significant for right upper chest wall tenderness. Differentials include costochondritis, muscular strain, pneumonia, URI, COVID, less likely ACS, pneumothorax Per patient report she tested positive for COVID 7/24/21 and was hospitalized for 4 days.

Other Meds: Unknown

Current Illness: Hx of well-controlled DM2 (no insulin) controlled by diet/exercise, and Hx of sarcoidosis

ID: 1750410
Sex: F
Age: 29
State:

Vax Date: 09/30/2021
Onset Date: 09/30/2021
Rec V Date: 09/30/2021
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: Attendee came to get 1st dose of vaccination, and when upon receiving a few minutes shortly, she became diaphoretic, and complained of blurred vision, light headedness, and dizzy. She was then sent to a cot to lay down and she then complained of sharp pain to her shoulders and generalized muscle pain. By the time of discharge at 11:25 she had a slight head ache and some of the ache to her shoulders remained but she stated she was ready to go home and wanted to rest.

Other Meds:

Current Illness:

ID: 1750411
Sex: F
Age: 52
State: TX

Vax Date: 09/28/2021
Onset Date: 09/28/2021
Rec V Date: 09/30/2021
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 as of yet trying home remedies first

Allergies: No

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

Symptoms: Very very achy. Skin hurts all over even to touch and it?s uncomfortable , fatigued on a high level Flu-like symptoms , muscles ache. Eyes ache. Shot site is extremely sore. 3 days so far. I?m taking pain meds and took flu medication to try and sooth the symptoms today , hopefully it?ll help. It got me for sure !

Other Meds: No

Current Illness: No

ID: 1750412
Sex: M
Age: 39
State:

Vax Date: 09/29/2021
Onset Date: 09/29/2021
Rec V Date: 09/30/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Tremor

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

Other Meds:

Current Illness:

ID: 1750413
Sex: F
Age: 29
State:

Vax Date: 09/30/2021
Onset Date: 09/30/2021
Rec V Date: 09/30/2021
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: Erythema, Pruritus

Symptoms: Attendee came to get 1st dose of vaccination, and when upon receiving a few minutes shortly, she became diaphoretic, and complained of blurred vision, light headedness, and dizzy. She was then sent to a cot to lay down and she then complained of sharp pain to her shoulders and generalized muscle pain. By the time of discharge at 11:25 she had a slight head ache and some of the ache to her shoulders remained but she stated she was ready to go home and wanted to rest.

Other Meds:

Current Illness:

ID: 1750414
Sex: F
Age: 68
State: FL

Vax Date: 03/10/2021
Onset Date: 06/24/2021
Rec V Date: 09/30/2021
Hospital: Y

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: MRI's of all blood vessels, heart cath, all kinds of blood work up for heart attack and stroke work up. Nuclear stress test, heart ultrasound, multiple chest xrays, looking for blood clots

Allergies: Ibuprofen

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

Symptoms: Increased heart rate to 150 with blood pressure up to 220, numbness and tingling on left side of body, left side of face have strange feelings and numbness. Pain down my left arm with rapid heart beat mimicking a heart attack. Heaviness in chest with chest pains, problem breathing with surges of pressure starting at my feet and up to my head and my blood pressure raising up to 180 and over.

Other Meds: Vitamin B stress complex

Current Illness: none

ID: 1750415
Sex: F
Age: 31
State: TX

Vax Date: 09/30/2021
Onset Date: 09/30/2021
Rec V Date: 09/30/2021
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: NKDA

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

Symptoms: Pfizer COVID-19 vaccine was administered to patient by pharmacist on 9/30/21. Approximately 10 minutes after the vaccine, pharmacist was alerted by the patient's co-worker that the patient was exhibiting signs of fainting. Pharmacist called emergency services according to standard operating procedures and when patient actually fainted, ammonia inhalant was used to awaken patient. An ice pack was used while emergency services arrived, and patient was released according to EMS suggestion and patient consent to decline hospital transport.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1750416
Sex: F
Age: 58
State: CO

Vax Date: 05/18/2021
Onset Date: 07/09/2021
Rec V Date: 09/30/2021
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: COVID+ s/p 2 doses Pfizer - received monoclonal antibodies for treatment

Other Meds:

Current Illness:

ID: 1750417
Sex: F
Age: 73
State: HI

Vax Date: 09/29/2021
Onset Date: 09/30/2021
Rec V Date: 09/30/2021
Hospital: Y

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

Lab Data: 9/30/21 Hb: 10.8 WBC: 27.8 (10% bands, 82% neutrophils, 3% lymphocytes) Platelet: 95 Na: 138 K: 2.9 Cl: 96 CO2: 21 BUN: 55 AST: 933 ALT: 774 Alk Phos: 232 T-bili: 2.4 Lactate: 6.8

Allergies: None

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

Symptoms: Adverse events: Hypotension, Lactic acidosis, Leukocytosis, Elevated LFTs Symptoms: Weakness, nausea Treatment: Vancomycin, Zosyn, Pressors

Other Meds: Aspirin 81mg PO QD Atorvastatin 80mg PO QD Epoietin 50mcg IV Q4 weeks Furosemide 80mg PO BID Gabapentin 300mg PO BID Sevelamer 1600mg PO TID Nephrovite 1 tab PO QD

Current Illness: COVID infection (Symptom onset 8/27/21)

ID: 1750418
Sex: M
Age: 90
State:

Vax Date: 09/16/2021
Onset Date: 09/16/2021
Rec V Date: 09/30/2021
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: unknown

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

Symptoms: PATIENT PRESENTED TO PHARMACY WITH A PRESCRIPTION FROM ONCOLOGIST FOR 3RD COVID DOSE WITH MODERNA SPECIFIED DESPITE THE PATIENT GETTING PFIZER FOR FIRST 2 DOSES. PT WAS MADE AWARE OF GUIDELINES AND RECOMMENDATIONS AND ALSO DISCUSSED THIS WITH DR. DR CONCLUDED THAT PT WOULD BENEFIT FROM 3 DOSE OF DIFFERENT MANUFACTURER.

Other Meds:

Current Illness: unknown

ID: 1750419
Sex: M
Age: 65
State:

Vax Date: 09/29/2021
Onset Date: 09/29/2021
Rec V Date: 09/30/2021
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: Pain in extremity

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

Other Meds:

Current Illness:

ID: 1750420
Sex: M
Age: 86
State:

Vax Date: 09/15/2021
Onset Date: 09/15/2021
Rec V Date: 09/30/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 2
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: patient came in to request moderna vaccine which was given; however, first two doses administered were pfizer

Other Meds:

Current Illness:

ID: 1750421
Sex: M
Age: 33
State: KS

Vax Date: 08/25/2021
Onset Date: 08/26/2021
Rec V Date: 09/30/2021
Hospital:

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

Lab Data: On Sept 9, checked heart and ran blood test. Test came back normal.

Allergies: None

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

Symptoms: Due to fluttering heart, I had difficulty sleeping between the hours of 1:00 a.m. and 5:00 a.m. on Aug 26 and Augt 27. On morning of Aug. 29 around 11am, I notice numbness in the 4th finger on my right hand. Today, I still have numbness and notice a bit of swelling but no discoloration. In general, my heart pace seemed high and overall fatigue for the initial 2 weeks following the vaccination. So much fatigue, I couldn't properly mow my lawn on Sept. 5. Feeling great fatigue and concerned about my heart on Sept. 5, I schedule an appointment with a community doctor on Sept. 9.

Other Meds: Take Zyrtec occasionally when needed; Flonase daily, and a daily vitamin

Current Illness: None

ID: 1750423
Sex: M
Age: 73
State: WI

Vax Date: 09/27/2021
Onset Date: 09/27/2021
Rec V Date: 09/30/2021
Hospital:

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

Lab Data: N/A - no adverse reactions

Allergies: No allergies

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

Symptoms: No adverse reaction - third dose (full dose of 0.5ml) was administered without proper implications (only risk factor was age above >65).

Other Meds: N/A

Current Illness: Not illnesses

ID: 1750424
Sex: F
Age: 69
State: WI

Vax Date: 08/20/2021
Onset Date: 08/20/2021
Rec V Date: 09/30/2021
Hospital:

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

Lab Data: Blood work; CAT scan; MRI

Allergies: None

Symptom List: Vomiting

Symptoms: Vision issues, hard for my vision to focus correctly, confusion, short term memory problems, headaches, white welts on my thighs.

Other Meds: None

Current Illness: None

ID: 1750425
Sex: M
Age: 55
State:

Vax Date: 09/29/2021
Onset Date: 09/29/2021
Rec V Date: 09/30/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

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

Other Meds:

Current Illness:

ID: 1750426
Sex: F
Age: 39
State: TX

Vax Date: 09/30/2021
Onset Date: 09/30/2021
Rec V Date: 09/30/2021
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: Back pain, Cold sweat, Headache, Nausea, Vomiting

Symptoms: Around 1520, while in observation, client stated feeling dizzy and anxious. EMS attended and cleared client.

Other Meds: None

Current Illness: None

ID: 1750427
Sex: F
Age: 12
State: NJ

Vax Date: 09/24/2021
Onset Date: 09/24/2021
Rec V Date: 09/30/2021
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: NONR

Allergies: NO

Symptom List: Injection site swelling, Limb discomfort

Symptoms: PATIENT WAS INFORMED, SHE HAD FEVER AND CHILLS

Other Meds: NO

Current Illness: NO

ID: 1750428
Sex: F
Age: 77
State:

Vax Date: 09/15/2021
Onset Date: 09/15/2021
Rec V Date: 09/30/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: patient came in to request moderna vaccine which was given; however, first two doses administered were pfizer

Other Meds:

Current Illness:

ID: 1750429
Sex: M
Age: 68
State:

Vax Date: 09/29/2021
Onset Date: 09/29/2021
Rec V Date: 09/30/2021
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:

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

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

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am