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: 1754959
Sex: F
Age: 31
State: FL

Vax Date: 04/16/2021
Onset Date: 05/01/2021
Rec V Date: 10/01/2021
Hospital: Y

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

Lab Data: CT heart with contrast : There appears to be a focus of loculated pericardial fluid between the left atrium and central right main pulmonary artery measuring approximately 3.4 x 1.9 x 1.0 cm (on image 20 series 8), which demonstrates an internal attenuation of approximately 10 Hounsfield units on pre and postcontrast images. Partial visualization of soft tissue attenuation within the upper anterior mediastinum likely representing residual thymus. There are mild patchy airspace opacities identified within the partially visualized left lower lobe, which may be concerning for an acute inflammatory or atypical infectious process. MRI BRAIN WO CONTRAST 5/1/2021 7:33 PM Indication: Seizure, nontraumatic (Age 18-40y) Technique: Multiplanar multisequence MR imaging of the brain was performed without intravenous gadolinium contrast. Comparison: 5/1/2021 Findings: There is a focus of abnormal signal in the splenium of the corpus callosum which demonstrates increased diffusion trace and decreased ADC map signal suggestive of an acute infarct this is subtly visible on the FLAIR signal sequences. No other areas of acute ischemia are identified no other areas of abnormal FLAIR signal are seen. The pituitary gland is not enlarged. There is no Chiari malformation seen. Vertebrobasilar carotid siphon flow voids are present. The optic apparatus appears unremarkable. No midline shift or mass effect is seen. No gross hemorrhage or hematoma is seen. The mesial temporal lobes appear normal. Hemosiderin sensitive sequences do not demonstrate evidence of hemosiderin deposition to suggest blood products. There is likely a small mucosal retention cyst or polyp in the posterior right ethmoid or right sphenoid sinus.

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Seizures, stroke, blood clot. now on blood thinner and anti seizure

Other Meds: Bupropion, Doxepin

Current Illness:

ID: 1754960
Sex: F
Age: 65
State: CA

Vax Date: 08/01/2021
Onset Date: 09/01/2021
Rec V Date: 10/01/2021
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

Allergies: Sulfa, Macrodantin, Red Delicious Apple Skin, Latex

Symptom List: Anxiety, Dyspnoea

Symptoms: Vibrating inside body

Other Meds: Pepcid, Atenolol, Amitriptyline, Flavoxate, Flector Patch, Ambien, Naltrexone, Neurontin, Clonidine, Forteo Inj, Norvasc, Ketamine, Linzess, Estrogen Cream, Progesterone Cream, Vit. D-3, Calcium, Tylenol.

Current Illness: None

ID: 1754961
Sex: M
Age: 1
State: OR

Vax Date: 09/30/2021
Onset Date: 10/01/2021
Rec V Date: 10/01/2021
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: 1 day after vaccine mild redness at vaccination site. Over the course of the day increasing redness, swelling, firmness to the touch and overlying warmth at the vaccination site (presented 30 hours after vaccination). No evidence of cellulitis given presentation close to administration timing - likely adverse reaction. Recommended ibuprofen or tylenol and ice. Will have triage RN f/u with parent tomorrow to evaluate improvement or progression. If symptoms progressing will consider antibiotic therapy for potential celllulitic reaction.

Other Meds: N/A

Current Illness: None

ID: 1754962
Sex: F
Age: 1
State: CA

Vax Date: 09/27/2021
Onset Date: 09/27/2021
Rec V Date: 10/01/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Flu vaccine was supposed to be given. MA did not verify vaccine, lot number, or patient prior to administration. No adverse effects were reported by parents. Parents were notified after the event and followed up 3 days after. Patient well and had no adverse side effects.

Other Meds: none

Current Illness: none

ID: 1754963
Sex: F
Age: 34
State: NC

Vax Date: 09/01/2021
Onset Date: 09/01/2021
Rec V Date: 10/01/2021
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: I was supposed to start my period 3 days after receiving the vaccine and have yet to have a period since.

Other Meds: none

Current Illness: none

ID: 1754965
Sex: M
Age: 40
State: AZ

Vax Date: 09/23/2021
Onset Date: 09/28/2021
Rec V Date: 10/01/2021
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: None

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

Symptoms: Five days after injection I began to have a severe headache. Six days after was a severe headache and backache with lots of fatigue. It appears to be a delayed adverse reaction. No fever though. Just bad headache, backache and fatigue. Negative for COVID twice. Is the delayed, adverse reaction normal?

Other Meds: Clomiphene citrate 25mg

Current Illness: None

ID: 1754966
Sex: F
Age: 63
State: TX

Vax Date: 09/08/2021
Onset Date: 09/09/2021
Rec V Date: 10/01/2021
Hospital:

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

Lab Data: Took rapid COVID test---negative.

Allergies: none

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Chills, fever, and headache. This lasted 2 days. Ten days later, fever and headache returned for one day. Took rapid COVID test---negative.

Other Meds: Effexor 75 mg daily Vitamin C, and Zinc

Current Illness: none

ID: 1754967
Sex: M
Age: 40
State: ID

Vax Date: 09/30/2021
Onset Date: 09/30/2021
Rec V Date: 10/01/2021
Hospital:

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

Lab Data: Original rash classified as a heat rash.

Allergies: None known

Symptom List: Pharyngeal swelling

Symptoms: Muscular pain along spine from bottom of shoulder to the neck. On going. Severe, spreading rash along back, moving to left side and up along the right shoulder

Other Meds: Hydrocodone prescribed but not taken that day. Ibuprofen prescribed but not taken that day. Zofran prescribed but not taken that day.

Current Illness: COVID 19 23 August 2021

ID: 1754968
Sex: F
Age: 24
State: TX

Vax Date: 10/01/2021
Onset Date: 10/01/2021
Rec V Date: 10/01/2021
Hospital:

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

Lab Data:

Allergies: bactrim

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Patient had rash, dizziness, loss of sensation, nausea, and difficulty breathing. Patient was given 50mg of benadryl and was administered 0.3mg of epinephrine. EMS was called and she was taken to local hospital for treatment.

Other Meds: none

Current Illness: none

ID: 1755107
Sex: F
Age: 75
State: AZ

Vax Date: 10/01/2021
Onset Date: 10/01/2021
Rec V Date: 10/01/2021
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: No known allergies

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Patient reported for second dose of Moderna vaccine. Pfizer was administered by mistake. No adverse events reported by patient to date.

Other Meds: ATORVASTATIN; LISINOPRIL

Current Illness: No known illnesses

ID: 1755108
Sex: F
Age: 59
State: WA

Vax Date: 07/31/2021
Onset Date: 08/01/2021
Rec V Date: 10/01/2021
Hospital:

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

Lab Data: Why put out more money for more ineffective junk, it is covered up and no responsibility anyway?

Allergies: toxins, MRI contrast, ?

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

Symptoms: extreme headache very different than regular headaches, shooting stabbing pains up the back of my head that made my head feel like it was going to explode. I still get the pain up back of head and it will feel like I have been hit with a hammer. The other thing is my legs seize up. I am avid walker (yes there are other things you can do for prevention and exercise is one never mentioned) and now limited because they cramp or seize up at unpredictable times.

Other Meds: antidepressants

Current Illness: none

ID: 1755109
Sex: F
Age: 51
State: CA

Vax Date: 10/01/2021
Onset Date: 10/01/2021
Rec V Date: 10/01/2021
Hospital:

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

Lab Data: None

Allergies: None

Symptom List: Rash, Urticaria

Symptoms: Strange taste, tingling and numbness in face, throat and tongue. Sore throat and chest congestion. All within 15 minutes of the shot. This happened on both the first and second shot. Severe headache with the first moderna vaccine.

Other Meds: Efexxor XL 150mg, wellbutrin 150mg, vitamin D3, omezeprole 20 mg, Zyrtec 10 mg, cinnamon

Current Illness: None

ID: 1755110
Sex: F
Age: 72
State: HI

Vax Date: 09/29/2021
Onset Date: 09/29/2021
Rec V Date: 10/01/2021
Hospital:

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

Lab Data:

Allergies: BEE VENOM

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

Symptoms: patient with rash/welts and urticaria over entire body, esp torso. administered own epipen and benadryl. no respiratory sx. Zyrtec daily x 1 wk.

Other Meds:

Current Illness:

ID: 1755111
Sex: M
Age: 72
State:

Vax Date: 09/30/2021
Onset Date: 09/30/2021
Rec V Date: 10/01/2021
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: 1755112
Sex: M
Age: 41
State:

Vax Date: 09/30/2021
Onset Date: 09/30/2021
Rec V Date: 10/01/2021
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: Administration error mixed series mRNA vaccine Pfizer and Moderna.

Other Meds:

Current Illness:

ID: 1755113
Sex: M
Age: 92
State:

Vax Date: 09/30/2021
Onset Date: 09/30/2021
Rec V Date: 10/01/2021
Hospital:

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

Lab Data:

Allergies:

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

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

Other Meds:

Current Illness:

ID: 1755114
Sex: M
Age: 12
State: IL

Vax Date: 08/11/2021
Onset Date: 09/23/2021
Rec V Date: 10/01/2021
Hospital:

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

Lab Data: 9/23/2021: testicular ultrasound, urinalysis

Allergies: Tree nuts and peanuts

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

Symptoms: On September 23, 2021, patient developed progressive right testicular pain that resulted in a visit to the emergency department. Urgent ultrasound was performed which did not show testicular torsion. Diagnosis was felt to be epididymitis. Treatment was ibuprofen. Follow-up with urologist was completed.

Other Meds: Miralax; loratadine as needed

Current Illness: None.

ID: 1755115
Sex: F
Age: 45
State: TX

Vax Date: 09/27/2021
Onset Date: 09/27/2021
Rec V Date: 10/01/2021
Hospital:

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

Lab Data: N/A

Allergies: NKDA,

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Patient requested the Pfizer vaccine but due to a misunderstanding, received a flu shot. She was also given a Covid vaccine after discovered the mistake.

Other Meds: Protonix, trazodone, sucralfate, methocarbamole

Current Illness: Unknown.

ID: 1755116
Sex: M
Age: 65
State:

Vax Date: 09/30/2021
Onset Date: 09/30/2021
Rec V Date: 10/01/2021
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: Administration error mixed series mRNA vaccine Pfizer and Moderna.

Other Meds:

Current Illness:

ID: 1755117
Sex: F
Age: 35
State: CA

Vax Date: 09/30/2021
Onset Date: 09/30/2021
Rec V Date: 10/01/2021
Hospital:

Vax Type: RV1
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: ROTAVIRUS (ROTARIX)
Lot:
Dose Series: 1
Vax Route: PO
Vax Site: MO

Lab Data:

Allergies: Rosephin (antibiotic)

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

Symptoms: Sore and swollen bump on injection site (left arm) around 7:15 pm, Tylenol extra strength 1 pill at 500 mg at 10 pm, 7:30 am this morning, & again at 1 pm. Low grade chills and fever at 4 pm, plan on taking Tylenol extra strength 1 pill at 500 mg at 8 pm 10/01/2021.

Other Meds: Losarton 12.5 mg, Claritin 10 mg

Current Illness:

ID: 1755118
Sex: F
Age: 28
State: FL

Vax Date: 09/30/2021
Onset Date: 10/01/2021
Rec V Date: 10/01/2021
Hospital:

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

Lab Data: None, recommend ER, states this is the worst headache in her life.

Allergies: N/a

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

Symptoms: Headaches, fever, body aches, declined covid test, and states it is reaction to the vaccine.

Other Meds: N/a

Current Illness: N/a

ID: 1755119
Sex: F
Age: 66
State: CO

Vax Date: 10/01/2021
Onset Date: 10/01/2021
Rec V Date: 10/01/2021
Hospital:

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

Lab Data: unknown

Allergies: erythromycin

Symptom List: Unevaluable event

Symptoms: patient reported abdominal pain after receiving shingrix

Other Meds: Imitrex 50, Topamax 50 mg

Current Illness: unknown

ID: 1755120
Sex: M
Age: 30
State: CA

Vax Date: 10/01/2021
Onset Date: 10/01/2021
Rec V Date: 10/01/2021
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: BP 112/70.

Allergies: trees, pollen, grass

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

Symptoms: Patient received his first dose of Moderna vaccine and was sitting down during the 15 minute post vaccine observation when he fell off the chair and fainted. Patient was unconscious for less than a minute. Once he recovered patient denied having any medical conditions or previous episodes of fainting after vaccines. Patient's blood pressure was taken (112/70) and 911 was called. Patient was transported to the hospital for further assessment by the first responders at around 5pm.

Other Meds: None

Current Illness: None

ID: 1755121
Sex: F
Age: 35
State: OK

Vax Date: 09/30/2021
Onset Date: 10/01/2021
Rec V Date: 10/01/2021
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: Levaquin

Symptom List: Injection site pain, Pain

Symptoms: Significant swelling and pain at the injection site.

Other Meds: Humira, Tirosint, alprazolam, pantoprazole, buproprion, leucovorin calcium, oxycodone, gabapentin, methocarbamol, potassium, montelukast, fludrocortisone, metoprolol, hydroxyzine, prednisone, topiramate, estrogen

Current Illness: none

ID: 1755122
Sex: F
Age: 53
State:

Vax Date: 09/28/2021
Onset Date: 09/29/2021
Rec V Date: 10/01/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: 09/28/2021, 2:30 PM, vaccines given, observed for the required amount of time in clinic, no adverse event. 09/29/2021, Patient called to report eyes swelling when she woke up, no other signs or symptoms or swelling any where else. Patient was advised to take an antihistamine and call 911 or go to nearest Emergency Department for observation and further management. 09/30/2021 Patient report took an antihistamine and all symptoms resolved so she did not go. report continued to be symptoms free. refused doctor's visit.

Other Meds:

Current Illness:

ID: 1755123
Sex: F
Age: 62
State: CA

Vax Date: 09/26/2021
Onset Date: 09/30/2021
Rec V Date: 10/01/2021
Hospital:

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

Lab Data: None

Allergies: Doxycycline, mangos, and poison oak

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

Symptoms: A rash started yesterday evening with redness and itching on the left shoulder blade. Resolved later in the evening. This evening my left deltoid became itchy, swollen with a red rash. So far I have not taken any medication for the rash. I did have diarrhea and nausea yesterday morning and again this morning with continued lower abdomen pain. I have not taken any medicine for diarrhea or nausea.

Other Meds: Trazadone, lamictal, vitamin D, calcium, Boniva; Influenza

Current Illness: None

ID: 1755124
Sex: M
Age: 84
State: PA

Vax Date: 09/23/2021
Onset Date: 09/28/2021
Rec V Date: 10/01/2021
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: troponin, covid PCR swab 10/1/21

Allergies: diltiazem, aspirin, amiodarone, ibuprofen, sotalol, pantoprazole

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: NSTEMI; tested positive for covid 10/1/21 (received the vaccine 9/23/21).

Other Meds: elavil, lipitor, coreg, vid D, proscar, neurontin, prevacid, lisinopril, xarelto, multivitamin

Current Illness: none

ID: 1755125
Sex: F
Age: 26
State: CA

Vax Date: 04/02/2021
Onset Date: 04/02/2021
Rec V Date: 10/01/2021
Hospital: Y

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

Lab Data: August 27, 2021 Brain MRI August 27, 2021 Cervical Spine MRI August 27, 2021 Lumbar Spine MRI August 27, 2021 Thoracic Spine MRI September 21, 2021 Upright Brain and Cervical Spine MRI September 20, 2021 Neck CT Angiogram

Allergies: Na

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Symptoms: Head pressure, neck pain, slurred speech, dissociation and body numbness, light headedness, visual changes (snow), cognitive impairment, memory loss. All symptoms lasted for 10 hours and became recurrent episodes until present day.

Other Meds: Midodrine, Acetazolemide, Sodium Chloride

Current Illness:

ID: 1755126
Sex: F
Age: 50
State: KY

Vax Date: 09/28/2021
Onset Date: 09/29/2021
Rec V Date: 10/01/2021
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: Rapid Covid test on 9-29-21 was negative.

Allergies: None

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

Symptoms: Severe weakness, persistent headache, nausea, joint pain, congestion, tiredness lasting almost 3 days.

Other Meds: Wellbutrin, Prilosec, Bentyl

Current Illness: None

ID: 1755127
Sex: F
Age: 23
State: UT

Vax Date: 10/01/2021
Onset Date: 10/01/2021
Rec V Date: 10/01/2021
Hospital:

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

Lab Data: N/A.

Allergies:

Symptom List: Nausea

Symptoms: About 5 minutes after receiving the second Moderna vaccination the patient had apparent Shortness of Breath, but she had good coloring in the lips and face. It seemed that she was having a panic/anxiety attack, but was given two BENADRYL just in case, and a bottle of water. She seemed to improve over the next few minutes. I offered to call the paramedics to come check on her, to which she declined. After a few minutes of fresh air under supervision, she felt good, and her husband/partner drove her. I recommended going to the hospital to get checked out.

Other Meds:

Current Illness:

ID: 1755591
Sex: M
Age: 22
State: TX

Vax Date: 06/05/2021
Onset Date: 07/05/2021
Rec V Date: 10/01/2021
Hospital:

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

Lab Data: None

Allergies: None

Symptom List: Injection site pain

Symptoms: About a month after my second dose, I seem to have gotten psoriasis across about half my back. I have never had any kind of condition like this before in my life. I have had it since about July.

Other Meds: None

Current Illness: None

ID: 1755592
Sex: F
Age: 45
State: OR

Vax Date: 09/02/2021
Onset Date: 09/06/2021
Rec V Date: 10/01/2021
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 induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Several days after first dose I experienced chest pain that I never had before, fast heart rate , dizziness. I work as a dentist and had to cancel patients due to severe dizziness when I was putting my head down. If my heart rate continues to be greater than usually I will see my PCP.

Other Meds: none

Current Illness: none

ID: 1755593
Sex: F
Age: 15
State: AZ

Vax Date: 10/01/2021
Onset Date: 10/01/2021
Rec V Date: 10/01/2021
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: nabumetone

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

Symptoms: Pt had a Vasovagal response to vaccine. Pt sat down and passed out, came to about 2-3 minutes after. Looked very pale and was very thirsty. Gave pt water and ice pack to cool body. Mom was present, 911 was called. No breathing issues, asked pt name and dob. and she was able to successfully answer. 911 came and They took vitals and after about 20 more minutes patient walked out.

Other Meds: none known

Current Illness: none known

ID: 1755594
Sex: M
Age: 20
State: NM

Vax Date: 10/01/2021
Onset Date: 10/01/2021
Rec V Date: 10/01/2021
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: patient had a partial seizure and hard time breathing approximately 20 minutes after receiving Moderna vaccine booster (2nd booster shot). We called 911 and took care of the patient until paramedics arrived. patient was still having seizures when paramedics took him away. I am not sure if he forgot to take his anti-epileptic drug for today or if partial seizures were caused by 2nd Moderna vaccine. His mom/grandma did mention to tech who was taking care of the patient at the time of the seizure that she neglected to mention or write on the patient consent form that he has a history of seizures. She just wanted him to receive his 2nd dose.

Other Meds:

Current Illness:

ID: 1755595
Sex: F
Age: 31
State: OR

Vax Date: 08/26/2021
Onset Date: 08/27/2021
Rec V Date: 10/02/2021
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: Chronic headache, chronic fatigue/tiredness

Other Meds: Depo Provera, multi vitamin, vitamin C and D

Current Illness:

ID: 1755596
Sex: F
Age: 20
State: FL

Vax Date: 09/13/2021
Onset Date: 09/30/2021
Rec V Date: 10/02/2021
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: D-Dimer test - results 3.3

Allergies: None

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

Symptoms: D-Dimer test results were 3.3 Horrible, itchy rash all over body. I have pictures if you need them. Drop in blood pressure. I have picture of the machine results if you need them. Shortness of breath Dizziness

Other Meds: Minocycline for acne.

Current Illness: None

ID: 1755597
Sex: F
Age: 40
State:

Vax Date: 09/01/2021
Onset Date: 10/01/2021
Rec V Date: 10/02/2021
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: Shrimp Amoxicillin

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

Symptoms: Lymph nodes nest to collar bone are huge and swollen and very tender

Other Meds: None

Current Illness: None

ID: 1755598
Sex: F
Age: 52
State: AL

Vax Date: 09/29/2021
Onset Date: 09/30/2021
Rec V Date: 10/02/2021
Hospital:

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

Lab Data: None

Allergies: NKA

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Temp at 24 hours was 100.4 which was slightly higher than the 100.1 temp at about the 30 hour mark post 2nd course. However, during the 3rd course, at about the 27 hour mark my temp was 102.1 with significant chills, sweats, body aches. This was markedly more severe than the 2nd course (which I thought was bad enough!), and seems worthy of reporting.

Other Meds: Estradiol 10mg, daily AllerClear 10mg, daily Lipitor 10mg, daily Vitamin D3, 5000IU, 2x/wk Vitamin C, 1000mg, daily

Current Illness: None

ID: 1755600
Sex: M
Age: 67
State: CO

Vax Date: 09/01/2021
Onset Date: 09/01/2021
Rec V Date: 10/02/2021
Hospital:

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

Lab Data: Sept 5, Covid test, chest x-ray and EKG normal.

Allergies: Chocolate, peanuts, sulfites

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

Symptoms: EVENTS August 1rst. I received a phone call from Security not to come to work without proof of vaccination, as the client was requiring all to show proof. This didn?t cause any problems other than a slightly sore arm, and what I perceived as being more fatigued, but I didn?t think it was the vaccine that was causing the fatigue. September 1rst. I received the second Pfizer dosage and spent two days in bed with flu-like symptoms, body aches and bad dreams. Thereafter I was exhausted and stayed home and slept and rested. By Friday September 3rd, I developed a rash or hives from my shoulders to thighs, and on Sunday the 5th I had swelling of the face and throat. A nurse suggested that I might be having an allergic reaction and to come in. I went to hospital which is in-network for my insurance and was seen by a P.A. who thought I had Covid, (maybe because I had a deep cough) and ordered an x-ray and a Covid swab, even though I informed him about my previous x-ray for you, and asthma. He totally discounted my full body rash and facial swelling, saying, ?We don?t know why that?s happening?, which I suppose is completely true. X-ray, EKG and Covid test were negative which I knew would be the case. His notes do not refer to the vaccine in any way. He suggested I take Benadryl. Today, September 12th I still have the rash, from nape of neck to legs. I have intermittent heavy joint pain in my right hip, and I?m sleeping 10-12 hours a day and falling asleep at work. I?m bright and alert for about 7 hours after I wake up, and then I?m struggling to keep my eyes open. The fatigue is the worst of this. I?m taking some Benadryl before I go to sleep to try and get rid of the rash, and that may not assist the fatigue even though it is one pill. I use topical Benadryl on the locations by my belt line and underwear. Hasn?t gone down. 10/01/21 I still have fatigue and joint soreness in knees and hip. Hives are still present but diminished. Have deep non productive cough when I lay down in my sleep and frequent when awake.

Other Meds: HCTZ, Allopurinol, Doxazosin, Losartan, Metoprolol, Vitamin D3, Zinc

Current Illness: none

ID: 1755601
Sex: F
Age: 29
State: GU

Vax Date: 01/25/2021
Onset Date: 02/22/2021
Rec V Date: 10/02/2021
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: Miscarriage, 02/22/2021 She received only first dose of Moderna vaccine. FIRST TRIMESTER MISCARRIAGE CONFIRMED POST VACCINE BY ULTRASOUND AND Beta HCG. Patient is recovering from physical and emotional trauma. Will continue to follow.

Allergies: Sulfa

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

Symptoms: LMP 12/12/2020 first dose moderna vaccine one 1/25/2021 patient states heavy vaginal bleeding on 2/22/2021

Other Meds: None

Current Illness: None

ID: 1755602
Sex: F
Age: 40
State: CA

Vax Date: 09/30/2021
Onset Date: 09/30/2021
Rec V Date: 10/02/2021
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: Elevated heart rate, arm pain, fatigue, and headache

Other Meds: Delete, Spiriva, azelastine, ipratropium bromide

Current Illness:

ID: 1755603
Sex: F
Age: 0
State: OH

Vax Date: 09/09/2021
Onset Date: 09/01/2021
Rec V Date: 10/02/2021
Hospital:

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

Lab Data: N/A

Allergies: Pomegranates & Nickel

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

Symptoms: Hives & itching- all over body, bottom of my feet and in bilateral groins.

Other Meds: OTC: Ibuprofen, acetaminophen, Prescription: Escitalopram 20mg once a day, Generic version of Yaz birth control

Current Illness: N/A

ID: 1755604
Sex: F
Age: 42
State:

Vax Date: 10/01/2021
Onset Date: 10/01/2021
Rec V Date: 10/02/2021
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: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: I submitted a first report w adverse reactions already; this is a follow up report w additional symptoms: Shortly after I submitted first report, I experienced additional symptoms which included profuse sweating from approx 3:00am-8:00am, 10/2/2021, day after vaccination, drenched/soaking wet in sweat, all throughout the early morning, and what felt like a low grade fever throughout the day, 10/2/2021. As well as continued left arm, shoulder blade, shoulder, and up through the left side of neck pain/soreness/muscle discomfort, on side injection was received.

Other Meds: Probiotics

Current Illness:

ID: 1755605
Sex: M
Age: 53
State: NC

Vax Date: 09/27/2021
Onset Date: 09/28/2021
Rec V Date: 10/02/2021
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: Penicillin.

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

Symptoms: Full body convulsions. Violent, alarming. Extreme headache, sweating and thirst, dramatic dizziness and lethargy. Muscle spasms. 1st convulsion lasted 10 minutes, fully conscious, breathing labored but still effective. Slept 15 hours in total, waking every 1.5 to 2 hours, convulsing less upon awakening each time. Drank six bottles of 16 oz water in an 8 hour period without urination. For the next 2 days, the symptoms occurred but became dramatically muted. My stomach is still spasming 4 days removed. Following emergency (as to pain) lower lumbar epidural injections (4) on 10/01, neurologist administering shots said the x-ray showed my stomach to be in spasm and asked how long. He also said that my calf muscle was spasming. I was only aware of the stomach as it was a tangible physical effect. Following 1st dose of Moderna vaccine, inexperienced headache, extremeextreme dizziness and dry heaves (absent vomitting) on the 2nd day.

Other Meds: Centrum Silver, Viva Naturals Omega-3, Vitamin D3, NOW brand psyllium husks, turmeric, Himalaya Liver Care, as needed 1/2 dose Tizanidine.

Current Illness: N/A

ID: 1755606
Sex: F
Age: 51
State: CA

Vax Date: 09/27/2021
Onset Date: 09/27/2021
Rec V Date: 10/02/2021
Hospital: Y

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

Lab Data:

Allergies: None

Symptom List: Vomiting

Symptoms: Tachyarrhythmia for 2 days, I had to be admitted from the ER to Inpatient.

Other Meds: Metformin Atorvastatin

Current Illness: None

ID: 1755607
Sex: F
Age: 52
State: TX

Vax Date: 09/28/2021
Onset Date: 09/28/2021
Rec V Date: 10/02/2021
Hospital:

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

Lab Data: See above

Allergies: Morphine, iodine, naproxen, sunflower seeds, seafood

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: 11:30 pm 9-28-21- fever,chills, nausea,vomiting, excruciating bone and muscle pain . Called dr at 7am on 9-29-21- instructed to take ibuprofen q8h and benedryl q8h. Did seem to help a little. 9-30-21 felt better in am until about noon then fever-chills-nausea- vomiting resumed and throat started to feel tight. Went to er. Treated for allergic reaction possibly from vaccine. Treated with injections of solumedrol, benadryl,zofran, epinephrine, and pepcid. 1 liter of iv fluids given. Labs showed high d dimer results. Cant do ct scan as im allergic to iodine contrast. Did nuclear scan and didnt see any clots. Cxr done showed no problem. Ekg showed abnormal rythmn after epi. Second ekg showed resolved. Sent home on pred for 5 days. 10-1-21 mouth ulcers appeared and legs are weak.

Other Meds: Gabapentin 300mg tid Amlodipine 1 mg sid

Current Illness: None

ID: 1755608
Sex: F
Age: 88
State: CA

Vax Date: 02/01/2021
Onset Date: 02/06/2021
Rec V Date: 10/02/2021
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: Just the doctor's examination. No labs.

Allergies: minor,

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

Symptoms: Days after the first shot I began to develop a cold sore on my lower lip. Two weeks later, days before the second shot on February 25, I developed another herpes patch on my hard palate. I saw my doctor and he agreed with my diagnosis of a herpes outbreak. I researched and learned this was not an uncommon side effect of the COVID19 vaccine.

Other Meds: vitamin c, d, e; saffron, cinnamon; horse chestnut, calcium, aspirin; Areds2, lumigan; eliquis

Current Illness: none

ID: 1755609
Sex: M
Age: 39
State:

Vax Date: 09/28/2021
Onset Date: 09/29/2021
Rec V Date: 10/02/2021
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: 18 hrs after vaccination i had severe shortness of breath Condition lasts for about 2 hrs 30 mints.

Other Meds:

Current Illness:

ID: 1755610
Sex: F
Age: 33
State: GA

Vax Date: 08/11/2021
Onset Date: 08/30/2021
Rec V Date: 10/02/2021
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: Latex, procardia

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

Symptoms: Heart feels like it is fluttering or skipping beats. At the same time, shortness of breath occurs with feeling of passing out. This happens every day at random times .

Other Meds: Effexor XR, Lansaprazole, multi vitamin

Current Illness: None

ID: 1755611
Sex: F
Age:
State: CA

Vax Date: 09/27/2021
Onset Date: 09/28/2021
Rec V Date: 10/02/2021
Hospital:

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

Lab Data: EKG

Allergies: Penicillin

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

Symptoms: Fever, chills, shortness of breath,headache, chest pain, lower abdomen,/side pain, fever, asthma flare up

Other Meds: Vitamin c, b12, iron, quercetin, celexa, thyroid medication, inhaler

Current Illness: None

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am