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: 1757281
Sex: F
Age: 22
State: AZ

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

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

Lab Data: I have not gotten tested yet. I have a doctors appointment this monday.

Allergies: Mango, cortisone

Symptom List: Dysphagia, Epiglottitis

Symptoms: The days following the vaccine I began experiencing tingling in my cheeks and some eye blurriness.It bothered me but did not think too much of it. It was a special week so I was excited about all the week events I was going to do with family. Then finally, on Thursday September 30th around 1 pm I felt the tingling return to my cheeks, then to my nose and forehead. I was also At around 3:30 pm, my face had gone numb. The entirety of it. I would touch my face and lightly slap it and I still couldn't feel. I immediately called the doctors office to schedule an appointment asap. I had done some research into the vaccine and this had been a side effect reported by people. The feeling came back to my face around 5:30 ish. My right cheek lost feeling the next morning around 8:30 am.l but was back around 12 pm. Today is sunday and I have not experienced any more numbness since friday.

Other Meds: N/A

Current Illness: N/A

ID: 1757282
Sex: M
Age: 85
State: NC

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

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

Lab Data: No tests but reported to Dr. and spoke with nurse at his office as well as nurse at Health. Nurse at Dept said she had same reaction on her 2nd dose. Both nurses assured us that is this 'normal' reaction and would go away in 24-48 hours. Had a major 'fever break' event on 10/1/21 about 6 am. Several other friends have had similar problems, BUT they probably don't take the time to report.

Allergies: Pamipexole

Symptom List: Anxiety, Dyspnoea

Symptoms: Fever, weakness/exhaustion, hallucinations (playing game that didn't exist), chills, feeling unwell, decreased appetite, loose bm,

Other Meds: Amiodarone, Xarelto, Furosemide, Klor-Con Potassium, Fish Oil, Vit D34, Magnesium Oxide, Levothyroxine, Galantamine,

Current Illness: none known

ID: 1757283
Sex: M
Age: 36
State:

Vax Date: 10/01/2021
Onset Date: 10/01/2021
Rec V Date: 10/03/2021
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: None

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

Symptoms: Chest pain (secondary to pericarditis).

Other Meds:

Current Illness: Nothing significant

ID: 1757284
Sex: F
Age: 44
State: NY

Vax Date: 10/01/2021
Onset Date: 10/03/2021
Rec V Date: 10/03/2021
Hospital:

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

Lab Data:

Allergies: No

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Swollen tender lymph nodes in left armpit (same side as vaccination). Started about 36 hours after shot. Soreness at injection site as well.

Other Meds: Crestor, birth control, Prevacid

Current Illness: No

ID: 1757285
Sex: F
Age: 37
State: MN

Vax Date: 10/03/2021
Onset Date: 10/03/2021
Rec V Date: 10/03/2021
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: Aspirin, Lisinopril, Vancomycin

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

Symptoms: Patient experienced generalized itching. I specifically observed scratching at back and inside of both arms. Patient described as "ants crawling all over me." Patient stated she has had this reaction at least 4 other times to injections, described Rituxan infusion and contrast dye, and to both previous doses of Pfizer Covid vaccine. She took 2 diphenhydramine 25mg capsules by mouth and felt better within 20 minutes. She declined additional care at our Emergency Dept.

Other Meds: Novolog, Losartan, Citalopram, Mycophenolate

Current Illness: Unknown

ID: 1757286
Sex: F
Age: 39
State: IN

Vax Date: 10/01/2021
Onset Date: 10/02/2021
Rec V Date: 10/03/2021
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: Sulfa

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

Symptoms: Severe headache, nausea, total body ache, dizziness, extreme fatigue lasting 30 hours

Other Meds: None

Current Illness: None

ID: 1757287
Sex: M
Age: 76
State: MA

Vax Date: 09/29/2021
Onset Date: 10/01/2021
Rec V Date: 10/03/2021
Hospital:

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

Lab Data: none

Allergies: None

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: extreme bloody diarrhea lasting roughly five hours starting at 7:00 p.m. on October 1. After passing blood once again in the middle of the night, bleeding completely stopped the following day and normal stools appeared by the end of the day. I also breifly suffered from extreme dehydration briefly until I replenished my fluids.

Other Meds: blood thinner (Eliquis) and many others

Current Illness: none

ID: 1757288
Sex: F
Age: 33
State: OR

Vax Date: 10/01/2021
Onset Date: 10/03/2021
Rec V Date: 10/03/2021
Hospital:

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

Lab Data:

Allergies: Latex, toradol, penicillin

Symptom List: Pharyngeal swelling

Symptoms: Pain and swelling of left armpit, nausea

Other Meds: Levothyroxine 200mcg

Current Illness: None

ID: 1757290
Sex: F
Age: 61
State: OR

Vax Date: 09/25/2021
Onset Date: 09/30/2021
Rec V Date: 10/03/2021
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: Sensitive to Sulfa drugs

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Extreme onset of hives. From mid chest down. Welts the size of a quarter to some size. Clustered in some areas or approx 6-9 inches apart. Very random. It was like all my skin in those areas was growing in intensity from 2pm? to about 2am (10/01) when it started to finally calm. I could not where my jeans because my skin was so irritated. It was all I could do to not scratch through my skin. I was unable to sleep as the tingling and itchiness was so intense. I was shocked when I woke up at 6am and it had all gone away. The only remnant we?re the few places that I had scratched and left a mark that had bled. So far I have not experienced this again? something I am truly thankful for!

Other Meds: None

Current Illness: None

ID: 1757291
Sex: F
Age: 52
State: MI

Vax Date: 09/30/2021
Onset Date: 10/01/2021
Rec V Date: 10/03/2021
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

Allergies: Avacados

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Fever, chills, muscle and joint aches

Other Meds: Received flu vaccine at same time

Current Illness: None

ID: 1757292
Sex: F
Age: 35
State: NE

Vax Date: 08/20/2021
Onset Date: 08/23/2021
Rec V Date: 10/03/2021
Hospital:

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

Lab Data: I went to see my GYN doctor, and had an annual women exam performed.

Allergies: Nonw

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

Symptoms: Lengthy and heavy menstrual period. Heavy days were generally 3, but I had about 10 days. I also experienced strong rectal pressure, while having such a strong menstrual period, which I had not experience before.

Other Meds: None

Current Illness: Nonw

ID: 1757293
Sex: F
Age: 73
State: AZ

Vax Date: 10/01/2021
Onset Date: 10/01/2021
Rec V Date: 10/03/2021
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: Bacitracin, nickel

Symptom List: Rash, Urticaria

Symptoms: Body aches, headache, chills

Other Meds: Sertraline, atorvastatin, fish oil, vitamin D, low-dose aspirin, Oxybutynin, melatonin, magnesium, multivitamin, potassium, Met Forman, Florsemide

Current Illness: None

ID: 1757294
Sex: M
Age: 37
State: CO

Vax Date: 09/29/2021
Onset Date: 10/01/2021
Rec V Date: 10/03/2021
Hospital: Y

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

Lab Data: WBC 17.2-- >11.4-- >7.0 Lactate 2.3-- >2.5-- >0.9 Na 133-- > 140 K 3.7-- >4.1 Phos 0.7-- >4.5-- >2.0-- >3.6 Magnesium 2.1-- >2.0 Troponin High Sensitive 14 Echocardiogram: Normal Left ventricle size, thickness, function, LVEF > 55%; no regional wall motion abnormalities; normal diastolic function; normal Right ventricle size and systolic function; mild Mitral insufficiency EKG: NSR 58; QTc 428; no other abnormalities

Allergies: No known allergies

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

Symptoms: Patient underwent his Covid booster (3rd vaccine) and Pneumococcal/ Varicella catch-up vaccination on 9/29/21. Next morning 9/30 had mild soreness at Left shoulder site, mild chills. Subsequently severe left shoulder swelling, erythema, severe pain and tenderness to palpation developed 10/1/21 AM and he presented to the Emergency room. Had evidence of Systemic Inflammatory response syndrome manifested by Fever (temp 101), hypotension (77/48), Leukocytosis (WBC 17.2), tachycardia (HR 124), tachypnea (RR 24) on arrival, requiring hospitalization, intensive fluid resuscitation (5 L saline/ LR), IV Antibiotics for presumed infectious process (cellulitis). Lactate 2.5. Subsequently hospitalization remarkable for initial bradycardia HR 48, hypotension requiring further fluid administration. Had one run of 12 seconds of Non-sustained Ventricular Tachycardia on the afternoon of 10/2/21 with some chest "fluttering", no pain. No other chest pain experienced otherwise. was able to be discharged home on 10/3/21 in stable condition

Other Meds: Acetaminophen 500 mg every 6 hrs as needed for pain Ibuprofen 200 mg every 6 hours as needed for pain Flonase 50 mg/spray every day as needed for allergies Zyrtec 10 mg daily as needed for allergies Melatonin nightly as needed for sleep

Current Illness: None

ID: 1757295
Sex: F
Age: 32
State: MN

Vax Date: 01/19/2021
Onset Date: 09/27/2021
Rec V Date: 10/03/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data: Covid-19 test

Allergies:

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

Symptoms: Employee tested positive for Covid-19 after being fully vaccinated

Other Meds:

Current Illness:

ID: 1757296
Sex: M
Age: 61
State: WV

Vax Date: 10/01/2021
Onset Date: 10/01/2021
Rec V Date: 10/03/2021
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: Unknown

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

Symptoms: When presenting for vaccination the patient reported to the healthcare providers that were administering the COVID-19 booster doses of Pfizer BioNTech's COVID-19 vaccine that he had completed the initial vaccination series with the Pfizer-BioNTech COVID-19 vaccine more than 6 months ago. Due to not having internet access at the site the patient's word was taken after the staff at the facility reported that the patient did not have any cognitive impairments. After the patient received the vaccine and returned to his apartment he informed the nursing home staff that he had received the Moderna COVID-19 vaccine for his initial vaccination series on 12/23/20 and 1/20/21 and showed the facility staff the vaccination card in his apartment. Patient did not report any symptoms, but this error is being reported since he was not eligible for a booster vaccine.

Other Meds: Unknown

Current Illness: Unknown

ID: 1757297
Sex: F
Age: 21
State: GA

Vax Date: 09/12/2021
Onset Date: 09/30/2021
Rec V Date: 10/03/2021
Hospital:

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

Lab Data: I took a pregnancy test and it is negative.

Allergies: N/A

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

Symptoms: Missing my period. I am 3 days late to my period, I have never been late before. I have a consistent period.

Other Meds: Birth Control

Current Illness: N/A

ID: 1757298
Sex: F
Age: 66
State: NC

Vax Date: 01/22/2021
Onset Date: 01/25/2021
Rec V Date: 10/03/2021
Hospital:

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

Lab Data: 2/02/2021 - xray rt great toe

Allergies: Sulfa

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

Symptoms: The week following my second dose, I experienced some sharp pain in my rt great toe. Intermittently at first but on 2/2/2021, I could not walk on it and sought medical attention. There was some mild swelling and redness. About 2 weeks later it became reddened and appeared bruised. 2/25/21 I saw a PA that thought there was pus in it and "deroofed" the lesion, no fluid just raw discolored area. Wound did not get better and I sought care at the wound clinic. Treatment there consisted of offload shoe for 3 mos, various wound treatments (medihoney, silvercel, prisma dressings, nitrostat ointment and several debridements). Wound finally healed by mid June. Currently just a scar and numbness at the site.

Other Meds: Metformin, lisinopril, Vit D, progesterone, aspirin

Current Illness: none

ID: 1757299
Sex: F
Age: 30
State: VA

Vax Date: 09/25/2021
Onset Date: 09/25/2021
Rec V Date: 10/03/2021
Hospital:

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

Lab Data: EKG, chest x-ray, bloodwork - September 26, 2021. All came back normal.

Allergies: None

Symptom List: Ear pain, Hypoaesthesia

Symptoms: 8 hours after the vaccine was administered, I started feeling some tightness in my chest. The following day, I felt very weak with typical side effects (chills, headache, body aches, low fever), as well as persistent tightness in my chest and an occasional racing heart. I went to the ER that evening where an EKG and chest x-ray were done, as well as bloodwork. Everything came back normal. Now, a week later, I am still feeling a tightness and weakness in my chest and lungs, though I have never had a real problem breathing.

Other Meds: Ritual Women's 18+ Multivitamin

Current Illness: None

ID: 1757300
Sex: F
Age: 52
State: NY

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

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

Lab Data:

Allergies: Unknown

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: I received the vaccine at 4:55 pm and my symptoms started at 11pm sneezing and running nose the next day I had a really bad headache and congested day 3 oct 3rd 2021 congested nd coughing.

Other Meds: None

Current Illness: None

ID: 1757301
Sex: M
Age: 37
State: MN

Vax Date: 08/16/2021
Onset Date: 08/20/2021
Rec V Date: 10/03/2021
Hospital:

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

Lab Data: Diagnosed with Shingles, more doctor visits to come.

Allergies: None

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

Symptoms: Nausea, Head cold, fever, chest sweats, morning leg pain, schizophrenic thoughts, loss of appetite, diarrhea.

Other Meds: None

Current Illness: None

ID: 1757303
Sex: F
Age: 96
State: WV

Vax Date: 10/01/2021
Onset Date: 10/01/2021
Rec V Date: 10/03/2021
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

Allergies: Unknown

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

Symptoms: When presenting for vaccination the patient reported to the healthcare providers that were administering the COVID-19 booster doses of Pfizer COVID-19 vaccine that she had completed the initial vaccination series with the Pfizer-BioNTech COVID-19 vaccine more than 6 months ago. Due to not having internet access at the site the patient's word was taken after the staff at the facility reported that the patient did not have any cognitive impairments. After the patient received the vaccine staff at the facility found the patient?s vaccination card and determined that the patient had received one dose of Moderna COVID-19 vaccine on 12/22/2020. Since the patient did not complete the initial series the second dose of the COVID-19 vaccine that was administered (Pfizer) will be the final in the primary series. Patient did not report any symptoms, but this error is being reported since she received Moderna for her first dose.

Other Meds: Unknown

Current Illness: Unknown

ID: 1757304
Sex: F
Age: 81
State: MA

Vax Date: 10/03/2021
Onset Date: 10/03/2021
Rec V Date: 10/03/2021
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

Symptom List: Unevaluable event

Symptoms: pt recieved vaccine and after getting up and leaving felt light headed, flushed, red face. had chest pain 911 was called pt left on own.

Other Meds: n/a

Current Illness: n/a

ID: 1757305
Sex: M
Age: 6
State: CO

Vax Date: 10/03/2021
Onset Date: 10/03/2021
Rec V Date: 10/03/2021
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: NA

Allergies: none

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

Symptoms: The pt received the wrong dose of the flu vaccine.

Other Meds: none

Current Illness: none

ID: 1757306
Sex: F
Age: 55
State: KS

Vax Date: 09/29/2021
Onset Date: 09/30/2021
Rec V Date: 10/03/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: 10/01/2021 meds given and monitored blood pressure and heart rate. No lab tests taken.

Allergies: Sulfur

Symptom List: Injection site pain, Pain

Symptoms: COVID Vaccine administered 10:00 09/29/2021. Symptoms started 2:00 am in morning following COVID vaccine. Fever, trembling, chills, profuse sweating, pins and need sensation in right hand side of back from shoulder to hip. Intense pain in lower back. Zaps of pain all over the body. 10/01/2021: hives started around injection site and raised itchy area where injection was given. Went to local ER. Benadryl and Prednisone given. Prescription given for Prednisone for four days. 10/03/2021 experiencing pins and needle sensation still in right side of body, pins and needle sensation in face, legs, extreme back pain and zaps of pain from head to toes. Knee is swollen and feels inflamed. Feel like have brain extreme brain fog.

Other Meds: Ivermectin/Stock Metronidazole Stock Niacinamide, Cerave, Topical face medicine for Rosacea Estradiol Vaginal Cream USP 0.01% Dotti Estradiol Transdermal System USP patch 0.1MG Levothyroxine Sodium 100 MCG Nature Made Vit C Gummies 250 mg

Current Illness: None

ID: 1757307
Sex: F
Age: 51
State: CA

Vax Date: 09/24/2021
Onset Date: 09/28/2021
Rec V Date: 10/03/2021
Hospital:

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

Lab Data:

Allergies: Penicillin, contrast in CT-Scans

Symptom List: Injection site pain, Menorrhagia

Symptoms: Excessive loss of hair. It started around 4 days after vaccine and now I'm afraid to even wash or brush my hair. It's falling off in clumps. This is not the normal amount one loses when you brush. I'm talking, I can't stop crying every time I run my fingers through my head and clumps of hair just fall off. My husband ran to the bathroom cause he heard me screaming and he was horrified at what he saw. There was so much hair on the tub floor that it looked like I was giving myself a haircut. At the rate is falling, if it continues, I don't know if I will have much hair left, if any, in a month or so.

Other Meds: Clonidine 0.1mg, Topiramate 25mg, Cyclobenzaprine 5mg

Current Illness:

ID: 1757308
Sex: F
Age: 51
State: NC

Vax Date: 08/11/2021
Onset Date: 08/12/2021
Rec V Date: 10/03/2021
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 - will be seeing the doctor soon

Allergies: not known

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

Symptoms: I had come off blood pressure medication for about a month before the vaccine. As soon as I got the vaccine, by BP went up and I have not been able to control it again. Back on BP meds

Other Meds: Artichoke supplements and multivitamins

Current Illness:

ID: 1757309
Sex: F
Age: 74
State: KS

Vax Date: 09/29/2021
Onset Date: 09/29/2021
Rec V Date: 10/03/2021
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: unknown

Allergies: none known

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Patient presented with bright red skin with irregular borders on lower part of upper right arm NOT at injection site location. Patient says the area "hurt" and began to develop right after her injection.

Other Meds: unknown

Current Illness: unknown

ID: 1757310
Sex: F
Age: 73
State: WA

Vax Date: 01/31/2021
Onset Date: 02/18/2021
Rec V Date: 10/03/2021
Hospital:

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

Lab Data: lab tests and hearing test were normal

Allergies: aspirin,

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: My tinittus became much worse. It was always mild before having the vaccine. After the shots it is always present as a loud buzzing noise that is especially loud . It is most annoying when I am in a quiet setting. After 6 months the noise has not reduced.

Other Meds: Metformin, simvastatin, levothyroxine, lisinopril, fish oil,

Current Illness:

ID: 1757311
Sex: F
Age: 45
State: MN

Vax Date: 01/19/2021
Onset Date: 09/24/2021
Rec V Date: 10/03/2021
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: Covid-19 test

Allergies:

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

Symptoms: Employee tested positive for Covid-19 after being fully vaccinated

Other Meds:

Current Illness:

ID: 1757312
Sex: M
Age: 78
State:

Vax Date: 10/02/2021
Onset Date: 10/02/2021
Rec V Date: 10/03/2021
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: Nausea

Symptoms: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1757313
Sex: M
Age: 78
State:

Vax Date: 10/02/2021
Onset Date: 10/02/2021
Rec V Date: 10/03/2021
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: Injection site pain

Symptoms: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1757314
Sex: F
Age: 47
State: AZ

Vax Date: 10/02/2021
Onset Date: 10/02/2021
Rec V Date: 10/03/2021
Hospital:

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

Lab Data: To be determined

Allergies: Penicillin, Cipro, Codeine, Aspirin

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

Symptoms: Within 30 minutes of the administration, tingling, cold sensations and numbness in toes on both feet. 24 hours after vaccination it has only slightly improved. We called the pharmacist who administered the vaccine and they stated this was not something they normally see, and was likely instead to be something circulation related and would check with me the next day.

Other Meds: Emergen-C immune supplement. BHRT pellets. Vitamin D3 supplements.

Current Illness: None

ID: 1757315
Sex: F
Age: 55
State: NM

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data: N/A

Allergies:

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

Symptoms: Severe Chills onset 11pm on 9/30/21, muscle/joint pain/fever/loss of appetite/fatigue onset 10/01/21 AM and lasting through 10/02/21 11pm, headache onset 10/02/21 and lasting 12 hours, covid arm onset 10/03/21 itching, swelling, redness, and warm to the touch.

Other Meds: Levoxyl, collagen, vit D

Current Illness:

ID: 1757316
Sex: F
Age: 64
State: NY

Vax Date: 05/12/2021
Onset Date: 05/12/2021
Rec V Date: 10/03/2021
Hospital:

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

Lab Data: Received Benedryl. Albuterol. Prednisone. Epinephrine and 2 breathing treatments

Allergies: Previous Flu shot reaction. Seafood

Symptom List: Tremor

Symptoms: Throat closed. Shortness of breath. Cough. Headache

Other Meds: Atenolol Lexapro. Ambien. Magnesium. Biotin

Current Illness: None

ID: 1757317
Sex: F
Age: 38
State: IL

Vax Date: 09/30/2021
Onset Date: 10/02/2021
Rec V Date: 10/03/2021
Hospital:

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

Lab Data: None

Allergies: None

Symptom List: Erythema, Pruritus

Symptoms: Rash on my left arm at the site on the injection. Pain in that spot and hot sensation. Pain in the armpit of left arm.

Other Meds: None

Current Illness: None

ID: 1757318
Sex: M
Age: 52
State:

Vax Date: 10/02/2021
Onset Date: 10/02/2021
Rec V Date: 10/03/2021
Hospital:

Vax Type: UNK
Manufacturer: UNKNOWN MANUFACTURER
Vax Name: VACCINE NOT SPECIFIED (NO BRAND NAME)
Lot:
Dose Series: UNK
Vax Route: SYR
Vax Site: UN

Lab Data:

Allergies:

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

Symptoms: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1757319
Sex: M
Age: 73
State:

Vax Date: 10/02/2021
Onset Date: 10/02/2021
Rec V Date: 10/03/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1757320
Sex: F
Age: 70
State: FL

Vax Date: 09/29/2021
Onset Date: 09/29/2021
Rec V Date: 10/03/2021
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: Quinolones, Cipro

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Extreme shaking chills making it difficult to walk or function, profuse sweating, severe nausea , weak - all of above lasted 5 hours. Then headache, marked fatigue for 3 days, with episodes of weakness & "brain fog", lower than usual blood pressure despite being well hydrated (114/68 vs WNL 126/84 typical) I had ONLY mild headache and fatigue after 1st and 2nd doses of Moderns COVID vaccine

Other Meds: Amlodipine, Atenolol, Losartan, Estring ,AREDS 2 vitamins , Rinocort nasal spray, Mg glycinate, VitD ,

Current Illness: Well, status quo, NO recent symptoms of URI etc

ID: 1757321
Sex: F
Age: 66
State:

Vax Date: 10/02/2021
Onset Date: 10/02/2021
Rec V Date: 10/03/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1757322
Sex: F
Age: 23
State: WI

Vax Date: 09/30/2021
Onset Date: 09/30/2021
Rec V Date: 10/03/2021
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: Did not go to the ER

Allergies: sulfa antibiotics

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

Symptoms: Fever of 102.9 Uncontrollable shaking Terrible migraine Numb arm on and off tingling N/V extreme fatigue Severe dizziness /vertigo Excessive sweating Blurry vision

Other Meds: Setraline 50 mg per day

Current Illness: NA

ID: 1757323
Sex: F
Age: 17
State: AL

Vax Date: 09/04/2021
Onset Date: 09/04/2021
Rec V Date: 10/03/2021
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: The patient came in for her second dose and it was brought to our attention that she is not yet 18. I questioned the patient about any adverse events she may have experienced and she stated that there were none.

Other Meds:

Current Illness:

ID: 1757324
Sex: M
Age: 51
State: CA

Vax Date: 07/07/2021
Onset Date: 07/10/2021
Rec V Date: 10/03/2021
Hospital:

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

Lab Data:

Allergies: sulfa

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

Symptoms: allergy sneeze.

Other Meds:

Current Illness: strange allergy

ID: 1757325
Sex: M
Age: 57
State:

Vax Date: 10/02/2021
Onset Date: 10/02/2021
Rec V Date: 10/03/2021
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: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1757326
Sex: F
Age: 51
State: AZ

Vax Date: 08/31/2021
Onset Date: 08/31/2021
Rec V Date: 10/03/2021
Hospital:

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

Lab Data: None

Allergies: None

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

Symptoms: Left arm administration 1 and 2 doses. After 2nd dose my left foot tingled/numb about 20 min after and subsided. By 8pm I was tired, headache starting. By midnight body aches, mild fever and head worsening. Awoke Sep 1 fever 102.5, excruciating headache/ice/tylenol, unrelievable. Body aches, chills. This subsided by Sept 2 mid-day. Left toes tingly again. Sept 3 a 4x 3 in rash appeared left arm, swollen slight pain no itch. Not at injection. About 3 in lower. Subsided 24 hrs. Sept 5 felt left pinky and ring toes cramping/moving. Different than normal cramp. Got phone to video and left big toe began moving sideways on its own. No cramping. Continued for 4 or 5 minutes. Tendons/arch simultaneously moving/flexing on its own for same time. This continued on and off through eve of Sep 5. Occurred 4 or 5 time over next 2 days. Over past month since Left two toes randomly cramp while resting, at least 2x daily then stops.

Other Meds: None.

Current Illness: None

ID: 1757327
Sex: M
Age: 73
State:

Vax Date: 10/02/2021
Onset Date: 10/02/2021
Rec V Date: 10/03/2021
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: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1757328
Sex: M
Age: 48
State:

Vax Date: 10/02/2021
Onset Date: 10/02/2021
Rec V Date: 10/03/2021
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: 1757329
Sex: M
Age: 67
State: WA

Vax Date: 10/01/2021
Onset Date: 10/02/2021
Rec V Date: 10/03/2021
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: penicillin

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

Symptoms: Severe flu-like symptons: chills, sweats, no appetite, no energy,

Other Meds: blood pressure beta blocker Flomax

Current Illness: none

ID: 1757331
Sex: F
Age: 41
State: IN

Vax Date: 09/25/2021
Onset Date: 10/03/2021
Rec V Date: 10/03/2021
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: Bactrim allergy Milk allergy

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Hard itchy red lump at vaccine site appeared 8 days after vaccine. Currently about 3 inch diameter across upper arm.

Other Meds: Multi-vitamin Vitamin D (5000) Calcium Magnesium Zinc Omega-3 s

Current Illness: None

ID: 1757332
Sex: F
Age: 54
State: WA

Vax Date: 09/15/2021
Onset Date: 09/16/2021
Rec V Date: 10/03/2021
Hospital:

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

Lab Data:

Allergies: Penicillin, garlic

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

Symptoms: Fever, body aches, head ache, pain and swelling at injection site, extreme tiredness that lasted for several days

Other Meds: None

Current Illness: No

ID: 1757333
Sex: M
Age: 50
State:

Vax Date: 10/02/2021
Onset Date: 10/02/2021
Rec V Date: 10/03/2021
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