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: 1758570
Sex: F
Age: 74
State: NY

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

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

Lab Data: Temp 101 degrees

Allergies: none

Symptom List: Dysphagia, Epiglottitis

Symptoms: Severe headache fever chills for 36hrs day after injection

Other Meds: Losartan

Current Illness: none

ID: 1758571
Sex: F
Age: 60
State: GA

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

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

Lab Data:

Allergies: Latex, sulfa, valtrex, quinolones

Symptom List: Anxiety, Dyspnoea

Symptoms: The pharmacist applied the bandage first and then gave me the vaccine injection THROUGH the bandage. I have redness and swelling of the injections site. My fear is that a piece of the bandage was injected into my muscle and I will develop an abscess. I AM REPORTING THIS BECAUSE IT WOULD NOT BE BECAUSE OF THE VACCINE ITSELF, BUT BECAUSE OF THE IMPROPER INJECTION TECHNIQUE AND MAY OCCUR TO OTHERS RECEIVING AN INJECTION FROM THIS PHARMACIST. ***********Please call me for details.*********** If you see a cluster of abscesses in the area this may be the cause. (I have saved the bandage.)

Other Meds: prednisone; methotrexate; Plaquenil;

Current Illness: lupus (SLE) flare

ID: 1758572
Sex: F
Age:
State: TN

Vax Date: 09/27/2021
Onset Date: 09/28/2021
Rec V Date: 10/04/2021
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: Tal win Codeine Amoxicillin Levaquin Piroxicam Butazolidin Erythromycin ZPac Latex

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

Symptoms: Swelling at injection site was size of dime next morning. Swelling continued each day. Today it is 5x6 measured by doctor. Headaches since Wednesday and pain down leg since Wednesday night. Doctor said celulitis or hematoma that has gotten infected.

Other Meds: Armour Thyroid B12 Vitamin C vitamin D Premarin Cream Multi Vitamin

Current Illness:

ID: 1758573
Sex: M
Age: 51
State: MN

Vax Date: 03/11/2021
Onset Date: 10/04/2021
Rec V Date: 10/04/2021
Hospital:

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

Lab Data: Positive COVID-19 RT-PCR Test

Allergies: NKA

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Positive COVID-19 when fully vaccinated

Other Meds: Aspirin, Lisinopril, Multivitamin, Keppra

Current Illness: N/A

ID: 1758574
Sex: F
Age: 73
State: GA

Vax Date: 10/03/2021
Onset Date: 10/03/2021
Rec V Date: 10/04/2021
Hospital:

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

Lab Data: none

Allergies: lisinopril, hypaque dye, morphine, strawberries, evergreens

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

Symptoms: Headache over right eye 5 hours after shot at 6pm, followed by chills, then general not feeling good, also injection site swelled and became painful for several inches around the site. took naproxin x1,, applied arnica cream to site went to bed and feel better this morning.

Other Meds: atorvastatin, lipitor, aspirin, levothyroid thyroid, ,hydroxychloriquin, methotrexate, mvi, naproxin

Current Illness: RA, hypothyroidism, partial blocked carotid arteries, blood pressure,kidney

ID: 1758575
Sex: M
Age: 60
State: TX

Vax Date: 10/04/2021
Onset Date: 10/04/2021
Rec V Date: 10/04/2021
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: n/a

Allergies: Shellfish, peanuts

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

Symptoms: Pt had received two Moderna vaccines and I gave the pt Pfizer vaccine as a booster. Pt did not have any adverse events at the time.

Other Meds: none

Current Illness: none

ID: 1758576
Sex: M
Age: 88
State: TX

Vax Date: 04/21/2021
Onset Date: 09/30/2021
Rec V Date: 10/04/2021
Hospital: Y

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

Lab Data: ABG, CBC, CMP, Cardiac Profile, CXR, EKG

Allergies: NKA

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: patient recieving COVID antibody infusion decompensated and became hypoxic

Other Meds: Protonix, tylenol, allopurinol, amlodipine, aspirin, lipitor, calcuim, cefdinir, plavix,lasix, losartan, metoprolol, Mycophenolate mofetil, nitroglycerin, miralax, flomax, tresiba, Zinc, melatonin, vitamin b12

Current Illness:

ID: 1758577
Sex: F
Age: 67
State: TX

Vax Date: 06/20/2021
Onset Date: 07/01/2021
Rec V Date: 10/04/2021
Hospital:

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

Lab Data:

Allergies: None noted

Symptom List: Pharyngeal swelling

Symptoms: 67 year old female with PMH anemia, HTN, HLD presents with headache, dizziness. Reports headache for 15 days, occipital, non-radiating, worse with bright lights and loud noises. Also reports associated dizziness, feels like the room is spinning, worse when she moves or head or tries to stand up. Reports intermittent paresthesia of right arm, no symptoms currently.

Other Meds: Amlodipine 5mg QD; Anastrazole 1mg QD; Famotidine 20mg BID; Fluocinonide topical solution; Lisinopril 20mg QD; Mesalamine 1000mg suppository QD.

Current Illness:

ID: 1758578
Sex: F
Age: 36
State: NY

Vax Date: 10/04/2021
Onset Date: 10/04/2021
Rec V Date: 10/04/2021
Hospital:

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

Lab Data: 11:11am: hr:78, r 17, bp 120/80/ sat 99%.

Allergies: seasonal allergies

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Within ten minutes of receiving first dose of pfizer patient reported itchiness of both arms and spread to neck.

Other Meds: n/a

Current Illness:

ID: 1758579
Sex: M
Age: 76
State: TN

Vax Date: 09/30/2021
Onset Date: 10/01/2021
Rec V Date: 10/04/2021
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: PCN

Symptom List: Diarrhoea, Nasal congestion

Symptoms: some body aches, left deltoid area is slightly pinkish/little reddened and tender.

Other Meds: 40 mg Atorvastatin, OTC Vitamins, Aspirin 81 mg

Current Illness: none

ID: 1758580
Sex: M
Age: 33
State: FL

Vax Date: 09/30/2021
Onset Date: 10/01/2021
Rec V Date: 10/04/2021
Hospital:

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

Lab Data: covid test on 10/1, negative

Allergies:

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

Symptoms: headache, body aches, fever

Other Meds:

Current Illness:

ID: 1758581
Sex: F
Age: 25
State: UT

Vax Date: 06/25/2021
Onset Date: 08/16/2021
Rec V Date: 10/04/2021
Hospital:

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

Lab Data: 8/17/2021: Sars-Cov-2 by PCR (TF) Covid Test- positive.

Allergies: None

Symptom List: Rash, Urticaria

Symptoms: 8/16/2021 I started to have COVID symptoms which I think I got from my husband because he wasn't vaccinated at that time. He had tested positive for COVID a day before. I was taking care of him while he had COVID and then I started showing symptoms the night of 8/16/2021. I ordered a online request for a COVID test. Then I went to the local Urgent Care to do the test on 8/17/2021. I got the results the next day on 8/18/2021, and tested positive for COVID. My symptoms weren't as bad as my husbands. I didn't lose my taste or smell. I had body aches, but I was still able to take care of him because he wasn't doing so well. We did the 10 days of isolation and quarantine. The body aches had died down after a few more days, and now I am fine.

Other Meds: Lexapro; Doxylamine; Prenatal; Vitamin C

Current Illness: None

ID: 1758582
Sex: M
Age: 48
State: KY

Vax Date: 01/17/2021
Onset Date: 09/21/2021
Rec V Date: 10/04/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: Tested Positive for Covid

Other Meds:

Current Illness:

ID: 1758583
Sex: M
Age: 73
State: NY

Vax Date: 09/27/2021
Onset Date: 10/01/2021
Rec V Date: 10/04/2021
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: 9/30/2021, went to ER, was given 1cc steriod injection right deltoid. 10/01/2021 went back to ER because patient was having more symptoms, was given oral steroid pack, muscle relaxer and was advised to take OTC Claritin 1 pill daily.

Allergies: no known allergies

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

Symptoms: Patient states that he received 3rd shot - Booster on 9/27/2021, On Thursday, 9/30/2021, Patient started feeling squeezing and tightening in chest, difficulty in getting air in.

Other Meds: Plaquenil, Methotrexate, Vitamin D, B Complex, Folic Acid, Proair HFA

Current Illness: none

ID: 1758584
Sex: F
Age: 60
State: WI

Vax Date: 03/26/2021
Onset Date: 07/06/2021
Rec V Date: 10/04/2021
Hospital:

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

Lab Data: ABNORMAL MAMAOGRAM SWOLLEN LYMPH NODE SWOLLEN AND ENLARGE BREAAST LUMP NEW BREAST LUMP

Allergies: none

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

Symptoms: At the time of both shots I have to lay down with fatigue and extreme dry mouth excessive thirst. My lumps on breast that have been presnet for years as my breast are dense became tender. Later present lump swelled and there was a new lump in the nipple that I saw my Dr. for in July 2021.

Other Meds: Zanex, menopause one by Rainbow light supplement

Current Illness: none healthy

ID: 1758585
Sex: F
Age: 38
State: NY

Vax Date: 03/29/2021
Onset Date: 04/19/2021
Rec V Date: 10/04/2021
Hospital:

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

Lab Data: Mammogram in May, September (breasts).

Allergies: Mango

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

Symptoms: Three weeks after second dose I had a cyst on my left breast felt like a mass. Then in July 2021 I had a smaller cyst under my left under armpit. The cyst under my left armpit came back in the beginning of September 2021 subsided and came back end of September 2021. The cyst on my left breast comes and goes every month since April 2021. The imaging doctor stated that the cyst under my left armpit are dense tissue have discussed possible surgery to remove has me very concerned.

Other Meds: Zolpidem; Multi vitamin; Probiotic; Calcium; Magnesium; Elderberry; B12; Vitamin D

Current Illness: No

ID: 1758586
Sex: M
Age: 43
State: PA

Vax Date: 08/18/2021
Onset Date: 08/18/2021
Rec V Date: 10/04/2021
Hospital:

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

Lab Data:

Allergies: No

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

Symptoms: Have been experiencing a chemical taste and smell since receiving vaccination. Everything smells and tastes like chemicals now.

Other Meds: Multivitamins B-complex Fish oil

Current Illness: N/A

Date Died: 09/29/2021

ID: 1758587
Sex: M
Age: 62
State: CA

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

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

Lab Data: Unknown

Allergies: No Known Allergies

Symptom List: Ear pain, Hypoaesthesia

Symptoms: According to Senior RN, upon arrival on unit seen presence of paramedics, physician. Patient acute change of physical condition. Patient was assessed by treatment nurse and was found to be conscious and hyperventilating around 2246. Emergency system was activated and dispatch notified at 2246 as acting shift lead dialed emergency number. Emergency activated. Initial vitals: pulse76, 30rr labored, O2 sat 87%, 0/10. Pt is alert and responsive. Sister units arrived. Nonrebreather mask applied with O2@15l/min. Final vitals at 2255: 100/68, 44p, 93% O2 sat, 30rr labored, 0/10. At 2258 the paramedics arrived. Pt is alert and responsive at 2258. Paramedics took control of the scene. CPR was provided along with twice using defibrillator and providing 6 doses of Epi-1mg. Pt pronounced dead at 2340.

Other Meds: Alpha-D-Galactosidase, Cholecalciferol, Docusate Sodium, Haloperidol, Ibuprofen, Lactulose, Lipase/Protease, Amylase, Melatonin, Multivitamin, Magnesium Hydroxide

Current Illness: Unknown

ID: 1758589
Sex: F
Age: 77
State: MA

Vax Date: 03/20/2021
Onset Date: 05/08/2021
Rec V Date: 10/04/2021
Hospital: Y

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

Lab Data: positive covid test on 4/28/21 chest x ray on 5/8/21 showed mild pulmonary edema

Allergies: dabigatran, efudex, imiquimod, pradaxa, iodinated contrast media, promacta, digoxin, oxycodone, codeine

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Patient presented to ED on 5/8/21 with worsening SOB. Patient is fully vaccinated. It was most likely CHF exacerbation superimposed on COVID recovering individual and the patient was treated appropriately, got discharged on 5/14/21.

Other Meds: atorvastatin, b complex vitamins, probiotics, carvedilol, vitamin d3, furosemide, magnesium gluconate, milk thistle, spironolactone

Current Illness: Not applicable

ID: 1758590
Sex: M
Age: 63
State:

Vax Date: 01/14/2021
Onset Date: 10/01/2021
Rec V Date: 10/04/2021
Hospital: Y

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: Admitted to Hospital on Date of Adverse Event [recorded in VAERS] for treatment of Covid-19 Positive following completion of Covid Vaccine Series

Other Meds:

Current Illness:

ID: 1758591
Sex: M
Age: 46
State: IL

Vax Date: 04/19/2021
Onset Date: 06/05/2021
Rec V Date: 10/04/2021
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.

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

Symptoms: Suffered a stroke on 06/06 , temporary paralysis in the left extremities of the body, and loss of speech.

Other Meds:

Current Illness: None.

ID: 1758592
Sex: M
Age: 48
State: TX

Vax Date: 08/13/2021
Onset Date: 08/20/2021
Rec V Date: 10/04/2021
Hospital: Y

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

Lab Data: CBC, CMP, CXR, EKG, ABG

Allergies: NKA

Symptom List: Unevaluable event

Symptoms: Recieved COVID antibody infusion the day before, became feverish and o2 sats in 80s,, SOB

Other Meds: Vitamins C and D

Current Illness:

ID: 1758593
Sex: F
Age: 47
State: MS

Vax Date: 09/23/2021
Onset Date: 09/24/2021
Rec V Date: 10/04/2021
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: ASA Pseudoephedrine

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

Symptoms: Fever to 102.7, body aches. Fever not responding well to antipyretics.

Other Meds: None

Current Illness: none

ID: 1758594
Sex: F
Age: 46
State: VA

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

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

Lab Data: MRI with my brain on June 23nd. MRI with my low back in July. Genetic test in Aug Infusion was performed in July Anti-body test performed in Sep.

Allergies: N/A

Symptom List: Injection site pain, Pain

Symptoms: I received the first dose on May 4th. I started to feel some problem with my left eye on May 10th. My left eye was blurry and floater and foggy. I did not take it seriously because I thought I need to clean and replace my eye contact lenses by then. Then it was getting worse after I received the second dose. I saw a few different eye doctors and I was told my left eye vision got dramatically lost in June at Eye doctors. I was asked to go to emergency right away because the doctor suspected something was going on my brain to affect optic nerve. I went to emergency room of local hospital and completed MRI with my brain and the results was normal. The hospital referred me to see neurologist . Then I started a few month long period to see different doctor in various states. So far all doctors ordered almost all procedures and test they could think of being correlating to my eye vision loss problem. All results are good. No one can give me firm diagnose about what are causing my eye problem. I have no ocular disease history as well as my family. I am near sight only. There is a timeline correlation between my vaccination dates and problem onset.. I am reporting this to see if any solution can help to get my vision back.

Other Meds: Multi-vitamin and grape seed supplement .

Current Illness: N/A

ID: 1758595
Sex: F
Age: 27
State: WA

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

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

Lab Data: CT scan and blood work

Allergies: None

Symptom List: Injection site pain, Menorrhagia

Symptoms: Symptoms still persisting today, missed two days of work. Diagnosed Gastritis, gastric diverticulum and multiple ovarian cysts. Treated with Maalox, morphine and zofran.

Other Meds: None

Current Illness: COVID, I tried to wait 90 days to be vaccinated and my job denied my request to wait. I was forced to get the vaccine early.

ID: 1758596
Sex: M
Age: 79
State: MI

Vax Date: 03/20/2021
Onset Date: 09/30/2021
Rec V Date: 10/04/2021
Hospital: Y

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: hypoxia & positive covid test 10/01/21

Other Meds:

Current Illness:

ID: 1758597
Sex: F
Age: 62
State: NM

Vax Date: 10/01/2021
Onset Date: 10/01/2021
Rec V Date: 10/04/2021
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: none

Allergies: none

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: all over body aches, low grade fever,chills, headache, extreme soreness to injection site , extreme fatigue x 48 hours

Other Meds: Rybelsus, Metformin, Januvia, Glyburide, Crestor, Premarin, Celexa, Toprol

Current Illness: none

ID: 1758598
Sex: M
Age: 62
State: AZ

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

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

Lab Data: N/A

Allergies: N/A

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Pt. states that after receiving the 1st dose of Phizer 09/29/2021, started experiencing symptoms within 10hrs of pain across the abdomen, shortness of breath, and constipation. No noted Primary visit, symptoms have subsided other than Constipation.

Other Meds: N/A

Current Illness: N/A

ID: 1758599
Sex: F
Age: 57
State: WY

Vax Date: 04/01/2021
Onset Date: 08/01/2021
Rec V Date: 10/04/2021
Hospital: Y

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

Lab Data: 2 day hospital stay in September. Seeing specialist to decide next step

Allergies: codeine

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

Symptoms: I have never had heart issues and I am now in A-fib. I believe this could have been brought on by the Johnson & Johnson Covid-19 Vaccination.

Other Meds: anti depressant aripiprazole januvia ozempic

Current Illness: shingles

ID: 1758600
Sex: M
Age: 57
State: GA

Vax Date: 09/23/2021
Onset Date: 09/23/2021
Rec V Date: 10/04/2021
Hospital:

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

Lab Data: None.

Allergies: None.

Symptom List: Nausea

Symptoms: Of course left arm sore for a couple of days which I think was standard. Within a few hours of the vaccine, numerous ulcers developed in my mouth and have just basically cleared up. Some minor issues with digestion resulting in (sorry for the following description) increased "stinky" gas, constipation and darker than usual pasty poop which is not normal for me. This too is leveling out and getting back to normal. Besides some slight initial head aches and weak legs it appears all may be back to close to normal.

Other Meds: None.

Current Illness: None.

ID: 1758601
Sex: F
Age: 67
State: GA

Vax Date: 03/31/2021
Onset Date: 08/20/2021
Rec V Date: 10/04/2021
Hospital:

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

Lab Data: Covid Test.

Allergies: None.

Symptom List: Injection site pain

Symptoms: I had symptoms August 20 and I was taking my granddaughter to get tested and they were doing the tests in the parking lot and as soon as we drove away I started sneezing, and so I went back and had myself tested on August 23rd and I tested positive. I experienced like a bad cold, little bit of a fever, and it pretty much went away but I couldn't go to work for 14 days, and it took my energy. On September 5 I had leg cramps very badly and I had to call out of work, and I very gently got myself going again. It sucked my energy a little bit. I did start taking an aspirin everyday and they did put me on steroids for ten days because that's the only thing they gave me. I also started taking Zinc, Magnesium, B3, and C and I'm going to finish those bottles. My symptoms lasted about 3-4 days altogether.

Other Meds: Multivitamin.

Current Illness: None.

ID: 1758602
Sex: M
Age: 55
State: IL

Vax Date: 08/20/2021
Onset Date: 09/06/2021
Rec V Date: 10/04/2021
Hospital:

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

Lab Data: 9-13-21 Immediate Care : SARS CoV-2 PCR- Negative; POCT COV-2, NAT-Negative; POCT Rapid Strep Antigen Group A: Negative

Allergies: none

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

Symptoms: Weekend of 9-3-21 felt overly tired. Eye's started to become red and bloodshot. Throat starting to become sore and hurt slightly to swallow. 9-8-21: Feeling exhausted and sinus's starting to hurt. Overall not feeling well. Throat continuing to hurt and feel's like burning -sensation at times. Start to have dry/non-productive cough during the night and occasionally during the day. Begin taking 60mg -Pseudoephedrine HCL 4x's / day along with 400mg Guaifenesin 4x's /day. Gargle with warm salt water 2-3x's per day. 9-13-21: Wake up to discharge in left eye that progressively becomes worse throughout the day. Still feeling tired and throat sore and dry cough. Schedule visit to Immediate care. 9-30-21 Visit to Primary Care: Prescribed Predisone 40mg for 5 days and Albuteral Sulfate inhalate

Other Meds: Kirkland brand Aller-Flex 180mg allergy medicine - taking prophylactically (no allergies-helps to clear nasal passages) Signature Care One Daily Men's formula Multivitamin Finest Nutrition Vitamin E 1,000 IU d-Alpha Tocopheryl Acetate and

Current Illness: none

ID: 1758603
Sex: F
Age: 23
State: PA

Vax Date: 08/20/2021
Onset Date: 09/30/2021
Rec V Date: 10/04/2021
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: Penicillin

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

Symptoms: Exactly 2 weeks after my second shot: sore throat, congestion, loss of taste/smell for a few hours.

Other Meds:

Current Illness:

ID: 1758604
Sex: M
Age: 74
State: CA

Vax Date: 09/30/2021
Onset Date: 10/02/2021
Rec V Date: 10/04/2021
Hospital: Y

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

Lab Data: Various Tests Ran

Allergies: Statin drugs

Symptom List: Tremor

Symptoms: Woke up and entire left side of body was swollen and dragging. Went to the ER and was admitted and diagnosed with a stroke.

Other Meds: None

Current Illness: None

ID: 1758605
Sex: M
Age: 59
State: SC

Vax Date: 09/30/2021
Onset Date: 10/01/2021
Rec V Date: 10/04/2021
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

Allergies: Latex

Symptom List: Erythema, Pruritus

Symptoms: N/A

Other Meds: N/A

Current Illness: N/A

ID: 1758606
Sex: M
Age: 39
State: AR

Vax Date: 09/28/2021
Onset Date: 09/29/2021
Rec V Date: 10/04/2021
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: area of painless swelling/effusion to posterior wrists/hands b/l started the day after receiving 2nd covid-19 vaccine

Other Meds:

Current Illness:

ID: 1758607
Sex: M
Age: 17
State: WI

Vax Date: 03/13/2021
Onset Date: 03/13/2021
Rec V Date: 10/04/2021
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: Child was 17 years old at time of vaccination.

Other Meds:

Current Illness:

ID: 1758608
Sex: F
Age: 65
State: NV

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

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

Lab Data: N/A. If the leg pain does not resolve by the morning of 10/05/2021, I'm thinking of visiting the local hospital ED.

Allergies: No known allergies. Sensitive to cardiac stimulants.

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Seven hours post vaccine: severe pain in both hands, strong headache, nausea, strong body aches, chills, elevated heart rate, temperature 1 to 1.4 degrees above my normal. During the night, several episodes of copious sweating. On 10/01/2021, hand pain was quite reduced, nausea was gone. On 10/02/2021, hand pain, headache, body aches resolved. But chills, sweats, and elevated heart rate continued. By 3 p.m. on 10/02/2021, deep pain in Right lower leg. Heart rate normalized sometime overnight. On 10/03/2021, still experiencing Right lower leg pain and throbbing. And still having chills and sweats during the night.

Other Meds: No prescriptions. No herbal remedies. 81 mg aspirin daily. Multi-vitamin/mineral, vitamin C, calcium, cranberry, L-lysine, Move Free.

Current Illness: None

ID: 1758609
Sex: F
Age: 61
State: AZ

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 10/04/2021
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: None

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

Symptoms: Extremely soar arm. The next 24 hours convulsion like shakes. Lethargic 48 hours

Other Meds: Losartan

Current Illness: None

ID: 1758611
Sex: M
Age: 17
State: WI

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 10/04/2021
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:

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

Symptoms: Child was 17 years old at time of vaccination.

Other Meds:

Current Illness:

ID: 1758612
Sex: M
Age: 77
State: MO

Vax Date: 01/29/2021
Onset Date: 09/24/2021
Rec V Date: 10/04/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: symptoms started 9/18 with cough and fatigue. tested on 9/23. admitted to hospital 9/24

Other Meds:

Current Illness:

ID: 1758613
Sex: F
Age: 84
State:

Vax Date: 10/04/2021
Onset Date: 10/04/2021
Rec V Date: 10/04/2021
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: Needle was not properly connected to syringe, which resulted in some leakage from the injection site. More than half was administered to the patient.

Other Meds:

Current Illness:

ID: 1758614
Sex: M
Age: 39
State: CT

Vax Date: 09/30/2021
Onset Date: 09/30/2021
Rec V Date: 10/04/2021
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: N/A

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

Symptoms: HEADACHE, LEFT SIDED NUMBNESS IN HEAD, FACE, NECK AND BILATERAL HANDS. HAS LASTED 4 DAYS CONTINUOUSLY. ZERO TREATMENTS AS THIS IS TO BE DOCUMENTED WITHIN FACILITY FIRST

Other Meds: N/A

Current Illness: N/A

ID: 1758615
Sex: F
Age: 35
State: OR

Vax Date: 09/26/2021
Onset Date: 09/26/2021
Rec V Date: 10/04/2021
Hospital:

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

Lab Data: No

Allergies: No

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

Symptoms: Started with soreness in arm that night. The next day, mild chills and body aches. That evening, I started to feel a tingling or trembling feeling in my chest and left arm. By the next day, it was also in my legs and I have been continuing to have this on and off. After the first day, the chills and body aches resolved. I have had on and off trembling in my extremities and my chest. Like an amped up electrified feeling. There has been several nights where I have slept very, very little. It's almost like my nervous system can't turn off and that I can't sleep at night. I did see my doctor and he talked about my lymph system going wild trying to do what it is suppose to do. I did have some very slight tenderness or awareness of lymph nodes in different areas in my body - armpits, in back of knees, groin area (lower abdomen) etc - that happened around 10/2 and 10/3. I am continuing to take supplements and take baths and try to drink lots of water and move around some. There are times when it's better but it's definitely worse at night when I'm not active. I feel it a lot at night and that is really bothersome. Doctor is having me wait it out.

Other Meds: Asthma inhaler; Vit D; Vit C; Multi-Vitamin; Supplement called NAC

Current Illness: No

ID: 1758616
Sex: F
Age: 78
State: PA

Vax Date: 04/27/2021
Onset Date: 10/02/2021
Rec V Date: 10/04/2021
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:

Symptom List: Vomiting

Symptoms: The patient was admitted to the hospital with COVID-19 on 10/2/21.

Other Meds:

Current Illness:

ID: 1758617
Sex: F
Age: 41
State: CA

Vax Date: 10/04/2021
Onset Date: 10/04/2021
Rec V Date: 10/04/2021
Hospital:

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

Lab Data: No

Allergies: UNKNOWN

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: The patient got the Moderna vaccine on 9/11/2021. She got J&J vaccine today from our office. She did not report she got the Moderna before got the J&J. We found it from system. Per the patient, she had adverse reactions from the Moderna and she did not want to get the Moderna 2nd dose. However, her workplace required COVID 19 vaccine. That's why she got J&J today per patient.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1758618
Sex: F
Age: 48
State: NY

Vax Date: 09/27/2021
Onset Date: 09/28/2021
Rec V Date: 10/04/2021
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: None

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

Symptoms: Headache, fatigue, heartburn, neuropathy

Other Meds: None

Current Illness: None

ID: 1758619
Sex: F
Age: 42
State: KS

Vax Date: 09/30/2021
Onset Date: 10/02/2021
Rec V Date: 10/04/2021
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: Patient stated that on Saturday she started getting a rash on her arm around the injection site and that it was pretty itchy. Did not have any other symptoms. It started getting better on Sunday and even better on Monday. Did not have this reaction to the first dose.

Other Meds:

Current Illness:

ID: 1758620
Sex: M
Age: 71
State: MN

Vax Date: 03/19/2021
Onset Date: 09/20/2021
Rec V Date: 10/04/2021
Hospital: Y

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

Lab Data: Lab Tests Completed BRAIN NATRIURETIC PEPTIDE C-REACTIVE PROTEIN (INFLAMMATION) COMPREHENSIVE METABOLIC PANEL D-DIMER QUANTITATIVE LAB ONLY-COMPLETE BLOOD COUNT WITH DIFFERENTIAL LAB ONLY-URINE MICROSCOPIC REFLEX LACTIC ACID REFLEX TO REPEAT MAGNESIUM PROCALCITONIN SARS-COV-2, INFLUENZA A+B, AND/OR RSV NUCLEIC ACID TESTING PANEL TROPONIN I TSH REFLEX URINE DIP, REFLEX TO MICROSCOPIC, REFLEX TO CULTURE Unknown Icon Lab Tests in Progress CULTURE, BLOOD performed 2 times Icon Imaging Orders Placed Today Imaging Tests CTA CHEST XRAY CHEST PORTABLE -

Allergies:

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

Symptoms: 2nd visit to ED after also being hospitalized. Diagnosis on 10/3: Reason for Visit Shortness of Breath Diagnoses 0 SOB (shortness of breath) 0 COVID-19 virus infection 0 Pneumonia of right upper lobe due to infectious organism 0 Hypotension, unspecified hypotension type transferred to hospital

Other Meds:

Current Illness:

ID: 1758621
Sex: F
Age: 66
State: UT

Vax Date: 08/16/2021
Onset Date: 09/16/2021
Rec V Date: 10/04/2021
Hospital:

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

Lab Data: CT scan at the ER, monitored heart, BP and all vitals. MRI scheduled for two weeks later. Negative results from CT and MRI.

Allergies: none

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

Symptoms: Had a seizure about 02:00 while sleeping. Whole body shakes, bit inside of mouth very severely, lost control of bowels... and I don't remember one bit of the entire event. Husband called 911, EMTs transported to hospital ER.

Other Meds: Humira ? 40 mg injection every week on Saturday Hydroxychloroquine 200 mg: one per day alternating with 2 tablets next day Acyclovir (Zovirax) 800 mg once per day Citalopram (Celexa) 40 mg once per day Simvastatin (Zocor) 20 mg once per

Current Illness: GI issues April-August 2021 - discovered 6cm linear ulcer on colon

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am