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: 1760275
Sex: F
Age: 62
State: NC

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: None to date - I left a message for my HC provider am awaiting a response or a call back.

Allergies: none

Symptom List: Dysphagia, Epiglottitis

Symptoms: I developed severe hip and lower back pain the 2nd day after the 2nd dose - I have seen a few chiropractors without relief. After I received the 3rd booster shot on Oct 1st, the next day, I had severe hip and lower back pain even worst than the previous shot. I couldn't bend, or sit without difficulty (excruciating pain). In addition, I experienced severe chills, face ache and sharp stabbing pains in my arms and legs. I also had abdominal pain, soreness at the site (not severe) and a fever of 100.0. At the time of the 3rd shot I was trying to cope with the pains, still not being quite sure that this was the source. However I'm not convinced that this is the source of my hip and back pain and it's not even worst.

Other Meds: Losartan Potassium 50 mg PO daily Crestor 10 mg PO nightly

Current Illness: none

ID: 1760276
Sex: F
Age: 75
State: MI

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: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data: None

Allergies: Sulfa and ophthalmic erythromycin each caused itching one time many years ago.

Symptom List: Anxiety, Dyspnoea

Symptoms: I had no immediate reaction at all to the vaccination. I awoke the next morning with only moderate pain and warmth at the injection site. However, 24 hours after the injection, I started developing isolated very small areas of itching -- these were tiny raised itchy spots, almost specks, that were either red, light pink, or colorless. The spots were very far apart from each other on my chest, abdomen, arms, legs, and scalp -- they did not cluster into any kind of rash formation. I would say that there were 10 to 20 spots at any one time, which would fade away, and then others would occur. I think the occurrence of these itchy spots may have interfered with my sleep (or maybe it was anxiety or something else from the vaccine), because I was practically sleepless the first night that this occurred. By 60 hours after the vaccination, the itchy spots were appearing with less frequency, and now 80 hours post-vaccination, there are only a few, although there are still new ones occurring. I am not reporting this as a major adverse event, but I wanted to document it for your records and because it would have been helpful and reassuring for me to find online information about such a reaction when it was at its worst.

Other Meds: None

Current Illness: None

ID: 1760277
Sex: F
Age: 49
State: PR

Vax Date: 10/01/2021
Onset Date: 10/03/2021
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: N/A

Allergies: Sulfa

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

Symptoms: Redness, edema, warm to the touch, itching, orange skin at injection site.

Other Meds: None

Current Illness: None

ID: 1760278
Sex: F
Age: 17
State: TN

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: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Pt report feeling light headed, dizzy, blurred vision, nauseated, loss of hearing, and tingling in the fingers in both hands.

Other Meds:

Current Illness:

ID: 1760279
Sex: F
Age: 81
State: MO

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

Lab Data:

Allergies:

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

Symptoms: SWOLLEN ARM, REDNESS, HOTNESS

Other Meds:

Current Illness:

ID: 1760280
Sex: M
Age: 42
State: PA

Vax Date: 05/15/2021
Onset Date: 06/01/2021
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:

Allergies:

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

Symptoms: Shingles

Other Meds:

Current Illness:

ID: 1760281
Sex: M
Age: 42
State: NY

Vax Date: 08/25/2021
Onset Date: 08/25/2021
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: -saw ENT about collarbone lump 9/10/21 -neck ultrasound 9/10/21 -results delivered 9/15 show multiple lymph nodes visualized all report as morphologically benign -report states collarbone lump is possible side effect of vaccine says ?known phenomenon? -follow up with ENT 9/20/21 as no change in collarbone lump. -dr ordered follow up ultrasound and FNAC biopsy of collarbone lump -biopsy completed 9/30/21 -results on 10/4/21 show reactive node -collarbone lump still no change 10/4/21

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Night of 1st vaccine had numbness in mouth & tongue Day after vaccine fever, malaise, back pain, hand pain 2 days after vaccine painful lump on collarbone on shot side 3 days after vaccine soreness in armpit on shot side All events subsided by day 4 except lump on collarbone which was then painless Lump on collarbone still there as of today 10/4/21

Other Meds:

Current Illness:

Date Died: 09/29/2021

ID: 1760282
Sex: F
Age: 83
State: KY

Vax Date: 07/22/2021
Onset Date: 09/29/2021
Rec V Date: 10/04/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: 83-year-old Caucasian female, initially seen in the emergency department with symptoms of cough, palpitations, body aches and fever. Patient had multiple family members positive COVID-19 in which she was in close contact. In the emergency department, patient required supplemental oxygen to keep O2 saturations above 88%. Patient also discovered to be atrial fibrillation with RVR. Patient was admitted to the hospitalist service, patient was started on COVID-19 protocol and isolation airborne precautions. Given dexamethasone 6 mg daily for 10 days and remdesivir for 5 days. Patient was started on therapeutic Lovenox. Cardiology was consulted for atrial fibrillation RVR, patient was to continue home amiodarone and started on a Cardizem drip. 21 September pulmonology is consulted with recommendations to keep potassium greater than 4 and magnesium greater than 2 in regards to atrial fibrillation. Treat hypoxia increasing O2 requirement to heated high-flow starting at 60 L at 100% FiO2. Patient's oxygen requirements continue to become problematic patient eventually was transferred to the ICU and placed on noninvasive ventilation. Atrial fibrillation and heart rate remained to be problematic with rate into the 130 to 140s at times. 29 September patient expressed to family members that she was tired and was ready to die, code status changed to DNR patient was transition to comfort measures and expired 1917Hr

Other Meds:

Current Illness:

ID: 1760284
Sex: F
Age: 78
State:

Vax Date: 03/01/2021
Onset Date: 03/01/2021
Rec V Date: 10/04/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Patient was given three shots way before a booster was ever in the picture. I was entering a flu shot into our state data base today and while updating the patients profile I noticed that the patient had received 3 moderna vaccines the last being at the first of march. She received her first 2 doses from our facility but the third was administered by a Hospital. That third dose was administered in error

Other Meds:

Current Illness:

ID: 1760285
Sex: F
Age: 18
State: WV

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: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: unknown

Allergies: NKA

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Patient began feeling flushed about 10 - 15 minutes after injection of 2nd Pfizer dose. (patient had similar reaction after 1st dose but symptoms subsided after 30 minutes and left clinic with no further issues.) This time however the patient rapidly began to decline and had tingling of the face with feeling of throat swelling and difficulty breathing. When the patient began to gasp for air we quickly called 911 and administered an epi-pen 0.3mg IM dose and 25 mg liquid diphenhydramine by mouth. The patient quickly began to stabilize and a few minutes later the EMS arrived and took over the patients care. After the EMS verified her vitals were stable she was transported to Hospital. Patient was monitored there then discharged and sent home. I checked on the patient post ER discharge and at one point she seemed to be feeling worse again so I instructed the family to administer 25mg diphenhydramine and return to the ER if the patient did not improve. After a couple of hours I checked on the her again and she seemed to be resting and improving. I advised the family to continue to monitor her vitals and give fluids and return to the ER if necessary.

Other Meds: escitalopram 20mg daily

Current Illness: none known

ID: 1760286
Sex: F
Age: 33
State: PA

Vax Date: 01/05/2021
Onset Date: 02/04/2021
Rec V Date: 10/04/2021
Hospital:

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

Lab Data: Labs testing for autoimmunity--my ANA was positive at 1:80 with a nucleolar pattern on 8/23; I had low IGG2 on 8/23. I had a normal Brain MRI And my other labs were normal.

Allergies: Sulfa drugs

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

Symptoms: Developed distal joint pain, subjective fevers/dysautonomia, tachycardia at rest, and palpitations around 1 week after my second vaccine. 6 months later developed new brain fog, tremors, paresthesias, and muscle fasciculations. This has now been going on for 8 months. I am currently being evaluated for suspected autoimmune small fiber neuropathy.

Other Meds: Align probiotic Nuvaring

Current Illness: None

ID: 1760287
Sex: F
Age: 53
State: NV

Vax Date: 05/19/2021
Onset Date: 05/31/2021
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:

Allergies: no

Symptom List: Rash, Urticaria

Symptoms: Had recurrent fever blisters lips beginning two days after shot - had 5 more bout os fever blisters next 10 weeks Had Ocular Migraine 1 week after - went to eye doctor Had UTI 2 weeks after the shot for 8 weeks went to 3 urgent care doctor and there was no bacteria and they could find nothing wrong

Other Meds: Vitamin D

Current Illness: none

ID: 1760288
Sex: M
Age: 32
State: AK

Vax Date: 09/11/2021
Onset Date: 09/20/2021
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: Covid-19 test taken on 9/24 returned negative.

Allergies: None

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

Symptoms: Pronounced fatigue in the morning, followed by 102 Fahrenheit fever, rapid breathing, shortness of breath, nausea, extreme pain in intestines/bowels (unable to sleep/rest), constant and severe (24/7) diarrhea, blood in stool mucus, headache.

Other Meds: None

Current Illness: None

ID: 1760289
Sex: F
Age: 73
State: WI

Vax Date: 03/04/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: No known allergies

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

Symptoms: Patient contracted COVID-19 after being fully vaccinated.

Other Meds: atorvastatin 10mg daily ergocalciferol 50,000IU Famotidine 20mg BID Hydrochlorothiazide 25mg Daily Metoprolol 25mg BID Mirtazapine 15mg HS Zinc acetate 50mg

Current Illness:

ID: 1760290
Sex: F
Age: 47
State: FL

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

Lab Data:

Allergies: NKA

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

Symptoms: Syncope. Patient woke up drank some Orange Juice. Blood pressure and vitals taken. Normal

Other Meds: Paroxetine 20mg, Buspirone 20mg, Lamotrigine 100mg, Aripiprazole 15mg, Lisinopril 5mg,

Current Illness: NONE

ID: 1760291
Sex: F
Age: 50
State: OH

Vax Date: 09/01/2021
Onset Date: 09/29/2021
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:

Allergies: None

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

Symptoms: Swallow limp mode in neck, headache, sore arm

Other Meds: None

Current Illness: None

ID: 1760292
Sex: F
Age: 56
State: PA

Vax Date: 05/15/2021
Onset Date: 08/10/2021
Rec V Date: 10/04/2021
Hospital: Y

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

Lab Data: Every test from brain Mri to heart cath. Spent 15 days total in hospital and still living with effects to the point I can?t drive or work. Was very healthy til now, tests from August 10, 2021 to present date of October 4, 2021

Allergies: Penicillin

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

Symptoms: Pericarditis, heart problems that I?m still being treated for. Fatigue, ill, can?t function to drive or work

Other Meds: Pantaprazole 40 mg oxycodone 5 mg

Current Illness: None

ID: 1760436
Sex: F
Age: 42
State: MA

Vax Date: 04/01/2021
Onset Date: 04/01/2021
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: NA

Allergies: Sulfa

Symptom List: Ear pain, Hypoaesthesia

Symptoms: 35-day migraine experienced with vaccines. Have had chronic migraines since. Never had chronic migraines before. I?ve had over 100 migraine days in 5 months, which is 66% of the time. It has been significantly debilitating.

Other Meds: Levothyroxene

Current Illness: None

ID: 1760439
Sex: F
Age: 32
State: OR

Vax Date: 09/24/2021
Onset Date: 09/28/2021
Rec V Date: 10/04/2021
Hospital:

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

Lab Data:

Allergies: Latex, oxycodone, amoxicillin

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Redness and swelling to left upper arm, developed 4 days after vaccination, hard lump to injection site, persistent redness swelling and pain present at day 10

Other Meds: NA

Current Illness: NA

ID: 1760440
Sex: F
Age: 42
State: CA

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

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

Lab Data:

Allergies:

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

Symptoms: Patient's arm was punctured by needle but there was no vaccine in the syringe. I explained to the patient that she was not given the vaccine the first time and that I had to puncture her arm a second time to inject the vaccine. She understood the explanation and agreed to the second puncture to get the vaccine.

Other Meds:

Current Illness:

ID: 1760441
Sex: M
Age: 62
State: HI

Vax Date: 09/16/2021
Onset Date: 09/16/2021
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: None

Allergies:

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

Symptoms: Client did not disclose that they had already recieved a dose of Janssen vaccine on 4/30/21 Lot # 201A21A from another provider. Requested a dose of Pfizer vaccine as his first dose, and it was administered as requested.

Other Meds:

Current Illness:

ID: 1760442
Sex: F
Age: 44
State: WI

Vax Date: 02/11/2021
Onset Date: 09/30/2021
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: Codeine - nausea and shaking losartan - cough

Symptom List: Unevaluable event

Symptoms: Patient contracted COVID after being fully vaccinated runny nose and congestion

Other Meds: fluticasone nasal BID hydrochlorothiazide-triamterene 25 daily olmesartan 5mg daily omeprazole 40mg daily polyethylene glycol 3350 daily valacyclovir 2gm q12hrs

Current Illness: None documented

ID: 1760444
Sex: F
Age: 41
State: MN

Vax Date: 02/11/2021
Onset Date: 09/27/2021
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: Covid-19 test

Allergies:

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

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

Other Meds:

Current Illness:

ID: 1760445
Sex: F
Age: 63
State: CA

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

Lab Data: None

Allergies: Sunscreens fragrances and scented shampoos and laundry detergents

Symptom List: Injection site pain, Pain

Symptoms: Numbness and Pain on left side of face. 15 minutes after vaccine was given . Not true bell palsy

Other Meds: Zyprexa and benedryl and doxylam8ne

Current Illness: Nothing just had flu shot two weeks prior.

ID: 1760446
Sex: M
Age: 26
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:
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data: None

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: No adverse outcomes have occurred thus far, however, patient was given .3 mL of Pfizer BioNTech vaccine straight (undiluted). The dose was drawn up without being reconstituted and was given to patient. We informed patient and had PCM monitoring x45 minutes. Consulted with Immunologist on next steps. Discussed red flag symptoms such as chest pain, racing heart, severe pain, etc. and when patient should go to the ER. Will follow up with patient in the morning to see how he feels.

Other Meds:

Current Illness:

ID: 1760447
Sex: F
Age: 75
State: CA

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

Lab Data:

Allergies:

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

Symptoms: Mid-Saturday afternoon - 10/2 - Patient reports a temperature of 100F. She understands as a former nurse that a fever is part of side effects. Today she said her fever peaked on Saturday to 104 F, but temperature now normal She has fever blisters in her mouth that makes it difficult for her to talk. Also, she says her vaccinated arm is red, swelling, and hot to touch from elbow to shoulder. I counselled her to see her PCP ASAP. She said when she woke up today she took some benadryl and valacylovir for her fever blisters. Patient finally said that she'd call her PCP after speaking to me.

Other Meds:

Current Illness:

ID: 1760448
Sex: F
Age: 71
State: AZ

Vax Date: 03/12/2021
Onset Date: 04/15/2021
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: LA

Lab Data: records available upon request

Allergies: none

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Blood clots in the brain, stroke, resulting in craniotomy for treatment.

Other Meds: unknown

Current Illness: none

ID: 1760449
Sex: F
Age: 33
State: MA

Vax Date: 05/02/2021
Onset Date: 06/09/2021
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: High blood pressure - 6/9/21 Protein in urine - 6/9/21

Allergies: Amoxicillin

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: At 34 weeks, 4 days pregnant I was diagnosed with preeclampsia. As a result I had to deliver early at 34 weeks, 5 days via emergency csection. My son was born 5 weeks and 2 days early at 4 pounds, 8 ounces on 6/10/21.

Other Meds: Prenatal vitamins

Current Illness: None

ID: 1760451
Sex: F
Age: 25
State: CT

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: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Tree nuts Mold Dust mites Pollen Seasonal

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

Symptoms: Chills Hot flashes Low grade fever Fatigue Body aches

Other Meds: Xolair 150mg injection Singulair 10mg Zyrtec 10mg Nexplanon Zoloft 50mg Effexor 75mg Spironolactone 100mg

Current Illness: Sore throat 2 hours prior

ID: 1760452
Sex: M
Age: 44
State: TN

Vax Date: 09/06/2021
Onset Date: 09/09/2021
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:

Allergies:

Symptom List: Nausea

Symptoms: Patient reported little "pimple like bumps" on arm where he received the injection 4-5 days post injection. He said it was not itchy or painful, but the bumps "kept growing"

Other Meds:

Current Illness:

ID: 1760453
Sex: M
Age: 48
State: GA

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:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data: None. Am a nurse practitioner; reporting as patient (received booster dose of Pfizer); deferring any work up for 4 weeks is plan. Likely association temporally with vaccine. Vaccine likely etiology; presuming reactionary lymphadenopathy only for now.

Allergies: NKDA

Symptom List: Injection site pain

Symptoms: No major systemic symptoms; minor, unilateral, ipsilateral, supraclavicular lymphadenopathy; single, mobile, slightly tender, not hard or fixed; approximately a cm; more medial and somewhat more proximal (roughly parasternal line)

Other Meds: Turmeric PRN Vitamin D PRN Alpha Lipoic Acid PRN

Current Illness: None

ID: 1760454
Sex: F
Age: 78
State: OK

Vax Date: 08/27/2021
Onset Date: 09/13/2021
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: Ct scan was clear, blood draw showed elevated white cell count.

Allergies: Phenagrin, Demerol.

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

Symptoms: Severe ongoing stomach pain, vomiting, diarrhea. Visted ER, ct scan, blood draw. Diagnosed Colitis, prescribed antibiotics and pain medication.

Other Meds: Amlodipine, folic acid, levothyroxin, licenspril, metoprolol, omeprozol, spiralnotone, sulphasalizine, atorvostatin, preservision, probiotic, prenatal vitamin, stool softener.

Current Illness: None

ID: 1760456
Sex: M
Age: 36
State: MI

Vax Date: 09/01/2021
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:

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

Symptoms: Severe rash on feet, 2 inches long on left foot and spotty on the right

Other Meds:

Current Illness:

ID: 1760457
Sex: F
Age: 47
State: CA

Vax Date: 10/02/2021
Onset Date: 10/04/2021
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: I'm going to make an appointment with my physician as soon as possible.

Allergies: Topical benzocaine causes itching. Allergic to walnuts.

Symptom List: Tremor

Symptoms: I also received the Influenza vaccine at the same time in the right arm. The metallic/electronic high pitched continuous buzzing in both ears started about 2.5 hours ago and it has not stopped despite changes in location.

Other Meds: Multi vitamin; iron supplement from Whole Foods; 81 mg aspirin. I take this most days. I do not know if I took these prior to my appointment.

Current Illness: None

ID: 1760458
Sex: M
Age: 64
State: NV

Vax Date: 09/24/2021
Onset Date: 09/24/2021
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: NONE

Allergies: unknown

Symptom List: Erythema, Pruritus

Symptoms: Patient received at a flu shot clinic at a casino a flu shot high dose , in such conditions that patient is not 65 years old until December 24th, patient did not have any side effect from vaccine , but he wrote on consent form 65 years old so pharmacist administered high dose instead of regular flu shot vaccine .

Other Meds: unknown

Current Illness: unknown

ID: 1760459
Sex: M
Age: 33
State: WA

Vax Date: 09/09/2021
Onset Date: 09/10/2021
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: sulfa antibiotics

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

Symptoms: Constant headache x 2.5 weeks. Pain level 4/10. Stabbing like to left side of the head. Typical pain medications for headaches did not improve the issue. The pain was constant, sleep did not cause the pain to go away. Each day, I woke up with the same headache. Had appt on 9/20/21 for the annual work exam. The issue was brought up during check-in with the nurse but not discussed or documented during the visit with the doctor.

Other Meds:

Current Illness: none

ID: 1760460
Sex: F
Age: 49
State: HI

Vax Date: 09/18/2021
Onset Date: 09/18/2021
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: unknown

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

Symptoms: Client did not disclose that they had already recieved a dose of Janssen vaccine on 3.12.21 Lot # 1805018 from another provider. Requested a dose of Moderna vaccine as her first dose, and it was administered as requested.

Other Meds: unknown

Current Illness: unknown

ID: 1760461
Sex: M
Age: 75
State: FL

Vax Date: 09/16/2021
Onset Date: 09/29/2021
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: as above; I do not have copy of these records yet

Allergies: Penicillin

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Patient developed acute onset of severe blurry vision in R eye on 9/29/21. He reports being diagnosed with "clot" in eye that "dissolved"--was seen by an Ophthalmologist while traveling. He also underwent hospital work up for CVA that was normal (initial CT apparently showed possible areas of concern but MRI was reassuring as per carotid ultrasound and ECHO per patient). No other associated neurologic symptoms. Vision back to baseline on 9/30/21.

Other Meds:

Current Illness: Eyelid surgery 9/8/21

ID: 1760462
Sex: M
Age: 68
State: NV

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: 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: PATIENT WIFE CALLED INFORMING US THAT PATIENT IS SHAKING UNCONTROLLABLY ASKING WHAT TO DO WE INFORM HER TO GO TO URGENT OR GO TO HOSPITAL INFORM HER THAT WE ARE MAKING A REPORT OF THE SITUATION

Other Meds: none

Current Illness: none

Date Died: 09/27/2021

ID: 1760463
Sex: F
Age: 71
State: TN

Vax Date: 03/17/2021
Onset Date: 09/25/2021
Rec V Date: 10/04/2021
Hospital: Y

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: None

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

Symptoms: Backache/side ache most of the day on Sept 25th. My mother thought it might be a kidney stone so she took Ibuprofen every 4 hours. She also had nausea most of the morning of the 25th. She woke up around 2am on the 26th gasping for air and could barely breathe. She went into cardiac arrest.

Other Meds:

Current Illness: None

ID: 1760464
Sex: F
Age: 52
State: CA

Vax Date: 09/16/2021
Onset Date: 09/18/2021
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: Being referred to an urologist after seeing ob/gyn on 10/04/21

Allergies: N/A

Symptom List: Pain in extremity

Symptoms: Uncontrolled bladder leakage. On the 18th of August, two days after the vaccination I was sitting in my office and when I stood up I looked down and I have urine all over, running down my legs and my chair was soaked. Since then I have been having to wear poise pads. It has not had any change. I have no warning of when it will happen or have any feeling of having to urinate. I have to change pads every 2 hours sometimes sooner. Can not sleep through the night with out getting up to shange pads.

Other Meds: Vitamin D Biotin 1000 Vitamin B12

Current Illness: N/A

ID: 1760465
Sex: M
Age: 66
State: SC

Vax Date: 09/24/2021
Onset Date: 09/25/2021
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: No Known Drug Allergies

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

Symptoms: Patient received vaccine on 9/24 and woke up on 9/25 with severe rash. Rash has persisted over the last 10 days. Will resolve for a few hours with Benadryl and cold compress but then reappears. Has presented on wrist, back, neck, inside of thighs. Does not report any difficulty breathing or swelling of tongue. Pharmacist encouraged patient to follow-up with PCP and report back to pharmacy. Pharmacist reported reaction to vaccine as soon as she was notified on 10/4/21.

Other Meds:

Current Illness:

ID: 1760466
Sex: F
Age: 64
State: KS

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: None as of yet.

Allergies: None

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

Symptoms: Within 6 hours of the booster shot, I started having numbness in my fingers, pain in my neck and down to my elbow. I started running a fever of 100.5. The next morning I couldn't get out of bed; couldn't lift my head off the pillow. Fever still at 100.5 throughout the second day. Third day fever was gone but the extreme fatigue continued to get worse. Fourth day again extreme fatigue and nausea. Also started bloating. On the 5th day again extreme fatigue. Continued pain in my neck and back and down my arm, as well as general aches and pains throughout my body. My heartrate has risen to 112 beats per minute, and my blood pressure as been around 100/73. I have been having a hard time getting a deep breath. It feels like I am always short on oxygen. My oxygen level has been 93 most of the day. I also have gained 7 pounds since the booster shot. 133 pounds to 140 pounds. Nausea has continued to get worse as well.

Other Meds: Lexapro; Xeloda; Atorvastatin; Aspirin; Calcium/Vitamin D3; Trazadone; Xanax

Current Illness: None

ID: 1760467
Sex: F
Age: 30
State: OR

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

Lab Data: N/A

Allergies: No

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

Symptoms: August 21st positive for COVID-19 - lingering symptoms: joint pain, LUQ pain, random headaches, sore muscles in legs. September 11th first dose of Pfizer (EW0191) sore arm, headache/tired next day. Worsening joint pain. Around 11:30am October 2nd received second dose of Pfizer. By 11:45 pm rigors, blue lips/fingers, elevated heart rate. Took scorching hot shower and bundled up. Fever followed 100.8, headache, took extra strength Tylenol 1000mg total. Relieved symptoms. October 3rd around 3:00pm had same symptoms , same treatment. Relieved fever. October 4th happened again around 4:15pm same treatment.

Other Meds: I take medication at night: Zoloft 25mg daily Vitamin D 50mcg daily Prenatal daily (breastfeeding)

Current Illness: No

ID: 1760468
Sex: F
Age: 54
State: VA

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: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: unknown

Symptom List: Vomiting

Symptoms: Patient reported itchy hives developing all over her body and numbness in her lower lip. She also reported a headache and arm soreness.

Other Meds: unknown

Current Illness: unknown

ID: 1760469
Sex: F
Age: 68
State: MI

Vax Date: 03/16/2021
Onset Date: 03/19/2021
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: None

Allergies: Sensitivity to egg white, yeast, sugar, possibly gluten

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Jansen COVID-19 vaccine eua, Three days after receiving the vaccine, I went into the most intense manic episode I have ever experienced. Symptoms began to abate within a few hours, but did not return to near normal for several weeks. I still have more mood instability than before receiving the vaccine.

Other Meds: Wellbutrin, lamotrigine, np thyroid, calcium-magnesium-zinc, B 12 sublingual, B complex, bioidentical estrogen, melatonin

Current Illness: None

ID: 1760470
Sex: F
Age: 31
State: GA

Vax Date: 10/02/2021
Onset Date: 10/02/2021
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: Unable to sleep the night of the vaccine due to sore arm and being uncomfortable. Next day whole body pain, sore arm, swelling around collar bone, chills, shaking, fever, headache, hardly able to walk around

Other Meds: None

Current Illness: None

ID: 1760471
Sex: F
Age: 46
State: GA

Vax Date: 01/20/2021
Onset Date: 01/23/2021
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: Seen by cardiologist, got EKG, labs, cardiac MRI. Seen by rheumatologist, labs done. Seen by neurologist, additional labs, EMG, and skin biopsy done.

Allergies: Sulfa

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Intermittent tachycardia began on 1/23/21. Small fiber neuropathy symptoms began about 6 weeks later with cough, arm weakness, fatigue, and pain.

Other Meds: NP thyroid, escitalopram, Mucinex, estradiol, medroxyprogesterone

Current Illness: None

ID: 1760472
Sex: F
Age: 21
State: TX

Vax Date: 10/01/2021
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: IM
Vax Site: RA

Lab Data:

Allergies: no

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

Symptoms: Patient received first dose of Pfizer vaccine on 9/24/21 at COVID vaccination clinic. Translation services was provided to patient instructing of Vaccine given, Vaccine information sheet provided, side effects to expect discussed, information regarding when to seem emergency medical services provided and information and written documentation of when second dose of vaccine due was also provided to patient. Patient' worksite offered another COVID Vaccine clinic the week after patient received first dose of Pfizer. The Moderna Vaccine was being administered on that day for patients to complete their second doses of Moderna. However, patient mistakenly arrived to onsite COVID vaccination clinic requesting administration of COVID vaccine. It was not know at the time of patient's request that she received Pfizer vaccine the previous week and Moderna vaccine was administered to patient. After Moderna vaccine dose was administered, it was later revealed that patient received Pfizer the previous week. Patient was monitored for 1 hour and CDC was contacted for next steps . Patient had no reaction and no noted adverse effects . Patient contacted and monitored for several days later till date of 10-4-21 and no adverse event and no reactions. CDC indicates no additional doses needed.

Other Meds: no

Current Illness: no

ID: 1760473
Sex: F
Age: 54
State: MO

Vax Date: 04/08/2021
Onset Date: 05/09/2021
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: none

Allergies: none

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

Symptoms: Severe nosebleed. Came one suddenly and lasted almost 20 minutes. I have never experienced any thing like this before. There was nothing I'm aware of that would have caused this.

Other Meds: none

Current Illness: none

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am