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: 1761300
Sex: F
Age: 52
State: RI

Vax Date: 09/15/2021
Onset Date: 09/16/2021
Rec V Date: 10/05/2021
Hospital:

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

Lab Data: Elevated D Dimer test CT scan to rule out pulmonary emboli Cardiac enzyme testing EKG Echocardiogram 24 hour cardiac monitoring

Allergies: PCN

Symptom List: Dysphagia, Epiglottitis

Symptoms: Consistent heart palpitations and tachycardia 48 hours post-vaccine Dyspnea with and without exertion 48 hours post-vaccine Unable to perform duties as RN since the vaccination

Other Meds: 120 Amrour thyroid 450mg XL Buproprion 20mg Viibryd 200mg Magnesium HRT cream - estrogen, progesterone, testosterone

Current Illness:

ID: 1761301
Sex: M
Age: 62
State: FL

Vax Date: 09/01/2021
Onset Date: 09/08/2021
Rec V Date: 10/05/2021
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: Pain in left calve

Symptom List: Anxiety, Dyspnoea

Symptoms: Pain in left calve

Other Meds:

Current Illness: Pain in left calve

ID: 1761302
Sex: M
Age: 74
State: MA

Vax Date: 08/19/2021
Onset Date: 08/09/2021
Rec V Date: 10/05/2021
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: Bactrim, Cephalexin, Oxycodone

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

Symptoms: Probably started 12-15 hours after the shot, I got COVID arm, from the injection site to the elbow. I was put on antibiotics. I had a fever of 99 to 103.2 which lasted about 3 days. I had extreme flu-like symptoms and lost the feelings in my legs. I could not walk for about a half a day. I went to urgent care and that is where I got the antibiotic by the way.

Other Meds: Xarelto, Methotrexate, L-Arginine, Humira, Sildenafil, Prednisone

Current Illness: n/a

ID: 1761303
Sex: M
Age: 60
State: OH

Vax Date: 03/13/2021
Onset Date: 10/04/2021
Rec V Date: 10/05/2021
Hospital:

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

Lab Data: Rapid test done on 10-4-2021, resulted positive.

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: unknown

Other Meds:

Current Illness:

ID: 1761304
Sex: M
Age: 40
State: NH

Vax Date: 09/24/2021
Onset Date: 09/24/2021
Rec V Date: 10/05/2021
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: Patient received expired dose of vaccine. Vaccine expired 9/21/2021

Other Meds:

Current Illness:

ID: 1761305
Sex: F
Age: 62
State: MD

Vax Date: 04/19/2021
Onset Date: 04/19/2021
Rec V Date: 10/05/2021
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: Seafood, amoxicillin.

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

Symptoms: Swelling lymph nodes, ear clogged, nauseous, elevated heart rate, headaches, began to turn bright red in the face area.

Other Meds: Synthroid.

Current Illness:

ID: 1761306
Sex: F
Age: 87
State: KY

Vax Date: 02/12/2021
Onset Date: 10/02/2021
Rec V Date: 10/05/2021
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:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: hospitalization (non-ICU)

Other Meds:

Current Illness:

ID: 1761307
Sex: F
Age: 60
State: TX

Vax Date: 05/01/2021
Onset Date: 06/21/2021
Rec V Date: 10/05/2021
Hospital:

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

Lab Data: None

Allergies: Unknown

Symptom List: Pharyngeal swelling

Symptoms: Excruciating pain traveling ip and down right arm. No formal treatment so far other than CBD Muscle & Joint to manage pain. I've been waiting for the pain to go as has been stated in my places.

Other Meds: Multivitamins and collagen

Current Illness: None

ID: 1761308
Sex: M
Age: 72
State: IN

Vax Date: 01/30/2021
Onset Date: 02/02/2021
Rec V Date: 10/05/2021
Hospital:

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

Lab Data: extensive blood work, details unknown course of Prednisone. Improved condition greatly but relapsed after 2 1/2 weeks

Allergies: none

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: chronic fatigue, loss of appetite , loss of weight, chronic nausea, persistent acute weakness

Other Meds: Suboxone 12/3, Lyrica 150,Trazadone 100,Dextroamphetamine 7.5, Amlodopine 100, Doxazosin 5, Finasteride 5, Breo Ellipta 1/day, Lisinopril 10, Linzess, Dexilant.

Current Illness: none

ID: 1761309
Sex: M
Age: 92
State: OH

Vax Date: 03/02/2021
Onset Date: 10/03/2021
Rec V Date: 10/05/2021
Hospital:

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

Lab Data: PCR collected on 10-3-2021, resulted positive on 10-5-2021

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: unknown

Other Meds:

Current Illness:

ID: 1761310
Sex: F
Age: 73
State: KY

Vax Date: 04/22/2021
Onset Date: 10/02/2021
Rec V Date: 10/05/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: hospitalization (non-ICU)

Other Meds:

Current Illness:

ID: 1761311
Sex: F
Age: 70
State: NY

Vax Date: 03/27/2021
Onset Date: 03/29/2021
Rec V Date: 10/05/2021
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: Penicillin MSG Paprika

Symptom List: Rash, Urticaria

Symptoms: Initially, I had flu like symptoms. I had a very sore arm, fever, and chills. The fatigue lasted quite a while. Now, I have a constant runny nose. I am achy. I have some joint discomfort. I went to my doctor and he said it was long haulers.

Other Meds: Ranolazine ER -2xday/1000mg Levothyroxine - 150mg/1xday Montelukast - 10mg/1xday Omeprazole - 20mg/1xday Lisinopril - 40mg/1xday Triamterene - HCTZ - 37.5-25mg/1xday Amlodipine Besylate - 10mg/1xday Janumet - 2xday/50-1000mg Gabapentin - 3x

Current Illness:

ID: 1761312
Sex: F
Age: 52
State: TX

Vax Date: 08/25/2021
Onset Date: 08/25/2021
Rec V Date: 10/05/2021
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: The patient was given 3 vaccines during a scheduled flu clinic. She received flu (left upper deltoid), shingles (right deltoid), and tdap (right upper deltoid) vaccines. Later that evening she developed a widespread rash covering most part of her body. She made an appointment with her MD who treated her accordingly.

Other Meds:

Current Illness:

ID: 1761313
Sex: M
Age: 64
State: KY

Vax Date: 03/29/2021
Onset Date: 10/04/2021
Rec V Date: 10/05/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: hospitalization (non-ICU)

Other Meds:

Current Illness:

ID: 1761314
Sex: F
Age: 33
State: LA

Vax Date: 06/23/2021
Onset Date: 09/20/2021
Rec V Date: 10/05/2021
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: NKDA

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

Symptoms: Patient reported that after receiving second COVID vaccination, left arm was very painful, hot to touch and swollen. Thought esperiencing normal reaction but pain never went away. Began experiencing an increased amount of pain and difficulty lifting light objects as well as dropping things. Reports it was very hard to lift or move arm even with nothing in her hand. Also reports shooting pain behind neck down arm to finger tips. Was seen by PCP because it would not stop. Reports that provider told her that she had nerve damage and is prescribed steroids and physicial therapy

Other Meds:

Current Illness:

ID: 1761315
Sex: M
Age: 63
State: NJ

Vax Date: 09/01/2021
Onset Date: 09/01/2021
Rec V Date: 10/05/2021
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 - referred -

Allergies: penicillin

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

Symptoms: Patient had pfizer vaccine mid September , he reports a headache x 3 days that he treated with tylenol, then about a week to 10 days after began having paroxysmal episodes of vertigo - no neuro deficits at time of exam and no other symptoms aside from one episode of nausea- episodes start with turning head to one side and resolve with changing position

Other Meds: Current Outpatient Medications Medication Sig Dispense Refill ? denosumab (PROLIA) 60 mg/mL Subcutaneous syrg as directed ? meclizine (ANTIVERT) 25 mg Oral tablet take 1 tab by mouth 3 times daily as needed for Dizziness for up to 10 days

Current Illness: being treated for rheumatoid arthritis and receiving Remicade infusions , physical therapy for left hip arthritis

ID: 1761316
Sex: F
Age: 51
State: NH

Vax Date: 09/24/2021
Onset Date: 09/24/2021
Rec V Date: 10/05/2021
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:

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

Symptoms: Patient received expired dose of vaccine. Vaccine expired 9/21/2021

Other Meds:

Current Illness:

ID: 1761317
Sex: M
Age: 12
State: PA

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

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

Lab Data: None

Allergies: None known

Symptom List: Ear pain, Hypoaesthesia

Symptoms: PAtient felt lightheaded immediately after initial dose of Pfizer COVID-19 vaccination. Patient reported having been extremely anxious about vaccination prior to administration. Had some pain at injection sight then felt lightheaded. No syncope, no shortness of breath and no other symptoms. No evidence of allergic reaction present on examination. Awake, alert, strong pulse, no rash, oropharynx clear, airway patent, no erythema. Reaction attributed to a vasovagal response to the injection related to anxiety.

Other Meds: None

Current Illness: None known

ID: 1761319
Sex: F
Age: 69
State: KY

Vax Date: 04/14/2021
Onset Date: 10/04/2021
Rec V Date: 10/05/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: hospitalization (non-ICU)

Other Meds:

Current Illness:

ID: 1761320
Sex: F
Age: 35
State: MI

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

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

Lab Data:

Allergies: Nickel, caffeine, morphine, vicodin

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

Symptoms: 3 hours later had tingling in the face that moved up from lip to cheek bone. Shooting nerve pain. Still to this day get this but was very prominent after both injections. Swollen lymph node in axillary region after each injection that lasted weeks. So severe it hurt to put arm down lymph node size of quarter. All covid like symptoms came back with both injections, worse after first injection. Had to take 3 days off work with second one because did not with the first one and felt terrible. Fever, headache, severe body aches, shortness of breath, red rash and swelling of injection site, swollen lymph nodes, tiredness, tingling in face and nerve pain.

Other Meds: Levothyroxine, sertraline, magnesium, probiotics, vitamin D, biotin, zinc

Current Illness: Long haulers symptoms of covid. Hashimoto?s thyroiditis, reactive airway from covid x 1.5 years.

ID: 1761321
Sex: M
Age: 50
State: KY

Vax Date: 09/27/2021
Onset Date: 09/27/2021
Rec V Date: 10/05/2021
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:

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

Symptoms: Immediately after vaccination patient said they were "feeling sick and needed a vomit bag." He described feeling "hot from his neck up...nauseous." He also said he felt, "out of it...out of body feeling." Vitals were checked by pharmacist - BP 181/111 and HR 69. EMS was called. While waiting for EMS, around 4:27 patient said they were feeling better. Still "queasy" but feeling better. EMS arrived at 4:36 pm and vitals were taken. BP 142/80, HR 74, O2 99%. Patient said he felt better. He told the EMS that he did not want to be transported to the hospital. Signed paperwork for refusal.

Other Meds:

Current Illness:

ID: 1761322
Sex: M
Age: 32
State: NJ

Vax Date: 09/13/2021
Onset Date: 09/15/2021
Rec V Date: 10/05/2021
Hospital:

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

Lab Data:

Allergies: Sudafed

Symptom List: Unevaluable event

Symptoms: Testical pain, diagnosed with premature ventricular contractions

Other Meds: medical weed

Current Illness:

ID: 1761323
Sex: M
Age: 68
State: MI

Vax Date: 04/07/2021
Onset Date: 10/05/2021
Rec V Date: 10/05/2021
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:

Allergies:

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

Symptoms: Pt comes with generalized weakness, cough, and increased shortness of breath for 1 weak. He tested positive for COVID 6 days ago. CXR consistent with COVID-19 pneumonia.

Other Meds:

Current Illness:

ID: 1761324
Sex: F
Age: 76
State: KY

Vax Date: 09/16/2021
Onset Date: 10/04/2021
Rec V Date: 10/05/2021
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:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: hospitalization (non-ICU)

Other Meds:

Current Illness:

ID: 1761325
Sex: F
Age: 55
State: PA

Vax Date: 09/27/2021
Onset Date: 09/28/2021
Rec V Date: 10/05/2021
Hospital:

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

Lab Data: EKG, Blood Work

Allergies: Percocet

Symptom List: Injection site pain, Menorrhagia

Symptoms: Chest pain and elevated blood pressure for 3 days. Body aches, low grade fever, fatigue

Other Meds: Premarin 0.625 mg, Prometrium, Magnesium 400 mg, Folic Acid, omega 3, Wellbutrin 150 mg

Current Illness: n/a

ID: 1761326
Sex: M
Age: 40
State: IN

Vax Date: 09/17/2021
Onset Date: 09/18/2021
Rec V Date: 10/05/2021
Hospital:

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

Lab Data: I have an appointment with my doctor soon.

Allergies:

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

Symptoms: Severe shoulder pain and loss of motion. Loss of motion 50% for day 1-7 and still painful and 10-20% loss of motion 18 days later. Loss of sleep for the first 2 weeks after the injection. Brain fog has been very bad since the day after the injection. I sometimes forget what I'm doing, can't focus at work, and I find myself struggling while doing a task that takes more than just a few moments. I have to force myself to pay attention and my attention keeps getting pulled away from whatever task I am doing.

Other Meds:

Current Illness:

ID: 1761327
Sex: M
Age: 77
State: KY

Vax Date: 03/25/2021
Onset Date: 10/02/2021
Rec V Date: 10/05/2021
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:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: hospitalized (ICU)

Other Meds:

Current Illness:

ID: 1761328
Sex: F
Age: 68
State: PA

Vax Date: 10/01/2021
Onset Date: 10/03/2021
Rec V Date: 10/05/2021
Hospital:

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

Lab Data:

Allergies: Penicillin, Sulfa and Macrodantin

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Redness, swelling, itchiness noted below injection site on my left arm, not on the exact injection site itself. The following day it increased in size, redness and hardness. I applied over the counter Cortisone cream and took an antihistamine. I also applied cold compress to the site later in the day when the cream and antihistamine didn't seem to be helping. It has increase in size to 51/2 inches by 5 inches.

Other Meds: none

Current Illness:

ID: 1761329
Sex: F
Age: 38
State: NC

Vax Date: 08/17/2021
Onset Date: 08/18/2021
Rec V Date: 10/05/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: CHF, and myocarditis.

Other Meds:

Current Illness:

ID: 1761330
Sex: F
Age: 40
State: IN

Vax Date: 09/30/2021
Onset Date: 09/30/2021
Rec V Date: 10/05/2021
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: Fever, chills, body aches so bad my clothes hurt touching my skin, nausea

Other Meds: Magnesium

Current Illness:

ID: 1761331
Sex: F
Age: 69
State: SD

Vax Date: 09/28/2021
Onset Date: 10/01/2021
Rec V Date: 10/05/2021
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: 18cm x 14cm red, firm/raised, hyperthermic area noted over upper lateral aspect of right upper arm which was the site of recent Covid booster.

Other Meds:

Current Illness:

ID: 1761332
Sex: F
Age: 69
State: MI

Vax Date: 04/02/2021
Onset Date: 07/31/2021
Rec V Date: 10/05/2021
Hospital:

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

Lab Data: Sunday, August 8, 2021 Rapid Covid Antigen Test - normal/negative Pulse OX Acute nasopharyngitis

Allergies: None

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

Symptoms: My second dose of the Moderna vaccine was April 02. 2021 In late July I came down with a cold that turned into a bad cough, congestion, and difficulty breathing by about a week after onset. Since I had never experienced symptoms these severe related to a cold before, and since they mimiced covid symptoms, I decided I should get tested. Test results were negative. Physical exam did not indicate bronchitis or pnuemonia. An over the counter cough aide was recommended, which I purchased. I rested, drank liquids, but was not fully recovered until about 3 weeks after the initial symptoms appeared.

Other Meds: levothyroxine, simvistatin, flonase, estradiol, multivitamin with iron, Vit B and Vit C supplements, Calcium, Fish oil

Current Illness: None

ID: 1761334
Sex: F
Age: 0
State: IA

Vax Date: 10/05/2021
Onset Date: 10/05/2021
Rec V Date: 10/05/2021
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: This was a new nurse that was hired. She told me she received Pfizer at previous employer but did not have card with her. She requested a dose of Pfizer at the end of our clinic so as not to waste. When she got home and pulled her vaccine card out she realized she had received Moderna from previous employment. She had no adverse side effects or reactions.

Other Meds:

Current Illness:

ID: 1761335
Sex: F
Age: 33
State: MD

Vax Date: 09/14/2021
Onset Date: 09/17/2021
Rec V Date: 10/05/2021
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: iodine - rash Shellfish - anaphylaxis latex - rash

Symptom List: Tremor

Symptoms: 3 days later the patient began having twitching symptoms in her right eyelid. This continued for 10 days before completely going away. She is currently asymptomatic.

Other Meds: None

Current Illness: no

ID: 1761336
Sex: M
Age: 37
State: DC

Vax Date: 03/30/2021
Onset Date: 08/01/2021
Rec V Date: 10/05/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: I had extremely sharp pain and loss of grip in my right arm. It comes and goes. It is about 6 inches from my elbows in my arm that is in extreme pain. I went to the emergency room and they told me that it will go away. I went to urgent care as well and they told me to take ibuprofen. That I must have hit it and I do not recall hitting my arm on anything. I wake up in extreme pain. I have not been able to get an appointment with a provider to have it checked out.

Other Meds: Allergy medication

Current Illness:

ID: 1761337
Sex: M
Age: 71
State: KY

Vax Date: 04/14/2021
Onset Date: 08/26/2021
Rec V Date: 10/05/2021
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: Tested Positive for Covid

Other Meds:

Current Illness:

ID: 1761338
Sex: M
Age: 45
State: VA

Vax Date: 08/15/2021
Onset Date: 08/16/2021
Rec V Date: 10/05/2021
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 : I was just notified of the reaction

Allergies: Iodine, prednisone, shrimp

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

Symptoms: Chills, and violent shaking , could barely speak , and stuttering. Vomiting for 3 hours Following day: brain fog and exhaustion

Other Meds: Vitamin D

Current Illness: none

ID: 1761339
Sex: M
Age: 78
State: KS

Vax Date: 09/30/2021
Onset Date: 10/05/2021
Rec V Date: 10/05/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Patient did not take off his bandaid until today (10/5/21) after receiving vaccine on Thursday (09/30/2021). When he took the bandaid off this morning, it was very red and the skin was broken open. He did report that he has gone swimming twice (Friday and Monday)and not showered since before last Thursday. He did not shower after swimming either and did not remove bandaid at any time between. Patient is going to try leaving the bandaid off and keeping an eye on it. He will contact his PCP if it doesn't look better in a day or so.

Other Meds:

Current Illness:

ID: 1761340
Sex: F
Age: 77
State: IN

Vax Date: 10/03/2021
Onset Date: 10/04/2021
Rec V Date: 10/05/2021
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: Bruise at site of injection. Approx 19h after injection: fever, chills, fragility, mild nausea, mild headache, unwell (all similar to flu) for 24h. Treatment: bed rest, hydration and aspirin. Full recovery by 48h post-injection.

Other Meds: Synthroid; ezetimibe; vitamin D; vitamin B

Current Illness: Sciatica

ID: 1761341
Sex: F
Age: 35
State: MN

Vax Date: 01/09/2021
Onset Date: 10/01/2021
Rec V Date: 10/05/2021
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: covid-19 rapid test, positive

Allergies:

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

Symptoms: covid-19 infection

Other Meds:

Current Illness:

ID: 1761342
Sex: F
Age: 56
State: KS

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 10/05/2021
Hospital:

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

Lab Data:

Allergies: none noted

Symptom List: Pain in extremity

Symptoms: 01/20/2021 Prior to getting the vaccine I took a Zyrtec and Ibuprofen. I had the vaccine around 0910 am. Approximately 2 hours later, maybe longer, I noticed both of my arms were bright red and either flushed or had a rash. I also noticed redness around my chest and neck area later that afternoon. I was fine at that point and had no other symptoms, except the typical arm soreness where the injection occurred. 01/21/2021 At approximately 1230 am the next morning I woke up with a headache, was sweating and vomited. I was awake most the night and stayed home from work. I ran a low grade fever 99.1-99.2. I also had some other common side effect, including feeling tired weak and a few spills of dizziness. I was fine by the next day and completely back to normal. 01/28/2021 I spoke to my doctor?s office this morning. They advised I was okay to take the second vaccine. They said one hour prior to taking the vaccine to take a Zyrtec, Ibuprofen, and Pepcid.

Other Meds:

Current Illness: none noted

ID: 1761343
Sex: M
Age: 42
State: WA

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

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

Lab Data: N/A

Allergies: Erythamiacin

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

Symptoms: Extreme flu like symptoms, loss of sleep, confusion, night sweats, chills

Other Meds: Vitamin c and D3

Current Illness: N/A

ID: 1761344
Sex: M
Age: 72
State: OH

Vax Date: 09/26/2021
Onset Date: 09/27/2021
Rec V Date: 10/05/2021
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: Client went to the ER, heart interventions and medication prescribed

Allergies: none noted

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

Symptoms: Had injection on 9/26/2021, on 9/27/2021 he stated he was watching football on television, Client stated at home and felt like torso was being crushed, foreboding feeling, took Tylenol and rested, by 5 PM he decided to go to ER, stated was taken by priority after 3 people were taken ahead of him in the crowded waiting room of ER, heart attack described as silent widowmaker, had balloon angioplasty and 2 cardiac stents placed, was admitted to the hospital as inpatient from 9/27-10/1/2021

Other Meds: Balsalazide 750 mg, Allopurinol 300 mg, Furosemide 20 mg, Cyclobenzaprine 10 mg, Glipizide ER 5 mg, Levothyroxine 50 mcg, Albuterol sulfate HTA 90 mcg inhaler, Ursodiol 250 mg, Lorazepam 0.5 mg, hyoscyamine ER 0.375 mg

Current Illness:

ID: 1761345
Sex: F
Age: 81
State: PR

Vax Date: 10/01/2021
Onset Date:
Rec V Date: 10/05/2021
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: N/A

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

Symptoms: N/A

Other Meds: For diabetes

Current Illness: DIABETES

ID: 1761346
Sex: M
Age: 27
State:

Vax Date: 09/09/2021
Onset Date: 09/13/2021
Rec V Date: 10/05/2021
Hospital:

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

Lab Data: CXR normal EKG normal

Allergies: NKDA

Symptom List: Vomiting

Symptoms: After injection pt noticed fatigue during workouts. Pt reports 'aggressive heart beat' during workouts which is new for him. He reports symptoms for past couple weeks after receiving initial COVID vaccine dose. Chest pain comes and goes intermittently throughout the day. Pain during exertion (working out). Pt had CXR, EKG and blood draw. He was also told he has heart murmur. EKG with sinus rhythm (normal).

Other Meds: None

Current Illness: None

ID: 1761347
Sex: F
Age: 90
State: KY

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

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: hospitalization (non-ICU)

Other Meds:

Current Illness:

ID: 1761349
Sex: F
Age: 82
State: SD

Vax Date: 09/28/2021
Onset Date: 10/01/2021
Rec V Date: 10/05/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Red swollen warm with 6x6 cm rash to R arm injection site

Other Meds:

Current Illness:

ID: 1761350
Sex: F
Age: 35
State: PA

Vax Date: 09/22/2021
Onset Date: 09/29/2021
Rec V Date: 10/05/2021
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: none

Allergies: ceftin, seasonal, apples, cherries

Symptom List: Injection site swelling, Limb discomfort

Symptoms: full body rash. pustular. painful on palms and soles of feet used telemedicine dr who prescribed 0 meds. told me to ride it out 10/2- onset of L finger severe swelling, fever and pain. onset random, no precipitating event. used telemedicine again and dr adivsed me to be seen in urgent care. Was seen in urgent care and told to take Allegra 60mg BID other fingers starting to now hurt mildly as well

Other Meds: vitamin c, coq10, melatonin, prenatal vitamin

Current Illness: none

ID: 1761351
Sex: M
Age: 76
State: KY

Vax Date: 03/22/2021
Onset Date: 10/01/2021
Rec V Date: 10/05/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: hospitalization (non-ICU)

Other Meds:

Current Illness:

ID: 1761352
Sex: F
Age: 29
State: KY

Vax Date: 05/12/2021
Onset Date: 08/30/2021
Rec V Date: 10/05/2021
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: Tested Positive for Covid

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am