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: 1762243
Sex: F
Age: 65
State: NH

Vax Date: 04/03/2021
Onset Date: 09/03/2021
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: Covid test

Allergies: Penicillin; Bee Stings

Symptom List: Dysphagia, Epiglottitis

Symptoms: I had a small tickle and sore throat on September 3 and the person I got it from that happens to be a therapist called me on 09/04/2021 and she said she tested positive and I wasn't feeling good and it kept getting worse. After she called me, I figured that's why I was feeling sick so I went and got tested at a walk in clinic on 09/05/2021 and since it was a rapid test it told me in 15 minutes it was positive. Then I got really sick that night, so I went to the hospital on 09/06/2021 around 10:00 and I was sick but not horrible. They gave me viral pack of antibiotics and fluids and they gave me something for the pain. I was there for hours and they sent me home and told me to call my doctor. I had No taste, no smell, headaches, Pain, aches, low grade fever. I normally run 97 and one day I was 99, Fatigue was so bad, I had anemia before and that's bad and I couldn't walk past my yard, and this was worse. I also had Decreased breath sounds The next day, on 09/07/2021 I got some codeine cough medicine and I got bronchitis and Dr also gave me inhalers. It took the whole ten days. On 09/21/2021 I went to the pharmacy and do the nasal swab in the car and wait for the results, so I waited 5 days for that and it came back negative on 09/26/2021.The hospital didn't admit me because I wasn't in desperate need to be in hospital and my lungs were good. I am still having ongoing symptoms of fatigue which hasn't stopped at all, I run out of breath easily, COVID Brain (brain fog), Forgetting things, I know it?s age related but it's worse now. I do have my taste and smell back, and not many aches and pains, no sore throat or headache. Just fatigue and brain.

Other Meds: Insulin; Low Thyroid Medication; Depression Medications

Current Illness: None.

ID: 1762244
Sex: F
Age: 59
State: WA

Vax Date: 09/01/2021
Onset Date: 09/02/2021
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: None

Allergies: Sulfa; topical thimerasol; melons

Symptom List: Anxiety, Dyspnoea

Symptoms: I woke up at 4am on 9/2/21 with a severe headache. Within 2-3 hours, I developed global, head to toe body aches. I also suffered severe fatigue and spent 21 of the next 24 hours 9n bed, sleeping.

Other Meds: Effector XR 150mg qd; Micardis 80mg qd; HCTZ 10mg qd; Singulair 20mg qd; Eloquis 10mg bid; Fish Oil 1400mg qd; Quercetin/Zinc qd: Vit D 5000mg qd; Vit C 1200mg qd; Calcuum citrate 1000mg qd; Women's formula multivitamin qd; Ceterizine qd;

Current Illness: None

ID: 1762245
Sex: M
Age: 61
State: CA

Vax Date: 03/17/2021
Onset Date: 03/27/2021
Rec V Date: 10/05/2021
Hospital: Y

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: Echo Cardiogram and more

Allergies: None

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

Symptoms: no history of heart issues prior to vaccine, as of today Aorta Valve Replacement done April 29, 2021

Other Meds: Levothyrooxien 125mg Simvastatin 40mg Bupropion HCL 150mg

Current Illness: None

ID: 1762246
Sex: F
Age: 61
State: MN

Vax Date: 12/18/2020
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:

Allergies: Bactrim; Tetracycline

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Lot numbers not documented for dose 1 and 2. Runny nose and congestion started 10/4/21

Other Meds: Zolpidem; Ondansetron; Wellbutrin; Meloxicam; Lyrica; Sumariptan; Vitamin D3; Magnesium; MiraLax, Flonase,

Current Illness: none

ID: 1762247
Sex: M
Age: 62
State: MS

Vax Date: 05/13/2021
Onset Date: 05/13/2021
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: 10/5/2021: CBC, CMP, ESR, CRP, uric acid, x-ray cervical spine/right shoulder/right elbow, MRI right shoulder

Allergies: none

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

Symptoms: unresolved right upper arm pain at site of injection radiating to right shoulder and right side of neck unresolved with acetaminophen and Aleve

Other Meds: allopurinol, atorvastatin, diclofenac gel, vitamin D, hydrochlorothiazide, Lantus Solostar, melatonin, metformin, omeprazole, sertraline, valsartan

Current Illness: no acute illness

ID: 1762248
Sex: M
Age: 27
State: NJ

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

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

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1762249
Sex: M
Age: 59
State: CA

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: LA

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Immunization given early (one week early)

Other Meds:

Current Illness:

ID: 1762250
Sex: F
Age: 44
State: WA

Vax Date: 04/05/2021
Onset Date: 07/07/2021
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: Ct scan of the chest x-ray of the chest ultrasound of the lower extremities

Allergies: Metformin

Symptom List: Pharyngeal swelling

Symptoms: I was having trouble SOB with exertion. I went to urgent care to see what was causing it. I had a pulmonary embolism in both lungs this happened 3-4 months after your vaccine. They did chest x-ray and CT scan, and ultrasound of my legs if they could find any other blood clots. There were not any blood clots in my legs just in my lungs. Because of my heart rate being high and other morbidities, and they recommended . I went to the Hospital, and they did no admit me but gave me two syringes with blood thinner medication to inject twice a day. I went home and I called clinic and was bale to get on Prodaxa medication which I took over the injections. I also took Tylenol for my arthritis now. I was told to be on blood thinners for at least six months.

Other Meds: Tylenol, prescription for Ibuprofen, Prozac and Hydroxyzine

Current Illness:

ID: 1762251
Sex: M
Age: 43
State: NC

Vax Date: 10/04/2021
Onset Date: 10/04/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: Systemic: Fainting / Unresponsive-Mild, Additional Details: patient fainted 5 minutes after injection. after recovery, felt like he was going to faint again. pt had covid several months ago, if that matters as a statistic for fainting reaction

Other Meds:

Current Illness:

ID: 1762252
Sex: F
Age: 58
State: LA

Vax Date: 09/15/2021
Onset Date: 09/15/2021
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: Did not go to MD after AE's

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Fever, chills, large swollen arm, patient fell down and hit head at 2:30am when walking dog. Attributes the fall the the covid shot.

Other Meds:

Current Illness:

ID: 1762253
Sex: F
Age: 41
State: OR

Vax Date: 10/03/2021
Onset Date: 10/05/2021
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:

Allergies: Strawberries Sulfa Drugs

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

Symptoms: Heart palpitations, fever, body aches, nausea, diarrhea

Other Meds: Levothyroxine Celexa Benadryl taken 30 minutes prior to vaccine, had itching reaction with first vaccine shot

Current Illness: None

ID: 1762256
Sex: M
Age: 54
State: FL

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

Symptom List: Rash, Urticaria

Symptoms: Site: Pain at Injection Site-Severe, Systemic: neck pain-Severe

Other Meds:

Current Illness:

ID: 1762257
Sex: F
Age: 50
State: CA

Vax Date: 05/22/2021
Onset Date: 05/23/2021
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: Nothing was done was simply told to take pain reliever to reduce headache.

Allergies:

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

Symptoms: I have had chronic headaches since getting the shot. I never have experienced headaches in the past except occasionally around my time of the month. I have had a headache every single day since I got the shot. The day following the shot the headache was so bad I couldn?t open my eyes or lift my head off the pillow. I have to take Excedrin migraine every day in order for the headaches to be relieved. When I mentioned it to the doctor at my last appointment (back pain) he just brushed it off and said it was most likely due to something else.

Other Meds: None

Current Illness: None

ID: 1762258
Sex: F
Age: 45
State: NJ

Vax Date: 09/18/2021
Onset Date: 09/18/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1762259
Sex: M
Age: 75
State:

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

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

Lab Data:

Allergies:

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

Symptoms: 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: 1762260
Sex: F
Age: 55
State: WI

Vax Date: 03/01/2021
Onset Date: 06/01/2021
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: Dermatologist examined forehead and took biopsy in September 2021. I was diagnosed with linear scleroderma - en coupe de sabre. Could be completely coincidental, but just in case others have received this diagnosis too.

Allergies: Sulfas, Erythromycin, Zithromycin

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

Symptoms: I experienced increased muscle and joint pain for several months following my 2 vaccines. Three months after my vaccines, I started noticing discoloration on my forehead and a crease in my forehead and skull.

Other Meds: Singular, Prempro, various allergy-related nasal sprays, Sudafed

Current Illness:

ID: 1762261
Sex: F
Age: 40
State: NY

Vax Date: 09/10/2021
Onset Date: 09/11/2021
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: I went to see my doctor on Tuesday September 14th 2021 at 10am. The doctor preformed a number of standard eye test on me and I failed them all she was able to determine right away that I have vertigo. She prescribed Meclize.

Allergies: Allergic to cigarette smoke, tree pollen, and dust.

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

Symptoms: About 24 hrs. after receiving my 2nd dose of the Pfizer vaccine, I developed extreme dizziness to the point where is could not stand up straight without falling over.

Other Meds: Zyrtec

Current Illness: None

ID: 1762262
Sex: F
Age: 23
State: NJ

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

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1762263
Sex: F
Age: 59
State: PA

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

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

Lab Data:

Allergies: No known drug or food allergies

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Severe hives all over upper and lower arms, upper and lower legs, stomach, back, sides, hips, entire body except face. Also, per my dermatologist to examine to me, the hives triggered an auto immune reaction and I also developed plaque psoriasis on my upper legs as a result of my body reacting to the Covid vaccination hives. This did not resolve on its own, I had to use anointment on my whole body twice a day for another three weeks, before the rashes disappeared around mid May 2021. Because of this, I will not be getting any boosters because of my severe reaction to this vaccine. The next one could be even worse for me.

Other Meds: Nifedipine, Modafinil, clonazepam, valacyclovir, Lasix, Antonella, losartan, bupropion, Restasis, tequila, horizant,

Current Illness: No acute illnesses at the time. Note that I did report this before, and someone did call me, but I lost the phone number before I could call back. I developed severe hives on upper and lower extremities, torso, back, pretty much everywhere. I have photos. For this reason I will not be getting any boosters. With all of my autoimmune illnesses, the second vaccine triggered such a bad reaction that who knows what subsequent vaccines will do to me. I believe this should be documented.

ID: 1762264
Sex: F
Age: 49
State: TX

Vax Date: 08/18/2021
Onset Date: 08/20/2021
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: COVID - got lost

Allergies: Sulphur, Latex

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

Symptoms: COVID test negative. took couple of days and with fatigue, Tuesday had normal doctor's appt and had sore throat, by that evening I felt worse and lasted 2 weeks. I had a fever, stomach issues. Diarrhea and aches and pains and chills. The COVID swap 23 AUG2021 got lost and now I feel like I have allergies. I am better but I have bad allergies with Hay fever some it's better and some days it's bad.

Other Meds: Vitamins Iron , B complex, C, D and Turmeric and Fish Oil Metformin - 500 milligrams twice a day, Gabapentin - 300milligram 3 times a day, rosuvastapin - 5milligram once a day, olmeartan - 20milligram once a day, duloxetine - 30 milligrams

Current Illness: no

ID: 1762265
Sex: F
Age: 51
State: IA

Vax Date: 09/11/2021
Onset Date: 09/11/2021
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: No known allergies

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

Symptoms: Patient received Jansen vaccination on 4/8/21 at another clinic, then received Pfizer dose 1 at this pharmacy on 9/11/21, and dose 2 at another pharmacy on 10/2/21. Patient did not disclose at either visit that she had Jansen previously.

Other Meds: Unknown

Current Illness: Unknown

ID: 1762266
Sex: M
Age: 51
State: MI

Vax Date: 09/03/2021
Onset Date: 09/05/2021
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: UNKNOWN

Allergies: NONE

Symptom List: Unevaluable event

Symptoms: MIGRAINE THAT LASTED 2 WEEKS, TREATMENT UNKNOWN

Other Meds: UNKNOWN

Current Illness: UNKOWN

ID: 1762267
Sex: M
Age: 28
State: NJ

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

Lab Data:

Allergies:

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

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1762268
Sex: F
Age: 51
State: CO

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

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

Lab Data:

Allergies: Lactose Latex Penicillin Ciprofloxacin

Symptom List: Injection site pain, Pain

Symptoms: The lymph node in the armpit of the arm I received the shot in became significantly swollen. I first noticed this on Saturday 10/2 when I woke up around 7 am. The size of the lymph node was about the same as a golf ball. The area was red and very tender. I have taken Tylenol and/or Advil regularly to help with the discomfort. I also applied a warm compress to the site. As of today (10/5/2021), the swelling has reduced, but the tenderness is still present.

Other Meds: B-12 Multi-Vitamin

Current Illness:

ID: 1762269
Sex: F
Age: 57
State: GA

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

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

Lab Data: no

Allergies: sulfa base antibiotics

Symptom List: Injection site pain, Menorrhagia

Symptoms: On 08/15/2021 I did not make an immediate correlation. Symptoms --mild headache, vaginal discharge, and thrush on my tongue. They continue to get worse until the end of September. In September I went to see my physician. She prescribed an absorbic acid flush, or vitamin C flush. I have been doing different baths to try get rid of the systemic candida. At the end of September, Dr. diagnosed it as systemic candida. My symptoms have not completely recovered. I am still experiencing some of the symptoms.

Other Meds: probiotic Garden of Life 100billion cu liquid vitamin D 3000 iu Evening primrose oil CBD tincture L-Gultamine cholenest omega 369 - complete omega multivitamin Biotoxin binder 2 od

Current Illness: no

ID: 1762270
Sex: F
Age: 28
State: CA

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

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

Lab Data:

Allergies: amoxicillin

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

Symptoms: Received shot on 10/2 11:30am, on 10/3 6:45am woke up to use the bathroom and as I was walking back from the bathroom I fainted and woke up gagging, sweaty, with 100.7 fever.

Other Meds: Lexapro, Portio Birth Control

Current Illness:

Date Died: 09/20/2021

ID: 1762271
Sex: M
Age: 74
State: MN

Vax Date: 03/17/2021
Onset Date: 09/20/2021
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: LA

Lab Data: Unknown. Medical investigator refused to engage.

Allergies: None.

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: The patient was found dead on 28th September. The deceased seemed to have struggled to stand up and fell onto the floor. There was a great deal of blood. The medical investigator immediately declared this death to be natural causes and refused to file a Vaers report stating that it had been too long (6 months and 2 weeks) and she would only file one up to 6 months; or carry out an autopsy which was requested by the various next of kin who were contacted, stating the body wasn't 'fresh enough'. Communications suggest the death occurred on 20th of September on the evening that the deceased had attended (and lead) a Meeting.

Other Meds: Unknown. None identified.

Current Illness: None.

ID: 1762272
Sex: F
Age: 61
State:

Vax Date: 06/11/2021
Onset Date: 10/04/2021
Rec V Date: 10/05/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

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: 1762273
Sex: F
Age: 58
State: MN

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: 1
Vax Route: IM
Vax Site: RA

Lab Data: NA

Allergies: Erythromycin, sulfa

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

Symptoms: Body aches chills fever 100.2 tiredness exhausted

Other Meds: No

Current Illness: N/A

ID: 1762274
Sex: F
Age: 26
State: IL

Vax Date: 10/01/2021
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: 1
Vax Route: IM
Vax Site: RA

Lab Data: blood sugar : 85 bp 66/40 pulse 88

Allergies: na

Symptom List: Nausea

Symptoms: Lost vision completely for 20 minutes diaphoretic hypotension left pupil 4 x larger than right not responsive to light short of breath

Other Meds: multivitamin, probiotic, magnesium

Current Illness: na

ID: 1762276
Sex: F
Age: 74
State: NE

Vax Date: 10/01/2021
Onset Date: 10/02/2021
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: N/A

Allergies: Losartan, Bacterium, Contrast Dye

Symptom List: Injection site pain

Symptoms: Pt. states that after receiving the 3rd dose Booster of Phizer 10/01/2021, started experiencing symptoms 10/02/2021 of Severe chills, shortness of breath, fatigued, swollen lymphoids, indigestion, and low-grade fever (99.3). No noted Primary visit. Symptoms have symptoms.

Other Meds: Plavix, Elaquix, Zedia, Clamonadien, Hydrolozien, Leveloxien, Renexa, Crestor, Fish Oil, Calcium D3, B12, Progestrone

Current Illness: N/A

ID: 1762277
Sex: M
Age: 68
State: NJ

Vax Date: 09/18/2021
Onset Date: 09/18/2021
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 induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1762278
Sex: F
Age: 65
State: NV

Vax Date: 04/01/2021
Onset Date: 04/23/2021
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: I have to take monthly labs for my liver and kidneys because all these drugs can damage my liver. All the tests have come back within the limits. That's related to the Arthritis medications (the testing is). Had a bone density test, too - when you take steroids for rheumatoid arthritis it can cause bone loss. The tests have shown over the last few years - first I was osteoporosis and then I got it down to Osteopenia but the latest test results are increasing the numbers again - still Osteopenia but higher number. The results are worse than it was in 2012. I am taking a drug called Alendronate - I started that two weeks ago today.

Allergies: no

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

Symptoms: I had increased symptoms - pain, stiffness and swelling has increased since I took the vaccination. I was pretty much symptom-free before that. But I did change medicine right before that on March 17th, 2021 - it was the Cimzia that was new to me. I have had increased pain requiring additional medications like Methylprednisolone - starting that in May 2021. I am continuing to have the pain, stiffness and swelling. I am on low doses of Methylprednisolone - because it's not good to be on a lot.

Other Meds: Cimzia - injection once a month; Amlodipine; Losartan; Finasteride; Fish Oil; Citracal; Vit C; Multiple Vitamin; Vit D; Folic Acid; Tamsulosin; Prilosec; Atorvastatin

Current Illness: no

ID: 1762279
Sex: F
Age: 16
State: GA

Vax Date: 10/04/2021
Onset Date: 10/04/2021
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: None

Symptom List: Tremor

Symptoms: Moderna COVID-19 Vaccine EUA inadvertently given instead of Pfizer BioNTech COVID-19 Vaccine EUA. No symptoms appeared during the 15 minute wait time after vaccine administered and currently no other symptoms at this time.

Other Meds: Unknown

Current Illness: None

ID: 1762280
Sex: F
Age: 38
State: TN

Vax Date: 10/04/2021
Onset Date: 10/05/2021
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: strep, flu and covid test both negative. cbc and cmp not available yet. Chest xray waiting for over read. Instructed if symptoms worsened or started having chest pain to go to nearest er.

Allergies: Tetracycline

Symptom List: Erythema, Pruritus

Symptoms: Pt awoke this morning running fever of 101, dyspnea, hear rate up to 130 at home and severe body aches. Pt took motrin pta and temp down to 98.5 once arrived

Other Meds: Aspirin 81mg daily, vitamin d.

Current Illness:

ID: 1762281
Sex: M
Age: 70
State: NJ

Vax Date: 09/21/2021
Onset Date: 09/21/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1762282
Sex: F
Age: 42
State: IL

Vax Date: 09/22/2021
Onset Date: 09/23/2021
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: On 9/28/21, CBC W/DIFF AUTOMATED, COMPREHENSIVE METABOLIC PANEL, MAGNESIUM, PARTIAL THROMBOPLASTIN TIME, PTT; PROTIME/INR, VENOUS; TROPONIN, QUANT; TSH W/REFLEX; ECG 12 lead; XR Chest Portable were normal.

Allergies: Shellfish, Soy, Latex, Iodine

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

Symptoms: Numbing and tingling sensation in left arm and hand occurring numerous times throughout the day and night. Occasional heart palpitations. Feeling of heaviness in left chest when arm and hand goes numb.

Other Meds: Dietary supplements taken (Women's One A Day, Vitamin C, Iron, B-complete, Fish Oil)

Current Illness: Test positive for Covid-19 on 7/17/21

ID: 1762283
Sex: F
Age: 90
State: NJ

Vax Date: 09/21/2021
Onset Date: 09/21/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1762284
Sex: F
Age: 31
State: PR

Vax Date: 10/04/2021
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: NONE

Allergies: NONE

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

Symptoms: Patient is an employee of the hospital and arrives to the vaccination area requesting to get the third dose PFIZER. Patient fills out the document. PFIZER vaccine is administered and when requesting the CDC card we realized that she had the first two doses of MODERNA. Patient reports not knowing that it was not PFIZER. We follow up by phone and she reports feeling good. Booster dose (third) PFIZER was administered to patient with MODERNA primary series without presenting adverse affects.

Other Meds: NONE

Current Illness: NONE

ID: 1762285
Sex: M
Age: 22
State: CA

Vax Date: 09/27/2021
Onset Date: 10/02/2021
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:

Allergies: Penicilins

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

Symptoms: Hives on lower back, shoulders, neck, arms, hands, feet, buttocks, genital area, ears, eyes, forehead, and scalp Variable frequency for three days and counting Treating with localized cold compress, Benadryl, epsom salt, Dermasil lotion

Other Meds: Paxil Buspar Trazodone

Current Illness:

ID: 1762286
Sex: F
Age: 81
State: NJ

Vax Date: 09/21/2021
Onset Date: 09/21/2021
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: Pain in extremity

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1762287
Sex: M
Age: 50
State: TN

Vax Date: 03/31/2021
Onset Date: 07/14/2021
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: Multiple Bloodwork checks of CEA Level, 2 Petscans a liver biopsy and a colonoscopys with no signs of cancer

Allergies: Shellfish

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

Symptoms: Increased CEA (Carcinoembryonic Antigen) Levels without finding any cancer. CEA Levels increased from a 2 to a 36 over a 6 month period.

Other Meds: Crestor 10mg Levothyroxine sodium 100mg Metformin HCL ER 500mg x2 Montelukast sodium 10 mg Flomax .4mg Duexis 800-26.6 mg x3 Adderall XR 30mg

Current Illness: Type 2 Diabetes Adult ADD

ID: 1762288
Sex: F
Age: 0
State: IN

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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Hydrocodone

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

Symptoms: Nausea - continuous Diarrhea Vomiting

Other Meds:

Current Illness:

ID: 1762289
Sex: F
Age: 77
State:

Vax Date: 08/09/2021
Onset Date: 10/05/2021
Rec V Date: 10/05/2021
Hospital: Y

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

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: 1762291
Sex: M
Age: 69
State: NJ

Vax Date: 09/20/2021
Onset Date: 09/20/2021
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:

Allergies:

Symptom List: Vomiting

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1762292
Sex: F
Age: 34
State: CA

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: 037K20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Allergic to Ibuprofin, Aspirin, and Mango

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: The following day after receiving the vaccine, I experienced a tightness in my chest that has been on going. 3 Days after vaccine I experienced fever, sore throat, chills, extreme fatigue, and cough. I am breast feeding an infant and the infant also began to experience same symptoms of illness. On the 8th day after receiving the vaccine, I discovered a large, swollen, itchy and painful rash at the injection site.

Other Meds: None

Current Illness: None.

ID: 1762293
Sex: F
Age: 68
State: IN

Vax Date: 10/05/2021
Onset Date: 10/05/2021
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: NONE

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

Symptoms: THE PATIENT IMMEDIATELY HAD A SEIZURE UPON ADMINISTRATION. SHE DOES HAVE A SEIZURE DISORDER AND IS ON DEPAKOTE FOR THE CONDITION. THE PATIENT HAD NO PREVIOUS ISSUES WITH DOSES 1 AND 2. SHE HAD 2 SEIZURES, CAME OUT OF THEM PRETTY QUICKLY. SHE WAS THEN NAUSEOUS AND HAS BEEN NAUSEOUS THE REST OF THE DAY. I JUST CHECKED IN ON HER THIS EVENING. SHE IS RESTING AT HOME.

Other Meds: UNKNOWN

Current Illness: SEIZURE DISORDER

ID: 1762294
Sex: F
Age: 52
State: FL

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: Patient contacted doctor on 10/5/21; pending response from md.

Allergies: MORPHINE

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Starting on 10/3/21 patient right arm developed redness, tenderness to touch, warm to touch, limited range of motion and headache. As of 10/5/21 patient is still experiencing symptoms and came to the pharmacy to report them. Patient was advised to contact the physician. Pending outcome from physician.

Other Meds: ATORVASTATIN, LOSARTAN

Current Illness: NONE

ID: 1762295
Sex: M
Age: 47
State: NJ

Vax Date: 03/29/2021
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: PCR + for Covid 10/3/2021

Allergies: none known

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

Symptoms: Client received Pfizer vaccines for Covid on 3/29 and 4/19/2021. Symptoms started 9/30: chills, fever, fatigue. Tested PCR + for Covid on 10/3. Reported as breakthrough Covid case in a fully vaccinated person

Other Meds: none known

Current Illness: none known

ID: 1762296
Sex: M
Age: 56
State: NY

Vax Date: 09/20/2021
Onset Date: 09/20/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am