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: 1763110
Sex: F
Age: 56
State: CA

Vax Date: 01/10/2021
Onset Date: 01/10/2021
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: Ongoing phy sical therapy

Allergies: Sulfa

Symptom List: Dysphagia, Epiglottitis

Symptoms: Sore arm at injection site. Joint pain 3rd day after shot which created imbalance (I think) leading to more chronic, and new ankle pain

Other Meds: Flonase Azelastine

Current Illness: N/A

ID: 1763111
Sex: F
Age: 69
State: CA

Vax Date: 09/26/2021
Onset Date: 09/26/2021
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:

Symptom List: Anxiety, Dyspnoea

Symptoms: Vaccine expired in refrigerator on 9/25/21, but vaccine was administered on 9/26/21 (vaccine is stable undiluted in the refrigerator on-label for a duration of 31 days, 9/25/21 would have been the 31st day). Vaccine had not been pulled from the refrigerator the day that it expired on 9/25/21, hence accidental continued use by another pharmacist on 9/26/21. Pfizer med info reported that, based on physical stability data, there is an extended excursion time of +1 day for a total stable undiluted refrigerated time of 32 days, but to still file reports due to off-label use.

Other Meds:

Current Illness:

ID: 1763112
Sex: F
Age: 51
State: MD

Vax Date: 05/09/2021
Onset Date: 05/10/2021
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:

Allergies: Doxycycline

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

Symptoms: 1 st vaccine soreness in my arm lasted a day 2nd vaccine weak no appetite could not get out of the bed left leg swollen (size of both calls together)for 9 days. Skin continues to break out since second injection in hives swelling itching.

Other Meds: Amlopidine-benazepril10-40MG

Current Illness: Was very weak, no appetite, cold sweats, in bed for over 9 days after second vaccination.

ID: 1763113
Sex: F
Age: 60
State: CA

Vax Date: 01/31/2021
Onset Date:
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: Audiologist 10/6/2021

Allergies: Shrimp Cefatraxone

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Tinnitus

Other Meds: Vit . B &D

Current Illness:

ID: 1763114
Sex: F
Age: 73
State: CA

Vax Date: 09/26/2021
Onset Date: 09/26/2021
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: Vaccine expired in refrigerator on 9/25/21, but vaccine was administered on 9/26/21 (vaccine is stable undiluted in the refrigerator on-label for a duration of 31 days, 9/25/21 would have been the 31st day). Vaccine had not been pulled from the refrigerator the day that it expired on 9/25/21, hence accidental continued use by another pharmacist on 9/26/21. Pfizer med info reported that, based on physical stability data, there is an extended excursion time of +1 day for a total stable undiluted refrigerated time of 32 days, but to still file reports due to off-label use.

Other Meds:

Current Illness:

Date Died: 04/30/2021

ID: 1763115
Sex: F
Age: 56
State: CA

Vax Date: 04/26/2021
Onset Date: 04/30/2021
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: Death within 7 days of receiving vaccine

Other Meds:

Current Illness:

ID: 1763116
Sex: M
Age: 35
State: NC

Vax Date: 03/01/2021
Onset Date: 04/01/2021
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: N/A

Allergies: dogs and cats

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: pain around heart

Other Meds: albuterol inhaler for asthma

Current Illness: N/A

ID: 1763117
Sex: M
Age: 74
State: CA

Vax Date: 09/26/2021
Onset Date: 09/26/2021
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: Pharyngeal swelling

Symptoms: Vaccine expired in refrigerator on 9/25/21, but vaccine was administered on 9/26/21 (vaccine is stable undiluted in the refrigerator on-label for a duration of 31 days, 9/25/21 would have been the 31st day). Vaccine had not been pulled from the refrigerator the day that it expired on 9/25/21, hence accidental continued use by another pharmacist on 9/26/21. Pfizer med info reported that, based on physical stability data, there is an extended excursion time of +1 day for a total stable undiluted refrigerated time of 32 days, but to still file reports due to off-label use.

Other Meds:

Current Illness:

Date Died: 08/15/2021

ID: 1763118
Sex: M
Age: 93
State: GA

Vax Date: 02/04/2021
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: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Patient fully vaccinated and died due to Covid related causes.

Other Meds:

Current Illness:

ID: 1763119
Sex: F
Age: 57
State: CA

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

Lab Data:

Allergies: Sulfa

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Pain at injection site, sore arm -- 10/4 and beyond Difficulty managing secretions while sleeping, a lot of coughing on first 10/5 while in bed Flare in joint symptoms. Persisitent neck nerve pain. Hand stiffness. Flare in wrist pain.

Other Meds: Flonase Azelastine

Current Illness: N/A

ID: 1763120
Sex: F
Age: 73
State: CA

Vax Date: 09/26/2021
Onset Date: 09/26/2021
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:

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

Symptoms: Vaccine expired in refrigerator on 9/25/21, but vaccine was administered on 9/26/21 (vaccine is stable undiluted in the refrigerator on-label for a duration of 31 days, 9/25/21 would have been the 31st day). Vaccine had not been pulled from the refrigerator the day that it expired on 9/25/21, hence accidental continued use by another pharmacist on 9/26/21. Pfizer med info reported that, based on physical stability data, there is an extended excursion time of +1 day for a total stable undiluted refrigerated time of 32 days, but to still file reports due to off-label use.

Other Meds:

Current Illness:

ID: 1763121
Sex: M
Age:
State: VA

Vax Date:
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: SYR
Vax Site: RA

Lab Data: None

Allergies: Ceclore. Amoxicillin

Symptom List: Rash, Urticaria

Symptoms: 15min after injection flush face and rapid heartbeat and drowsy.

Other Meds: Tax 3mg once a day. Fluoxtine 30mg

Current Illness:

Date Died: 03/19/2021

ID: 1763122
Sex: M
Age: 62
State: CA

Vax Date: 03/17/2021
Onset Date: 03/19/2021
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: Death within 7 days of vaccination

Other Meds:

Current Illness:

ID: 1763668
Sex: F
Age: 54
State: CA

Vax Date: 09/26/2021
Onset Date: 09/26/2021
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: Please verify dose, typical MFG recommendation for 1-2 years old is 75-80mg/dose (this is 128mg/dose). Thank you!

Other Meds:

Current Illness:

ID: 1763670
Sex: F
Age: 40
State: WA

Vax Date: 09/02/2021
Onset Date: 09/18/2021
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: Ultrasound test to locate blood clot

Allergies: None

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

Symptoms: Deep Vein Thrombosis, with blood clots identified in lower left leg

Other Meds: None

Current Illness: None

ID: 1763671
Sex: M
Age: 4
State: KS

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

Lab Data: None

Allergies: No

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

Symptoms: Immediately after administration of the flu shot, patient developed full tonic clinic seizure lasting 10 minutes. Recovered well. Call neurology and told to dc home with return precautions and outpatient follow up.

Other Meds: Zarbees elderberry Kids multivitamin

Current Illness: Runny nose

ID: 1763672
Sex: F
Age: 30
State: FL

Vax Date: 09/01/2021
Onset Date: 09/13/2021
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: Dairy Gluten Soy

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

Symptoms: Extreme fatigue Caused period to begin weeks early. Extreme clots. Cramps similar to labor cramps. Extremely painful, nausea

Other Meds:

Current Illness:

ID: 1763673
Sex: F
Age: 38
State: CA

Vax Date: 04/27/2021
Onset Date: 04/28/2021
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: No

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Diarrhea for several weeks, extending beyond the second dose. Weight loss.

Other Meds: No

Current Illness: No

ID: 1763675
Sex: M
Age: 37
State: CA

Vax Date: 09/26/2021
Onset Date: 09/26/2021
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:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Vaccine expired in refrigerator on 9/25/21, but vaccine was administered on 9/26/21 (vaccine is stable undiluted in the refrigerator on-label for a duration of 31 days, 9/25/21 would have been the 31st day). Vaccine had not been pulled from the refrigerator the day that it expired on 9/25/21, hence accidental continued use by another pharmacist on 9/26/21. Pfizer med info reported that, based on physical stability data, there is an extended excursion time of +1 day for a total stable undiluted refrigerated time of 32 days, but to still file reports due to off-label use.

Other Meds:

Current Illness:

ID: 1763676
Sex: F
Age: 51
State: OR

Vax Date: 10/01/2021
Onset Date: 10/04/2021
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: Nothing yet, waiting for my Cardiologist to call back or send a message.

Allergies: Tree nuts, wheat, some sea food, beans, soy, latex and a host of other things.

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

Symptoms: Chest pain, heart palpitations, lightheaded lasted a few hours. Then soreness in the chest, ribs still having palpitations 24 hours later. Now adding body aches and pains and skin tenderness.

Other Meds: Allegra-D, spironolactone, Amlodipine, sertraline, probiotics

Current Illness: None

ID: 1763677
Sex: M
Age: 28
State: AL

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: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Red Dye

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

Symptoms: Tingling in left side of face and throat

Other Meds: Vitamin D Daily Multivitamin Amlodipine-Besylate Fenofibrate Hydralazine Atenolol-Chlorthalidone Adderall

Current Illness:

ID: 1763665
Sex: F
Age:
State: PR

Vax Date:
Onset Date:
Rec V Date: 10/06/2021
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: Unevaluable event

Symptoms: Allergic reaction; This is a spontaneous report from a contactable consumer (Patient is reporter's wife). A female patient of unknown age received bnt162b2 (COMIRNATY PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Strength: unknown, Batch/Lot Number: unknown), dose 1 on unknown date as Dose 1 SINGLE for covid-19 immunization (Age of vaccination was unknown). The patient medical history and concomitant medications were not reported. On an unknown date the patient had Allergic reaction. The reporter clarified that his wife had the Pfizer Covid-19 Vaccine, and she did not have a severe reaction, but she had an allergic reaction to the Pfizer Covid-19 Vaccine. The outcome of the event was unknown. No follow-up attempts are possible information about lot/batch number cannot be obtained. No further information is expected.

Other Meds:

Current Illness:

ID: 1763666
Sex: M
Age:
State: PR

Vax Date: 04/13/2021
Onset Date: 04/14/2021
Rec V Date: 10/06/2021
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: Swollen lymph node in left armpit; Discomfort in joints; fever; This is a spontaneous report received from a contactable consumer or other non-HCP (patient reported for himself). A 48-year-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection, Lot Number: Unknown), dose 2 via an unspecified route of administration, administered in Arm Left on 13Apr2021 at 11:00 AM (at the age of 48-year-old), as DOSE 2, SINGLE for covid-19 immunisation. Medical history included Crustacean allergy. Prior to vaccination, the patient was not diagnosed with COVID-19. Concomitant medication(s) included Levothyroxine sodium (Sintroid 112) (SYNTHROID) taken for an unspecified indication, start and stop date were not reported. The patient previously received his first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection, Lot Number: Unknown), via an unspecified route of administration, administered in Arm Left on 23Mar2021, as single for covid-19 immunisation. Since the vaccination, the patient had not been tested for COVID-19. On 14Apr2021, the patient experienced swollen lymph node in left armpit tennis ball sized, discomfort in joints and fever. No treatment was received for the adverse events. The events did not result into death, Life threatening, caused/prolonged hospitalization, Disabling/Incapacitating and Congenital anomaly/birth defect. The case was reported as non-serious. The patient outcome of the events was Resolving at the time of this report. No follow-up attempts are needed. No further information is expected.

Other Meds: SYNTHROID

Current Illness:

ID: 1763678
Sex: F
Age: 59
State: CO

Vax Date: 09/14/2021
Onset Date: 09/15/2021
Rec V Date: 10/06/2021
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: none

Symptom List: Injection site pain, Pain

Symptoms: The injection itself was very smooth and almost painless. The next day, however, I experienced extreme pain in left shoulder, inability to move upper arm without significant pain. This pain got increasingly worse over the next few days and for the most part, has not improved since. Ibuprofen seems to make little difference. I saw my PCP 10 days after the injection and I am scheduled to see an orthopedic doctor tomorrow to see what treatment path is advised. The injection site itself was the normal kind of pain- in other words, just a minor bit of soreness. The shoulder pain is a very different sort of pain. It sometimes feels like there is broken glass in my shoulder joing.

Other Meds: omeprazole, famotodine, mirtazapine, aspirin, multivitamin, melatonin, vit B12, vit D, fish oil, probiotic

Current Illness: none

ID: 1763679
Sex: M
Age: 42
State: MT

Vax Date: 05/01/2021
Onset Date: 09/01/2021
Rec V Date: 10/06/2021
Hospital:

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

Lab Data: Positive PCR, two positive rapid tests

Allergies: None

Symptom List: Injection site pain, Menorrhagia

Symptoms: Breakthrough COVID-19 infection

Other Meds: Singulair

Current Illness: None

ID: 1763680
Sex: F
Age: 37
State: OR

Vax Date: 04/01/2021
Onset Date: 07/14/2021
Rec V Date: 10/06/2021
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: Within 4 months of receiving the J and J vaccine, I developed a kidney infection. I have never had any sort of infection in my life. I'm a healthy 37 year old. I don't smoke or do drugs. I drink alcohol very minimally on occasion. I'm reporting this because I know my body. The only change I've had recently is the fact that I got the shot. I believe it is something to look into: If these vaccines are linked to kidney or other infections in individuals. I have no proof the vaccination caused my infection but it is highly suspicious. Also, I'm on antibiotics again for an infection in my right breast. So why all of a sudden is my body not fighting infection? Please look into this!

Other Meds:

Current Illness:

ID: 1763682
Sex: M
Age: 22
State: IL

Vax Date: 10/05/2021
Onset Date: 10/05/2021
Rec V Date: 10/06/2021
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: N/a

Allergies: N/a

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Fainted about a minute after receiving vaccination. Nothing major, just want to make sure it is known in case related to lot or similar.

Other Meds: N/a

Current Illness: N/a

ID: 1763683
Sex: F
Age: 33
State: MI

Vax Date: 08/12/2021
Onset Date: 08/13/2021
Rec V Date: 10/06/2021
Hospital:

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

Lab Data: N/A - TBD after Dr. visit

Allergies: N/A

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Shortness of breath and increased heart rate - resting heart rate jumped from avg 54 to 65-70 on 8/13, day after first dose and now nine weeks later my rhr avg is 65. My VO2 max was consistently above average for years, since mid August it has steadily declined to below average. I was in excellent health, with an extremely healthy heart and now my heart health is rapidly declining.

Other Meds: Junel fe 24

Current Illness: N/A

ID: 1763684
Sex: M
Age: 48
State: NC

Vax Date: 09/07/2021
Onset Date: 09/23/2021
Rec V Date: 10/06/2021
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: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: Heart palpitations for 4-5 days.

Other Meds: Beef organs and vitamin D

Current Illness: None

ID: 1763685
Sex: F
Age: 27
State: MA

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

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

Lab Data:

Allergies: Sulfa

Symptom List: Nausea

Symptoms: Developed severe nerve pain over entire body. History of Shingles shortly after second dose of vaccine, at the time assumed to be unrelated with intermittent residual nerve pain localized to L arm. Received booster in AM, ~12hrs later sudden intense onset of severe nerve pain over entire body, unrelieved so far.

Other Meds: Aviane

Current Illness:

ID: 1763686
Sex: F
Age: 40
State: AZ

Vax Date: 10/05/2021
Onset Date: 10/05/2021
Rec V Date: 10/06/2021
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: pt verbally attest to needing pfizer booster and showed on phone vaccine history and dates to technician. dose 1 :3/10/21, dose 2 : 4/7/21. Pharmacist verified with patient that pfizer was being administered and asked pt to bring physical card next day to fill out for pt since they only had a digital image available. Later in day when billing insurance and get rejection, saying different manufacturer. After checking state registery discovered pt had moderna dose 1 and 2 and was not due for a booster. Pharmacist attempt to call pt to discuss and had to leave a voicemail

Other Meds:

Current Illness:

ID: 1763687
Sex: F
Age: 56
State: CA

Vax Date: 09/29/2021
Onset Date: 09/29/2021
Rec V Date: 10/06/2021
Hospital:

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

Lab Data: BP: 199/100, 188/89, 190/89 HR: 117bpm O2 sat: 99%

Allergies: no known allergies

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

Symptoms: Patient initially experienced tachycardia (HR >110 bpm). She reported that she's not feeling too well and that her heart is beating so fast. This occurred within the 15 min monitoring period post vaccination. Checked her bp and reading was 199/100. checked it once again after 15 mins and it was at 188/89. 15 mins after paramedics came, her bp was still at 190/89 and HR of 117bpm, O2 sat 99%. Patient was still not feeling too well, although conscious and was able to communicate with me and the paramedics.

Other Meds: Losartan

Current Illness: no known illnesses

ID: 1763688
Sex: M
Age: 41
State: OR

Vax Date: 06/26/2021
Onset Date: 06/01/2021
Rec V Date: 10/06/2021
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: dairy

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

Symptoms: Severe fatigue, muscles aches and weakness, joint pain, swelling of throat, shallow breathing. Persisted form 6/27/21 to 6/30/21.

Other Meds: vitamin c, calcium/magnesium, vitamin d

Current Illness:

ID: 1763689
Sex: F
Age: 67
State: CA

Vax Date: 08/03/2021
Onset Date: 08/03/2021
Rec V Date: 10/06/2021
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: eggs, dairy, sugar

Symptom List: Tremor

Symptoms: severe fatigue, dizzy, palpitations, breathing issues Holistic treatment -stem cell supplements Cellorane #3 27 days

Other Meds: Levothyroxine 125 MCG

Current Illness: none

ID: 1763690
Sex: M
Age: 55
State: CA

Vax Date: 09/17/2021
Onset Date: 09/21/2021
Rec V Date: 10/06/2021
Hospital:

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

Lab Data: Went to urgent care and ER test didn?t find anything doctors just said possible ear infection and vertigo.

Allergies: Vicadin dairy

Symptom List: Erythema, Pruritus

Symptoms: Light headed, vertigo, vision issues, headache, body aches and feeling very tired

Other Meds: Tylenol cold and flu

Current Illness: None

ID: 1763691
Sex: F
Age: 50
State: PA

Vax Date: 05/17/2021
Onset Date: 05/18/2021
Rec V Date: 10/06/2021
Hospital: Y

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: Imitrex, sulfa drugs and Alec Shrimp

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

Symptoms: I felt very sick could not get out of bed. Then I started to have chest pain. On June 10th i had a stent out in my LED. Freak incident with no explanation

Other Meds: Atenolol, Zyrtec, Wellbutrin, singulair, baby aspirin , thyroid medicine

Current Illness: None

ID: 1763693
Sex: F
Age: 14
State: CA

Vax Date: 06/07/2021
Onset Date: 06/08/2021
Rec V Date: 10/06/2021
Hospital:

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

Lab Data: All lab comes back negative for bacterial infection and /or another stomach virus or disease

Allergies: None

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

Symptoms: Stomach discomfort and constant watery diarrhea that has not stop since Pfizer second dose

Other Meds: None

Current Illness: None

ID: 1763694
Sex: F
Age: 49
State: MD

Vax Date: 10/05/2021
Onset Date: 10/06/2021
Rec V Date: 10/06/2021
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: Racing heartbeat at 12 hours post vaccine

Other Meds: Losartan, setraline, crestor, garlique

Current Illness: Elevated blood pressure, headache

ID: 1763695
Sex: M
Age: 60
State: CA

Vax Date: 08/17/2021
Onset Date: 08/18/2021
Rec V Date: 10/06/2021
Hospital: Y

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

Lab Data: MRI, Cat Scan, EKG on 08/18/2021

Allergies: none

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

Symptoms: During visit to store returning some items around 10 am. Had numbness of face and legs, blurry vision and had slurred speech could not walk very well. Store employee help me to sit and called my daughter and took me to ER.

Other Meds: none

Current Illness: none

ID: 1763696
Sex: M
Age: 26
State: WA

Vax Date: 09/20/2021
Onset Date: 09/21/2021
Rec V Date: 10/06/2021
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: Chest X-ray, EKG, troponin, CBC, BMP

Allergies: Sulfa, wasps

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

Symptoms: Chest pain, left sided. Patient went to the ED, two times, 9/22 and 9/25.

Other Meds: Vitamin D3, Probiotic, Digestive Enzyme

Current Illness: n/a

ID: 1763697
Sex: F
Age: 30
State:

Vax Date: 10/03/2021
Onset Date: 10/03/2021
Rec V Date: 10/06/2021
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

Symptom List: Pain in extremity

Symptoms: Sore arm starting immediately after shot and lasting more than 3 days. Acne breakout on face starting the day after the shot.

Other Meds: none

Current Illness: none

ID: 1763698
Sex: M
Age: 60
State: OK

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

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

Lab Data: None

Allergies: None known.

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

Symptoms: Within less than three hours of injection. Every arthritic joint (From previous injury or strains) was alternating between aching and numbing. Took Tylenol as advise, but the aching persisted.

Other Meds: Multivitamin, Vitamin C & Zinc., Garlic and Fish Oil

Current Illness: None

ID: 1763699
Sex: F
Age: 47
State: TX

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

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

Lab Data: Pending

Allergies: NA

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

Symptoms: Evening of the vaccination( 10/4/2021 malaise, soreness (9/10 pain) LUE @ injection site . 0300, early next morning 9/10 pain continued through tonight in LUE. 1100 AM Tuesday : pain/tenderness in Left axillary. Noted a soft moveable lump upon assessment. Malaise, ache in neck noted throughout today and into the 6th.

Other Meds: NA

Current Illness: NA

ID: 1763700
Sex: F
Age: 34
State: CA

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

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

Symptoms: Bleeding right after shot. Then I discovered bruised in the shower around 8pm. Woke up at 4am with tingling and burning sensation from Left shoulder radiating to arm and fingers. Elevated arm with a pillow. Symptoms have not improved yet.

Other Meds: Omeprazole, Tums

Current Illness: No

Date Died: 08/11/2021

ID: 1763701
Sex: F
Age: 75
State: GA

Vax Date: 01/29/2021
Onset Date: 08/11/2021
Rec V Date: 10/06/2021
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: Patient fully vaccinated and died due to Covid related causes. Patient believes was exposed from husband

Other Meds:

Current Illness:

Date Died: 08/10/2021

ID: 1763702
Sex: M
Age: 78
State: GA

Vax Date: 02/24/2021
Onset Date: 08/10/2021
Rec V Date: 10/06/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Patient fully vaccinated and died due to Covid related causes

Other Meds:

Current Illness:

ID: 1763704
Sex: M
Age: 51
State: ID

Vax Date: 05/18/2021
Onset Date: 05/31/2021
Rec V Date: 10/06/2021
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: Paresthesias pins needles feelings of neuropathy and pain traveled up and down my right arm and hand. My thumb and first two fingers went numb with very little feeling. After several days had moderate to severe pain in my right hand and numbness and paralysis to the extent I could not close my fingers and make a fist. This hand paralysis went away after about a week and a half. The paresthesias continued in my hand and arms for about two months and then gradually improved. To date about 95 percent better but still continue experiencing occasional paresthesias in a couple fingers

Other Meds: Nirtec, testosterone, ibuprophen

Current Illness: None

ID: 1763705
Sex: F
Age: 53
State: CA

Vax Date: 10/03/2021
Onset Date: 10/05/2021
Rec V Date: 10/06/2021
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: No

Allergies: Vicodin Codein

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Swollen under left arm Swollen tender arm around injection site Red swollen area around injection site

Other Meds: Daily multi vitamin Zyrtec

Current Illness: None

ID: 1763706
Sex: F
Age: 61
State: NY

Vax Date: 09/01/2021
Onset Date: 10/04/2021
Rec V Date: 10/06/2021
Hospital:

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

Lab Data: none

Allergies: none known.

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

Symptoms: Initial response normal- injection site sore (as for first, two doses). Then, on day 5 (Monday, October 4), late at night, I was woken up by serious (level 3-5? out of 10) THROBBING pain: absolutely no swelling or redness (i.e. nothing visible). Throbbing has stopped but a consistent, low-grade pain, UNDER the skin (not external) persists. ?! (Everything I have read on internet suggestion symptoms should diminish and/or disappear after ~24 hours).

Other Meds: Migrelief. Propranalol.

Current Illness: none.

ID: 1763707
Sex: M
Age: 46
State:

Vax Date: 08/23/2021
Onset Date: 08/24/2021
Rec V Date: 10/06/2021
Hospital: Y

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

Lab Data: keep going as above.

Allergies: none

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

Symptoms: Cerebral infarction. Acute hydrocephalus. Cerebral edema. Stenosis of the lower cerebral artery.

Other Meds: none

Current Illness: none

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am