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: 1764779
Sex: F
Age: 92
State: KY

Vax Date: 01/17/2021
Onset Date: 09/03/2021
Rec V Date: 10/06/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Tested Positive for Covid

Other Meds:

Current Illness:

ID: 1764780
Sex: M
Age: 41
State: NY

Vax Date: 10/06/2021
Onset Date: 10/06/2021
Rec V Date: 10/06/2021
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: Patient started feeling dizzy after receiving the second dose. He was given water and asked to sit for a while. He felt somewhat better and went home.

Other Meds:

Current Illness:

ID: 1764781
Sex: F
Age: 84
State: FL

Vax Date: 09/30/2021
Onset Date: 09/30/2021
Rec V Date: 10/06/2021
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: Cipro, Arithamicine

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

Symptoms: Pt. states that after receiving the 3rd dose of Booster Moderna 09/30/2021, started experiencing symptoms 09/30/2021 of chills, fever, nausea, fatigue, loss of appetite, and dry cough. Still continuing to experience symptoms, Primary communications still waiting for recommendations.

Other Meds: Extra-Strength Tylenol, Prednisone 5mg, Lisaprenaprol, Hydrochlorothiazide, Amistad, Aumapramazal, Astrozal

Current Illness: N/A

ID: 1764782
Sex: F
Age: 19
State: KY

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

Lab Data: none

Allergies: NKA

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Vaccine was administered on 10/05/2021, vaccine expired 10/01/2021

Other Meds: unknown

Current Illness: none

ID: 1764783
Sex: F
Age: 44
State: FL

Vax Date: 08/10/2021
Onset Date: 08/16/2021
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: patient is uninsured and is being seen at a community clinic, approval for xray orders (lumbar and bilateral hips) are currently pending. Patient is being treated with conservative treatment including low back stretches, NSAIDs and encouraged of decreased exercise, especially movements that increase pain.

Allergies: none known

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

Symptoms: mild headache for several days after then resolved and had onset of tingling and "shooting pain sensation like electric shocks radiating toward her head and all extremities with increased weakness and pain in low back with pressure sensation with aching pain radiating in saddle formation from low back to bilateral hips toward her knees with heaviness in the feet. Painful to walk down stairs specifically in the knees. Significant reduction in range of motion with back. Previously patient had been very active, lifting weights, working out, push ups, planks, running. Now unable to tolerate plan position, running or any twisting of low back. Denies any specific back injury or trauma, no falls or MVA (motor vehicle accident)

Other Meds: OTC advil for aches and pains only as needed

Current Illness: none

ID: 1764784
Sex: F
Age: 49
State: FL

Vax Date: 10/04/2021
Onset Date: 10/05/2021
Rec V Date: 10/06/2021
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: none

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

Symptoms: Swollen lymph nodes right axilla

Other Meds: none

Current Illness: none

ID: 1764785
Sex: M
Age: 49
State: MI

Vax Date: 04/11/2021
Onset Date: 10/05/2021
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: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Patient received Janssen vaccine on 04/11/2021 Patient tested positive for Covid on 10/05/2021 and was hospitalized. Per ED Note: Patient indicates over the past 3 days he has developed a nonproductive cough and difficulty breathing. He indicates that he is not complain of any chest pain. Does complain of some abdominal pain with nausea. No problems with his bowel or urine. No fevers has had chills but did not take anything for fever today. The patient states that he has been taking Tylenol 6900 mg daily for 3 months for his Charcot foot. Prior to that he was taking 9200 mg daily for 3 months. About 1 week ago he stopped taking all Tylenol at the request of his physician. He did see his physician today who took a chest x-ray and noted that he had a left upper lobe pneumonia.

Other Meds:

Current Illness:

ID: 1764787
Sex: F
Age: 67
State: AK

Vax Date: 02/23/2021
Onset Date: 03/10/2021
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: Blood draw on 6/24/21 at clinic

Allergies: none known

Symptom List: Pharyngeal swelling

Symptoms: compromised immune system after injection series led to extreme herpes simplex outbreak that has lasted to present day with bleeding ulcerations

Other Meds: Estradiol, Metoporol, vitamin supplements

Current Illness: Herpes Simplex virus (latent)

ID: 1764788
Sex: F
Age: 73
State: IN

Vax Date: 10/01/2021
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: LA

Lab Data:

Allergies: Codine

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Chills, tired and just felt bad.

Other Meds: Synthroid, fiber, Tamsulosin, Nexium

Current Illness: No

ID: 1764789
Sex: F
Age: 74
State: KY

Vax Date: 09/25/2021
Onset Date: 09/25/2021
Rec V Date: 10/06/2021
Hospital:

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

Lab Data: N/A

Allergies: NKDA

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Patient inadvertently give 0.15 mL dose instead of required/recommended 0.3 mL dose. CDC contacted and advised to have patient return ASAP fto receive correct dosage. Patient returned 9/28/2021 and received 0.3 mL. No adverse affects reported per patient.

Other Meds:

Current Illness:

ID: 1764790
Sex: M
Age: 66
State: TX

Vax Date: 02/24/2021
Onset Date: 10/05/2021
Rec V Date: 10/06/2021
Hospital: Y

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

Lab Data: CBC, CMP, CARDIAC PROFILE, RAPID COVID, CXR, EKG

Allergies: NKA

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

Symptoms: Cough, congestion, weakness

Other Meds: Amlodipine, atorvastatin, doxazosin, benazepril, HCTZ, levemir, metformin, omeprazole, pioglitazone

Current Illness:

ID: 1764791
Sex: F
Age: 39
State:

Vax Date: 08/19/2021
Onset Date: 08/21/2021
Rec V Date: 10/06/2021
Hospital:

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

Lab Data:

Allergies: no drug allergies

Symptom List: Rash, Urticaria

Symptoms: one sided paralysis and uncontrollable facial movement.

Other Meds: no prescription r herbal supplement

Current Illness: non

ID: 1764792
Sex: M
Age: 72
State: IA

Vax Date: 03/03/2021
Onset Date: 03/03/2021
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:

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

Symptoms: given pfizer vaccines and already had received from another medical office. patient reported no adverse reactions or outcomes

Other Meds:

Current Illness:

ID: 1764793
Sex: F
Age: 23
State: OR

Vax Date: 06/07/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: 2 Miscarriage's directly following vaccine. Had two pregnancies beforehand with no complications to the baby or mother. Mother in perfect healthy condition.

Other Meds: None

Current Illness: None

ID: 1764794
Sex: F
Age: 45
State: OR

Vax Date: 09/23/2021
Onset Date: 09/27/2021
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:

Allergies: Sulfa

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

Symptoms: Left upper arm swelling and redness, a few days later after vaccine felt a lump on the injection site, now it has turned into diffuse swelling and redness and itchy. Was diagnosed as Cellulitis of the arm and was given antibiotics and a steroid to help with inflammation.

Other Meds: Atorvastatin, cyclobenzaprine, escitalopram oxalate, lisinopril, metformin, protonox, Qvar, Semglee insulin, Singulair, Cranberry, Flaxseed oil, iron

Current Illness:

ID: 1764795
Sex: M
Age: 20
State: NY

Vax Date: 08/26/2021
Onset Date: 09/01/2021
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: labs drawn 9/29/21 Labs reveal elevated CK of 811, and LD of 409 plus AST of 53. Normal Sed Rate and CRP and elevated WBC of 13.3 with a left shift.

Allergies:

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

Symptoms: myositis 3+ weeks of muscle cramping with exercise. Labs reveal elevated CK of 811, and LD of 409 plus AST of 53. Normal Sed Rate and CRP and elevated WBC of 13.3 with a left shift. referral to rheumatology

Other Meds:

Current Illness:

ID: 1764796
Sex: U
Age:
State: FL

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

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

Lab Data: Blood work, various dates unknown, elevated white blood cell count

Allergies:

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

Symptoms: I went to a specialist which documented hearing loss and tinnitus. I did two rounds of steroids. I went to ER a few times. They came me steroids and antibiotics. Then I also had an antiviral, I saw like three different DRs at that point. I still have hearing loss and Tinnitus and am not taking anything for it. It is not resolving though. I have gone to a rheumatologist and a hematologist.

Other Meds:

Current Illness:

ID: 1764797
Sex: F
Age: 56
State: FL

Vax Date: 03/11/2021
Onset Date: 10/06/2021
Rec V Date: 10/06/2021
Hospital: Y

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

Lab Data: blood work chest xray echocardiogram Holter monitor

Allergies: elderberry penicillin codeine demerol Benadryl morphine

Symptom List: Ear pain, Hypoaesthesia

Symptoms: chest pain BP 250/195 pulse rate 40's blacking out

Other Meds: vit c iron

Current Illness: none

ID: 1764798
Sex: F
Age: 33
State: MN

Vax Date: 02/05/2021
Onset Date: 10/03/2021
Rec V Date: 10/06/2021
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: Tested positive for COVID 10/3/21 after being fully vaccinated.

Other Meds:

Current Illness:

ID: 1764799
Sex: F
Age: 61
State: AZ

Vax Date: 03/29/2021
Onset Date: 07/20/2021
Rec V Date: 10/06/2021
Hospital:

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

Lab Data: tests at doctor's office - they checked blood - and some of my readings were off but now everything is showing it's going back to normal (that bloodwork was 1st part of September) - they checked for every other type of infection but I didn't have any other.

Allergies: no

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

Symptoms: Had pain in my pelvic area and it got worse and worse over a month and I went to see doctor (normally, I'm healthy- I exercise and I am not obese). They did tests. I had a rare thing - Epiploc Appendagitis - and it's like a tumor on the outside of colon and it's in the Appendages that hang on the outside. It's benign. They gave antibiotics for the inflammation. The whole thing lasted about 2 months - the constant pain. It is still there but not it just flares up from time to time. It has been okay since September. The doctor said to treat with ibuprofen and not Tylenol. I might need antibiotic again if it's inflaming other things.

Other Meds: Spironolactone - use it for hair loss (have taken it four or five years); Centrum daily; Vit D 2000 IU/day; Biotin - 5000 mcg; Vit E - 180mg; once in a while I take Vit C - about three times a week - 500 mg

Current Illness: no

ID: 1764800
Sex: M
Age: 38
State: FL

Vax Date: 09/29/2021
Onset Date: 09/29/2021
Rec V Date: 10/06/2021
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: Pending Optometry evaluation

Allergies: None

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

Symptoms: Patient reports blurred vision that got much worse after initial injection

Other Meds: Lexapro, Ambien, Viagra, Motrin, Flexeril

Current Illness: None

ID: 1764801
Sex: F
Age: 56
State: CA

Vax Date: 04/02/2021
Onset Date: 06/01/2021
Rec V Date: 10/06/2021
Hospital:

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

Lab Data: x-rays for my hip and MRI. They said with the MRI my cartilage is gone.

Allergies: None

Symptom List: Unevaluable event

Symptoms: I came home after getting the vaccine and I felt a little bit different but after that I was ok. In the beginning of June it just hit me. I could not understand what happened. My hip and leg gave up on me. I could hardly walk. I had a bunch of mucus in my chest. I was taking different antibiotics to get it together. I am almost cleared up but I still have the wheezing every now and then. I had to go to an urgent care clinic for the stuff in my chest. They did x-rays for my hip and MRI. They said with the MRI my cartilage is gone. At the end of July I went to the doctor because the z-pak did not work, and then the amoxicillin did not work either. They gave me Amoxicillin Clavulanate and that has been helping.

Other Meds: Advair, Oxybutynin, Vitamin D2, Metformin Olanzapine, Hydrocodone, Albuterol solution, hair and skin vitamin, potassium glutamate

Current Illness: None

ID: 1764802
Sex: M
Age: 86
State: MS

Vax Date: 09/28/2021
Onset Date: 09/28/2021
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: none

Allergies: unknown

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

Symptoms: Patient received a third booster dose of Pfizer but his first two doses Moderna. No adverse reaction known.

Other Meds: unknown

Current Illness: unknown

ID: 1764803
Sex: M
Age: 75
State: KY

Vax Date: 09/25/2021
Onset Date: 09/25/2021
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: N/A

Allergies: NKDA

Symptom List: Injection site pain, Pain

Symptoms: Patient inadvertently give 0.15 mL dose instead of required/recommended 0.3 mL dose. CDC contacted and advised to have patient return ASAP fto receive correct dosage. No adverse affects reported per patient. Patient returned 9/28/2021 and received 0.3 mL. dosage.

Other Meds:

Current Illness:

ID: 1764804
Sex: U
Age: 59
State: KY

Vax Date: 03/30/2021
Onset Date: 09/17/2021
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 COVID PCR.

Allergies: UNK

Symptom List: Injection site pain, Menorrhagia

Symptoms: DEVELOPED COVID AFTER BEING FULLY VACCINATED. ASYMPTOMATIC.

Other Meds: UNK

Current Illness:

ID: 1764805
Sex: M
Age: 66
State:

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

Lab Data:

Allergies:

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

Symptoms: Administration error mixed series mRNA vaccine Pfizer and Moderna.

Other Meds:

Current Illness:

ID: 1764806
Sex: F
Age: 69
State: WI

Vax Date: 02/05/2021
Onset Date: 03/15/2021
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: N/A

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Around mid-March began having issues with pain in lower left buttock, saw primary physician and sent to orthopedic doctor. By then pain was spreading to upper part of buttock. Did a CATSCAN and found an abcess on the colon, did PT for 2 months, seeing GI doctor and a spine doctor. Have repeat CATSCAN, repeat ultrasound on the 29th of October. Given ciprofloxifin and flagil for 10 days and just finished taking that. The symptoms have slightly diminished, hoping abcess resolves on itself. Also found fluid buildup at L4 and l5 vertebrae, scheduled to have a steroid injection once other health issues resolved.

Other Meds: Vitamin D and B12. Amlodapene and Losartin Glutozide, Hydrochlorisiozide and Metformin , Rosavastin (for cholesterol)

Current Illness: N/A

ID: 1764807
Sex: F
Age: 54
State: WI

Vax Date: 05/13/2021
Onset Date: 08/19/2021
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: + Covid NAAT test on 8/19/2021

Allergies: n/a

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Covid 19 break-through infection 8/19/2021

Other Meds: n/a

Current Illness: n/a

ID: 1764808
Sex: F
Age: 42
State: AL

Vax Date: 05/20/2021
Onset Date: 05/01/2021
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: Latex, betadine

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

Symptoms: Many headaches and migraines over the next 30 to 45 days

Other Meds: Amitriptyline, montelucast, multi-vitamin, vitamin C, albuteral

Current Illness:

ID: 1764809
Sex: F
Age: 73
State:

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:

Symptom List: Nausea

Symptoms: Administration error mixed series mRNA vaccine Pfizer and Moderna.

Other Meds:

Current Illness:

ID: 1764810
Sex: F
Age: 61
State: ID

Vax Date: 08/26/2021
Onset Date: 08/28/2021
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: I have malignant hyperthermia. I hesitated to get the vaccine because of issues with immunizations, anesthesia, etc in the past.

Symptom List: Injection site pain

Symptoms: I woke up about 4 am with no feeling on the right side of my face. After about 6 hours the feeling in my face began to return, but it was as if my face was asleep, the feeling was of almost numbness, a tingling sensation. By about 6 p.m. my face was back to normal, however my lymph nodes in my neck and head had begun to swell about noon, and by the afternoon, were excruciatingly painful. This lasted for over 3 weeks. Taking 800mg of ibuprofen made the pain manageable.

Other Meds: None

Current Illness: None

ID: 1764813
Sex: M
Age: 64
State: KY

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: LA

Lab Data: none

Allergies: NKA

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

Symptoms: Moderna Vaccine was administered on 10/05/2021 vaccine expired 10/01/2021.

Other Meds: unknown

Current Illness: none

ID: 1764814
Sex: M
Age: 14
State: KY

Vax Date: 09/25/2021
Onset Date: 09/25/2021
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: N/A

Allergies: NKDA

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

Symptoms: Patient inadvertently give 0.15 mL dose instead of required/recommended 0.3 mL dose. CDC contacted and advised to have patient return ASAP fto receive correct dosage. No adverse affects reported per patient. Patient returned 9/28/2021 and received 0.3 mL. dosage.

Other Meds:

Current Illness:

ID: 1764815
Sex: F
Age: 53
State: NV

Vax Date: 08/21/2021
Onset Date: 08/21/2021
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: Results will be given for these test on 10/11/2021: VI Test Echocardiogram CAT Scan of heart with and without contrast Left and Right Cartiod of neck LEA Test

Allergies: Sulfa Penicillin

Symptom List: Tremor

Symptoms: After receiving the vaccine, within 20 minutes, I immediately got sick to my stomach. My stomach was feeling woozy. Within 30 minutes I was throwing up. I had an unbearable headache, and I had diarrhea. I was sick like that for about 3 or 4 days. I've always had headaches but since getting the vaccine the headaches have worsened. After that I had started fainting, and at that point I started seeing a cardiologist who is running all kinds of test on me. I will be getting those results on Monday 10/11/2021.

Other Meds: I don't want to add them.

Current Illness: Bechet's autoimmune disease

ID: 1764817
Sex: F
Age: 71
State: NJ

Vax Date: 03/23/2021
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: Light test and normal eye exam - long appointment , there was an urgency in the doctor's concern for her diagnoses

Allergies: no, shellfish sometimes and scallops , cats.

Symptom List: Erythema, Pruritus

Symptoms: My eyes were feeling dry and irritated and I was going to bed to close my eye. In September felt like something was in my eye. The white of the eyes looked red and called the doctor and was diagnosed with Episcleritis. Steroid drops were prescribed. Normally people with lupus , cron;s disease and rheumatoid arthritis which I don't have. This Sat, I was outside watching a game outside, the sun in my eye bothered me felt irritated, eyelid didn't feel right like difficulty focusing.

Other Meds: no

Current Illness: no

ID: 1764818
Sex: M
Age: 70
State: IN

Vax Date: 02/28/2021
Onset Date: 04/24/2021
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: Temporal Artery Biopsy - Negative. MRI - Negative.

Allergies: Oxycodone.

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

Symptoms: Severe pain in lower back down to feet, severe swelling, stiff neck, fever, pain in eyes, jaws, and teeth. Prescribed Prednisone by healthcare professional. Was diagnosed with Adult Still's Disease.

Other Meds: Losartan, Glipizide.

Current Illness:

ID: 1764819
Sex: F
Age: 58
State: KY

Vax Date: 03/31/2021
Onset Date: 08/28/2021
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:

Allergies:

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

Symptoms: Tested Positive for Covid

Other Meds:

Current Illness:

ID: 1764820
Sex: F
Age: 87
State: MI

Vax Date: 04/17/2021
Onset Date: 10/05/2021
Rec V Date: 10/06/2021
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:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Patient received Pfizer vaccine with 1st dose on 03/25/2021 and 2nd dose on 04/17/2021. Patient Covid + on 10/05/2021 and hospitalized Per ED note: The patient presents emergency department after experiencing multiple falls over the past 1 week. She states that over the past 1 month she has been supposed to be using a walker at home although she really is not using the walker at home. She reports that throughout the last week with these falls she has not been using the walker as she is still "getting used to it". The patient is alert oriented answering my questions appropriately and denies any specific pain anywhere. She denies any blood thinners at home and denies any particular pain. The patient was laying on the floor but she is unsure of how long she was on the floor for. She denies any fevers or chills, she does report a mild dry cough. She denies vomiting or diarrhea.

Other Meds:

Current Illness:

ID: 1764821
Sex: F
Age: 76
State: MA

Vax Date: 02/27/2021
Onset Date: 08/11/2021
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: 8/11/21 - COVD PCR +

Allergies: tramadol

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

Symptoms: 76F h/o COPD (not on home O2), HTN, HLD, severe OA who presents with LLE edema and dyspnea, found to have COVID-19.

Other Meds: albuterol, atorvastatin, symbicort, oscal with D, lisinopril, omeprazole, spiriva, acetaminophen

Current Illness: 76F h/o COPD (not on home O2), HTN, HLD, severe OA who presents with LLE edema and dyspnea, found to have COVID-19.

ID: 1764822
Sex: M
Age: 72
State: IN

Vax Date: 10/04/2021
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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: None

Allergies: None

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

Symptoms: Muscle ache, fever and fatigue

Other Meds: Lisinopril Atorvastatin

Current Illness: None

ID: 1764823
Sex: F
Age: 38
State: MO

Vax Date: 10/04/2021
Onset Date: 10/06/2021
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: n/a

Allergies: none

Symptom List: Pain in extremity

Symptoms: Swollen area near clavicle (lymph node maybe). Appx the size of a pingpong ball but flattened and not fully round. Sore, tender to the touch in area on and around the swelling.

Other Meds: Losartan, Lo Loesterin, Famitodine, Mucinex, methotrexate, ashwagandha, probiotic, collagen, multivitamin, vit. D, zinc, magnesium, fish oil, ginko

Current Illness: None

ID: 1764824
Sex: M
Age: 56
State: WI

Vax Date: 04/22/2021
Onset Date: 08/16/2021
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: + Covid NAAT test on 8/6/2021.

Allergies: n/a

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

Symptoms: Covid 19 break-through infection 8/6/2021, received REGEN-COV due to risk factors next day.

Other Meds: n/a

Current Illness: n/a

ID: 1764825
Sex: M
Age: 59
State: WA

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: No

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

Symptoms: Massive headache, everything hurts, nausea, throwing up, stuffed up head

Other Meds: No

Current Illness: None

ID: 1764826
Sex: F
Age: 63
State: CO

Vax Date: 09/20/2021
Onset Date: 09/25/2021
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: Codiene, Peppermint

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

Symptoms: On 09/25/2021 I had rash, hives, blistering on my pelvic area from left to right of my legs and rawness and blistering on the lips of my vagina. My body was freezing of and on. Headache, fatigue, runny nose and body aches. I started using Allegra Allergy Pills and put Aveeno Cream on the areas on 09/27/2021, did make the rawness and blistering go away after October 4, 2021.

Other Meds: Levothyroxine 0.075mg, Alprazolam 0.50mg, Lisiopril Hetz 10/12, Simvastine 20mg, Clopidogrel 75mg, Trintellix 20mg. Over the counter: Assured Laxative Bisacodyl USP mg and Tension Headache Relief Acetaminophen + Caffine.

Current Illness:

ID: 1764827
Sex: F
Age: 30
State: KY

Vax Date: 03/17/2021
Onset Date: 09/01/2021
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: Tested Positive for Covid

Other Meds:

Current Illness:

ID: 1764828
Sex: F
Age: 44
State: KY

Vax Date: 09/20/2021
Onset Date: 09/20/2021
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: NO

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Within 30 minutes of 1st dose of Pfizer I started experiencing shortness of breath, shakes and tremors throughout body, chest pains and this lasted for 4 straight days. I also had tiredness and weakness and blood circulation felt "off".

Other Meds: Synthroid (100 mcg) once per day and 50,000 IU of Vitamin D once per week.

Current Illness: NO

ID: 1764829
Sex: F
Age: 71
State: CT

Vax Date: 09/29/2021
Onset Date: 09/30/2021
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: None. Had online visit with primary care doctor in afternoon.

Allergies: none

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

Symptoms: Fever 103 with chills 4 hours, then 102.4 another 4 hours. Dizzy, headache, weak. No food. Water caused vomiting twice around 10 am. Fever gradually went down over afternoon. 100 at 9 p.m. Okay the following day.

Other Meds: Prednisone, allopurinol, mycophenolate, belatacept, atorvastatin

Current Illness: none

ID: 1764830
Sex: M
Age: 73
State: KY

Vax Date: 09/25/2021
Onset Date: 09/25/2021
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: N/A

Allergies: Ace Inhibitors/Penicillin V. Potassium

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Patient inadvertently give 0.15 mL dose instead of required/recommended 0.3 mL dose. CDC contacted and advised to have patient return ASAP fto receive correct dosage. No adverse affects reported per patient. Patient returned 9/27/2021 and received 0.3 mL. dosage.

Other Meds:

Current Illness:

ID: 1764831
Sex: F
Age: 33
State: MN

Vax Date: 02/04/2021
Onset Date: 10/02/2021
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: Tested 10/3/21

Allergies:

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

Symptoms: Fully vaccinated employee developed symptoms and tested positive for Covid 19.

Other Meds:

Current Illness:

ID: 1764832
Sex: F
Age: 36
State: FL

Vax Date: 09/20/2021
Onset Date: 09/21/2021
Rec V Date: 10/06/2021
Hospital:

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

Lab Data: PCR hospital wont release CPR 65 other blood , full blood panel ultrasound of stomach abdomen and legs with swoellen lymphnodes.

Allergies: none

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

Symptoms: I think I almost died. having gone thru covid in early 2020, I can say that this was worse- I am traumatized. Truly. Immediately after vaccination I fell faint. It passed and I got up to go get groceries and eat. However, after 2 hours I started having symptoms of nausea. By evening, I was nauseated, weak, and a low grade fever had started. By day 1 I had all the symptoms above as well as lack of appetite and I was losing my ability to intake fluid. I had increased urination and pressure in my head began to build. By day 5 and 6 the symptoms were lessening. However, on day 7, by the night time all the symptoms were full force and the cramping in my legs had turned into swollen lymphnodes in my ingenuial area. By day 8 I could not get out of bed from overall weakness. I felt like I needed to vomit, passout, lay down, stand up, pee in place, and everything all at the same time. I could not get my bearings. Now, over 1 week had past and I had no taken in enough fluids. I tried, but I could not. I was unable to get myself to the toilet or shower. I could not walk my dogs. I was traveling, but my health got so bad that I went back home. My breathing was hard because I was weak. I was weak from lack of fluids or nutrition. I went to three hospitals begging them to call somewhere to report the adverse reactions. but nobody would. I was treated like a slaughter animal. I did not have a force to vomit, but I felt very full, at the top of my abdomen, and the idea of food or water made me sick to my stomach, a constant nausea. Even my hair follicles hurt. My fever was something I had NEVER had before. The pressure in my head and the convulsions from when my fever would break caused me to pull muscles all the way down to underneath my shoulder blades. I had a dry cough that eventually became deep and produced thick but clear fluid. Everything was painful. I was going to sleep weeping after forcing myself to get up to get a bottle of water and walk my dogs (3 of them) for just a few minutes each. Lymph nodes were burning and aching. AT one point the lymphnode near the top of my knee cap filled up. When I tried to walk it coupled with the very large (about 25mm) lymph on my right inside of thigh and made my leg freeze. I'd just fall. I was almost completely incapacitated and could not get help. I could not look at a computer or phone screen long enough to make sentences in reading or writing. Everthing made me sick. I could curl up in featle position with my head only raised by my hands and arms and that was how i could sleep without the pain as much. The pressure in my head had built up so bad by day 10 that I could not even begin to bend forward for anything. I could not sit up or stand up or lay down or turn or anything without having to be real careful that the blood or whatever all came with my head. it was a very weird experience. The pressure felt like it would bulge my eyes out. My eyes- the pain started day 1 when iw oke up. it subsided but then returned when the pressure in my head became unberable. Id have to talk myself through getting out of bed . it would take hours . I would take a parol at night, 500mg -1500mg just to ease the pain by it would break the fever. but before breaking the fever my fever would go so high, i would get too weak and have to sleep suddenly. 5-6 hour later i would wake up soaking wet, even with my mattress soaking wet. their covid precautions- theres like none. So i thought i had covid. I didnt have sweats last time- i had phenomenon where i lost my memory instead. in all 37 years of my life i can only vaguely remember sweats like this- when there was chickpox outbreak really bad and i had gotten it really bad. My inituition is never wrong and it was saying no about this vaccine but i needed it to meet a time requirement. iwas trying to escape leaving a relationship where the man became a stalker adn started to shoot at me. so understand me. I would not be faking sick. I have only taken health care when I was in crisis from dehydration or overhydration. I was so scared. and nobody helped. The last hospital tried to blame this on a female "problem" a small small tiny sign of infection taht would be normal for a woman who hasnt had miuch to drink in 10 days. tehy wouldnt even keep me in hospital to rehydrate me. I crawled back next morning telling them to please report the reaction so we can see if theres a way to treat e and the doctor screaamed at me. it was a nightmare. so day 16 now and my upper left rib to the back hurts. maybe my spleen. i could be the one that dies from this vaccine and everyone who could save me wouoldnt have. i feel so scared.

Other Meds: none

Current Illness: period started day of vaccination

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am