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: 1765204
Sex: M
Age: 33
State: MA

Vax Date: 07/22/2021
Onset Date: 08/07/2021
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: shellfish

Symptom List: Dysphagia, Epiglottitis

Symptoms: Pt has been experiencing a dull pain in your left arm near the injection site of the vaccine. Symptoms started mildly around August 7th and have persisted. Trying to get in to see MD

Other Meds: none

Current Illness: none

ID: 1765205
Sex: F
Age: 52
State: HI

Vax Date: 05/03/2021
Onset Date: 08/27/2021
Rec V Date: 10/06/2021
Hospital: Y

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: COVID hospitalization after full vaccination.

Other Meds:

Current Illness:

ID: 1765206
Sex: F
Age: 54
State: NJ

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

Allergies: septra naproxyn

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

Symptoms: painfully swollen lymph node - right armpit fatigue chills

Other Meds: synthroid hormone replacement therapy low-dose aspirin

Current Illness:

ID: 1765207
Sex: M
Age: 34
State: KY

Vax Date: 03/10/2021
Onset Date: 09/11/2021
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:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: COVID 19

Other Meds:

Current Illness:

ID: 1765208
Sex: M
Age: 8
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:

Allergies:

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

Symptoms: Error: Patient Too Young for Vaccine Administered-

Other Meds:

Current Illness:

ID: 1765209
Sex: M
Age: 36
State: SC

Vax Date: 09/10/2021
Onset Date: 09/20/2021
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: NA

Allergies: NA

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

Symptoms: I had right side facial pausing and my right side of my eye brow and eye lid were having facial drooping. I also experienced facial hemiparesis and I had lost of muscle tone of right side of my mouth. I lost taste in certain parts of my tongue. I went to my PCP for treatment and was prescribed medicine for 7 days 1000mg Valtrex 3xday and prednisone 80mg 1xday. I was diagnosed with facial paralysis/ bell palsy.

Other Meds: Lisinopril ( 5mg 1xday ) Hydrochlorothiazide ( 25mg 1xday ) Simvastatin ( 10mg 1xday )

Current Illness: NA

ID: 1765210
Sex: M
Age: 25
State: KY

Vax Date: 06/17/2021
Onset Date: 09/15/2021
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: Pyrexia, White blood cell count decreased

Symptoms: COVID POSTIVE

Other Meds:

Current Illness:

ID: 1765211
Sex: F
Age: 59
State: KY

Vax Date: 02/07/2021
Onset Date: 09/30/2021
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: Pharyngeal swelling

Symptoms: Tested Positive for Covid

Other Meds:

Current Illness:

ID: 1765212
Sex: M
Age: 38
State: KY

Vax Date: 04/19/2021
Onset Date: 08/25/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: Covid19

Other Meds:

Current Illness:

ID: 1765213
Sex: M
Age: 47
State: IL

Vax Date: 05/01/2021
Onset Date: 05/09/2021
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: Echocardiogram -40-45 CT- Pericardial infusion

Allergies: None.

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Ongoing chest pains, inflammation of the blood, WBC -15,000.

Other Meds: None.

Current Illness:

ID: 1765214
Sex: M
Age: 25
State: NV

Vax Date: 09/30/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: none

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

Symptoms: Discomfort in Chest prolonging for 3+ days. Hard and swollen lymph node on the left jaw line, abnormal shooting headache, serious fatigue, nausea, dizziness.

Other Meds: N/A

Current Illness: none

ID: 1765215
Sex: M
Age: 44
State: KY

Vax Date: 03/30/2021
Onset Date: 09/11/2021
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:

Symptom List: Rash, Urticaria

Symptoms: COVID 19

Other Meds:

Current Illness:

ID: 1765216
Sex: F
Age: 31
State: NY

Vax Date: 09/30/2021
Onset Date: 09/30/2021
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: muscles shaking, quivering (left calf muscle and left thigh), lips go numb, and left arm in injection site still hurts

Other Meds: none

Current Illness: none

ID: 1765217
Sex: F
Age: 33
State: GA

Vax Date: 09/23/2021
Onset Date: 09/26/2021
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: CBC came back normal

Allergies: N/a

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

Symptoms: Lump in neck (current) Swollen sore Lymph nodes in armpit (lasted 3 days) Bottom Lip swollen and went away over night Skin around eyes swollen and left eye red and sore current Flu symptoms

Other Meds: N/a

Current Illness: N/a

ID: 1765218
Sex: F
Age: 60
State: IN

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: 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: Site: Pain at Injection Site-Medium, Systemic: Abdominal Pain-Medium, Systemic: Body Aches Generalized-Medium, Systemic: Chills-Medium, Systemic: Fever-Medium, Systemic: Headache-Medium, Systemic: Joint Pain-Medium, Systemic: Nausea-Medium

Other Meds:

Current Illness:

ID: 1765219
Sex: F
Age: 44
State: TX

Vax Date: 01/25/2021
Onset Date: 01/26/2021
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: pecans, pistachios, walnuts

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

Symptoms: Left upper arm is weak and has pain when turning to pick up item or buckle a seat belt. This has been continuous since the first vaccine. It is difficult to flex the muscle.

Other Meds: Vasotec, Lasix, metoprolol, daily vitamins

Current Illness: none

ID: 1765220
Sex: F
Age: 56
State: OH

Vax Date: 03/20/2021
Onset Date: 03/21/2021
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: X-Ray

Allergies: None

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

Symptoms: The whole right upper arm hurts in different areas, worse at night

Other Meds: Sertraline and Buspirone

Current Illness: None

ID: 1765221
Sex: M
Age: 46
State: UT

Vax Date: 09/30/2021
Onset Date: 10/01/2021
Rec V Date: 10/06/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List: Ear pain, Hypoaesthesia

Symptoms: DAY AFTER VACCINE PATIENT HAD SEVERE CRAMPING DOWN LEFT SIDE OF ARM AND BACK. SAID IT FELT LIKE SOMEONE HAD BEAT THEM WITH A SLEDGE HAMMER ON HIS LEFT SIDE. LASTED FOR 2 DAYS WHERE PATIENT COULD NOT DO ANY NORMAL DAILY ACTIVITY.

Other Meds: unaware of any at this time

Current Illness: NONE

ID: 1765222
Sex: M
Age: 80
State: MN

Vax Date: 03/17/2021
Onset Date: 09/18/2021
Rec V Date: 10/06/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Patient was hospitalized with Covid 19

Other Meds:

Current Illness:

ID: 1765223
Sex: F
Age: 69
State: PA

Vax Date: 09/09/2021
Onset Date: 09/12/2021
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:

Allergies: none known

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

Symptoms: Intense itching of torso for 2 weeks

Other Meds: Metoprolol Eliquis Famotidine

Current Illness: none

ID: 1765224
Sex: F
Age: 13
State: IL

Vax Date: 08/27/2021
Onset Date: 08/01/2021
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:

Allergies: None

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

Symptoms: Patient received the wrong BRAND of the vaccine. Instead of Pfizer pt received Moderna. No reaction or adverse events occured.

Other Meds: None

Current Illness: None

ID: 1765225
Sex: F
Age: 36
State: KY

Vax Date: 03/11/2021
Onset Date: 08/27/2021
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: Unevaluable event

Symptoms: Covid19

Other Meds:

Current Illness:

ID: 1765226
Sex: F
Age: 27
State: NY

Vax Date: 09/27/2021
Onset Date: 09/27/2021
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: Dust.

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

Symptoms: My reaction started with a burning tingling sensation down my left arm. Then the joint pain continued to spread from my arm to my neck and hip area. This severe joint pain lasted for two whole days, it would hurt if I tried to put my arms over my head. Along with the body aches I also had headn aches, chills, a fever, no enery, shortness of breath and sensitivity to light. The joint pain, fever/ chills side effects lasted for two whole days whereas others still linger on. It has been a little over a week and I still feel run down/ tired and out of breath.

Other Meds: None.

Current Illness: None.

ID: 1765227
Sex: F
Age: 46
State: NC

Vax Date: 10/04/2021
Onset Date: 10/04/2021
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:

Symptom List: Injection site pain, Pain

Symptoms: Patient was given Moderna vaccine on 10/4/2021. The shelf life of the vaccine expired on 10/3/21. The vaccine was not expired

Other Meds:

Current Illness:

ID: 1765228
Sex: F
Age: 30
State: MD

Vax Date: 06/12/2021
Onset Date: 08/02/2021
Rec V Date: 10/06/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Injection site pain, Menorrhagia

Symptoms: Extremely irregular menstrual cycle.

Other Meds: Tri-lo-sprintec

Current Illness:

ID: 1765229
Sex: M
Age: 68
State: TN

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: Patient's wife called on 10/6/21 stating that he began feeling bad at 8 pm on 10/5/21 after receiving his vaccine earlier in the day. She reported that he was having horrible chills, headache, and body aches. She said he is continuing to feel poorly as of 11 am on 10/6/21. She reports that he went back to bed.

Other Meds:

Current Illness:

ID: 1765230
Sex: F
Age: 23
State: PA

Vax Date: 10/06/2021
Onset Date: 10/06/2021
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: Nausea, Pain in extremity, Pyrexia

Symptoms: She developed pain and tingling in her Left Arm immediately after receiving the vaccine. A few hours later she became clammy and developed a red bump on the opposite arm after vaccine. This bump was warm to touch.

Other Meds: Atenolol

Current Illness:

ID: 1765231
Sex: M
Age: 73
State: KY

Vax Date: 03/20/2021
Onset Date: 09/07/2021
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:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: COVID 19

Other Meds:

Current Illness:

ID: 1765232
Sex: F
Age: 49
State: MN

Vax Date: 01/26/2021
Onset Date: 09/25/2021
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: Covid-19 test

Allergies:

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

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

Other Meds:

Current Illness:

ID: 1765233
Sex: F
Age: 72
State: MI

Vax Date: 05/03/2021
Onset Date: 09/16/2021
Rec V Date: 10/06/2021
Hospital: Y

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

Lab Data:

Allergies: TramadolNausea and Vomiting, Headache Clonazepam Dilaudid [Hydromorphone]Nausea and Vomiting GabapentinNausea Only Hydrocodone-acetaminophenNausea and Vomiting Klonopin [Benzodiazepines] Vicodin [Hydrocodone-acetaminophen]Nausea and Vomiting, Headache

Symptom List: Nausea

Symptoms: Hospitalized (9.25.21 - present); COVID-19 positive (9.16.21); fully vaccinated From Admission note: HISTORY OF PRESENT ILLNESS: Patient is a 73 y.o. female who presents today with CC of dyspnea. Patient states that she and her husband tested positive foir COVID on 9/16. Both are fully vaccinated. Patients husband was very SOB today and EMS was called. EMS found both the husband and the patient were hypoxic and both were transported to hospital. Other than dyspnea, patient only complaint is fatigue and cough.. PROGRESS NOTE FROM 10/5/21: Date of admission: 9/25/2021 Date of encounter: 10/05/2021 COVID 19 Pneumonia Acute hypoxic respiratory failure secondary Patient is vaccinated Continue dexamethasone to complete 10 days Completed 5 days of Remdesivir Encourage acapella, IS and Proning Monitor CMP, CRP, D-dimer Continue to wean oxygen as tolerated PT/OT Disposition Pending improvement of respiratory status Anticipating pulmonary rehab evaluation or home oxygen need Possible DC in the next 24-48 hours SUBJECTIVE: Patient improving slowly however she is very emotional as her husband is now intubated in intensive care unit due to COVID-19

Other Meds: acetaminophen (TYLENOL) 650 MG tablet alprazolam (XANAX XR) 0.5 MG tablet amLODIPine (NORVASC) 10 MG tablet atorvastatin (LIPITOR) 40 MG tablet Cholecalciferol 2000 units CAPS esomeprazole (NEXIUM) 20 MG delayed release capsule fexofenadine

Current Illness: 9.15.21: reported COVID symptoms starting 9.14.21

ID: 1765234
Sex: F
Age: 65
State: CA

Vax Date: 03/30/2021
Onset Date: 04/15/2021
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: x-ray- normal ultrasound- normal MRI- nerve damage in her back , arthritis and nerve issues colonoscopy-bile duct was 8 mm rather than the normal 5 mm endoscopy- hiatal hernia- not severe enough to be an issue EKG gastric emptying study ruled gastro paresis

Allergies: no

Symptom List: Injection site pain

Symptoms: In late January 2021- she had a TIA- mini stroke. She spent 2 nights in the hospital, she changed her diet and was doing well. The medications, to lower her cholesterol and blood pressure were making her groggy and she slowly stopped taking them. She started eating healthy and lost weight. She lost about 25 lbs. 03/31/2021, the day after the vaccine. she felt chills and flu like symptoms and she took Tylenol for it. Her left index finger became stiff, the same side as the vaccination injection. and she could not move it for a few hours. The stiffness went away. On 04/15/2021, She felt the need to go to the bathroom all the time, Like she felt bloated. When she was eating, she immediately felt like she had to go to the bathroom . She felt nausea and nervousness in her stomach. The doctor suggested to stop taking all her medications away. She was sensitive to her medications. Her stomach problems started getting better after she stopped taking her medications. Now she is limited to what she can eat. Her diet is very limited. She slowly learned what she could eat without having problems. She has continued to lose weight. She lost 50 - 60 lbs. She is very fragile. She is afraid to drive by herself. She is very weak. She has had every test possible without any significant findings.. She will have an MRI on her abdomen on 10/08/2021. And she will see her neurologist on 10/07/2021.

Other Meds: atorvastatin 20 mg od/bedtime lisinopril 10 mg od aspirin 81 mg od

Current Illness: no

ID: 1765235
Sex: F
Age: 28
State: CA

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

Lab Data: ESRD dialysis that day

Allergies: Per hospital report: Vancomycin; Iodinated diagnostic agents; Capsaicin; Fentanyl and related -Morphine Base

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

Symptoms: patient reported apparent disorientation/confused/ disconnected sensation; described as "feeling crazy and not right in her head; like she felt like she wasn't there but she knew she was there" per pt, this happened at Dialysis tx session and she was taken to hospital by ambulance. Admitted and stayed x 3 days; diagnosed with Hypertensive crisis and h/o having missed 2 - dialysis treatment sessions

Other Meds: Labetalol 800mg Hydralazine 50 mg Flexeril PRN

Current Illness: anxiety; MSK pain

ID: 1765236
Sex: M
Age: 58
State: MA

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: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: Error: Wrong Vaccine Formulation (ex. different manufact. initial and booster)-

Other Meds:

Current Illness:

ID: 1765237
Sex: F
Age: 44
State: NH

Vax Date: 05/06/2021
Onset Date: 06/01/2021
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: MRI of brain, cervical (neck) and thoracic spine. EEG, EKG, chest x-ray

Allergies: Sulfa - slight allergy

Symptom List: Tremor

Symptoms: Diagnosed with post vaccine inflammatory syndrome Five months of chronic head pain/zaps, dizziness, peripheral neuropathy with tingling and burning, and twitching. rapid heart rate

Other Meds: Vybrid 10 mlg

Current Illness: None

ID: 1765239
Sex: F
Age: 58
State: FL

Vax Date: 03/14/2021
Onset Date: 09/30/2021
Rec V Date: 10/06/2021
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: No Known Allergies

Symptom List: Erythema, Pruritus

Symptoms: 9/30/21: ED for AMS and hypoxic respiratory failure. Hx limited and mainly obtained from EMR review and ED physician. Pt was emergently intubated on arrival to the ED d/t saturating in the 60s. In the ED pt was found to have leukocytosis w/ PNA and was tx w/ Vanc and Cef. Patient has developed sustained hypotension at the time when she was in respiratory distress and getting intubated. Currently patient is on norepinephrine. Her urine output has been declining. Please note: Patient received J&J vaccine on 3/14/2021 Lot # 1805025

Other Meds:

Current Illness:

ID: 1765240
Sex: F
Age: 72
State: KY

Vax Date: 03/20/2021
Onset Date: 09/07/2021
Rec V Date: 10/06/2021
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: COVID 19

Other Meds:

Current Illness:

ID: 1765241
Sex: F
Age: 57
State: KY

Vax Date: 02/26/2021
Onset Date: 08/22/2021
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: Covid19

Other Meds:

Current Illness:

ID: 1765242
Sex: F
Age: 72
State:

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: Not necessary

Allergies: Calcium chloride

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Arm pain, tiredness, first muscle pain about 24 hours after shot injection site redness and itchiness 36 to 48 hours after injection and continuing.

Other Meds: Raloxifene, multi vit, calcium suppl, vit D

Current Illness: None

ID: 1765243
Sex: F
Age: 62
State: IA

Vax Date: 09/22/2021
Onset Date: 10/04/2021
Rec V Date: 10/06/2021
Hospital:

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

Lab Data:

Allergies: NKDA

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

Symptoms: On October 5th patient presented to the pharmacy stating that she has a warm, itchy, red area in the region of where she received her first Moderna shot. She states that she has been having this for several days.

Other Meds: Unknown

Current Illness: Unknown

ID: 1765244
Sex: M
Age: 12
State: FL

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

Allergies:

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

Symptoms: Systemic: Blood Disorder (diagnosed by MD)-Medium, Systemic: Cardiac Disorder (diagnosed by MD)-Medium, Systemic: Chest Tightness / Heaviness / Pain-Medium, Systemic: Fever-Medium

Other Meds:

Current Illness:

ID: 1765245
Sex: F
Age: 31
State: AZ

Vax Date: 09/30/2021
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: LA

Lab Data: None

Allergies: None

Symptom List: Pain in extremity

Symptoms: Swelling, tenderness and pain of lymph nodes in shot arm (R) that started on full day 2 with spread to upper and lower armpit nodes over the course of 5 days. Moderate pain causing immobility. Of note- this is a booster shot administered approx 7mo after 2nd dose of same vaccine. This is not a symptom experienced with first or second vaccine.

Other Meds: Omeprazole DR capsule, Cetirizine tablet, Sertaline 20mg tablet

Current Illness: Rhinovirus

ID: 1765246
Sex: M
Age: 44
State: KY

Vax Date: 05/14/2021
Onset Date: 09/22/2021
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:

Allergies:

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

Symptoms: Tested Positive for Covid

Other Meds:

Current Illness:

ID: 1765247
Sex: M
Age: 62
State: KY

Vax Date: 02/01/2021
Onset Date: 09/17/2021
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: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: COVID POSTIVE

Other Meds:

Current Illness:

ID: 1765248
Sex: F
Age: 64
State: TN

Vax Date: 03/30/2021
Onset Date: 04/07/2021
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: codeine

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

Symptoms: Not certain if this is an adverse event but ... since this is a new vaccine I thought I should report this On 3/09/21, I received my first Covid vaccine. No abnormal reactions. On 03/31/21 I started having pain on my lower back with blisters appearing 04/03/21. I went to the Urgent Care on 04/04/21 and was told it was shingles. I received a steroid shot and anti-viral medication. Told to take Advil & Tylenol for pain. Second Covid vaccine was given 04/22/2021 without any other unexpected reactions or issues. I plan to get the booster sometime after Oct 22, 2021

Other Meds: Olmesartan medox/hctz, Duloxetine, Esomeprazole, Oxybutynin, Vit D, Vit C, Omega 3

Current Illness: none

ID: 1765249
Sex: F
Age: 62
State: IN

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

Lab Data: None

Allergies: None

Symptom List: Vomiting

Symptoms: Fever, chills, headache,fatigue, joints ache

Other Meds: None

Current Illness: None

ID: 1765250
Sex: F
Age: 26
State: NC

Vax Date: 10/04/2021
Onset Date: 10/04/2021
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 was given Moderna Vaccine on 10/4/2021. The self life of the vaccine expired on 10/3/21. The vaccine was expiration date is 10/10/2021.

Other Meds:

Current Illness:

ID: 1765251
Sex: M
Age: 39
State: NJ

Vax Date: 05/26/2021
Onset Date: 05/27/2021
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: INJECTION SITE IS SORE DAILY AND THE PAIN WAKES ME UP AT NIGHT- HAPPENS ALMOST DAILY

Other Meds: aderrall

Current Illness: none

ID: 1765252
Sex: F
Age: 31
State: KY

Vax Date: 04/19/2021
Onset Date: 09/04/2021
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:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: COVID19

Other Meds:

Current Illness:

ID: 1765253
Sex: M
Age: 30
State: TX

Vax Date: 09/25/2021
Onset Date: 09/26/2021
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

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

Symptoms: Heavy fever of 103 degree on the 2nd and 3rd day of vaccination. Muscle and body aches and hard to breathe still ongoing for over a week.

Other Meds: None

Current Illness: None

ID: 1765254
Sex: F
Age: 51
State: FL

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

Allergies: banana mango and avocado

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

Symptoms: pain in her thighs like muscle aches and then nausea and then bad swelling in her right axialla same arm of shot and had mammogram scheduled today and they could not do it with the swelling and pain

Other Meds: none

Current Illness: none

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am