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**
PLEASE CHECK BACK SOON
Download the files above while you wait.







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: 1772348
Sex: M
Age: 57
State:

Vax Date: 03/23/2021
Onset Date: 10/05/2021
Rec V Date: 10/08/2021
Hospital: Y

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: acute appendicitis, asymptomatic covid

Other Meds:

Current Illness:

ID: 1772349
Sex: M
Age: 62
State: CA

Vax Date: 09/28/2021
Onset Date: 09/28/2021
Rec V Date: 10/08/2021
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: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1772351
Sex: F
Age: 46
State: GA

Vax Date: 09/08/2021
Onset Date: 09/28/2021
Rec V Date: 10/08/2021
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:

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

Symptoms: Vaccine error-vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.

Other Meds:

Current Illness:

Date Died:

ID: 1772352
Sex: M
Age: 78
State: KY

Vax Date: 03/24/2021
Onset Date: 09/17/2021
Rec V Date: 10/08/2021
Hospital: Y

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

Lab Data: Echocardiogram

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Patient was admitted to hospital with hypoxic failure and COVID-19 . Poor baseline health prior to COVID. Hypoxemia worsed; was initially treated with remdesivir, decadron and baricitnib. Possible secondary bacterial pneumonia so baricitinib stopped and bacterial antibiotics started. Prior decubitus present upon admit. Murmur with severe aortic stenosis. Acute Kidney Injury with hyperkalemia; not a dialysis candidate. Patient made comfort care. Admitted to hospital 9/17/21. Died 9/30/2021. CEntral LIne placed 9/28/21

Other Meds:

Current Illness: Decubitis ulcer

ID: 1772353
Sex: M
Age: 71
State: NY

Vax Date: 01/24/2021
Onset Date: 02/21/2021
Rec V Date: 10/08/2021
Hospital: Y

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

Lab Data: Multiple MRI's, CT's, Ultrasounds and blood draws between 7/28/21 and 8/3/21.

Allergies: none

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

Symptoms: On 7/28/21 was diagnosed with large blood clots, 1 in each lung and 1 in leg. Shortness of breath, fatigue,and jittery were symptoms leading to hospital visit. Was in hospital for a week.

Other Meds: Lisinopril/Hctz Atorvastatin Metoprolol Succinate ER Famciclovir Fluoxetine Hcl Rivastigmine Centrum Silver Multivitamin

Current Illness: none

ID: 1772354
Sex: F
Age: 46
State: VA

Vax Date: 10/04/2021
Onset Date: 10/04/2021
Rec V Date: 10/08/2021
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: Penicillin

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

Symptoms: large hive on neck and skin itchy and tightness in the throat within one hour of receiving the vaccine. Took a couple of Benadryl and 'eventually' subsided. No medical visit or treatment by physician, UR Or ED

Other Meds:

Current Illness:

ID: 1772355
Sex: F
Age: 15
State: NC

Vax Date: 09/01/2021
Onset Date: 09/01/2021
Rec V Date: 10/08/2021
Hospital:

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

Lab Data: NA

Allergies: environmental allergies

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Diarrhea 2-3 times daily x 2 days. Nausea, congestion and chills intermittent x 2 days.

Other Meds: Singulair, Cetirizine, Buspirone, Omeprazole, Trazodone, Aripiprazole, Rizatriptan, Trokendi, Vitamin D3

Current Illness: unknown

ID: 1772356
Sex: F
Age: 58
State: CA

Vax Date: 10/07/2021
Onset Date: 10/07/2021
Rec V Date: 10/08/2021
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: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1772357
Sex: M
Age: 78
State: GA

Vax Date: 09/17/2021
Onset Date: 09/28/2021
Rec V Date: 10/08/2021
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: Vaccine error-vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.

Other Meds:

Current Illness:

ID: 1772358
Sex: F
Age: 54
State: CA

Vax Date: 09/28/2021
Onset Date: 09/28/2021
Rec V Date: 10/08/2021
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:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1772360
Sex: M
Age: 61
State: GA

Vax Date: 02/12/2021
Onset Date: 08/28/2021
Rec V Date: 10/08/2021
Hospital: Y

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

Lab Data: 08/30/2021 PCR+ COVID-19 test at Hospital

Allergies:

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

Symptoms: Breakthrough COVID-19 case with symptom onset 8/28/2021: Fever, Shortness of breath/difficulty breathing, Nausea/Vomiting, Loss of smell or taste, Fatigue or tiredness. Patient admitted to hospital on 8/30/21 with fever, shortness of breath (OXygen sat 87%), abdonminal pain, nausea, and vomiting. General A/P included acute respiratory failure with hypoxia, COVID-19 pneumonia. Patient never received mechanical ventilation and never entered the ICU. Discharged 9/8/2021

Other Meds:

Current Illness:

ID: 1772361
Sex: M
Age: 50
State: CA

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

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

Lab Data: Patient admitted to hospital with right lower extremity non-occlusive clot (ultrasound 10/6) and moderate volume of pulmonary embolism most pronounced in right lower lobe (chest CT 10/6). Remains in hospital at time of filing this form. 5 months post vaccine - possible connection?

Allergies: Barley, Hops, Tramadol, Yeast, Wheat.

Symptom List: Rash, Urticaria

Symptoms: Came into hospital with right lower leg pain 10/6/2021. Had vaccine 5/3/2021 at pharmacy.

Other Meds: Clonazepam, Depakote ER, Lisinopril, Seroquel, Eliquis, Multivitamin, Vitamin C.

Current Illness: None.

ID: 1772362
Sex: M
Age: 71
State: KY

Vax Date: 10/07/2021
Onset Date: 10/07/2021
Rec V Date: 10/08/2021
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: EXPIRED VACCINE GIVEN

Other Meds:

Current Illness:

ID: 1772363
Sex: M
Age: 75
State: CA

Vax Date: 09/28/2021
Onset Date: 09/28/2021
Rec V Date: 10/08/2021
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: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1772364
Sex: M
Age: 54
State: FL

Vax Date: 04/12/2021
Onset Date: 04/12/2021
Rec V Date: 10/08/2021
Hospital:

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

Lab Data: Blood work, Urine test

Allergies: None

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

Symptoms: Feeling "flu-ish" Thought it was allergies. The next day, felt really sick. Flu-like symptoms. Took Covid test. It was negative. Issues with dyslexia came back. Having some memory issues. Memory fog. Memory lapses. Also having issues with knees and legs

Other Meds: Ometazole 40ml, Clonidine 0.3ml, Vitamin D2 .25ml, Hydrochlorot 25ml, Singular 10ml, Clonidine .03ml, Aldactone 50ml, Estradiol 2ml, skin creams, Benedryl, Hycrobodone/Acetamin .325 ml, Soma 350ml, Xanax 2ml

Current Illness: Insect bites, dust mites, certain fabrics

ID: 1772365
Sex: F
Age: 50
State: MN

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

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

Lab Data:

Allergies:

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

Symptoms: patient reported developing pain in lymph nodes of right arm and developing numbness in arm and into neck about 6 hours later.

Other Meds:

Current Illness:

ID: 1772366
Sex: M
Age: 28
State: CA

Vax Date: 09/28/2021
Onset Date: 09/28/2021
Rec V Date: 10/08/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1772367
Sex: F
Age: 28
State: PR

Vax Date: 08/25/2021
Onset Date: 09/15/2021
Rec V Date: 10/08/2021
Hospital:

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

Lab Data:

Allergies: Patient refers no allergies.

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Patient refers that approximately 3 weeks after the administration of the vaccine she feel blurred vision, and "white spots in her vision as if she is about to faint" the patient refers that she has not visited a dr. because she does not know if it is "something else".

Other Meds: Patient refers not using medications at the moment.

Current Illness:

ID: 1772368
Sex: M
Age: 61
State: CA

Vax Date: 09/28/2021
Onset Date: 09/28/2021
Rec V Date: 10/08/2021
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: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1772369
Sex: F
Age: 67
State: CA

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

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

Lab Data:

Allergies:

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

Symptoms: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1772370
Sex: M
Age: 74
State: FL

Vax Date: 02/26/2021
Onset Date: 02/26/2021
Rec V Date: 10/08/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Feet tingling, achy joints, ringing in the ears, headaches, blurry vision, rash over entire body.

Other Meds:

Current Illness:

ID: 1772371
Sex: F
Age: 60
State: CA

Vax Date: 09/28/2021
Onset Date: 09/28/2021
Rec V Date: 10/08/2021
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: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1772372
Sex: F
Age: 56
State: TX

Vax Date: 03/30/2021
Onset Date: 08/24/2021
Rec V Date: 10/08/2021
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: Non-shellfish (salmon, trout, etc.)

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

Symptoms: Starting around the end of August, I had a rash that started on my left arm, as well as my chest and abdomen (upper right to lower left). The rash on my arm was quite bad, and despite using over-the-counter Cortizone, started oozing and scaling. I contacted my doctor who prescribed a 7-day steroid pack, which resolved the problem. It was presumed to be either plant origin or due to recent use of highly-concentrated milk products.

Other Meds: Lisinopril/Hctz, 20mg/10mg daily, multi-vitamin supplement, omeprazole, 20mg daily

Current Illness: None

ID: 1772373
Sex: U
Age: 69
State: GA

Vax Date: 09/08/2021
Onset Date: 09/08/2021
Rec V Date: 10/08/2021
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: Vaccine error - Vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.

Other Meds:

Current Illness:

ID: 1772374
Sex: F
Age: 62
State: CA

Vax Date: 10/07/2021
Onset Date: 10/07/2021
Rec V Date: 10/08/2021
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: Injection site pain, Menorrhagia

Symptoms: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1772375
Sex: F
Age: 20
State: TX

Vax Date: 10/08/2021
Onset Date: 10/08/2021
Rec V Date: 10/08/2021
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: Penicillin

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

Symptoms: patient was administered 3ml of moderna vaccine

Other Meds: Escitalopram 20mg

Current Illness:

ID: 1772376
Sex: F
Age: 56
State: CA

Vax Date: 10/07/2021
Onset Date: 10/07/2021
Rec V Date: 10/08/2021
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: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1772377
Sex: M
Age: 73
State: CA

Vax Date: 08/26/2021
Onset Date: 09/25/2021
Rec V Date: 10/08/2021
Hospital:

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

Lab Data: 9/26/21 X-ray, ultrasound, EKG, COVID test, full blood chemistry - all mostly in range, some slightly elevated, some slightly low.

Allergies: Lisinopril

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Fever a month later.

Other Meds: Metformin, Colchicine, Meloxicam, Montelukast, Tamsulosin, Allopurinol, Atorvastatin, Jardiance, Losartan, Famotidine, Cetirizine HCl, Acetaminophen, One-a-Day Men's Vitamin

Current Illness: None

ID: 1772378
Sex: F
Age: 30
State: CA

Vax Date: 09/28/2021
Onset Date: 09/28/2021
Rec V Date: 10/08/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Administration error mixed series mRNA vaccine Pfizer and Moderna

Other Meds:

Current Illness:

ID: 1772379
Sex: M
Age: 22
State: ME

Vax Date: 10/08/2021
Onset Date: 10/08/2021
Rec V Date: 10/08/2021
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: patient became pale, light headed - Janssen covid vaccine

Other Meds:

Current Illness:

ID: 1772380
Sex: F
Age: 76
State: MI

Vax Date: 02/25/2021
Onset Date: 09/30/2021
Rec V Date: 10/08/2021
Hospital: Y

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

Lab Data:

Allergies: AntihistaminesRash, Asthma/Shortness of Breath, Unknown HistamineRash, Asthma/Shortness of Breath MorphineOther, Unknown OxycodoneHallucinations, Confusion Alcohol AtorvastatinOther, Unknown CodeineConfusion, Unknown Lisinopril [Ace Inhibitors]Cough StatinsMyalgia

Symptom List: Injection site pain

Symptoms: Hospitalized (9.30.21); COVID-19 positive (); fully vaccinated BRIEF OVERVIEW: Admission Date: 9/30/2021 Discharge Date: Oct 7, 2021 Brief history and medical decision making: 77 y/o female hx of Fallopian tube cancer with recurrent SBO. Came in with another SBO. Was responding poorly to non-surgical management. After discussion with gyn onc, patient and husband elected to go to hospice care. Had decompressive G tube placed 10/6 and went home with hospice. Does have asymptomatic COVID 19 infection. Discharge Disposition: home with hospice/medical facility Active Issues Requiring Follow-up: Hospice admission in patient's home 10/7/21 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Dehydration Bowel obstruction Acute kidney injury Intractable vomiting with nausea, unspecified vomiting type COVID-19 HOSPITAL COURSE: Patient is a 77 y.o female with PMHx of fallopian tube serous adenocarcinoma stage IIIc s/p chemotherapy and multiple surgeries, recurrent bowel obstruction, diastolic heart failure EF 63%, and CKD stage 4 presents with a 5-day history of nausea, vomiting, anorexia, and constipation. In the ED she was found to be hypertensive, have Bicarb of 29, Cr of 4.14, s/p 3L fluid, Reglan, Zofran. She was admitted for fluid resuscitation for dehydration and investigation of bowel obstruction. Ctap with evidence of high grade small bowel obstruction with transition point in pelvis. This is likely due to adhesions from extensive intraabdominal surgeries, however Gyn/Onc was consulted with concern for extension of malignancy. She was initially treated with medical management with antiemetics, NGT decompression, and IV fluids. She initially had BM and flatulence on 10/2, however did not tolerate NG clamping and clear liquid diet, thus NG decompression resumed. Gyn/Onc discussed treatment options with patient, and ultimately reached the decision to pursue hospice. A G-tube was placed for decompression per IR. Hospice was coordinated for home and discharge on 10/7. Her hospital course was complicated by AKI on CKD and hypokalemia, which improved with IV fluid maintenance. Additionally, she was incidentally found to be COVID-19 positive, intermittently required 2L NC however mostly asymptomatic from a respiratory standpoint throughout her stay.

Other Meds: acetaminophen (TYLENOL) 500 MG tablet HYDROcodone-acetaminophen (HYCET) 7.5-325 MG/15ML solution ondansetron (ZOFRAN-ODT) 4 MG disintegrating tablet Spacer/Aero-Holding Chambers (AEROCHAMBER) MISC temazepam (RESTORIL) 30 MG capsule

Current Illness: 9.8.21 - office visit - chronic fatigue related to cancer; insomnia; chronic pain 9.28.21 - vomiting, abdominal pain, decreased urine output, constipation continued dehydration

ID: 1772381
Sex: F
Age: 51
State: WA

Vax Date: 04/03/2021
Onset Date: 09/14/2021
Rec V Date: 10/08/2021
Hospital:

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

Lab Data: No

Allergies: Sulfa drugs

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

Symptoms: When I woke up, I had a relapse of MS with a new symptom. In addition to pain, fatigue...I had vocal issues called Dysphonia. As I increased dosage of my medications, the symptoms seem to disappear or improve. I wasn't sure if the symptoms were vaccine related but wanted to report anyway.

Other Meds: Gabapentin; baclofen; clonazepam; methylphenidate

Current Illness: No

ID: 1772382
Sex: F
Age: 75
State: MD

Vax Date: 04/06/2021
Onset Date: 04/13/2021
Rec V Date: 10/08/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data: No

Allergies: Light reactions to antibiotics, but have not taken any in a very long time.

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

Symptoms: 04/13/2021-after receiving your vaccine-my chronic condition Cranial palsy went away till mid July 2021. At that time the muscles that controlled the eye and I had to go back to my PT for the eye. In early September of 2021 my dr did a visual test was bout 90% under control then.

Other Meds: I took Prese vison-areds2; Biotin;

Current Illness: No

ID: 1772383
Sex: F
Age: 87
State: KY

Vax Date: 10/07/2021
Onset Date: 10/07/2021
Rec V Date: 10/08/2021
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: Tremor

Symptoms: EXPIRED VACCINE GIVEN

Other Meds:

Current Illness:

ID: 1772384
Sex: F
Age: 66
State: WV

Vax Date: 09/29/2021
Onset Date: 10/04/2021
Rec V Date: 10/08/2021
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: 10/5/21 EKG unchanged, triponins WNL, THS undetectable Free T4 14.2 Echo unchanged, stress test Normal. Low grade temp 99.2 Dc'd 10/6

Allergies: sulfa

Symptom List: Erythema, Pruritus

Symptoms: 10/4/2021 started with severe fatigue, muscle aches. started having mid throat pressure and it radiated to upper chest. constant. no sweating, no relief with Tylenol or nsaids. Hx of afib and increased in short runs of RVR rate 120-130. 10/5/2021 Pain throat/chest intensified and continued. fatigue arms legs ache and felt tired. went to er 10/6/21 discharged after tests. fatigue aching nausea

Other Meds: synthroid, wellbutrin, HCTZ, vit d, magnesium

Current Illness:

ID: 1772385
Sex: F
Age: 26
State: CA

Vax Date: 02/28/2021
Onset Date: 03/01/2021
Rec V Date: 10/08/2021
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: MRI; BLOOD WORK; CT FULL AUTO IMMUNE TEST; COMMON VIRUSES TEST

Allergies: None

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

Symptoms: AFTER THE SECOND DOSE I HAD CHILLS PAIN IN MY ARM ADN HAD FEVER AND FATIGUE AND TIRED FOR ABOUT 24HRS. IN AUGUST I STARTED DEVELOPING CHEST PAINS AND THEN I WAS HOSPITALIZED. THE CHEST HAPPENS REGULARLY AND I HAVE BEEN DOCTORS AND THEY RAN A COUPLE OF TESTS BUT NOTHING WAS FOUND.

Other Meds: Levothyroxine; birth control

Current Illness: None

ID: 1772386
Sex: F
Age: 32
State: CA

Vax Date: 09/30/2021
Onset Date: 09/30/2021
Rec V Date: 10/08/2021
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: Received J&J vaccine at 7:45am on Thursday 9/30/21, by 9:00am extreme muscle soreness in left arm (site of injection) and nausea/vomiting. Throughout the day experienced increased muscle soreness concentrated in lower back, hips, neck and jaw causing debilitating pain. At 8:00pm spiked a fever of 102 and developed a rash on back and shoulders. Also developed a migraine that night. Rash, fever and migraine continued throughout the night. Also had intermittent numbness in fingers on both hands that night. Still had a fever of 102 the next morning (Friday). On Saturday fever resolved but developed cold/flu like symptoms (body aches, coughing, sneezing, loss of appetite, vomiting) which lasted until Monday. Rash disappeared on Monday.

Other Meds:

Current Illness: HPV, elevated thyroid antibodies, low progesterone, chronic migraines

ID: 1772387
Sex: F
Age: 37
State: WI

Vax Date: 09/28/2021
Onset Date: 09/29/2021
Rec V Date: 10/08/2021
Hospital:

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

Lab Data: None

Allergies: None

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Lymphadenopathy of head and neck, migraine.

Other Meds: Vyvance, pantoprazole, lexapro.

Current Illness: None

ID: 1772388
Sex: F
Age: 41
State: PA

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

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

Lab Data:

Allergies:

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

Symptoms: Swollen lymph nodes and pain from left armpit to left breast and ribs

Other Meds:

Current Illness:

ID: 1772389
Sex: F
Age: 72
State: GA

Vax Date: 09/08/2021
Onset Date: 09/08/2021
Rec V Date: 10/08/2021
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: Vaccine error - Vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.

Other Meds:

Current Illness:

ID: 1772390
Sex: M
Age: 26
State: TX

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

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

Lab Data:

Allergies: nkda

Symptom List: Pain in extremity

Symptoms: patient was administered 3ml

Other Meds:

Current Illness:

ID: 1772391
Sex: F
Age: 64
State: NV

Vax Date: 03/31/2021
Onset Date: 04/01/2021
Rec V Date: 10/08/2021
Hospital:

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

Lab Data: Covid test- negative Covid test- positive

Allergies: Penicillin, Cephalexin, Hydrocodone

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

Symptoms: The next day after having the vaccine, I had some sores underneath my nose and I was always hot. It felt like I was having menopause again. Then I got sick a couple of days before 07/23/2021. It was really terrible. My daughter tested positive for Covid. I contacted my doctor and told them about it. They sent me to get a test at urgent care. The next morning I got notified that I was positive. I also had a home test 2 hours before getting the test at urgent care and that one was negative. I got quarantine through my birthday. It felt like I had 5 different flues all going at the same time. The sores got bigger. I got them on my lips. I had a terrible fever. I had headaches. My ears were clogged up. My nose was running. I was tired all the time. I feel like I still have some brain fog sometimes. I still get some fever sores but I am taking some medication every day. When I had diarrhea they also gave me something for that. They also gave me something for the dry cough. It has continued with the dry cough off and on. I still get the sores but the medicine clears them off the next day. I still have the sweating off and on. While I was sick with Covid I was passing in and out for 3-4 days.

Other Meds: None

Current Illness: None

ID: 1772392
Sex: F
Age: 68
State: GA

Vax Date: 03/15/2021
Onset Date: 09/16/2021
Rec V Date: 10/08/2021
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: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: PUI tested positive on 9/16 after experiencing diarrhea and dehydration. PUI was admitted to Hospital from 9/17-9/19 for an IV as she was dehydrated. PUI has no other symptoms. PUI is fully vaccinated with Pfizer vaccine that she got on 2/25 and 3/15. PUI has an autoimmune condition, kidney disease and diabetes that she is not experiencing any difficulties with during this time.

Other Meds:

Current Illness:

ID: 1772394
Sex: M
Age: 86
State: LA

Vax Date: 07/28/2021
Onset Date: 07/28/2021
Rec V Date: 10/08/2021
Hospital:

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

Lab Data: Pt reports all blood work was wnl, CXR wnl and EKG wnl.

Allergies: PCN, crestor, mobic, oxycontin, zetia

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

Symptoms: Pt reports that around 4:45 pm, after receiving the shingrix vaccine around 2, he started feeling clammy, an increase in heart rate and "shaky". He had his soon bring him to local ER. Pt reports also had a cardiac evaluation a week later and all tests were wnl.

Other Meds: aspirin, atorvastatin, carvedilol, Co-Q 10, ginger extract, nitroglycerin, omeprazole, Vitamin D

Current Illness: None

ID: 1772395
Sex: M
Age: 63
State: CA

Vax Date: 07/19/2021
Onset Date: 07/19/2021
Rec V Date: 10/08/2021
Hospital:

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

Lab Data: NA

Allergies: NKA

Symptom List: Vomiting

Symptoms: Mixed dose series. Previously vaccinated with Pfizer on 3/17/21 and 4/7/21

Other Meds: NA

Current Illness: NA

ID: 1772396
Sex: F
Age: 72
State: KY

Vax Date: 10/07/2021
Onset Date: 10/07/2021
Rec V Date: 10/08/2021
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: EXPIRED VACCINE GIVEN

Other Meds:

Current Illness:

ID: 1772397
Sex: F
Age: 66
State: MI

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

Allergies: Penicillin, sensitivity to Zantac and NSAIDS

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

Symptoms: L upper arm swollen, redness and warmth beyond vaccination injection site, painful

Other Meds: Levothyroxine in am

Current Illness: None

ID: 1772398
Sex: M
Age: 73
State: MI

Vax Date: 02/26/2021
Onset Date: 09/28/2021
Rec V Date: 10/08/2021
Hospital: Y

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: NKDA

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Hospitalized (9.29.21); COVID-19 positive (9.28.21); fully vaccinated Admission Date: 9/29/2021 Discharge Date: 10/02/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Dehydration AKI (acute kidney injury) COVID-19 HOSPITAL COURSE: Patient is a 74 year old male with h/o CAD and ischemic cardiomyopathy, prior DVT on chronic Xarelto, HTN, HLD, NIDDM and BPH who presented to the ER with complaints of increasing fatigue. Patient reported increasing myalgias and had not been eating or drinking well for the past several days. Wife reported he was answering questions sore than normal and incorrectly. She also had transient loose stools and was sometimes to her to reduce her bathroom in time. In the ER, patient was mildly hypotensive in the ER which responded to IVF. COVID testing was positive. CXR revealed subtle bilateral patchy airspace disease, consistent with early COVID pneumonia. He was admitted under observation for AKI in setting of COVID 19 infection. Renal function improved with gentle IV fluids with baseline creatinine 1.4-1.5. AKI likely prerenal in setting of nephrotoxic medications. Lisinopril and hydrochlorothiazide were held during his stay and resumed after discharge. Patient had no evidence of hypoxia during his hospitalization less not qualify for Decadron or Remdesivir. As he was under observation status, patient received monoclonal antibody infusion on 09/30. PT/OT recommended home with assistance in no identified needs. Patient felt much improved on 10/02. Renal function had returned to baseline (Cr 1.45), and patient was discharged to home in improved condition. We discussed signs and symptoms to monitor for any worsening of COVID infection.

Other Meds: acetaminophen (TYLENOL) 500 MG tablet Ascorbic Acid (VITAMIN C PO) atorvastatin (LIPITOR) 80 MG tablet cholecalciferol (VITAMIN D3) 50 MCG (2000 UT) TABS empagliflozin (JARDIANCE) 25 MG TABS glipiZIDE (GLUCOTROL) 10 MG tablet hydroCHLOROthi

Current Illness: Wife - COVID-19 positive (~9.27.21) 9.27.21 - symptoms reported and swabbed - fatigue, exposure, body aches, fever 9.29.21 - altered mental status

ID: 1772399
Sex: F
Age: 43
State: NY

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

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

Lab Data:

Allergies: Contrast media, flu vaccine, latex, sulfa antibiotics

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

Symptoms: Developed hives on both arms and shortness of breath. NP administered 25 mg benadryl IM, Offered 911 but patient refused. Transferred from the vaccine to Medical department and seen by physician for evaluation. Prednisone 40 mg administered along with albuterol treatment. Stabilized and discharged

Other Meds: 81 mg Aspirin

Current Illness: Positive COVID test 2 weeks before

ID: 1772400
Sex: M
Age: 6
State: NC

Vax Date: 09/29/2021
Onset Date: 09/29/2021
Rec V Date: 10/08/2021
Hospital:

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

Lab Data: NA

Allergies: none known

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

Symptoms: Left arm swelling, erythema, and warmth. Spreading to entire upper arm within 24hours of vaccine. Treated with oral prednisone. Resolved over 3 days after oral medication.

Other Meds: none

Current Illness: none

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am