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: 1775101
Sex: M
Age: 74
State: CA

Vax Date: 10/07/2021
Onset Date: 10/07/2021
Rec V Date: 10/09/2021
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: Systemic: Chills-Mild, Systemic: Fainting / Unresponsive-Mild, Systemic: Flushed / Sweating-Mild, Additional Details: Patient was extremely nervous prior to being given shot and was sweating. After being given the Pfizer injection, pt fainted and paramedics were called and showed up to the site in a timely manner. The patient was treated on site and brought to stable status and in the end refused to go with paramedics for any further help or evaluations.

Other Meds:

Current Illness:

ID: 1775102
Sex: F
Age: 23
State:

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

Symptom List: Anxiety, Dyspnoea

Symptoms: swelling of injection site very sore arm after administration giant welt appeared on right arm less than 24 hours after administration only went away after taking Benadryl for2-3 days

Other Meds: montelukast 10 mg once dialy

Current Illness: no

ID: 1775103
Sex: F
Age: 54
State: MT

Vax Date: 10/07/2021
Onset Date: 10/07/2021
Rec V Date: 10/09/2021
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: None

Allergies: None

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

Symptoms: Overnight (12-24 hours) after vaccine: aches, chills, fever (100 degrees), fatigue

Other Meds: Fluticasone propionate inhaler, cetirizine, fish oil

Current Illness: None

ID: 1775104
Sex: F
Age: 51
State: PA

Vax Date: 09/24/2021
Onset Date: 09/26/2021
Rec V Date: 10/09/2021
Hospital: Y

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

Lab Data: CTA angio chest in hospital, D dimer, labs

Allergies: none

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: pulmonary vein thrombosis

Other Meds: none

Current Illness: none

ID: 1775105
Sex: M
Age: 30
State: NY

Vax Date: 10/03/2021
Onset Date: 10/07/2021
Rec V Date: 10/09/2021
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: Site: Pain at Injection Site-Severe, Site: Redness at Injection Site-Severe, Site: Swelling at Injection Site-Severe, Systemic: stiff/frozen in position hand-Severe, Systemic: Joint Pain-Severe, Systemic: Numbness (specify: facial area, extremities)-Severe, Systemic: Tingling (specify: facial area, extemities)-Severe, Systemic: Weakness-Severe, Additional Details: pt can not hold/grasp items such as a pen. started with arm pain/swelling - now hand is "locked" in a position where thumb meets pointer and middle finger - went to urgent care who told them they could not help. iI referred to ER/neurologist for consultation.

Other Meds:

Current Illness:

ID: 1775106
Sex: F
Age: 72
State: MI

Vax Date: 10/07/2021
Onset Date: 10/07/2021
Rec V Date: 10/09/2021
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: none. called my doctor.

Allergies: Sulfa drugs. Lactose intolerant.

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

Symptoms: swelling, inflamed, itching, sore. Began a couple hours after shot on 10/7 and persisted and ongoing.

Other Meds: Armour thyroid 30 mg. B vitamin, Calcium Magnesium, D3.

Current Illness: Acute Bronchitis diagnosed 8/25, but recovered fine.

ID: 1775107
Sex: M
Age: 37
State: CA

Vax Date: 08/31/2021
Onset Date: 08/31/2021
Rec V Date: 10/09/2021
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: Site: Bruising at Injection Site-Severe

Other Meds:

Current Illness:

ID: 1775108
Sex: M
Age: 41
State: TX

Vax Date: 01/07/2021
Onset Date: 05/28/2021
Rec V Date: 10/09/2021
Hospital:

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

Lab Data: ECG Monitor - -Frequent Premature atrial complexes-Frequent short runs of atrial tachycardia, longest 4.1 seconds, fastest 174bpm Lipoprotein - High LDL Cholesterol - High Stress Test - Normal EchoCardiogram - V EF is normal. Estimated EF is 60-64%., RV systolic function is normal., Mild RA/RV enlargement noted., Normal, diastolic function and LV filling pressures., No significant valvular abnormalities. RA Volume Enlarged GFR - Normal POC - Hematocrit Low CVMRI - EFT VENTRICLE: Quantitative LVEF 57 %. LV wall thickness is normal. LV cavity size is normal. LV systolic function is normal. There is no LV mass/thrombus. VIABILITY: No evidence of myocardial infarction or scar. RIGHT VENTRICLE: Quantitative RVEF 51 %. RV wall thickness is normal. RV cavity size is upper limits of normal. RV systolic function is normal. There is no RV mass/thrombus. LEFT ATRIUM: LA is mildly enlarged. There is no LA mass/thrombus. RIGHT ATRIUM: RA cavity size is upper limits of normal. There is no RA mass/thrombus.

Allergies: None

Symptom List: Pharyngeal swelling

Symptoms: Heart Flutter - heart would rapidly flutter for several seconds then return to normal. This could occur repeatedly for up to 60-90 minutes During Flutter - Lightheadedness and shortness of breath Chest pain Feeling of not being able to catch breath

Other Meds: None

Current Illness: None

ID: 1775109
Sex: F
Age: 29
State: CA

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

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

Lab Data:

Allergies: N/A

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Menstrual cycle started 5 days early which is highly unusual for me personally, it's never happened before. Day 3 of my period I was bleeding extensively - soaking through a super plus tampon and overnight maxipad every 45 minutes. I am used to having very heavy periods but this was extreme. At one point I was bleeding so much I had to sit on the toilet for 15minutes before the blood and clotting stopped, almost as if I was urinating. I was extremely light headed and woozy for the rest of the evening. By the next morning it had slowed down to a slightly heavier version of normal.

Other Meds: Magnesium + Ibuprofen post vaccine

Current Illness: N/A

ID: 1775110
Sex: M
Age: 54
State: MO

Vax Date: 10/07/2021
Onset Date: 10/07/2021
Rec V Date: 10/09/2021
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: Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium, Additional Details: patient reported blisters formed at injection site

Other Meds:

Current Illness:

ID: 1775111
Sex: M
Age: 38
State: NV

Vax Date: 02/06/2021
Onset Date: 06/02/2021
Rec V Date: 10/09/2021
Hospital:

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

Lab Data: June 2nd, 2021 - Hospital ER - Labs and tests ran - Negative results for Strep, Hep, Abscess, Infections Around June 22nd, 2021 - Hospital ER - More Labs and tests ran including x-rays and MRI - Negative results for all test

Allergies: Cats

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

Symptoms: Tonsillitis June 2nd, 2021 - Hospital ER - Labs and tests ran - Negative results for Strep, Hep, Abscess, Infections - Given Antibiotics Appointment made for ENT Specialist for mid July Around June 22nd, 2021 - Hospital ER - More Labs and tests ran because I had trouble breathing - Negative results for all test. - Given Antibiotics Mid July, Saw ENT Doctor at hospital - Discuss negative test results, prescribed more antibiotics, talked about surgery. Swelling did not go down after 3rd course of antibiotics, tonsillectomy set for Sept 20, 2021 Tonsillectomy performed on Sept 20, 2021. In recovery.

Other Meds: None

Current Illness: Wisdom teeth removal around May 18th, 2021

ID: 1775112
Sex: F
Age: 54
State: IN

Vax Date: 08/16/2021
Onset Date: 08/19/2021
Rec V Date: 10/09/2021
Hospital:

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

Lab Data: 8/30/21 - Ultrasound/doppler test on right ankle and leg to check for blood clots. No blood clots were detected.

Allergies: Hydrocodone - rash/hives

Symptom List: Rash, Urticaria

Symptoms: I got the first COVID (Pfizer) shot on 8/16/21 and my arm not only stayed red, swollen (hardness knot under the skin), warm to the touch, and hurting for about a week, but my ankle starting getting sore, tight, and swelling on 8/19/21. It feels like fluid pools in the lymph nodes after I have stood on it during the day. My ankle would swell to the point I couldn't even see my ankle and nothing like this has happened to me before. I am in very good health. I would send pictures if you had that option. I consulted my doctor and started icing it, using Ibprofin or Tylenol, and wearing compression socks. It got a little better, but then I got my second COVID (Pfizer) shot on 9/6/21 and all the soreness, tightness, and swelling got worse again. Here we are on 10/9/21, and I am still having these issues with my ankle. It is not as severe as it was, but it is still a problem and I still take Ibprofin and wear compression socks when I can. I sure hope this isn't permanent damage!

Other Meds: Multi vitamin, vitamin B Complex, Vitamin C, Vitamin D3, Estroven, Calcium + D, Probiotic, Flonase, Famotidine

Current Illness: None

ID: 1775113
Sex: M
Age: 50
State: MN

Vax Date: 09/14/2021
Onset Date: 09/28/2021
Rec V Date: 10/09/2021
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: Site: Itching at Injection Site-Mild, Site: Redness at Injection Site-Mild, Site: Swelling at Injection Site-Mild, Additional Details: Patient presented with a round scab on upper arm in vaccination area. He said at first there was a raised spot where needle was injected, then it went away. A couple weeks later it felt like there was something under the skin surface in the area , so he picked at it and it bled and formed a scab. There is no pain at all, scab is healing.

Other Meds:

Current Illness:

ID: 1775114
Sex: F
Age: 63
State: NC

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 10/09/2021
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: None

Allergies: Possible latex

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

Symptoms: Cool odd feeling from right to left side of upper chest, tingling and numbness in right foot. Later around 10 pm same night chills and sleeplessness next day extremely fatigued too tired to walk much and too tired to chew food beyond a few bites lasted 22 hours from start to finish. More symptoms came a couple day later right foot had vibrations on bottom of foot (like stepping on a vibrating cell phone) lasted a couple days and had off/on tickle cough. Have had slight tingling in lower right leg since.

Other Meds: Np thyroid, vivelle dot, progesterone cream, vit c d3

Current Illness: None

ID: 1775115
Sex: F
Age: 58
State: PA

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

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

Symptoms: PATIENT'S REPRESENTATIVE REPORTS NAUSEA, VOMITTING, FATIGUE THAT BEGAN WITHIN 24 HOURS OF RECEIVING VACCINE DOSE.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1775116
Sex: F
Age: 15
State: OH

Vax Date: 07/08/2021
Onset Date: 07/08/2021
Rec V Date: 10/09/2021
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: Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium, Systemic: Allergic: Rash Generalized-Medium

Other Meds:

Current Illness:

ID: 1775117
Sex: M
Age: 12
State: CA

Vax Date: 10/08/2021
Onset Date: 10/08/2021
Rec V Date: 10/09/2021
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: Systemic: Chest Tightness / Heaviness / Pain-Medium, Additional Details: Patient reported trouble breathing for several minutes after being administered second dose of Pfizer. Water was given and patient recovered within 5 minutes

Other Meds:

Current Illness:

ID: 1775118
Sex: M
Age: 12
State: CA

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

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

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Systemic: Chest Tightness / Heaviness / Pain-Medium, Additional Details: Patient reported trouble breathing after being administered second dose of Pfizer COVID19 vaccine. After being given water, patient recovered within 10 minutes.

Other Meds:

Current Illness:

ID: 1775119
Sex: F
Age: 47
State: MO

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

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

Lab Data: None

Allergies: Vicodin, vicks vapor inhaler, vinyl gloves, Levaquin, Zithromax, Prednisone, Lidocaine, Percoset

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: I received my third Pfizer (booster) Covid -19 shot at the same time as my annual flu shot. One vaccine was in my left arm, one in my right arm. My left arm hurt significantly worse. The night of the vaccine administration, I developed joint pain. The joint pain was significant in both of my knees. I could hardly sleep. I took Tylenol 500 mg x 2, but this did not affect the pain. On 10-9-2021 I took some 12 hour naproxen, ( 2 pills- max 3 in one day) and this helped significantly.

Other Meds: Hydrocortisone, Fludrocortisone, vitamin C, Vitamin D, Phenergan, Pantropazole, Levothyroxine, Topiramate, Cimetedine

Current Illness: No

ID: 1775120
Sex: F
Age: 65
State: CO

Vax Date: 07/16/2021
Onset Date: 08/17/2021
Rec V Date: 10/09/2021
Hospital:

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

Lab Data: I was scoped in my nasal passages and Dr. said there was no fluid, but probably inflammation and sinus drainage. I am to come back in 3 weeks if not improved to have a surgical procedure in my ear drum to relieve pressure

Allergies: PCN and sulfa

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

Symptoms: After one month of getting my second dose, I woke up with fullness in my ears as well as slight fatigue, slight chills, and loss of appetite for 3 weeks. After 3 weeks, my appetite came back but still fullness. Visited 4 different doctors and was prescribed prednisone pack as well as nasacort and sudafed. After 10 fays, there was slight improvement. I was then referred to ENT and was given another round of prednisone for 10 days as well as Alkalol nasal rinse and Ipratropim Bromide nose spray. I can take allergy meds as well and Flonase. I am on day 4 of this next treatment and still have fullness and exacerbated tinnitus. I did have tinnitus before, but it is worse because of the fullness. I also have phlegm in my throat that is very hard to clear

Other Meds: trazadone, levothyroxine, vit d, and Primal Mind Fuel=b vitamins

Current Illness: none

ID: 1775121
Sex: F
Age: 57
State: CO

Vax Date: 10/07/2021
Onset Date: 10/09/2021
Rec V Date: 10/09/2021
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: Shellfish, Sulfa anbitiotics

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

Symptoms: Cellulitis in left anterior upper arm, looked to be about 2" x 3" in size.

Other Meds:

Current Illness:

ID: 1775122
Sex: F
Age: 56
State: NJ

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

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

Lab Data: Emergency Room visit 7/21/21 CT lumbar sping - 8/4/21 MRI cervical spine - 8/5/21 MRI - thorasis - 8/10/21 knee x rays - 8/12/21 Rheumatologist : 17 vials of blood for bloodwork - 8/23/21 hip and shoulder x-rays - 8/24/21 MRI brain - 9/1/21 pelvis and hip x-rays - 9/9/21

Allergies: None

Symptom List: Unevaluable event

Symptoms: severe auto immune reaction ; soreness and tightness from hips to the knees Esr level 108 White blood cell count 1200 Could barely walk for 6-7 weeks still struggling 7 months later with high inflammaiton

Other Meds: Levothyroxine 5o mg 3x a week 75mg 4x week

Current Illness: NONE

ID: 1775123
Sex: F
Age: 81
State: TX

Vax Date: 09/29/2021
Onset Date: 10/04/2021
Rec V Date: 10/09/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Site: Bruising at Injection Site-Medium, Site: Itching at Injection Site-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium, Systemic: Allergic: Itch Generalized-Medium

Other Meds:

Current Illness:

ID: 1775125
Sex: M
Age: 31
State: FL

Vax Date: 10/08/2021
Onset Date: 10/08/2021
Rec V Date: 10/09/2021
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: Site: Itching at Injection Site-Mild, Site: Redness at Injection Site-Mild, Systemic: Confusion-Mild, Systemic: Shakiness-Mild, Additional Details: I have him the shot around 7.15 pm. he has stated that he passed out after the first dose as well and I told him we will monitor him for at least half hour. He sat on the outside chair and passed out, his wife held him and we had him lay on the floor. 911 was called and he was taken to the hospital. He came back to his consciouness after about 2 minutes.

Other Meds:

Current Illness:

ID: 1775126
Sex: F
Age: 64
State: NV

Vax Date: 08/29/2021
Onset Date: 08/29/2021
Rec V Date: 10/09/2021
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: Error: Wrong Vaccine Formulation (ex. different manufact. initial and booster)-

Other Meds:

Current Illness:

ID: 1775127
Sex: F
Age: 56
State: AZ

Vax Date: 10/08/2021
Onset Date: 10/08/2021
Rec V Date: 10/09/2021
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: Systemic: Fainting / Unresponsive-Mild

Other Meds:

Current Illness:

ID: 1775128
Sex: F
Age: 71
State: VA

Vax Date: 10/06/2021
Onset Date: 10/06/2021
Rec V Date: 10/09/2021
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: Error: Booster Given Too Early-

Other Meds:

Current Illness:

ID: 1775129
Sex: F
Age: 64
State: VA

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

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

Lab Data: N/A

Allergies: None

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: After the flu shot, developed Bell's Palsy. Left side face drooping, cannot close left eye, mouth is pulled to the right side of the face., plue headache, etc. Went to clinic the 2nd day and was treated with predniSONE 60mg per day.

Other Meds: LEVOTHYROXINE

Current Illness: None

ID: 1775130
Sex: F
Age: 45
State: SC

Vax Date: 08/26/2021
Onset Date: 09/05/2021
Rec V Date: 10/09/2021
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: Chest x rays (2x) 1 negative COVID test (nasal swab) on Sept 21 (approx)

Allergies:

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

Symptoms: Within 10 days I had symptoms of headache, sinus congestion, body aches, chest pain and mild dry cough. It turned into a bad ?cold or flu-like? feeling. I did an E- visit thru my insurance company because I thought I had a secondary infection starting. They prescribed Augmentin for 10 days. I took and it didn?t help. I then went to medical facility and they did Rx for Z Pack. It didn?t help and my chest was hurting so bad I thought my ribs were broken. Went back to them and they called in an inhaler for acute bronchitis. XRay showed no pneumonia. Diagnosed me finally with costochondritis. Gave Keterolac shot that did not help. Now I am just fighting it at home and the pain has intensified all around my rib cage. I have been putting off my 2nd vaccine dose because of illness and PA?s recommendation.

Other Meds: Levothyroxine daily for hypothyroidism .50 mcg

Current Illness: None

ID: 1775131
Sex: F
Age: 68
State: VA

Vax Date: 10/02/2021
Onset Date: 10/02/2021
Rec V Date: 10/09/2021
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: Site: Pain at Injection Site-Severe, Site: Redness at Injection Site-Severe

Other Meds:

Current Illness:

ID: 1775132
Sex: F
Age: 27
State: KY

Vax Date: 03/04/2021
Onset Date: 05/01/2021
Rec V Date: 10/09/2021
Hospital:

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

Lab Data: N/A

Allergies: Lexapro, nickel, rabbits

Symptom List: Injection site pain

Symptoms: Itchy and painful rash in underarm area, both arms. Started late April/early May after receiving both vaccines. Also persistent itch on vulva. Saw my PCP, she prescribed a steroid cream for underarms. Gynecologist suggested Vagisil for vulval itching. Neither treatments are working and rash on underarms is getting worse.

Other Meds: Cbd oil 50 ml daily

Current Illness: Migraines with aura, PCOS

ID: 1775133
Sex: F
Age: 33
State: IL

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

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

Lab Data:

Allergies:

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

Symptoms: Systemic: Burning sensation-Medium, Systemic: Flushed / Sweating-Medium, Systemic: Tingling (specify: facial area, extemities)-Mild, Additional Details: Pt felt light headed and a burning sensation for 4 minutes. Ice pack and juice were provided, pt felt okay after 10 mins

Other Meds:

Current Illness:

ID: 1775134
Sex: F
Age: 66
State: VA

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

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

Lab Data: none at this time.

Allergies: nka

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

Symptoms: Patient having swelling and redness in right arm. no pain at injection site. Noticed itching approximately 2 hours post vaccination. 12 hours post vaccination, noticed redness and swelling in upper arm. Swelling and redness extends from injection site to elblow. no reduction in range of motion. no fever. patient took 400mg ibuprofen at 11:00pm night of vaccine and 400mg ibuprofen morning after. minor reduction in symptoms. patient presented to pharmacy to have someone look at arm. pharmacist comfirmed redness and swelling. arm warm to touch. no other symptoms of note.

Other Meds: lisinopril 10mg once daily

Current Illness: none

ID: 1775135
Sex: M
Age: 39
State: NJ

Vax Date: 10/08/2021
Onset Date: 10/08/2021
Rec V Date: 10/09/2021
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: Error: Wrong Vaccine Formulation (ex. different manufact. initial and booster)-

Other Meds:

Current Illness:

ID: 1775136
Sex: F
Age: 24
State: WA

Vax Date: 10/09/2021
Onset Date: 10/09/2021
Rec V Date: 10/09/2021
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: Erythema, Pruritus

Symptoms: After received the shot about 5 min later patient start to have dizziness and hard time of breathing. We called the paramedics and paramedic took patient after accessment

Other Meds:

Current Illness: Type I diabetes and kidney disease

ID: 1775137
Sex: F
Age: 34
State:

Vax Date: 10/07/2021
Onset Date: 10/07/2021
Rec V Date: 10/09/2021
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: Itchy arm, arm swelling, and hardness. No symptoms until one week post-injection.

Other Meds:

Current Illness:

ID: 1775138
Sex: F
Age: 40
State: NJ

Vax Date: 10/08/2021
Onset Date: 10/08/2021
Rec V Date: 10/09/2021
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: Error: Wrong Vaccine Formulation (ex. different manufact. initial and booster)-

Other Meds:

Current Illness:

ID: 1775139
Sex: F
Age: 76
State: NC

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

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

Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Error: Wrong Patient (documentation in EMR)-

Other Meds:

Current Illness:

ID: 1775140
Sex: M
Age: 45
State: MD

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

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

Lab Data: unknown

Allergies: shrimp, cats, dogs

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

Symptoms: Patient reported feeling dizzy, light headed and a feeling of pins and needles after his first covid pfizer vaccine. His blood pressure was monitored and readings were as follows: approx 30 min after vaccine 149/92 hr 69, 2:00pm 148/85 HR 67, 205pm 162/105 HR 74 208pm 166/94 HR 71. 1 dose of Epinephrine autoinjector 0.3mg was given at 210pm. 212pm: 154/85 HR 71, 216pm 145/86 HR 86 EMS was called at 2:10pm after epeneprine. EMS arrived and transported patient to hospital

Other Meds: metformin

Current Illness:

ID: 1775141
Sex: F
Age: 63
State: CO

Vax Date: 10/09/2021
Onset Date: 10/09/2021
Rec V Date: 10/09/2021
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: n/a

Allergies: none

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

Symptoms: Patient is eligible for Flucelvax, not for Fluad, since patient is aged 63 and 11 months. Not eligible for FLUAD influenza vaccine but was administered to patient unintentionally.

Other Meds: unknown

Current Illness: none

ID: 1775142
Sex: M
Age: 50
State: CA

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

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

Lab Data:

Allergies:

Symptom List: Pain in extremity

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

Other Meds:

Current Illness:

ID: 1775143
Sex: M
Age: 66
State: CA

Vax Date: 10/08/2021
Onset Date: 10/08/2021
Rec V Date: 10/09/2021
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: Error: Incorrect Reconstitution-

Other Meds:

Current Illness:

ID: 1775144
Sex: F
Age: 27
State: IN

Vax Date: 10/07/2021
Onset Date: 10/08/2021
Rec V Date: 10/09/2021
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: Ranitidine

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

Symptoms: Dizzy, body aches, headache, sore throat,

Other Meds: Herbal teas

Current Illness:

ID: 1775145
Sex: M
Age: 14
State: MN

Vax Date: 10/08/2021
Onset Date: 10/08/2021
Rec V Date: 10/09/2021
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: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Medium, Systemic: Nausea-Medium, Systemic: Vomiting-Medium

Other Meds:

Current Illness:

Date Died: 09/25/2021

ID: 1775146
Sex: F
Age: 70
State: WA

Vax Date: 09/23/2021
Onset Date: 09/25/2021
Rec V Date: 10/09/2021
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: None

Symptom List: Vomiting

Symptoms: My mother died suddenly on 9/25/2021 around noon while swimming in a pool. Pathologist cause of death was aortic dissection.

Other Meds: Metropolol, morphine, adderall, anti-depressant I don?t know the name because they took down her my chart.

Current Illness: Mild hypertension, fibromyalgia, irritable bowel syndrome, add

ID: 1775147
Sex: F
Age: 78
State: CA

Vax Date: 10/06/2021
Onset Date: 10/07/2021
Rec V Date: 10/09/2021
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: none

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Patient received a high dose flu shot from the pharmacy on 10/6/21. She came by on 10/9/21 and stated that the next day after the shot on 10/7/21 her warm was swollen and red and itchy and sore. It has not gotten better since that day. She was advised to apply ice on it and also call the doctor. She said she will call the doctor today.

Other Meds: not known

Current Illness: not known

ID: 1775148
Sex: F
Age: 33
State: AL

Vax Date: 10/09/2021
Onset Date: 10/09/2021
Rec V Date: 10/09/2021
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: patient stated she was allergic to flu vaccine and it caused hives.

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

Symptoms: Patient passed out and was unresponsive. She was breathing and had heart rate. Epinephrine was administered. Patient became coherrent. EMS transported patient to hospital for evaluation

Other Meds:

Current Illness:

ID: 1775149
Sex: F
Age: 59
State: NY

Vax Date: 10/07/2021
Onset Date: 10/07/2021
Rec V Date: 10/09/2021
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: NO KNOWN ALLERGIES

Symptom List: Injection site swelling, Limb discomfort

Symptoms: PATIENT CAME IN AND STATED THAT ON 10/7 AROUND 5PM, SHE NOTICED A HARD, SWOLLEN LUMP ON HER ARM AND THE INJECTION SITE THAT WAS HOT TO THE TOUCH. IT WAS THE APPROXIMATE SIZE OF A GOLFBALL IN DIAMETER.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1775150
Sex: F
Age: 29
State: WA

Vax Date: 09/24/2021
Onset Date: 09/24/2021
Rec V Date: 10/09/2021
Hospital:

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

Lab Data: I visited a doctor on October 6. He performed hearing tests and checked my ears. He said everything looked totally normal. He will refer me to an ENT if this issue persists.

Allergies: No

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

Symptoms: I got the vaccine on 9/24/21 at 9:35 AM. At 7:30 PM that night, I started to get ringing (tinnitus) in my left ear. The ringing has been constant and has not gone away. It has only gotten worse and is now in my right ear as well. This side effect from the vaccine has increased my anxiety exponentially. I have a difficult time going to sleep at night because of this.

Other Meds: No

Current Illness: No

ID: 1775152
Sex: F
Age: 45
State: NY

Vax Date: 10/08/2021
Onset Date: 10/08/2021
Rec V Date: 10/09/2021
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: None

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

Symptoms: Progressing injection site soreness extending down arm and up left side neck. Fatigue, body ache and chills starting apps 3 hours later, joint pain, fever mild sore throat next morning

Other Meds: Lamotrigine Vyvanse Venlafaxine

Current Illness: None

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am