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: 1775425
Sex: F
Age: 58
State: FL

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

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

Lab Data: Optometrist exam

Allergies: None

Symptom List: Dysphagia, Epiglottitis

Symptoms: I experienced aura headache next day and 2 days later sudden vision loss in both eyes. I was diagnosed with macular puckers.

Other Meds: Multi vitamin

Current Illness: None

ID: 1775426
Sex: F
Age: 13
State: NC

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data: Blood work 9/26/2021 Bloodwork 10/06/21

Allergies: Lamictal

Symptom List: Anxiety, Dyspnoea

Symptoms: Anemia

Other Meds: Ability Tegratol Effexor Trazadone Hydroxyzine

Current Illness:

ID: 1775427
Sex: F
Age: 46
State: FL

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

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

Symptoms: Following the date of vaccination I felt a very strong pressure in chest radiating to left side and pain in the left arm. The same night i noticed swelling in my left underarm around 7PM. The underarm is swallen and hurts

Other Meds: none

Current Illness: NONE

ID: 1775428
Sex: M
Age: 35
State: CA

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

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

Lab Data: N/A

Allergies: Septra

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Hyperglycemia,headaches,fatigue,soreness at injection site,blurry vision

Other Meds: Hydrocortisone Levothyroxine

Current Illness: N/A

ID: 1775429
Sex: F
Age: 70
State: CT

Vax Date: 10/08/2021
Onset Date: 10/09/2021
Rec V Date: 10/10/2021
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: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: sore arm at injection site ib 10/8,10/9 and 10/10 on 10/9 ached all over my body and felt like I had the flu

Other Meds: tylenol

Current Illness: rapid pulse

ID: 1775430
Sex: F
Age: 24
State: OH

Vax Date: 10/08/2021
Onset Date: 10/09/2021
Rec V Date: 10/10/2021
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: Sulfa drugs

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

Symptoms: Full body aches and pain so bad it woke me up. Legs, back, arm and injection site hurt so bad I could barely move. OCT pain killers and a heating pad helped enough. Was very sore and stiff all day, OTC helped enough, but pain lasted all day. Decreased mobility and range of motion all day. No fever, pain almost fully gone on the next day.

Other Meds: Prozac 60 mg, Claritin, bentyl 10 mg, famotadine 40 mg, multivitamin

Current Illness:

ID: 1775431
Sex: F
Age: 39
State: NY

Vax Date: 04/01/2021
Onset Date: 04/14/2021
Rec V Date: 10/10/2021
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: Pollen

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Chronic intermittent headaches lasting for 1-4 days at once after receiving vaccination. Symptoms is still persisting.

Other Meds: None

Current Illness: None

ID: 1775432
Sex: F
Age: 45
State: VA

Vax Date: 10/08/2021
Onset Date: 10/09/2021
Rec V Date: 10/10/2021
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: tylenol with codeine - causes itching

Symptom List: Pharyngeal swelling

Symptoms: urticaria rash started 24hrs after injection

Other Meds: venlafaxine, buproprion, clonazepam, buspirone. levonorgestrel,

Current Illness: Flu vaccine on same date

ID: 1775433
Sex: F
Age: 65
State: IN

Vax Date: 10/07/2021
Onset Date: 10/08/2021
Rec V Date: 10/10/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: Body aches, chills, slight temp, headache, felt really lousy. Took 1000mg of Tylenol extra strength every four fours during the day

Other Meds: High blood pressure medicine HCTZ Valsartan, multi vitamin, fish oil, vit B6, glucosamine, vit c, calcium, vit D3, stress level vit b, st John wort

Current Illness: None

ID: 1775434
Sex: F
Age: 74
State: IN

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

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

Lab Data: None

Allergies: Zocor, penicillin, yellow dye #5

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Body aches, back aches, chills, shivering, fever. Sore muscle at injection site. Little to no sleep first night. Symptoms began approximately 12 to 14 hours following injection. Took tylenol. 2 every 6 hours. Fever gone in about 12 hours. Still some body aches and sore injection site but greatly reduced at 48 hours following injection.

Other Meds: Niacin, allegra, pantropazol, vitamin D3

Current Illness: Seasonal allergies

ID: 1775435
Sex: F
Age: 57
State: NY

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

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

Lab Data:

Allergies:

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

Symptoms: Severe headache, muscle aches, diarrhea, severe lower back pain for more than 10 days

Other Meds:

Current Illness:

ID: 1775436
Sex: F
Age: 77
State:

Vax Date: 10/06/2021
Onset Date: 10/08/2021
Rec V Date: 10/10/2021
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: None

Symptom List: Rash, Urticaria

Symptoms: Headache, muscle pain, dizziness, nausea, constipation, fatigue, dry cough, fever, blotchy vision, clamminess.

Other Meds: Lisinopril 15mg, Atorvastatin 20 mg, aspirin 75 mg

Current Illness: None

ID: 1775437
Sex: F
Age: 76
State: IN

Vax Date: 10/08/2021
Onset Date: 10/09/2021
Rec V Date: 10/10/2021
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: Nauseous, chills, sweats, fever reached 104.3 Rest, Ibuprofen, ice

Other Meds: Pristiq, Synthrois, Tamoxifin, Multivitamins, Calcium with D2 and E2

Current Illness: cancer

ID: 1775438
Sex: F
Age: 65
State: MA

Vax Date: 10/07/2021
Onset Date: 10/08/2021
Rec V Date: 10/10/2021
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: Patient developed fatigue, malaise, abdomen pain, and diarrhea starting 12 hours after getting vaccine.

Other Meds:

Current Illness:

ID: 1775439
Sex: F
Age: 42
State: TN

Vax Date: 08/26/2021
Onset Date: 08/30/2021
Rec V Date: 10/10/2021
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: Neomycin

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

Symptoms: Persistent soreness and tenderness in the arm muscle where the injection was given. It worsens when I use the muscle. I also feel like a "heaviness" there, like something is present in my muscle. I had a cyst - like lump for about 2 weeks post shot that eventually went away.

Other Meds: Indapamide, lisinopril

Current Illness:

ID: 1775440
Sex: M
Age: 64
State: TX

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

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

Symptoms: Pain spread in muscle flesh, in ring form away from right arm injection site, down arm to elbow, across and down upper right side chest, and down back side similar to chest. A dull ache remains in upper right side of body 3-months later.

Other Meds: None

Current Illness: None

ID: 1775441
Sex: M
Age: 40
State: NY

Vax Date: 10/06/2021
Onset Date: 10/07/2021
Rec V Date: 10/10/2021
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: Penicillin, Codine

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

Symptoms: -Sharp pain in my head when sneezing or coughing, still today 10/10/2021 -Oxygen levels dropped to 92% 2 days after shot.

Other Meds:

Current Illness:

ID: 1775442
Sex: F
Age: 29
State: OK

Vax Date: 08/31/2021
Onset Date: 09/22/2021
Rec V Date: 10/10/2021
Hospital:

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

Lab Data: N/a

Allergies: Penicillin, lactose

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Period was over a week late following both vaccines. My cycle shot up to 39 and 35 days long, respectively. Second vaccine was administered on September 28th 2021. My cycle is always normal, around 25 days.

Other Meds: N/a

Current Illness: N/a

ID: 1775444
Sex: F
Age: 51
State: TX

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

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

Lab Data: N/A

Allergies: Possibly PCN, but unsure. Goes back to childhood, so avoid.

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Like when I've had the flu in the past. Hot/cold chills (chills, yet hot to the touch--didn't take temp), All-over body ache, severe aching when got up to use the restroom, etc. Could not get comfortable in any position. The injection site hurt like a bad charliehorse. Pounding headache. Eyes felt hot. This was a booster to the Pfizer vaccine, and I had no such reaction to the first two, other than I slept about 30 hours in a weekend following the first, and slight headache. ALSO, as a patient, I do not have manufacturer information for my influenza vaccine I rec'd less than a month ago, however, I had to select one from the drop-down on the next page.

Other Meds: Bupropion (375mg), Loratadine, 10mg (OTC), Meloxicam, 15mg (Taking less than one month, daily).

Current Illness: None.

ID: 1775445
Sex: M
Age: 60
State: NC

Vax Date: 10/09/2021
Onset Date: 10/09/2021
Rec V Date: 10/10/2021
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: PATIENT CAME IN FOR HIS SECOND DOSE OF MODERNA AND TECHNICIAN GAVE PATIENT PFIZER -BioNTech INSTEAD

Other Meds:

Current Illness:

ID: 1775446
Sex: F
Age: 34
State: IN

Vax Date: 09/17/2021
Onset Date: 09/18/2021
Rec V Date: 10/10/2021
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: 9/22/21 EKG: normal Chest X-ray: negative for blood clots or fluid in the lungs Blood tests: no marker for heart attack

Allergies: None

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

Symptoms: Friday 9/17: 1 hour after getting vaccine I was tired and had a headache Saturday 9/18: I woke up around 9:30am and my heart felt like it was fluttering, I had pressure on my sternum, and it felt as though there was something pressing on my throat making it hard to breath. The headache was still there and very noticeable. I went about my daily routine, except I was so exhausted that I could hardly stay awake. This continued all day. I noticed that the chest pressure/fluttering was worsened by eating our drinking. Sunday 9/19: all of the previous day's symptoms continued and I began to be winded after walking from one room to another. Monday/Tuesday 9/20-21: the headache went away and I wasn't exhausted, but the other symptoms were very present. Wednesday 9/22: I woke up with the symptoms like U had been, but as soon as I started to move around the pressure turned into the feeling that my heart was going to explode. I went to my local urgent care center. They ran tests and sent me to the hospital to have more tests run. The hospital found I wasn't having a heart attack or had a blood clot. They sent me home to rest. Thursday 9/23-Friday 10/1: The symptoms were still very present in my daily routine, but lessened over time. 10/8/21: I received my 2nd dose

Other Meds: Welbutrin 300mg, Lexapro 20mg, levothyroxine 200mcg, Metformin XR 500mg, Mirena IUD.

Current Illness: None

ID: 1775447
Sex: F
Age: 46
State: CA

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

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

Lab Data: N/a

Allergies: None

Symptom List: Unevaluable event

Symptoms: Dizziness, buzzing sound in ears, disequilibrium

Other Meds: None

Current Illness: None

ID: 1775448
Sex: M
Age: 69
State:

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

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: COVID infection

Other Meds:

Current Illness:

ID: 1775449
Sex: F
Age: 72
State: FL

Vax Date: 02/05/2021
Onset Date: 07/29/2021
Rec V Date: 10/10/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: Chest X-Ray 08/05/2021 Covid -19 Positive 08/05/2021

Allergies: Iodine Dye, Codeine, Penicillin, Sudafed-rapid heartbeat

Symptom List: Injection site pain, Pain

Symptoms: I started to feel unwell, and I had chills and fever. I had a dry cough. Five days later I went to the ER and I tested positive for Covid-19. I was given monoclonal antibodies. I had home health and when I returned home my blood pressure was high. My Amlodipine was increased. I still had a runny nose and a slight cough and extreme fatigue with headaches. The symptoms lasted for about two weeks. I did not have any loss of taste or smell. It has been over two months and I am still a little fatigued.

Other Meds: Rosuvastatin, Metoprolol, Levothyroxine, Amlodipine, Eye Drops for Glaucoma, Alendronate Sodium

Current Illness: N/A

ID: 1775450
Sex: M
Age: 76
State: AZ

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

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

Lab Data: Echocariogram, CTs.

Allergies: No

Symptom List: Injection site pain, Menorrhagia

Symptoms: Too weak following day to even roll over in bed Tues); some mobility the second day, although still mostly bedbound due to extreme fatigue (Wed). Excessive urination throughout the period; able to eat very little; took some fluids the second day. Massive night sweats that second night. Felt much better at beginning of third day (Thurs), but over the space of four hours became dizzier and dizzier, blood pressure fell gradually and steadily. When it reached 60/40, decided ER visit would be necessary. While attempting to reach bedroom to get some clothes, fainted and fell in hallway. County Fire had to establish IV and transport to Medical Center ER. ER continues hydration through IV all that day (Thurs) thru 4:00 PM Fri, then released me from hospital. Extensive tests during this period were all negative.

Other Meds: Atorvastatin (LIPITOR) 20 mg PM statin ? lower cholesterol Irbesartan 300 mg ? tab AM, ? tab PM blood pressure Amlodipine Besylate 2.5 mg 1 tab AM, 1 tab PM blood pressure Omeprazole 20mg AM Glucosamine/Ch

Current Illness: No

ID: 1775451
Sex: F
Age: 76
State: NY

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

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

Lab Data: Sed rate 31, CRP 12 (05/12/2021). Repeated on 09/14/2021 with normal results Sed 14, CRP <3

Allergies: NONE

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

Symptoms: Polymyalgia rheumatica rapidly worsened. Pain and stiffness in thigh muscles and upper arm muscles and neck muscles. Polymyalgia was diagnosed after I received doses 1 and 2 of the Pfizer vaccine on 2/26/21 and 3/19/21. Prednisone regimen was started on 5/18/21. By the time of the CoVid boosterI had tapered down to 2mg of prednisone and would finish taking prednisone in one week as the follow-up blood tests showed a return to normal range.

Other Meds: Neurontin, Levothyroxine, prednisone,baby aspirin, multivitamin, roxine

Current Illness: poymyalgia rheumatica

ID: 1775452
Sex: M
Age: 79
State:

Vax Date: 04/24/2021
Onset Date: 10/10/2021
Rec V Date: 10/10/2021
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: covid infx

Other Meds:

Current Illness:

ID: 1775453
Sex: M
Age: 45
State: GA

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

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

Lab Data: None

Allergies: None Known

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: 40hrs insomnia 40hrs of my heart booming (feeling of beating out of my chest) 4 days of itching skin on my back of my hands, forearms, back of my knees, and around my neck.

Other Meds: None

Current Illness: None

ID: 1775455
Sex: F
Age: 51
State:

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

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: None stated.

Other Meds:

Current Illness:

ID: 1775457
Sex: F
Age: 29
State: WA

Vax Date: 06/15/2021
Onset Date: 06/16/2021
Rec V Date: 10/10/2021
Hospital:

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

Lab Data:

Allergies: None known

Symptom List: Nausea

Symptoms: 3 days of strong fever and chills. Could not leave house for normal activities. Constricted chest and trouble breathing fully for several weeks. Intermittent pain in left chest.

Other Meds: None

Current Illness: None

ID: 1775458
Sex: F
Age: 72
State:

Vax Date: 02/12/2021
Onset Date: 10/10/2021
Rec V Date: 10/10/2021
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:

Symptom List: Injection site pain

Symptoms: covid infx

Other Meds:

Current Illness:

ID: 1775459
Sex: F
Age: 55
State: TX

Vax Date: 10/09/2021
Onset Date: 10/09/2021
Rec V Date: 10/10/2021
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: Severe reaction with histamine response and rash to arms, neck, face, and spreading to legs

Other Meds:

Current Illness: Healthy

ID: 1775460
Sex: M
Age: 59
State: FL

Vax Date: 09/24/2021
Onset Date: 09/27/2021
Rec V Date: 10/10/2021
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

Allergies: none

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

Symptoms: Severe, chronic skin itch with numbing and and tingling throughout both arms.

Other Meds: none

Current Illness: none

ID: 1775461
Sex: F
Age: 47
State: KS

Vax Date: 04/15/2021
Onset Date: 05/15/2021
Rec V Date: 10/10/2021
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: Penicillin

Symptom List: Tremor

Symptoms: Haven't had a cycle since the shot. Also had a severe case of dymenthia eczema on the bottom of my feet for 4 months. Never had it before.

Other Meds: Affair, proair

Current Illness: None

ID: 1775462
Sex: F
Age: 55
State:

Vax Date: 07/27/2021
Onset Date: 07/28/2021
Rec V Date: 10/10/2021
Hospital:

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

Lab Data: Working with hospital withDr He is tried medication that?s doesn?t work and having a hard time trying to solve problem. I booked in for urgent MRI which could take months. I am in extreme pain each day and my jaw is starting to go numb in places

Allergies: Sulplur drugs

Symptom List: Erythema, Pruritus

Symptoms: I have had extreme georgific tongue very painful and peeling raw all the time and burning mouth sydome also very painful 24 hours a day and unable to work

Other Meds: Clonazepam 1mg twice a day Tynol 2s Zopiclone 1 at night

Current Illness: Had a dentist hygienist cleaning that she was very rough and had left me with a sore mouth and gums

ID: 1775463
Sex: M
Age: 62
State: MD

Vax Date: 09/15/2021
Onset Date: 09/17/2021
Rec V Date: 10/10/2021
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: Emergency room 9/18-19/21

Allergies: None

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

Symptoms: rapid heartbeat-Afib

Other Meds: Metoprolol Tartrate 2mg twice daily, hydrochlorothiazide 2mg one daily

Current Illness: None

ID: 1775464
Sex: M
Age: 44
State: MI

Vax Date: 10/08/2021
Onset Date: 10/09/2021
Rec V Date: 10/10/2021
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: Tinnitus, came on as fever and other regular reaction symptoms started. As of mid sunday morning other symptom have resolved tinnitus has not

Other Meds:

Current Illness:

ID: 1775465
Sex: M
Age: 37
State: NJ

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

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

Lab Data: I have recovered from Covid 3 month before taking the 2nd shot, in late February 2021.

Allergies: Nothing

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Around 8 or 9 pm - 10 hours after receiving the 2nd shot, I nearly collapsed. Somehow I manage to fall on the bed instead of the floor and then for about 15-20 minutes I was shivering, sweaty, heart racing up and down - and overall a very bad reaction.

Other Meds: Nothing

Current Illness: Nothing

ID: 1775466
Sex: F
Age: 29
State: RI

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

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

Lab Data: Currently trying to find somewhere to go aside from the ER

Allergies: Latex

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

Symptoms: Horrible shooting/stabbing pains at the base of my esophagus/rib cage. Constant stOmach cramps and nausea. Almost like heartburn or acid reflux but not quite. Back pain from the middle of my back and up. Drowsiness, headaches. Sore muscles. All of this started either in the day after or two days after, it's hard to remember.

Other Meds: Naproxen sodium, tums, daily multivitamins, elderberry supplements

Current Illness:

ID: 1775467
Sex: F
Age: 63
State: IN

Vax Date: 10/07/2021
Onset Date: 10/08/2021
Rec V Date: 10/10/2021
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: Sulfa, penicillin

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

Symptoms: Very lethargic, lightheaded, sleeping a lot . On the third day of this now!

Other Meds: Lisinopril, methimazole, famotidine

Current Illness:

ID: 1775468
Sex: M
Age: 46
State: MS

Vax Date: 09/15/2021
Onset Date: 09/18/2021
Rec V Date: 10/10/2021
Hospital:

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

Lab Data: none, I am currently trying to get an appointment with a cardiologist.

Allergies: none

Symptom List: Pain in extremity

Symptoms: I broke out in hives on my entire torso on 9-16, and 17. I suffered high fever, and a seizure on 9-17. I continue to have tightness in the chest, shortness of breath, and sweating.

Other Meds: Neurotin, Zanaflex, and Lisinopril

Current Illness: none

ID: 1775469
Sex: M
Age: 66
State: NY

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

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

Lab Data: none

Allergies: none

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

Symptoms: Woke up at 4 am with severe headache ,diaphoretic, and dry heaves. I took 1 Tylenol and checked my blood pressure which was 179/123 at 4:26 am, pressure dropped to 154/112 by 4:42 am and 148/106 by 5:55 am. Blood pressure varies normally between 120/80 to 140/90 pain and other symptoms subsided by 5 am

Other Meds: Vitamins B C D, Omeprazole 20mg, Rosuvastatin 10 mg

Current Illness: gurd

ID: 1775470
Sex: F
Age: 74
State: OH

Vax Date: 05/14/2021
Onset Date: 10/03/2021
Rec V Date: 10/10/2021
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: PCR + 10.4.2021. CXR: negative

Allergies: lisinipril

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

Symptoms: breakthrough covid + 10.3.21 w/ new onset Afib RVR, no resp symptoms

Other Meds: albuterol, amlodipine, atorvastatin, vit D, doxazosin, fluticasone, losartan, tramadol

Current Illness: UTI

ID: 1775471
Sex: F
Age: 56
State: WI

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

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

Lab Data: None. Did not seek medical attention.

Allergies: No

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

Symptoms: About 15 hours after getting booster shot began having high fever 102, chills, sweats, mild nausea, tachycardia and body aches. Also unable to sleep even before severe symptoms started, despite feeling tired. Quite significant as I had not had anything to this level with 1st or 2nd COVID vaccines. I am a health care worker in a hospital. My second COVID vaccine was 1/11/2021. Only injection site pain, fatigue and sleep problem with second dose. It is now 24 hours later. I took acetaminophen to try to break the fever. Feeling a bit better?no more fever but do have body aches, mild dehydration (tachycardia), dizziness and fatigue.

Other Meds: Bupropion xl Buspirone Cetirizine Multivitamin Evening Primrose oil CoQ 10 Vitamin D

Current Illness: None Did get Quadrivalent influenza vaccine on 10/5/21 (no adverse effects)

ID: 1775472
Sex: F
Age: 76
State:

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

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

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: Tingling/ prickly throughout body at night. Cold. Could not sleep.

Other Meds:

Current Illness:

ID: 1775473
Sex: F
Age: 41
State: FL

Vax Date: 08/23/2021
Onset Date: 08/23/2021
Rec V Date: 10/10/2021
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: Lost my period since the first shot

Other Meds:

Current Illness:

ID: 1775474
Sex: M
Age: 76
State:

Vax Date: 10/08/2021
Onset Date: 10/09/2021
Rec V Date: 10/10/2021
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: Shell fish, Xanax, prednisone

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

Symptoms: VERTIGO/LIGHTHEADEDNESS/DIZZINESS

Other Meds:

Current Illness:

Date Died: 09/18/2021

ID: 1775475
Sex: M
Age: 71
State: KY

Vax Date: 02/12/2021
Onset Date: 09/18/2021
Rec V Date: 10/10/2021
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: Signee called to resident''s room. Upon entering room resident noted lying on his left side. Skin noted to be warm to touch. Eyes open and fixed. Absent movement of chest noted. Heart and lungs sounds auscultated and noted to be absent. Absent vital signs. Resident assessed by signee. Time of death- 1:52pm. Call placed to Dr. New order received to release body to funeral home of choice. Call placed to on-call guardianship office. Call placed to resident''s son. No answer and signee un-able to leave message due to mailbox being full. Number for resident''s daughter-in-law listed but not a working number. No funeral home is listed with facility or guardianship office. Will continue to keep calling resident''s son. Awaiting returned call.

Other Meds:

Current Illness:

ID: 1775476
Sex: M
Age: 58
State: NY

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

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

Lab Data:

Allergies: Unknown

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

Symptoms: I faint and blackout when I use the toilet. Aches and pains everywhere

Other Meds: 150mg Venlafaxine (Effexor) daily

Current Illness: Unknown

ID: 1775478
Sex: F
Age: 31
State: AL

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

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

Lab Data:

Allergies: NSAID's (anaphylaxis) Ciprofloxacin Doxycycline Minocycline Latex sensitive

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

Symptoms: 930am on 10/9 fever began. Spent all day with fever, no appetite, joint pain. Fever varied from 100.9 - 102.6 1130pm on 10/9: got into bed. Temp 99.1, All following events occurred on 10/10 2:45am: woken with severe abdominal cramping, flushing of skin, diarrhea. While in the bathroom dealing with diarrhea my eyelid began to swell and breathing turned wheezing. Took a tablet of benadryl and decided to monitor to see if it would progress or if I needed to administer epipen/inhaler and go to ER. 4:00am: I noticed breathing had improved, no longer wheezing, eyelid wasn't swelling further. 4:30am: uncontrollable shaking/chills (temp 98.4) No amount of clothing or blankets helped but a hot bath for 30 min helped. 515am: no longer shaking, and comfortable enough to sleep. 830am: woke up for the day. Eyelid still swollen, still having diarrhea but infrequently need to run to toilet. Normal temp. Normal breathing. Okay as of now. We will see if anything happens today but suspect it wont. This is typically how allergic reactions start with me. Always early morning, diarrhea, one eyelid will swell. This is #3 in my life. The prior 2 resulted in ER visit.

Other Meds: Dupixent, restaysis, sublingual allergy drops, budesonide,

Current Illness: No illnesses

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am