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: 1776609
Sex: M
Age: 71
State: NV

Vax Date: 08/03/2021
Onset Date: 08/03/2021
Rec V Date: 10/11/2021
Hospital:

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

Lab Data: None

Allergies: No

Symptom List: Dysphagia, Epiglottitis

Symptoms: Chills, Sweating, heart racing throughout the night. Extreme body aches and extreme tiredness which lasted 3 days or more. Body aches, tiredness, brain fog have lasted up to now intermittently. Also strange smells in my nose intermittently and off and on cough. Just don't feel well overall

Other Meds: None

Current Illness: No

ID: 1776610
Sex: F
Age: 34
State: NC

Vax Date: 10/11/2021
Onset Date: 10/11/2021
Rec V Date: 10/11/2021
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: Latex

Symptom List: Anxiety, Dyspnoea

Symptoms: Metallic taste, left side of neck pain-moderate, sore throat of left side-mild, left side of face and neck swellling, and mild headache-frontal

Other Meds: None

Current Illness: None

ID: 1776611
Sex: F
Age: 57
State: FL

Vax Date: 08/25/2021
Onset Date: 08/26/2021
Rec V Date: 10/11/2021
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: Dental Xrays--October 4, 2021, and October 7, 2021.

Allergies: Byetta

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

Symptoms: Twelve hours after my booster shot I developed fever, chills, aches, and severe headache, which lasted over twelve hours. The second day I ached all over, but I felt better on day three. At midnight on day 4 (Saturday) I had a leg vein open and bleed uncontrollably. I had to use Blood Stop to stop the bleeding. I saw my vein doctor the following Monday, and he injected the vein to shut it down. That same week I developed a worsening of my arthritic knee--much more pain and loss of mobility. It feels like burning nerve pain from my knee down to my ankle and up to my hip. It hurts to even drive my car. A few days after that I began having terrible tooth pain on the upper AND lower left side teeth. Two of those top teeth already have root canals. The lower teeth have repairs. The pain slams my face and radiates to the front teeth. I saw my dentist. His X-rays did not show anything conclusive. I saw the periodontist. His X-rays didn't really show anything either. I have a visit scheduled with my endodontist this week to evaluate the roots and try to determine where the pain is coming from. The pain is debilitating. I've begun Advil around the clock to keep it from becoming overwhelming. I have no idea if any of this is related to the vaccine. But it all came on within days of the shot. As a nurse, I'm wondering if I've mounted an inflammatory response that is causing me all this pain.

Other Meds: Eliquis, Farxiga, Glimepiride, Tradjenta, Omeprazole, Vitamin B12, Vitamin C, Vitamin D3, Super-B Complex Vitamins, Biotin. PRN: prednisone, albuterol, Duo-Neb,

Current Illness:

ID: 1776612
Sex: M
Age: 76
State: MI

Vax Date: 01/16/2021
Onset Date: 10/09/2021
Rec V Date: 10/11/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Pt had attended an outdoor wedding over the weekend where everyone was unmasked. He now had shortness of breath, cough, and diarrhea. He was found to be COVID positive. Pt had acute hypoxic respiratory failure secondary to COVID-19 pneumonia.

Other Meds:

Current Illness:

ID: 1776613
Sex: F
Age: 46
State: PA

Vax Date: 04/08/2021
Onset Date: 04/15/2021
Rec V Date: 10/11/2021
Hospital:

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

Lab Data:

Allergies: Augmentin Guaifennessin Percocet Ginger, nutmeg, cloves, red dye 40

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

Symptoms: Lump and pain in left breast, consulted gynecologist, televisit

Other Meds: Metoprolol XR 12 mg daily Aimovig Monthly injection 70mg

Current Illness:

ID: 1776614
Sex: M
Age: 60
State: IL

Vax Date: 07/08/2021
Onset Date: 07/28/2021
Rec V Date: 10/11/2021
Hospital: Y

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: Underwent two different lumbar punctures on 10/2 and 10/5 and both did not reveal bacterial meningitis. Studies for a virus did not reveal any findings at the time of discharge. West Nile results are negative. CT head was negative. CTA head was negative. Electroencephalogram was negative for seizure-like activity. Neurology and infectious disease were following my case. Received intravenous antibiotics during your hospital stay. Were deemed stable for discharge per both neuro and infectious disease.

Allergies: no

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

Symptoms: Jul 29, 2021 Felt weak & fainted twice at night, had to call an ambulance. Jul 29, 2021 Went into the emergency room at Hospital feeling weak and dizzy. Jul 29- October 1, 2021 Constant dizziness October 1, 2021 Loss of consciousness & memory. October 1-7, 2021 Hostpital, multiple tests run was. Discharged from the hospital without a diagnosis.

Other Meds: no

Current Illness: no

ID: 1776615
Sex: F
Age: 46
State: AZ

Vax Date: 05/08/2021
Onset Date: 07/30/2021
Rec V Date: 10/11/2021
Hospital:

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

Lab Data: Lab work, CT Scan of head. MRI of brain Sleep deprived EEG

Allergies: Cipro Morphin Penicillin

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: First time Grand Mal seizure, severe concussion, confusion. lasting 5 min. Transported by ambulance to hospital. Admitted to telemetry overnight.

Other Meds: Hctz 25mg Potassium

Current Illness: Kidney disease

ID: 1776616
Sex: M
Age: 86
State: CT

Vax Date: 01/21/2021
Onset Date: 10/09/2021
Rec V Date: 10/11/2021
Hospital:

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

Lab Data: No tests other than the COVID-19 test taken at the hospital for unrelated reasons.

Allergies: NKDA/NKA

Symptom List: Pharyngeal swelling

Symptoms: Resident fell in his apartment. Complained of pains in his side. Resulted in a trip to the ER to check for injuries. At ED received a COVID-19 test and tested positive. Resident was initially asymptomatic but now has aches and a non-productive cough.

Other Meds: Aspirin, B-Complex, Certavite Senior, Finasteride, Folic Acid, Hydrochlorothiazide, PreserVision AREDS, Tamsulosin HCL, Vitamin D3; Acetaminophen, Blink Tears, Ibuprofen and Nasal Spray.

Current Illness: None

ID: 1776617
Sex: M
Age: 47
State: KY

Vax Date: 04/02/2021
Onset Date: 09/01/2021
Rec V Date: 10/11/2021
Hospital:

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

Lab Data: SARS CoV 2 Antigen Positive 9/1/2021

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Breakthrough case after Covid vaccination. Dose #1 03/05/2021 Dose # 2 04/02/2021. Asymptomatic

Other Meds:

Current Illness:

ID: 1776618
Sex: F
Age: 69
State: FL

Vax Date: 09/28/2021
Onset Date: 09/29/2021
Rec V Date: 10/11/2021
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: Patient stated she felt soreness and redness at site of injection. Felt Flu-shot was administered differently (SQ) than recommended (IM)

Other Meds:

Current Illness:

ID: 1776619
Sex: F
Age: 64
State:

Vax Date: 04/05/2021
Onset Date: 05/01/2021
Rec V Date: 10/11/2021
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: diagnosed with Lichen Planus, given Clobetasol 0.05% cream, flare controlled but not gone

Other Meds:

Current Illness:

ID: 1776620
Sex: F
Age: 37
State: OH

Vax Date: 09/29/2021
Onset Date: 09/30/2021
Rec V Date: 10/11/2021
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: Penicillin, amoxicillin, ceclor, sulfa, estrogen, levaquin , cephalosporin,

Symptom List: Rash, Urticaria

Symptoms: chronic coughing, sore throat, SOB, chest tightness, congestion, losing my voice. This all started at 5:00 AM on 9/30/2021. I still have a sore throat, chronic cough, some SOB, and losing my voice, so now my voice is deep because of that. I saw a doctor and she gave me tessalon for the cough, and albuterol inhaler. She does not think it is Covid-19.

Other Meds: Vyvanse

Current Illness: none

ID: 1776621
Sex: M
Age: 92
State: CA

Vax Date: 04/30/2021
Onset Date: 08/29/2021
Rec V Date: 10/11/2021
Hospital: Y

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

Lab Data: 2 EKG 2 Ultra sounds of corotid arteries.chest xray. blood work. MRI.

Allergies: no

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

Symptoms: Two possible TIA events shortly after the vaccine One definite TIA on date noted, another TIA one month later and another within the week.

Other Meds: prostata herbs, cranberry

Current Illness: none

ID: 1776622
Sex: F
Age: 53
State:

Vax Date: 09/24/2021
Onset Date: 09/24/2021
Rec V Date: 10/11/2021
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: nkda

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

Symptoms: throat burning and chest tightness

Other Meds: methylphenidate, bupropion

Current Illness:

ID: 1776623
Sex: F
Age: 80
State: CA

Vax Date: 09/29/2021
Onset Date: 09/29/2021
Rec V Date: 10/11/2021
Hospital: Y

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

Lab Data: Dose1#EL3249 Dose2#EL9266

Allergies: N/A

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

Symptoms: One hour after getting the 3rd dose of the vaccine, I was at the store and I got very dizzy. I managed to get home during the dizzy period which lasted for the rest of the day. The next day I felt better. On the second day after the shot I got vertigo and everything was spinning. I was diagnosed with Acute Vertigo I was taken to the hospital and the Vertigo lasted for three days. I could not do anything and I was in the hospital for four days. I was prescribed a medication Meclizine. I am still experiencing dizziness and I have to move slowly especially when I stand up.

Other Meds: Pradaxa, Diltiazem, Omeprazole, Lovastatin, Temazepam PRN, Multivitamin

Current Illness: N/A

ID: 1776624
Sex: M
Age: 43
State: IN

Vax Date: 10/08/2021
Onset Date: 10/09/2021
Rec V Date: 10/11/2021
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

Allergies: none

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

Symptoms: Fever over 102, dizziness, headache, malaise, muscle and joint aches, fatigue, beginning within 12 hours of the vaccine administration, lasting nearly 48 hours.

Other Meds: none

Current Illness: none

ID: 1776625
Sex: F
Age: 65
State: AZ

Vax Date: 10/03/2021
Onset Date: 10/10/2021
Rec V Date: 10/11/2021
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

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

Symptoms: Ocular herpes flare up right eye

Other Meds: Citalopram

Current Illness:

ID: 1776626
Sex: M
Age: 66
State: NJ

Vax Date: 04/12/2021
Onset Date: 05/01/2021
Rec V Date: 10/11/2021
Hospital:

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

Lab Data: ENT visit9/29/2021 @ 2:oo pm. hearing tests, including VGN, a hearing center 10/8/2021

Allergies: none

Symptom List: Ear pain, Hypoaesthesia

Symptoms: loss of hearing, along with tinitus.

Other Meds: none

Current Illness: none

ID: 1776627
Sex: M
Age: 73
State:

Vax Date: 10/11/2021
Onset Date: 10/11/2021
Rec V Date: 10/11/2021
Hospital:

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

Lab Data: NA

Allergies: NA

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: 3rd Dose was given too soon , 5 months not 6

Other Meds: NA

Current Illness: NA

Date Died: 10/10/2021

ID: 1776628
Sex: M
Age: 83
State: TN

Vax Date: 02/03/2021
Onset Date: 10/10/2021
Rec V Date: 10/11/2021
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: PT EXPIRED; COVID BREAKTHROUGH CASE

Other Meds:

Current Illness:

ID: 1776629
Sex: M
Age:
State: AL

Vax Date:
Onset Date:
Rec V Date: 10/11/2021
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: None.

Allergies: None.

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

Symptoms: The day he got the vaccine he was fine and he got the vaccine earlier in the morning but the next day he woke up and he was very tired and was running a fever of 100.3 and that was at 6 AM. He took a dose of Tylenol and went back to bed. He was very weak and lethargic, and at 1:00 PM his fever was at 103.4 so we called the Doctor and I put him in a bath and let him cool off and his fever broke after the bath. He was still tired and lethargic the rest of the day and two days afterwards but his fever did break. His fever broke at 530 PM and it did not go down with Tylenol or Motrin. His weakness was bad that he couldn't get to the couch to the bath. We only called and talked to nurse and they said if it reached 104 to go to the ER.

Other Meds: Omeprazole; Zyrtec; Niacin; Multivitamin

Current Illness: None.

ID: 1776630
Sex: F
Age: 35
State: NM

Vax Date: 03/08/2021
Onset Date: 04/24/2021
Rec V Date: 10/11/2021
Hospital:

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

Lab Data: Troponin levels checked, CBC, Holter monitor, Zio patch, Echocardiogram, Stress Test scheduled on 11/4/21.

Allergies: None

Symptom List: Unevaluable event

Symptoms: I continue to have chest pains that cause me to be lightheaded and dizzy. The pain is not going away; it's only getting stronger. It feels like my heart is squeezing, like having contractions. I don't feel pain until my heart starts squeezing, then I get lightheaded and dizzy, and sometimes I feel a sharp pain in my arm. The pain is not getting better, only worsening.

Other Meds: None

Current Illness: None

ID: 1776631
Sex: F
Age: 58
State: KY

Vax Date: 01/22/2021
Onset Date: 08/21/2021
Rec V Date: 10/11/2021
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: COVID 19 Coronavirus SARS COV PCR Positive on 8/23/2021

Allergies:

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

Symptoms: Breakthrough case after Covid vaccination. Dose #1 12/31/2020 Dose # 2 1/22/2021. C/O fever, runny nose, and headache, onset 8/21/2021

Other Meds:

Current Illness:

ID: 1776632
Sex: F
Age: 50
State: OH

Vax Date: 09/14/2021
Onset Date: 09/15/2021
Rec V Date: 10/11/2021
Hospital:

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

Lab Data: A basic metabolic panel from blood - 9/17, urine culture - 9/17, urinalysis chemistry- 9/17, urinalysis (micro) - 9/17, CT scan kidney - 9/17, cytology urine - 9/23, urinalysis auto 9/23

Allergies: sulfasalazine, silver (plastic)

Symptom List: Injection site pain, Pain

Symptoms: On Wed 9/15 I had normal COVID side effects (sore arm and feverish) but in addition I had a large amount of blood in my urine (urine was raspberry red). This continued through Thursday and into Friday morning. I called the clinic on Friday morning and was directed to the Express clinic. At the clinic, I provided a urine sample and the results were that all of my parameters (with the exception of blood in the urine which was large) were normal and there were no signs of infection. The doctor recommended that I go to the ER for a CT scan which I did that evening. The CT scan was negative for kidney stones and they could not see any abnormalities. Therefore, they referred me to a Urologist on on 9/23/21 at 10 am. Another urine sample was collected and still contained blood although not to the extreme of the previous week. Cellular abnormalities were not detected. The urologist recommended a urology cytoscopy which has been scheduled for 10/27 where they will check my bladder, urethra, etc. I have seen 2 doctors and been to the ER as a result of this event. I did not receive any other vaccines on 9/14.

Other Meds: Simponi (50 mg/month), Methotrexate (10 mg/week), L-thyroxine (25 Mcg/week), folic acid, calcium & vitamin D

Current Illness: none other than chronic condition

ID: 1776633
Sex: M
Age: 63
State: VA

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

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

Lab Data:

Allergies: No

Symptom List: Injection site pain, Menorrhagia

Symptoms: Apparently, in reaction to the vaccine, a Cytokin storm occurred at my insulin port shutting off my insulin. This resulted in me going into diabetic ketoacidosis.

Other Meds: Humalog Rosuvastatin Ezetimibe Losartan Plavix Pantoprazole Sodium Androgel 1.62% Evenity Fexofenadine HCL Tadalfil Aspirin Probiotic

Current Illness:

ID: 1776634
Sex: F
Age: 36
State: TX

Vax Date: 05/03/2021
Onset Date: 05/03/2021
Rec V Date: 10/11/2021
Hospital:

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

Lab Data: None, called my OB/gyn to report it. He said to make an appointment if it continues.

Allergies: none

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

Symptoms: abnormal mentrual cycle: Heavy bleeding lasting 6 weeks post vaccination which has never happened before.

Other Meds: Zoloft, multivitamin

Current Illness: none

ID: 1776635
Sex: F
Age: 49
State:

Vax Date: 06/22/2021
Onset Date: 06/23/2021
Rec V Date: 10/11/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Continuous heart palpitations and localized pain in upper left chest. Head aches joint stiffness that do not subside with movement or exercise. Sleep disturbances

Other Meds: Vitamin D, vitamin B12

Current Illness: N/A

Date Died: 08/23/2021

ID: 1776636
Sex: M
Age: 73
State: AK

Vax Date: 08/11/2021
Onset Date: 08/23/2021
Rec V Date: 10/11/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Died of heart attack 10 days after vaccine with no family history or prior indication of heart problems

Other Meds: iodine supplement

Current Illness: none

ID: 1776637
Sex: F
Age: 53
State: CA

Vax Date: 09/11/2021
Onset Date: 09/24/2021
Rec V Date: 10/11/2021
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: N/A

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

Symptoms: Severe impetigo after mosquito bite all over the body.

Other Meds: N/A

Current Illness: N/A

ID: 1776638
Sex: F
Age: 74
State: CA

Vax Date: 10/08/2021
Onset Date: 10/10/2021
Rec V Date: 10/11/2021
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: pain in joints, muscles, fatigue, swollen lymph nodes under arm towards the side, large in size

Other Meds:

Current Illness:

ID: 1776639
Sex: M
Age: 87
State:

Vax Date: 04/13/2021
Onset Date: 10/06/2021
Rec V Date: 10/11/2021
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: none

Symptom List: Injection site pain

Symptoms: COVID19 PNA sob, cough, fever. pt now admitted requiring HFNC

Other Meds: atenolol, ibrutinib, kenalog cream, norvasc, losartan-hctz

Current Illness: none

ID: 1776640
Sex: F
Age: 53
State: CA

Vax Date: 02/01/2021
Onset Date: 07/05/2021
Rec V Date: 10/11/2021
Hospital: Y

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

Lab Data: EKG, echocardiogram, blood panels, MRI, heart issues but they did not see any heart damage.

Allergies: Sulfa; Codeine.

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

Symptoms: I had a sharp pain going from my left arm into my heart. My jaw stiffened up. All signs indicated it was a heart attack. I went to the hospital and I was there for 2 days. I still have heart palpitations. They ran EKG and I was on a heart monitor. I had a follow up with a cardiologist and he did an echocardiogram and ran all kinds of blood panels. They also did an MRI. All tests came back negative, they said I was having some heart issues but they did not see any heart damage. I also had a PIA. It took me like 6 weeks to recover from that and to recover my strength. I have had terrible headaches ever since.

Other Meds: Levothyroxine; Citalopram; Anxiety medication; Aspirin; Cholesterol medication.

Current Illness: None.

ID: 1776642
Sex: F
Age: 79
State: IL

Vax Date: 03/07/2021
Onset Date: 03/08/2021
Rec V Date: 10/11/2021
Hospital:

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

Lab Data: Ran Various Test

Allergies: Codeine

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

Symptoms: Sore arm at injection sight that itched. Blood pressure elevated causing a trip to the ER.

Other Meds: None

Current Illness: None

ID: 1776643
Sex: F
Age: 75
State: KY

Vax Date: 02/19/2021
Onset Date: 08/18/2021
Rec V Date: 10/11/2021
Hospital:

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

Lab Data: COVID 19 Coronavirus SARS COV PCR Positive on 8/23/2021

Allergies:

Symptom List: Tremor

Symptoms: Breakthrough case after Covid vaccination. Dose #1 1/21/2021 Dose #2 2/19/2021. C/O runny nose, sore throat, cough, and nausea/vomiting. Onset 8/18/2021

Other Meds:

Current Illness:

ID: 1776644
Sex: M
Age: 71
State: OK

Vax Date: 09/27/2021
Onset Date: 09/28/2021
Rec V Date: 10/11/2021
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: " Patient began developing elevated blood pressures on Sept 28, somewhat without provocation known other than he had received his third dose of Pfizer COVID 19 vaccine the day prior. Before that his pressures were doing well without meds. They were ranging 150s over 90s and he started back on lisinopril 10mg daily. He then had some headache and chest discomfort this past Monday so he went to the ER at hospital where they did labs and enzymes and EKG. He did not have any ischemic damage and was released and told to follow-up with PCP and Cardiology. PCP added additional BP med. "

Other Meds: Lisinopril

Current Illness:

ID: 1776645
Sex: F
Age: 50
State:

Vax Date: 08/04/2021
Onset Date: 08/07/2021
Rec V Date: 10/11/2021
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: None

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

Symptoms: Edema. Swelling began in right arm where shot was administered , predominantly in middle and ring finger. After a few days, it spread to the left arm, same fingers. Swelling was worst at about 2.5 weeks after the vaccine. Edema progressed to noticeable swelling in ankles too. It took two months to reduce the swelling in the fingers. There is still some slight swelling not present prior to the vaccine, but it is vastly improved, improving and no longer painful. No prior history of edema.

Other Meds: None

Current Illness: None

ID: 1776646
Sex: F
Age: 57
State: WI

Vax Date: 10/01/2021
Onset Date: 10/01/2021
Rec V Date: 10/11/2021
Hospital:

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

Lab Data: none

Allergies: penicillin sulfa

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

Symptoms: Swollen lymph nodes arm pit, clavicle and neck. Have been icing/heat and alternating with acetaminophen and ibuprofen.

Other Meds: Hydrochlorothiazide Acebutolol Paroxetine

Current Illness: none

ID: 1776647
Sex: F
Age: 69
State: OR

Vax Date: 04/08/2021
Onset Date: 08/12/2021
Rec V Date: 10/11/2021
Hospital:

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

Lab Data: Sleep study - my doctor ordered it

Allergies: Penicillin

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: I wake up every 2- 3 hours and then sometimes I can't get back to sleep. Went to the doctor in August for that. He ordered a sleep study. I haven't gotten the results back yet - will see the doctor on Wednesday of this week. Note: I had COVID in March of 2020. I went to the hospital - they did a testing for COVID because they decided not to send it in. My lungs looked clear - so it was never confirmed. The second time I got it was in July 2020 - and I got tested. It resulted in positive test with that one confirmed. I had noticed sleep issues since I've had all of this. I have a really foggy brain. I don't know if it's related to sleep or vaccines - because my foggy brain keeps getting worse. I know I haven't been sleeping well. No treatment yet.

Other Meds: Levothyroxine; Triamterene; Vita-eyes (for macular degeneration); Multivitamin through Vita Eyes

Current Illness: no

ID: 1776648
Sex: M
Age: 43
State: MN

Vax Date: 01/18/2021
Onset Date: 09/28/2021
Rec V Date: 10/11/2021
Hospital:

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

Lab Data: 10/8 SARS/COV-2, NAAT, Positive.

Allergies:

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

Symptoms: Breakthrough COVID-19.

Other Meds:

Current Illness:

ID: 1776649
Sex: M
Age: 51
State: CA

Vax Date: 04/09/2021
Onset Date: 04/12/2021
Rec V Date: 10/11/2021
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: I had a full panel with my feceis and everything came up normal. It feels like the exact same thing when I had COVID.

Allergies: Lisinopril

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

Symptoms: I had diarrhea for almost 4 months. I went on for a while and stopped. It was the same thing that happened when I caught COVID. It would go in a 10 to 20 day cycle for a about 4 months and 2 days ago it just stopped. It just stopped yesterday. I had a weird tingling in my mouth like I had COVID.

Other Meds: I was taken heart and blood pressure medication. I have two blood pressure medications and a allergy medication.

Current Illness: I a had caught COVID in September on the 29th of 2021.

ID: 1776650
Sex: M
Age: 49
State: SC

Vax Date: 09/27/2021
Onset Date: 10/06/2021
Rec V Date: 10/11/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Pain in extremity

Symptoms: Developed sores on bottom side and top of tongue. Tongue turned white and is sore. Hurts when eating. Gums also swollen and some bleeding. Developed a week after 3rd shot was given. Using mouthwash but not getting any better.

Other Meds: Zetia, Prilosec

Current Illness: None

ID: 1776651
Sex: F
Age: 53
State: IL

Vax Date: 03/10/2021
Onset Date: 03/31/2021
Rec V Date: 10/11/2021
Hospital:

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

Lab Data: Negative COVID tests on approximately 4/1/21 and on 9/28/21.

Allergies: Dust mites, Daypro

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

Symptoms: 100-102 Degree fever, chills, and severe body aches, beginning about 12 hours after first injection and lasting 24 hours. A second 24-hour fever occurred about 3 weeks following my initial dose. This experience was repeated with my second Moderna dose on 4/7/21 with another follow-up fever event about 2 weeks after injection. I have since had even worse reactions to my 2 shot shingles vaccine series, and another fever event on 9/27 in no proximity to a vaccination. The fevers are debilitating enough to prevent me from working and put me in bed for the duration of each event.

Other Meds: Multivitamin, medical cannabis

Current Illness:

ID: 1776652
Sex: M
Age: 58
State: TX

Vax Date: 04/07/2021
Onset Date: 08/01/2021
Rec V Date: 10/11/2021
Hospital:

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

Lab Data: COVID-19 - positive. Bloodwork - everything ok.

Allergies: No

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

Symptoms: In Aug2021, diarrhea, stomach issues one night, the next day irritated throat. 3rd day I work I had really bad night sweats, body aches and sore throat . ER Aug2021 - body aches , really tired and body. Still now, I get really tired really easily. Every now and then I get an irritated throat and achy.

Other Meds: No

Current Illness: No

ID: 1776653
Sex: F
Age: 41
State: CA

Vax Date: 07/03/2021
Onset Date: 07/03/2021
Rec V Date: 10/11/2021
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: N/A

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

Symptoms: Left Leg pain / numbness. headache, anxiety, shortness of breath .

Other Meds: N/a

Current Illness: N/a

ID: 1776654
Sex: F
Age: 33
State: NV

Vax Date: 09/06/2021
Onset Date: 09/06/2021
Rec V Date: 10/11/2021
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: Latex

Symptom List: Vomiting

Symptoms: patient states after she got her second dose she had tenderness and soreness at the site of inject she also experienced tenderness, swelling, rash, and redness in her left armpit. she also had fever 103 and nausea. she ended up going to the hospital and the ER doctor told her she has cellulitis.

Other Meds: no

Current Illness: No

ID: 1776655
Sex: F
Age: 49
State: MN

Vax Date: 03/19/2021
Onset Date: 03/20/2021
Rec V Date: 10/11/2021
Hospital:

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

Lab Data: None.

Allergies: I'm only allergic to some medication, but I don't have the name of it. I'm not taking it at this time.

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: I woke up with pain on my neck head and left side. During the day wasn't that bad , but it was worse at night. It took about a month for it to go away. I saw my doctor, and they gave me a Cortisone shot , and prescribed Prednisone and Tylenol. I usually have pain, but after the injection the pain increased.

Other Meds: I take 1 Tylenol only if im pain, i dont know if took it on that day , Folic Acid, I take 3 tablet 400 micro grams Centroid I take 1 tablet, its about 112 micro grams. I also take a lot of supplements Magnesium I take 1 400mg , a combine

Current Illness: I suffer from hyperthyroidism and arthritis

ID: 1776656
Sex: M
Age: 60
State: TX

Vax Date: 02/02/2021
Onset Date: 10/08/2021
Rec V Date: 10/11/2021
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: CBC, CMP, CXR, EKG, CARDIAC PROFILE,

Allergies:

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

Symptoms: cough and chest pain

Other Meds:

Current Illness:

ID: 1776657
Sex: F
Age: 74
State: PA

Vax Date: 10/08/2021
Onset Date: 10/08/2021
Rec V Date: 10/11/2021
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: none

Symptom List: Injection site swelling, Limb discomfort

Symptoms: At around 4:00 p.m. the same day of receiving the vaccine I started feeling slightly dizzy which progressed. Went to bed early evening to lie down, assuming possible side effect from vaccine. Also felt very slight feeling of nausea. I got up a couple of times to go to bathroom and still felt slightly dizzy as I walked into bathroom each time. Overnight, but before morning found myself sweating a lot as if I might have a fever. It was not hot in the loft where I was sleeping; however. I changed into a tiny slip. By the next morning I felt better but was still slightly dizzy when I sat up in bed. I started to feel less dizzy as the morning progressed and got up to eat mid morning. Between 1:30 and 2:30 p.m. Saturday (the following day) I felt fine and went outside. I called my insurance company's 24-hour nurse on Saturday but have not yet contacted doctor. During time I felt dizzy as a precaution I would not have gotten into my car to drive anywhere and did not feel bad enough to call taxi to go anywhere either.

Other Meds: none

Current Illness: none

ID: 1776658
Sex: F
Age: 65
State: GA

Vax Date: 03/08/2021
Onset Date: 05/01/2021
Rec V Date: 10/11/2021
Hospital:

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

Lab Data: Allergy test, blood comprehensive panel.

Allergies:

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

Symptoms: The first time it happened I was coughing and choking and I looked in mirror my eyelid was swollen, I put ice on it, I went to bed and it was still there in the am so I went to doctor. It went away. Then the 2nd time it happened we were at our granddaughters birthday . I started noticing different episodes it would happen on either eye or lips . Again I put ice on it. My son in law is a PA looked at it, said you are having an allergic reaction. I went to Urgent care in morning during one of theses episodes. Urgent care gave me shot of prednisone and they gave me prednisone to take home. At this point I started logging everything I ate and wash my hands constantly because I'm afraid to have a reaction. I went to my ENT because at one point my ear had gotten blocked and my eyes had swollen and I showed him my pictures of my angioedema, he referred to me to another doctor . He recommended taking zyrtec every time it happens and now it happens everyday. I have no idea what it is from , I have an over sensitive to allergies since my vaccine

Other Meds: hydrochlorothiazide , pravastatin 10 mg, klor con 20 meq k, trazodone 50 mg , aspirin 81 low dose, vitamin D3, women's 50 plus vitamins, flonase, latanoprost ophthalmic solution

Current Illness:

ID: 1776659
Sex: F
Age: 40
State: NH

Vax Date: 05/17/2021
Onset Date: 05/24/2021
Rec V Date: 10/11/2021
Hospital:

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

Lab Data: echocardiogram- normal blood work- normal stress test- normal nuclear imaging- normal

Allergies: None

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

Symptoms: I started having steady chest pain in the center of my chest and into the breast muscles. I still have it but not as bad. I went to the ER and they did an echocardiogram and blood work in July. They thought it was angina so I went to have a stress test and nuclear imaging. They said everything looked normal. I did not do anything to strain muscles or cause chest pain. They did not prescribe any medications.

Other Meds: Topamax, Cyclobenzaprine

Current Illness: None

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am