VAERS 2021 Database www.vaers.hhs.gov

Main Page | All 2021 Deaths | Videos
VAERS Updated: 11/12/2021
** VAERS DATABASE Last updated: November 12, 2021**
PLEASE CHECK BACK SOON
Download the files above while you wait.







Manufacturers

Total Manufacturer
199,106MODERNA
36,710JANSSEN
5,381PFIZER\BIONTECH
2,555GLAXOSMITHKLINE BIOLOGICALS
1,469UNKNOWN MANUFACTURER
897MERCK & CO. INC.
627SEQIRUS, INC.
112DYNAVAX TECHNOLOGIES CORPORATION
91SANOFI PASTEUR
75NOVARTIS VACCINES AND DIAGNOSTICS
40EMERGENT BIOSOLUTIONS
14PAXVAX
12TEVA PHARMACEUTICALS
12PROTEIN SCIENCES CORPORATION
9PFIZER\WYETH
4BERNA BIOTECH, LTD.
4SMITHKLINE BEECHAM
3INTERCELL AG
1MEDIMMUNE VACCINES, INC.
1CSL LIMITED

COVID19 Lot Number

VAX LOT Total
2S9CL7,949
7,473
2,547
1,506
1,187
1,051
1,049
s0294561,043
866
IMM209861
816
UT7065MA766
657
579
U62828AA563
557
538
U6737AA516
515
S034636506
4F472471
458
P100253275449
444
276563436
429
418
4BH32414
MENVEO404
PP9L5362
UJ446AA337
319
306
290
271
49TM3270
R1B252M253
4F472179
933622147
C5763AA144
CW3116134
3Y7NL126
UNK114
113
ARBA141A105
104
103
96
300057A90
79
1F4EB73
R1B743M62
56
UJ090AA55
51
UH894AB46
45
UNK44
UNK42
42
EJ168638
Unknown36
35
34
32
32
26
el128424
24
A115A22
22
EN620222
21
UNK20
20
19
Z127A19
19
17
JEV18K95E15
12
111798PI12
10
A739088
No batch number8
3333324181078
6
6
TAR356
5
5
U6935AA5
UNK5
4
unknown4
3
2
55RB72
2
2
2
2
2
U7124AA2
JEV18A68E2
2
ABYB05BA1
1
1
1
1
AMVA436A1
1
1
TJ3521
A130A; VIS give1
1
U7140BB1
1
1
SP UP016AA1
1
1808P08802/ESV01
037K20A300,947
EL1284288,578
57,766
1,432

Incidents per State

State Total
82,750
CA62,821
FL38,209
TX36,512
NY34,921
PA23,646
IN23,622
IL20,597
MI19,590
OH19,426
NJ18,413
NC16,769
GA15,932
WA15,351
VA15,234
MA14,876
AZ14,206
MN12,940
MD12,656
CO11,908
WI11,425
MO10,240
TN9,685
OR8,768
KY8,437
CT8,300
SC6,700
OK6,293
AL5,692
LA5,025
IA4,825
KS4,821
UT4,637
NV4,374
NM3,967
AR3,807
ME3,161
NH3,096
NE2,918
MS2,859
ID2,785
WV2,469
HI2,459
PR2,417
MT2,414
RI2,076
DE1,868
AK1,830
VT1,734
DC1,715
ND1,388
SD1,269
WY866
GU118
VI69
AS47
MP29
MH8
XB6
FM4
QM3
XV2
XL1

ID: 1779517
Sex: M
Age: 62
State:

Vax Date: 07/16/2021
Onset Date: 08/21/2021
Rec V Date: 10/12/2021
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: Sore throat and nasal congestion

Other Meds:

Current Illness:

ID: 1779518
Sex: M
Age: 71
State: GA

Vax Date: 04/04/2021
Onset Date: 09/04/2021
Rec V Date: 10/12/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Patient went to the Birthday party on 09/03/2021 and exhibited the symptoms on 09/04/2021. He was admitted to the hospital on 09/04/2021 and was tested on 09/04/21 at the hospital. Patient is fully vaccinated.

Other Meds:

Current Illness:

ID: 1779519
Sex: F
Age: 44
State:

Vax Date: 09/17/2021
Onset Date: 09/19/2021
Rec V Date: 10/12/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: COVID 19

Other Meds:

Current Illness:

ID: 1779520
Sex: F
Age: 33
State: PA

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

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

Lab Data: Vital checks and ED monitoring

Allergies: Latex

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Chest tightness, shortness of breath, tasted metal, light headed, hives/rash, nausea Started immediately after injection

Other Meds: None

Current Illness: None

ID: 1779521
Sex: F
Age: 29
State:

Vax Date: 04/20/2021
Onset Date: 08/19/2021
Rec V Date: 10/12/2021
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: runny nose, headache, fatigue, nasal congestion

Other Meds:

Current Illness:

ID: 1779522
Sex: F
Age: 61
State:

Vax Date: 04/19/2021
Onset Date: 10/12/2021
Rec V Date: 10/12/2021
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:

Allergies:

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

Symptoms: Admitted to Hospital on Date of Adverse Event [recorded in VAERS] for treatment of Covid-19 Positive following completion of Covid Vaccine Series

Other Meds:

Current Illness:

ID: 1779523
Sex: F
Age: 39
State: OR

Vax Date: 09/08/2021
Onset Date: 09/08/2021
Rec V Date: 10/12/2021
Hospital:

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

Lab Data: 9/13/21: EKG- negative for any heart issues. CAT scan- negative for stroke or heart issues. COVID test- negative. Pregnancy test- negative. Blood work- normal ranges.

Allergies: Nickle

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Approximately 5 min after injection my lips became numb. Three days later tongue was numb. By Monday there was noticeable droopiness of the face and lack of movement on the right side of my face. I went to the emergency room and was diagnosed with having Bell's Palsy,

Other Meds: Duloxetine 60 mg, Amphet\dextr 10 mg 3x day.

Current Illness: None

ID: 1779524
Sex: M
Age: 54
State:

Vax Date: 03/19/2021
Onset Date: 09/18/2021
Rec V Date: 10/12/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: COVID 19

Other Meds:

Current Illness:

ID: 1779525
Sex: M
Age: 68
State: OR

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

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

Lab Data:

Allergies: tylenol, morphin, augmentin

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Couldn't get out the bed for 2 days. On the 9th he had a racing heart that lasted for 30 seconds.

Other Meds: Acedabuteral, Zenpak, seizure drug

Current Illness: no

ID: 1779526
Sex: F
Age: 36
State: FL

Vax Date: 10/11/2021
Onset Date: 10/12/2021
Rec V Date: 10/12/2021
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: NKA

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Swollen, painful throat and swollen tongue. Ear pain.

Other Meds: Diltiazem, Zyrtec, Prilosec, Singular

Current Illness: None

ID: 1779527
Sex: F
Age: 44
State: MI

Vax Date: 05/07/2021
Onset Date: 05/08/2021
Rec V Date: 10/12/2021
Hospital:

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

Lab Data:

Allergies: Sudafed

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

Symptoms: Severe chills, severe fatigue, lethargy for 24 hours

Other Meds: Concerta, Lexapro, Zetia

Current Illness:

ID: 1779528
Sex: M
Age: 61
State: CA

Vax Date: 08/05/2021
Onset Date: 08/05/2021
Rec V Date: 10/12/2021
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: Burning in arms, back of the head, neck, ringing in the ears, blurred vision.

Other Meds: None.

Current Illness:

ID: 1779529
Sex: M
Age: 32
State: VA

Vax Date: 10/12/2021
Onset Date: 10/12/2021
Rec V Date: 10/12/2021
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: No known allergies

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

Symptoms: Numbness and tingling in both arms, face turned red (warm sensation to face)

Other Meds: none

Current Illness: none

ID: 1779530
Sex: M
Age: 72
State:

Vax Date: 03/15/2021
Onset Date: 10/12/2021
Rec V Date: 10/12/2021
Hospital: Y

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: Admitted to Hospital on Date of Adverse Event [recorded in VAERS] for treatment of Covid-19 Positive following completion of Covid Vaccine Series

Other Meds:

Current Illness:

ID: 1779531
Sex: M
Age: 73
State: TX

Vax Date: 10/12/2021
Onset Date: 10/12/2021
Rec V Date: 10/12/2021
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: rash associated with band-aid adhesive

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

Symptoms: Within 2 minutes of receiving the shot, I felt lightheaded and had a rapid heart beat and moderate stomach pain. Reported to the doctor monitoring the immunization. Saw a paramedic about 5 minutes later where a blood pressure of 156/92 was obtained and a pulse of 92. Within another 10 minutes the pulse and blood pressure returned to normal and the lightheadedness resolved. The stomach pain resolved and mild nausea remained for another hour. No rash noted. No hives.

Other Meds: Trazodone 75mg at bedtime, Metamucil fiber supplement 1Tablespoon in AM, Fluticasone nasal spray in the morning.

Current Illness: None

ID: 1779532
Sex: M
Age: 58
State: CA

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

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

Lab Data:

Allergies:

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

Symptoms: Patient had received COVID19 vaccine and has today received Janssen vaccine. Patient also had moderna vaccine in immunization registry, but patient claims someone had used his identity to receive moderna.

Other Meds:

Current Illness:

ID: 1779533
Sex: F
Age: 49
State: IL

Vax Date: 02/01/2021
Onset Date:
Rec V Date: 10/12/2021
Hospital:

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

Lab Data: Per my PCP. This is a possible Covid vaccine reaction.

Allergies: Gentamycin

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

Symptoms: Both legs noted with dark , nodules/lumps underneath the skin. It started in June . The nodules keeps on growing on my both legs, back of the shern, feet, ankles. It is tender to touch, lumps are hard to touch, dark in appearance, some skins are red in appearance. I am in pain. I do prolonged standing on my work & i never had this problem before. No new medications was given to me, after I received the vaccine, 4 months after, my legs have a lot of nodules, scattered on my legs.

Other Meds: Atorvastatin, Singular, Advair inhaller

Current Illness: N/a

ID: 1779534
Sex: F
Age: 68
State: OH

Vax Date: 08/20/2021
Onset Date: 08/27/2021
Rec V Date: 10/12/2021
Hospital:

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

Lab Data:

Allergies: SULFA, LATEX

Symptom List: Ear pain, Hypoaesthesia

Symptoms: SO THIS IS AN ADMINISTRATION ERROR - PATIENT CAME TO OUR PHARMACY TO GET SECOND DOSE, SO OUR STAFF INFORMED HER THAT WE HAVE ONLY MODERNA VACCINE AND SHE SAID OK SO WE GAVE MODERNA VACCINE TO HER, SO AFTER COUPLE WEEKS SHE CALLED US AND STATING THAT WE GAVE WRONG VACCINE, SO BASICALLY SHE GOT PFIZER VACCINE AS 1ST DOSE AND MODERNA VACCINE AS A SECOND DOSE.

Other Meds: YES

Current Illness:

ID: 1779535
Sex: F
Age: 43
State: TX

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

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

Lab Data:

Allergies: allergies in general , after immunization administered reported to hep B ,

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: After administering vaccination pt asked to stay in pharmacy to monitor. While patient was sitting in waiting area about 10 minutes saw her wiggling so I approached her and asked if she was doing ok, She said no I am getting like I usually get and did not bring epipen. I asked her if had reaction to vaccines before ? Saw pt flushed and agitated, I asked to remain sitted and offfered some water. Gave a bottle of water and asked her if she would be ok to take zyrtec or benadryl to conteract reaction. or I could call 911 . She agreed to cetirizine and she took it. Continued to monitor patient , started to calm down a bit. Continued to monitor for 45 minutes , asked if we could call someone to pick her up and she did . Advised pt to seek medical care next day with primary or seek emergency care if needed

Other Meds: none reported

Current Illness: none known

ID: 1779536
Sex: F
Age: 15
State: LA

Vax Date: 08/23/2021
Onset Date: 08/23/2021
Rec V Date: 10/12/2021
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: was supposed to get pfizer instead on moderna, not authorized for anyone under 18

Other Meds:

Current Illness:

ID: 1779537
Sex: F
Age: 75
State:

Vax Date: 02/26/2021
Onset Date: 09/21/2021
Rec V Date: 10/12/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: COVID 19

Other Meds:

Current Illness:

ID: 1779538
Sex: M
Age: 65
State: NY

Vax Date: 09/28/2021
Onset Date: 09/29/2021
Rec V Date: 10/12/2021
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: N/A

Symptom List: Unevaluable event

Symptoms: Pt. states that after the 1st dose of High-Dose Influenza 09/28/2021, started experiencing symptoms 09/29/2021 of dry coughing, joint pain, and fatigue. Primary Follow-Up 10/12/2021 no recommendations. Symptoms have subsided.

Other Meds: Amlodipine

Current Illness: N/A

ID: 1779539
Sex: F
Age: 49
State: OH

Vax Date: 05/24/2021
Onset Date: 05/25/2021
Rec V Date: 10/12/2021
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: none

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

Symptoms: Severe muscle pain at certain postures. Can not bend arm to back. Greatly changed life quality. The muscle pain at first localized in injection site. Now it migrant to adjacent muscles.

Other Meds: none

Current Illness: none

ID: 1779540
Sex: F
Age: 62
State: NJ

Vax Date: 04/03/2020
Onset Date: 04/10/2020
Rec V Date: 10/12/2021
Hospital:

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

Lab Data: Shoulder X-ray.

Allergies: Penicillin

Symptom List: Injection site pain, Pain

Symptoms: Burning sensation beginning at the injection site, extending to the neck and down to the fingers. Extreme pain followed and continued for about 7 days. Took Advil, but no relief. I could not move my arm at all without excruciating pain. Went to see the doctor and steroids were prescribed for 2 weeks, which relieved the pain somewhat. It never really went away. In June, it flared up again. Steroids were prescribed again for 2 more weeks. My arm was not much better, so I went to physical therapy for 8 weeks. The diagnosis: frozen shoulder.

Other Meds: Multivitamin

Current Illness: None

ID: 1779541
Sex: F
Age: 68
State: FL

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

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

Lab Data:

Allergies: Sulfa based medications.

Symptom List: Injection site pain, Menorrhagia

Symptoms: Shortness of breath, dizziness, pain in chest and body. Required to sit and wait 40 minutes till symptoms went away. Staff took blood pressure, and temperature before allowing to leave pharmacy. Took one Benadryl upon arriving at home.

Other Meds: None

Current Illness:

ID: 1779542
Sex: F
Age: 51
State: GA

Vax Date: 04/12/2021
Onset Date: 09/02/2021
Rec V Date: 10/12/2021
Hospital: Y

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: Symptoms started on 9/3/2021.

Other Meds:

Current Illness:

ID: 1779543
Sex: F
Age: 47
State:

Vax Date: 04/08/2021
Onset Date: 09/22/2021
Rec V Date: 10/12/2021
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 19

Other Meds:

Current Illness:

ID: 1779544
Sex: F
Age: 82
State: IN

Vax Date: 02/08/2021
Onset Date: 04/20/2021
Rec V Date: 10/12/2021
Hospital: Y

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

Lab Data: CT abd, echocardiogram, colonoscopy, heart monitor, blood work, ECG, colon biopsy

Allergies: Ultram: Itching Metformin Pravastatin Sodium: myopathy

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: atrial fib, ischemic colitis (4/2021), trigeminal neuralgia 5/2021-present

Other Meds:

Current Illness:

ID: 1779545
Sex: M
Age: 51
State: CA

Vax Date: 01/04/2021
Onset Date: 01/26/2021
Rec V Date: 10/12/2021
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: Unknown

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

Symptoms: From ED MD notes: Chest pain x 2 days; substernal; hurts worse with mvmts and cough; pt covid + 4 days ago; +HA/ST/NP COUGH; negative fevers/n/v/d; fully vaccinated From ED DC summary: You were seen in the emergency department for evaluation of chest pain. While you were here we did a physical exam, bloodwork, chest xray. All of your tests were normal and did not show a cause of your symptoms. We do not think you are having a heart attack or a pneumonia. However, there is still a risk that you may have a blood clot in your lungs. If your symptoms are not improving, you should come back to the emergency department for further evaluation.

Other Meds: Unknown

Current Illness: Unknown

ID: 1779546
Sex: F
Age: 54
State: WI

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

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

Lab Data: None

Allergies: none

Symptom List: Nausea

Symptoms: Expired dose of flu vaccine administered to the Dr.

Other Meds: Multii- vitamin Extra Stength Tylenol

Current Illness: Kidney Stones

ID: 1779547
Sex: M
Age: 44
State: CA

Vax Date: 05/17/2021
Onset Date: 08/15/2021
Rec V Date: 10/12/2021
Hospital:

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

Lab Data:

Allergies: Iodine used for imaging

Symptom List: Injection site pain

Symptoms: Began experiencing tinnitus 3 months after injection.

Other Meds: None

Current Illness: None

ID: 1779548
Sex: F
Age: 56
State: CA

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

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

Lab Data: June 3rd, Hospital ER

Allergies: Naproxen Demerol Levaquin

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

Symptoms: 04/11/21 05/02/21 Noticed that I could not Pass a Bowel Movement Mid May, 2021

Other Meds: Ambien, Xannax Phentermine Previcide

Current Illness: None

ID: 1779549
Sex: M
Age: 80
State: FL

Vax Date: 02/02/2021
Onset Date: 09/03/2021
Rec V Date: 10/12/2021
Hospital: Y

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

Lab Data:

Allergies: No Known Allergies

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

Symptoms: Admission to hospital with COVID-19 diagnosis on admission.

Other Meds:

Current Illness:

ID: 1779550
Sex: F
Age: 15
State: LA

Vax Date: 08/23/2021
Onset Date: 08/23/2021
Rec V Date: 10/12/2021
Hospital:

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

Lab Data: None

Allergies: None

Symptom List: Tremor

Symptoms: Moderna vaccine given under the age of 18, no adverse reaction reported

Other Meds: None

Current Illness: None

ID: 1779551
Sex: F
Age: 72
State: AL

Vax Date: 04/08/2021
Onset Date: 08/01/2021
Rec V Date: 10/12/2021
Hospital:

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

Lab Data: no

Allergies: no

Symptom List: Erythema, Pruritus

Symptoms: my granddaughter had covid, no symptoms. Then, I started weak, tired on covid in 29aug2021 and had the infusion friday. I saw my doctor . Cant smell and no appetite to eat

Other Meds: no

Current Illness: no

ID: 1779552
Sex: F
Age: 63
State:

Vax Date: 03/11/2021
Onset Date: 09/19/2021
Rec V Date: 10/12/2021
Hospital:

Vax Type: UNK
Manufacturer: UNKNOWN MANUFACTURER
Vax Name: VACCINE NOT SPECIFIED (NO BRAND NAME)
Lot:
Dose Series: UNK
Vax Route: SYR
Vax Site: UN

Lab Data:

Allergies:

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

Symptoms: COVID 19

Other Meds:

Current Illness:

ID: 1779553
Sex: F
Age: 33
State: AZ

Vax Date: 10/05/2021
Onset Date: 10/05/2021
Rec V Date: 10/12/2021
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: Vicodin

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

Symptoms: Ear pain, needed antibiotics, running nose and dizzy.

Other Meds: Participant insist on: See previous record Dose 1

Current Illness: None

ID: 1779554
Sex: F
Age: 25
State:

Vax Date: 07/27/2021
Onset Date: 08/20/2021
Rec V Date: 10/12/2021
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: COVID 19

Other Meds:

Current Illness:

ID: 1779555
Sex: F
Age: 68
State: CA

Vax Date: 09/09/2021
Onset Date: 09/10/2021
Rec V Date: 10/12/2021
Hospital:

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

Lab Data: No

Allergies: Sulfa drugs; iodine; shellfish; insect bites (bees)

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

Symptoms: I began having low grade fever and joint aches on pains on 09/10/21. Due to a recent brain injury, I had been having trouble with processing thought. On 09/12/21, I noticed that those symptoms getting worse for about one week. On 10/05/2021, I had a fever of 99.6 and the next day no fever but a sore throat. I took a home covid test and it was negative. Thursday, 10/07/2021, stayed home to rest. On 10/8/2021, my temp went to 102.2 and had severe neck pain for a day. By morning it had improved. 10/09/21, I developed a headache during the day. I took a second test 10/12/2021, it came back negative.

Other Meds: None

Current Illness: Mild head injury

ID: 1779556
Sex: F
Age: 57
State:

Vax Date: 04/23/2021
Onset Date: 10/12/2021
Rec V Date: 10/12/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Admitted to Hospital on Date of Adverse Event [recorded in VAERS] for treatment of Covid-19 Positive following completion of Covid Vaccine Series

Other Meds:

Current Illness:

ID: 1779557
Sex: F
Age: 68
State: FL

Vax Date: 09/24/2021
Onset Date: 09/24/2021
Rec V Date: 10/12/2021
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: Patient received two doses of Fluad (flu shot for 2020-2021) first on 8/30/21 and a second and extraneous dose on 9/24/21. The patient filled out both vaccine immunization consent forms requesting a flu vaccine. She did not report any symptoms or side effects.

Other Meds:

Current Illness:

ID: 1779558
Sex: M
Age: 66
State:

Vax Date: 03/11/2021
Onset Date: 09/16/2021
Rec V Date: 10/12/2021
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: COVID 19

Other Meds:

Current Illness:

ID: 1779559
Sex: F
Age: 58
State: IL

Vax Date: 04/12/2021
Onset Date: 05/02/2021
Rec V Date: 10/12/2021
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: Nothing conclusive to say what's going on with me: Upper GI Colonoscopy Bloodwork- okay (sometimes) EKG- okay CT Scan MRI

Allergies: I don't want to add those.

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

Symptoms: The first time I got an initial attack was about May 2, 2021. I felt a flushing sensation, my heart was racing, nauseous, dizzy, and my blood pressure was high at the time, but I didn't know it. I had to lay down. I felt terrible for several hours. I just laid in bed, I didn't know what was going on. Then I felt better the next day. I had a couple of these events off and on with same symptoms. I didn't check my blood pressure so at the time I didn't now it was high. May 10th I saw my doctor. I was also having pain in my gut. She did bloodwork and said to go to gastroenterologist. She increased the dosage of my blood pressure medication. I seen the gastroenterologist and she performed an upper GI and a colonoscopy but didn't find anything. June 9th I went back to my doctor because I was continuing to have the same attacks. My blood pressure was 170/110. I have never had anything like this before previously before having the COVID vaccine. I got a really bad attack at work on June 17th. I work with senior citizens and help take care of them. I felt fine in the morning and then by 1:00pm when I was going to bathroom I was dizzy, vision was swimming, and I thought I was going to pass out. I looked at my heart rate and it was 130 BPM. I still didn't know that my blood pressure was high at that time. I laid down, and I didn't feel good at all. I tried to rest and stay calm. At that point I had to call my company and send someone to come in for me so they could release me. I felt my heart rate racing and fluttering. I went to urgent care and my blood pressure was 190/ 117. They kept me there for about 3 or 4 hours. By then my blood pressure came down, and my symptoms kind of subsided. They wanted me to go over to the hospital, but I didn't want to. So did they did an EKG that showed my heart rate and blood work was okay. They released me, and then I went home. June 22nd I called my doctor. Before April 12 the last time I saw my doctor was December 2020 but since getting the vaccine I have been to the doctor so many times and taking so many different test. June 29th I talked to my doctor about my symptoms and she increased my blood pressure medication again. July 8th I had to leave work again. This time it was late at night. I had gotten a blood pressure monitor and it was getting high even while taking my blood pressure medication that was adjusted to a higher dosage. I went into ER again and they kept me overnight because of heart racing and blood pressure was so high. I asked them to check my adrenal glands. And I found out that I have an issue with my adrenal glands. They diagnosed me with hyperaldosteronism. My endocrinologist said that that diagnosis shouldn't cause the symptoms that I have been having except for my potassium being low and having a racing heart. The doctors still don't know why I am still having these attacks if my potassium isn't low. I had to go to ER again in October 2021 because of an attack I had in September 28th at work. I had the same symptoms. My blood pressure was 180/110. My doctor boosted blood pressure medication again to an even higher dosage. I started a new medication for hyperaldosteronism which is spironolactone 50mg, 2xday. September 29 I got another attack and went to the emergency room. Since then I have still had some attacks. I have missed 10 working days from all of this over the course after getting vaccine. I have a couple more appointments coming up. Symptom causes are still unknown. I am going to see a more experienced endocrinologist next month. I have almost passed out twice. I have felt horrible ever since getting the vaccine. I really didn't want to get the vaccine, but due to my previous health and my job I decided to take it. July 8th i was hospitalized. I have been to my doctor 6 times since April 2021. I usually see her every 3 or 4 months. Now I am in and out of the hospital.

Other Meds: Euthyrox 25mg, 1xday Aspirin 325mg, 1xday Norvasc 5mg, 1xday Metoprolol 25mg, 2xday

Current Illness: none

ID: 1779560
Sex: M
Age: 50
State: CO

Vax Date: 04/07/2021
Onset Date: 09/21/2021
Rec V Date: 10/12/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: Pt tested positive for COVID 9/21/21 s/p fully vaccinated w/ J&J vaccine on 4/7/21. Pt admitted to hospital 10/11/21 with CVA - d/t coagulopathies from COVID.

Other Meds:

Current Illness:

ID: 1779561
Sex: M
Age: 19
State: OH

Vax Date: 10/12/2021
Onset Date: 10/12/2021
Rec V Date: 10/12/2021
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: The patient was sitting on the medical exam chair and couple minutes after receiving the shot he told his mom that he feels light headed and moment after he blacked out and fell from the chair to the floor. He was out for couple seconds then opened his eyes but not responding much. We provided Epipen since we noticed he was kind of shaking. We called 911 and EMT showed up at our lab and took his vitals. His blood sugar was at 90, and blood pressure at 100/80. They recommended taking him to the ER to be evaluated for any possible head or neck injury from the fall. The mother said he had blacked out before at sight of blood.

Other Meds: Not known

Current Illness: Not known

ID: 1779562
Sex: F
Age: 36
State:

Vax Date: 09/22/2021
Onset Date: 09/22/2021
Rec V Date: 10/12/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Patient received full contents of one vaccine vial (5 doses). Patient was sent to ED for evaluation but was asymptomatic. Patient reported fever (Tmax of 102) and low blood pressure overnight on day of event. Has been followed by Primary Care and Hematology since event. On 9/24, patient presented with malaise, mild back pain, headache, and bruise on hip. BP and vitals were normal. Labs, including CBC and coagulation panel, have remained normal throughout. Lung examination on 10/4 was normal. On 10/11, patient reported some numbness and drooping on right side for 5-6 minutes (no slurred speech or numbness down arm). Patient planned to be discharged from Hematology service after 10/18 appointment, if all remains the same.

Other Meds:

Current Illness:

ID: 1779563
Sex: M
Age: 43
State:

Vax Date: 09/22/2021
Onset Date: 09/25/2021
Rec V Date: 10/12/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: COVID 19

Other Meds:

Current Illness:

ID: 1779564
Sex: F
Age: 74
State: VA

Vax Date: 10/05/2021
Onset Date: 10/06/2021
Rec V Date: 10/12/2021
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: hydrocodone, latex

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Extreme swelling at the injection site which became worse and went to under her armpit. It became tight and tender.

Other Meds: Nystatin, Minocycline, multi vit, calcium, vit d

Current Illness: no

ID: 1779565
Sex: F
Age: 30
State: DC

Vax Date: 04/06/2021
Onset Date: 09/26/2021
Rec V Date: 10/12/2021
Hospital:

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

Lab Data: Labs WBC, CBC panel, D-dimer results were positive, but they have not determined why. Chemistry panel, liver function panel, thyroid test, CT, ultrasound. All results turned out positive.

Allergies: Amoxicillin; iodine; seafood

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

Symptoms: On 09/26/2021 I have shortness of breath, fatigue and muscle soreness and it still continues. The doctor originally thought it might be a blood clot, but that was ruled out.

Other Meds: Albuterol; multivitamin

Current Illness: No

ID: 1779566
Sex: M
Age: 64
State: MN

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 10/12/2021
Hospital:

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

Lab Data: No action has been taken

Allergies: sulfa, PCN

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

Symptoms: First vaccination 3/16/21 (EN6203): Very slight headache the evening after the injection, faded away without any pain meds.Second vaccination 4/6/21 (ER8733): Headache and general flu symptoms with low grade fever began the evening after the first vaccination. Fever and general malaise faded away over two to three days, the headache persisted for one week. Began to feel shortness of breath within two to three days after second injection. Shortness of breath has continued. When resting it is only slightly noticeable. When attempting to do any physical activities to include walking up or down stairs, carrying packages, or any physical exertion it has gotten continuously more noticeable. It got to the point where I felt like I was gasping for breath on Monday 10/11/21, when I assisted a friend lifting a dishwasher. I have always been physically fit, a runner, and continuous exercise all my life, and now am becoming concerned about my health conditions. I did not feel shortness of breath prior to receiving the vaccination. I reported this to my doctor,on 13 September. No action was taken.

Other Meds: hydrocortisone, fludrocortisone, Synthroid

Current Illness: None

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am