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: 1793964
Sex: M
Age: 61
State: CO

Vax Date: 08/17/2021
Onset Date: 08/20/2021
Rec V Date: 10/17/2021
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: Isotrentin

Symptom List: Dysphagia, Epiglottitis

Symptoms: Neuropathy in both feet and right forearm and hand. Substantial memory loss and lack of cognitive function.

Other Meds: Hydrocort, levothyroxine, Adderall, duloxetine

Current Illness: Cancer

ID: 1793965
Sex: F
Age: 58
State:

Vax Date: 10/01/2021
Onset Date: 10/09/2021
Rec V Date: 10/17/2021
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: No

Symptom List: Anxiety, Dyspnoea

Symptoms: For 3 days whole body ache including fingers and have had a constant headache don't want to do the second shot

Other Meds: No

Current Illness: No

ID: 1793966
Sex: F
Age: 44
State: CA

Vax Date: 10/13/2021
Onset Date: 10/13/2021
Rec V Date: 10/17/2021
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: Penicillin, honeydew, cantaloupe, insect bites, bees stings

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

Symptoms: I started feeling dizzy and my arm felt heavy after 20 minutes. That night my muscles started to ache. My muscles ached intensely for 2 days. The third day, today I have felt foggy and dizzy all day. I started sneezing and have a sore throat. I also have the COVID arm where my injection arm has become warm to the touch, swollen, sore, and red.

Other Meds: Bupropion

Current Illness:

ID: 1793967
Sex: F
Age: 54
State: MA

Vax Date: 10/04/2021
Onset Date: 10/05/2021
Rec V Date: 10/17/2021
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: Lactose

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Vaccinated Mon 10/4 evening , next day around 8am constant ringing in ears began with dizziness and right arm pain @ injection site with numbness in right hand.

Other Meds: none

Current Illness: no

ID: 1793968
Sex: M
Age: 43
State:

Vax Date: 07/29/2021
Onset Date: 09/29/2021
Rec V Date: 10/17/2021
Hospital:

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

Lab Data:

Allergies: No

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

Symptoms: On 09/08 a first attack: - difficulty in breathing.- intense fatigue which required hospitalization, the diagnosis did not reveal any anomalies For two weeks I observed the same symptoms and in addition loss of appetite, the blood tests are good, covid test negative. The symptoms disappeared afterwards, but reappeared on 9/30, but more severe this time. Until today I suffer from the same symptoms, which required two hospitalizations. All the analyzes and chest/abdominal scans are good: - Covid Negative test - thoracic and abdominal CT scan; No abnormality - blood tests No anopamlie. Please advise me what to do, I suspect Janssen vaccine as the cause of these disorders.

Other Meds: Nothing

Current Illness: No

ID: 1793969
Sex: M
Age: 30
State:

Vax Date: 06/29/2021
Onset Date: 07/07/2021
Rec V Date: 10/17/2021
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:

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

Symptoms: Still not taken any treatment

Other Meds:

Current Illness:

ID: 1793970
Sex: F
Age: 40
State: PR

Vax Date: 10/15/2021
Onset Date: 10/16/2021
Rec V Date: 10/17/2021
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: Aspirin

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Swollen linfatic node (right underarm)

Other Meds: None

Current Illness: None

ID: 1793971
Sex: F
Age: 61
State:

Vax Date: 10/06/2021
Onset Date: 10/06/2021
Rec V Date: 10/17/2021
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: Administered expired vaccine to patient.

Other Meds:

Current Illness:

ID: 1793972
Sex: F
Age: 63
State:

Vax Date: 10/06/2021
Onset Date: 10/06/2021
Rec V Date: 10/17/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Administered expired vaccine to patient

Other Meds:

Current Illness:

ID: 1793973
Sex: M
Age: 61
State: FL

Vax Date: 03/28/2021
Onset Date: 03/28/2021
Rec V Date: 10/17/2021
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: None

Symptom List: Diarrhoea, Nasal congestion

Symptoms: I started with a tingling in my left arm, which lasted about a month and then turned into severe pain. Later the pain disappeared but moved to the left arm, after about 2 weeks the pain in the arm stopped but moved to the upper back where it lasted about 3 weeks and after which the pain returned to the arms. At that time, my left buttock began to hurt simultaneously, then it spread to the thigh of my left leg. I have received physiotherapy, treatment only with heat because with the cold the pain became more intense. I have received massages, rubs with ointments and done exercises guided by the Physiotherapist. None of that worked and I stopped after about a month because the manipulation aggravated the pain. I went to a pain management doctor, who had to inject the painful area on my left buttock. Only the injection has relieved the pain in the left buttock a lot, but it still does not go away completely, still being of moderate intensity only in the presence of certain movements. Today, 10 months after these symptoms began, the pain has been decreasing. I no longer have pain in my upper back, but there is still a slight pain in both arms. The pain in the left buttock still persists, it is not permanent but it is moderate with many movements (such as lifting the leg for example to climb stairs). I have also noticed a tendency to cramp my arms, hands and legs with an ease and frequency that I did not have before.

Other Meds: Cholestyramine (powder) Ecotrin Vascepa (1grm.) Atorvastatin

Current Illness: None

ID: 1793975
Sex: F
Age: 31
State: TX

Vax Date: 07/01/2021
Onset Date: 07/21/2021
Rec V Date: 10/17/2021
Hospital:

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

Lab Data:

Allergies: No

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

Symptoms: Very heavy period compared to baseline periods, very sore breasts

Other Meds: June Fe 1/20 Escitalipram 10 mg

Current Illness: No

ID: 1793976
Sex: F
Age: 56
State: FL

Vax Date: 08/14/2021
Onset Date: 09/09/2021
Rec V Date: 10/17/2021
Hospital:

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

Lab Data: EKG. CAT scan

Allergies: Hydrolazine

Symptom List: Rash, Urticaria

Symptoms: Inflammation left atrial ventricular

Other Meds: Losartan Hydrochlorothorazide Pottasium Atorvistatin Clopidogrel

Current Illness:

ID: 1793977
Sex: F
Age: 37
State: MA

Vax Date: 09/27/2021
Onset Date: 10/07/2021
Rec V Date: 10/17/2021
Hospital: Y

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

Lab Data:

Allergies: NKA

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

Symptoms: Ruptured membrane occurred at 6:30PM on 07OCT2021. Labor began around 9:00PM on 07OCT2021. Premature baby born at 6:38AM on 08OCT2021 at 34 weeks and 4 days. Original due date was 15NOV 2021. Premature baby admitted to NICU for undetermined length of stay to promote growth. Mother discharged 48 hours following delivery.

Other Meds: NA

Current Illness: NA

ID: 1793978
Sex: M
Age: 29
State: MN

Vax Date: 10/16/2021
Onset Date: 10/16/2021
Rec V Date: 10/17/2021
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: Error: Incorrect Reconstitution-

Other Meds:

Current Illness:

ID: 1793979
Sex: M
Age: 62
State: CA

Vax Date: 10/14/2021
Onset Date: 10/14/2021
Rec V Date: 10/17/2021
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: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: Site: Bruising at Injection Site-Medium, Site: Redness at Injection Site-Medium, Systemic: Allergic: Rash (specify: facial area, extremeties)-Medium

Other Meds:

Current Illness:

ID: 1793980
Sex: M
Age: 34
State: NJ

Vax Date: 10/14/2021
Onset Date: 10/14/2021
Rec V Date: 10/17/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Site: Pain at Injection Site-Severe, Systemic: Tingling (specify: facial area, extemities)-Mild, Additional Details: pain of the arem received the injection, couldn't lift the arm well, no mobility of the affected arm

Other Meds:

Current Illness:

ID: 1793981
Sex: F
Age: 47
State: IN

Vax Date: 10/15/2021
Onset Date: 10/16/2021
Rec V Date: 10/17/2021
Hospital:

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

Lab Data: None

Allergies: None

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

Symptoms: Fever of up to 101 for 24 hours, body aches, extreme fatigue, dry mouth

Other Meds: Insulin

Current Illness: None

ID: 1793982
Sex: F
Age: 53
State: CA

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

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

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

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

Other Meds:

Current Illness:

ID: 1793983
Sex: M
Age: 21
State: NV

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

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

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Systemic: Dizziness / Lightheadness-Medium, Systemic: Tingling (specify: facial area, extemities)-Medium, Additional Details: Patient asked to call 911 -cannot speak English (Mom translated)..seemed the longer he waited he got more anxious after the shot

Other Meds:

Current Illness:

ID: 1793984
Sex: M
Age: 32
State: CA

Vax Date: 10/07/2021
Onset Date: 10/07/2021
Rec V Date: 10/17/2021
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: Site: Bruising at Injection Site-Medium, Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium

Other Meds:

Current Illness:

ID: 1793985
Sex: M
Age: 25
State: MA

Vax Date: 10/16/2021
Onset Date: 10/16/2021
Rec V Date: 10/17/2021
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: Systemic: Dizziness / Lightheadness-Medium, Additional Details: Pt passed out but recovered and felt fine after

Other Meds:

Current Illness:

ID: 1793986
Sex: F
Age: 53
State: CA

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

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

Lab Data:

Allergies:

Symptom List: Unevaluable event

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

Other Meds:

Current Illness:

ID: 1793987
Sex: F
Age: 76
State: PA

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

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

Lab Data:

Allergies:

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

Symptoms: Error: Booster Given Too Early-

Other Meds:

Current Illness:

ID: 1793988
Sex: F
Age: 76
State: TX

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

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Error: Booster Given Too Early-

Other Meds:

Current Illness:

ID: 1793990
Sex: M
Age: 20
State: OH

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

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Medium, Additional Details: Patient fainted and fell but was conscious and alert. EMT service was called and patient was evaluated. Patient was feeling better and did not need to be transported to ER. Patient was taken home by his mother. A follow up call to the patient was made 3 hours later. Mom inform Rph that patient was feeling fine and everything was OK.

Other Meds:

Current Illness:

ID: 1793991
Sex: F
Age: 71
State: FL

Vax Date: 08/04/2021
Onset Date: 08/04/2021
Rec V Date: 10/17/2021
Hospital:

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

Lab Data:

Allergies:

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

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

Other Meds:

Current Illness:

ID: 1793992
Sex: M
Age: 71
State: TX

Vax Date: 09/27/2021
Onset Date: 09/27/2021
Rec V Date: 10/17/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Error: Shoulder Joint Injury (prolonged pain, tingling, etc.)-

Other Meds:

Current Illness:

ID: 1793993
Sex: F
Age: 61
State: OH

Vax Date: 06/18/2021
Onset Date: 09/23/2021
Rec V Date: 10/17/2021
Hospital:

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

Lab Data: See above

Allergies: Lisinipril

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: I?m broke out with a rash that won?t go away. I?ve undergone treatments fir scabies, hives, shingles twice each, had steroids, antibiotics, the best of creams, lotions, ointments? been to urgent care, Er, dermatologist, family md, skin dr to no avail. I?ve had this since Sept and it?s not getting better.

Other Meds: Omeprazole, Asprin, loratadine, vit D2 & D3, propranolol, alli, ester c, senna plus.

Current Illness: None

ID: 1793994
Sex: F
Age: 24
State: NE

Vax Date: 10/15/2021
Onset Date: 10/16/2021
Rec V Date: 10/17/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Systemic: Chest Tightness / Heaviness / Pain-Severe, Systemic: Chills-Medium, Systemic: Fever-Medium, Systemic: Tachycardia-Mild, Additional Details: Chest pains (sharp, severe) from about 2-5am on 10/16/21. Currently on 10/16/21, fever/chills and elevated HR.

Other Meds:

Current Illness:

ID: 1793995
Sex: F
Age: 67
State: VA

Vax Date: 08/28/2021
Onset Date: 08/28/2021
Rec V Date: 10/17/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Site: Pain at Injection Site-Medium, Systemic: Body Aches Generalized-Medium, Systemic: Headache-Mild

Other Meds:

Current Illness:

ID: 1793996
Sex: F
Age: 76
State: PA

Vax Date: 08/16/2021
Onset Date: 08/16/2021
Rec V Date: 10/17/2021
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: Injection site pain

Symptoms: Error: Booster Given Too Early-

Other Meds:

Current Illness:

ID: 1793997
Sex: F
Age: 53
State: MN

Vax Date: 10/15/2021
Onset Date: 10/16/2021
Rec V Date: 10/17/2021
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: I woke up and there was swelling in my left axilla the size of a large lemon. The area around my left shoulder/axilla (site of COVID booster) is tender and painful. My left hand is tingly and colder than my right. The swelling and pain has continued to today.

Other Meds:

Current Illness:

ID: 1793998
Sex: F
Age: 52
State: OH

Vax Date: 04/01/2021
Onset Date: 05/01/2021
Rec V Date: 10/17/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Major hairloss,fungal infection of scalp,left ear,metalic particles coming out of scalp,hands,arms. Headache, tingling in arms,itchy rash on scalp and arms.

Other Meds: Vyvanse 30mg

Current Illness:

ID: 1793999
Sex: M
Age: 32
State: IN

Vax Date: 10/15/2021
Onset Date: 10/15/2021
Rec V Date: 10/17/2021
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: None

Symptom List: Tremor

Symptoms: Exact same as first dose. 9-12 hours after dose I got severe chills. Uncontrollable. Along with a fever up to 104.9 . A splitting headache with very loud ringing in ears. I used Tylenol every 6 hours to keep my fever down. It broke a few times cause extreme sweating. I slept for 36 hours.

Other Meds: None

Current Illness: None

ID: 1794000
Sex: F
Age: 25
State:

Vax Date: 04/09/2021
Onset Date: 04/26/2021
Rec V Date: 10/17/2021
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: Amoxicillin Pineapple Benadryl

Symptom List: Erythema, Pruritus

Symptoms: After the my Jannsen vaccine on 04/09, the pain at my injection site slowly increased (getting worse every few days) until the reaction on 4/26-4/27. In the middle of the night 11-12 (4/26) my arm began to hurt to the point on near incapacitation. The pain radiated from the injection site down to my fingertips. Upon the next morning I began to loose use of my left hand and became shift in the same arm (left side where I was vaccinated). My hand became numb, loading some color, and almost entirely without use. Upon going to urgent care, they were concerned I had a blood clot and sent me to Hospital. The hospital denied to file my case as a vaccine related incident, because I was not found to have a blood clot. Sensation and movement returned to my arm progressively on 4/28. Tender maintained for 2-3 days.

Other Meds: None

Current Illness: None

ID: 1794001
Sex: F
Age: 31
State: NY

Vax Date: 12/28/2020
Onset Date: 04/28/2021
Rec V Date: 10/17/2021
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: Shellfish

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

Symptoms: I received my vaccine when I was in my second trimester 18 weeks and then at 22 weeks. Uncomplicated Ivf pregnancy because of my pcos. No other medical history other than hypothyroid. Pregnancy was moving right along as normal. In late April I experienced black out of my right eye which I went to see an ophthalmologist who after doing multiple tests concluded I had a TIA. I thought I maybe vaccine related as a friend of mine also had a TIA months after her second dose.

Other Meds: Prenatal vitamins

Current Illness: None

ID: 1794002
Sex: F
Age: 69
State: NV

Vax Date: 10/28/2020
Onset Date: 10/29/2020
Rec V Date: 10/17/2021
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: Arm very sore. Went to doctor and he ordered an MRI. Found out the tendon in the right arm was 50 percent torn. Went to orthopedic doctor. Started physical therapy. Arm still in pain. Continue with the orthopedic doctor. Will probably need shots in the arm and maybe continued physical therapy.

Other Meds:

Current Illness:

ID: 1794003
Sex: F
Age: 51
State: KS

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

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

Lab Data: 3 EKGs and CT scan 9/20/21 Covid test 9/20/21

Allergies: sulfa, latex, flagyl

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Fever, chills, muscle aches, extreme fatigue, shortness of breath, chest pain

Other Meds: Levothyroxine

Current Illness: none

ID: 1794004
Sex: M
Age: 44
State:

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

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

Lab Data:

Allergies:

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

Symptoms: Muscle pain for a week. Headache since Monday, has yet to pasd.

Other Meds:

Current Illness:

ID: 1794005
Sex: F
Age: 30
State: AL

Vax Date: 09/03/2021
Onset Date: 09/18/2021
Rec V Date: 10/17/2021
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: None

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

Symptoms: Chronic tinnitus.

Other Meds: Tramadol, Zoloft, nexium

Current Illness: None

ID: 1794006
Sex: M
Age: 35
State: MI

Vax Date: 10/08/2021
Onset Date: 10/08/2021
Rec V Date: 10/17/2021
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. Sensitivity to NSAIDS and mirilax.

Symptom List: Pain in extremity

Symptoms: Extreme fatigue and discomfort throughout entire body. Tightness in chest, that resembled pericardial pain I have had in the past. Sinus and respiratory congestion with extreme mucous production. Shortness of breath. Fever. Cold sweats, restlessness. Cough. Tender throat.

Other Meds: None

Current Illness: None

ID: 1794007
Sex: M
Age: 86
State: MI

Vax Date: 10/16/2021
Onset Date: 10/16/2021
Rec V Date: 10/17/2021
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: THE PATIENT WAS ADMINISTERED THE WRONG VACCINE. HE WAS HERE TO GET THE FLUAD QUADRIVALENT BUT THE TECHNICIAN GAVE HIM THE PFIZER COVID VACCINE BY MISTAKE. THE PATIENT HAD PREVIOUSLY RECEIVED 2 DOSES OF THE MODERNA COVID VACCINE ON 2/11/21 AND 3/10/21. LATER THAT DAY THE PATIENT STATED HE HAD A MILD HEADACHE BUT FELT FINE OTHER THAN THAT.

Other Meds:

Current Illness:

ID: 1794008
Sex: F
Age: 59
State: LA

Vax Date: 10/12/2021
Onset Date: 10/12/2021
Rec V Date: 10/17/2021
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: codeine

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

Symptoms: Fever of 103.4 within 5 hours of booster shot. Extreme right sided head pain with difficulty walking. Intermittent loss of vision in right eye that is still present today 10/17/21. Will see eye Dr Monday. Still having some gait issues and dizziness. Fever never under 101 for 48 hours even with 800 motrin q 8 hours alternating with tylenol ESq 4hrs

Other Meds: benazepril 5 mg BID, Corig 12.5 mg BID, crestorQD

Current Illness: none

ID: 1794009
Sex: M
Age: 47
State:

Vax Date: 09/22/2021
Onset Date: 09/01/2021
Rec V Date: 10/17/2021
Hospital:

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

Lab Data: I was evaluated by an HCP.

Allergies: Polyethylene Glycol

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

Symptoms: Patient presents with complaints of rash and whole body itching. He states he recently got the 2nd COVID vaccine this past week. He states he noticed increased itching and his wife also noticed it. He states today when he was working outside and sweating the itching and redness became worse. He also then started to feel very hot all over. He has not taken anything for the symptoms. He did apply over the counter spray type calamine lotion to help with itching.

Other Meds: Synthroid, Amlodipine & Prozac

Current Illness: n/a

ID: 1794010
Sex: M
Age: 33
State: OR

Vax Date: 10/01/2021
Onset Date: 10/01/2021
Rec V Date: 10/17/2021
Hospital:

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

Lab Data: Blood draws from October 4th through the 6th.

Allergies: Codine

Symptom List: Vomiting

Symptoms: I previously had the Covid 19 virus on December 7, 2020. I received my first shot on October 1, 2021. Upon receiving my first dose of the Pfizer-Biontech Covid-19 vaccine I have had diarrhea since the shot. Severe abdominal, like some one is stabbing a knife into me while I am sleeping, and lower back pain, so bad I thought I cracked a vertebrae. This has caused so much pain I have gotten about 4 hours of sleep a night and I also went to my Dr because I have been in so much pain I thought I may have had appendicitis. I also have had consistent joint and muscle pain else where.

Other Meds: Sertaline

Current Illness:

ID: 1794011
Sex: F
Age: 56
State: NJ

Vax Date: 04/01/2021
Onset Date: 04/14/2021
Rec V Date: 10/17/2021
Hospital:

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

Lab Data: Hospital

Allergies: Some seafood

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Increase heart rate during the night when at rest. Heart rate 136BPM-144BPM.

Other Meds: Advil

Current Illness: N/A

ID: 1794012
Sex: F
Age: 16
State: AL

Vax Date: 08/22/2021
Onset Date: 08/23/2021
Rec V Date: 10/17/2021
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: Neurology appointment scheduled for 10/19/21

Allergies: Cats Dogs, miscellaneous plants

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

Symptoms: Severe migraine headaches, light and noise sensitivity. We have been to the pediatrician and have now been referred to a neurologist

Other Meds: Zyrtec as needed

Current Illness: None, perfectly healthy 16 year old. Had asymptomatic Covid November 2020

ID: 1794013
Sex: M
Age: 67
State: OH

Vax Date: 08/01/2021
Onset Date: 09/01/2021
Rec V Date: 10/17/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none know

Symptom List: Injection site swelling, Limb discomfort

Symptoms: mental anxiety, confusion, restlessness, feeling directionless, in a fog, no drive, led to acute stress disorder

Other Meds: eliquis, rosuvastatin, flecainde, brio, asprin (81mg) , magnesium oxide, vitiamin d3, docusate sodium, glucosime sulfate, meloxicam, melatonin, gabapentin

Current Illness: none

ID: 1794014
Sex: M
Age: 35
State: OR

Vax Date: 09/21/2021
Onset Date: 09/21/2021
Rec V Date: 10/17/2021
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

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

Symptoms: Experienced 3-4 days of Fever above 100 deg, Cold Chills, Body Aches, Left Arm (swollen,red, hot), severe back spasms, drowsiness. Continued 4-5 days of tiredness. Was given Acetaminophen (Tylenol), Ketorolac (Toradol) & Orphenadrine (Norflex).

Other Meds: Doxycycline (VIBRA-TABS) 100 MG Tablet.

Current Illness: none

ID: 1794015
Sex: F
Age: 55
State: FL

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

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

Lab Data: None yet

Allergies: None

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

Symptoms: My first shot sent me hurling back into menopause. Worse than my first menopause. Night sweats, hot flashes, moody... Etc etc etc My second shot has almost rendered me unable to walk. My back and my right knee are in complete and utter pain. I can only walk with a cane or a walker. I am in so much pain that I just cry. Although all of my issues were there to start with...it is now, 5 times worse, and much more pain.

Other Meds: Albuterol sulfate inhalation aerosol for asthma. Brezetri aerosphere inhaler. Children's bear chewable Aspirin low dose once a day. Rosuvastatin 10 mg. 1 per day for high cholesterol.

Current Illness: Herniated discs Osgood-Schlatter disease in both knees Carpal tunnel in both wrists Chronic bursitis in both hips High cholesterol Borderline osteoporosis COPD Asthma Pleurisy

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am