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: 1794228
Sex: F
Age: 73
State: OH

Vax Date: 10/13/2021
Onset Date: 10/13/2021
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:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: patient was vaccinated by a technician who inadvertently selected an expired vial and adminstered an inert dose.

Other Meds:

Current Illness:

ID: 1794229
Sex: F
Age: 58
State: CT

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: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data: None

Allergies: NKA

Symptom List: Anxiety, Dyspnoea

Symptoms: 24 hours after injection I had nausea, body aches, chills and a temp of 102. 36 hours temp 101, body aches, 48 hours low grade temp. Body aches continued, had improved. By end of day 3 from injection increase in body aches and chills with no fever, Day four feeling better. Arm pain throughout not bothersome. I took ibuprophen to help reduce fever. I had the first 2 doses of the pfizer vaccine in Dec 2020 and second dose January 2021. I had COVID in November of 2020 symptoms were low grade fever and I developed severe nerve pain in my right leg that improved until I got each dose of the vaccine, The pain continued until the end of February. I did not have that symptom with the 3rd dose. I do occasionally have the nerve pain in my in my right leg.

Other Meds: Metoprolol, lisinopril, atorvastatin, ASA

Current Illness:

ID: 1794230
Sex: F
Age: 69
State: IL

Vax Date: 09/21/2021
Onset Date: 09/28/2021
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: Scheduled stress test

Allergies: no

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

Symptoms: I feel unusual in the chest area, I feel discomfort in the chest a feeling that my heart will jump out of my chest for no reason. I wake up in the middle of the sleep because I hear the heart bubbling and beating fast and faster in the lower part as it pumps blood, sounds like the the heart is working as water boiling/pounding. I feel the heart is warm, sometimes squeezing and releasing, pressing, stabbing pains and kind of pins pocking. Sometimes I experience muscle spasms in the stomach area and my limbs.

Other Meds: no

Current Illness: no

ID: 1794231
Sex: F
Age: 41
State: WA

Vax Date: 08/06/2021
Onset Date: 08/21/2021
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:

Allergies: Sulfa

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: My normally typical menstrual cycle (25-28 days) has significantly changed since getting these two vaccines. I have an app that I've been logging my cycle in for years to compare. Here is a record of what I've experienced, with three periods in the month of September: August 21 (22 day cycle) bleeding lingered for two weeks September 6 (16 day cycle) September 16 (10 day cycle) September 25 (9 day cycle) October 7 (12 day cycle) October 17 (10 day cycle)

Other Meds: Vitamin D drops

Current Illness:

ID: 1794232
Sex: F
Age: 79
State: SD

Vax Date: 10/06/2021
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: None yet

Allergies: pencillin, erythromycin, mala one

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

Symptoms: General malaise starting 2 days post vaccination. Inability to stay warm. Chills. Pain medicines for fibromyalgia (hydrocodone) help for 4 hours.

Other Meds: Advil

Current Illness: none

ID: 1794233
Sex: F
Age: 67
State: GA

Vax Date: 10/13/2021
Onset Date: 10/15/2021
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: none

Allergies: none knowingly

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

Symptoms: My right leg and foot went completely mumb and cold for about 30 secs., also there has been some pain in back of right knee. I don't know if that experience had anything to do with the vaccine I received or not. I just never had that experience before and I thought it may be important to note and submit. I didn't call the doctor nor did I go to get medical attention. I rubbed and worked my leg and foot until it began to warm and feel normal again.

Other Meds: aspirin, multivitamin, glucosamine chrondroitin, B12, calcium citrate D3, Glipizide/Metformin, Carvedilol, Amlodipine, Olmesartan HCTZ, Rosuvastatin, Euthyrox, Timolol Maleate, Latanprost

Current Illness: none obviously

ID: 1794234
Sex: M
Age: 37
State: NY

Vax Date: 08/18/2021
Onset Date: 08/19/2021
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: Elevated TNFa and Cytokine markers

Allergies: Phenergen, Toradol

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: From August 2020 through August 2021 ? I was able to run and lift weights in small doses for the first time since 2011. I had small relapses but it was the healthiest I have felt since 2011, when the drug Imunvoir cured me for 18 months. Covid Vaccine Dose #1: Pfizer ? March 7 ? Fatigue for 4 days starting on Day 2. I felt completely normal after a week. Covid Vaccine Dose #2: Pfizer ? August 18 ? Minor fatigue turned into intense body fatigue and body aches for the first 2.5 weeks. Symptoms included headache and nausea. I felt absolutely awful On Day 18, I started a course of Prednisone ? 20 mg for 5 days. My strength began to come back but my brain fog was still very intense. My physical strength held up after the steroids but my energy would crash around 4 pm. One month after the vaccine, I re-started Thymasin Alpha 1 daily and then added BPC 157 to 4 pills per day. This was the regimen that I used in early 2020 that coincided with improvement. I also started Ketotifen, an antihistamine to combat possible Mast Cell issues. Three days later on September 21, I woke up nauseous in the middle of the night and began several weeks of intense anxiety that I had not experience since early 2020. I also began to experience very bad tinnitus in my ears. Toward the end of September 2021, the weakness in my body began to increase. I stopped the Thymasin Alpha 1 and Ketotifen to see if there was a correlation. I cut the BPC 157 to twice per day. October 5: My legs and arms felt so weak that they felt numb. This was a new feeling for me and something I never experienced before. It lasted about an hour. The next day it happened again around 11 am, but this time it did not improve. As I write this update on October 17, from morning until night, but body is incredibly weak and I feel absolutely awful. Sometimes it?s difficult for me to walk and sometimes my limbs feel so tired they feel numb. My brain fog is intense and has limited my ability to function like a normal person. The anxiety is okay, but the tinnitus in my ears is very loud. It feels like every week my condition begins to worsen.

Other Meds: Zyrtec

Current Illness:

ID: 1794235
Sex: M
Age: 29
State: WI

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: PATIENT FAINTED JUST 3-5 MINUTES AFTER RECEIVING THE VACCINE THEN HE REGAINED CONSCIOUS AFTER 2 MINUTES OF FAINTING

Other Meds: N/A

Current Illness:

ID: 1794236
Sex: F
Age: 33
State: NC

Vax Date: 10/08/2021
Onset Date: 10/15/2021
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 known allergies

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: One week after vaccination (10/15/21), patient started developing new swelling at the site of injection. Through 10/16 and 10/17 swelling turned red and painful and grew down arm and under arm. It is a continuous redness, and is not a rash. Patient had no reaction at all up until 10/15/21.

Other Meds: Unknown

Current Illness:

ID: 1794237
Sex: F
Age: 73
State: PA

Vax Date: 10/07/2021
Onset Date: 10/09/2021
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 that I am aware of.

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Wednesday, Oct. 6, went to Urgent Care for rash. Prescribed Clotrimazole-betamethasone cream for fungal infection. Thursday, Oct. 7, Pfizer COVID booster (both my husband and I received the same Lot # Pfizer vaccine). I used Clotrimazole-Betamethasone cream 3 times before booster. Two applications on Wednesday, Oct. 6, and one application day of booster. Also, I had never heard of not using Tylenol or Motrin before a COVID vaccination. I cannot remember if I might have been taking Tylenol for tooth discomfort after a dental implant September 1, 2021. Friday, Oct. 8, mild discomfort. Took Tylenol. Saturday Evening, Oct. 9, extreme reaction to what I believe to be the Pfizer booster. Symptoms appeared severely and suddenly. From my neck to my waist, front, sides, and back of my torso, what felt like piercing, debilitating muscle spasms with any extremely small movement. With movement, even breathing the wrong way, must have lasted only seconds but felt like minutes of torture. I do not remember my legs or arms having, for lack of a better word, spasms, but I could not put my leg on a small step stool without my husband?s help. Perhaps because the leg movement could not be achieved without some mid-body movement. I felt weakened to the point of not being able to perform the smallest task, but I think it was from the pain, not that my muscles could not move. When my husband helped me into bed Saturday evening, I could not budge, one way or the other, the physical suffering was too much. One other prominent symptom that appeared quickly, my right knee that had meniscus surgery several years ago ballooned with swelling. Sunday, Oct. 10, misery. Continuation of Saturday evening symptoms. No relief. Tylenol and Motrin could not touch the pain. Monday, Oct. 11, Dr. appointment with primary care physician. Doctor?s notes ?acute myalgia after COVID vaccination.? RX, Prednisone, 20 mg, 3xday, for 5 days. After 2nd dose of Prednisone, symptoms began to dissipate quickly with each passing hour and day. Sunday, Oct. 17, I feel fatigued and weakened, some joint stiffness in my left foot and right knee, however, pain is gone, and agony is over. I hope my reporting can help in a small way to help advance COVID vaccines.

Other Meds: Clotrimazole-Betamethasone cream, Tylenol, PreserVision Areds 2, vitamins C, B12, D3, and Zinc

Current Illness: 9/1/2021, Dental Implant, RX Amoxicillin, Tramadol-Acetaminohhin 10/6/2021, fungal infection

ID: 1794238
Sex: F
Age: 56
State: FL

Vax Date: 10/13/2021
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: UNKNOWN

Allergies: NONE

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

Symptoms: INFECTION DEVELOPED APPROX 3 DAYS POST VACCINATION CAUSING SORENESS IN LEFT ARM. PT SOUGHT TREATMENT AT A WALK-IN CLINIC AND WAS PRESCRIBED 2 ANTIBIOTICS, NAUSEA MEDICATION AND PAIN MEDICATION. THE PROVIDER DID NOT ATTRIBUTE HER SYMPTOMS TO THE VACCINATION NECESSARILY.

Other Meds: SINGULAR 10MG

Current Illness: ASTHMA OFF AND ON AFTR PNEUMONIA

ID: 1794239
Sex: M
Age: 21
State: FL

Vax Date: 08/25/2021
Onset Date: 08/25/2021
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: None

Allergies: None

Symptom List: Rash, Urticaria

Symptoms: Fever (38.5 C?) lasted 2 hours , Pail and Swelling in Left Arm lasted 2 days Headache lasted 12 hours Used Tylenol 1 gram each 12 hours for 2 days

Other Meds: None

Current Illness: None

ID: 1794240
Sex: F
Age: 57
State: WA

Vax Date: 04/09/2021
Onset Date: 04/10/2021
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: I have not received medical treatment as I don't need medical bills right now. Hoping systoms will go away. I have them less often than I did at firs.

Allergies: none

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

Symptoms: I have had events since I received the first does. My blood presure has been going up and down, I have been having panic attacks and at time feel really weird, like I'm going to pass out.

Other Meds: none

Current Illness: none

ID: 1794241
Sex: F
Age: 31
State: NY

Vax Date: 10/07/2021
Onset Date: 10/07/2021
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: N.A.

Allergies: erythromycin ointment

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

Symptoms: hives all over entire body, lip swelling, in 3-4 hours after administration.

Other Meds: none

Current Illness: none

ID: 1794242
Sex: F
Age: 62
State: FL

Vax Date: 07/25/2021
Onset Date: 07/28/2021
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: MRI, mammogram and follow up with OBGYN and primary doctor in August, September, and October 2021.

Allergies:

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

Symptoms: Patient received the first dose of Moderna vaccine on 7/25/21 at about 3:00 pm. That night she experienced severe left breast pain including a rash from the nipple and top of her breast to under her armpit. She stated it felt like mastitis. After 3-5 days she observed a caramel color discharge from the left breast. When compressed her breast would discharge this caramel color. Once she received her second dose in the series on 8/22/21, she reports having blood discharge from the same breast. Even now she can get some blood to discharge from her breast if compressed.

Other Meds:

Current Illness:

ID: 1794243
Sex: F
Age: 57
State: OR

Vax Date: 09/05/2021
Onset Date: 09/05/2021
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: Morphine, ibuprofen, Imitrex, , Maxalt, Ultram..

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

Symptoms: Have had a headache since time of injection.....(42 days!). CAN NOT GET RID OF HEADACHE!!!!??????

Other Meds: Methadone 5mg oxytocin 5mg Estradiol .5

Current Illness: NONE

ID: 1794245
Sex: F
Age: 53
State: MD

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:

Allergies: None

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

Symptoms: Left arm severe swelling, lymphoedema and bruising below injection site. Unable to move arm. Swelling not coming down after2 days.

Other Meds: None

Current Illness: Gerd

ID: 1794246
Sex: F
Age: 88
State: PA

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

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

Lab Data:

Allergies: Gabapentin

Symptom List: Ear pain, Hypoaesthesia

Symptoms: 30 minutes after vaccine administration, resident presented with slurred speech and abnormal vital signs including a spike in blood pressure. Resident was sent out to hospital Emergency.

Other Meds: Aspirin, Arthritis Pain Relief, Duloxetine, Fluticasone, Furosemide, Irbesartan, Levothyroxine, Metformin, Potassium Chloride, Ropinirole, Rouvastatin, Vitamin D

Current Illness:

ID: 1794247
Sex: M
Age: 67
State: OR

Vax Date: 03/10/2021
Onset Date: 07/20/2021
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: Sonogram.

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Two lumps growing on my back, very strange.

Other Meds:

Current Illness:

ID: 1794248
Sex: F
Age: 28
State: NY

Vax Date: 10/12/2021
Onset Date: 10/13/2021
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: Tested for blood bacteria with blood cultures - negative Pregnancy test and uti - negative Heart ultrasound - normal

Allergies: Gluten (celiac), dairy

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

Symptoms: Tuesday night 10/12 had chills, fever, nausea, whole body inflamed, neck and spine so painful I couldn?t move. Swelling of lymph nodes and throat hurt to swallow. Then Wednesday night 10/13 started excruciating burning sensation in toes and fingers. All extremities turned deep red and developed chilblains. Felt like someone had lit every finger and toe on fire. Couldn?t walk or use hands or feet. Worst pain I?ve ever experienced. Didn?t sleep Wednesday or Thursday night due to pain. Also developed lesions and puss filled cracking red splotches on my face starting Thursday afternoon 10/14. Doctor told me to go to ER Friday morning to check circulation and compromised blood vessels. ER gave me Tylenol and was sent home. Swelling redness and burning sensation in hands feet and face lessened Saturday afternoon and was gone by Sunday with residual blisters and splotches from chilblains. Scheduled doctor appointment to review long term autoimmune side effects.

Other Meds: Vitamin C, vit E, vit B complex, Vit D, thuja homeopathic, echinacea, ginger.

Current Illness:

ID: 1794249
Sex: F
Age: 35
State: TX

Vax Date: 09/26/2021
Onset Date: 09/28/2021
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: cipro

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

Symptoms: When giving her the second Pfizer vaccine, patient stated that a couple days after receiving the first Pfizer, she had red spots on her arm and stomach. She didn't think she had got bitten by a bug and hadn't changed laundry detergent. She discussed with her doctor and her doctor advised her to get the second Pfizer vaccine. He wasn't sure if the spots could be from pregnancy.

Other Meds:

Current Illness:

ID: 1794250
Sex: M
Age: 51
State: FL

Vax Date: 04/01/2021
Onset Date: 04/01/2021
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: EKG - showed PVCs and arythmia Holter monitor for 7 days Echo cardiogram All done May2021 through current date

Allergies: None

Symptom List: Unevaluable event

Symptoms: Night sweats, Rash over torso and back, heart palpitations, PVC?s, heart arythmia, increased heart rate, shallow breathing . Still being treated but currently on Atenalol and aspirin daily regimen. Also on atrial dialater called Ranolazine ER

Other Meds: GNC multi-vitamin for men Omega Fish Oil capsule

Current Illness: None

ID: 1794251
Sex: F
Age: 44
State: NY

Vax Date: 01/04/2021
Onset Date: 01/06/2021
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: I have a high ANA level, EKG changes and new onset left ventricular hypertrophy since the vaccine dose.

Allergies: none

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

Symptoms: Two days after the first does I developed chest pressure, palpitations and shortness of breath. These symptoms lasted about a week and the shortness of breath continued with exertion for a few weeks more. A week after the vaccine I developed a rash on my arms and legs that lasted about a month

Other Meds: Vitamins, B complex

Current Illness: none

ID: 1794252
Sex: F
Age: 55
State: IN

Vax Date: 03/07/2021
Onset Date: 03/15/2021
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: Tinnitus in left ear; received vaccine in left arm

Other Meds: Anastrazole

Current Illness:

ID: 1794253
Sex: F
Age: 66
State:

Vax Date: 09/25/2021
Onset Date: 09/25/2021
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: Mammogram and ultrasound in December scheduled

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Headache;fever;nausea;vomiting;body aches;exhaustion; Was seen by Emergency Room Department-given IV to start hydration and Zofran. Saw Family Doctor for Lump under right arm - could be due to vaccine -have a scheduled mammogram & ultrasound as follow up on Lump.

Other Meds:

Current Illness:

ID: 1794254
Sex: M
Age: 40
State: SC

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: 025J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data: none yet. getting blood work done tomorrow (October 18, 2021)

Allergies: penicillin

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

Symptoms: Possibly swollen lymph node or gland under left areola.

Other Meds: vitamin d3, c, zinc, daily probiotic, Allegra

Current Illness:

ID: 1794255
Sex: F
Age: 28
State: MD

Vax Date: 05/12/2021
Onset Date: 07/15/2021
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: sunflower seeds

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: headache

Other Meds: vitamin c and vitamin d

Current Illness: na

ID: 1794256
Sex: F
Age: 39
State: MA

Vax Date: 10/09/2021
Onset Date: 10/09/2021
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:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Patient claims technician injected flu shot into shoulder. She reported joint pain, arm pain, and swollen fingers immediately after vaccination and for several days after. She is now under care and treatment by her PCP.

Other Meds:

Current Illness:

ID: 1794257
Sex: F
Age: 16
State: FL

Vax Date: 10/17/2021
Onset Date: 10/17/2021
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: patient reported feeling dizzy and nauseous but resolved in about 20 minutes

Other Meds:

Current Illness:

ID: 1794258
Sex: F
Age: 38
State: AZ

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:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Vaccine given 10/15/2021 @ 330pm Headache 20 minutes after vaccine Weird head fog 20 minutes after vaccine Shooting pain right kidney area at 5pm Metallic Taste in mouth 530pm Sleeping at 8pm Up every 2 hours or so throughout the night Achy body 1030- painful aches, shivers, hurts to move Fell asleep at 1130am Woke up at 430 feeling light headed, less achy, hot/cold, sweaty Bed at 8pm- noticed pain in right armpit. fell asleep at 830- up every 3 hours with pain Woke up at 630- pain in armpit worse, swollen, side pain

Other Meds:

Current Illness:

ID: 1794259
Sex: F
Age: 74
State: TX

Vax Date: 10/13/2021
Onset Date: 10/13/2021
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: none

Allergies: nsaids

Symptom List: Injection site pain

Symptoms: Had chills and fever and achy. Woke up on the floor next to my bed and had a lot of trouble getting back in bed. Had fever most of the day and slept most of the day.

Other Meds: none

Current Illness: no

ID: 1794260
Sex: F
Age: 14
State: NC

Vax Date: 09/15/2021
Onset Date: 09/15/2021
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: Pt was under the age of 18 when she received this dose of Moderna. Pt presented with mother and sister to clinic asking specifically for Moderna vaccine. Pt was assumed to be over the age of 18. Pt correct age discovered after administration of second dose 10/14/2021. Mother of pt was informed of this VAERS 10/16/2021. Mother stated pt had typically side effects following second dose such as malaise but had recovered to normal as of the time of the phone call 10/16/2021. Mother and father both very concerned.

Other Meds:

Current Illness:

ID: 1794261
Sex: F
Age: 43
State: SC

Vax Date: 10/17/2021
Onset Date: 10/17/2021
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: nka

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

Symptoms: as vaccine was being given, vaccine leaked out from between syringe and needle and leaked down patient arm

Other Meds: n/a

Current Illness: n/a

ID: 1794262
Sex: F
Age: 69
State: CA

Vax Date: 09/17/2021
Onset Date: 09/18/2021
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: Dr examination and x-rays 9/13/2021 - severe tendinitis

Allergies: None

Symptom List: Tremor

Symptoms: SIRVA - severe pain in right shoulder night and day since vaccination. Dr prescribed Nabumetone 750 MG 2 x daily and Tylenol 1300 MG 3 x daily for 3 to 4 weeks

Other Meds: Atenelol

Current Illness: None

ID: 1794263
Sex: F
Age: 15
State: NC

Vax Date: 09/15/2021
Onset Date: 09/15/2021
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: multiple allergies

Symptom List: Erythema, Pruritus

Symptoms: Pt was under the age of 18 when she received this dose of Moderna. Pt presented with mother and sister to clinic asking specifically for Moderna vaccine. Pt was assumed to be over the age of 18. Pt correct age discovered after administration of second dose 10/14/2021. Mother of pt was informed of this VAERS 10/16/2021. Mother stated pt had typically side effects following second dose such as malaise but had recovered to normal as of the time of the phone call 10/16/2021. Mother and father both very concerned.

Other Meds:

Current Illness:

ID: 1794264
Sex: F
Age: 60
State: FL

Vax Date: 10/14/2021
Onset Date: 10/14/2021
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: None. Sent message and photo to my doctor. She was not concerned, but asked that I report the reactions.

Allergies: Sulfa drugs & Hydrocholorothiazide ? joint inflammation/pain Milk Protein allergy +Lactose intolerance-gastroenteritis, congestion Codeine ? nausea/vomiting Propranolol ? dizziness, sinus bradycardia, hypotension Nitroglycerine ? hypersensitive Mastisol adhesive ? contact dermatitis Artificial Scents ? asthma trigger, hives, congestion, headache

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

Symptoms: Localized red area 3" x2" warm and tender to the touch. Generalized body aches starting the day after. Both continue 3 days after receiving the vaccine.

Other Meds: ARMOR THYROID, 45MG; LEVOTHYROXINE 25 MCG; CELEBREX 100 MG; DULOXETINE 30 MG; ACYCLOVIR 200 MG; BUSPAR 15 MG 2x per day; SIMVASTATIN 10MG; Xyzal 5 MG Supplements: Omega 3, Philips Colon Health Probiotic 10, Glucosamine/Chondroitin 1500 MG/2

Current Illness: None

ID: 1794265
Sex: M
Age: 49
State: KS

Vax Date: 04/06/2021
Onset Date: 10/09/2021
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: Allergic to penicillin

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

Symptoms: No adverse events from 2nd vaccine shot. Little soreness at the site of shot. Nothing else

Other Meds: Calcium + vitamin D3

Current Illness: No

ID: 1794266
Sex: F
Age: 57
State: IA

Vax Date: 10/03/2021
Onset Date: 10/06/2021
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: Physical examination by PCP

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Patient stopped into pharmacy to report a painful shoulder and an inability to lift her arm after receiving her seasonal influenza vaccine. Patient states her pain has gotten progressively worse and spoke to her doctor about the issue. She said she can't lift her arm at all. She referenced a potential torn rotator cuff, but is undergoing an MRI in 2 weeks (around 10/31/21) to determine the extent of her ailment if her condition does not improve.

Other Meds:

Current Illness:

ID: 1794267
Sex: F
Age: 59
State:

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: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Patient came on 10/14/21 in the morning to request for her Moderna additional dose (3rd dose). Pharmacy technician provided her the consent form and Moderna booster eligibility (attestation) form. Patient gave us a covid card with 2 doses of Pfizer and pharmacy technician placed a sticker for her 3rd dose with lot number and today's date (10/14/21). Rph checked the consent form, Moderna booster eligibility form and received a verbal answer from the patient that the patient is here for her 3rd Moderna dose. At the end of the shift, Rph batched all consent forms and found out this is potentially her 4th Moderna dose (based on rx/tx history). Rph called the patient on 10/14/21 but patient cannot be reached. Rph called again on 10/17/21 twice but pt still cannot be reached. Rph filed an incident report on 10/14/12 through company's (Safeway) website. Rph is currently filing a report on VAERS and will work on submitting QA form today.

Other Meds:

Current Illness:

ID: 1794268
Sex: F
Age: 41
State: NY

Vax Date: 09/27/2021
Onset Date: 10/01/2021
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: pending

Allergies: shrimp

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

Symptoms: blood test.

Other Meds: chest pain, constant vaginal bleeding , strong stomach pain, high blood pressure

Current Illness: high blood pressure

ID: 1794269
Sex: M
Age: 37
State: WA

Vax Date: 05/11/2021
Onset Date: 05/14/2021
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: I had hearing tests and physical exam. Hearing test showed higher than average hearing.

Allergies: No

Symptom List: Pain in extremity

Symptoms: I have bad tinnitus now. It gradually started after my first dose and has been constant since receiving my 2nd dose. It is really bad.

Other Meds: None

Current Illness: None

ID: 1794270
Sex: F
Age: 54
State: NC

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: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: Allergies to penicillin, amoxycillin, codeine, keflex, ancef

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

Symptoms: 10/16/21 broke out in hives on my torso, back, legs, arms, head and face

Other Meds: Sertraline

Current Illness:

ID: 1794271
Sex: F
Age: 51
State: MD

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: I called Sunday for a doctors appointment was was referred to this site to report my symptoms. I am going to see a doctor tomorrow as recommended by doctor.

Allergies: Sulfa

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

Symptoms: About 10 mins after injection there was a tingling and zinging sensation down the left arm on the underside. It started in the arm pit and traveled down to the wrist. This went on for about 2 hours post injection. About 12:15pm muscle pain and joint pain started through out the whole body. A very intense headache started shortly after. There is also a feeling of complete exhaustion. I went to bed after taking some Exedrine Migraine to try to quell the INTENSE headache. That really did not help the headache at all. It was the most intense migraine like headache I've ever had. I had the feeling of chills but never registered a fever. I can not get warm. The headache and achy feeling has lasted for 2 days so far. It is not as intense as Friday and Saturday but I still do not feel well.

Other Meds: Levothyroxine, Estrodiol, Lexapro, Vit D, Cranberry extract, Probiotic

Current Illness: none

ID: 1794272
Sex: F
Age: 75
State: CA

Vax Date: 09/27/2021
Onset Date: 10/01/2021
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:

Allergies: SULFONAMIDES

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

Symptoms: PATIENT STATED ARM SORENES AT INJECTION SITE

Other Meds: NONE

Current Illness: NONE

ID: 1794273
Sex: F
Age: 71
State: IA

Vax Date: 10/12/2021
Onset Date: 10/14/2021
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:

Allergies:

Symptom List: Vomiting

Symptoms: Patient reported when she received her vaccine, the immunizer did not sanitize the inject site prior to applying the barrier-safe bandage. She also stated that after the needle was inserted, immunizer "pulled back on the syringe and jammed it in again". She reported pain during and after the injection. The patient went to her doctor and she developed redness and pain at the injection site. It was determined that she has an infection and was prescribed antibiotics.

Other Meds:

Current Illness:

ID: 1794274
Sex: M
Age: 37
State: CO

Vax Date: 10/17/2021
Onset Date: 10/17/2021
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: n/a

Allergies: No known allergies.

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Patient experienced a syncopal episode; was evaluated by EMS. Recovered and denied transport to hospital.

Other Meds: No known prescriptions.

Current Illness: No current illnesses.

ID: 1794275
Sex: F
Age: 74
State: TN

Vax Date: 10/12/2021
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:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: Feeling bad, red rash on chest and back, injection site red, hot and itchy.

Other Meds:

Current Illness:

ID: 1794276
Sex: F
Age: 23
State: WI

Vax Date: 10/17/2021
Onset Date: 10/17/2021
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: IM
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Patient was given the second dose on day 27 instead of day 28

Other Meds: none

Current Illness: none

ID: 1794278
Sex: F
Age: 28
State: CA

Vax Date: 10/17/2021
Onset Date: 10/17/2021
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: none known

Allergies: nka

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

Symptoms: pt got immediate tingling in left pinky and ring finger.

Other Meds: unknown

Current Illness: unknown

ID: 1794279
Sex: F
Age: 54
State: WA

Vax Date: 09/13/2021
Onset Date: 09/14/2021
Rec V Date: 10/17/2021
Hospital:

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

Lab Data: None

Allergies: Keflex

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

Symptoms: Fever 101.2 Weakness Chills Fatigue

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am