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: 1797671
Sex: F
Age: 72
State: VT

Vax Date: 10/16/2021
Onset Date: 10/17/2021
Rec V Date: 10/19/2021
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: Licinopril

Symptom List: Dysphagia, Epiglottitis

Symptoms: Lump around injection site

Other Meds: Blood Pressure meds, blood thinner meds

Current Illness: NONE

ID: 1797672
Sex: M
Age: 41
State: PA

Vax Date: 10/15/2021
Onset Date: 10/15/2021
Rec V Date: 10/19/2021
Hospital:

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

Lab Data: Ultra Sound and MRI were ordered. The MRI showed significant swelling and a torn Labrum due to the vaccine.

Allergies: N/A

Symptom List: Anxiety, Dyspnoea

Symptoms: The Vaccine was administered on the high side of the right shoulder of a 41 year old male with a build. The patient felt immediate pain during and after the injection. Swelling became prominent with limited range of motion to the right arm laterally and at different angles. Patient followed up with primary DR who ordered tests to determine what occurred due to the continuous pain, limited mobility and swelling in the right arm shoulder region.

Other Meds: N/A

Current Illness: N/A

ID: 1797673
Sex: F
Age: 29
State: MN

Vax Date: 01/19/2021
Onset Date: 10/16/2021
Rec V Date: 10/19/2021
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: Tested PCR positive for COVID 10/16/21 after being fully vaccinated.

Other Meds:

Current Illness:

ID: 1797674
Sex: F
Age: 69
State: MA

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

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

Lab Data:

Allergies: penicillin, sulfa

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: headache, nausea, fever, chills, body aches

Other Meds: none

Current Illness: none

ID: 1797675
Sex: M
Age: 31
State: VA

Vax Date: 10/19/2021
Onset Date: 10/01/2021
Rec V Date: 10/19/2021
Hospital:

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

Lab Data: CK > 400---it has returned to 208, however, patient continues to feel poorly

Allergies:

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

Symptoms: Patient developed fatigue, shortness of breath, myalgias, restless sleep, feeling of "menthol" in his chest Elevated CK levels

Other Meds:

Current Illness:

ID: 1797677
Sex: M
Age: 24
State: FL

Vax Date: 10/13/2021
Onset Date: 10/15/2021
Rec V Date: 10/19/2021
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: Troponin 0.250 Echo normal ejection fraction

Allergies:

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

Symptoms: Patient developed chest pain 2 days of after COVID 19 vaccine received on 13 October 2021. He went to the ER and was admitted to the hospital with a positive troponin and diagnosis of myocarditis on 16 October 2021. He had a normal echocardiogram and symptoms resolved and he was discharged on 17 October 2021

Other Meds:

Current Illness:

ID: 1797678
Sex: M
Age: 86
State:

Vax Date: 10/11/2021
Onset Date: 10/13/2021
Rec V Date: 10/19/2021
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: Pyrexia, White blood cell count decreased

Symptoms: TIA, inability to walk, transfer, unresponsive for approx 2 minutes with right side weakness.

Other Meds:

Current Illness:

ID: 1797679
Sex: F
Age: 48
State: NY

Vax Date: 10/13/2021
Onset Date: 10/17/2021
Rec V Date: 10/19/2021
Hospital:

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

Lab Data: 10/18/21 - Ultrasound to confirm

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Enlarged lymph nodes on the left side of neck

Other Meds:

Current Illness:

ID: 1797680
Sex: F
Age: 44
State: OR

Vax Date: 03/01/2021
Onset Date: 05/11/2021
Rec V Date: 10/19/2021
Hospital:

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

Lab Data: seeking medical care next week at primary care

Allergies: na

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: I have had menstrual periods and heavier bleeding since the second dose, I am now cycling every two weeks since the vaccine. Previously I had not even had spotting. They are becoming unusually intense and long

Other Meds: na

Current Illness: na

ID: 1797681
Sex: M
Age: 70
State: TN

Vax Date: 10/19/2021
Onset Date: 10/19/2021
Rec V Date: 10/19/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: The patient presented to the pharmacy for his booster dose of covid vaccine. He had not set up an appointment online so we accepted him as a walk in. He had to be added into our system. The technician processed the information through the computer. Once in the vaccine room the pharmacist asked the patient if he was here for his booster dose of Pfizer vaccine. He replied yes. He was also asked about side effects he experienced with his first two doses. He said he was expecting more side effects but did just fine with the first two doses. After the vaccine was administered the pharmacist counseled the patient on taking a picture of his vaccine card to have on hand and then to store his card in a safe place at home. He asked if his card was filled out and the pharmacist asked to see it. Immediately it was noted that the first 2 doses that the patient received were Moderna. The pharmacist told the patient to call the pharmacy back if he experienced any problems or had any questions. Fifteen minutes after his dose he was doing just fine and continued shopping in the grocery section of our store.

Other Meds:

Current Illness:

ID: 1797683
Sex: F
Age: 23
State: OH

Vax Date: 03/30/2021
Onset Date: 04/13/2021
Rec V Date: 10/19/2021
Hospital:

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

Lab Data: April 20th 2021-Bloodwork Panel, EKG Lead April 29th 2021- Brain MRI July 8th 2021- Spine MRI July 29th 2021 Lyme Disease Bloodwork, TB Bloodwork

Allergies: None Known.

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

Symptoms: After getting my first Pfizer shot, a week-two later I started experiencing tingling/numbness in my whole left arm, left leg and occasionally my right leg. Thought I was potentially having a heart attack/stroke. Saw my primary care Dr. Did bloodwork and EKG. Everything came back fine. Eventually developed Lhermitte's Sign the following week of April 26th. Had brain scan the following week, seemed relatively normal. After finally seeing a Neurologist in June, in July I was diagnosed with MS through a spine MRI which showed one new lesion. Was not presenting any MS symptoms previously to the vaccine. Mentioned this in the follow up the CDC provides, however, was never able to make true phone contact to notify.

Other Meds: Generic Birth Control-Norethrin Vitamin C

Current Illness: Kidney Crystals(No Stones)

ID: 1797684
Sex: F
Age: 25
State: ID

Vax Date: 10/18/2021
Onset Date: 10/18/2021
Rec V Date: 10/19/2021
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: .

Symptom List: Rash, Urticaria

Symptoms: vaccine was left out of fridge since 10/15/21. I had not noticed it was left out and thought it was the new one for the day. I administered it to the patient by accident.

Other Meds: .

Current Illness: .

Date Died: 10/18/2021

ID: 1797685
Sex: F
Age: 71
State: KY

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

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

Lab Data:

Allergies:

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

Symptoms: Moderna on 1/12 and 2/8. Positive on 10/9

Other Meds:

Current Illness:

ID: 1797686
Sex: F
Age: 16
State: FL

Vax Date: 10/19/2021
Onset Date: 10/19/2021
Rec V Date: 10/19/2021
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: 2nd dose administered at 14-day interval instead of 21-day interval.

Other Meds:

Current Illness:

ID: 1797687
Sex: F
Age: 79
State:

Vax Date: 03/12/2021
Onset Date: 09/30/2021
Rec V Date: 10/19/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: breakthrough COVID-19 case

Other Meds:

Current Illness:

ID: 1797689
Sex: M
Age: 37
State: ID

Vax Date: 10/18/2021
Onset Date: 10/18/2021
Rec V Date: 10/19/2021
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: Vaccine was left out of the refrigerator since 10/15/21 and I did not notice until after the shot was given to the patient.

Other Meds: .

Current Illness: .

ID: 1797690
Sex: M
Age: 86
State:

Vax Date: 02/17/2021
Onset Date: 10/16/2021
Rec V Date: 10/19/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: breakthrough COVID-19 case

Other Meds:

Current Illness:

ID: 1797691
Sex: F
Age: 35
State: MN

Vax Date: 10/14/2021
Onset Date: 10/14/2021
Rec V Date: 10/19/2021
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: N/A

Other Meds:

Current Illness:

ID: 1797692
Sex: F
Age: 40
State: FL

Vax Date: 08/13/2021
Onset Date: 08/16/2021
Rec V Date: 10/19/2021
Hospital:

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

Lab Data: Negative COVID test at the time of going to the hospital. No other treatment.

Allergies: NKA

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: 3 days after patient received first dose she was dehydrated due to nausea and vomiting, she had chest pain and chills. She went to hospital 1 week later and they gave her IV fluids and sent her home. Blood Pressure was elevated but no treatment administered.

Other Meds: None

Current Illness: None

ID: 1797693
Sex: F
Age: 60
State: OK

Vax Date: 03/23/2021
Onset Date: 03/23/2021
Rec V Date: 10/19/2021
Hospital:

Vax Type: RV1
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: ROTAVIRUS (ROTARIX)
Lot:
Dose Series: 1
Vax Route: PO
Vax Site: MO

Lab Data: Xray of shoulder area Dr. doesn't think an MRI would show the damage if it is nerve related and that's what they think it is.

Allergies: Cipro, Macrobid

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

Symptoms: At time of shot, The nurse said, I think I hit a blood vessel! Blood started running down my arm and she had to grab a paper towel to soak it up. My arm immediately began to ache. I took about an hour to stop aching and it hurt to move it for a few days. I thought it was the normal side effect. About a week later it began to really HURT to move my arm. I saw my doctor for the first time in April and I mention the knot which had appeared on my arm and the fact the it had started to hurt when moving it. He said just give it some time and it should get better. The knot was lower on my arm that my muscle is. As time went by, the pain in my arm got worse and worse. I went to physical therapy and now I can't put on a jacket, dry my back after a shower, do anything and make the tiniest of wrong moves without it hurting extremely bad. It is a SHARP pain now, not an ache. My life with this arm has totally change. I feel like I went to get the Covid shot to make me better and now Im disabled.

Other Meds: Cymbalta, Gabapentin, Toprol, Lisinopril, Prilosec, Topamax, Nurtec (as needed), Hydrocodone (as needed), Vit B12, Vit D3

Current Illness:

ID: 1797695
Sex: F
Age: 43
State: VA

Vax Date: 04/14/2021
Onset Date: 06/01/2021
Rec V Date: 10/19/2021
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: Blood work.

Allergies: Had a bad reaction to Bactrim recently; Rice; Carrots; Oranges

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

Symptoms: I have experienced more bruising. I had blood work done. My b12, iron, WBC counts were observed. All my levels were normal. My WBC was not but that was because I had a UTI. I did not receive treatment since the bloodwork was normal but I am still bruising very easily. I am also experiencing a change in my menstrual cycle and duration. I had my hormone levels checked which showed normal. I also have not received treatment for this. I am taking a hormonal supplement.

Other Meds: Yes, levothyroxine; Vitamin D; Flonase; Allegra; Allergy shots; Azelaic acid; Xanax; Multivitamin

Current Illness: No

ID: 1797696
Sex: F
Age: 39
State: VA

Vax Date: 10/18/2021
Onset Date: 10/18/2021
Rec V Date: 10/19/2021
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: Body aches, severe headache, vomiting, insomnia, fatigue, black stool

Other Meds: Nifedipine Zoloft

Current Illness:

ID: 1797698
Sex: M
Age: 57
State: VA

Vax Date: 02/05/2021
Onset Date: 03/06/2021
Rec V Date: 10/19/2021
Hospital: Y

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

Lab Data:

Allergies: penicillin

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

Symptoms: One month after receiving second Pfizer dose for COVID-19 vaccination, I started experiencing A-FIB out of the blue. The A-FIB was continuous until I received cardioversion/TEE procedure (3/10/21); followed by cryoablation on 6/2/21.

Other Meds: multivitamin; CoQ10; turmeric; glucosamine/chondroitin

Current Illness: none

ID: 1797699
Sex: F
Age: 38
State: IN

Vax Date: 10/16/2021
Onset Date: 10/16/2021
Rec V Date: 10/19/2021
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: Latex

Symptom List: Injection site pain, Pain

Symptoms: Blurry vision, numbness in face and mouth.

Other Meds: NONE

Current Illness: NONE

ID: 1797700
Sex: F
Age: 54
State: VA

Vax Date: 04/19/2021
Onset Date: 09/25/2021
Rec V Date: 10/19/2021
Hospital: Y

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

Lab Data: Covid Test - 10/6/2021 - negative Flu test - 10/5/2021 - negative Chest Xray - 10/5/2021 - normal Covid test - 9/25/2021 - negative Full panel - 10/5/2021 - upper respiratory infection EKG - 10/12/2021 - normal Chest Xray - 10/12/2021 - normal

Allergies: N/a

Symptom List: Injection site pain, Menorrhagia

Symptoms: My sister traveled to stay with me on the week of September 20th 2021, she felt ill on September 22 2021 with a very bad cough and fever. I felt ill the next day, on the 23rd. On the 25th we both got tested for Covid. We were both negative. She was very ill, but I was coughing and had a low grade fever at that time. Knowing I did not have Covid, I was just treating myself for an upper respiratory infection. I was home sick for that time. I was coughing, having trouble breathing and sharpness in my chest like knives. I took Tylenol every four hours and drinking Pedialyte and also taking Mucinex. For the first week, my chest was really bad so I was making myself walk around and take deep breathes because I was fearful that it would turn into Pneumonia. The fever broke around October 3rd. I was weak and didn't feel good still but was getting a little better. On October 5th my friend called the ambulance because I was coughing and my back went out. I was in extraordinary pain so the ambulance took me to the hospital. When I got there, they tested me for Covid and Flu, both negative. They did testing and some of my testing came back normal, without a copy of the test I cannot tell you what all that was. I had some sort of strain on my heart and was admitted to the hospital on the 5th of October and they did full test for upper respiratory infections and I tested positive for an infection. I was discharged on the 6th and followed up with my heart DR, I saw her on the 11th or 12th of October. She sent me home and told me to continue to taking Tylenol. Today I have a follow up with my GP and he may advise other follow up treatment. Also around October 7th my left ear plugged and I got a really bad earache, I used over the counter ear drops for that as well. When I did see the Cardiologist she noticed my left side lymph nodes were very swollen and they still are today as well.

Other Meds: Magnesium Supplement, Wellbutrin 300, Trazadone 100MG, Trileptal generic 150MG, Lorazepam .5MG

Current Illness: N/a

ID: 1797701
Sex: F
Age: 49
State: FL

Vax Date: 10/11/2021
Onset Date: 10/12/2021
Rec V Date: 10/19/2021
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.

Allergies: None.

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

Symptoms: She got her vaccine, had a little bit of tenderness in her arm within 5 hours. She didn't feel great but not horrible, just a little weird. She went to bed, woke up with a headache, soreness in her arm. The headache is frontal pressure and her head feels like her brain is swollen. She has been taking Tylenol which did not help, and has been taking Advil which is helping some, but she goes to bed with a headache and wakes up with a headache. She also started coughing a little bit yesterday and also continues today, just like a tickle. She feels a pressure in her head. She typically does not have constant headaches.

Other Meds: Amoxicillin, Concerta, Zoloft, Metformin.

Current Illness: Stye in left eye.

ID: 1797702
Sex: M
Age: 67
State: NY

Vax Date: 06/16/2021
Onset Date: 07/20/2021
Rec V Date: 10/19/2021
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: CT scan with contrast of the chest, and ultrasound of the right thigh, and multiple blood tests to confirm diagnosis

Allergies: Phenobarbital, Black pepper, cat dander, pears, sesame seeds, ginger, black walnut leaf

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: 2 P.E.s 1 in each lung, and DVT in the right thigh, hospitalized for 4 days, given heparin, resolved, continues with Eloquis

Other Meds: Rilizole

Current Illness: ALS

ID: 1797703
Sex: M
Age: 35
State: TX

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

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

Lab Data: None

Allergies: None

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Immediately and for the rest of the day and into the next day- sore left arm. The night of the injection and into the following morning (now) fatigue, congestion, tightness in chest (hard to breathe) and headache.

Other Meds: None

Current Illness: None

ID: 1797704
Sex: F
Age: 47
State: VA

Vax Date: 10/15/2021
Onset Date: 10/15/2021
Rec V Date: 10/19/2021
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: No

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

Symptoms: About 4-5 hours after COVID booster (flu shot at 11 AM, COVID at 2:30) - nausea and dizziness started. Vomited multiple times with severe dizziness and nausea. No fever or below 99.5. Dizziness and vomiting continued through night from Oct 15 into mid-morning Oct 16. Symptoms alleviated on Sat Oct 16 afternoon through Sun afternoon. Then on Sunday evening (Oct 17th) dizziness returned and nausea and vomiting. These symptoms continued throughout night and into early morning of Oct 18. Symptoms alleviated at this time and now have mostly disappeared. Some slight nausea still felt as of Oct 19. Dull headache now and some fatigue.

Other Meds: Vitamin D, Daily Multivitamin

Current Illness: Flu shot received at 11 AM same day as Pfizer Covid booster at 2 Pm

ID: 1797705
Sex: F
Age: 30
State: IL

Vax Date: 09/01/2021
Onset Date: 09/01/2021
Rec V Date: 10/19/2021
Hospital:

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

Lab Data: I used a digital thermometer to measure temperature .. No other tests

Allergies: Non

Symptom List: Nausea

Symptoms: Mild soreness in the injection site and general achiness started within the first couple hours of taking the vaccine Headache, weakness and flu like achs started in the evening on the same day with mild elevation in temperature (99 F underarms) Symptoms peaked the next day with a temp of 101 F underarm .. Sever headache and flu like muscle and joint pains and more pain at the injection site but when pressure is applied ( like trying to sleep on that side) plus tender swollen lymph nodes on the neck only on the left side ( same side where I got the injection) On the third day achs and pains were very mild and fever subsided .. Sever headache, pain at injection site with applied pressure and swollen neck lymph nodes lasted about a week then completely resolved

Other Meds: Oral Vitamin D ( 1000 IU) and Calcium (600 mg) Topical Erythromycin gel for Acne Fluticasone intranasal spray for allergies

Current Illness: No illnesses but was 1 month postpartum and exclusively breastfeeding

ID: 1797706
Sex: F
Age: 34
State: WI

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

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

Lab Data:

Allergies: RED DYE. METOPROLOL, AMLODIPINE ATENOLOL AND LISINOPRIL.

Symptom List: Injection site pain

Symptoms: SORE INJECTION SITE FOR 5 DAYS AFTER. 10 HRS AFTER INJECTION STARTED TO EXPERIENCE FEVER, CHILLS, HEADACHE AND BODY ACHE. FEVER AND CHILLS LASTED 15 HOURS AFTER START. BODY ACHES LASTED 48 HOURS AFTER INIAL SIGNS. HEADACHES CONTINUED DAILY FOR A WEEK, LESSENING IN STRENGTH, FOLLOWING INITIAL ONSET.

Other Meds: LOSARTAN.

Current Illness:

ID: 1797707
Sex: M
Age: 78
State: MN

Vax Date: 04/01/2021
Onset Date: 09/30/2021
Rec V Date: 10/19/2021
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: Client was diagnosed with COVID after receiving the vaccination.

Other Meds:

Current Illness:

ID: 1797708
Sex: F
Age: 57
State: GA

Vax Date: 04/21/2021
Onset Date: 04/22/2021
Rec V Date: 10/19/2021
Hospital:

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

Lab Data: bloodwork (CBC) for heart and bp

Allergies: PENICILLIN & ZPAK

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

Symptoms: Heart racing and edema caused by application of compounded hormone cream post-vaccine and never had any side effects previous to covid vaccination. Had been on HRT since 8/2020.

Other Meds: PROGESTERONE, TESTONSTERONE, AND ESTRADIOL COMPOUNDED CREAM

Current Illness:

ID: 1797709
Sex: F
Age: 36
State:

Vax Date: 05/07/2021
Onset Date: 05/08/2021
Rec V Date: 10/19/2021
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: Tremor

Symptoms: PATIENT EXPERIENCED CRAMPING AND SPOTTING WITH NO PERIOD. PATIENT EXPEREINCED NO PERIOD IN THE MONTH OF MAY & JUNE, HOWEVER CRAMPING WAS EXPERIENCED BOTH MONTHS. PATIENT EXPERIENCED MENSTRATION IN JULY, EXTREMLY HEAVY. PATIENT DID NOT MENSTRATE IN AUGUST. PATIENT IS A NURSING MOTHER WHOSE LEFT BREAST (SHOT WAS IN THE LEFT ARM) WAS SORE FOR 5 DAYS. NURSING BABY ALSO APPEARED WITH SYMPTOMS OF LETHARGY AND CLAMMY SKIN.

Other Meds:

Current Illness:

ID: 1797710
Sex: F
Age: 42
State: IA

Vax Date: 10/13/2019
Onset Date: 10/13/2019
Rec V Date: 10/19/2021
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: Metronidazole, Eggs

Symptom List: Erythema, Pruritus

Symptoms: Face Welts, Injection site redness and inflamed, upset stomach

Other Meds:

Current Illness: None

ID: 1797711
Sex: F
Age: 15
State: NY

Vax Date: 06/18/2021
Onset Date: 06/29/2021
Rec V Date: 10/19/2021
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: MRI Pelvis w/o contrast 8/2/21 CT Scan 8/4/21 MRI Pelvis with and w/o contrast 8/4/21 PET Scan 8/4/21

Allergies: penecillin

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

Symptoms: A week and a half after receiving her second dose of the Pfizer covid vaccine, my daughter noticed a lump near her groin and another on her lower buttock. Further evaluation and tests have resulted in Rhabdomyosarcoma Diagnosis.

Other Meds: minocycline, actzone, clindimicin/Benzoyl peroxide, singulair,

Current Illness: none

ID: 1797712
Sex: F
Age: 70
State: FL

Vax Date: 10/14/2021
Onset Date: 10/15/2021
Rec V Date: 10/19/2021
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: Sulfa

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

Symptoms: Hard chills, fever, myalgia, fatigue, loss of appetite, malaise

Other Meds: Breo inhaler, omeprazole, dyazide, losartan, elmiron, Montelukast, albuterol inhaler, vit e, B12

Current Illness: None

ID: 1797713
Sex: F
Age: 38
State: OR

Vax Date: 10/16/2021
Onset Date: 10/18/2021
Rec V Date: 10/19/2021
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: Latex, sulfa, cephalosporins, reglan; Cross reaction with foods list for Latex allergy.

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Loss of smell, painful lymph nodes in left armpit , painful bicep, painful achy joints in left arm all the way to fingers, swollen lymph nodes in throat, headache's.

Other Meds: Women's multivitamin and vitamin c.

Current Illness: None.

ID: 1797714
Sex: F
Age: 77
State: NH

Vax Date: 03/28/2021
Onset Date: 03/28/2021
Rec V Date: 10/19/2021
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: cyclobenzaprine naproxen

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

Symptoms: Patient states that 5 hours after receiving 2nd dose of Moderna she hemorrhaged. Patient has subsequently developed "blood cancer" as stated by patient after receiving 2nd Moderna vaccine. No documentation of hospital visit for hemorrhage can be obtained by this reporter but there was documentation by an ENT visit for the patient looking for medical clearance for surgery after having epistaxis where it states that the patient began experiencing nose bleeds after the second vaccine. Patient was also seen at the end of March for TIA and has known carotid artery disease.

Other Meds: acetaminophen 325 mg oral tablet amLODIPine 10 mg oral tablet aspirin 325 mg oral tablet atorvastatin 40 mg oral tablet: oral bumetanide 1 mg oral tablet cholecalciferol 2000 intl units (50 mcg) oral tablet cyanocobalamin 1000 mcg oral tabl

Current Illness:

ID: 1797715
Sex: U
Age:
State: TX

Vax Date:
Onset Date:
Rec V Date: 10/19/2021
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: None

Allergies:

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

Symptoms: Sent: 10/18/2021 Question: Black female, 61, NO underlying conditions, NO medication. Healthy. Never tested positive for Covid-19. I avoid crowds, when I go anywhere, I always wear a mask with a filter, social distance and wash my hands as often as possible. Following CDC guidelines WORK. Fully vaccinated + booster/Pfizer: 3/5/2021 #1, 3/26/2021 #2, Booster 9/27/2021. #1 & #2 vaccine, NO PROBLEM NO SIDE EFFECTS. By the way, I've NEVER had a flu shot, Pneumonia shot, shingles shot or any other vaccine as an adult. Booster!!! Monday 10/18/2021, week 3. I'm getting concerned. Day 1, 24 hours after taking booster.....extremely tired and sore arm; no biggie. Day 2, still tired, sore arm; no biggie, I'm getting lots of rest, more than usual because I'M REALLY TIRED, I HAVE ZERO ENERGY. Day 3, every joint in body is seriously hurting, I can barely move. I make myself move, I soak in warm water, I try walking on the treadmill. For 3 days, every joint in my body is aching, I have no appetite, I'm drinking chicken broth, tomato basil soup, water, gingerale, etc. warm baths and really trying to keep moving. NOT nausea, NOT throwing up, just no appetite. One week later body aches are better BUT now I have a scratchy throat and runny nose. I gargle with warm salt & water for an entire week. During that week mucus buildup in my throat and nose that I've never had in my life. I'm healthy, I've never had crap like this before. This thick green mucus is so bad I'm up for hours coughing and blowing. I don't feel bad, no fever, no chest pains, no shortness of breath. Today, Tuesday, 10/19/2021 is day 8 with this thick green mucus. Should I be concerned? should I go to the doctor? Is this normal? Feel free to give me a call

Other Meds:

Current Illness:

ID: 1797716
Sex: F
Age: 64
State: MN

Vax Date: 03/11/2021
Onset Date: 09/29/2021
Rec V Date: 10/19/2021
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: Diagnosed with COVID after receiving the vaccination. Symptoms started on 9/29/2021 with a headache, cough, shortness of breath and stomach upset.

Other Meds:

Current Illness:

ID: 1797717
Sex: F
Age: 57
State:

Vax Date: 10/18/2021
Onset Date: 10/18/2021
Rec V Date: 10/19/2021
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: Following vaccination, patient experienced chest pain, throat tightness, dizziness, nauseous, heart racing, initially hypertensive with elevated pulse. Transported the the emergency department.

Other Meds:

Current Illness:

ID: 1797718
Sex: F
Age: 40
State: TX

Vax Date: 04/16/2021
Onset Date: 04/17/2021
Rec V Date: 10/19/2021
Hospital:

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

Lab Data: COVID -12Oct2021.

Allergies: No

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

Symptoms: 12 hours after 2nd dose, I had the worst headache lasing a day and went away. I had my annual physical and I told her about my pain in my calves, mostly the left. She order the doppler and it wasn't covered by the insurance and did not do it. Having COVID now, the headaches started in 11Oct2021. Went to urgent care on 12Oct2021. Only had headache. I had COVID before in Mar2020.

Other Meds: Tylenol

Current Illness: No

ID: 1797719
Sex: F
Age: 64
State: MI

Vax Date: 10/11/2021
Onset Date: 10/13/2021
Rec V Date: 10/19/2021
Hospital:

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

Lab Data: 5 by 3 cm supraclavicular left node node enlargement and tenderness. Lacy generalized pruritic raised linear and annular lesions on left side of face left clavicular region bilateral hips left buttocks and left perineal region

Allergies: None

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

Symptoms: 5 by 3 mm supraclavicular

Other Meds: Ditalizem , Crestor, Claritin, singularity, lexapro, vitamin d , asa,,cozaar

Current Illness: None

ID: 1797720
Sex: F
Age: 34
State: TX

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

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

Lab Data: none

Allergies: All Nuts

Symptom List: Vomiting

Symptoms: INTENSE headache (migraine) starting about 2 hours after injection and lasting 12+ hours. Minor headache continues. Muscle pain and swelling at site of injection about 2 hours after injection and continues

Other Meds: Lisinopril 10 mg

Current Illness: None

ID: 1797721
Sex: F
Age: 80
State: MN

Vax Date: 03/15/2021
Onset Date: 10/15/2021
Rec V Date: 10/19/2021
Hospital: Y

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 was fully vaccinated for COVID (dose 1 = 2/22/21, dose 2 = 3/15/21), but was hospitalized on 10/15/21 with COVID and is in acute resp. failure.

Other Meds:

Current Illness:

ID: 1797722
Sex: F
Age: 59
State: IL

Vax Date: 05/16/2021
Onset Date: 06/01/2021
Rec V Date: 10/19/2021
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: Had annual fasting blood work at this visit results pending.

Allergies: Codeine.

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

Symptoms: Pain in right arm and in both legs started two weeks after second covid vaccine. She also has weak muscle tone in painful extremity . For example her left arm is significantly stronger then her right one . Has been doing Phyiscal Therapy and acupuncture treatments to help with symptoms. Currently on this visit today her right arm pain has resolved but the bilateral leg pain has not. She is limited in her daily functioning due to the pain and cramping in her legs.

Other Meds: vitamin d, vitamin c, Magnesium, Aleve, lotrisone cream, Fish oil.

Current Illness: None.

ID: 1797723
Sex: F
Age: 33
State: WI

Vax Date: 10/06/2021
Onset Date: 10/13/2021
Rec V Date: 10/19/2021
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: N/A Clinic Appointment scheduled for 11/1

Allergies: None

Symptom List: Injection site swelling, Limb discomfort

Symptoms: I received the 2nd dose on 10/6/21. On 10/13/21 I developed pain in my left ear. I thought I was getting an ear infection. By 10/15/21, my left eye had drooped and the pain was a feeling of "pins and needles." This presentation was similar to my diagnosis of bells palsy with associated neuropathy in 2017. My face had recovered from the episode in 2017 but it seems I am back to looking like a stroke victim at 33!

Other Meds: Metformin, Amlodipine, Synthroid, and Effexor

Current Illness: None

ID: 1797724
Sex: F
Age: 72
State: SC

Vax Date: 10/02/2021
Onset Date: 10/02/2021
Rec V Date: 10/19/2021
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: Chills, Diarrhoea, Fatigue, Feeling abnormal, Headache

Symptoms: Has not been able to reach patient by phone number given

Other Meds:

Current Illness:

ID: 1797725
Sex: F
Age: 36
State: OH

Vax Date: 04/16/2021
Onset Date: 07/04/2021
Rec V Date: 10/19/2021
Hospital:

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

Lab Data: Covid test positive 07/06/2021 Chest X Ray 07/06/2021 blood work showed low potassium follow up CT was done in August showing 2 calcified nodes in my lungs

Allergies: none

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

Symptoms: I felt like I was having allergies like hay fever, I had a little scratchy throat, runny nose and later that evening I started coughing I could not catch my breath, so the next day I went to a clinic and had a rapid test. At that point they gave me a decongestant and an albuterol inhaler. On July 6th, I started having chest pains and went to ER. WE found out the albuterol was causing chest pain and causing my heart rate spike into 160. They did find from nodes in my lungs and they are monitoring. By Friday I felt better. I did lose my taste and smell on Friday when I started to feel better, I still have some fatigue.

Other Meds: birth control Incissa

Current Illness: none

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am