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: 1798048
Sex: M
Age: 43
State: NY

Vax Date: 05/06/2021
Onset Date: 05/07/2021
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: NA

Symptom List: Dysphagia, Epiglottitis

Symptoms: My normal body temp is 97.5. The first 2 days after the first shot I had a fever of 103.1 with entire body ache and extreme fatigue. The 3rd and 4th day still fever of 101 with continued fatigue and body ache which kept me bed ridden. The 5th day after 1st shot, fever of 100. For the 6th day and on temp was back to 97 but the continued fatigue lasted another week or so

Other Meds: Gabapentin

Current Illness: NA

ID: 1798049
Sex: F
Age: 29
State:

Vax Date: 03/24/2021
Onset Date: 10/17/2021
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:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: tested positive for covid after receiving vaccine

Other Meds:

Current Illness:

ID: 1798050
Sex: M
Age: 23
State: CA

Vax Date: 04/18/2021
Onset Date: 09/24/2021
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: Neomycin

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

Symptoms: Chest pain due to pericarditis as a result of COVID-19 infection. Resolved after every 8 hours for 3 weeks.

Other Meds: None

Current Illness: None

ID: 1798051
Sex: F
Age: 78
State: AZ

Vax Date: 10/15/2021
Onset Date: 10/18/2021
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:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Headache on Saturday and Sunday, Light headed, chills on Monday

Other Meds:

Current Illness:

ID: 1798052
Sex: F
Age: 25
State: OH

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

Lab Data: None

Allergies: None

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

Symptoms: 0.5ml was injected instead of 0.3ml. Attempted to contact patient via telephone and e-mail on 10/18/21 without response.

Other Meds: Unknown

Current Illness: Unknown

ID: 1798053
Sex: M
Age: 43
State: WA

Vax Date: 08/19/2021
Onset Date: 09/10/2021
Rec V Date: 10/19/2021
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: no

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

Symptoms: Chronic headache for over 5 weeks post vaccine (2/10 to 4/10 px 50% of waking hours.)

Other Meds: no

Current Illness: no

ID: 1798054
Sex: F
Age: 65
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:

Allergies: None

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Large swelling under arm Fever

Other Meds: Rouvastatin Levothyrorin Venafaxline

Current Illness: None

ID: 1798055
Sex: M
Age: 49
State: KY

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:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data: none

Allergies: ACE Inhibitors

Symptom List: Pharyngeal swelling

Symptoms: dosage was given from a vial that expired the previous day, patient was monitored with no adverse effects

Other Meds: hctz, prilosec, amlodipine, pepcid, phenergan, zofran, januvia

Current Illness: none

ID: 1798056
Sex: M
Age: 81
State: MI

Vax Date: 03/23/2021
Onset Date: 10/18/2021
Rec V Date: 10/19/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Patient came in with lack of energy chronic shortness of breath

Other Meds:

Current Illness:

ID: 1798057
Sex: M
Age: 78
State: IL

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

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

Lab Data: ECG, CT, MRI June 8. ECG, CT, MRI June 28, echocardiogram June 29

Allergies: none

Symptom List: Diarrhoea, Nasal congestion

Symptoms: change in heart rate from 65 over 10 years to 45 6 days after vaccine - no change 6 mo later Stroke on June 7 and another on June 28

Other Meds: metoprolol, atorvastatin, tamsulozin, 81 mg aspirin, AREDS formula eye vitamins, senior multi-vitamin

Current Illness: A-fib

ID: 1798059
Sex: F
Age: 54
State: MS

Vax Date: 08/14/2021
Onset Date: 08/23/2021
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: blood tests and ultrasound and manual examination

Allergies: none

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

Symptoms: Sore throat to swallow surrounding esophagus approximately August 23rd, about three weeks after the first vaccine. Mild flu-like symptoms in the evenings at the onset of sore throat. After a visit to my primary physician, an ultrasound showed multiple nodes on my thyroid gland, and was prescribed four days of prednisone to "calm it down". Felt good for about 6 days and then the soreness returned in my throat/neck area. I was referred to an endocrinologist to have a closer look at the largest node of 1.6 cm. I was unable to see the endocrinologist until October 12th. I was scheduled to take my second shot on September 11, 2021, and I took it on September 12, 2021. I have typical second covid-19 vaccine symptoms that lasted only about 12 hours. However, the days following my throat became more and more tender, sore and at times throbbed. I began to have evening flu-like symptoms to the point of taking medication to mitigate fever, aches, and chills. I began researching thyroid symptoms from the website and felt that maybe I was suffering from Subacute Thyroiditis. The treatment was high doses of aspirin or ibuprofen. On October 4th I began taking 600 mg of ibuprofen each day at 1:00 p.m. I discontinued this Sunday, October 10, 2021, and was surprised that my symptoms did not return. I saw the endocrinologist on October 12th, where I underwent blood testing and ultrasound to determine what might be going on. The endocrinologist confirmed that I indeed had Subacute Thyroiditis. Due to the fact that I have no family history and no previous history of thyroid issues, he diagnosis was that it was related to me taking the covid-19 vaccine.

Other Meds: Vitamin D, multi-vitamin and low dose aspirin

Current Illness: fluid on ears

ID: 1798060
Sex: F
Age: 70
State: MN

Vax Date: 03/31/2021
Onset Date: 10/02/2021
Rec V Date: 10/19/2021
Hospital: Y

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

Lab Data: POSITIVE COVID TEST 10/4/2021

Allergies: Cortisone Animal Dander (Nic) Diltiazem Metal (Nic) Mold (Nic) Statins-Hmg-Coa Reductase Inhibitors Iodinated Contrast Media

Symptom List: Rash, Urticaria

Symptoms: COUGH, WEAKNESS, BODY ACHES, DIARRHEA, SHORTNESS OF BREATH, MILD CHEST DISCOMFORT

Other Meds: acetaminophen (TYLENOL ARTHRITIS PAIN) 650 mg oral TbSR aspirin 81 mg Oral TbEC atorvastatin (LIPITOR) 20 mg oral tablet carvedilol (COREG) 12.5 mg oral tablet Cholecalciferol, Vitamin D3, (VITAMIN D3) 2,000 unit O

Current Illness:

ID: 1798061
Sex: F
Age: 82
State: AR

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

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

Lab Data:

Allergies:

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

Symptoms: Admission: 10/11/2021: pt arrives via EMS after falling from ground level. Pt is not oriented to time. pt does not remember the event TB# B886127; Patient is noted to be mildly hypoxic on pulse ox in the emergency room. And also EMS reported that she had a temperature of a 101?. She has not been febrile in the emergency room. The patient's daughter reports having COVID approximately 6 weeks ago. She was diagnosed on 08/30/2021. The patient herself had an initial to vaccinations in January in February this year and the daughter reports that she had a booster approximately 1 week ago. The patient has not really had any cough. She may have had some mild shortness of breath. No diarrhea reported. On blood gas in the emergency room the patient has a PO2 of 55. The patient also has a history of COPD and according to the daughter has been out of her Breo Ellipta for approximately 2 weeks. Patient is not normally on oxygen at home. Chest x-ray in the emergency room tonight does not look particularly bad. It actually appears unchanged from her previous chest x-rays. I have been asked to admit the patient due to her COVID positivity and mild hypoxia. The daughter does report that the patient has had a mild cough which she thinks has been present for a couple of weeks. Pt discharged on 10/15/2021: She was diagnosed with COVID-19. She was initially started on dexamethasone. Couple of days into her hospital course, she was encephalopathic and her steroid was stopped in case it was contributing to her confusion. Regarding her hypoxia, she required anywhere from room air to 2 L of oxygen. Regarding her weakness and falls, she was evaluated by Physical Therapy, it was recommended to go to rehab. Arrangements were made for her to go to her local clinic. Her magnesium was low and was replaced. It will need to be monitored as an outpatient. She is on a proton pump inhibitor. She did have 1 out of 2 positive blood cultures that was a contaminant. Regarding her acute metabolic encephalopathy, this resolved with stopping her dexamethasone. By October 15, she was accepted to another facility.

Other Meds:

Current Illness:

ID: 1798063
Sex: M
Age: 20
State: GA

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

Allergies: No known allergies.

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

Symptoms: He states his arm hurt some on 10/15 and 10/16 after getting his first Covid shot but the pain became worse on Sunday, 10/17. States he has not been able to work this week due to the pain and not being able to move his arm like usual. Reports swelling at injection site.

Other Meds:

Current Illness: None

ID: 1798064
Sex: F
Age: 81
State: MI

Vax Date: 04/08/2021
Onset Date: 10/16/2021
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: SARS-COV-2 by NAA, micro detected SARS on 10/16/21.

Allergies: Ultram, coedine, motrin, tape.

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

Symptoms: Pt received COVID Pfizer vaccines on 04/08/21 and 04/29/21. Pt presented to the ED on 10/16/21 with complaints of difficulty breathing, and AMS. Pt was found to be COVID positive.

Other Meds: Lipitor, Vitamin D, Aricept, Cozaar, Namenda, Toprol, Coumadin.

Current Illness:

ID: 1798065
Sex: F
Age: 27
State: CA

Vax Date: 10/06/2021
Onset Date: 10/09/2021
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: Office visit

Allergies: NKA

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

Symptoms: Patient developed fever and malaise for four days followed by development of persistent fatigue and positional vertigo.

Other Meds: B12, folic acid

Current Illness: None

ID: 1798066
Sex: F
Age: 66
State: AZ

Vax Date: 08/30/2021
Onset Date: 08/30/2021
Rec V Date: 10/19/2021
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: Compazine

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

Symptoms: I now have a vertigo type dizziness, when I lay horizontal. The room spins and I've become a fall ridk.

Other Meds: Diltiazem, compazine, triamterene, gabapintin

Current Illness: None

ID: 1798067
Sex: F
Age: 61
State: WA

Vax Date: 04/14/2021
Onset Date: 09/15/2021
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: no

Allergies: Medication allergies: Penicillin; sulfa; Propoxyphene; Fentanyl; Oxycodone; Eurproprion; Meperidine; Omeprazole; Hydrocodone; Sulindac; Diclofenac; Pantoprazole; Iodine; Metrizamide; Sulfasalazine; Hydromorphone Grasses NutraSweet

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Vertigo - Started about Sept 15. Feeling like I'm spinning and unstable on my feet. I went to a doctor (mine was on maternity leave) at clinic. I am going to ENT on Thursday who may order testing. The vertigo happens every day. I have been taking Meclizine and Lorazepam and I have been doing physical maneuvers: Eppley manuever and another one Semount Manuever; those are helping occasionally.

Other Meds: Escitalopram Oxalate - 50 mg a day; Lorazepam - 1 mg a day; Gabapentin - 400 mg; Asmanax inhaler; Albuterol inhaler - as needed; Azelastine 137 mcg - 2 - twice a day; Flonase - two puffs twice a day; Flax seed supplement; Turmeric; Vit D

Current Illness: no

ID: 1798068
Sex: M
Age: 34
State: OH

Vax Date: 10/15/2021
Onset Date: 10/15/2021
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: None

Allergies: None

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: 0.5ml was injected instead of 0.3ml. Attempted to contact patient via telephone and e-mail on 10/18/21 without response.

Other Meds: Unknown

Current Illness: Unknown

ID: 1798069
Sex: M
Age: 23
State: LA

Vax Date: 10/08/2021
Onset Date: 10/14/2021
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: NONE

Allergies: NKA, NKDA

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

Symptoms: 6 days post vaccination pt reports lymphadenopathy in left auxiliary space that is tender to palpation.

Other Meds: NONE

Current Illness: NONE

ID: 1798070
Sex: F
Age: 49
State: CA

Vax Date: 10/18/2021
Onset Date: 10/19/2021
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: NONE AT THIS TIME

Allergies: na

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

Symptoms: SWELLING TO l COLLAR BONE AREA

Other Meds: lopressor 25mg bid, HCTZ 25mg qd

Current Illness: nA

ID: 1798071
Sex: F
Age: 67
State: SC

Vax Date: 10/17/2021
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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: Vaccine had expired w/ expiration date of 06/30/2021. Patient experienced no reaction or ill effects.

Other Meds:

Current Illness:

ID: 1798072
Sex: F
Age: 61
State: WA

Vax Date: 04/14/2021
Onset Date: 09/15/2021
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: LA

Lab Data: no

Allergies: Medication Allergies:

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

Symptoms: Vertigo - Started about Sept 15. Feeling like I'm spinning and unstable on my feet. I went to a doctor (mine was on maternity leave). I am going to ENT on Thursday who may order testing. The vertigo happens every day. I have been taking Meclizine and Lorazepam and I have been doing physical maneuvers: Eppley manuever and another one Semount Manuever; those are helping occasionally.

Other Meds: Escitalopram Oxalate - 50 mg a day; Lorazepam - 1 mg a day; Gabapentin - 400 mg; Asmanax inhaler; Albuterol inhaler - as needed; Azelastine 137 mcg - 2 - twice a day; Flonase - two puffs twice a day; Flax seed supplement; Turmeric; Vit D

Current Illness: no

ID: 1798074
Sex: F
Age: 36
State: CA

Vax Date: 03/07/2021
Onset Date: 03/07/2021
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: Prescription albuterol with chamber. Prescription for daily use from pick up date.

Allergies: Olanzepine

Symptom List: Injection site pain, Pain

Symptoms: Home oxymeter registration 92 oxygen. Respiratory distress. Extreme fatigue. Unable to stay awake. Severe continuous headache. Short term memory loss. Severe body aches. Leg stremors. Nausea. Confusion.

Other Meds:

Current Illness:

ID: 1798075
Sex: F
Age: 76
State: IL

Vax Date: 04/20/2021
Onset Date: 10/14/2021
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:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: HOSPITALIZED WITH COVID-19 BREAKTHROUGH CASE

Other Meds:

Current Illness:

ID: 1798076
Sex: F
Age: 38
State:

Vax Date: 08/31/2021
Onset Date: 09/06/2021
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:

Allergies: Latex allergies with cross related food allergies

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

Symptoms: Since receiving the vaccine I have had continuous episodes of insomnia and headaches. The headaches are not resolved with OTC products.

Other Meds:

Current Illness:

ID: 1798077
Sex: F
Age: 30
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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Nausea, vomiting, diarrhea, weakness, extreme fatigue

Other Meds:

Current Illness:

ID: 1798078
Sex: F
Age: 41
State: NJ

Vax Date: 09/28/2021
Onset Date: 09/28/2021
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: N/a

Allergies: Amoxicillin

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: I got my covid vaccine on sept 28. I already had a mild headache so it was no surprise when it turned into a migraine. 29th migraine (took a maxalt around 12pm) 30th migraine (took a maxalt at 2am)- gone by mid afternoon October 1st- no headache but tired/ foggy brained (common after long migraine) 2nd- woke up ok! Mid afternoon I got a sharp stabbing pain in the left side of my neck, all the way down my arm and down my back. Lasted the rest of the day, made it hard to sleep 3rd- stiff neck, shoulder, arm, back. No longer stabbing but still really hurt 4th- stiff painful neck and headache on left side of head 5th- headache on left side of head 6th- headache on left side of head 7th- headache on left side of head 8th- headache on left side of head allergy type symptoms 9th-headache on left side of head allergy type symptoms 10th- lots of sinus pressure. 11th- runny nose but no headache 12th- sinus issues are gone. But headache is back. On the RIGHT side of my head. 13th- woke up with a migraine- took a maxalt at 7pm for some relief. Cold sore on bottom lip started this afternoon (noticed it around lunch) 14th- jaw feels stiff. Mild headache. Coldsore 15th - Mild headache and coldsore 16th- FINALLY Woke up feeling Good! For the first time since September 28th.

Other Meds: Garden of Life women?s ?vitamin code ? vitamin Magnesium 200mg

Current Illness: Hormonal Migraines 2x month (one at ovulation and the other at mensuration)

ID: 1798080
Sex: F
Age: 54
State: NY

Vax Date: 04/14/2021
Onset Date: 04/15/2021
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: bone density scan- Osteoporosis, biopsy- Invasive Ductal Carcinoma CBC

Allergies: Penicillin

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

Symptoms: About 12 hrs after the vaccine I developed a excruciating headache, loss of appetite, fever, body aches and extreme fatigue which lasted for about 48 hrs and by the 3rd day I developed diarreah which lasted about 12 hrs. On 6/29 I felt a small lump in my right breast. Reached to my Gynecologist who advised I have a biopsy done. A monography was done and biopsy on 7/1 and 7/7 the results came back that I have Invasive Ductal Carcinoma. I had a bone density scan done d/t the meds taken and that revealed I have bad Osteoporosis. I have to see an Endocrinologist to see if I have any underlying condition that could have resulted in me having Osteoporosis. 7/20 I had a lumpectomy to remove the lump in the breast. 21 days of radiation has been performed on my right breast and now I am currently taking Arimidex, a hormone blocker as part of the treatment for the breast cancer and have to take IV infusions of Zometa for the osteoporosis

Other Meds: Atorvastatin 10mg, paroxetine 10mg, Vit D., Fish Oil

Current Illness: no

ID: 1798081
Sex: F
Age: 46
State: CA

Vax Date: 10/11/2021
Onset Date: 10/14/2021
Rec V Date: 10/19/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Patient reports getting both vaccines in same arm on 10/11/2021. Patient reports needing to go to the hospital on 10/14/2021 due to increased heart rate, chest pain, and difficulty breathing.

Other Meds:

Current Illness:

ID: 1798082
Sex: M
Age: 20
State: NY

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:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: convulsions, sweating, vomiting, confusion, amnesia

Other Meds:

Current Illness:

ID: 1798083
Sex: M
Age: 56
State: NY

Vax Date: 10/06/2021
Onset Date: 10/07/2021
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: none to date

Allergies: latex

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

Symptoms: Recieved vaacine afternoon of 10/6. Awoke 5;30 am on 10/7 with pain and severe intense itching at vaccination site. Notice left side of face felt numb, similar to having dental Novocain type sensation. had numbness from left upper arm, left neck and left side of face. Also associated with left ear fullness. Saw provider later that day as symptoms were persisting. started on steroid. one week later, better but still there. On 10/14 symptoms about 50 percent better. still with numbness to left side of face. hear fullness still there. started having ringing in Left ear. occasional ringing. high pitched. having more frequently during the week. 10/19 ringing increasing, not going way. ,made appointment to see ENT

Other Meds: amlodipine, olmesartan, omeprazole

Current Illness: none

ID: 1798084
Sex: F
Age: 18
State: AL

Vax Date: 08/06/2021
Onset Date: 08/26/2021
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: HCG, PELVIC ULTRASOUND

Allergies: Blueberries

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

Symptoms: DYSMENORRHEA AND PELVIC PAIN NOT ASSOCIATED WITH MENSTRUATION

Other Meds: Levonorgestrel IUD, Zoloft 50mg, Propranolol 10mg, Protonix 40mg, Vitamin D, Naproxen

Current Illness: no

ID: 1798085
Sex: F
Age: 55
State: MO

Vax Date: 04/14/2021
Onset Date: 10/07/2021
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 Test- positive

Allergies: Penicillin

Symptom List: Tremor

Symptoms: I felt like I had a bad head cold. I never really felt sick at all. I just had nasal congestion and sneezing a little bit. I didn't have any fever or body aches. Someone in my family that I was around had tested positive for covid. I went to get tested for covid on 10/7/2021. The results were positive. The next day on 10/8/2021 I got the infusion treatment to help with covid.

Other Meds: Relafen 1000mg 1xday Timolol 0.5mL in each eye 1xday Multivitamin Red Yeast Rice

Current Illness: none

ID: 1798086
Sex: F
Age: 55
State: NC

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

Lab Data:

Allergies: NKA

Symptom List: Erythema, Pruritus

Symptoms: chills, sweats, unbearable headache, nausea rt arm numbness/tingling and rt leg

Other Meds: lisinopril 20 mg daily vitamin d3 1000 unit daily tramadol 50 mg prn diclofenac 75 mg bid

Current Illness: None

ID: 1798087
Sex: F
Age: 63
State: KY

Vax Date: 04/23/2021
Onset Date: 10/06/2021
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:

Allergies:

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

Symptoms: Covid positive contact unknown

Other Meds:

Current Illness:

ID: 1798088
Sex: F
Age: 41
State: CA

Vax Date: 10/01/2021
Onset Date: 10/01/2021
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: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: Systemic: Headache-Medium, Additional Details: Patient made an appt online with her daughter on 10/1/21. Daughter checked in 1st, and recieved vaccine. Afterwards, mother decided to check in for her premade online appt & received vaccine. Patient came into pharmacy on October 16,2021 and states that once the needle was in her muscle she had changed her mind and did not want to recieve the vaccine but it was too late because she had already been injected. Patient now states that she has had a headache and anxious ever since.

Other Meds:

Current Illness:

ID: 1798089
Sex: F
Age: 28
State: MN

Vax Date: 10/04/2021
Onset Date: 10/05/2021
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: Penicillin, doxycycline, and latex.

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Loss of taste that comes and goes. It almost feels like my tongue is numb. It's been 15 days and I still experience partial loss of taste in waves.

Other Meds: Multivitamin, zinc, magnesium, calcium, and omega

Current Illness:

ID: 1798090
Sex: F
Age: 77
State: OH

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

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

Symptoms: I GAVE PATIENT FLUZONE HD INSTEAD OF PFIZER BOOSTER. RECEIVED HER FLUZONE HD A WEEK BEFORE.

Other Meds:

Current Illness:

ID: 1798092
Sex: F
Age: 60
State: CA

Vax Date: 04/14/2021
Onset Date: 08/16/2021
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: Covid-19 test

Allergies: Penicillin

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

Symptoms: I had cough, congestive, and very fatigue. I was in bed for 3 days. I had lost of smell. I had headache and a fever. Some of my symptoms lasted about a month. I contacted my doctor about this. I went to a urgent care to get a Covid-19 test, positive results.

Other Meds: Levothyroxine

Current Illness: N/A

ID: 1798093
Sex: F
Age: 74
State: FL

Vax Date: 08/18/2021
Onset Date: 08/20/2021
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: Allergies: Last Reviewed on 10/19/2021 12:04 PM Cipro: Levaquin: Sulfa (Sulfonamide Antibiotics): Augmentin: Plaquenil: Lexapro: (Adverse Reaction) escitalopram oxalate: diarrhea (Adverse Reaction)

Symptom List: Pain in extremity

Symptoms: pt has a flare up of musculoskeletal symptoms after MOderna shot in 08/2021, since then she is having inflammatory response. d/w pt , she contacted her rheumatologist, increased prednisone to 20 mg daily. Please, report it, Moderna was given, third shot on 08/18/21.

Other Meds: Current Medications: Last Reviewed on 10/19/2021 12:04 PM CeleBREX 200 mg oral capsule [take 1 capsule (200 mg) by oral route once daily] NexIUM 40 mg oral capsule,delayed release (enteric coated) [take 1 capsule (40 mg) by oral route onc

Current Illness:

ID: 1798094
Sex: M
Age: 25
State: IN

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: Systemic: Dizziness / Lightheadness-Severe, Systemic: Fainting / Unresponsive-Severe, Systemic: Seizure-Medium

Other Meds:

Current Illness:

ID: 1798095
Sex: M
Age: 55
State: KY

Vax Date: 01/20/2021
Onset Date: 10/07/2021
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: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: Covid positive contact unknown

Other Meds:

Current Illness:

ID: 1798096
Sex: M
Age: 74
State: IL

Vax Date: 03/24/2021
Onset Date: 10/09/2021
Rec V Date: 10/19/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: ADMITTED TO HOSPITAL WITH DIAGNOSIS OF COVID BREAKTHROUGH CASE

Other Meds:

Current Illness:

ID: 1798097
Sex: M
Age: 70
State: CA

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:

Allergies:

Symptom List: Vomiting

Symptoms: Systemic: pain around collarbone area-Mild, Additional Details: Patient says he felt pain in collarbone area after the vaccine. He said it was mild, but he felt some pain there

Other Meds:

Current Illness:

ID: 1798098
Sex: M
Age: 13
State: TX

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: 037K20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Allergy to certain foods; takes allergy shots

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Patient was given the COVID vaccine instead of the Fluarix vaccine. Patient was told after COVID vaccination was given. Then patient received the Fluarix after patient was spoken too about the wrong initial vaccination was given. No Adverse event after patient was consulted by the pharmacy manager.

Other Meds: none

Current Illness: none

ID: 1798099
Sex: F
Age: 57
State: TX

Vax Date: 10/19/2021
Onset Date: 10/19/2021
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: BP 135/71, HR 78 , EKG

Allergies: N/A

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

Symptoms: 11:29AM - NP notified of pt C/O SOB, chest pain. NP at car assessed pt noted with chest pain that she described as heaviness and SOB denies these symptoms prior to vaccine @ 11:35am. PT given 0'3 of epi to left thigh. EMS on scene PT BP 135/71, HR 78 , EKG NSR on monitor. PT reports history of blood clots, ulcers, strokes, z ta, seizure. TIA (2016 & 2018) taking Keppra, Eliquis daily 7 days. PT reports after 5mins 11:40am of chest pain & SOB subsiding. PT educated about the side affects of epi injection and the importance of being evaluated by the hospital.PT agreed and transported to Hospital by EMS.

Other Meds: Keppra 3000mg Eliquis 10mg

Current Illness: Blood clots,

ID: 1798100
Sex: F
Age: 16
State: NV

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: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Difficulties breathing, chest pain, severe headaches, nausea, fatigue

Other Meds: Venlafaxine 75mg

Current Illness: None

ID: 1798101
Sex: M
Age: 17
State: CA

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: RA

Lab Data:

Allergies:

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

Symptoms: Systemic: Dizziness / Lightheadness-Severe, Systemic: Flushed / Sweating-Severe, Systemic: Weakness-Medium, Additional Details: Paramedics were called in. Patient's mom insists he visits the ER. Patient is conscious throughout, just weak, dizzy, flushed. Color came back to normal after lying down for 5-10 minutes.

Other Meds:

Current Illness:

ID: 1798102
Sex: M
Age: 64
State: KY

Vax Date: 03/31/2021
Onset Date: 10/01/2021
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:

Allergies:

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

Symptoms: Covid positive contact unknown

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am