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: 1801517
Sex: F
Age: 43
State: MN

Vax Date: 03/04/2021
Onset Date: 10/19/2021
Rec V Date: 10/20/2021
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: Tested PCR positive for COVID 10/19/21 after being fully vaccinated.

Other Meds:

Current Illness:

ID: 1801518
Sex: M
Age: 65
State:

Vax Date: 09/30/2021
Onset Date: 09/30/2021
Rec V Date: 10/20/2021
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: Received the vaccine beyond the use date.

Other Meds:

Current Illness:

ID: 1801519
Sex: F
Age: 76
State: UT

Vax Date: 09/23/2021
Onset Date: 09/23/2021
Rec V Date: 10/20/2021
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: Vaccine error - Vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.

Other Meds:

Current Illness:

ID: 1801520
Sex: M
Age: 83
State: MA

Vax Date: 10/11/2021
Onset Date: 10/11/2021
Rec V Date: 10/20/2021
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: Error: Incorrect Reconstitution-

Other Meds:

Current Illness:

Date Died: 10/01/2021

ID: 1801521
Sex: M
Age: 75
State: TX

Vax Date: 02/23/2021
Onset Date: 09/12/2021
Rec V Date: 10/20/2021
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: NKDA

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

Symptoms: Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 1/28/2021 and 2/23/2021. He began to feel unwell on 9/12 and tested COVID+ on 9/14. He began to have progressive dyspnea and fevers at home up to 103 F so he presented on 9/19 to ED. SpO2 was in 70s on RA, failed NRB, and was placed on HFNC. CTA chest negative for PE but notable for extensive GGO and alveolar infiltrates. He was also found to have an AKI and elevated LFTs. He was admitted to HCF due to HCF requirements. He was started on Decadron. Dr was consulted who recommended Remdesivir and okay with continuation of his cellcept. He was determined not to be a candidate for Toci or Baricit a. He was started on empiric abx. Unfortunately, he decompensated requiring intubation. Despite supportive measures, he slowly clinically declined with multisystem organ failure including ARF requiring dialysis. He was compassionately extubated and passed at 1225 10/1/21.

Other Meds: Mycophenolate 500 mg BID, Aspirin 81 mg QD

Current Illness:

Date Died: 10/19/2021

ID: 1801522
Sex: M
Age: 81
State: OH

Vax Date: 10/18/2021
Onset Date: 10/19/2021
Rec V Date: 10/20/2021
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: No known allergies

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

Symptoms: Patient was a Hospice patient with no change in symptoms

Other Meds: AzaSite Solution, hydrochlorothiazide, Lisinopril, Magnesium Oxide, Melatonin, Spironolactone, Toprol XL, Trazodone, Artificial Tears, Seroquel, Ativan, Tylenol

Current Illness: Hospice patient

ID: 1801523
Sex: M
Age: 16
State: UT

Vax Date: 09/23/2021
Onset Date: 09/23/2021
Rec V Date: 10/20/2021
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: Vaccine error - Vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.

Other Meds:

Current Illness:

ID: 1801524
Sex: F
Age: 33
State: IL

Vax Date: 10/07/2021
Onset Date: 10/07/2021
Rec V Date: 10/20/2021
Hospital:

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

Lab Data: CBC-W DIFFERENTIAL, ASSAY CK (CPK), C-REACTIVE PROTEIN (CRP), METABOLIC PANEL,BASIC, CHORIONIC GONADOTROPIN TEST

Allergies: seasonal allergies, allergic to ceclor medication

Symptom List: Pharyngeal swelling

Symptoms: Received booster shot on 10/7 and started feeling lethargic in the evening. I also experienced enlarged lymph nodes in my armpits as with the other two doses. 10/8 I felt generally lethargic all day but I had to work so I pushed through the symptoms. 10/9 I again had to work and was experiencing dizzy spells about mid afternoon. That evening, I went to bed about 9 PM. I woke up 10/10 at 2:30 AM in extreme pain from the lymph nodes. The pain that had originated in my left armpit/breast area had migrated to my right breast. I took advil and went to sleep. Woke up again at 6:30 in horrific pain and my husband drove me to the emergency room. ER took bloodwork and put me on toradol and zofran. ER told me that my pain was typical with the reaction my body was having to the booster. ER prescribed me dilauded and sent me home. Took two pills total through out the day. Spent 10/10 into 10/11 on the toilet with diarrhea and vomiting. I got in to see my PCP on 10/12 and my PCP inspected my breasts as I was still experiencing a lot of pain, redness, swelling in my right breast. My PCP diagnosed me with mastitis and prescribed me antibiotics. The paib, redness, swelling in my right breast has slowly lessened.

Other Meds: Lol Loestrin-FE, daily multivitamin, daily probiotic, daily vitamin D

Current Illness: no

ID: 1801525
Sex: M
Age: 79
State:

Vax Date: 02/19/2021
Onset Date: 10/16/2021
Rec V Date: 10/20/2021
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: Admitted to Hospital on Date of Adverse Event [recorded in VAERS] for treatment of Covid-19 Positive following completion of Covid Vaccine Series

Other Meds:

Current Illness:

ID: 1801526
Sex: F
Age: 84
State: NH

Vax Date: 04/29/2021
Onset Date: 05/13/2021
Rec V Date: 10/20/2021
Hospital:

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

Lab Data: 4 mm punch Biopsy 06/14/2021

Allergies: Narcotics for pain management

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Bullous pemphigoid

Other Meds: Vitamin C: 1000 mg per day Vitamin D3: 5000 mg per day Super B complex: 1 tab daily Omega 3 Fish Oil: 1400 mg daily Atenolol: 25 mg, 1/2 tab per day HCTZ: 1 tab per day

Current Illness: None

ID: 1801527
Sex: F
Age: 65
State: PA

Vax Date: 10/20/2021
Onset Date: 10/20/2021
Rec V Date: 10/20/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: During injection patient jumped and moved, stating that it felt like a nerve was hit. Afterwards said she felt okay.

Other Meds:

Current Illness:

ID: 1801528
Sex: U
Age: 51
State: UT

Vax Date: 09/23/2021
Onset Date: 09/23/2021
Rec V Date: 10/20/2021
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 error - Vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.

Other Meds:

Current Illness:

ID: 1801529
Sex: F
Age: 69
State:

Vax Date: 09/30/2021
Onset Date: 09/30/2021
Rec V Date: 10/20/2021
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: received the vaccine beyond the use date.

Other Meds:

Current Illness:

ID: 1801530
Sex: M
Age: 84
State: MA

Vax Date: 10/11/2021
Onset Date: 10/11/2021
Rec V Date: 10/20/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Error: Incorrect Reconstitution-

Other Meds:

Current Illness:

ID: 1801531
Sex: U
Age: 33
State: UT

Vax Date: 09/23/2021
Onset Date: 09/23/2021
Rec V Date: 10/20/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Vaccine error - Vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.

Other Meds:

Current Illness:

ID: 1801533
Sex: F
Age: 9
State: AR

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

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

Lab Data: na

Allergies: unknown

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

Symptoms: Child received a flu shot on 10/8 at the school flu clinic but had already had a flu vaccine at the health clinic on 10/5. Mom stated child has some fever after the 2nd vaccine but is fine now with no problems.

Other Meds: unknown

Current Illness: unknown

ID: 1801534
Sex: M
Age: 57
State: SC

Vax Date: 08/23/2021
Onset Date: 08/24/2021
Rec V Date: 10/20/2021
Hospital:

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

Lab Data: three doctors visits at doctors office and several visits at medical facility at work.

Allergies: none

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

Symptoms: pain and swelling in upper arm and shoulder area along with severe headaches. since within 24 hours of second shot.

Other Meds: none

Current Illness: none

ID: 1801535
Sex: U
Age: 73
State: UT

Vax Date: 09/23/2021
Onset Date: 09/23/2021
Rec V Date: 10/20/2021
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: Vaccine error - Vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.

Other Meds:

Current Illness:

ID: 1801536
Sex: F
Age: 69
State:

Vax Date: 09/27/2021
Onset Date: 09/29/2021
Rec V Date: 10/20/2021
Hospital: Y

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

Lab Data: Troponin negative x 4. TTE reporting "There is small pericardial effusion which is circumferential, more so anterior than posterior. There is organized material along the anterior visceral pericardium." There were no other significant findings on TTE.

Allergies: hives to cephalexin, nickel, nitrofurantoin, and amlodipine

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: This patient presented to the ED on 10/7/2021 which chest pain. She was found on CTA to have a pericardial effusion and subsequent TTE reported "There is small pericardial effusion which is circumferential, more so anterior than posterior. There is organized material along the anterior visceral pericardium." She did not have EKG changes suggestive of pericarditis other than possible PR depression in one lead. Troponins were negative x 4. In retrospect, she said she began to feel chest discomfort about 2 days after vaccination, but she was taking scheduled naproxen at the time for side effects from the vaccine, then her chest discomfort became more noticeable when she stopped taking naproxen, which was the days she came to the ED. Our cardiologists felt that pericarditis was the most likely diagnosis. Given the temporal association with her 3rd dose of the pfizer vaccine, they felt it was possible that this was the trigger. We did not identify evidence for other causes of pericarditis. She was treated with colchicine and ibuprofen with good response.

Other Meds:

Current Illness:

ID: 1801537
Sex: M
Age: 69
State: KY

Vax Date: 03/20/2021
Onset Date: 03/21/2021
Rec V Date: 10/20/2021
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: Kelfex

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

Symptoms: 12 hours after vaccine around midnight, my symptoms occured and I realized I had the headache and at that point I'm in bed, but waking up the next morning I still had a headache and I had it for the next 48 hours and then it just disappeared. I also had a sore upper arm.

Other Meds: Carvedilol, Crestor, Lisinopril, and Nexium, baby aspirin.

Current Illness: None

ID: 1801538
Sex: M
Age: 85
State: MO

Vax Date: 03/25/2021
Onset Date: 10/09/2021
Rec V Date: 10/20/2021
Hospital: Y

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: UNKNOWN

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

Symptoms: DEVELOPED COUGH, RUNNY NOSE, CONGESTION, HEADACHE, MYALGIAS ON 10/09 TESTED (+) AT AN URGENT CARE ON 10/14 AND THEN ADMITTED TO 10/15 TO HOSPITAL DUE OT LOW OXYGENATION

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1801539
Sex: F
Age: 65
State: VA

Vax Date: 10/20/2021
Onset Date: 10/20/2021
Rec V Date: 10/20/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Unevaluable event

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

Other Meds:

Current Illness:

ID: 1801540
Sex: F
Age: 100
State:

Vax Date: 09/30/2021
Onset Date: 09/30/2021
Rec V Date: 10/20/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Received the vaccine beyond the use date.

Other Meds:

Current Illness:

ID: 1801541
Sex: M
Age: 48
State: UT

Vax Date: 09/23/2021
Onset Date: 09/23/2021
Rec V Date: 10/20/2021
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: Vaccine error - Vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.

Other Meds:

Current Illness:

ID: 1801543
Sex: M
Age: 32
State: ME

Vax Date: 10/20/2021
Onset Date: 10/20/2021
Rec V Date: 10/20/2021
Hospital:

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

Lab Data: N/A

Allergies: penicillin, singulair

Symptom List: Injection site pain, Menorrhagia

Symptoms: Patient was given Pfizer vaccine as dose #2 after he reported receiving Pfizer initially. We later found out he received Moderna as dose #1, about 6mos prior to today's dose #2.

Other Meds: Breo ellipta, albuterol prn

Current Illness: N/A

ID: 1801544
Sex: F
Age: 37
State: UT

Vax Date: 09/23/2021
Onset Date: 09/23/2021
Rec V Date: 10/20/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Vaccine error - Vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.

Other Meds:

Current Illness:

ID: 1801547
Sex: F
Age: 69
State: IL

Vax Date: 10/04/2021
Onset Date: 10/04/2021
Rec V Date: 10/20/2021
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: Site: Bruising at Injection Site-Medium, Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Medium

Other Meds:

Current Illness:

ID: 1801548
Sex: F
Age: 59
State: UT

Vax Date: 09/23/2021
Onset Date: 09/23/2021
Rec V Date: 10/20/2021
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: Vaccine error - Vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.

Other Meds:

Current Illness:

ID: 1801549
Sex: F
Age: 14
State: OH

Vax Date: 09/09/2021
Onset Date: 10/20/2021
Rec V Date: 10/20/2021
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: Pt under 18, moderna vaccine administered on 9/9/21 instead of pfizer. Discovered on 10/20/21 when returning for second dose. Pt guardian reports no adverse side effects at this time.

Other Meds:

Current Illness:

ID: 1801550
Sex: M
Age: 80
State: MN

Vax Date: 10/18/2021
Onset Date: 10/18/2021
Rec V Date: 10/20/2021
Hospital:

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

Lab Data: unknown

Allergies: none known

Symptom List: Nausea

Symptoms: Patient was on a conference call and the other participants noticed some facial drooping. Patient felt better following the call and did not seek care until the following morning (10/19/21). Patient was evaluated by primary care provider and determined that he had experienced a TIA (mini stroke). Patient is currently back at home and will be following up with cardiology and neurology to look at long-term issues/damage.

Other Meds: alfuzosin 10mg; aspirin EC 81mg; carvedilol 6.25mg (1 tablet with breakfast and 2 tablets with dinner); clopidogrel 75mg; Welchol 667 tablets (total daily dose 3750mg); famotidine 40mg tablets (1 tablet twice daily); finasteride 5mg; furose

Current Illness: No specific illnesses at time of vaccination or during the month before

ID: 1801551
Sex: M
Age: 58
State: FL

Vax Date: 09/30/2021
Onset Date: 10/02/2021
Rec V Date: 10/20/2021
Hospital:

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

Lab Data: Visual field test, Retina scan

Allergies: Sulfa

Symptom List: Injection site pain

Symptoms: I had a feeling something was in my left eye with increase pressure. I was treated with drops for my ocular pressures. I have seen the Ophthalmologist four times. I'm having a operation this Friday on my left eye.

Other Meds: Vimpat; lisinopril

Current Illness: No

ID: 1801552
Sex: F
Age: 42
State: UT

Vax Date: 09/23/2021
Onset Date: 09/23/2021
Rec V Date: 10/20/2021
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: Vaccine error - Vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.

Other Meds:

Current Illness:

ID: 1801553
Sex: M
Age: 86
State: OR

Vax Date: 10/05/2021
Onset Date: 10/19/2021
Rec V Date: 10/20/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: woke up last night 10/20/21, very dizzy

Other Meds:

Current Illness:

Date Died: 08/10/2021

ID: 1801554
Sex: M
Age: 66
State:

Vax Date: 03/20/2021
Onset Date: 07/19/2021
Rec V Date: 10/20/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: admitted to hospital with acute encephalopathy, COVID positive; placed on a nonrebreather; pt was a DNR/DNI; condition declined with AKI; comfort care received; pt worsened and died in the hospital

Other Meds:

Current Illness:

ID: 1801555
Sex: F
Age: 33
State: UT

Vax Date: 09/24/2021
Onset Date: 09/24/2021
Rec V Date: 10/20/2021
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: Erythema, Pruritus

Symptoms: Vaccine error - Vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.

Other Meds:

Current Illness:

ID: 1801556
Sex: F
Age: 40
State: NV

Vax Date: 07/26/2021
Onset Date: 10/18/2021
Rec V Date: 10/20/2021
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: I saw a doctor on 10/18/2021.

Allergies: N/A.

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

Symptoms: I received the second dose on July 26, 2021. I developed hives on 10/18/2021. I saw a doctor and was prescribed steroid medication.

Other Meds: N/A.

Current Illness: N/A.

ID: 1801558
Sex: F
Age: 70
State: TN

Vax Date: 01/27/2021
Onset Date: 10/15/2021
Rec V Date: 10/20/2021
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: Positive COVID-19 test

Allergies: Sausage, sulfa, lisinopril, paroxetine, risedronic acid, apple

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

Symptoms: Patient hospitalized with COVID-19 after being vaccinated.

Other Meds: diphenhydramine, fexofenadine, ferrous sulfate, isosorbide mononitrate, aspirin, sertraline, sumatriptan, topiramate, furosemide, glipizide, insulin glargine

Current Illness: unknown

ID: 1801559
Sex: F
Age: 39
State: UT

Vax Date: 09/24/2021
Onset Date: 09/24/2021
Rec V Date: 10/20/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Vaccine error - Vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.

Other Meds:

Current Illness:

ID: 1801560
Sex: F
Age: 33
State: MO

Vax Date: 10/12/2021
Onset Date: 10/12/2021
Rec V Date: 10/20/2021
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: no known allergies per intake sheet

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

Symptoms: Patient reported a scratchy throat with both doses of vaccine. Patient disclosed this at the time of her 2nd dose. Reaction occurred within approximately one to two minutes of receiving her dose. She said she was having no difficulty in breathing and that she felt "normal" other than a scratchy throat. Patient was offered Benadryl and declined. Patient was given a cetirizine tablet and a cup of water and said she was feeling better within about 10 minutes. She was also monitored for an extended time period.

Other Meds: unknown

Current Illness: Unknown

ID: 1801561
Sex: M
Age: 31
State:

Vax Date: 10/14/2021
Onset Date: 10/14/2021
Rec V Date: 10/20/2021
Hospital:

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

Lab Data:

Allergies: None per client

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

Symptoms: client was siting in the monitoring section and stated he felt fine and then as monitor walked away he fell taking the chair with him. He came around and asked in a strong regular voice what happen. BP 120/72. Placed on back with legs raised. EMS came assess felt his head and gave in instructions for a headache and if had blurred vision and other signs to go to the urgent or ED for evaluation for concussion. Client had decline going to the hospital.

Other Meds: None per client

Current Illness:

ID: 1801562
Sex: M
Age: 32
State: CA

Vax Date: 10/12/2021
Onset Date: 10/13/2021
Rec V Date: 10/20/2021
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: Systemic: Chest Tightness / Heaviness / Pain-Medium, Systemic: shortness of breath not allergy related-Medium

Other Meds:

Current Illness:

ID: 1801563
Sex: F
Age: 47
State: OH

Vax Date: 04/19/2021
Onset Date: 08/01/2021
Rec V Date: 10/20/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 2
Vax Route:
Vax Site:

Lab Data: full blood work panel 09/15/2021- all normal

Allergies: Vicodin Levaquin codeine

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

Symptoms: Since August 2021, all day and all night I smell cigarette smoke. I literally chokes me and burns my eyes. It is constant. There are very few times I don't smell it. I went to my primary doctor and chiropractor and neither of them knew what to do. They believe it could be because I had covid back in 2019 or related to the vaccine. I have received no treatment for it. They said there's nothing they can do. I have tried a number of home remedies and nothing works.

Other Meds: Zoloft- 25mg once daily clonazepam - 1mg once daily vitamin c-1000 mg once daily various vitamins

Current Illness: none

ID: 1801564
Sex: M
Age: 74
State: UT

Vax Date: 09/24/2021
Onset Date: 09/24/2021
Rec V Date: 10/20/2021
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: Vaccine error - Vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.

Other Meds:

Current Illness:

ID: 1801565
Sex: F
Age: 72
State: UT

Vax Date: 09/24/2021
Onset Date: 09/24/2021
Rec V Date: 10/20/2021
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: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: Vaccine error - Vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.

Other Meds:

Current Illness:

ID: 1801566
Sex: F
Age: 30
State: GA

Vax Date: 10/20/2021
Onset Date: 10/20/2021
Rec V Date: 10/20/2021
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: no

Symptom List: Vomiting

Symptoms: patient passed out 1 minute after injection and then regained concussion

Other Meds: unknown

Current Illness: no

ID: 1801567
Sex: M
Age: 72
State: UT

Vax Date: 09/24/2021
Onset Date: 09/24/2021
Rec V Date: 10/20/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Vaccine error - Vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.

Other Meds:

Current Illness:

ID: 1801568
Sex: M
Age: 21
State:

Vax Date: 09/30/2021
Onset Date: 09/30/2021
Rec V Date: 10/20/2021
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: received the vaccine beyond the use date.

Other Meds:

Current Illness:

ID: 1801569
Sex: F
Age: 14
State: OH

Vax Date: 10/20/2021
Onset Date:
Rec V Date: 10/20/2021
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:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Given FluBlok when should have received Fluzone per age

Other Meds:

Current Illness:

ID: 1801570
Sex: F
Age: 55
State: UT

Vax Date: 09/24/2021
Onset Date: 09/24/2021
Rec V Date: 10/20/2021
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: Vaccine error - Vaccine was administered past its beyond use date. The vaccine had been stored in the freezer beyond the time frame recommended by the manufacturer.

Other Meds:

Current Illness:

ID: 1801571
Sex: F
Age: 16
State: OH

Vax Date: 09/09/2021
Onset Date: 10/20/2021
Rec V Date: 10/20/2021
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: Pt under 18, moderna vaccine administered on 9/9/21 instead of pfizer. Discovered on 10/20/21 when returning for second dose. Pt guardian reports no adverse side effects at this time.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am