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: 1804436
Sex: F
Age: 54
State: WA

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

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

Lab Data: Ekg

Allergies: Sulfa zine family

Symptom List: Dysphagia, Epiglottitis

Symptoms: Racing heart shortening breath chest pain arm pain headache

Other Meds:

Current Illness:

ID: 1804437
Sex: M
Age: 31
State: NC

Vax Date: 09/16/2021
Onset Date: 09/16/2021
Rec V Date: 10/21/2021
Hospital:

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

Lab Data: None

Allergies: None

Symptom List: Anxiety, Dyspnoea

Symptoms: After receiving the vaccine there was very little change to my normal health and bodily functions. I noticed late that night that I began having low libido. No ED noticed. However I did experience premature ejaculation. PE and low libido have continue after receiving the vaccine despite no other changes in health, diet or lifestyle.

Other Meds: None

Current Illness: None

ID: 1804439
Sex: M
Age: 93
State:

Vax Date: 03/25/2021
Onset Date: 10/15/2021
Rec V Date: 10/21/2021
Hospital: Y

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: 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: 1804440
Sex: F
Age: 14
State: MO

Vax Date: 09/11/2021
Onset Date: 09/11/2021
Rec V Date: 10/21/2021
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: Patient was under the age of 18 at time of vaccination. No adverse results were reported by patient.

Other Meds: Novolog Flexpen, Lantus Solostar, Glucagon Kit, BD Swabbs, Loratadine 10mg, Atenolol 25mg, Clonidine 0.2mg, Naproxen 500mg,

Current Illness:

ID: 1804441
Sex: M
Age: 78
State: NJ

Vax Date: 10/18/2021
Onset Date: 10/18/2021
Rec V Date: 10/21/2021
Hospital: Y

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

Lab Data: he is under hospital care

Allergies:

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

Symptoms: He is unable to move his legs and has memory loss - currently in the hospital

Other Meds: Dialysis patient

Current Illness: Dialysis patient Diabetes

ID: 1804442
Sex: M
Age: 73
State: CT

Vax Date: 10/08/2021
Onset Date: 10/08/2021
Rec V Date: 10/21/2021
Hospital:

Vax Type: FLUC4
Manufacturer: SEQIRUS, INC.
Vax Name: INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT)
Lot: 276563
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

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

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

Other Meds:

Current Illness:

ID: 1804443
Sex: F
Age: 74
State: NH

Vax Date: 10/21/2021
Onset Date: 10/21/2021
Rec V Date: 10/21/2021
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, Iodine and "mild egg"

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Dose administered at 10:38. Patient observed due to past Shingrix Vaccine adverse reaction. Patient sat for 10 to 12 mnutes, then patient presented to counter and stated she felt nauseous and hot at 10:50. I had my tech call for assistance team and got the patient an ice pack. Assistance team arrived, took her blood pressure. She then felt fine. Team left, she stayed for about 10 minutes more, felt fine and left. I followed up via phone call at 12:05 and she was out walking with her husband and felt fine.

Other Meds: None known

Current Illness: None known

ID: 1804444
Sex: F
Age: 23
State: NE

Vax Date: 08/20/2021
Onset Date: 08/20/2021
Rec V Date: 10/21/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Per ER note from hospital on 8-20-21, patient had uncontrollable shaking, nausea, and headache following injection.

Other Meds:

Current Illness:

Date Died: 09/13/2021

ID: 1804445
Sex: M
Age: 66
State:

Vax Date: 07/02/2021
Onset Date: 09/08/2021
Rec V Date: 10/21/2021
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: per pt he was diagnosed COVID positive 3 wks prior to coming to the hospital; saw PCP and was sent to ED for dyspnea and cough not improving ;diagnosed with acute on chronic hypoxic respiratory failure due to pneumonia; hx of COPD; required BiPAP; DNR/DNI; pt's condition worsened and he died in the hospital

Other Meds:

Current Illness:

ID: 1804447
Sex: M
Age: 70
State: WA

Vax Date: 03/03/2021
Onset Date: 04/05/2021
Rec V Date: 10/21/2021
Hospital:

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

Lab Data: 8/13/2021 X-ray of heart No acute thoracic abnormality. 8/20/2021 Holter monitor 48 hours see above

Allergies: None

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Do not know if this was related to the vaccine. A few weeks after shot noticed palpitations, recorded slow heart rate several times while resting. Halter monitor results: The baseline rhythm was sinus rhythm . The minimum heart rate was 42 bpm, the average heart rate was 75 bpm, and the maximum heart rate was 127 bpm. There were occasional premature ventricular beats, as well as very rare premature atrial beats, very rare ventricular couplets, and very rare up to 6 beat nonsustained runs of ventricular tachycardia . No patient diary was returned with the report to correlate with symptoms. No sustained arrhythmias or pauses were seen. Treatment One 25 mg metoprolol per day, ordered echo on 10/28/2021 with follow up with Dr.

Other Meds: Tylenol 3, hydrocodone 5-325, (No more than 1 per day )gabapentin 300mg once per day, daily vitamin, baby asprin

Current Illness: None

ID: 1804448
Sex: M
Age: 37
State: MI

Vax Date: 09/28/2021
Onset Date: 09/28/2021
Rec V Date: 10/21/2021
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: Patient presented to clinic with a single dose Moderna on their card, requesting a second dose. A dose was given, which was later discovered to be a third dose

Other Meds:

Current Illness:

ID: 1804449
Sex: F
Age: 63
State: NY

Vax Date: 10/21/2021
Onset Date: 10/21/2021
Rec V Date: 10/21/2021
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: Error: Booster Given Too Early-

Other Meds:

Current Illness:

ID: 1804450
Sex: F
Age: 50
State: FL

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

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

Lab Data: Visual confirmation of shingles blisters and pain from Dr.

Allergies: none

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

Symptoms: A couple of days after my third Moderna vaccine I developed a painful area and tingling on my skin on my left lower stomach area and left lower and mid back area. I then developed red spots that became very itchy and painful. By Friday October 15 tiny blisters appeared. I sent photos to my doctor on Saturday and on Sunday he called in a 7 day course of antivirals called Valacyclovir, 1000 mg 3 times day.

Other Meds: vitamin d, c

Current Illness: none

ID: 1804451
Sex: F
Age: 76
State: VA

Vax Date: 02/26/2021
Onset Date: 03/12/2021
Rec V Date: 10/21/2021
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: CT (chest),Xray (knees, hip, spine) Blood work, EKG, CT (thoracic lumbar)

Allergies: Bactrim

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

Symptoms: For 5 months I have experienced pain in left hip, left knee and left spine. I take control substance for arthritis the pain has been a incredible flare. I have been to lots of doctors Orthopedic (knees, hips), Spine Orthopedic(back) and referred to physical therapy. I have had 22 sessions of physical therapy. Im exp hard time sleeping. I developed pneumonia for 2 weeks given antibiotic not sure if any of this is related this is only thing changed getting the vaccine.

Other Meds: Latace, Metoprolol, Eliquis, Flecainide Acetate, Tylenol Arthritis, Tylenol 3, Levocetirizine, Calcium plus Vit D, Vit, Dulcolax

Current Illness: No

ID: 1804452
Sex: F
Age: 20
State:

Vax Date: 09/19/2021
Onset Date: 09/19/2021
Rec V Date: 10/21/2021
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: Patient received Pfizer COVID vaccine on 9/19/2021 as documented in this report. After patient was vaccinated- patient reported being fully vaccinated with Sinopharm on 5/13/2021 and 6/3/2021.

Other Meds:

Current Illness:

ID: 1804453
Sex: M
Age: 72
State: MA

Vax Date: 03/30/2021
Onset Date: 09/25/2021
Rec V Date: 10/21/2021
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: 9/25/21 AND 9/27/21 - covid POSITIVE pcr.

Allergies: Egg, contrast media, shellfish

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

Symptoms: Patient presents, hx of cardiomyopathy, squamous cell carcinoma- not currently being treeated-- COVID positive dx Tuesday c/o with body aches, SOB, denies fevers/chills. Patient was treated with antiviral yesterday. Patient denies CP.

Other Meds: albuterol, allopurinol, vitamin C, aspirin, finasteride, flonase, adviar, synthroid, claritin, metoprolol, MVI, omeprazole

Current Illness: unknown,

ID: 1804454
Sex: F
Age: 34
State: DC

Vax Date: 10/14/2021
Onset Date: 10/14/2021
Rec V Date: 10/21/2021
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:

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

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

Other Meds:

Current Illness:

ID: 1804455
Sex: F
Age: 37
State: MN

Vax Date: 05/28/2021
Onset Date: 10/20/2021
Rec V Date: 10/21/2021
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: Tested positive for COVID 10/20/21 after being fully vaccinated.

Other Meds:

Current Illness:

ID: 1804456
Sex: F
Age: 62
State: GA

Vax Date: 09/02/2021
Onset Date: 09/02/2021
Rec V Date: 10/21/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Unknown

Other Meds:

Current Illness:

ID: 1804457
Sex: M
Age: 65
State:

Vax Date: 04/05/2021
Onset Date: 10/16/2021
Rec V Date: 10/21/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: 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: 1804458
Sex: M
Age: 41
State: MI

Vax Date: 10/15/2021
Onset Date: 10/18/2021
Rec V Date: 10/21/2021
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: elevated CRP

Allergies:

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

Symptoms: Onset of constant sharp chest pain 3.5 days after vaccine.

Other Meds: none

Current Illness: none

ID: 1804460
Sex: M
Age: 49
State: TX

Vax Date: 10/12/2021
Onset Date: 10/15/2021
Rec V Date: 10/21/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Unevaluable event

Symptoms: Excessive joint pain in fingers, toes, and lower back. Preventing sleep and limiting physical activity.

Other Meds: None

Current Illness: None

ID: 1804461
Sex: U
Age: 14
State: NY

Vax Date: 06/06/2021
Onset Date: 06/06/2021
Rec V Date: 10/21/2021
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: Site: Bruising at Injection Site-Mild, Site: Itching at Injection Site-Mild, Site: Pain at Injection Site-Mild, Site: Redness at Injection Site-Mild, Systemic: Allergic: Anaphylaxis-Mild, Systemic: Allergic: Difficulty Breathing-Mild, Systemic: Allergic: Difficulty Swallowing, Throat Tightness-Mild, Systemic: Allergic: Itch (specify: facial area, extremeties)-Mild, Systemic: Allergic: Itch Generalized-Mild, Systemic: Allergic: Rash (specify: facial area, extremeties)-Mild, Systemic: Allergic: Rash Generalized-Mild, Systemic: Allergic: Swelling of Face / Eyes / Mouth / Tongue-Mild, Systemic: Abdominal Pain-Mild, Systemic: Autoimmune Disease (diagnosed by MD)-Mild, Systemic: Bell's Palsy-Mild, Systemic: Blood Disorder (diagnosed by MD)-Mild, Systemic: Body Aches Generalized-Mild, Systemic: Cardiac Disorder (diagnosed by MD)-Mild, Systemic: Chest Tightness / Heaviness / Pain-Mild, Systemic: Chills-Mild, Systemic: Confusion-Mild, Systemic: Diarrhea-Mild, Systemic: Dizziness / Lightheadness-Mild, Systemic: Exhaustion / Lethargy-Mild, Systemic: Fainting / Unresponsive-Mild, Systemic: Fever-Mild, Systemic: PREVIOUS EVENT EFFECTING LOT-Mild, Systemic: Flushed / Sweating-Mild, Systemic: Headache-Mild, Systemic: Heart Attack-Mild, Systemic: Hypertension-Mild, Systemic: Hyperventilation-Mild, Systemic: Hypotension-Mild, Systemic: Joint Pain-Mild, Systemic: Lymph Node Swelling-Mild, Systemic: MIS (Multisystem Inflammatory Syndrome)(diagnosed by MD)-Mild, Systemic: Nausea-Mild, Systemic: Neurological Disorder (diagnosed by MD)-Mild, Systemic: Numbness (specify: facial area, extremities)-Mild, Systemic: Seizure-Mild, Systemic: Shakiness-Mild, Systemic: Stroke-Mild, Systemic: Tachycardia-Mild, Systemic: Tingling (specify: facial area, extemities)-Mild, Systemic: Tinnitus-Mild, Systemic: Unable to Sleep-Mild, Systemic: Visual Changes/Disturbances-Mild, Systemic: Vomiting-Mild, Systemic: Weakness-Mild, Additional Details: PEARL RIVER RX HAS NOTIFIED EACH PATIENT INDIVIDUALLY AND WE ATTEST WE HAVE FOLLOWED THE COMPANY DIRECTION FOR PATIENT NOTIFICATION

Other Meds:

Current Illness:

ID: 1804462
Sex: F
Age: 48
State: CA

Vax Date: 04/17/2021
Onset Date: 10/02/2021
Rec V Date: 10/21/2021
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: none

Symptom List: Injection site pain, Pain

Symptoms: This is some time later - obviously - since this Vaccine is new I wanted you to know about possible symptoms that may or may not be related, but after speaking with multiple people thought you should know or look into it. I have had odd neuropathy symptoms and pulsing and throbbing in my entire body, including my feet and knees, that eventually moved to my chest. At first I thought i injured myself running, but symptoms began to move on both sides of my body. Its hard to put pressure on my feet. I saw my cardiologist who took me off my BP medicine as this could be a symptom from the med, but I am still experiencing symptoms. After volunteering at an event I spoke with 2 other women who also had the Moderna shot and were experiencing similar symptoms. I continuously feel like I am getting sick, and like I am getting the chills. I am exhausted and sleeping all the time. Its very interesting that 2 other people had the same symptoms with no other previous issues. My cardiologist referred me to a rheumatologist and so did the other gals I spoke with.

Other Meds: Spironolactone, bystolic

Current Illness: none

ID: 1804463
Sex: F
Age: 20
State: CA

Vax Date: 07/11/2021
Onset Date: 07/11/2021
Rec V Date: 10/21/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Ever since I got the the vaccine, my hair has been falling out a lot.

Other Meds:

Current Illness:

ID: 1804464
Sex: M
Age: 35
State: AR

Vax Date: 10/05/2021
Onset Date: 10/07/2021
Rec V Date: 10/21/2021
Hospital:

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

Lab Data: Bloodwork taken but results not yet ready

Allergies: None Known

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

Symptoms: 48 hours post second vaccine symptoms included: fever 48 hours up to 7 days post vaccine symptoms included: leg stiffness behind knee including pain and difficulty walking, pain in back between shoulder blades, joint stiffness in hands. 9 days post vaccine saw Rheumatologist who started patient on Prednisone to knock out arthritis flare

Other Meds: Embrel Sureclick 50mg Daily Vitamin Aleve Benadryl Zyrtec

Current Illness: None

ID: 1804465
Sex: M
Age: 67
State:

Vax Date: 01/12/2021
Onset Date: 10/06/2021
Rec V Date: 10/21/2021
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:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Patient arrived to the hospital 10/16/2021 after having SOB for 10 days. His oxygen saturations were in the 70's. He was found to have multifocal pneumonia along with a positive COVID test. Patient was placed on bipap. Vancomycin and Cefepime wee started along with Dexamethasone and Baricitinib. Patient remains on Bipap at night at 80% FIO2 and is on heated high flow via nasal cannula at 100%. He remains in the ICU FIO2.

Other Meds:

Current Illness:

ID: 1804466
Sex: M
Age: 87
State:

Vax Date: 02/03/2021
Onset Date: 10/16/2021
Rec V Date: 10/21/2021
Hospital: Y

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: 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: 1804467
Sex: M
Age: 26
State: WA

Vax Date: 08/31/2021
Onset Date: 09/25/2021
Rec V Date: 10/21/2021
Hospital: Y

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

Lab Data: Cat Scan, MRI, EEG

Allergies: none

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

Symptoms: Vaccine given 8/31/21 9/25/21 left temporal lobe hemorrhage, acute cerebral venous sinus thrombosis, hypercoagulable state, stroke

Other Meds: none

Current Illness: none

ID: 1804468
Sex: F
Age: 43
State: NY

Vax Date: 10/08/2021
Onset Date: 10/09/2021
Rec V Date: 10/21/2021
Hospital:

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

Lab Data: None, but labs are pending.

Allergies: Cephalexin Gluten Clindamycin

Symptom List: Nausea

Symptoms: Palpitations, severe anxiety, suicidal ideation

Other Meds: Arimidex 1mg Vitamin C Vitamin D3

Current Illness: None

ID: 1804470
Sex: F
Age: 66
State: WI

Vax Date: 10/13/2021
Onset Date: 10/13/2021
Rec V Date: 10/21/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Injection site pain

Symptoms: The first evening after the vaccine, I had strong shaking (the "chills"). In the morning I first took my temperature and had 101.6 fever which lasted all day. My arm was extremely sore at the vaccination site and whenever raising my arm and lasted over three days. I was nauseated all day and slightly nauseated the next day. my fever subsided the next day to 99.6-100. I had a slight headache.

Other Meds: none

Current Illness: none

ID: 1804471
Sex: M
Age: 48
State: ND

Vax Date: 05/07/2021
Onset Date: 05/26/2021
Rec V Date: 10/21/2021
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: Bees

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

Symptoms: I have never had migraines, now I get them every two weeks along with vertigo sometimes. My feet are always cold now. My feet tingle and feel like they are falling asleep. My hands feel like they are cramped in a fist from riding motorcycle all day and I do not own one. I am tired all the time. I usually only needed 4 to 6 hours of sleep and now I need 8 to 10. Sometimes I will start to feel tired and sit down and wake up 12 to 14 hours later. I have odd feelings in my chest like it hurts then it disappears all of a sudden.

Other Meds:

Current Illness: none

ID: 1804472
Sex: M
Age: 50
State: WI

Vax Date: 04/02/2021
Onset Date: 10/16/2021
Rec V Date: 10/21/2021
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: Bactrim - abnormal vital signs, nausea and vomiting Sulfamethoxazole - Heart rate change, blood pressure change.

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

Symptoms: Patient contracted COVID after being fully vaccinated. Congestion and Runny nose

Other Meds: Baclofen 10mg daily Ibuprofen 400mg q6hr prn for fever or pain Tadalafil 10mg daily prn, as neded.

Current Illness: None documented

ID: 1804474
Sex: F
Age: 49
State: CA

Vax Date: 10/15/2021
Onset Date: 10/16/2021
Rec V Date: 10/21/2021
Hospital:

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

Lab Data: none

Allergies: seasonal allergies

Symptom List: Tremor

Symptoms: I woke up the next morning with fever, body aches, sore arm, chills and fatigue. Two day later, I developed painful sores along the roof of my mouth and it became difficult to eat. I called my doctor and she believed it was an inflammatory response to the vaccine. She offered a medicine to reduce to reaction but I declined. They finally went away after 4 days.

Other Meds: propranolol -20 mg twice daily

Current Illness: none

ID: 1804475
Sex: F
Age: 29
State: MN

Vax Date: 05/28/2021
Onset Date: 10/20/2021
Rec V Date: 10/21/2021
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: Tested NAAT positive for COVID 10/20/21 after being fully vaccinated.

Other Meds:

Current Illness:

Date Died: 09/10/2021

ID: 1804476
Sex: F
Age: 69
State:

Vax Date: 04/05/2021
Onset Date: 08/26/2021
Rec V Date: 10/21/2021
Hospital: Y

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: pt diagnosed COVID positive on 8/23; hx of MS; admitted to hospital 8/26 for increasing dyspnea, cough, weakness; diagnosed with COVID pneumonia, acute hypoxic respiratory failure; developed pneumothorax; chest tube placed; on BiPAP mask, DNR/DNI; condition worsened and pt died in the hospital

Other Meds:

Current Illness:

ID: 1804477
Sex: F
Age: 15
State: MA

Vax Date: 10/02/2021
Onset Date: 10/02/2021
Rec V Date: 10/21/2021
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: Pfizer dose 1 administered vaccinator went to start timer and pt states she felt light headed pt passed out was carried to stretcher pt regained consciousness vitals accessed 115/73 hr 84 sat 100 pt waited for 30 minutes released to care of Mother bd120/76 hr88 sat 100

Other Meds:

Current Illness:

ID: 1804478
Sex: F
Age: 79
State:

Vax Date: 02/15/2021
Onset Date: 10/16/2021
Rec V Date: 10/21/2021
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: Asthenia, Chills, Headache, Myalgia

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: 1804479
Sex: M
Age: 29
State: OR

Vax Date: 10/15/2021
Onset Date: 10/19/2021
Rec V Date: 10/21/2021
Hospital: Y

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

Lab Data: see above

Allergies: none

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

Symptoms: Myocarditis: elevated ST ; troponin leak; overnight hospitalization

Other Meds: Humira 40 mg SC Q 2wks

Current Illness: none

ID: 1804480
Sex: F
Age: 30
State: IN

Vax Date: 10/19/2021
Onset Date: 10/21/2021
Rec V Date: 10/21/2021
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:

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

Symptoms: Tingling in lip, swollen lymph nodes ( L axillary), hives (no previous issues following vaccine administration in the past)

Other Meds:

Current Illness:

ID: 1804481
Sex: F
Age: 39
State: NC

Vax Date: 04/20/2021
Onset Date: 04/20/2021
Rec V Date: 10/21/2021
Hospital:

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

Lab Data: I thought I was pregnant and did a test and back back not pregnant

Allergies: Bactrim

Symptom List: Pain in extremity

Symptoms: You a fever later that night and lasted for 24 hrs and tired for a week. I had covid arm, swollen and red for a couple weeks. 2 months after the dose , my menstrual days is really short about 3 days and normally its 5 days but the cycle has been shorter or land sometimes it comes back 2 weeks later and period last 2 weeks late. I called my gynea and talked to her

Other Meds: Vitamins B12,D and klonopin,

Current Illness: no

ID: 1804482
Sex: F
Age: 57
State: AL

Vax Date: 03/12/2021
Onset Date: 03/12/2021
Rec V Date: 10/21/2021
Hospital:

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

Lab Data: blocked oil glands in right eye

Allergies:

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

Symptoms: headaches and stiff neck for 2 weeks and blocked oil glands in right eye

Other Meds: Tegretol, Victoza, Atenolol, and Estradiol

Current Illness:

ID: 1804483
Sex: F
Age: 39
State: MA

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

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

Lab Data: went to er and was checked out to see if she had a stroke, pt left because she didnt want to wait to be seen.

Allergies: isoniazid

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

Symptoms: immediately after after getting shot she felt her left hand, left side of mouth and tongue felt weird. about 20 minutes later her left side of her face/mouth was numb and cold.

Other Meds:

Current Illness:

ID: 1804484
Sex: F
Age: 15
State: GA

Vax Date: 10/13/2021
Onset Date: 10/13/2021
Rec V Date: 10/21/2021
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: No Known allergies

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

Symptoms: Patient's Father called to say that the child who received the vaccine started being dizzy on the day of vaccination and had to wait in the store for 30 minutes for observation. later that day, the child experienced sweating. The child also developed redish rash the next day. The child also had high temperature for 4 days. The Father reported all these to the child's doctor who he said advised him not to allow the child to receive second dose of the vaccine.

Other Meds: Don't Have that information

Current Illness: Don't have that information

ID: 1804485
Sex: F
Age: 79
State: IN

Vax Date: 09/30/2021
Onset Date: 09/30/2021
Rec V Date: 10/21/2021
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: Shellfish

Symptom List: Vomiting

Symptoms: 09/30/2021-10/04/2021. 6-7 hrs. after vaccination awoke feeling like a truck hit all of my insides, organs hurt, bones and muscles hurt, feverish, chills continued for 4 days. Slept for 2 days. No stomach, runs, etc. issues. Temperature from 99.7-102.1. Awoke 10/02/2021 with heart racing, pounding and thought it was going to jump out of my chest. There was tingling sensation moving down my arms to mid-shin area. Hands were splotchy blue, later just the palms.

Other Meds: Vitamins C, D, B-12

Current Illness:

ID: 1804486
Sex: F
Age: 40
State: PA

Vax Date: 08/05/2021
Onset Date: 08/05/2021
Rec V Date: 10/21/2021
Hospital:

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

Lab Data: None.

Allergies: None

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: I missed my period a few weeks after I took the vaccine. I would have ordinarily gotten it the last week of August, and that skipped entirely, so I went from July to September with no period at all.

Other Meds: None.

Current Illness: None

ID: 1804487
Sex: M
Age: 44
State: OK

Vax Date: 10/18/2021
Onset Date: 10/18/2021
Rec V Date: 10/21/2021
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: None

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

Symptoms: Severe joint pain- sites of previous surgery such as lower back, hip and shoulder showed even worse inflammation and pain. Would rate pain in triage areas at 10/10 or higher Fever up to 103 degrees F, shivering, unable to sleep due to joint and body pain. Headache causing dizziness and confusion. Treated initially with Tylenol but moved up to Oxycodone 7.5/325 that I had from a surgery, took that every 4 hours for next day. Absolutely horrible 72 hours. Will not take another vaccination. This was mandated by my company.

Other Meds: Simvastatin Celebrex

Current Illness: None

ID: 1804488
Sex: F
Age: 26
State:

Vax Date: 10/21/2021
Onset Date: 10/21/2021
Rec V Date: 10/21/2021
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: Patient reported slight headache after 15 minutes of being monitored. no other symptoms noted. patient stable upon discharge.

Other Meds:

Current Illness:

ID: 1804489
Sex: F
Age: 74
State: TN

Vax Date: 10/02/2021
Onset Date: 10/12/2021
Rec V Date: 10/21/2021
Hospital: Y

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

Lab Data: CT Scan showed blood clots in right lung.

Allergies: none

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

Symptoms: went to the ER on 10/12/21 with shortness of break and pain in chest.

Other Meds:

Current Illness: none

ID: 1804490
Sex: M
Age: 65
State: FL

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 10/21/2021
Hospital: Y

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

Lab Data:

Allergies: None

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

Symptoms: Plural Effusion - treated by Thoracentesis -

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am