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: 1807821
Sex: F
Age: 60
State: IL

Vax Date: 09/30/2021
Onset Date: 10/02/2021
Rec V Date: 10/22/2021
Hospital:

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

Lab Data: N/A

Allergies: N/A

Symptom List: Dysphagia, Epiglottitis

Symptoms: Pt. states that after receiving the 2nd dose of Phizer 09/30/2021, started experiencing symptoms 10/02/2021 of Headaches, muscle pain, leg swelling *both lasting 10/09/2021, 10/12/2021 Vein Burst (Ankle) Emergency Room visit, Primary visit planned for 10/27/2021 for Follow-Up.

Other Meds: Losartan, Chlorthalid

Current Illness: N/A

ID: 1807823
Sex: M
Age: 47
State: MD

Vax Date: 10/17/2021
Onset Date: 10/18/2021
Rec V Date: 10/22/2021
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: None

Symptom List: Anxiety, Dyspnoea

Symptoms: 3 days with fever, body aches, chills 5 days and counting of headache, tiredness, nausea, and heavy night sweats.

Other Meds: Lisinopril

Current Illness: N/A

ID: 1807824
Sex: F
Age: 49
State: AL

Vax Date: 10/21/2021
Onset Date: 10/21/2021
Rec V Date: 10/22/2021
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: started getting dizzy about 10 minutes after shot .. she got some water and went on after about 20 minutes .. I called to check on her 2 hours later and still a little dizzy. I checked on her the next morning and she said dizziness gone but lasted about 4.5 hours.

Other Meds:

Current Illness:

ID: 1807826
Sex: F
Age: 36
State: FL

Vax Date: 10/14/2021
Onset Date: 10/17/2021
Rec V Date: 10/22/2021
Hospital:

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

Lab Data: EkG was done , troponins were tested, chest xray was done, blood work was completed

Allergies: Aspirin, codeine, penicillin, Bactrim, clindamycin

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: After second dose on 10/14 I was completely fine until 10/17 around 5 pm I developed a really swollen throat and congestion outta nowhere. 10/18 -10/ 19 Congestion continued with sore throat only appearing at night. On 10/20 resting heart that's normally in 70's increased to high 80-90 that morning. Around 2pm on 10/20 it turned into tachycardia with heart rate bouncing between high 80s to around 120s. I rested thinking it would go away. On 10/21 I went to ER because tachycardia was so bad i began to experience shortness of breath. AS OF 10/22 I WAS STILL CONGESTED , SORE THROAT, WITH TACHYCARDIA ON DAY 8 AFTER MY SECOND SHOT

Other Meds: Xanax, Hyaciamine, esomeprazole

Current Illness: H pylori, IBS,

ID: 1807827
Sex: F
Age: 38
State:

Vax Date: 10/01/2021
Onset Date: 10/11/2021
Rec V Date: 10/22/2021
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: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Enlarged pupil - 3 days after Vision can?t go from bright to dark room Neurological sensations in face two days after Geographical tongue two days after

Other Meds: Vitamin D Iron, Prilosec Macrobid Zyrtec

Current Illness: None

ID: 1807828
Sex: F
Age: 62
State:

Vax Date: 04/13/2021
Onset Date: 04/15/2021
Rec V Date: 10/22/2021
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: Compazine

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

Symptoms: Left foot ankle rash described as red and slightly raised approx 4.5inx2in

Other Meds: None

Current Illness:

ID: 1807829
Sex: F
Age: 74
State: CA

Vax Date: 10/19/2021
Onset Date: 10/19/2021
Rec V Date: 10/22/2021
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: NKDA

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Patient had a fever of 101.6. She was nauseated and throwing up. Her muscles ached. She stood up to go to the restroom and was unable to hold herself up and fell on her face.

Other Meds:

Current Illness: NONE

ID: 1807830
Sex: F
Age: 43
State: TN

Vax Date: 07/21/2021
Onset Date: 07/23/2021
Rec V Date: 10/22/2021
Hospital: Y

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

Lab Data: CT Scan (2), Echogram, MRI(2), Cerebral Angiogram,

Allergies: Epinepherin

Symptom List: Pharyngeal swelling

Symptoms: She began to have a severe headache with in 36 hours of the second dose. The headache progressively worsened without letting up at all for several days. On the evening of August 4 she began feeling light headed as well as the headache. On August 6 she began to speak oddly and we called emergency services in fear of stroke. The medics said at that time she was not hacing a stroke and she returned to bed. She slept all day Saturday August 7 and on Sunday August 8 she was not thinking clearly or acting right so I took her to the ER where it was discovered that she had suffered a massive stroke in the MCA region of her brain. She now has quite a lot mental and physical impairment. She had a physical one day before the first dose of the vaccine and was in perfect health, NO ISSUES. After the second dose she had this stroke and is imparired permanently.

Other Meds: Sertraline

Current Illness: None

ID: 1807831
Sex: F
Age: 57
State: AZ

Vax Date: 10/19/2021
Onset Date: 10/20/2021
Rec V Date: 10/22/2021
Hospital:

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

Lab Data: i went to urgent care on 10/21/2021 because I still had all the symptoms mentioned in (Item 18) they did flu swap(came back negative), covid swap ( still waiting results) chest xray( negative) gave me ZOFRAN , TORODAL, and 2 Tylenol. Temp at urgent went to 103, they kept me longer to monitor me until temp came down to 101, they released me and advised I take Tylenol and Advil and hydrate

Allergies: NONE

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Went for my required FLU shot and was asked if I would like a BOOSTER as well, I was told it was safe, and was told multiple people get double shots...24 hours later i became fatigued, chills, nauseous, dizzy, light headed, headache, joint pain, fever (103).

Other Meds: MULTI VITAMIN , MILK THISTLE

Current Illness: NONE

ID: 1807832
Sex: F
Age: 34
State: VA

Vax Date: 10/19/2021
Onset Date: 10/20/2021
Rec V Date: 10/22/2021
Hospital:

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

Lab Data: CT scan; EKG; blood work; Echo cardio gram

Allergies: N/A

Symptom List: Diarrhoea, Nasal congestion

Symptoms: I been having dull chest pain with SOB. I also been having an evaluated heart rate that worsen when walking around. I have some headaches. I went to ER about this last night. They did a CT scan of my chest, EKG and blood work. I am been referred to a cardiologist. He ordered an Echo cardio gram and more blood work. I am waiting on that results. Even when I stand up my get an evaluated heart rate. I also with my first dose, I had a evaluated heart rate that when away with medicine.

Other Meds: Prenatal vitamin; vitamin D

Current Illness: N/A

ID: 1807833
Sex: F
Age: 28
State: FL

Vax Date: 10/20/2021
Onset Date: 10/21/2021
Rec V Date: 10/22/2021
Hospital:

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

Lab Data: none

Allergies: none

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

Symptoms: localized redness and warmth at site , axillary lymph node tenderness and swelling the size of a cherry

Other Meds: elderberry supplement

Current Illness: none

ID: 1807834
Sex: M
Age: 43
State: FL

Vax Date: 05/20/2021
Onset Date: 06/20/2021
Rec V Date: 10/22/2021
Hospital:

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

Lab Data: Planning on speaking with my primary care physician about hearing test and any other tests or treatments available.

Allergies: none

Symptom List: Rash, Urticaria

Symptoms: Intense and sudden tinnitus in one ear or the other that lasts for 12 to 24 hours and causes a headache and nausea after a few hours. Usually starts to subside over the next few days and randomly repeats.

Other Meds: 30mg Tamazapam Vitamin D3 w/ Magnesium Melatonin

Current Illness: none

ID: 1807835
Sex: F
Age: 46
State: TX

Vax Date: 10/21/2021
Onset Date: 10/21/2021
Rec V Date: 10/22/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: Confusion, fever, fatigue, headaches, joint pain, chest discomfort.

Other Meds: None.

Current Illness:

ID: 1807836
Sex: F
Age: 62
State: MI

Vax Date: 10/17/2021
Onset Date: 10/19/2021
Rec V Date: 10/22/2021
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: quinolones

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

Symptoms: Received vaccine on 10-17-21 no issues on 10-18-21 Redness, mild pain, slightly warm near injection site 10-19-21 Pt thought size had increased slightly on 10-20-21 Seeked medical attention on 10-21-21, doctor diagnosed as cellulitis, pt reported location of rash had moved more towards underarm and thought was slightly less red, no change in pain level

Other Meds: unknow

Current Illness: unknown

ID: 1807837
Sex: M
Age: 40
State: IL

Vax Date: 10/21/2021
Onset Date: 10/21/2021
Rec V Date: 10/22/2021
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:

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

Symptoms: Patient was given Pfizer vaccines for his 6 month booster shot and it should have been Moderna. He previously had Moderna for 1st and 2nd doses.

Other Meds:

Current Illness:

ID: 1807838
Sex: F
Age: 50
State: CT

Vax Date: 04/16/2021
Onset Date: 04/17/2021
Rec V Date: 10/22/2021
Hospital:

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

Lab Data: Colonoscopy in the summer (Jun-Aug2021) and it was cleared

Allergies: Penicillin; sulfur; erythromycin; codeine; latex; pine nuts; lactose intolerant

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

Symptoms: 1ST dose - armpits got swollen; 2nd dose - the next day, I couldn't get out of the couch. Slept longer. Extreme fatigue till Sunday. Don't know when my GI problems happened. Like making noise in the tummy and not sure if its after certain foods. I get gassy. I mentioned to my doctor but he didn't say anything about this and I view this as an inconvenience and not life altering.

Other Meds: No

Current Illness: No

ID: 1807839
Sex: F
Age: 55
State: MA

Vax Date: 10/16/2021
Onset Date: 10/19/2021
Rec V Date: 10/22/2021
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: Shellfish

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

Symptoms: I started feeling heart palpitations 3 days after my second shot. Yesterday, I took my blood pressure at home and it was 177/91.

Other Meds: Yes, I take prescription medication for ADHD every morning

Current Illness: None

ID: 1807840
Sex: M
Age: 56
State: NJ

Vax Date: 04/11/2021
Onset Date: 04/12/2021
Rec V Date: 10/22/2021
Hospital:

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

Lab Data: None

Allergies: Penicillin (Rash)

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Strong Sinus Pressure / Pain, treatment Flonase spray once daily, 2 months, outcome sinus pressure continued and very slowly declined and was back to pre-injection status in approximately 5 months.

Other Meds: Metaprolol 25MG

Current Illness: None

ID: 1807841
Sex: F
Age: 26
State: CT

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

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

Lab Data:

Allergies: NKA

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Within 3hrs of receiving vaccine, patient had hives on her chest and right arm. Patient took Benadryl 25mg at 8pm (after receiving vaccine at 2pm). Hives had improved. Employee reports severe itching of entire body last night and today.

Other Meds: Metformin, lexapro, valtrex, seasonale, spirinalactone

Current Illness: No

ID: 1807842
Sex: M
Age: 74
State:

Vax Date: 09/14/2021
Onset Date: 10/17/2021
Rec V Date: 10/22/2021
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: 1807843
Sex: F
Age: 67
State: MN

Vax Date: 10/22/2021
Onset Date: 10/22/2021
Rec V Date: 10/22/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: nka

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

Symptoms: Administered expired dose of moderna to patient. Vial expired at 0358AM on 10/22/21 and the vaccine was administered at 08:50AM on 10/22/21. Vial opened at 1558 on 10/22/21 and placed in room temperature

Other Meds: Acetaminophen TYLENOL 500 MG Take 1,000 mg by mouth daily as needed for pain Albuterol Sulfate ACCUNEB 1.25 MG/3ML Inhale 1 ampule into the lungs every 4 hours as needed for wheezing amLODIPine Besylate NORVASC 5 MG Take 5 mg by mouth 2 t

Current Illness:

ID: 1807844
Sex: F
Age: 79
State: AZ

Vax Date: 10/11/2021
Onset Date: 10/13/2021
Rec V Date: 10/22/2021
Hospital:

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

Lab Data: CT scans and multiple 3-way abdominal studies and small bowel follow through showing ileus vs obstruction. WBC never elevated. She required some supplemental potassium inicialt.

Allergies: milk

Symptom List: Unevaluable event

Symptoms: Patient admitted on 10/13/2021 with profound ileus vs obstruction. She had NG to suction for one day. She had both a CT and later a small bowel follow through showing the contrast getting all the way to the colon but she was vey slow to advance in her diet. She never developed normal bowel movement but was having liquid stools and passing gas at the time she left against medical advice on 10/21/2021

Other Meds: carboxymethylcellulose 0.5% drops and 1% gel for eyes, Ketotifen Fumarate ).025% for eyes, mineral oil 20%/petroleum jelly 80% oph ointment for eyes, meloxicam 15 mg tab BOD

Current Illness: R upper quadrant pain after riding her ATV for 10 miles the day before

ID: 1807845
Sex: M
Age:
State: GA

Vax Date:
Onset Date:
Rec V Date: 10/22/2021
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: I experienced dizziness, lack of energy and my pulse was rose to 160. I also felt like my heart was about to come out of my chest.

Other Meds:

Current Illness:

ID: 1807846
Sex: M
Age: 89
State: TN

Vax Date: 04/07/2021
Onset Date: 10/17/2021
Rec V Date: 10/22/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: 10/18/21 COVID-19SARSCoV2 = DETECTED.

Allergies: NO KNOWN ALLERGIES

Symptom List: Injection site pain, Pain

Symptoms: 10/17/21 SEEN IN THE ER AFTER FALLING AT HOME. REPORTED FEVER, HEMATURIA, DIZZINESS. COMPLAINS OF LEFT FLANK PAIN WITH CHILLS. DISCHARGE 10/21/21 TO health care FACILITY. WITH DIAGNOSIS OF ESBL ECOLI INFECTION UTI/BACTEREMIA.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1807847
Sex: M
Age: 17
State: NY

Vax Date: 10/19/2021
Onset Date: 10/19/2021
Rec V Date: 10/22/2021
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: N/A

Symptom List: Injection site pain, Menorrhagia

Symptoms: Pt.'s Mother states that after receiving the 1st dose of Phizer 10/19/2021, started experiencing symptoms that evening of headache, muscle aches, and swollen Lymphoid under left arm. Primary communications recommendation for Tylenol. Still continuing to experience symptoms.

Other Meds: N/A

Current Illness: N/A

ID: 1807848
Sex: F
Age: 42
State: IL

Vax Date: 04/15/2021
Onset Date: 08/15/2021
Rec V Date: 10/22/2021
Hospital:

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

Lab Data: Covid 19- positive

Allergies: erythromycin, progesterone, sesame oil, ovidrel possible reaction to name brand

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

Symptoms: I developed muscle aches, fatigue, dry cough that turned into a barking cough, I had a fever for over a week it ran around 101.6. I had a tele visit with my own doctor through video he diagnosed me with pneumonia and bronchitis. He prescribed me antibiotics, steroids , and an inhaler I was using every four hours and a cough suppressant with codeine that was 10 days after I had tested positive for covid. I lost my taste and smell. I still don't have my taste and smell, and have some lingering brain fog.

Other Meds: levothyroxine 88 mcg, Vit d, E, DHEA, baby aspirin, magnesium, prenatal vitamin, leutradide daily shots (leupron) with a 2 week kit.

Current Illness: none

ID: 1807849
Sex: F
Age: 43
State: WI

Vax Date: 10/20/2021
Onset Date: 10/21/2021
Rec V Date: 10/22/2021
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: No

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Heartbeat was double my normal while resting Severe headaches, extreme pain in back into upper legs, hard to move

Other Meds: Lexapro

Current Illness: None

ID: 1807850
Sex: M
Age: 17
State:

Vax Date: 10/22/2021
Onset Date: 10/22/2021
Rec V Date: 10/22/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Patient received booster dose of Pfizer, not the proper age at time of vaccination.

Other Meds:

Current Illness:

ID: 1807851
Sex: M
Age: 46
State: NJ

Vax Date: 10/19/2021
Onset Date: 10/19/2021
Rec V Date: 10/22/2021
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: None known

Allergies: none known

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

Symptoms: Client was given Pfizer\BioNTech vaccine for a second dose after a Moderna COVID vaccine first dose., given on 4/29/2021.

Other Meds: unknown

Current Illness: none known

ID: 1807852
Sex: F
Age: 56
State: OK

Vax Date: 03/05/2021
Onset Date: 10/01/2021
Rec V Date: 10/22/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Patient completed Moderna series in April 2021 (had COVID in November 2020). In October 2021 while planning her son's wedding she developed bells palsy. The symptoms are lingering with no relief. "Functional Nerve Disorder" has been mentioned by her PCP in relation to receiving the vaccine.

Other Meds:

Current Illness:

ID: 1807853
Sex: M
Age: 38
State: NC

Vax Date: 10/07/2021
Onset Date: 10/07/2021
Rec V Date: 10/22/2021
Hospital:

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

Lab Data: n/a

Allergies: N/A

Symptom List: Injection site pain

Symptoms: On 10/6/21 0845 COVID 19 Moderna vaccine doses were drawn up. Vaccine labeled and staff notified that doses should be used by 1445 on 10/6/21. At end of day on 10/6, Moderna vaccines were not wasted. Later on 10/7, 38yr old patient presented to clinic for 2nd COVID 19 vaccine. CMA administered expired COVID-19 Moderna vaccine (lot # 004C21A) to patient on 10/7 1057. NM notified. Follow up indicates that manufacturer contacted to clarify if patient needs another dose and pharmacy to follow up. Per manufacturer another dose is not required. No patient harm noted.

Other Meds: N/A

Current Illness: N/A

ID: 1807854
Sex: M
Age: 77
State: FL

Vax Date: 03/14/2021
Onset Date: 09/15/2021
Rec V Date: 10/22/2021
Hospital: Y

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

Lab Data: POSITIVE COVID TEST 10/15/2021

Allergies: NKA

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

Symptoms: LOWER LEG SWELLING AND SHORTNESS OF BREATH ON EXERTION

Other Meds: azithromycin 250 mg oral tablet, 250 mg= 1 TAB, PO, Daily predniSONE 20 mg oral tablet, 20 mg= 1 TAB, PO, Daily zolpidem 10 mg oral tablet, 10 mg= 1 TAB, PO, QHS (At bedtime), PRN

Current Illness:

ID: 1807855
Sex: F
Age: 52
State: MI

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

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

Lab Data: None

Allergies: None

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

Symptoms: 10 minutes after receiving shot, tingling both arms and brief moment of feeling like falling. Headache started quickly and remained for next 3 days. That evening more tired than usual. Next day, fever 100.2, body aches/skin, headaches, nauseated, redness on injection site with pain; toward evening SOB and Heartrate 140?s with minimal exertion ( problem I had after covid in March 2020, still have issues with it but not that high and when resting it is normal however that night resting was 120). Symptoms continued for next 2 days. Then fever broke, still tired and nauseated and large painful red bump on arm at injection site.

Other Meds: Centrum 50 vitamin

Current Illness: ?Long Hauler? - Covid March 202O.

Date Died: 10/19/2021

ID: 1807856
Sex: M
Age: 95
State: MN

Vax Date: 10/13/2021
Onset Date: 10/18/2021
Rec V Date: 10/22/2021
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: Citalopram, Red dye, Strawberry Extract

Symptom List: Tremor

Symptoms: Resident passed away on 10/19/21 he had received the Booster dose of Pfizer on 10/13/21 the primary doses were 1/28/21 and 2/22/21. The Medical Director said to report it

Other Meds: Arava, Erythromycin, Flonase suspension, Guaifenesin Albuterol Solution, Ipratroplum, Tamsulosin, Omeprazole, Prednisone, Morphine Sulfate, Metoprolol, Levothyroxine

Current Illness: was on Hospice and nearing end of life - was not swallowing food or meds the last few days.

ID: 1807857
Sex: F
Age: 53
State: WI

Vax Date: 03/24/2021
Onset Date: 04/02/2021
Rec V Date: 10/22/2021
Hospital:

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

Lab Data: 4/4/21 CT Scan and EKG

Allergies: unknown

Symptom List: Erythema, Pruritus

Symptoms: Discussion with patient about booster doses and she revealed that after her 2nd Moderna vaccine on 4/2/21 she developed a fever of 99-100', felt "woozy", was short of breath, and her BP was very high. She presented to the Medical Center- ER at approximately 2pm on 04/04/21 where she was seen by Dr. She had a CT Scan and EKG. They found 2 upper lobe pulmonary embolisms. She reports she does have Factor V. She is now on Coumadin.

Other Meds: Unknown

Current Illness: unknown

ID: 1807858
Sex: F
Age: 28
State: NY

Vax Date: 10/18/2021
Onset Date: 10/19/2021
Rec V Date: 10/22/2021
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: Fever, body aches, joint pain, migraine, arm pain, felt like my chest was burning inside, inflammation etc.

Other Meds:

Current Illness:

ID: 1807859
Sex: F
Age: 34
State: IN

Vax Date: 10/20/2021
Onset Date: 10/20/2021
Rec V Date: 10/22/2021
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: Neomycin

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

Symptoms: Swelling and redness at the injection site, spreading in size. Localized itching, area is hard and hot to touch.

Other Meds: None

Current Illness: Ear infection 2 weeks prior

ID: 1807860
Sex: M
Age: 89
State: MN

Vax Date: 02/19/2021
Onset Date: 10/21/2021
Rec V Date: 10/22/2021
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: Fully vaccinated patient admitted to ICU on10/21/21 for COVID resp failure. First Moderna COVID dose 1/22/2021, second COVID Moderna dose 2/19/2021

Other Meds:

Current Illness:

ID: 1807861
Sex: F
Age: 67
State:

Vax Date: 02/02/2021
Onset Date: 10/21/2021
Rec V Date: 10/22/2021
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: COVID test + 10/21/2021

Allergies: no known allergies

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

Symptoms: Breakthrough COVID admitted for low H/H SOB and weakness.

Other Meds:

Current Illness:

ID: 1807862
Sex: F
Age: 49
State:

Vax Date: 09/30/2021
Onset Date: 09/30/2021
Rec V Date: 10/22/2021
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: UNKNOWN

Allergies: SHELLFISH

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

Symptoms: TACHYCARDIA IMMEDIALTLEY AFTER BOOSTER. AND SUBSIDED WITHIN MINUTES. Later that day I began to experience the following side effects: headache, bilateral ear pain, neck pain, muscular pain and fatigue. Most symptoms resolved within 2 days; muscular discomfort/weakness still lingers post 5 days.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1807863
Sex: M
Age: 64
State: PA

Vax Date: 09/18/2021
Onset Date: 09/19/2021
Rec V Date: 10/22/2021
Hospital:

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

Lab Data: Xray 10/21/21

Allergies: penicillin

Symptom List: Pain in extremity

Symptoms: The day after injection: pain inside the shoulder joint (not muscular); significantly reduced range of motion especially in lifting arm over head. Treated with heat and ibuprofen. No improvement. It felt like the needle was still in the joint. No progress for 3 weeks, at which point pharmacy called me to say the lot of vaccine had been recalled by CDC for improper storage and I needed another shot. I did get that, and also started physical therapy, at which point I was advised that I probably had SIRVA. Saw an orthopedist 10/21/21 who confirmed this and prescribed more physical therapy and a course of oral steroids.

Other Meds: Pantoprazole 40mg; finasteride 1mg

Current Illness: none

Date Died: 10/18/2021

ID: 1807864
Sex: M
Age: 90
State: MN

Vax Date: 10/13/2021
Onset Date: 10/18/2021
Rec V Date: 10/22/2021
Hospital:

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

Lab Data:

Allergies: Lisinopril, Metoprolol, Morphine

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

Symptoms: Resident suddenly collapsed to ground unresponsive at 14:46, CPR initiated and continued until 15:32 when paramedic pronounced death.

Other Meds: Tamsulosin HCl Capsule, Losartan Potassium Tablet, FerrouSul Tablet (Ferrous Sulfate), Torsemide Tablet, Carvedilol Tablet, Finasteride Tablet, Ipratropium-Albuterol Solution 0.5-2.5 (3) MG/3ML, Albuterol Sulfate Aerosol Powder Breath Ac

Current Illness:

ID: 1807865
Sex: F
Age: 86
State: MA

Vax Date: 10/15/2021
Onset Date: 10/21/2021
Rec V Date: 10/22/2021
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: None

Allergies: PCN

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

Symptoms: On 8/21/21 at approximately 810am the patient was exiting the bathroom with a staff member and reported that she was not feeling well. Patient was observed with shortness of breath. T 97.2 P 105 R 22-26 BP 124/67. O2 Sat 78-83% on Room air. Resident mental status fluctuating with periods of lethargy but arousable. EMS Activated. Supplemental O2 applied via Nasal Cannula without improvement. O2 Sat remained in the 80s. O2 delivery changed to Non Rebreather mask at 15 l/m with O2 sat improving to 98%. Respiratory rate without improvement. Lung sounds diminished at R side. Resident transferred to Hospital for evaluation. The patient is currently diagnosed with diagnosis of bilateral pulmonary emboli. No previous history.

Other Meds: Calcium 500 + D oral daily, Vitamin B-12 500mcg oral daily, Zonisamide 100mg oral daily, Levothyroxine 25mcg oral daily, Losartan 25mg oral daily, Remeron 7.5mg oral daily, Trazadone 50mg oral daily, Lamictal 50mg twice daily, MOM 30ml oral

Current Illness: Progressive Weight Loss over the past 30 days. (5 pounds)

ID: 1807866
Sex: F
Age: 80
State: FL

Vax Date: 04/03/2021
Onset Date: 09/23/2021
Rec V Date: 10/22/2021
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: PREDNISONE, STATINS, TIZANIDINE

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

Symptoms: PAIN UNDER BILATERAL RIBCAGE

Other Meds: aspirin 81 mg oral delayed release tablet, 81 mg= 1 TAB, PO, Daily Combivent Respimat 20 mcg-100 mcg/inh inhalation aerosol, 1 Puff, Inhalation, 4 times a day Coreg 6.25 mg oral tablet, 6.25 mg, PO, BID (2 times a day) levothyroxine, 137 mc

Current Illness:

ID: 1807867
Sex: F
Age: 39
State: MD

Vax Date: 10/20/2021
Onset Date: 10/20/2021
Rec V Date: 10/22/2021
Hospital:

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

Lab Data: n/a

Allergies: NKDA

Symptom List: Vomiting

Symptoms: after injection site became very itchy, hrs. later warm, sore and hard. the next AM lymph node under rt. arm was swollen and tender and still itchy. 2 days after injection lymph node still tender and somewhat swollen

Other Meds: lamictal, zoloft, pantoprazole, zyrtec

Current Illness: no

ID: 1807868
Sex: F
Age: 65
State: FL

Vax Date: 04/21/2021
Onset Date: 04/28/2021
Rec V Date: 10/22/2021
Hospital:

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

Lab Data: Heart Monitor for 7 days - October 2021 - heart arrhythmia

Allergies: Z-pac

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: The first thing I noticed is the rash and then I noticed my heart was skipping. That is when I started calling the DR, and I started to become very worried. They told me that something was elevated, they did a test which usually indicates a heart attack or clot but that was in normal range so they sent me home in the same day. The symptom continued so I went to my DR and got a heart monitor for 24HRS. My DR gave me medications to try and control my blood pressure but did not pay attention to my irregular heart rate. The medication gave me swollen legs so that medication was stopped. My blood pressure is continued to be monitored, I see the DR every 2-3 weeks. Up until this date, my BP was 159-96 which is not a normal BP. Right now, they increased all my medications - Losartan and Bystolic 10MG and I am taking an antidepressant which is nothing, but that is the story. My heart skip is somewhat under control when they increase the Bystolic. It has been a mission and I am still not comfortable with the meds I am taking.

Other Meds: Omega 3; vitamin D; losartan; DEPLIN; BYSTOLIC; Cholesterol medication

Current Illness: N/a

ID: 1807869
Sex: M
Age: 58
State: OH

Vax Date: 04/21/2021
Onset Date: 08/15/2021
Rec V Date: 10/22/2021
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: EKG CT scan

Allergies: penicillin

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

Symptoms: I was in the shower. I got a dizzy, my arm started tingling, and my whole back started hurting. I went to ER. They did a EKG and a CT scan of my heart, and found out that one of my artery's was blocked. So they put a stent in right then and there. I had a heart attack. I was hospitalized for 2 days.

Other Meds: N/A

Current Illness: N/A

ID: 1807870
Sex: M
Age: 81
State: KS

Vax Date: 09/24/2021
Onset Date: 09/24/2021
Rec V Date: 10/22/2021
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: None

Allergies: None

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Chest pressure, nausea, vomiting, soreness at injection site X 2 weeks

Other Meds: Unknown

Current Illness: None

ID: 1807871
Sex: F
Age: 57
State: MD

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

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

Lab Data: Tylenol Oct 19,2021 to present

Allergies: Codeine

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

Symptoms: Bad headache, bodyache , underarm swollen, underarm pain

Other Meds: None

Current Illness: Migraines

ID: 1807873
Sex: F
Age: 24
State: NY

Vax Date: 02/09/2021
Onset Date: 02/09/2021
Rec V Date: 10/22/2021
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: Allergic to cefzil, hydroxychloroquine, and kiwis

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

Symptoms: chest pain

Other Meds: Spironolactone 50mg 2xdaily....nuva ring....synthroid 100mg 1x daily.....ibuprofen as needed...inhaler as needed....

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am