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: 1813651
Sex: F
Age: 32
State: CT

Vax Date: 10/15/2021
Onset Date: 10/15/2021
Rec V Date: 10/24/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1813652
Sex: M
Age: 32
State: CT

Vax Date: 10/15/2021
Onset Date: 10/15/2021
Rec V Date: 10/24/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1813653
Sex: M
Age: 24
State: CT

Vax Date: 10/15/2021
Onset Date: 10/15/2021
Rec V Date: 10/24/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1813654
Sex: F
Age: 54
State: CT

Vax Date: 10/16/2021
Onset Date: 10/16/2021
Rec V Date: 10/24/2021
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: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1813655
Sex: M
Age: 63
State: CT

Vax Date: 10/16/2021
Onset Date: 10/16/2021
Rec V Date: 10/24/2021
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 erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1813656
Sex: M
Age: 34
State: CT

Vax Date: 10/15/2021
Onset Date: 10/15/2021
Rec V Date: 10/24/2021
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: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1813657
Sex: F
Age: 32
State: CT

Vax Date: 10/14/2021
Onset Date: 10/14/2021
Rec V Date: 10/24/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1813659
Sex: F
Age: 18
State: OH

Vax Date: 10/22/2021
Onset Date: 10/23/2021
Rec V Date: 10/24/2021
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: Site: Itching at Injection Site-Medium, Site: Redness at Injection Site-Medium, Systemic: Allergic: Itch (specify: facial area, extremeties)-Medium, Systemic: Chest Tightness / Heaviness / Pain-Medium, Additional Details: patient called on saturday 10/23/2021 and said she had an allergic reaction and hives and I adviced the patient to take a bendryl and she said she alreadt did, and I told her to go to the urgent care or emergency room

Other Meds:

Current Illness:

ID: 1813660
Sex: F
Age: 73
State: VA

Vax Date: 10/22/2021
Onset Date: 10/22/2021
Rec V Date: 10/24/2021
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: penicillin, tetracycline, doxycline, latex, medical dyes, latex, laundry detergents, shellfish

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Very bad headache, fever of 101, arm so painful i could not even lift it, general aches and pains all over, extreme tiredness, extreme thirst - lasted about 36 hours and is easing up gradually. I reacted to the second Moderna shot, but not this strongly. This was so painful and uncomfortable that it makes me hesitant to get any more boosters if they become an annual recommendation. Couldn't you try to regulate the dosage by weight? The folks I know who weigh a lot more than i do did not have any reactions. One person in particular had his antibody levels tested before getting the vaccine, and they were very high. He still did not have a reaction. So, it is not that my antibodies were high!

Other Meds: atenolol, nexium, AlgaeCal, vitamins: E, D, biotin, B12, Vitron C

Current Illness: None

ID: 1813661
Sex: F
Age: 33
State: CT

Vax Date: 10/15/2021
Onset Date: 10/15/2021
Rec V Date: 10/24/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1813662
Sex: F
Age: 60
State: CT

Vax Date: 10/16/2021
Onset Date: 10/16/2021
Rec V Date: 10/24/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1813663
Sex: M
Age: 21
State: CT

Vax Date: 10/16/2021
Onset Date: 10/16/2021
Rec V Date: 10/24/2021
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: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1813664
Sex: M
Age: 26
State: CT

Vax Date: 10/14/2021
Onset Date: 10/14/2021
Rec V Date: 10/24/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1813665
Sex: M
Age: 65
State: GA

Vax Date: 04/23/2021
Onset Date: 04/24/2021
Rec V Date: 10/24/2021
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: N/A

Allergies: None, except beer often makes me sneeze

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

Symptoms: after a full night's sleep on the 23rd I was completely wasted on the 24th and feel asleep about 10am and slept for another 8 hours, and continued to be tired after waking. Fell asleep again about 9:pm and slept all night. On the 25th I was fine.

Other Meds: Lisinopril-HCTZ, Prilosec, Niacin, Potassium, Vit C, fish oil, CoQ10, folic acid

Current Illness: None

ID: 1813666
Sex: M
Age: 33
State: CT

Vax Date: 10/15/2021
Onset Date: 10/15/2021
Rec V Date: 10/24/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1813667
Sex: M
Age: 26
State: GA

Vax Date: 10/16/2021
Onset Date: 10/16/2021
Rec V Date: 10/24/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Site: Pain at Injection Site-Medium, Systemic: Confusion-Severe, Systemic: Dizziness / Lightheadness-Severe, Systemic: Fainting / Unresponsive-Severe, Systemic: Flushed / Sweating-Severe, Additional Details: Patient passed out within 2 minutes of being given the COVID-19 Pfizer vaccine on 10/16/2021. 911 was called and Epi-pen was administered as well. Please contact vaccination site if further information is needed.

Other Meds:

Current Illness:

ID: 1813668
Sex: F
Age: 41
State: RI

Vax Date: 10/05/2021
Onset Date: 10/15/2021
Rec V Date: 10/24/2021
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: Site: Bruising at Injection Site-Mild, Site: Itching at Injection Site-Mild, Site: Pain at Injection Site-Severe, Site: Redness at Injection Site-Mild, Site: Swelling 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-Severe, Systemic: Exhaustion / Lethargy-Severe, Systemic: Fainting / Unresponsive-Mild, Systemic: Fever-Mild, Systemic: multiple prominent lymph nodes (thyroid/neck) demonstrating loss of normal fatty hila-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-Severe, 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: extreme fatigue, swollen/sore neck area. sent for ultrasound which presented with 'multiple mildly prominent lymph nodes that are demonstrating loss of normal fatty hila'. Did not present immediately, approx 7 days after 1st dose.

Other Meds:

Current Illness:

ID: 1813669
Sex: F
Age: 22
State: TX

Vax Date: 10/23/2021
Onset Date: 10/23/2021
Rec V Date: 10/24/2021
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: Systemic: Chills-Mild, Systemic: Fainting / Unresponsive-Mild, Systemic: Fever-Mild, Additional Details: A few minutes after receiving vaccination patient complained of feeling hot and cold and also sleepy. Patient dozed off and had decreased responsiveness for a few minutes then recovered. Had patient stay at pharmacy for 30 minutes and seemed to fully recover. Patient took some tylenol and benadryl afterwards.

Other Meds:

Current Illness:

ID: 1813670
Sex: M
Age: 58
State: MO

Vax Date: 12/18/2020
Onset Date: 08/12/2021
Rec V Date: 10/24/2021
Hospital:

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

Lab Data: none

Allergies: nkda

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: ruptured left biceps tendon under no duress

Other Meds: mobic, msm sulfur, melatonin

Current Illness: none

ID: 1813671
Sex: F
Age: 83
State: FL

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

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: Systemic: Dizziness / Lightheadness-Severe, Additional Details: Patient recieved booster dose and within a few minutes became dizzy/lightheaded/faint. Paramedics called. Patient did not pass out. She laid down with assistance. Patient maintained awareness of her surroundings and answered assessment questions by medical staff. No signs or symptoms of allergic reaction. Given patients age and past medical history, patient was transported to hospital for further evaluation.

Other Meds:

Current Illness:

ID: 1813672
Sex: F
Age: 77
State: OH

Vax Date: 10/21/2021
Onset Date: 10/21/2021
Rec V Date: 10/24/2021
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:

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

Symptoms: Error: Wrong Dose of Vaccine - Too High-

Other Meds:

Current Illness:

ID: 1813673
Sex: F
Age: 63
State: CT

Vax Date: 10/15/2021
Onset Date: 10/15/2021
Rec V Date: 10/24/2021
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: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1813674
Sex: F
Age: 73
State: FL

Vax Date: 10/15/2021
Onset Date: 10/15/2021
Rec V Date: 10/24/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1813675
Sex: F
Age: 58
State: CT

Vax Date: 10/16/2021
Onset Date: 10/16/2021
Rec V Date: 10/24/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1813676
Sex: F
Age: 79
State: CT

Vax Date: 10/16/2021
Onset Date: 10/16/2021
Rec V Date: 10/24/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1813677
Sex: F
Age: 76
State: NC

Vax Date: 10/20/2021
Onset Date: 10/20/2021
Rec V Date: 10/24/2021
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: Systemic: Dizziness / Lightheadness-Medium, Systemic: Nausea-Medium, Additional Details: pt stated that she is experiencing vertigo. has not taken anything to help symptoms

Other Meds:

Current Illness:

ID: 1813678
Sex: F
Age: 25
State: MD

Vax Date: 10/23/2021
Onset Date: 10/23/2021
Rec V Date: 10/24/2021
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: Error: Wrong Dose of Vaccine - Too Low-

Other Meds:

Current Illness:

ID: 1813679
Sex: M
Age: 30
State: TX

Vax Date: 10/23/2021
Onset Date: 10/23/2021
Rec V Date: 10/24/2021
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: Systemic: Shakiness-Mild, Additional Details: PATIENT WAS GIVEN SECOND DOSE OF PFIZER VACCINE. HE DID NOT AHS ANY REACTION FROM FIRST VACCINE AS PER PATIENT. THOUGH PER GUIDELINES TOLD HIM TO WAIT FOR OBSERVATION. AFTER 10 MINS HE LEAN DOWN HIS HEAD NEARBY AND PASSED OUT FOR VERY FEW SECONDS AROUND 3-4 SEC. HE HAS LITTLE SHAKING AS PER THE NEXT CUSTOMER SITTING NEXT TO HIM. OBSERVED GAVE WATER TOOK PULSE AND ALL CAME OUT NORMAL. CALLED 911 TO MAKE SURE THAT HE IS DOING OK. TOOK CARE TILL PARAMEDICS ARRIVED. TRIED TO REACH OUT TO THE PERSON

Other Meds:

Current Illness:

ID: 1813681
Sex: M
Age: 14
State: IL

Vax Date: 10/23/2021
Onset Date: 10/23/2021
Rec V Date: 10/24/2021
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: Systemic: Dizziness / Lightheadness-Mild, Systemic: Fainting / Unresponsive-Medium, Additional Details: this is not for a covid vaccine. only for flu shot

Other Meds:

Current Illness:

ID: 1813683
Sex: F
Age: 52
State: CT

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

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

Lab Data: EKG, X-RAY, Ultrasound, blood work, echocardiogram.

Allergies: Allergies to peanuts, nuts in general.

Symptom List: Nausea

Symptoms: Severe shortness of breath, pain in center of chest, center of chest right side of heart ached, heaviness and tightness in chest all the time, heart rate increase, heart palpitations, fatigue, swollen lymph nodes under both armpits, pain in armpits, headache, could not lie down on back or side as I could not breath, pain in left and right arms more in left arm where shot given, rash off and on on left arm.

Other Meds: Vitamins D, Vitamin C. No prescribed prescriptions used on a regular.

Current Illness: Acute Hypersensitivity Pneumonitis. Allergen found and removed. Health and breathing was GOOD.

ID: 1813684
Sex: M
Age: 75
State: IA

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

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

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: No adverse reaction noted. Vaccine given outside of EUA

Other Meds:

Current Illness:

ID: 1813685
Sex: M
Age: 67
State: PA

Vax Date: 10/21/2021
Onset Date: 10/21/2021
Rec V Date: 10/24/2021
Hospital:

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

Lab Data: none

Allergies: none

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

Symptoms: used a vanish point syringe and the vaccine leaked out of the side while I was administering. I offered to revaccinate since I am unsure how much liquid came out but patient declined

Other Meds: unknown

Current Illness: unknown

ID: 1813686
Sex: F
Age: 71
State: IA

Vax Date: 10/04/2021
Onset Date: 10/04/2021
Rec V Date: 10/24/2021
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: No adverse event noted. Vaccine given outside of EUA

Other Meds:

Current Illness:

ID: 1813687
Sex: M
Age: 62
State: IA

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

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

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: No adverse event reported. Vaccine given outside of EUA

Other Meds:

Current Illness:

ID: 1813688
Sex: F
Age: 63
State: IA

Vax Date: 10/04/2021
Onset Date: 10/04/2021
Rec V Date: 10/24/2021
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: No adverse reaction noted. Vaccine given outside of EUA

Other Meds:

Current Illness:

ID: 1813689
Sex: F
Age: 48
State: CA

Vax Date: 10/20/2021
Onset Date: 10/22/2021
Rec V Date: 10/24/2021
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: N/A

Allergies: specific kind of shrimp sometimes

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

Symptoms: pain and swelling on my armpit the following day and is still swollen and tender on palpation to this date (10/24/2021)

Other Meds: none

Current Illness: none

ID: 1813690
Sex: M
Age: 44
State: MS

Vax Date: 09/14/2021
Onset Date: 09/16/2021
Rec V Date: 10/24/2021
Hospital:

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

Lab Data: At medical said what symptoms I had, and my blood pressure was in the 130's Sys and in the upper 80's DIA (normally I am 120 over 72) Discussed pain in my shoulder above my heart and pain in my back somewhat behind my heart. At which time given two EKG's (good Dr.) which both had probable left ventricle hypertrophy. As I was still having pain Dr. ordered an Xray and blood work, then highly recommended me to go the ER. Did the blood work on site. Xray machine down on site went to the ER around 1100. Did more blood work hooked to heart monitoring machine. Blood pressure was 150 over 108 in the ER. Had an Xray which came out normal and blood work resulted in no active heart attack. Currently on Blood pressure monitoring as it is elevated.

Allergies: lactose intolerant

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

Symptoms: 14 Sep21 8pm constantly feeling my heart beating rapidly took nyquil to go to sleep. 15Sep21 11am left work had numbness in hands and drove slowly home. Joint pain had left knee go out 3:50pm (previous injury but that has not happened since physical therapy 2008 time frame). Left shoulder pain near heart 7:17pm. Contacted medical and came in for an appointment on 22 Sept2021

Other Meds: Men's multi vitamin. Omega 3 Fish oil.

Current Illness: N/A

ID: 1813692
Sex: F
Age: 40
State: PA

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

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: L supraclavicular lymph node swelling and discomfort. This did not happen after the first dose. After first dose I just had headache for about a day. After second dose I also had this swelling also on same side as injection. It started approximately the day after injection and lasted about 3 days. This time it started a little earlier, the evening of the injection, and this is day 2 after injection and it?s still uncomfortable and swollen. No other symptoms no issues at site of injection.

Other Meds: Levothyroxine Premarin

Current Illness: None

ID: 1813693
Sex: F
Age: 32
State: LA

Vax Date: 08/20/2021
Onset Date: 08/27/2021
Rec V Date: 10/24/2021
Hospital:

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

Lab Data: None

Allergies: None

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

Symptoms: One week post injection numbness was noted on top of left foot. Numbness is still present as of filing.

Other Meds: Metformin, multivitamin, vitamin B, omeprazole, loryna

Current Illness: None

ID: 1813694
Sex: M
Age: 54
State: ND

Vax Date: 10/16/2021
Onset Date: 10/16/2021
Rec V Date: 10/24/2021
Hospital: Y

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: Previous physicals blood platelets count is 250,000. 10/20/21 count was 28,000 10/21/21 count was 35,000 after decadron 10/22/21 count was 65,000 after decadron

Allergies: none

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

Symptoms: chills, fever, aches, blood platelets plummeted. Thrombocytopenia

Other Meds: hydrochlorothiazide 12.5 mg, losartan 50 mg

Current Illness: none

ID: 1813695
Sex: F
Age: 23
State: OH

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

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

Lab Data:

Allergies: Latex

Symptom List: Pain in extremity

Symptoms: Several largely swollen lymph nodes on left side making it hard to move head/neck. Congestion and cough worse than first two shots.

Other Meds: Multi vitamin

Current Illness: None

ID: 1813696
Sex: F
Age: 61
State: KS

Vax Date: 10/12/2021
Onset Date: 10/13/2021
Rec V Date: 10/24/2021
Hospital:

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

Lab Data: None

Allergies: PCN

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

Symptoms: At 2 am I was awaken by a strange heart rate. I was very aware of a fast, irregular rhythm. I listened with my stethoscope and the rhythm was all over the place. I tried to take my blood pressure with our automatic machine but it just kept reading ?error?. I also had a headache and heartburn. The episode lasted about 45 min and stopped suddenly. My pulse rate and rhythm were normal again.

Other Meds: Citalopram 20 mg Losartan 50 mg Pepsid Melatonin 10 mg Zyrtec 10mg

Current Illness: None

ID: 1813697
Sex: F
Age: 38
State: WI

Vax Date: 04/01/2021
Onset Date: 08/29/2021
Rec V Date: 10/24/2021
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: EKG, Echocardiogram, stress test, MRI, CTscan, blood tests

Allergies: Gluten, Fish, Tomato

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

Symptoms: Pericarditis diagnosis, current treatment 3 months of colchicine, and ibuprofen.

Other Meds: Vitamin D, Claritin on occasion

Current Illness: None

ID: 1813698
Sex: F
Age: 64
State: NY

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

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

Lab Data: I chose to not go to the ER as blood was everywhere. I had bloodwork done the month prior-9/2/21 RBC 4.87, platelets 228

Allergies: erythromycin- swells throat

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

Symptoms: Woke up in middle of the night as felt wet on pillow- pillow soaked with blood which was bright red with clots covering a very large portion of my pillow. I got up and went to the bathroom- spit out atleast 3 large blood clots that were almost the size of ?? an apricot. The bleeding continued for 40 minutes. I applied pressure at the nostrils and bridge of nose. When it did not stop, applied a very cool compress to the nose and face while husband held pressure on the bridge of my nose. At 45 minute mark, the bleeding went to only light red when dabs my nose.

Other Meds: align probiotic, daily womans multivite and apple cider vinegar gummies

Current Illness: diabetes, kidney disease stg1, lumbar disc herniation and radiculopathy

ID: 1813699
Sex: M
Age: 43
State: TX

Vax Date: 10/22/2021
Onset Date: 10/24/2021
Rec V Date: 10/24/2021
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: Mild to lactose and cider pollen

Symptom List: Vomiting

Symptoms: Swelling and pain in my armpit on the same side as the vaccine dose was given. Swelling at injection site worse over time (this is just for your information as the concern is the armpit swelling/pain). The armpit swelling/pain was not experienced during the first or second vaccine dose.

Other Meds: Ibuprofen and NyQuil last dose 8 hours before I noticed swelling and pain under my arm.

Current Illness: None known

ID: 1813700
Sex: F
Age: 72
State: IN

Vax Date: 10/22/2021
Onset Date: 10/23/2021
Rec V Date: 10/24/2021
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: Localized pain, heat swelling rt. arm

Other Meds: Atorvastatin. Lasix.

Current Illness: None

ID: 1813701
Sex: F
Age: 42
State: GA

Vax Date: 09/28/2021
Onset Date: 09/30/2021
Rec V Date: 10/24/2021
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: I had covid symptoms for 3 days. Now theres some kinda damage to the arm that I got the shot in cause I have very limited motion and shooting pains down my shoulder and arm at all times

Other Meds:

Current Illness:

ID: 1813702
Sex: F
Age: 48
State: IN

Vax Date: 10/22/2021
Onset Date: 10/22/2021
Rec V Date: 10/24/2021
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: Na

Allergies: Na

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Extreme temperature for 24 hrs (101.4- 102). Fatigue

Other Meds: Na

Current Illness: Na

ID: 1813703
Sex: F
Age: 56
State: MA

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

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

Lab Data: none

Allergies: hydrocodone and percocet

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

Symptoms: itching immediately after vaccines. reports 2 weeks of itching and scratching, petechaie developed over areas of itching. itching to bilateral arms, and right side of head. red skin to torso

Other Meds: unknown

Current Illness: unknown

ID: 1813704
Sex: M
Age: 66
State: TX

Vax Date: 09/03/2021
Onset Date: 09/04/2021
Rec V Date: 10/24/2021
Hospital:

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

Lab Data: None to date

Allergies: Many grasses, trees, pollens. Had allergy shot since 6 years old. Had allergy shots on and off since about age 35. Food allergies are onions, olives and radishes.

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

Symptoms: I turned 65 years old in May of 2020 so this is my second high-does influenza shot. The first shot in 2020 was a trivalent and in 2021, I received the quadrivalent. The influenza shot has alway affected my joints but the high-dose is significantly worse. In 2020 the shot gave me arthritis which had taken 6 weeks until my joint returned to normal. I am now over 7 weeks since my 2021 shot and I am still having problems with my joints. This is significant because I need to exercise to stay healthy. Typical exercises are walking, pushups and calisthenic exercises. I should also mention that I had my second COVID-19 Moderna shot on 02/09/2021 (if that an issue)

Other Meds: Finasteride 5mg tablet for BPH

Current Illness: None

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am