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: 1813705
Sex: F
Age: 65
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: IM
Vax Site: LA

Lab Data:

Allergies: Sulfa

Symptom List: Dysphagia, Epiglottitis

Symptoms: Headache. Joint pain.

Other Meds:

Current Illness:

ID: 1813707
Sex: M
Age: 79
State: FL

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: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Dizziness, nausea and weakness persisting approx. 18 hours

Other Meds: B12, Valsartan, Atorvastatin, Aspirin, Metoprolol, Tramadol

Current Illness:

ID: 1813708
Sex: F
Age: 36
State: PA

Vax Date: 09/07/2021
Onset Date: 09/08/2021
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: N/A

Allergies: None

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

Symptoms: Migraines with cyclic vomiting. Started the day after vaccine was given. Placed on tramadol, Phenergan, and Ativan for immediate action. Started on propranolol for migraine presentation. At this time, still unable to come off propranolol.

Other Meds: Unithroid Metformin Birth Control

Current Illness: None

ID: 1813709
Sex: F
Age: 71
State: MD

Vax Date: 02/25/2021
Onset Date: 02/26/2021
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: none

Allergies: soy, malt; tramadol, fosamax

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Chills, shaking, headache, achy joints, nausea - lasted about 6 hours

Other Meds: none

Current Illness: none

ID: 1813710
Sex: F
Age: 84
State: GA

Vax Date: 10/18/2021
Onset Date: 10/18/2021
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: NKDA, NKA

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

Symptoms: Was administered a Moderna vaccine with expiry date 10/15/2021. She was monitored for 15min after injection. No complications or adverse events were noted.

Other Meds: Unknown

Current Illness: Unknown

ID: 1813711
Sex: F
Age: 35
State: PA

Vax Date: 01/11/2021
Onset Date: 01/22/2021
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: None

Allergies: None

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

Symptoms: Migraines with cyclic vomiting. Controlled with Excedrin and Phenergan. Daily from weeks 0-12 then taper off between weeks 12-24 then resolved after week 24

Other Meds: Unithroid Metformin

Current Illness: None

ID: 1813712
Sex: F
Age: 73
State: CO

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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Headache, chills, fatigue, extreme runny nose, swelling and soreness at injection site. Ibuprofen , sudafed lots of fluids, sleep. Chills and headache broke about 28 hours after onset. Runny nose responded to ibuprofen immediately. Injection site is still sore.

Other Meds: Levothyroxin, calcium, Vitamin D

Current Illness:

ID: 1813713
Sex: F
Age: 70
State: NY

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data: None

Allergies: Penicillin, environmental /seasonal

Symptom List: Pharyngeal swelling

Symptoms: Fever~10 pm, headaches; 4 am chills myalgia, fatigue, 6 am dizziness and headache., myalgia , fatigue, throughout day. Slight improvement 6 pm. , but still fatigue and myalgia in thighs mostly around knees and distal thighs,. Day 2 post vax , no pain, but slightly fatigued.

Other Meds: Digoxin, metoprolol, atorvaststin, b12, ibuprofen,

Current Illness:

ID: 1813714
Sex: F
Age: 39
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Fever, body aches, head ache, chills

Other Meds:

Current Illness:

ID: 1813715
Sex: F
Age: 44
State: PR

Vax Date: 07/29/2021
Onset Date: 07/29/2021
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: None

Symptom List: Diarrhoea, Nasal congestion

Symptoms: An hour after the second dose of the COVID vaccine was administered, I began to experience intermittent on the same front of the right leg, Since then the pain has been daily.

Other Meds: None

Current Illness: None

ID: 1813716
Sex: M
Age: 62
State: FL

Vax Date: 04/22/2021
Onset Date: 05/13/2021
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: EKG- heart palpitations Stress test Ultrasound ultrasound study- calcification build up

Allergies: no

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

Symptoms: 3 weeks to a month after my second injection, while sleeping, I had muscle twitching in my chest. I didn't think anything of it, but it got worse, especially at night. It wasn't until September I saw the cardiologist. On 9/29 they did a stress test and EKG. I was told I was having palpitations that was causing my heart to skip a beat or two. Presently it is almost gone but I still get a few at night.

Other Meds: Zocor, Tamsulosin, Prednisone, baby aspirin, multi vitamin, fish oil, CoQ 10, vitamin D tablet

Current Illness: no

ID: 1813717
Sex: F
Age: 55
State: IL

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: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies: Norco

Symptom List: Rash, Urticaria

Symptoms: Chills fever body aches

Other Meds: Nexium Effexor calcium

Current Illness: None

ID: 1813718
Sex: M
Age: 6
State: WA

Vax Date: 05/25/2021
Onset Date: 05/25/2021
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: None that is known

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

Symptoms: After receiving all those immunization shots I noticed on the leg that recieved the shots he could barely walk on that leg and was walking on his tip toes. For almost a week after my son had that limp and tip toe walking. Eventually the limp went away but the tip toe walking never went away and now he tip toe walks with both legs. I have had my son with me every day of his life I don?t work so I literally mean every single day he never walked like that prior

Other Meds: None

Current Illness: None

ID: 1813719
Sex: F
Age: 39
State: NH

Vax Date: 04/01/2021
Onset Date: 06/01/2021
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:

Allergies: None

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

Symptoms: Shortness of breath getting worse Rapid heart rate more frequently Dizziness

Other Meds: Hormone patch Vitamins B6, B12, fish oil, probiotics Vitamin supplements from Nutrofol for hair growth

Current Illness: None

ID: 1813720
Sex: F
Age: 51
State: NY

Vax Date: 07/21/2021
Onset Date: 07/25/2021
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: On September 28, various blood tests were performed. The results indicated prediobetic (5.7) and elevated cholesterol.

Allergies: Not known (Had a few reactions only to strawberry)

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

Symptoms: 1. Got sick on 07.25.2021 with running nose, coughing, sneezing, headache (lasted for 3 weeks). Tested for COVID on August 2- negative 2. Infection in the throat on August 19 while on vacation, had to admit myself to the emergency room 3. Swallowing parts of the face from around September 7. It swallows by sections: lower lip, upper lip, under and above left eye, then the same around right eye, forehead and nose.

Other Meds: None

Current Illness:

ID: 1813721
Sex: F
Age: 37
State: FL

Vax Date: 10/07/2021
Onset Date: 10/08/2021
Rec V Date: 10/24/2021
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: EEG CPap Lab draws frequently

Allergies: PCN, Tramadol, Doxycycline

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

Symptoms: I started having neck pains, body aches, right arm pain that felt like my arm was ripping and it was hard for me to hold things in my right hand. Over the next few days the symptoms had gotten worse until I had to go to the emergency room. I then was admitted to the hospital for 5 days and was assessed for a stroke/TIA. I had to get an EEG, labs every 12 hours, I had to be hooked up to a heart monitor, I have developed sleep apnea . I am now on medication that I will have to take for the rest of my life. I am still in so much pain. I have chronic headaches, my right arm isn?t better, my back is in so much pain, I have a bulging disk between C5-C6. I can barely put weight on my right foot. Everything was affected on my right side but I received the shot in my left arm.

Other Meds:

Current Illness:

ID: 1813722
Sex: F
Age: 56
State: NJ

Vax Date: 09/30/2021
Onset Date: 09/30/2021
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: Will be making appt with doctor.

Allergies: none

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

Symptoms: 09/30/21 sleepy, drunk-like, neck hurts, both arms tingling, arms itchy, lump in throat, foggy, arms numb and tingly, ears clogges 10/1/21 out sick from work, headache, neck hurts, shoulders sore, back hurts, injection site sore, lump in throat, exhaustion, skin burning on arms, headache, injection site sore 10/5 tingly arms and fingers, headache 10/12 continual itching, anxiety, headache, foggy 10/13 arms itching all through the night, cramps in feet 10/14 itching, cramps in feet 10/15 itching, exhuasted, piercing headache 10-17 muscle pain in right hand, neck hurts 10/18 exhausted, right kidney pain 10/19 stiff neck, tight chest, left big toe stiff 10/23 feel awful, whole body hurts, neck and I have not felt myself since I got the vaccine. Every day since, itchy, foggy, sore muscles, headache, overall exhaustio, weak. It's been 3 weeks and I continue to feel awful.

Other Meds: vit d3, vit c, zinc, turmeric, lunesta

Current Illness: none

ID: 1813723
Sex: F
Age: 53
State: VA

Vax Date: 10/23/2021
Onset Date: 10/24/2021
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: It started around 2 AM while I was sleeping. I had a fever of 103 and vomited several times. I still have a low grade fever at 10:34 AM and have been taking tylonel and advil. I have a horrible headache as well.

Other Meds:

Current Illness:

ID: 1813724
Sex: F
Age: 36
State: NC

Vax Date: 10/22/2021
Onset Date: 10/22/2021
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: NA

Allergies: Gluten

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Symptom within 1 hour post vaccine Injection site pain Symptoms 11 hours post vaccine Fatigue Swollen lymph under left arm (injection arm) Sore throat Headache Chills Feeling feverish Symptoms 24 hours post vaccine Muscle aches Skin soreness Fever 102 - excessive sweats and chills Headache Sore throat Swollen lymphs in neck and under both arms Fatigue Symptoms 48 hours post vaccine Injection site pain Swollen lymph under injection arm Headache

Other Meds: Venlafaxine Klonopin

Current Illness: None

ID: 1813725
Sex: M
Age: 25
State: SC

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

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

Symptoms: Right arm locked up during 1st and second dose. Shortly after feeling my arm get tense my chest locked up and I was unable to breathe and lost consciousness. Since receiving my second dose I have woken up everyday with a headache and my legs frequently go numb.

Other Meds:

Current Illness:

ID: 1813726
Sex: F
Age: 34
State: MN

Vax Date: 10/16/2021
Onset Date: 10/17/2021
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: None

Allergies: unknown

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

Symptoms: Full body splotchy rash persisting up to 7 days. Patient recommended to use Benadryl and contact primary care provider in case course of prednisone is indicated.

Other Meds: birth control, topiramate, lexapro

Current Illness:

ID: 1813727
Sex: F
Age: 71
State: MD

Vax Date: 09/02/2021
Onset Date: 09/08/2021
Rec V Date: 10/24/2021
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: None

Symptom List: Unevaluable event

Symptoms: She had cardiac arrest as a result of blood clots in her lungs. She had no history of blood clots. They could not stabilize her, she had numerous heart attacks back to back, she was on life support. She would have died if paramedics weren't there. They placed stents in her lungs to break up clots. She remained in the hospital for 3 weeks. She lost the ability to walk, rehab has helped with this.

Other Meds: 1x week vitamin D 1 for cholesterol

Current Illness: None

ID: 1813728
Sex: F
Age: 31
State: MA

Vax Date: 09/16/2021
Onset Date: 09/21/2021
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: October 18,2021 tests and EKG. Blood tests, and EKG done, with borderline abnormal t waves, and anterior leads. Blood test are normal. October 23,2021 I visited the emergency room for the heart palpitations I had a few EKgsdone, monitored my heart, and more blood tests. Blood tests normal, with exception of elevated d-dimer levels. We followed up with this doing a CT CHEST SCAN which showed No clots. Heart palpitations continue.

Allergies: None

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

Symptoms: Heavy Heart palpitations a few days following the shot, everyday following any stimulating activity such as eating, laughing, laying down, walking. It happens when I am doing nothing as well. heart palpitations occur every 5 seconds on average at least

Other Meds: Multivitamin

Current Illness: None

ID: 1813730
Sex: F
Age: 60
State: FL

Vax Date: 04/22/2021
Onset Date: 09/16/2021
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: Blood work which showed my potassium levels were slightly low. Chest x-ray was clear.

Allergies: Allergic to Parafon Forte and possibly Cipro

Symptom List: Injection site pain, Pain

Symptoms: On September 16, at approximately 12:00 pm I went into Atrial Fibulation. I was wearing an I-watch and it confirmed I was in A-Fib, so I called my cardiologist's office and spoke to a nurse. She told me to call an ambulance, which I did. Paramedics arrived four minutes later, hooked me up to an EKG to confirm A-Fib, which is was, was taken to hospital via ambulance. Shortly after arriving, my heart went back into normal sinus rhythm on its own. No medication was needed or other treatment. Resident Doctor spoke to my cardiologist via telephone and they decided on a course of treatment which was Eloquis and Bystolic. Followed up with doctor a week later. I am a 60 year old female who exercises 5-6 days a week for the last 40 years. Cardio, yoga, weight training. Not over weight, eat fairly healthy. Never had any heart issues my entire life until this.

Other Meds: Levothyroxine 112 mcg, Lipitor 10 mg, Fosomax 70 mg, Baby Aspirin, Vitamin D3, Calcium 600 1200 mg, Vitamin C, Mature Multi Vitamin, Probiotics, Biotin with Collagen, Zinc,

Current Illness: None

ID: 1813731
Sex: F
Age: 48
State: TN

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: SYR
Vax Site: LA

Lab Data: None

Allergies: Myrbetriq

Symptom List: Injection site pain, Menorrhagia

Symptoms: Rash appears on bilateral arms about 45 min after injections given. Benadryl, Claritin and pepcid taken but hives became bigger and more itchy. Steroid shot given at urgent care 3 days later

Other Meds: Estrace, nadolol, lexapro, Mvi, vit d, zinc, magnesium, ibuprofen, excedrin

Current Illness: None

ID: 1813732
Sex: F
Age: 39
State: VA

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

Lab Data:

Allergies:

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

Symptoms: Psychotic episode more severe than has been since I?ve been on an anti psychotic medication. Lasted about an hour until the 6mg of klonopin kicked in and I fell asleep.

Other Meds: Phenelzine sulfate 15 mg BID Lamotrigine 200 mg QD Haloperidol 4 mg QD Deplin 15 mg QD Dexilant 60 mg QD Clonazepam 0.5 mg PRN Fish oil 1200 mg QD Vitamin D3 5000 IU QD Tylenol 1000mg

Current Illness:

ID: 1813733
Sex: F
Age: 53
State: WI

Vax Date: 10/22/2021
Onset Date: 10/22/2021
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: Penicillin

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: headache, arm lot of pain swollen and hot, very dizzy , VERY exhausted VERY weak VERY hard to even just stand walking only few steps knees going VERY weak. Wheezing & hard to breath hard to speak chest heavy

Other Meds: Tylenol

Current Illness: none

ID: 1813734
Sex: F
Age: 66
State: CT

Vax Date: 04/01/2021
Onset Date: 04/02/2021
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: Sulfa

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: COVID Arm: large lump, large rash and warm to the touch.

Other Meds: Vitamin D, calcium, vitamin B complex, aripipazole, prameprexole, trazadone, sertriline, clonazapam, atorvastatin, wellbutrin

Current Illness:

ID: 1813735
Sex: F
Age: 66
State: IN

Vax Date: 10/22/2021
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: None

Allergies: Sulfa

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

Symptoms: Fever 101-102 x 24 hrs, hard chills x 4 hrs, headache x 24 hrs, severe body aches x 24 hrs, severe injection site soreness x 24 hrs, agitation x 12 hrs, generalized malaise and fatigue x 48 hrs

Other Meds: Simvastatin, HTCZ, metoprolol, fish oil, CoQ10, vitamin D, multivitamin, turmeric

Current Illness: None

ID: 1813736
Sex: M
Age: 29
State: NY

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: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Pt received J+J as their first vaccination. Came in to get the moderna booster. According CDC guidelines pt is to get 0.25ml booster, instead he was given full 0.5ml booster. No adverse affects.

Other Meds:

Current Illness:

ID: 1813737
Sex: F
Age: 34
State: CA

Vax Date: 08/14/2021
Onset Date: 10/09/2021
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: My menstrual period ended on 10/2/21, and I began having period symptoms 1 week later- on 10/9/21, very strange and at the wrong time of the month. Symptoms include breast pain, hunger, and irritability. My next period came early, a 26 day cycle, on 10/24/21. My period is very regular and I have never experienced a disruption to my cycle.

Other Meds: Prenatal vitamin

Current Illness:

ID: 1813738
Sex: F
Age: 58
State: MN

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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Depakote; Fentanyl; Morphine; Meperidine

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

Symptoms: Fever, chills, body aches, nausea started about 1 day after 3rd dose of modern. Arm pain started same day as injection but is less severe than other symptoms being experienced.

Other Meds: Aripiprazole (ABILIFY) 2 mg oral tablet Take 2 mg by mouth; aspirin 81 mg Oral chew tab Take 1 Tab; butalbital-acetaminophen-caf-cod 50-300-40-30 mg Oral Cap Take 1 capsule; carboxymethylcellulose sodium (REFRESH) 1 % Opht Drop; clonazepam

Current Illness: Cardiac palpitations; right knee pain

ID: 1813739
Sex: F
Age: 76
State: SC

Vax Date: 10/05/2021
Onset Date: 10/05/2021
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: None

Allergies: Penicillin, Tetracycline, Cleocin, Cipro, Bactrim

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

Symptoms: Four straight hours of diarrhea starting 5 1/2 hours after injection on Tuesday. Followed by chills the rest of the night with increasing temp., every joint in my body ached, hips, spine, neck and head were on fire. By 1:00 p.m. on Wednesday temp topped out at 102.4, (my normal is high 97's) chills continued. Nausea. No vomiting, but close...and the mere thought of food started the stomach rolling. By Thursday morning temp was down to 101.0, nausea slightly improved. Friday, temp down to 100's, nausea gone and body aches were still there but better. Saturday temp in the 99's, actually hungry. Weak, tired, felt like I had been hit by a bus. It was Sunday before temp finally returned to normal. I'm sole caretaker for my husband and this was not a fun week!

Other Meds: Armour Thyroid, Meloxicam, ASA, Simvastatin, Lisinoprol, Singular, Zolpidem, Melatonin, Zyrtec, Prilosec, Trelegy Multi vitamin, Fish oil, Salmon oil, Big B 100, Vitamin C, Calcium, Cranberry, Vitamin E, Flaxseed oil, Lutein, Niacin, Potass

Current Illness: None

ID: 1813741
Sex: F
Age: 30
State: GA

Vax Date: 10/19/2021
Onset Date: 10/20/2021
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: After receiving her COVID-19 vaccine, patient developed a red, indurated and warm area to the skin overlying the injection site.

Other Meds:

Current Illness:

ID: 1813742
Sex: M
Age: 36
State: NY

Vax Date: 10/14/2021
Onset Date: 10/19/2021
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: None

Symptom List: Erythema, Pruritus

Symptoms: Chest pain. Tingling in hands and feet that won't go away.

Other Meds:

Current Illness: None

ID: 1813744
Sex: F
Age: 43
State: CA

Vax Date: 05/10/2021
Onset Date: 05/18/2021
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: Full testing for parasites, bacteria, viral causes of said symptoms. All negative. Awaiting colonoscopy.

Allergies: Celiac- gluten intolerance

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

Symptoms: 5 months ongoing, daily abdominal pain and colorectal bleeding. Frequent (several times weekly) uterine bleeding.

Other Meds: None

Current Illness: none

ID: 1813745
Sex: M
Age: 85
State: NJ

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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: None

Allergies: Fentanyl

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

Symptoms: Moderna Covid-19 Vaccine EAU I received my third shot of the Vaccine on Friday at about 4 PM. ( 10/22/2021). On Saturday morning about 9 AM I began to have chills, teeth chattering, and some head aches. At the time I was working in a boat yard and often on boats. I had a friend drive me home and I got home late morning. More headaches and continued chills and teeth chattering. I went to bed for the rest of the day and basically stayed in bed till this morning. I believe I am now OK but will take it easy today. The first two Moderna shots did not trouble me at all. This came as a surprise.

Other Meds:

Current Illness:

ID: 1813746
Sex: F
Age: 40
State: FL

Vax Date: 10/15/2021
Onset Date: 10/17/2021
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: I have been tested for allergies. I have Severe Allergies to All seafood and shellfish. All nuts except peanuts and almonds. Outdoor misc allergies (e.g., oaks, grasses, etc), dust, carcass proteins (bugs), dogs, and cats. Moderate allergies to Wheat (Gluten), and dairy.

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: I have been experiencing chronic fatigue and sleepiness. I usually have the energy to go to the gym and move about as needed during my day. I used to sleep about 8 hours and sometimes dealt with a bit of insomnia. Now I am requiring 10-12 hours of sleep to even function. Even when I wake I am still chronically tired and could sleep all day if I was able to do that. I feel like I am walking through mud all of the time and fighting to stay awake. I have also have nerve pain in my feet and hands that I did not have before.

Other Meds: Cetirizine 10mg daily Supplements/Daily: Iodine, Collegen, Spirulina, Biotin, Multivitamin, Fiber, and probiotic.

Current Illness: none known

ID: 1813747
Sex: F
Age: 26
State: NY

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: 011J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Pt received J+J as their first vaccination. Came in to get the moderna booster. According CDC guidelines pt is to get 0.25ml booster, instead he was given full 0.5ml booster.

Other Meds:

Current Illness:

ID: 1813748
Sex: M
Age: 66
State: FL

Vax Date: 10/18/2021
Onset Date: 10/22/2021
Rec V Date: 10/24/2021
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: None

Allergies: None

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

Symptoms: Sudden onset of extreme fatigue and systemic pain in joints (hands, shoulders, knees)

Other Meds: Bystolic, Vytorin, Metformin

Current Illness: None

ID: 1813749
Sex: F
Age: 29
State: MN

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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Sulfa

Symptom List: Pain in extremity

Symptoms: Chills

Other Meds: Lamotrigine, sertraline

Current Illness:

ID: 1813750
Sex: F
Age: 29
State: MA

Vax Date: 10/23/2021
Onset Date: 10/24/2021
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:

Allergies:

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

Symptoms: Woke up at 2AM with full-body aches and chills, nausea, headache. Alternating hot and cold, and muscle weakness. Patient blacked out twice, at 2:30 and 8:30 AM, for approximately 20 seconds each time. Temperature was slightly elevated at 99.1. Currently (11 AM) patient is sore and feeling feverish, with a headache.

Other Meds:

Current Illness:

ID: 1813751
Sex: F
Age: 67
State: IN

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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: none

Allergies: none

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

Symptoms: Began experiencing chills approx. twelve hours after receiving the Pfizer booster. Began running a fever of 102F for 24 hours which then lowered to 100F for another 24 hours. Total time running fever=48 hours. Fever broke with intense sweating requiring a change of pajama top.

Other Meds: lisinopril, atorvastatin,melaxicam

Current Illness: none

ID: 1813752
Sex: F
Age: 58
State: WA

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

Lab Data:

Allergies:

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

Symptoms: Fatigue Headache Muscle aches Shivering/chills Lethargy Loss of appetite Diarrhea

Other Meds: Topirimate Black cohosh magnesium Multi vitamin Nifedipine xl Miralax Flonase Zinc Selenium D3

Current Illness:

ID: 1813753
Sex: F
Age: 46
State: TX

Vax Date: 03/01/2021
Onset Date: 06/01/2021
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:

Allergies: None

Symptom List: Vomiting

Symptoms: On my period for 26 straight days. Hair is falling out. Digestive issues

Other Meds: Adderall, lamictal, Zoloft, alprazolam

Current Illness: None

ID: 1813754
Sex: F
Age: 64
State: DC

Vax Date: 10/03/2021
Onset Date: 10/23/2021
Rec V Date: 10/24/2021
Hospital: Y

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

Lab Data: WBC count 0.8 hemoglobin 7.0

Allergies: ketoconazole, penicillins

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: anemia and leukopenia

Other Meds: prednisone, furosemide, sodium bicarbonate, nifedipine, Lokelma, vitamin c, sevelamer, fish oil

Current Illness: lupus/Sjogren's syndrome/pulmonary amyloidosis, heart failure, chronic kidney disease, Tubulo-interstitial nephritis, chronic anemia, requiring transfusions

ID: 1813755
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: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data: None done I did have labs in Sept 2021 and CBC was unremarkable

Allergies: Erythromycin

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

Symptoms: woke up from sleep with pillow 1/2 covered in blood with blood clots, nose freely dripping blood and clots. Went to bathroom and applied pressure, spit out many blood clots the size of ?? an apricot. 45-50 minutes pressure to nose and bridge of nose and cold compresses and finally stopped. Lost a remarkable amount of blood

Other Meds: ACV, womans multivite, probiotic

Current Illness: Diabetes, kidney, lumbar disc herniations

ID: 1813756
Sex: M
Age: 26
State: NY

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:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Pt received J+J as their first vaccine, and came in for their moderna booster. According to CDC guidelines pt is to get 0.25ml Moderna booster. Instead the patient received full 0.5ml dose.

Other Meds:

Current Illness:

ID: 1813757
Sex: F
Age: 19
State: FL

Vax Date: 10/23/2021
Onset Date: 10/24/2021
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:

Allergies: N/A

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

Symptoms: Fever/chills, nausea, vomiting, syncope, increased urination

Other Meds: Potassium citrate 15meq, daily vitamin

Current Illness: N/A

ID: 1813758
Sex: M
Age: 28
State: CO

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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data: N/A

Allergies: No

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

Symptoms: Patient was given his Pfizer booster dose 9 days before eligibility. Patient had no adverse side effects.

Other Meds: No

Current Illness: No

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am