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: 1814647
Sex: F
Age: 64
State: MN

Vax Date: 10/06/2021
Onset Date: 10/06/2021
Rec V Date: 10/25/2021
Hospital:

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

Lab Data: None, it's much better and did not require treatment.

Allergies: Latex

Symptom List: Dysphagia, Epiglottitis

Symptoms: Moving L arm as I was driving home and began aching to the point that I had to hold the arm very still. The arm was better by bedtime but continued to periodically ache slightly for about 1 week. Currently, certain movements cause slight and fleeting discomfort

Other Meds: Mega red, eye vitamin, vitamin D, vitamin B complex, MVI, calcium

Current Illness: None

ID: 1814648
Sex: M
Age: 56
State: NC

Vax Date: 10/22/2021
Onset Date: 10/23/2021
Rec V Date: 10/25/2021
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: About 19 hours after my injection I began experiencing pain and swelling in the injection site and headache. The following morning on Sunday, 10/24, I was experiencing fatigue, headache, dizziness, chills, slight fever and pain/swelling in the injection site. The swelling was about 3 inches in diameter. On Monday morning, the symptoms above were still present but about half as they were on Sunday.

Other Meds: Eliquis, Famotidine, Amlodipine, Atorvastatin, Men's 50+ Multivitamin

Current Illness: N/A

ID: 1814649
Sex: M
Age: 68
State: IA

Vax Date: 05/13/2021
Onset Date: 05/29/2021
Rec V Date: 10/25/2021
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: Bloodwork

Allergies: Oxymorphone, All Codeine, Diagnostic Iodine

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

Symptoms: I was a little dizzy and with thin a couple of weeks I had neuropathy that started to set in. I went and saw my PCP and was prescribed two medications ( Gabapentin and Tizanidine ). I went to the ER/Hospital due to an adverse reaction to the gabapentin that I was prescribed. I had a medical work up at the ER and that's when I got the diagnoses of the neuropathy.

Other Meds: Aspirin (81mg Daily), Nitroglycerin Spray

Current Illness: NA

ID: 1814650
Sex: F
Age: 31
State: NY

Vax Date: 10/20/2021
Onset Date: 10/21/2021
Rec V Date: 10/25/2021
Hospital:

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

Lab Data:

Allergies: food- mushrooms

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: chills, fever, diarrhea

Other Meds: Tylenol

Current Illness: none

ID: 1814651
Sex: F
Age: 11
State: MN

Vax Date: 10/21/2021
Onset Date: 10/22/2021
Rec V Date: 10/25/2021
Hospital:

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

Lab Data:

Allergies: Seasonal

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

Symptoms: None noted

Other Meds: Zyrtec

Current Illness:

ID: 1814652
Sex: F
Age: 49
State: TX

Vax Date: 10/22/2021
Onset Date: 10/24/2021
Rec V Date: 10/25/2021
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: N/A

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

Symptoms: General body aches and chills with no fever, slight headache and tinnitus

Other Meds: Aimovig, Ambien, Estradiol 2 MG, Levothyroxine 25 MG, Xyzal

Current Illness: None

ID: 1814653
Sex: M
Age: 35
State: OK

Vax Date: 10/22/2021
Onset Date: 10/22/2021
Rec V Date: 10/25/2021
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: within 10 mins of vax on 10/22 pt says his neck/skull was hot, a few hours later pt arm was painful like a beesting, on 10/23 his chest felt tight and his arm is still sore, tightness in chest persisted on 10/23, pt says his heart beat was slower then usual, pt has low energy

Other Meds:

Current Illness: cut on shoulder

ID: 1814654
Sex: F
Age: 57
State: AZ

Vax Date: 10/17/2021
Onset Date: 10/18/2021
Rec V Date: 10/25/2021
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: None

Symptom List: Pharyngeal swelling

Symptoms: Fibromyaglia Flare Up. Very bad migraine (worst ever) that lasted 3 days until I started a course of Methylpred to try to reduce the pain. Nausea. Body Aches. Fatigue. Dizziness.

Other Meds: Vitamin D3, Magnesium, Biotin, Ibuprofen, Tylenol, Allegra, Zetia

Current Illness: None

ID: 1814655
Sex: F
Age: 67
State: VA

Vax Date: 04/20/2021
Onset Date: 09/29/2021
Rec V Date: 10/25/2021
Hospital:

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

Lab Data: Covid Test - 10/1/2021 - positive

Allergies: Penicillin, Sulfa drugs

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: It happened on 9/29/21, I woke up in the middle of the night with a severe headache and chills. I had a fever or 103.8, I also had coughing and congestion all of which hit at one time. I had a fever through the 29th, 30th and congestion and headache as well. I called my DR and he ordered for me to go get Covid tested. On Friday the 1st of October I still had a fever and congestion and headache it lingered. On Monday and Tuesday (4th and 5th) I did not go to work. On October the 7th I still had the congestion and was coughing up stuff too, extremely tired as well. In fact, I did not work that entire week and then I went back to work for half days on the 11th, 12th and 13th. On the 14th and 15th I went back full time. I still do not have any smell or taste today (10/25) as well. By the way, my DR had given me a seven day supply of Doxycycline 100mg.

Other Meds: Cymbalta 30MG 1x daily, Levothyroxine 75McG 1x daily, Lisinopril 20mg 1x daily

Current Illness: n/a

ID: 1814656
Sex: M
Age: 54
State: NC

Vax Date: 03/17/2021
Onset Date: 10/13/2021
Rec V Date: 10/25/2021
Hospital:

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

Lab Data: 10/15/21 positive covid test

Allergies: none

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Contracted Covid, tested positive 10/15/21

Other Meds: none

Current Illness: none

ID: 1814657
Sex: M
Age: 37
State: FL

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

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

Lab Data: i went to the Dr on 10/15/2021. I was prescribed the erythromycin. at this time, the itching was in my left eye only. Then on monday the 18th of october, it spread to my right eye.

Allergies: none

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

Symptoms: at first my left eye started getting itchy and my eye lid started to get red and swell. over the next couple of days it kept getting worse. Then it spread to my right eye. I was given Erythromycin ophthalmic ointment and started taking benadryl, zyrtec and eye drops but nothing helped. There was a severe burning and itching sensation in both eyes, non-stop. the skin around my eyes has turned dry and itchy as well. The itching spread to my ears, forehead and other parts of my body. Eventually I was given a Medrol pack, this has helped alot but I can feel the itchy and burning trying to come back. I am on the 5th day of the methylprednisolone, the itching is minimal now but my eyes still burn from time to time. the burning feels like I just cut an onion . In addition to this, I was having stomach issues for the first week, I was having diarrhea and random lower body parts were itchy. When i put hot water on the itchy areas, it felt very good, but it did not relive the pain/itching.

Other Meds: Buprenorphine

Current Illness: none

ID: 1814658
Sex: F
Age: 55
State: MN

Vax Date: 03/18/2021
Onset Date: 10/19/2021
Rec V Date: 10/25/2021
Hospital:

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

Lab Data: SARS-CoV-2 10/22/21

Allergies: None

Symptom List: Rash, Urticaria

Symptoms: Patient tested positive for COVID after being fully vaccinated

Other Meds: Progesterone Micronized ALPRAZolam (XANAX) 0.25 MG tablet meloxicam (MOBIC) 7.5 MG tablet Estradiol-Estriol-Progesterone (BIEST/PROGESTERONE) CREA hydrocortisone (ANUSOL-HC) 2.5 % rectal cream cyclobenzaprine (FLEXERIL) 10 MG tablet ac

Current Illness:

ID: 1814659
Sex: M
Age: 37
State: IL

Vax Date: 10/08/2021
Onset Date: 10/17/2021
Rec V Date: 10/25/2021
Hospital: Y

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

Lab Data: COVID-19 test - negative. MRI brain, negative any findings. CT angio of the neck - negative for any vascular abnormalities. Cardiac monitored for at least 24h due to autonomic symptoms during episodes (extreme cold sweat, pins and needles in arms and legs, muscle rigidity, BP changes, bradycardia). Normally BP normal, HR 60's-70' and was a low as 50.

Allergies: None

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

Symptoms: I had previously opened a VAERS report, but more details are now available. Significant to this injection that was also left out originally was that the injection in my right arm almost completely missed my deltoid and was partially into my right shoulder joint. I was hospitalized for 3 days with vestibular neuritis; I had previously entered a VAERS report regarding this incident with the ADR simply as vertigo. I was diagnosed by a neurologist as having vestibular neuritis by the day of discharge after ruling out other explanations of symptoms. I was treated with a Medrol-Dose Pak taper, Valium, and now have significant improvement without any vertigo episodes since hospital discharge.

Other Meds: Zoloft, Allegra, Flonase

Current Illness: None

ID: 1814660
Sex: F
Age: 80
State: IL

Vax Date: 09/28/2021
Onset Date: 10/01/2021
Rec V Date: 10/25/2021
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: no known allergies

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

Symptoms: Patient contacted the pharmacy on October 1st, 2021 complaining of redness and swelling at the injection site. We counseled patient to ice the area and massage. Also recommended using acetaminophen for pain relief.

Other Meds: Fluoxetine 20mg caps

Current Illness: no know illnesses

ID: 1814661
Sex: F
Age: 28
State: FL

Vax Date: 10/20/2021
Onset Date: 10/22/2021
Rec V Date: 10/25/2021
Hospital:

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

Lab Data: Vitals/PE - referred to PCP for diagnostics

Allergies: Amoxil, Shellfish

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

Symptoms: Left arm sore, Fatigue, Dizziness, CP

Other Meds: Albuterol prn, Zyrtec/Benadryl prn

Current Illness: Not known

ID: 1814662
Sex: F
Age: 30
State:

Vax Date: 10/06/2021
Onset Date: 10/06/2021
Rec V Date: 10/25/2021
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: Pt received the second shot 16 days after the first COVID shot, which is one day too early. Pt experienced fatigue and headache for 2 days and both of those have since resolved.

Other Meds:

Current Illness:

ID: 1814663
Sex: F
Age: 64
State: MI

Vax Date: 10/23/2021
Onset Date: 10/25/2021
Rec V Date: 10/25/2021
Hospital:

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

Lab Data: none

Allergies: none

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

Symptoms: Swollen Lymph notes in left arm pit. Woke up during the night from the pain.

Other Meds: Multiple vitamins-minerals, Armour Thyroid 60mg, Atorvastain 10MG, cymbalta 90mg

Current Illness: none

ID: 1814664
Sex: F
Age: 59
State: NY

Vax Date: 10/13/2021
Onset Date: 10/15/2021
Rec V Date: 10/25/2021
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: none

Symptom List: Ear pain, Hypoaesthesia

Symptoms: dizzy/light headed still-when i close my eyes it feels like i am falling

Other Meds: one a day multi

Current Illness: none

ID: 1814665
Sex: M
Age: 52
State: NJ

Vax Date: 06/02/2021
Onset Date: 06/02/2021
Rec V Date: 10/25/2021
Hospital:

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

Lab Data: None

Allergies: None known

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: I suffered some type of allergic reaction in which the glands in my throat swelled, which resulted in difficulty swallowing and labored breathing. Although the swelling decreased after a day, I still have difficulty swallowing and experience occasional shallow breath. This has made use of my CPAP for sleep apnea incredibly difficult. I need to keep the CPAP on its highest setting, but this causes my nasal passages to dry out to a point where swallowing becomes impossible. When this has happens, I have awake in a panic until my ability to swallow resumes.

Other Meds: Metformin, Finasteride

Current Illness: None

ID: 1814666
Sex: F
Age: 40
State: NY

Vax Date: 06/07/2021
Onset Date: 06/08/2021
Rec V Date: 10/25/2021
Hospital:

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

Lab Data: Culture Bloodwork Pelvic Exam Ultrasound

Allergies: ciproflaxin

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

Symptoms: When I woke up the morning after the shot, I could tell I had a temperature. I checked and it was 101.5. When I had COVID, it only got up to 99. I had a headache and felt very ill. I took Tylenol to help with the temperature. The symptoms were consistent throughout the day. The next day I felt a little better. This resolved within 36 hours. My cycle, which is very consistent, has become very erratic. I noticed my flow is lighter and I have spotting in between. It was almost 5 weeks between which is almost double what it usually is before I got the vaccine. My cycle is routine and punctual so this is a concern to me. I saw my naturopathic doctor who suggested I see a gynecologist. I had bloodwork done on Friday, so I do not have any results yet.

Other Meds: Synthroid, cytomel, multivitamin, Vitamin B, Vitamin D

Current Illness: COVID 19

ID: 1814667
Sex: F
Age: 48
State: MN

Vax Date: 10/24/2021
Onset Date: 10/24/2021
Rec V Date: 10/25/2021
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: Paramedics and police were called. I had blood pressure, blood sugar, pulse, and EKG of heart done to determine why. Questioned on health history, which history is normal. All vitals came back normal, I was treated on scene and not transported, was told it may have been an adverse reaction to booster.

Allergies: NA

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

Symptoms: Received booster, left facility and entered my vehicle. Left facility parking lot by car, injection site felt tingly and I became lightheaded and dizzy. Attempted to pull car over however blacked out while driving, crashed car and had to be woken up by witness to crash, I was not required or told by pharmacy to wait for observation after booster was administered. No bodily injury to myself or anyone else, just property damage and auto damage.

Other Meds: Allegra, Junel Fe, DayQuil

Current Illness: Cold like symptoms, mild cough

ID: 1814668
Sex: F
Age: 41
State: MO

Vax Date: 03/30/2021
Onset Date: 03/30/2021
Rec V Date: 10/25/2021
Hospital:

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

Lab Data: Hand Xray, hand mri and Ana other autoimmune tests. All normal yet you can VISIBLY see swelling in my knuckle. My arm and especially elbow hurts the most now but knuckle does too. I felt like I couldn't get help and tried stretches daily and therapy on my own but will follow up with Dr again soon about pain moving up right arm to elbow and continued swelling in knuckle. I just don't know what to do. I am losing range of motion and stability in my dominant arm because of this. It is causing a concern that it will become a disability if it isn't already. I can't mow, lift a pitcher, walk my fog without severe pain. It gives out on me. Dr doesn't seem to have an answer which is why I delayed going back yet but it is worse every day.

Allergies: Codeine

Symptom List: Unevaluable event

Symptoms: Day-horizontal watching TV. Nothing strenuous for says before and during. Evening, swollen RIGHT middle finger KNUCKLE and painful. Continued to increase in pain. Saw Dr a few months later. Xray normal. Month later mri normal. Week later, pain moved up arm into elbow. Pain is constant increasing in intensity. Knuckle still swollen. Can't brush hair or scratch back or scoop cat litter without severe arm pain. Knuckle still swollen and hurts. Will follow up with doctor soon. Started day OF shot. No other reasons or activities to cause it. No tick bites no changes in environment or illnesses or scratches or strenuous activity. Very frustrated. I know that shot caused this and I am NOT an antivaxer. But this caused my pain and there is no resolution or end to it. My daughter still got both her shots. But I know something j. The shot triggered this in me. Because of this, I did not get my second shot.

Other Meds: Birth control Vitamin d Vitamin b

Current Illness: No

ID: 1814669
Sex: M
Age: 79
State: KY

Vax Date: 03/24/2021
Onset Date: 10/23/2021
Rec V Date: 10/25/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: Pfizer on 3/3 and 3/24. Positive on 10/22

Other Meds:

Current Illness:

ID: 1814670
Sex: F
Age: 65
State:

Vax Date: 05/26/2021
Onset Date: 10/24/2021
Rec V Date: 10/25/2021
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:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Vaccine breakthrough, inpatient admit currently

Other Meds:

Current Illness:

ID: 1814671
Sex: M
Age: 20
State: NC

Vax Date: 10/22/2021
Onset Date: 10/23/2021
Rec V Date: 10/25/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List: Injection site pain, Menorrhagia

Symptoms: Body aches, headache, difficulty breathing/chest pain

Other Meds: Pt denies

Current Illness: Pt denies

ID: 1814672
Sex: M
Age: 59
State: KY

Vax Date: 08/28/2021
Onset Date: 10/24/2021
Rec V Date: 10/25/2021
Hospital: Y

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: Janssen on 8/28. Positive on 10/24

Other Meds:

Current Illness:

ID: 1814673
Sex: M
Age: 37
State: VT

Vax Date: 10/18/2021
Onset Date: 10/21/2021
Rec V Date: 10/25/2021
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: none

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Approximately 3 days following the vaccine, I developed a severe migraine (aura, severe headache and nausea) that lasted for about 4 hours followed by 24 hours of fatigue and weakness.

Other Meds:

Current Illness:

ID: 1814674
Sex: F
Age: 1
State: IL

Vax Date: 09/23/2019
Onset Date: 09/25/2021
Rec V Date: 10/25/2021
Hospital:

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

Lab Data: None

Allergies: None

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: 2cm in diameter redness and swelling with left over mild scarring of the skin at 1 month out. No skin breakdown or necrosis. Redness followed by mild hyperpigmentation with overlying rough texture.

Other Meds: None

Current Illness: None

ID: 1814675
Sex: M
Age: 63
State: NE

Vax Date: 10/24/2021
Onset Date: 10/24/2021
Rec V Date: 10/25/2021
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: Pfizer covid vaccine was reconstituted with 1.4 ml of diluent instead of 1.8ml. This was realized soon after the patient's dose was given. CDC was called and after consulting with the CDC pharmacist. I counseled the patient that they might experienced more severe arm pain, body aches, fever, etc,

Other Meds:

Current Illness:

ID: 1814676
Sex: F
Age: 57
State: KY

Vax Date: 04/12/2021
Onset Date: 10/20/2021
Rec V Date: 10/25/2021
Hospital:

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

Lab Data: Antigen test administered on 10/22/2021 at the Hospital

Allergies: Unknown

Symptom List: Nausea

Symptoms: Patient contracted COVID-19

Other Meds: Unknown

Current Illness: Unknown

ID: 1814677
Sex: F
Age: 38
State: PR

Vax Date: 08/16/2021
Onset Date: 08/16/2021
Rec V Date: 10/25/2021
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: Female patient 38 years old, 16 weeks of gestation uncontrolled DM II does not comply with medical recommendations to take her medications daily or to eat an adequate diet for her dx or her pregnancy. Patient in area of observation at 5:30 feeling dizzy, cold and hot. EMT transports patient to area of observation and paramedic takes her vitals BP 140/70, HR 81, Dext 87, SPO99. 5:35 Doctor is called and gives order for patient to drink juice or 7-UP and to keep her under observation for 30min, Patient verbalizes having taken Cyclon before the vaccination on D/C; min home. Patient was kept under observation for 30min as instructed by Doctor. Patient is instructed to talk with her OBG. Patient improves and after 30min and she is discharged to go home.

Other Meds: N/A

Current Illness: N/A

ID: 1814678
Sex: F
Age: 53
State: TN

Vax Date: 09/27/2021
Onset Date: 10/12/2021
Rec V Date: 10/25/2021
Hospital: Y

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

Lab Data: ER 10/13/2021: ER :10/16/2021 and 10/18/2021; 10/18/2021-10/24/2021: Lumbar Puncture, MRI; Dose 1:12/29/2020 025L20A; Dose 2:01/29/2021 030L20A.

Allergies: Tetracycline; Sulfa; Bactrim; Shellfish and Shrimp

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

Symptoms: About two weeks after the third dose of the vaccine I started to have severe low back. I had also had back pain after the other two doses of the vaccine which was around the same timing. I also had abdominal pain midline in the front. The Abdominal pain got worse and I went to the Emergency Room. They treated the abdominal pain with Morphine and another narcotic which did not seem to help. I was prescribed Bentil and Zofran. I was later prescribed Prednisone and Flexeril. The next day I broke out in a burning rash on my Trunk and the backs of my knees. I had a burning sensation in my mouth and Esophagus. I went to a walk-in clinic on 10/16/2021 and I was sent to the ER. I was prescribed medication. I got weaker over the next tow days. I fainted twice. I was taken by ambulance on 10/18/2021 with Right sided Paralysis after being unconscious. All tests were normal. I was transferred to the hospital. After testing I was told it was a Guillen Barre syndrome. I still have some Right Sided Neurological problems and Bladder disfunction with shortness of breath. I have trouble swallowing and some coughing.

Other Meds: Nexium; Lomotil; Collagen; Peptide Powder

Current Illness: N/A

ID: 1814679
Sex: M
Age: 45
State: NY

Vax Date: 02/25/2021
Onset Date: 02/26/2021
Rec V Date: 10/25/2021
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: SULFA

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

Symptoms: MIGRAINE

Other Meds: N/A

Current Illness: NONE

ID: 1814680
Sex: M
Age: 36
State: VT

Vax Date: 01/09/2021
Onset Date: 01/12/2021
Rec V Date: 10/25/2021
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: Approximately 3 days after receiving vaccine, developed severe migraine (aura, sharp headache and nausea) that lasted about 4 hours followed by 24 hours of fatigue and weakness.

Other Meds:

Current Illness:

ID: 1814681
Sex: M
Age: 49
State: AL

Vax Date: 06/15/2021
Onset Date: 06/17/2021
Rec V Date: 10/25/2021
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: Extreme chills.

Other Meds: None.

Current Illness: None.

ID: 1814682
Sex: F
Age: 63
State: NE

Vax Date: 10/24/2021
Onset Date: 10/24/2021
Rec V Date: 10/25/2021
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: Vaccine was mixed with 1.4 ml of diluent instead of 1.8 ml. The mixing error was discovered shortly after administration. The patient was notified immediately (still in recovery area.) CDC was called and I spoke to a pharmacist who said the patient may have more localized reaction (arm pain) as well as fever, body ache, etc.

Other Meds:

Current Illness:

ID: 1814683
Sex: F
Age: 40
State: WI

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

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

Lab Data: na

Allergies: Shrimp, pistachios, bee stings, seasonal environmental

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

Symptoms: 5 minutes after booster injection, I noticed the injection site was starting to itch. I looked at it and it was red. I waited 5 more minutes and I felt more of my arm and chest starting to itch. My upper arms, armpit and chest was red. I notified the RN and was taken to lay down. I felt very hot. BP was elevated. Neck and head started to itch. At about 1245 Benadryl was given orally and I was wheeled to the Emergency department. BP 220/110. I felt dizzy and back and upper legs also starting to itch. Oral steroids given and also prescribed for the next 4 days.

Other Meds: Multivitamin; Mirena IUD

Current Illness: none

ID: 1814684
Sex: F
Age: 51
State: MD

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 10/25/2021
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: Allergy to medications Theralene and Prometazine

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: I had some of the expected side effects: nausea, fatigue, significant muscle pain (it felt like my bones were hurting too), congestion, headache. I also developed other side effects not listed: the most troublesome that just recurred with the booster is increased heart rate. For several hours (3-4 hours) I had tachycardia. The other, less bothersome, was pain upon anything touching my skin.

Other Meds: Sertraline 12.5mg, Vitamin D 1000IU, Ca/Mg supplement

Current Illness: None

ID: 1814685
Sex: M
Age: 58
State: NY

Vax Date: 04/24/2021
Onset Date: 04/28/2021
Rec V Date: 10/25/2021
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: Bactrim, Penicillin.

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

Symptoms: absolutely the most debilitating and severe upper arm/shoulder pain I have ever had. EXCRUCIATING!!!! Woke me up out of a sound sleep and it was nearly a month before I could use that arm. I STILL get twinges in that arm about once a week. I believe it may have been a type of bursitis?? I can not stress how painful this was. On a scale of 1-10, it was a 10.

Other Meds: Ibuprofen, Acetaminophen.

Current Illness:

ID: 1814686
Sex: M
Age: 28
State: MD

Vax Date: 10/20/2021
Onset Date: 10/20/2021
Rec V Date: 10/25/2021
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: Chest xrays- No active cardiopulmonary disease , effusion or pneumothorax EKG_ labs -Troponin <3, CBC-WNL, Electrolyte Panel- WNL covid testing-Negative

Allergies: No Known Drug Allergies

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

Symptoms: Associate was seen in the Emergency room 10/22/2021 , w/ complaints of chest pain and shortness of breath Symptoms started approximately 2 hours after vaccine

Other Meds: none

Current Illness: None

ID: 1814687
Sex: F
Age: 52
State: MD

Vax Date: 10/23/2021
Onset Date: 10/24/2021
Rec V Date: 10/25/2021
Hospital:

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

Lab Data:

Allergies: Allergy to medications Theralene and Prometazine

Symptom List: Pain in extremity

Symptoms: I developed similar side effects as with the second dose. Again, I experienced another episode of tachycardia that lasted about 3 hours.

Other Meds: Sertraline 12.5mg, Vitamin D 1000IU

Current Illness: None

ID: 1814688
Sex: M
Age: 63
State: AZ

Vax Date: 10/20/2021
Onset Date: 10/21/2021
Rec V Date: 10/25/2021
Hospital:

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

Lab Data: Covid test and chest X-ray while at the ER.

Allergies: None

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

Symptoms: Fever over 104 for 2 days. Fever above 101 for 2 days. Respiratory issues such as asthma started a day after injection. Major erection reported within 6 hours after injection. Same thing happen with the 2 prior injections. Patient is very tired and feels like his mind in in a fog. No loss of smell. Major chills and body akes. As of October 25, 2021 patient is in excellent shape but has not returned to normal activity.

Other Meds: None

Current Illness: None

ID: 1814689
Sex: F
Age: 74
State: MD

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 10/25/2021
Hospital:

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

Lab Data: don't remember dates, but within a few days after March 17, i had a blood test to see how it affected my blood platelets, they seemed to be ok. However, seven months later, in October 18, 2021, during my annual physical, in preparation for that had blood test on October 8, the results of the test showed a drop in platelets - from around 110,000 to 88,000.

Allergies: no

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

Symptoms: With a couple of hours of the vaccine shot, i started bleeding vaginally, similar to getting a period which i have not had for about 20 years. it stopped that evening, but started again the next day, for a short time, my panties were covered in bright blood and then it just stopped that day

Other Meds: synthroid, Vitamin C, 1000

Current Illness: none

ID: 1814690
Sex: U
Age:
State: CA

Vax Date:
Onset Date:
Rec V Date: 10/25/2021
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: MRI, EKG, CT, scans & spinal tap all indicate there are no physical injuries to the brain or brain stem and no infection. All tests were administered between the dates of 10-18-2021 to 10-23-2021.

Allergies:

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

Symptoms: Loss of cognitive function and critical thinking skills, reduced ability to communicate, acute hemiplegia of the left arm & leg

Other Meds:

Current Illness:

ID: 1814691
Sex: M
Age: 75
State: IL

Vax Date: 10/22/2021
Onset Date: 10/22/2021
Rec V Date: 10/25/2021
Hospital:

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

Lab Data: MRI - NORMAL CT SCAN - NORMAL

Allergies: None.

Symptom List: Vomiting

Symptoms: Numbness in the hands and face area, left leg became weak (was unable to walk), was referred to a Neurologist.

Other Meds: None.

Current Illness: None.

ID: 1814692
Sex: F
Age: 41
State: PA

Vax Date: 10/20/2021
Onset Date: 10/22/2021
Rec V Date: 10/25/2021
Hospital:

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

Lab Data:

Allergies: NA

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Swollen armpit (lymph nodes) in right arm (received shot in right arm). Noticed 36 hours after covid booster. Large swollen area - about the size of tennis ball in armpit. Tender. Swollen area has not decreased.

Other Meds: Cytomel Levoxthyroxine Lexapro

Current Illness: NA

ID: 1814693
Sex: F
Age: 18
State: WI

Vax Date: 03/11/2021
Onset Date: 10/21/2021
Rec V Date: 10/25/2021
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: positive for covid

Other Meds:

Current Illness:

ID: 1814694
Sex: F
Age: 76
State: MI

Vax Date: 03/10/2021
Onset Date: 10/24/2021
Rec V Date: 10/25/2021
Hospital: Y

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: past medical historyof CHF, chronic kidney disease, coronary artery disease, presented to emergency room with short of breath, short of breath on exertion, edema, multiple admissions for the sameproblem. The patient recently had a cardiac cath, but the patient needsanother cardiac catheterization. The patient also complains of cough.

Other Meds:

Current Illness:

ID: 1814695
Sex: M
Age: 42
State: TX

Vax Date: 09/01/2021
Onset Date: 10/01/2021
Rec V Date: 10/25/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Irregular heart beat. Chest pain. 10/10/2021-10/25/2021

Other Meds: None

Current Illness: Covid-19

ID: 1814696
Sex: F
Age: 53
State: IL

Vax Date: 10/22/2021
Onset Date: 10/25/2021
Rec V Date: 10/25/2021
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

Allergies: None

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

Symptoms: Low grade fever, chills, joint and muscle aches, headache, nausea, fatigue. Indurated swelling about 2-3? diameter near injection site like a medallion, noticing left axillary tender lymph nodes on 2nd day. Itching near injection site. Headache, nausea, Vomiting on 3rd day. Taking Tylenol and Advil for the symptomatic treatment

Other Meds: Levothyroxine

Current Illness: Hypothyroidism

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am