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: 1815912
Sex: M
Age: 58
State: CA

Vax Date: 03/30/2021
Onset Date: 04/01/2021
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: My daily blood sugar tests are showing sugar levels consistently around 200 or more.

Allergies: None

Symptom List: Dysphagia, Epiglottitis

Symptoms: My blood sugar has gone up by about 75-100 points since the day of the vaccine and has consistently stayed up even 7 months later. I have had diabetes since 2002 but I have managed it without any medications and only by diet and exercise. I check my blood sugar levels daily in the morning. They were about 150 every morning for 6 months prior to the vaccine. Since the first day of the vaccine and until today, my blood sugar levels are between 200 - 250. At first the doctor said that they will go down after a week or two of the vaccine, but that has not happened 7 months later. I would still take the vaccine if I had to do all over again, but wanted to inform you of this side effect. Also my sister in law who also has diabetes has also experienced the same side effects of elevated sugar levels since she took the vaccine.

Other Meds: None

Current Illness: Diabetes

ID: 1815913
Sex: M
Age: 32
State: VA

Vax Date: 10/18/2021
Onset Date: 10/21/2021
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: 10/21/2021: Decreased Pedal pulses- (Anterior Tibial & Dorsalis Pedis: 1+ weak, difficult to locate at first upon initial palpation in LLE) 10/21/2021: Evaluations done by Medical Center ED: Bedside Doppler - Inconclusive Knee & Below Plain X-Ray - Negative Ultrasound Study - ? Results (NMCP refused to release records of imaging or work-up to patient upon discharge) 10/22/2021: PCP Office Visit (Note available upon request)

Allergies: Coconut - Anaphylaxis

Symptom List: Anxiety, Dyspnoea

Symptoms: -Constant sharp and stabbing pain in left Biceps muscle experienced between hour 18 and hour 54 post vaccination administration. He states his left biceps muscle "feels like it is tearing". -In hour 70 post vaccination administration, after 3 hours of continuous sedentary working, upon standing experienced immediate and sudden onset of excruciating, sharp, and stabbing pain in left posterior mid-tibial area. Followed by sudden onset of marked edema in this area described as "the size of a baseball, cut in half". Immediately following, he developed dizziness, lightheadedness, became diaphoretic and felt near to syncope (No LOC). The pain felt, was the same pain he has felt in his Bicep in the past 3 days since receiving the Janssen vaccine. No obvious damage to surrounding tissue suggestive of contusion. No puncture marks to suggest insect bite. No reported trauma, no vigorous activity, no history of clots. No pertinent Family History of clotting or bleeding disorders. No changes to medications, aside from the Janssen COVID-19 vaccine, or diet/supplements. Nothing obvious to trigger the onset of these symptoms. No recent travel by airplane, or Cardiovascular history. Young, active, otherwise healthy patient without obesity. Powerlifter, even took precautions by resting muscles and abstaining from health supplements for 5 days ahead of vaccine to return body to baseline.

Other Meds: Singulair 10mg at Bedtime Every Other Day Adderall 10mg BID Lovastatin 10mg at Bedtime Every Other Day Sildenafil 50mg PRN Glucosamine 1500mg /Chondroitin 1200mg Omega-3 Fish Oil 1250mg Men?s One A Day Multivitamin Maca Root Extra Strength

Current Illness:

ID: 1815914
Sex: F
Age: 66
State: CA

Vax Date: 10/06/2021
Onset Date: 10/09/2021
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:

Allergies: NONE

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

Symptoms: Patient received a swollen arm that was red and presented as an infection following vaccine administration. She went to the ER and was diagnosed with a skin infection and prescribed KEFLEX.

Other Meds: KEFLEX

Current Illness: NONE

ID: 1815915
Sex: F
Age: 36
State: NJ

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: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data: 10/25 - blood clot testing - negative treated with steroids

Allergies: mushrooms, wasps, fish, biaxin, bactrum, azythromiacin, zofran, reglan, seasonal

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: shortness of breath, hives, elevated heart rate and blood pressure.

Other Meds: Tironsint, valium, proair, baclofen, adderall

Current Illness:

ID: 1815917
Sex: F
Age: 59
State: WA

Vax Date: 05/12/2021
Onset Date: 06/12/2021
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: No

Allergies: Pollen

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

Symptoms: Facial dermatitis spreading down to the neck. It occurs about 1 month after getting 2nd dose of Pfizer Covid-19 vaccine. Skin rash, redness and intense itching. Treatments tried and failed: Benadryl capsules and Cream, Zyrtec tablets, Lidocaine Cream, Hydrocortisone 1 % Cr. and 2.5% Oint, Prednisone 20mg 2 tab daily x 5 days, and Metronidazole 1 % cream. Current Rx: Desonide 0.05% Oint. and Pimecrolimus 1% Cream.

Other Meds: No

Current Illness: No

ID: 1815918
Sex: F
Age: 25
State: MD

Vax Date: 04/22/2021
Onset Date: 04/22/2021
Rec V Date: 10/25/2021
Hospital: Y

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: Heart monitor, EKG

Allergies: Almonds Snap peas

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

Symptoms: I became incredibly dizzy, and fainted twice. My EKG showed inflammation. I was very very dizzy for the next 2-3 months. I was advised to go to the ER by a teledoc and Tele nurse, and almost vomited from being so dizzy. I stayed in the hospital for more than 24 hours. I had a similar reaction of dizziness and fainting after my first shot. The worst part was my very rapid heart rate. I could not move an inch without my heart rate going up very fast. So fast that I had to pee in a bowl, I could move without having an extremely rapid heart rate, I felt like I was having a heart attack. I still have dizziness.

Other Meds: Lithium carbonate Zyrtec

Current Illness: None

ID: 1815920
Sex: F
Age: 0
State: TX

Vax Date: 08/05/2021
Onset Date: 08/06/2021
Rec V Date: 10/25/2021
Hospital: Y

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

Lab Data: MRI

Allergies: None

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Early next morning feverish and fatigued. Then massive seizures began which lead to hypoxia-ischemic encephalopathy and permanent brain damage.

Other Meds: Tylenol

Current Illness: None

ID: 1815921
Sex: F
Age: 41
State: VA

Vax Date: 04/06/2021
Onset Date: 05/07/2021
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: Physical at the moment and second time MRI & full blood work

Allergies: n/a

Symptom List: Pharyngeal swelling

Symptoms: Bella Palsy

Other Meds: n/a

Current Illness: n/a

ID: 1815922
Sex: F
Age: 57
State: CA

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

Lab Data:

Allergies: no allergy

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: pt got covid vaccine may be 1 min ago ,gave her flu shot ,even before putting the flu syringe back in shart container ,injection site swoll up right away ,bled little bit ,stop bleeding,pt started filling weak ,like she was gonna pass out ,sweating and feeling hot ,after paramedics came ,bp was low ,pt was not filling well ,paramedics wanted to take patient to hospital ,pt did not go,patient husband is a doctor ,was on speacker phone with patient ,told to take benadryl ,pt took 4 teaspoon of benadryl ,waited for husband who is a doctor almost 40 -45 min ,paramedics was still with patient ,patient went home wiht husband ,called patien twice ,got holf of her on 10/25/21 around 3.30 - 4 pm ,pt was doing ok ,still not feeling 100 % normal

Other Meds:

Current Illness: no illnesses

ID: 1815923
Sex: M
Age: 15
State: CA

Vax Date: 10/25/2021
Onset Date: 10/25/2021
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: none

Allergies: Peanuts and tree nuts

Symptom List: Diarrhoea, Nasal congestion

Symptoms: The patient was waiting for his flu vaccine as he was the last family member to receive his vaccine. We administered the vaccine and then he started to look pale, and then immediately lost consciousness . He came to very quickly and we gave him Gatorade and a popcorn snack to help raise his blood sugar as he had not eaten for hours before his vaccine appointment. We had him and his family wait for 30 minutes after the vaccination and called our liability hotline to report.

Other Meds: None

Current Illness: none

ID: 1815924
Sex: F
Age: 40
State: CO

Vax Date: 09/30/2021
Onset Date: 10/16/2021
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: None

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

Symptoms: Shingles

Other Meds: None

Current Illness: None

ID: 1815925
Sex: M
Age: 37
State: CA

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

Lab Data:

Allergies: N/A

Symptom List: Rash, Urticaria

Symptoms: Patient lost consciousness after receiving a vaccine and appeared to be having a tonic-clonic type seizure. Paramedics were called and arrived on scene. Patient regained consciousness and was evaluated by the paramedics. His blood glucose levels were tested and upon pricking the finger to draw blood the same event of losing consciousness/seizing occured. Patient was monitored and regained consciousness. He was then cleared by EMTs before leaving the pharmacy on his own.

Other Meds: N/A

Current Illness: N/A

ID: 1815926
Sex: F
Age: 33
State: TN

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:
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: Patient received first dose of J&J vaccine and came in to get Moderna booster. Communication we receive from corporate looked like those who got J&J would receive a full 0.5ml dose of Moderna so that is what this patient got. Much later that evening, we learned that everyone who gets a Moderna booster gets 0.25ml with the exception of those who are immunocompromised. Spoke to patient to inform that she got the full dose and she was very happy to have received the full dose. She felt just fine after the shot.

Other Meds:

Current Illness:

ID: 1815928
Sex: M
Age: 60
State: FL

Vax Date: 09/18/2021
Onset Date: 10/21/2021
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: NKA

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

Symptoms: Patient stated he requested to receive a flu shot.

Other Meds: Not known

Current Illness: None indicated

ID: 1815929
Sex: M
Age: 52
State: AR

Vax Date: 10/25/2021
Onset Date: 10/25/2021
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: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: Within hours I am experiencing ringing in my ears. Doubt I will be able to sleep tonight due to this.

Other Meds:

Current Illness:

ID: 1815930
Sex: M
Age: 76
State: PA

Vax Date: 05/04/2021
Onset Date: 05/30/2021
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: Orthopedic knee specialist...MRI revealed arthritis in R knee....no explanation for weakness in L Knee/hips. Persistant weakness and pain in R knee to this date.

Allergies: None

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

Symptoms: Swelling R Knee with 2 observable lumps. Swelling in ankle with extreme heat. Seen family practice physician, sent to hosp for doppeling for suspected clots. None noted. Swelling persist in R knee and marked weakness in L knee and hips.

Other Meds: Lisinopril, Coreg, Atorvastatin, Thyroxin

Current Illness: None

ID: 1815931
Sex: F
Age: 57
State: TX

Vax Date: 10/15/2021
Onset Date: 10/15/2021
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:

Allergies: Gentamicin, Iodine Contrast

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

Symptoms: Muscle spasms in legs & feet; hives & rash around neck; migraine with heavy sweating.

Other Meds: Losartan, Carvedilol, allergy tablets

Current Illness:

ID: 1815932
Sex: F
Age: 48
State: WV

Vax Date: 01/08/2021
Onset Date: 02/01/2021
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: ANA , Lymes test

Allergies: None

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Rash on peri orbital rash, upper and lower lip swelling and rash, both arm rah swelling, left arm weeping, abdomen rash, bilateral lower leg rash, was referred to dermatologist put on oral steroids and 2 types of creams, been going on for 9 months, once stopped oral steroids rash came back in same areas and new areas, can?t keep lips from cracking daily, will break out into a extremely itchy rash anywhere for no reason. Had changed diet; tried 5 different allergy meds with no relief and still can?t not get the rash to resolve. Tried using unvented soaps , detergents and air drying clothes. Have tried changing diets with no relief. NOTHING ISHELPING! I am a physician assistant for over 20 years I?ve never had issues with vaccinations till this one.

Other Meds: Oral contraceptive

Current Illness: None

ID: 1815933
Sex: M
Age: 28
State: NJ

Vax Date: 04/02/2021
Onset Date: 04/04/2021
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: Tests are ongoing.

Allergies: Strawberries, penicilleen

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: For 6 months I have had episodes of Ventricular Tachycardia, PVCs, and PACs with no prior history. From April to about August I had chest pressure and numbness on left side of face. Thankfully this wasn't a stroke. I am still seeing cardiologists and a neurologist to figure out what exactly is wrong. Pain in neck going down to shoulder which is sometimes a dull tingling feeling. Body tremors all over body randomly throughout the day.

Other Meds: None

Current Illness: None

ID: 1815935
Sex: M
Age: 36
State: TX

Vax Date: 10/24/2021
Onset Date: 10/25/2021
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:

Allergies: Distaste for ??? pepper

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

Symptoms: Fatigue, headache, dry cough, soreness in chest area

Other Meds: 1/2 of a multivitamin with iron daily

Current Illness:

ID: 1815936
Sex: M
Age: 54
State: SC

Vax Date: 10/21/2021
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: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

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

Symptoms: Severe muscular pains. Started below my right shoulderblade. Then worked over the right pectoral muscle. Then across the whole of my back. Now also affecting my right hand. It was so bad on Sunday that I didn't think I was going to make it into work. Ibuprofen does nothing to the pain. If I cough, it really hurts. Bending my back is well nigh impossible. The discomfort severely restricts my daily activities as a school bus driver.

Other Meds: occasional antihystemines

Current Illness: none

ID: 1815937
Sex: F
Age: 24
State: ID

Vax Date: 04/03/2021
Onset Date: 06/13/2021
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: I have received two tests checking my platelets count. I apologize I don?t know the exact day. I do know that both times my reading was 105,000 platelets per microliter.

Allergies:

Symptom List: Unevaluable event

Symptoms: thrombocytopenia I received my Covid vaccine at the beginning of April and near the end of April I found out I was pregnant. During my 12 week blood test, it was found that my platelets were low. I actually didn?t associate the correspondence between the low platelets and my vaccine until I was reading a peer reviewed article regarding this being a potential side effect of the Pfizer vaccine.

Other Meds:

Current Illness:

ID: 1815938
Sex: F
Age: 49
State: VA

Vax Date: 01/15/2021
Onset Date: 02/16/2021
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: Lab work FTSH 0.48 4/14/2021. Thyroid scan -overactive 7/13/2021

Allergies: Nkda

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

Symptoms: I was diagnosed with Graves? disease starting in April 2021. This occurred just 2 months after my last dose of moderna

Other Meds: Calcium, vit d

Current Illness: N/a

ID: 1815939
Sex: M
Age: 45
State: IN

Vax Date: 09/24/2021
Onset Date: 09/25/2021
Rec V Date: 10/25/2021
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: Codeine

Symptom List: Injection site pain, Pain

Symptoms: I've been a well controlled type 1 diabetic for over 32 years. After this shot, my blood sugars were randomly high for about a week. They have since resolved, but with my experience as a diabetic, I believe the random highs were related to getting the shot.

Other Meds: Insulin

Current Illness:

ID: 1815940
Sex: F
Age: 53
State: CA

Vax Date: 01/12/2021
Onset Date: 01/20/2021
Rec V Date: 10/25/2021
Hospital:

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

Lab Data: My cardiologist performed an echocardiogram. My ejection fraction was 56% on January 20, 2021. My previous ejection fraction had been 69% about 8 years ago. I had another echocardiogram March 15, 2021 and my ejection fraction was 62%. (I am an RN). I?m not sure if my misdiagnosed celiac disease (for decades!)and therefore untreated (gluten consumption )contributed to the decrease in ejection fraction or the Covid vaccine. January 20, 2021 troponin levels were negative. I didn?t put any of this together until I was chatting with my colleague/cardiologist who told me about a 19-year-old patient that had myocarditis post vaccination, and I looked back at the dates of my vaccination and lowered ejection fraction and considered that I might have had a flare of myocarditis post vaccination.

Allergies: Gluten intolerance

Symptom List: Injection site pain, Menorrhagia

Symptoms: I had been having tachycardias one month prior to vaccination and made appointment with cardiologist for echocardiogram. My appointment happened to be one week AFTER vaccination.

Other Meds: Estradiol patch 0.05 mg daily Progesterone 100 mg oral daily Super B complex daily Calcium citrate with vitamin D and magnesium BID Cyanocobalamin injection 1000 ?g subcutaneously Q2 weeks Fish oil capsule 1000 mg daily Costco adult multivi

Current Illness: Polymyalgia rheumatica, possibly starting

ID: 1815941
Sex: F
Age: 72
State: NC

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

Lab Data:

Allergies:

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

Symptoms: red itchy arm. fever; very fatigued

Other Meds:

Current Illness:

ID: 1815942
Sex: F
Age: 57
State: MI

Vax Date: 04/05/2021
Onset Date: 08/17/2021
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: CT Scan-lungs are clear with no residual damage , no history of DVT's etc.

Allergies: Sulfa, Keflex, penicillin

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Massive Pulmonary Emboli from DVT in right calf. Near death reaction had a Thrombectomy on Aug 23, 2021 at Hospital.

Other Meds: Armour Thyroid Vitamin D

Current Illness: Ski injury to right leg pulled muscle in hamstring

ID: 1815943
Sex: F
Age: 38
State: NC

Vax Date: 03/07/2021
Onset Date: 03/07/2021
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:

Allergies: Localized allergic reaction to mosquito / other bug bites - large welts. Form a rash with Zithromax.

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Redness, swelling, warm to the touch, hardness/induration under the skin, burning, itching sensation at site of injection. Took more than a week to resolve. After several days of the induration growing more painful, I began an OTC oral antihistamine for approximately a week - this seemed to help. Fexofenadine hydrochloride tablets, antihistamine. The injection site fully resolved.

Other Meds: Womens daily vitamin, gummy probiotics

Current Illness: None

ID: 1815944
Sex: F
Age: 53
State: LA

Vax Date: 10/23/2021
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: Penicillin and Ragweed

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

Symptoms: Rash and red welt at the injection site that is round and two inches but 2 inches.

Other Meds: None

Current Illness: None

ID: 1815945
Sex: F
Age: 49
State: OR

Vax Date: 01/13/2021
Onset Date: 01/14/2021
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: RA

Lab Data: I am not sure of the exact dates of tests: CT Scan, Ultra sound, blood tests, stool tests xray

Allergies: ampicillin

Symptom List: Nausea

Symptoms: Had my first Pfizer vaccine on 1/13/21 started feeling pain and burning within 48 hours of the injection that went into the right flank and stomach area. An ultrasound was performed and later had a appendicitis, appendectomy and later a CT scan showed Colits. All stemmed from or happened after a very short time window of receiving my first vaccine. I am still experiencing colits, spastic colon with IBD, IBS-C and have not worked since February.

Other Meds: multi vitamin, levothyroxine, birth control , zanax

Current Illness: none

ID: 1815946
Sex: F
Age: 60
State: SC

Vax Date: 04/15/2021
Onset Date: 04/20/2021
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:

Allergies: celebrex, red dye, zonisamide

Symptom List: Injection site pain

Symptoms: Pt had significant worsening of migraines that became debilitating, with generalized weakness and decreased balance and instability. Pt has had multiple falls since the vaccination and report from ENT indicates vestibular migraines likely triggered by the vaccine.

Other Meds: albuterol atomoxatine B12 Depakote Hydroxyzine Losartan Magnesium Meloxicam Tizanidine Zanaflex

Current Illness: HTN fibromyalgia depression neuropathy sleep apnea Vit D deficiency psoriasis

ID: 1815947
Sex: M
Age: 12
State: CA

Vax Date: 10/09/2021
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: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: The patient passed out and convulsed. After some rest, water and snacks the patient was back to normal.

Other Meds:

Current Illness:

ID: 1815948
Sex: F
Age: 49
State: CT

Vax Date: 09/25/2021
Onset Date:
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: Due to have an MRI, labs so far showed CRP 8.7.

Allergies: Shellfish

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

Symptoms: Day 2 post vaccine numbness and tingling in fingertips and feet, and face. Over next 2-3 weeks continued n/t that now spread to lower legs and hand and forearms. I was seen by primary care md, going approx 25 days post vaccine I went to ED to be seen for continued symptoms as well as facial spasm uncontrolled. I followed up with my PCP where she witnessed such spasm and sent me to a neurologist. I saw the neurologist where she witnessed the facial spasm and said the closest thing she can diagnosis it as is atypical hemifacial spasm.

Other Meds: hydrocholorathiazide, levothyroxine, omeprazole, colace

Current Illness: n/a

ID: 1815949
Sex: M
Age: 48
State:

Vax Date: 10/24/2021
Onset Date: 10/25/2021
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: on 10/24/21 pt received Tdap and Covid vaccine. spouse called 10/25/21 stating pt had fevers and felt nauseous. spouse said pt previously had seizures with fever. I advised pt to take tylenol and seek medical attention if matters do not improve.

Other Meds:

Current Illness:

ID: 1815950
Sex: F
Age: 28
State: MI

Vax Date: 03/26/2021
Onset Date: 03/26/2021
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: None

Allergies: None

Symptom List: Erythema, Pruritus

Symptoms: Arm pain near injection site immediately following injection at 8am. No other symptoms besides arm pain until that evening. Around 9pm began to experience fatigue and muscle pains all over body. I took a dose of Tylenol and went to bed. Woke up the next morning with a fever of 101 degrees F. Continued to have fatigue, muscle pains, chills through the next day until about 9pm (symptoms lasted about 24hrs).

Other Meds: Probiotic, Zyrtec allergy medicine

Current Illness: No

ID: 1816131
Sex: F
Age: 35
State: NH

Vax Date: 09/22/2021
Onset Date: 09/23/2021
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: None

Allergies: None

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

Symptoms: I got my period and it lasted for a month.

Other Meds: Yaz (birth control)

Current Illness: No

ID: 1816132
Sex: M
Age: 54
State: CA

Vax Date: 03/08/2021
Onset Date: 04/02/2021
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: At that time I emailed my doctor, he said that this was not typical of the vaccine side effects.

Allergies: sulfa based antibiotics, prednisone, z pak

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

Symptoms: Muscle cramping, legs feet and hands. Brain Fog moderate to severe.

Other Meds: None

Current Illness: none

ID: 1816133
Sex: F
Age: 53
State: GA

Vax Date: 04/09/2021
Onset Date: 04/25/2021
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: Iron/Ferritin/Testosterone/scalp biopsy.

Allergies: Hydrocodone; penicillin

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Hair Loss/Massive Shedding. Not breakage. Abnormal hair shedding started in June and progressively getting worse. Have lost about 45% of normal volume

Other Meds: None

Current Illness: Nine

ID: 1816134
Sex: F
Age: 24
State: PA

Vax Date: 09/07/2021
Onset Date: 10/13/2021
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: No

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

Symptoms: Severe menstrual cycle changed after first dose of Covid vaccine, including severe abdominal cramping, increased menstrual flow

Other Meds: None

Current Illness: No past medical history

ID: 1816135
Sex: F
Age: 45
State: NJ

Vax Date: 07/30/2021
Onset Date: 08/06/2021
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: CAT scan 10/04/2021 : No sign of sinus

Allergies: IV contrast dye

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

Symptoms: 08/06/2021 : I woke up with left face under left eye swelling . I went to see my primay doctor. He gave me oral steriod and eye drop ( anti biotics and steriod ) for 10 days. My face swelling started to go away. 08/28/2021 : I went to see eye doctor because my left eye itchy and red . Sometimes painful. Part of my face surrounding my left eye felt painful as well. I was givin eye drops again. 09/12/2012 : Went to see an ENT . 10/04/2021 : Did CAT scan and doctor told me there is no sign of sinus. 10/08/2021 - 10/20/2021 : had second round of oral steriod. Left eye was getting better but not back to normal . still swelling and feel something inside my eye. my left eye is sensitive. I have been avoided using my eye a lot. 10/21/2021 - follow up visit with doctor 10/25/2021 - Went to see another eye doctor and was told my eye has only minor infection. Probably the pain/uncomfortable is from the tissue around my eye got inflammated. There is nothing he can do for me and I can see an eye plastic surgeon. 10/25/2021 - Went to see an allegery doctor . Was told I don't have allgery. was told it is inflammation and I should take motrin.

Other Meds: amlodipine

Current Illness:

ID: 1816136
Sex: F
Age: 65
State: MD

Vax Date: 10/24/2021
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:

Symptom List: Pain in extremity

Symptoms: Patient said the pharmacist did not administer the vaccine in the deltoid muscle.

Other Meds:

Current Illness:

ID: 1816137
Sex: M
Age: 68
State: OK

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

Allergies: none

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

Symptoms: redness, soreness, itching, took benadryl by mouth, ice packs

Other Meds: unknown

Current Illness: none

ID: 1816138
Sex: F
Age: 28
State: MI

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

Lab Data:

Allergies: None

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

Symptoms: Intense arm pain and weakness on injection site arm (left) around 10 or 11 pm (6 hours after injection). Then I took a dose of Tylenol and went to bed shortly after. May have had symptoms in the night, but I woke up around 7am due to intense nausea and chills. I took a dose of pepto bismol and went back to sleep. All throughout the next several hours I experienced chills, nausea, fever (100.3 degrees F) and fatigue. My fever broke and I was able to get out of bed and eat something around 6pm. I felt much better and was no longer nauseous. Still felt fatigued until the next day around 10am.

Other Meds: Probiotic, Zyrtec allergy medicine

Current Illness:

ID: 1816140
Sex: M
Age: 69
State: MD

Vax Date: 10/24/2021
Onset Date: 10/24/2021
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: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: Patient said the pharmacist did not administer the vaccine in the deltoid muscle.

Other Meds:

Current Illness:

ID: 1816141
Sex: F
Age: 13
State: CA

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: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: no known allergies

Symptom List: Vomiting

Symptoms: Patient's mom stated that Vivienne's face was swelling up and some rashes. No other symptoms

Other Meds: none

Current Illness: none

ID: 1816142
Sex: M
Age: 38
State: IL

Vax Date: 04/05/2021
Onset Date: 04/06/2021
Rec V Date: 10/25/2021
Hospital:

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

Lab Data:

Allergies: penicillin

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Patient has had persistent pain in left upper arm/deltoid area since having vaccine. Pain has progressed to having limited range of motion in upper arm/shoulder

Other Meds: Vitamin D

Current Illness: none

ID: 1816143
Sex: F
Age: 43
State: OH

Vax Date: 10/12/2021
Onset Date: 10/12/2021
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: next contact from patient, received telephone call from her on 10/25/21. reported that she had been improving. she did visit with primary care physician on 3 occasions. primary care prescriber treated her for fever, and related symptoms, and completed VAERS REPORT #683460.

Allergies: no known drug allergies

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

Symptoms: patient extremely anxious about getting vaccine prior to administration on 10/12/2021. patient anxiety continued following administration of vaccine. reported feeling nervous, chills, and general anxiety. patient left pharmacy approximately 30 minutes after vaccination, accompanied by her spouse. established contact with primary care physician.

Other Meds: none known

Current Illness: none known

ID: 1816144
Sex: M
Age: 37
State: NJ

Vax Date: 09/14/2021
Onset Date: 09/14/2021
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: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Within 5 minutes of receiving vaccine started getting tunnel vision, nearly passing out. After about 10 minutes I was mostly back to normal. The day after vaccination I started getting spasms in my calves, which happened dozens of times a day. This went on for about 2 weeks before dissipating

Other Meds: None

Current Illness: None

ID: 1816145
Sex: F
Age: 32
State: MO

Vax Date: 10/15/2021
Onset Date: 10/16/2021
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: Lamictal

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

Symptoms: Seizure which resulted in bitten tongue, bruised/swollen index finger and dislocated finger. Missed menstrual cycle. Extreme depression with suicidal thoughts and hostility

Other Meds: Keppra, vimpat, Topamax, Zonosemide, multivitamin

Current Illness: None

ID: 1816146
Sex: M
Age: 25
State: NC

Vax Date: 10/15/2021
Onset Date: 10/16/2021
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: The first 2 days, I had fever, aches and pains, headaches, and fatigue. I also had an increased heart rate and shortness of breathe. All of the symptoms went away except for the increased heart rate and shortness of breathe. No treatment has been done for these two symptoms.

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am