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: 1817844
Sex: F
Age: 68
State: FL

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

Allergies: codeine, chocolate

Symptom List: Dysphagia, Epiglottitis

Symptoms: migraine, muscle aches, muscle weakness, joint aches, insomnia, nausea, diarrhea, injection site very sore and up and down the arm from it, fever over night

Other Meds: amlodipine; metformin ER 750; vitamin D

Current Illness: None

ID: 1817845
Sex: M
Age: 70
State: KY

Vax Date: 02/09/2021
Onset Date: 08/23/2021
Rec V Date: 10/26/2021
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: Tested Positive for Covid

Other Meds:

Current Illness:

ID: 1817846
Sex: F
Age: 83
State: NJ

Vax Date: 10/14/2021
Onset Date: 10/14/2021
Rec V Date: 10/26/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1817847
Sex: M
Age: 57
State: CO

Vax Date: 12/17/2020
Onset Date: 12/27/2020
Rec V Date: 10/26/2021
Hospital:

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

Lab Data: Blood tests, lung function tests

Allergies: nka

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Shortness of breath. Diagnosis: Reactive airway disease, secondary to a highly elevated Eosinophil lab test. Treatment: Montelukast P.O. and Asminex, a steroid inhaler, forever

Other Meds: Lisinipril, metformin, atorvastatin, aspirin, nexium

Current Illness: none

ID: 1817848
Sex: M
Age: 29
State: MI

Vax Date: 10/19/2021
Onset Date: 10/19/2021
Rec V Date: 10/26/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Pt. stated that as he was driving home after recieving the covid vaccine the left side of his face became numb , he also said the left arm was sore and stiff and tight feeling. He said it lasted a few days and was gone by Thursday 10-21-2021. He did not seek medical care and feels good now. He did stay in office for the 15 min. after injection with no c/o.

Other Meds: unknown

Current Illness:

ID: 1817849
Sex: F
Age: 67
State: KY

Vax Date: 05/01/2021
Onset Date: 08/30/2021
Rec V Date: 10/26/2021
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: POSITIVE Antigen test on 08/30/2021

Allergies:

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

Symptoms: She developed a fever, chills, rigors, muscle aches , lost taste and smell ,headache runny nose, cough, wheezing ,shortness of breath diarrhea and congestion and felt weak.

Other Meds:

Current Illness:

ID: 1817850
Sex: M
Age: 22
State: NJ

Vax Date: 10/14/2021
Onset Date: 10/14/2021
Rec V Date: 10/26/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1817851
Sex: F
Age: 37
State: WI

Vax Date: 08/06/2021
Onset Date: 08/06/2021
Rec V Date: 10/26/2021
Hospital:

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

Lab Data: With the lower extremity weakness & falls post Covid- I saw neurology. I had MRIs & blood tests done. After the vaccine I saw my primary care provider (October 22, 2021). She did a physical examination, routine blood tests, & referred me to gastroenterology.

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: I had Covid in October 2020. It left me with residual episodic lower extremity weakness & woozy/dizzy spells (at times even while seated/at rest). I have had a couple of falls. It aggravated my chronic medical conditions. My asthma is normally induced with environmental allergens- now it will occasionally flare up without being exposed to allergen. My GI symptoms became worse- longer flare ups, more severe nausea & abdominal pain. My intestines shut down for about 1.5-2 weeks. I was able to re-start them with fluids, walking, & laxatives. I received the Covid vaccine in August of 2021 due to work mandating it. It literally felt like having Covid all over again. All of the above symptoms/residual issues were aggravated & amplified. I had corn a couple of days after I received the vaccine. The corn did not even begin to be visible in stool until about 20 days later & it ceased to be visible in stool at around the 30 day mark.

Other Meds:

Current Illness:

ID: 1817852
Sex: M
Age: 77
State: KY

Vax Date: 02/22/2021
Onset Date: 08/18/2021
Rec V Date: 10/26/2021
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: Tested Positive for Covid

Other Meds:

Current Illness:

ID: 1817853
Sex: F
Age: 41
State: NJ

Vax Date: 10/14/2021
Onset Date: 10/14/2021
Rec V Date: 10/26/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1817854
Sex: F
Age: 63
State: VA

Vax Date: 10/25/2021
Onset Date: 10/25/2021
Rec V Date: 10/26/2021
Hospital:

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

Lab Data: n/a

Allergies: Percocet, milk, peanuts, bananas

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

Symptoms: Around 7:30 p.m. my face and especially cheeks, started getting very hot and even appeared to be very red. This continued through the night and forced me to blow a fan on my face in order to sleep. The hot feeling in my face had dissipated by the time I woke up at 6:30 a.m., however, my cheeks remain rosy in color.

Other Meds: Meloxican 15mg, Fexofenadine 180 mg, Hydrochlorothizide 25mg,

Current Illness: None

ID: 1817855
Sex: M
Age: 44
State: NJ

Vax Date: 10/14/2021
Onset Date: 10/14/2021
Rec V Date: 10/26/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1817856
Sex: M
Age: 50
State: NJ

Vax Date: 10/14/2021
Onset Date: 10/14/2021
Rec V Date: 10/26/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1817857
Sex: F
Age: 67
State: PR

Vax Date: 10/22/2021
Onset Date: 10/23/2021
Rec V Date: 10/26/2021
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: None

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

Symptoms: The area became swollen and very red. It felt hot and hard and hurt. The glands under the arm became sensitive and also hurt.

Other Meds: None

Current Illness: None

ID: 1817858
Sex: M
Age: 88
State: KY

Vax Date: 02/09/2021
Onset Date: 08/23/2021
Rec V Date: 10/26/2021
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: Tested Positive for Covid

Other Meds:

Current Illness:

ID: 1817859
Sex: F
Age: 59
State: GA

Vax Date: 09/26/2021
Onset Date: 09/28/2021
Rec V Date: 10/26/2021
Hospital:

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

Lab Data: No I have an appointment with my Orthopedic doctor on 10/28/21 at 8;45 a

Allergies: Pneumonia Vac, Flu Vac and TB shot, Polysorbate

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

Symptoms: Left hip joint pain/lower back/shoulder area

Other Meds: Tylenol

Current Illness: Previous surgery ,I had to get a pelvic pacemaker/interstim implant stimulator

ID: 1817860
Sex: M
Age: 58
State: WV

Vax Date: 06/19/2021
Onset Date: 06/22/2021
Rec V Date: 10/26/2021
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: NONE

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

Symptoms: Ringing in head. Patient stated that it sounds like locusts are in his head 24/7.

Other Meds: Tamuolsen HCL

Current Illness: NONE

ID: 1817861
Sex: F
Age: 23
State: KY

Vax Date: 01/29/2021
Onset Date: 08/27/2021
Rec V Date: 10/26/2021
Hospital:

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

Lab Data: POSITIVE Covid-19 test 08/27/2021

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Low grade fever of 100.2 , chills, muscle aches, runny nose , sore throat, headache, cough, wheezing, shortness of breathe diarrhea and lost taste and smell.

Other Meds:

Current Illness:

ID: 1817862
Sex: F
Age: 63
State: CT

Vax Date: 10/23/2021
Onset Date: 10/24/2021
Rec V Date: 10/26/2021
Hospital:

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

Lab Data: None

Allergies: Latex

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Fever up to 103, chills, body aches, headaches , tiredness. Day 3 afterwards injection arm is severely swollen, hot and red. (Covid arm). The Covid arm happened after all 3 doses.

Other Meds: Metformin, atorvastatin, 1 a day for women 50+,

Current Illness: None

Date Died: 09/29/2021

ID: 1817863
Sex: F
Age: 83
State: GA

Vax Date: 08/25/2021
Onset Date: 08/25/2021
Rec V Date: 10/26/2021
Hospital: Y

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

Lab Data: CAT scan at Hospital. Battery of tests at same facility. Records available via Hospital requisition. Primary care records available via Doctor. Last physical dated Feb, 05, 2021 showed COPD and before mentioned medications. No dementia as noted by staff. Any instances of hallucinations or possible dementia happened after vaccination.

Allergies: None

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

Symptoms: On Wednesday, August 25th, 2021 my mother awoke and assumed her normal daily routine. She had a breakfast of one egg, two slices of bacon and wheat toast. She was perfectly ambulatory and needed no help in walking, dressing, her personal hygiene or assistance in going to the restroom. At 12:30 that afternoon she walked down the stairs of her home and she and I left for her COVID vaccination at the local store. We arrived at store and immediately went to the pharmacy department where she received the Moderna vaccination. We continued shopping for grocery items for an additional 15-20 minutes, paid our bill and exited the store. As we were leaving the store she complained of soreness in her vaccinated arm and a feeling of weakness. I had to help her into our vehicle and upon arriving home had to physically carry her up the steps and into the house. I put her onto the couch where she could relax and watch television. She was alert and mentally clear but extremely weak. I researched reactions to the vaccination on line and attributed her initial weakened condition as normal reaction to the vaccination and that they could last 1-3 days with minor continuing symptoms for as long as two weeks. She continually worsened for the next three days and her mental state continually degenerated to where she seemed unaware of her surroundings and had difficulty responding to verbal stimuli. She could not walk, dress, bathe herself, lost control of her bowels and could not eat without assistance. I contacted my sister and she came over to help me care for her in regards to personal hygiene, feeding, dressing and putting her into and changing of adult diapers. After three days passed with her showing no signs of improvement, I reached out to her primary care physician and left a detailed message of her symptoms with the messaging service of what was happening and asked for advice. I was informed that it was a normal reaction to the vaccine and to monitor her for any worsening signs. On 17 September with her health showing no signs of improving we called 911 for emergency care and had her transported to hospital. A full battery of tests were performed including a CAT scan with no indications of what was causing this digression in her health. The staff stated she was exhibiting signs of dementia which we refute. Her last complete physical dated Feb 05, 2021 indicates her mental and Neurological state at baseline and her Psychiatric state as normal. She was discharged from hospital on Sept 22, 2021 and was transported home where she remained under family care pending assistance from local elderly programs. On Sept, 29th 2021 she was reclining in her armchair when she slumped over to the side and was unresponsive. 911 was called and paramedics arrived, transported her into the emergency vehicle where she went into cardiac arrest. The emergency response team administered CPR until arrival at hospital where she was pronounced dead. My mother went from a person able to care for herself with minimum assistance to a person who seemed to be in the last stages of Alzheimer?s disease in a matter of three weeks. She did not suffer from any of the mental or physical problems until immediately after the receiving the Moderna COVID vaccination. At 83 years of age she did have normal health issues associated with someone of her age. She was a colon cancer survivor and had been diagnosed with COPD and was on oxygen but she suffered no medical condition which would have resulted in her rapid decline and subsequent death such as happened immediately following her vaccination. Based on what I personally witnessed following her vaccination, I fully believe that if she had not taken it, that she would be with us still. There has not been enough time allowed or documentation of adverse reactions to the COVID vaccination, especially with the elderly or persons with pre-existing medical conditions.

Other Meds: Pravastin, Ramipil, Ipratropium atrovent nebulizer

Current Illness: COPD, Hyperlipidemia, Hyperextension

ID: 1817864
Sex: F
Age: 35
State: TN

Vax Date: 09/15/2021
Onset Date: 09/16/2021
Rec V Date: 10/26/2021
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: Sulfa drugs

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

Symptoms: Patient experiences hives and pruritis and a feeling of lips and ears swelling. She describes the rash as burning. She is tachycardic (128 bpm) BP = 148/88.. All other vitals are within normal limits. Patient initially saw her PCP, who administered a steroid injection. She took diphenhydramine and cetirizine at home with no improvement. In the ER, she is treated with diphenhydramine, famotidine, methylprednisolone x 2, epinephrine x 2. She improved and was d/c home with prescriptions for Epi pen, steroid dosepak and famotidine.

Other Meds: none documented

Current Illness: Negative for any disease

ID: 1817865
Sex: M
Age: 52
State: CT

Vax Date: 10/22/2021
Onset Date: 10/25/2021
Rec V Date: 10/26/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium

Other Meds:

Current Illness:

ID: 1817866
Sex: F
Age: 21
State: TN

Vax Date: 10/25/2021
Onset Date: 10/25/2021
Rec V Date: 10/26/2021
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: N/A

Allergies: Ativan, Penicillin, Phenergan, Tamiflu, Zoloft.

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

Symptoms: Hive rash on back. Generalized paresthesias and hyperesthesia. Subjective shortness of breath. Confounded by anxiety flare. Tearful. Mildly tachypneic. Lungs clear to auscultation. No respiratory distress.

Other Meds: Inconsistent use of Abilify, EffexorXR, Gabapentin, Microgestin 1.5/30.

Current Illness: None known.

ID: 1817867
Sex: M
Age: 25
State: KY

Vax Date: 06/22/2021
Onset Date: 08/30/2021
Rec V Date: 10/26/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Tested Positive for Covid

Other Meds:

Current Illness:

ID: 1817868
Sex: F
Age: 72
State: CA

Vax Date: 09/20/2021
Onset Date: 09/20/2021
Rec V Date: 10/26/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1817869
Sex: M
Age: 41
State: CA

Vax Date: 08/20/2021
Onset Date: 08/20/2021
Rec V Date: 10/26/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1817870
Sex: F
Age: 38
State: IN

Vax Date: 01/19/2021
Onset Date: 04/01/2021
Rec V Date: 10/26/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Ever since getting the Covid 19 vaccination, I have been getting my period every 2 weeks, consistently.

Other Meds:

Current Illness:

ID: 1817872
Sex: F
Age: 38
State: DE

Vax Date: 03/26/2021
Onset Date: 04/09/2021
Rec V Date: 10/26/2021
Hospital: Y

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

Lab Data: I had an EKG, an echocardiogram, MRI's, ENP, blood work and cardiac enzyme.

Allergies: I am allergic to walnut; pecans; Cipro; Augmentin; Keflex.

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: About two weeks after receiving my second dose, I was walking my dog and I felt like my body became heavy. I was short of breath also. The next day, I was at work. I took my patient to the mall and I couldn't continue walking so we had to leave. The following day, I felt like I was choking if I tried to drink something. My oxygen dropped to 85. The chest pain was constant. By 04/11, I couldn't get down the hallway without stopping three times. My husband took me to the ER and I was given a prescription for my asthma. I went to get the prescription filled and noticed that my breathing was even worse. My husband took me back to the local HCF and two minutes after being taken back, there was a cardiac alert for me. They performed the EKG and I had congestive heart failure and a heart attack. I had pericarditis, possible pneumonia, myocarditis and pleural effusion. I was so short of breath, they had me on 10-20 liters of oxygen and it was not helping. They tried to rush me to have a triple bypass surgery, but I declined. I later found out that I have small arteries that wouldn't last during a bypass. I decided to get another opinion, so I went to another HCF and I ended up having to get 5 stents in my heart. My heart is now at 24-26%. I no longer have any faith in myself, I lost my self esteem, I lost my job, my voice, my vision, my house and my mother because of this vaccine. I am crying all of the time and currently living at a hotel. This has turned my world into a whirlwind.

Other Meds: I was taking prenatal vitamins; diazepam.

Current Illness: I cannot remember.

ID: 1817873
Sex: F
Age: 48
State: CT

Vax Date: 10/19/2021
Onset Date: 10/19/2021
Rec V Date: 10/26/2021
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: Went back to clinic on 10/22 and Doctor examined me and said it looked like shingles. I was advised to see my PC doctor. I saw a PA, on 10/22at my primary care and she also said it looked like shingles.

Allergies: None

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

Symptoms: Started with itchy rash on medial right clavicle. The next day rash traveled lateral to lateral right shoulder. Every day rash got worse. Today is one week and reaction is still itchy and sore covering most of my right shoulder with a few spots going down right arm. I also received the Johnson and Johnson vaccine on 9/13/21

Other Meds: Pure NAC

Current Illness: None

ID: 1817874
Sex: M
Age: 14
State: CA

Vax Date: 08/21/2021
Onset Date: 08/21/2021
Rec V Date: 10/26/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1817875
Sex: F
Age: 21
State: CA

Vax Date: 08/22/2021
Onset Date: 08/22/2021
Rec V Date: 10/26/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1817877
Sex: F
Age: 77
State: IN

Vax Date: 10/22/2021
Onset Date: 10/23/2021
Rec V Date: 10/26/2021
Hospital:

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

Lab Data: None

Allergies: None

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

Symptoms: Woke from sleep at 3:00AM with terrible aches throughout muscles and joints. Difficult to get out of bed; pain started subsiding 3 to 4 PM following day and following morning was able to eat breakfast and move about. I experienced same symptoms after second injection; however they only lasted almost exactly 12 hours. This third injection lasted nearly 36 hours.

Other Meds: Celecoxib 100 mg 2Xday; Escitalopram 10 mg 1Xday; Myrbetrig 50 mg 1Xday;

Current Illness: None

ID: 1817878
Sex: F
Age: 53
State: CA

Vax Date: 08/22/2021
Onset Date: 08/22/2021
Rec V Date: 10/26/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1817879
Sex: F
Age: 47
State:

Vax Date: 10/22/2021
Onset Date: 10/24/2021
Rec V Date: 10/26/2021
Hospital:

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

Lab Data: Covid/strep throat test 10/25/2021

Allergies: strawberry, pineapple, banana, SPF

Symptom List: Tremor

Symptoms: 5 days of fevers/chills 3rd day-sore throat that feels like strep/sore gums. went to med appt 10/25 and covid/step tests are negative

Other Meds:

Current Illness: na

ID: 1817880
Sex: M
Age: 37
State: CA

Vax Date: 08/22/2021
Onset Date: 08/22/2021
Rec V Date: 10/26/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1817881
Sex: F
Age: 59
State: NC

Vax Date: 04/01/2021
Onset Date: 06/01/2021
Rec V Date: 10/26/2021
Hospital:

Vax Type: UNK
Manufacturer: UNKNOWN MANUFACTURER
Vax Name: VACCINE NOT SPECIFIED (NO BRAND NAME)
Lot:
Dose Series: UNK
Vax Route: SYR
Vax Site: UN

Lab Data: n/a

Allergies: avocado, levaquin

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

Symptoms: experiencing heart flutters with episodes of insomnia

Other Meds: valsartan, ibuprofen, Goli

Current Illness: none

ID: 1817882
Sex: M
Age: 70
State: FL

Vax Date: 10/25/2021
Onset Date: 10/25/2021
Rec V Date: 10/26/2021
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: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: A patient came in yesterday and verbally requested a flu shot and a booster for Moderna as well as checking flu shot and COVID booster on immunization intake form; the patient attested multiple times both verbally and on intake form which shots he needed/requested. Patient's wife called and told us the patient "forgot" he got his flu shot at another pharmacy on 10/15/21. Patient's wife said she is not placing blame on the pharmacy because her husband requested the shot and it was his mistake. I called patient this morning to check on him and he said he is completely fine and no adverse side effects.

Other Meds:

Current Illness:

ID: 1817883
Sex: M
Age: 54
State: KY

Vax Date: 04/02/2021
Onset Date: 08/24/2021
Rec V Date: 10/26/2021
Hospital:

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

Lab Data: POSITIVE Covid-19 Test 08/27/2021

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Muscle aches

Other Meds:

Current Illness:

ID: 1817884
Sex: M
Age: 32
State: WV

Vax Date: 10/25/2021
Onset Date: 10/26/2021
Rec V Date: 10/26/2021
Hospital:

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

Lab Data: n/a

Allergies: n/a

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

Symptoms: Patient report that his arm is very sore unable to move arm up... injection site red and warm to touch... also experiencing severe headache and sift neck...108 degree fever and feel nauseous....

Other Meds: none

Current Illness: no

ID: 1817885
Sex: F
Age: 47
State: MI

Vax Date: 10/19/2021
Onset Date: 10/23/2021
Rec V Date: 10/26/2021
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: Have not received any yet.

Allergies: 0

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

Symptoms: Throbbing headache sore throat,cough lasted couple days,rash started around Sunday evening groin area,butt,thighs,neck,chest.Started self care Saturday,ibuprofen,rest,Sunday started Benadryl,itch creams,cold packs,monistat,made appt.for Thursday 10/28/21 family doc.

Other Meds: Norco,gabapentin,pristiq,lamisil,synthroid,adipex,amoxicillin,

Current Illness: Sinus infection

ID: 1817886
Sex: F
Age: 41
State: KY

Vax Date: 01/20/2021
Onset Date: 08/29/2021
Rec V Date: 10/26/2021
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: Tested Positive for Covid

Other Meds:

Current Illness:

ID: 1817887
Sex: F
Age: 72
State: TX

Vax Date: 10/23/2021
Onset Date: 10/23/2021
Rec V Date: 10/26/2021
Hospital:

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

Lab Data: None

Allergies: None known

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

Symptoms: Skin rash, inflamed face, puffiness

Other Meds: Iron - infusion, vitamins B, B-Complex, C, D3. Calcium, Biotin, E, Allegra, Senna

Current Illness: None

ID: 1817888
Sex: M
Age: 25
State: CA

Vax Date: 08/22/2021
Onset Date: 08/22/2021
Rec V Date: 10/26/2021
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: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1817889
Sex: U
Age: 32
State: VA

Vax Date: 10/08/2021
Onset Date: 10/08/2021
Rec V Date: 10/26/2021
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: Per hospital event reporting system " I received Hepatitis A vaccine, flu vaccine and COVID booster shot (Pfizer) on 10/9/21 after being informed there were no contraindications in taking all 3 at the same time by Employee. I worked my 12 hours shift as scheduled, just feeling lightheaded, sweats and chills. I took tylenol during my shift. My shift ended around 1930 and I drove home. As I was driving home, I started to feel shakiness and numbness and tingling all over that started in my midsection and radiated outwards into my extremities, head, face, neck, mouth, tongue and throat. I became aware that either my blood glucose level was low, or I was having an immune reaction from the vaccines. I got home and immediately thought I was going to pass out. I tried to eat but was unable to swallow crackers. At this point, I was afraid my airway is being compromised, so my wife called 911. I was brought to the ER and was there for about 6 hours (discharged at around 0130)."

Other Meds:

Current Illness:

ID: 1817890
Sex: F
Age: 49
State: OH

Vax Date: 09/10/2021
Onset Date: 09/30/2021
Rec V Date: 10/26/2021
Hospital:

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

Lab Data: I have an appointment to see my gyn .

Allergies: Amoxicillin

Symptom List: Vomiting

Symptoms: Severe menstrual type cramps (EVERYDAY). I haven't had a period since my thermal ablation 11/2008. Significant breast tenderness. Fatigue.

Other Meds: Birth control, Buproprion, Synthroid, Hair supplements, Lasix. NONE OF WHICH WERE NEW PRESCRIPTIONS

Current Illness: None that I can recall

ID: 1817891
Sex: M
Age: 21
State: CA

Vax Date: 08/23/2021
Onset Date: 08/23/2021
Rec V Date: 10/26/2021
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:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1817893
Sex: M
Age: 13
State: CA

Vax Date: 08/23/2021
Onset Date: 08/23/2021
Rec V Date: 10/26/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1817894
Sex: M
Age: 42
State: KY

Vax Date: 04/06/2021
Onset Date: 08/31/2021
Rec V Date: 10/26/2021
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: Tested Positive for Covid

Other Meds:

Current Illness:

ID: 1817895
Sex: M
Age: 12
State: MD

Vax Date: 09/25/2021
Onset Date: 09/25/2021
Rec V Date: 10/26/2021
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: Patient received Pfizer as first dose of vaccine and accidentally received Johnson and Johnson as second vaccine dose. Father reports after vaccine immediately was tired, limp and pale with emesis. Since then he has had continued concentration and short term memory difficulties requiring additional assistance in school

Other Meds:

Current Illness: None

ID: 1817896
Sex: M
Age: 31
State: FL

Vax Date: 10/01/2021
Onset Date: 10/01/2021
Rec V Date: 10/26/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Extreme fever, extreme migraine. Dizziness, fatigue.

Other Meds: Multi vitamin

Current Illness: None

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am