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: 1818214
Sex: F
Age: 34
State: NY

Vax Date: 10/23/2021
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: N/a

Allergies: Allergy to shellfish

Symptom List: Dysphagia, Epiglottitis

Symptoms: Blood clot in right eye, headache frontal lobe and over right eye. Dizziness upon standing. Can not look directly into light. Left arm very sore

Other Meds: N/A

Current Illness: N/A

ID: 1818215
Sex: M
Age: 54
State: OK

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

Lab Data: none

Allergies: no know allergies

Symptom List: Anxiety, Dyspnoea

Symptoms: Moderna vaccination booster was given 1 month before due date. Moderna booster was due 11/24/2021. Client was notified at 5:30 pm on 10/25/2021 . On 10/26/2021 Client was contacted for follow-up and stated only sore arm from vaccination.

Other Meds: vitamin c

Current Illness: no

ID: 1818216
Sex: M
Age: 73
State: ID

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: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Upon charting the vaccination given it was found that the vial had expired 10/15/2021

Other Meds:

Current Illness:

ID: 1818217
Sex: M
Age: 51
State: PA

Vax Date: 04/06/2021
Onset Date: 04/07/2021
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:

Allergies: None

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Started with watery eyes after never having allergy before. Watery eyes turned to itching, itching turned to pain, eye drops did not offer relief, both eyes suffered from high eye pressure, left eye developed corneal erosion, both eyes developed cataracts upon healing 6 months later.

Other Meds: Insulin, Ramipril, Atorvistatin, low dose aspirin

Current Illness:

ID: 1818218
Sex: F
Age: 65
State: KS

Vax Date: 03/25/2021
Onset Date: 03/29/2021
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: none

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

Symptoms: pain in hips, back, stiffness, now arms and shoulders

Other Meds: dexedrine; rhodiola inositol

Current Illness: none

ID: 1818219
Sex: F
Age: 69
State: GA

Vax Date: 10/10/2021
Onset Date: 10/11/2021
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: none

Allergies: penicillin, latex

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

Symptoms: Fever, chills, profuse sweating. Pain and swelling in arm. Unable to sleep for 2 nights due to chills and sweats. Fatigue. Recovered after 4 days of symptoms. I had COVID in December 2020 through January 2021.

Other Meds: Fluoxetine, trazadone, lamotrigine, buproprion, rosuvastatin

Current Illness: none

ID: 1818220
Sex: F
Age: 56
State: PA

Vax Date: 05/13/2021
Onset Date: 05/20/2021
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: penicillin

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Local pain and swelling of the injection site occurred within 24 hours. Bruising /discoloration at injection site began within 7 days. Within 2 weeks, the injection soreness returned along with muscle weakness followed by atrophy. It has been 5 months and now there is a persistent and visible concavity/indentation of the injection site. An irreversible erosion of the flesh. Not a disability but permanent damage

Other Meds: none

Current Illness: none

ID: 1818221
Sex: M
Age: 75
State: MI

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

Symptom List: Pharyngeal swelling

Symptoms: Pt upon finishing dialysis tx and receiving vaccine injection began feeling weak . Pt was unable to stand and had to be transported in a wheelchair. Pt remained sitting for about 30 minutes c/o of severe fatigue. Pt drove himself home from clinic. At home pt reported feeling very confused and lethargic. Pt stated that family was unable to understand his speech and that he was not making sense. Pt returned to clinic for HD tx and reported that he still felt some fatigue (ambulating w/o assistance but was feeling better than before and also reported that he was functioning normally cognitively again.

Other Meds: Asprin, atorvastatin, calcium acetate, dialyvite, vitamin D2, Humalog, lantus, Nitrostat, vitamin D, Heparin

Current Illness: ESRD, Type 2 Diabetes, Acute diastolic congestive heart failure, Atherosclerotic, Thrombocytopenia Secondary Parathyroidism of renal origin, anemia, hyperlipidemia

ID: 1818222
Sex: F
Age: 17
State: WI

Vax Date: 10/26/2021
Onset Date: 10/26/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: CLIENT WAS GIVEN A 3RD DOSE AT THE AGE OF 17 WHEN THE RECOMENDATIONS ARE FOR THOSE 18 AND OLDER.

Other Meds: NONE

Current Illness: NONE

ID: 1818223
Sex: F
Age: 69
State: VA

Vax Date: 09/16/2021
Onset Date: 09/18/2021
Rec V Date: 10/26/2021
Hospital: Y

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

Lab Data: Lipase 279, Abdominal CT scan- swollen pancreas- NO gallstones

Allergies: NONE

Symptom List: Diarrhoea, Nasal congestion

Symptoms: About 36 hours after vaccine, nausea and severe gastrointestinal distress occurred. Patient diagnosed with acute pancreatitis and hospitalized for 2 days

Other Meds: Amlodipine, Fosamax, Levoxyl, Metoprolol, Vitamin D, CoQ10, Reserveratrol, Calcium carbonate

Current Illness: NONE

ID: 1818224
Sex: F
Age: 57
State: MN

Vax Date: 03/25/2021
Onset Date: 03/26/2021
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: None

Allergies: significant reaction to gluten

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

Symptoms: See first page Significant increase in tinnitus. Prior to 1st & 2nd dose of Moderna, I had had mild tinnitus for 10-15 years that was rarely bothersome. However, 12-15 hours after 2nd dose, I was dizzy, had reverberations in my ears & the significant increase in tinnitus. I can't sit in a room that is quiet; I need to have music on or I use a white noise app on my phone. To sleep, I must use the white-noise app or the tinnitus won't allow me to go to sleep. On Mon. Oct. 25, 2021, I received the Moderna Booster of .25 cc

Other Meds: Fluoxetine Iron Calcium w/Vit. D

Current Illness: None

ID: 1818225
Sex: F
Age: 69
State: MA

Vax Date: 09/27/2021
Onset Date: 10/26/2021
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: Fever 100.3, tired

Other Meds:

Current Illness:

ID: 1818226
Sex: F
Age: 77
State: MN

Vax Date: 03/30/2021
Onset Date: 10/24/2021
Rec V Date: 10/26/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: Dose 1 Pfizer 3/9/21, dose 2 Pfizer 3/30/21, hospitalization for breakthru COVID on 10/24/21 - expected D/C tomorrow, 10/27/21

Other Meds:

Current Illness:

ID: 1818227
Sex: F
Age: 61
State: WI

Vax Date: 09/29/2021
Onset Date: 10/01/2021
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: Bloodwork (10/9/2021). Comprehensive metabolic PN (10/9/2021). Lipid (10/9/2021). Lung X-ray (10/15/2021). Ct Scan- showed that I had nodules on left side of my body (10/20/2021). Bone density-(10/22/2021).

Allergies: None

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

Symptoms: Within 10 minutes of receiving the vaccine, I felt it hit my head. I knew something wasn't right. 2 days later I started to feel pain in my back. I thought it was just from sleeping wrong. On 10/5/2021 I started feeling something in my neck. It was getting swollen. I went to see my doctor and they started me on amoxicillin. That medicine didn't work because my neck started getting really sore and hard. The doctor said I have nodules on the left side of my body located on my jaw, one below my salivary gland, lymph node, spine, and on the upper back. The nodules are all located on the left side of my body. The doctor then put me on a Z-PAK. On the back of my spine at the top it started getting sore. I have chills at night and its harder to move my neck. I can't sleep because I keep waking up because of the pain in my neck. My doctor referred me to an ENT specialist. The ENT prescribed me a stronger antibiotic and prednisone to take. She said to drink lots of water and to massage my nodules. The doctor is most concerned about the nodule on the jaw because it is hard. Ever since this has happened, I haven't been able to watch my granddaughter like I used to because I just feel weak. The doctors think it could possibly be an infection, but they are not sure on what it is. I have an upcoming appointment with the ENT specialist again.

Other Meds:

Current Illness: None

ID: 1818228
Sex: F
Age: 17
State: CA

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: none.

Allergies: NKDA or Known Food Allergies

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

Symptoms: Pain at injection site and rash on that arm mostly, and less so on rest of body. Start about 4hours post vaccine; and next day symptoms were improving, but still there.

Other Meds: None

Current Illness: No

ID: 1818229
Sex: F
Age: 56
State: PA

Vax Date: 10/26/2021
Onset Date: 10/26/2021
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: Beef, Flu, Iodine, IV contrast, Keflex, soy, watermelon, toradol

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

Symptoms: Patient was administered the COVID-19 vaccine. Within a few minutes she began to experience pruritus, her throat itching, mild chest tightness, nausea. There are no visible hives, lungs were clear, no angioedema of the oral mucosa and blood pressure was 122/78. Patient denied any throat swelling or difficulty breathing. Patient was talking comfortably. She just kept itching her skin and then the skin would become slightly red. She reported having an allergic reaction to the flu vaccine that required an EpiPen injection. She also has a history of chronic idiopathic urticaria. She takes Zyrtec daily. Administered Benadryl 50 mg orally Administered Solu-Medrol 40 mg IM Patient symptoms remain stable Patient was escorted to the ED for further observation and management.

Other Meds: Albuterol, flonase, flovent, lisinopril, naproxen, priolsec, vit D

Current Illness: Dysuria-treated for UTI

ID: 1818230
Sex: F
Age: 50
State: IL

Vax Date: 10/22/2021
Onset Date: 10/23/2021
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: NONE

Allergies: none

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

Symptoms: 10/23/21- SORE LT ARM, FEVER, WEAKNESS, FATIGUE, NAUSEA, CRAMPING IN LEGS,LIGHT HEADED, HEART RACING ALL DAY 10/24/21- SORE LT ARM AND ARM PIT, FATIGUE, WEAKNESS, SLIGHT LIGHTHEADNESS,HEART RACING ALL DAY 10/25/21- SLIGHTLY SORENESS TO LT ARM & ARM PIT TILL AT NIGHT NOTICED RASH ON LT ARM ABOUT 3INCHES BELOW WHERE INJECTION WAS GIVEN. WARM TO TOUCH & SWOLLEN. STOMACH CRAMPING THROUGH NIGHT, HEART RACING ALL DAY 10/26/21- LT ARM & ARM PIT SORENESS . RASH STILL PRESENT ,VERY WARM TO TOUCH. STOMACH REMAINS UPSET AND NAUSEA PRESENT. LIGHT HEADNESS

Other Meds: none

Current Illness: none

ID: 1818231
Sex: M
Age: 29
State: ID

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

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Upon charting the given vaccine, it was found that the vial had expired 10/15/2021.

Other Meds:

Current Illness:

ID: 1818233
Sex: F
Age: 43
State: PA

Vax Date: 02/19/2021
Onset Date: 02/28/2021
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:

Allergies: N/a

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Impact to menstrual cycle Reduced regular cycle from 27-29 to 21 -26 days reduced bleeding from 4-5 days to 2-3 days

Other Meds: N/a

Current Illness: N/a

ID: 1818234
Sex: F
Age: 60
State: FL

Vax Date: 09/24/2021
Onset Date: 09/24/2021
Rec V Date: 10/26/2021
Hospital:

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

Lab Data: Ultrasound

Allergies: None

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

Symptoms: Vaccine was administered very high on my shoulder and caused a lot of pain at the time. The pain became increasingly worse. I am now unable to use my left arm with full range of motion without extreme pain in my shoulder and upper arm.

Other Meds: Zyrtec, Progesterone 100mg, Bio-Identical Hormones, Prilosec

Current Illness: None

ID: 1818235
Sex: F
Age: 31
State: VA

Vax Date: 04/23/2021
Onset Date: 04/24/2021
Rec V Date: 10/26/2021
Hospital: Y

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: Blood work Chest X-ray EKG Brain MRI CT scan Echocardiogram Holter monitor D-dimer was extremely high White blood count is high

Allergies: None

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

Symptoms: Around the time I was going to sleep, I felt very nauseous and I was vomiting. I also felt an electric jolt throughout my body. I tried to go to sleep afterwards, but I would still get these jolts on the right side of my chest. I didn't get much sleep that night. On April 30, 2021, I went to the hospital. I took many tests. On May 2, 2021, I went back to the hospital because I was still experiencing chest problems. I took more tests. I am still dealing with chest pains and an electric jolt sensation in my chest. I am also dealing with shortness of breath, vomiting, and coughing. I also have a lump on my left breast and I have never had this before.

Other Meds: None

Current Illness: None

ID: 1818236
Sex: F
Age: 39
State: MN

Vax Date: 01/20/2021
Onset Date: 10/22/2021
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: 10/25 SARS/COV-2, NAAT, Positive

Allergies:

Symptom List: Unevaluable event

Symptoms: Breakthrough COVID

Other Meds:

Current Illness:

ID: 1818237
Sex: F
Age: 41
State: FL

Vax Date: 10/26/2021
Onset Date: 10/26/2021
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: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

Symptoms: Rash that grew to torso and other areas

Other Meds:

Current Illness:

Date Died: 09/23/2021

ID: 1818238
Sex: M
Age: 89
State: TN

Vax Date: 02/18/2021
Onset Date: 09/23/2021
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: Tested positive on 9/14/2021 SARS-CoV-2 Ag Resp Ql IA.rapid

Allergies: Unknown

Symptom List: Injection site pain, Pain

Symptoms: Symptomatic on 9/13/2021: subjective fever, cough, Pneumonia, difficulty breathing

Other Meds: Unknown

Current Illness: Unknown

ID: 1818239
Sex: F
Age: 36
State: ID

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:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Upon charting the given vaccine, it was found that the vial had expired 10/15/2021.

Other Meds:

Current Illness:

ID: 1818240
Sex: F
Age: 58
State: CO

Vax Date: 10/14/2021
Onset Date: 10/15/2021
Rec V Date: 10/26/2021
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: CTA, MRI(s), lab work, thrombectomy though right groin

Allergies: nkda

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

Symptoms: on Oct 15th 2021 had facial numbness and left hand numbness. Increase to mouth numbness and memory difficulty. Went to primary care Dr. on Oct 19 no testing completed. Oct 20th 2021 my son had to call EMS for stroke symptoms, slurred speech, droopy gave, difficulty walk standing, cognitive difficulty. Went to hospital and found to have had Rt MCA stroke. The had worsening stroke with secondary stroke and received a thrombectomy to my on 10/20/2021.

Other Meds: oxybutynin xl 15 mg daily, sertraline 100 mg daily, lisinopril-hctz 20-25 mg daily, alive woman?s multivitamin daily, calcium 600 mg daily, vit-c 500 mg daily, magnesium 400 mg daily, cetirizine 10 mg daily, metamucil fiber daily, turmer

Current Illness: none

ID: 1818241
Sex: F
Age: 26
State: CA

Vax Date: 10/05/2021
Onset Date: 10/13/2021
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: N/A

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Prior to taking the Covid-19 Janssen vaccination, I have had normal menstrual cycles since menstruation began at age 11. After receiving the shot on 10/5/ 21 menstrual cycle was expected between 10/13/2021 - 10/18/2021 and did no come. Cycle still has yet to come, even though all typical symptoms revolving around cycle have occurred (menstrual cramps, face break out, etc). There is no pregnancy, medications, or use of birth control to affect this change.

Other Meds: N/A

Current Illness: N/A

ID: 1818243
Sex: F
Age: 82
State: WV

Vax Date: 02/02/2021
Onset Date: 04/12/2021
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:

Allergies: NKA

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Ten weeks after getting second Moderna she developed blood clots in leg and lungs. Taking Elequist at this time and doing better.

Other Meds:

Current Illness:

ID: 1818244
Sex: F
Age: 46
State: MT

Vax Date: 10/14/2021
Onset Date: 10/15/2021
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: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: The patient experienced fever, body aches and chills. All symptoms subsided between 24-48 hours after booster.

Other Meds:

Current Illness:

Date Died:

ID: 1818245
Sex: U
Age: 72
State:

Vax Date: 02/26/2021
Onset Date: 09/05/2021
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: fully vaccinated, had CVA after vaccine, went to hospital and died

Other Meds:

Current Illness:

ID: 1818246
Sex: F
Age: 74
State:

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: Upon charting the given vaccine, it was found that the vial had expired 10/15/2021.

Other Meds:

Current Illness:

ID: 1818247
Sex: M
Age: 15
State: AZ

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

Lab Data: n/a

Allergies: nkda

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

Symptoms: fever, chills, body aches, and fatigue x 24 hrs

Other Meds: n/a

Current Illness: n/a

ID: 1818248
Sex: U
Age: 69
State: ID

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: RA

Lab Data:

Allergies:

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

Symptoms: Upon charting the given vaccine, it was found that the vial had expired 10/15/2021.

Other Meds:

Current Illness:

ID: 1818249
Sex: U
Age: 85
State:

Vax Date: 02/11/2021
Onset Date: 10/22/2021
Rec V Date: 10/26/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: fully vaccinated, hospitalizd with severe weakness and pneumonia

Other Meds:

Current Illness:

ID: 1818250
Sex: M
Age: 57
State: MN

Vax Date: 02/01/2021
Onset Date: 10/25/2021
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: 10/25 SARS/COV-2, NAAT Positive

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: Breakthrough COVID

Other Meds:

Current Illness:

ID: 1818251
Sex: M
Age: 72
State: CO

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

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: A SARS Cov-2 FLUVID test on 10/25/21 indicated positive COVID-19 RNA (influenza A PCR, influenza B PCR, and RSV PCR were not detected).

Allergies: Patient reports allergies to atorvastatin (myalgia), pravastatin (myalgia), lisinopril (cough), rosuvastatin (myalgia), simvastatin (myalgia), spironolactone (breast swelling), statins drug class (malaise).

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

Symptoms: Patient was admitted to the hospital with COVID infection on 10/25/21, after receiving a booster dose of Pfizer COVID vaccine (lot # FF2590) on 10/22/21. Of note, this patient had previously received two doses of Pfizer COVID vaccine ( on 2/1/21 lot # EN5318, and on 2/22/21 lot # EL9264, respectively). The patient reported experiencing weakness, diarrhea, and myalgia for 2 days prior to admission. Per provider notes, the patient reported that his diarrhea symptoms had started 4 days prior to admission. The patient tested positive for COVID via FLUVID test on 10/25/21. At the time of this report, the patient remains hospitalized and is being treated for COVID infection.

Other Meds: Unknown

Current Illness: Unknown

ID: 1818252
Sex: F
Age: 69
State: WA

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: None to this point.

Allergies: none

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

Symptoms: Swelling at injection site, warmth, firm. Itching. No systemic symptoms. Started 2 hours after injection of booster dose.

Other Meds: Losartan 100mg and pravastatin 20mg

Current Illness: none

ID: 1818253
Sex: M
Age: 91
State: OH

Vax Date: 10/19/2021
Onset Date: 10/20/2021
Rec V Date: 10/26/2021
Hospital: Y

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

Lab Data: patient reported feeling "not too lucid" the day after the injection and called the emergency squad, he was taken to the hospital and was evaluated by physician who stated in discharge report: "91 year-old male who presents with cough fever and fatigue for 2-3 days and notably received the COVID vaccination 1 day prior. CXR with possible early PNA of left lung. Fever curve improved, symptoms improving, on room air, no leukocytosis. COVID negative. Overall, appeared to be improving but was observed closely due to age. Suspect fever may be related to COVID vaccine but difficult to know for sure giving imaging appearance however does not otherwise appear systemically ill. He received treatment with ceftriaxone and azithromycin inpatient and monitored and then narrowed to PO to complete 5 day total course with 3 remaining days of amoxicillin +azithromycin. Home health referral was made and set up on discharge." Physician completing report is Dr. from local health care facility.

Allergies: none on file

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: patient reported feeling "not too lucid" the day after the injection and called the emergency squad, he was taken to the hospital and was evaluated by physician who stated in discharge report: "91 year-old male who presents with cough fever and fatigue for 2-3 days and notably received the COVID vaccination 1 day prior. CXR with possible early PNA of left lung. Fever curve improved, symptoms improving, on room air, no leukocytosis. COVID negative. Overall, appeared to be improving but was observed closely due to age. Suspect fever may be related to COVID vaccine but difficult to know for sure giving imaging appearance however does not otherwise appear systemically ill. He received treatment with ceftriaxone and azithromycin inpatient and monitored and then narrowed to PO to complete 5 day total course with 3 remaining days of amoxicillin +azithromycin. Home health referral was made and set up on discharge." Physician completing report is local Dr. from local health care facility.

Other Meds: synthroid 75 mcg, citalopram 20 mg, buspirone 15 mg, timolol maleate 0.5% eye drops, ranolazine ER 500 mg, pantoprazole 40 mg, nifedipine ER 30 mg, atorvastatin 80 mg

Current Illness: anxiety disorder, HTN, hypothyroidism, gait abnormalities, diverticulum of esophagus, ASHD, atherosclerosis of aorta, malignant neoplasm prostate, hyperlipidemia, depression, GERD, glaucoma, per the ER summary the patient complained of cough and fever and fatigue for 2-3 days and notable received the covid vaccination 1 day prior to hospital admission

ID: 1818254
Sex: F
Age: 55
State: GA

Vax Date: 04/15/2021
Onset Date: 06/01/2021
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: EKG Testing, Blood Testing also Ultrasound Test for Thyroid

Allergies: Bee's , Fish, Valium, Sulfur, Leziquin and Feathers

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

Symptoms: Extremely tired, could not eat and could not move.

Other Meds: Repatha, Chlordiaz, Ibesartan, Temazetam, Albuterol, Amlodipine, Adderall, and Tylenol

Current Illness: High cholesterol, High blood pressure, Asthma , and IBS

ID: 1818255
Sex: U
Age: 72
State:

Vax Date: 03/06/2021
Onset Date: 10/11/2021
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:

Allergies:

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

Symptoms: fully vaccinated, came down with covid

Other Meds:

Current Illness:

ID: 1818256
Sex: M
Age: 71
State: DE

Vax Date: 04/15/2021
Onset Date: 10/18/2021
Rec V Date: 10/26/2021
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 PCR test positive on 10/20/21

Allergies: NKDA, NKA

Symptom List: Pain in extremity

Symptoms: Acute hypoxic respiratory failure persists after completing 5 day course of Remdesivir, day 6/10 of Decadron while on CPAP.

Other Meds: Aspirin 81mg PO daily, carvedilol CR 20mg PO daily, glimepiride 1mg daily, metformin 500mg BID PO, niacin 500mg PO daily, omega 3 FA 1capsule PO daily.

Current Illness:

ID: 1818257
Sex: F
Age: 69
State: TX

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: 2
Vax Route:
Vax Site:

Lab Data: No

Allergies: No

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

Symptoms: Woke up to severe uncontrolled shivering that lasted about two hours, my right and left metal hip implants became very painful and hurt more when I tried to weight bear, Muscle cramps in left leg, fever and headache.It was the shivering that was the worst, almost like my body was in mild shock.

Other Meds: Levothyroxine,Turmeric,Magnesium,D-Mannose,MSM, B-12,Vitamin D, Fiber Powder, Herbal sleep aids

Current Illness: No

ID: 1818258
Sex: F
Age: 58
State:

Vax Date: 10/16/2021
Onset Date: 10/16/2021
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: ECG: normal blood presure: 192/79

Allergies: Aspirin, Bactrim, Ciprofloxacin, gabapentin, IV contrast, Morphine, Levaquin, Metronidazole, Bee stings, oxycodone, penicillins, sulfa abx, toradol, vancomycin, questran

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

Symptoms: Patient started with symptoms approximately 11 minutes after vaccination. She reports feelings of difficulty swallowing as well as some chest discomfort with radiation up into her head. She has had similar reactions in the past vaccinations. Reports no associated rashes at this time. Has not had any nausea or vomiting. Does have slight burning sensation in her chest.

Other Meds: Pepcid, Fioricet, albuterol, levothyroxine

Current Illness: None

ID: 1818259
Sex: F
Age: 30
State: UT

Vax Date: 10/26/2021
Onset Date: 10/26/2021
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: Client came in to receive a booster dose of Moderna after a Janssen vaccine. Client received a 0.5 ML dose when she should have received a 0.25 ML dose. No symptoms at this time.

Other Meds:

Current Illness:

ID: 1818260
Sex: F
Age: 73
State:

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

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: Upon charting the given vaccine, it was found that the vial had expired 10/15/2021.

Other Meds:

Current Illness:

ID: 1818261
Sex: F
Age: 40
State: AZ

Vax Date: 04/21/2021
Onset Date: 04/21/2021
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: no

Allergies: flonase; latex

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: My arm got really stiff. At the injection site it was red and sore for a day. Later that night, that is when the other side affects came (the adverse side affects). Severe fatigue; really bad headache; muscle pain that on a lot of days I was needing to take 6 Advil during the course of the day - really painful. Also, the Bells Palsy symptoms started up that night. It was like a really bad case of flu that wouldn't go away. A constant fever for about a week. I had chills. The nausea was full-blown for about 6 weeks. It also swelled up my joints so that in the morning or at night I couldn't move my hands or arms. I do get side affects with medications that I take. I took natural supplements and was bedridden for about the first week because the muscle pain and inflamed joints were so bad. I did acupuncture for bells palsy - that was onset after the vaccine. Bell Palsy -usually my symptoms for chronic condition are non existent (can't tell that I have it) but each time I had the COVID vaccine, it made me have the worse Bells Palsy symptoms that I've had in my life. My eye that wouldn't close; my drooling from my mouth because I couldn't move it. Ringing in the ears, and metallic taste in my mouth. A week and a half after the side affects lessened, I got Shingles - from June 18th and ended before my birthday on 8-22. My doctors think I got it because of the vaccine. Shingles symptoms lasted about 8 weeks - and it was pretty painful. Growing across my head and over my eyes. They gave me an anti-viral and I also took Olive Leaf Extract and I used EMU oil as well. With those it stopped growing. Doctor said it was the vaccine that brought the symptoms. My body was under duress. I had a relapse of the Shingles- the beginning of September. It was a minute bout of it -they thought it was pseudo pain from the shingles which I may have re-occur for 6 months. October 1st, I had my flu shot. My prior flu shot was August 30, 2020.

Other Meds: basic diabetic meds and vitamin supplements

Current Illness: no

ID: 1818262
Sex: M
Age: 71
State: OH

Vax Date: 10/14/2021
Onset Date: 10/16/2021
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: Patient has contacted Cardiologist regarding the chest pain and was told to be seen if chest pain continues another week or to be seen in the ER if 3 consecutive Nitroglycerin tablets do not relieve pain.

Allergies:

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

Symptoms: Patient complains of chest pain sharp enough to take prescribed Nitroglycerin tablets 2 days after receiving third dose of Pfizer COVID-19 Vaccine. Patient states continues to have 2-3 episodes every day of chest pain that needs the use of Nitroglycerin tablets to relieve.

Other Meds:

Current Illness:

ID: 1818263
Sex: F
Age: 33
State: MT

Vax Date: 10/14/2021
Onset Date: 10/15/2021
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: This patient experienced chills, fever, body aches, nausea, and a headache. Symptoms subsided 24-48hrs after booster was given.

Other Meds:

Current Illness:

Date Died: 08/22/2021

ID: 1818264
Sex: M
Age: 80
State:

Vax Date: 02/10/2021
Onset Date: 08/09/2021
Rec V Date: 10/26/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: pt admitted to hosp with acute on chronic systolic heart failure; CRTD placed; pt c/o weakness, poor appetite, food tasted like "cardboard"; positive COVID test; DNR; O2 @6L/M via face mask; pt's condition worsened and he passed away in the hospital

Other Meds:

Current Illness:

Date Died: 07/26/2021

ID: 1818265
Sex: F
Age: 33
State: TN

Vax Date: 03/04/2021
Onset Date: 07/20/2021
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: my sister went to the er on July 20th with what seem to be a illergic reaction... she said she was itching all over and was swelling. They sister passed away on July 26th from myocarditis which is stated o. The cdc website a direct side effect of the moderna shot.

Other Meds: CF meds.

Current Illness: cf

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am