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**
PLEASE CHECK BACK SOON
Download the files above while you wait.







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: 1821062
Sex: M
Age: 71
State: TX

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

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

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1821063
Sex: M
Age: 35
State: NY

Vax Date: 10/23/2021
Onset Date: 10/26/2021
Rec V Date: 10/27/2021
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: None

Symptom List: Anxiety, Dyspnoea

Symptoms: I felt these symptoms after my first shot as well, but since they occured nearly 48 hours after my shot I didn't think they were associated with the vaccine. Now having experienced them after my second dose and reading that many other people are having these issues, I felt compelled to file a report so that this can be studied or investigated. After both doses, 48 hours later I begin to experience what I can only describe as an intense brain fog and this feeling like something is wrong or off. I experience bouts of nausea and dizziness. I become unfocused, cannot concentrate and my eyes hurt. I also experience intense headaches. Finally, and most debilitating, I experienced a horrible anxiety attack after each shot. This most recent one was this morning. There has to be a reason for these symptoms after each of my doses, and reading online I am one of many who has experienced this. I pray this goes away soon.

Other Meds: Multi vitamin and fish oil, l-carnitine, whey protein

Current Illness: None

ID: 1821064
Sex: F
Age: 61
State: MT

Vax Date: 05/17/2021
Onset Date: 10/04/2021
Rec V Date: 10/27/2021
Hospital: Y

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: Patient diagnosed and hospitalized with COVID-19 while fully vaccinated.

Other Meds:

Current Illness:

Date Died: 05/04/2021

ID: 1821065
Sex: M
Age: 85
State: PA

Vax Date: 03/06/2021
Onset Date: 05/04/2021
Rec V Date: 10/27/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Pt died on 05/04/2021. COVID Negative at time of death.

Other Meds:

Current Illness:

ID: 1821066
Sex: M
Age: 76
State: TX

Vax Date: 09/09/2021
Onset Date: 09/09/2021
Rec V Date: 10/27/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1821067
Sex: F
Age: 42
State: VA

Vax Date: 01/29/2021
Onset Date: 02/01/2021
Rec V Date: 10/27/2021
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: Patho test for fibroid tissue

Allergies: None

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

Symptoms: Lower abdominal cramping. Spontaneous fibroid expulsion about two weeks after vaccine.

Other Meds: None

Current Illness: None

ID: 1821068
Sex: F
Age: 69
State: IN

Vax Date: 10/25/2021
Onset Date: 10/26/2021
Rec V Date: 10/27/2021
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: Benzodiazepines

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Headache Muscle aches Joint aches Soreness at injection site Loss of appetite

Other Meds: Mestizo Estradiol Celebrex Metoprolol Multivitamin

Current Illness:

ID: 1821069
Sex: F
Age: 70
State: MA

Vax Date: 02/28/2021
Onset Date: 03/05/2021
Rec V Date: 10/27/2021
Hospital:

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

Lab Data: Catscan MRI No reason found for this abdominal pain. Still investigating.

Allergies: Hydroxychloroquine, contrast dye, certain antibiotics

Symptom List: Pharyngeal swelling

Symptoms: Approximately five days after receiving the injection; sharp, stabbing to dull abdominal pains started concentrated and emanating from about two inches to the left of my umbilicus. Many tests have ensued without findings.

Other Meds: None

Current Illness:

ID: 1821070
Sex: M
Age: 75
State: TX

Vax Date: 09/07/2021
Onset Date: 09/07/2021
Rec V Date: 10/27/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1821071
Sex: M
Age: 42
State:

Vax Date: 10/22/2021
Onset Date: 10/22/2021
Rec V Date: 10/27/2021
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: stomach nausea, Sore muscles, shoulder, back, tailbone, and joints plus, fatigue along with small headache. Had the same issue on the first vaccine that was giving on 9/24/21 with more of a pounding headache and spent the whole 3days sleeping. My fatigue felt as if I ran a marathon with no breaks. Spent most of my days sleeping until it was over.

Other Meds:

Current Illness:

ID: 1821072
Sex: M
Age: 79
State: MT

Vax Date: 01/28/2021
Onset Date: 10/19/2021
Rec V Date: 10/27/2021
Hospital: Y

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: Vaccination site erythema, Vaccination site pruritus, Vaccination site swelling

Symptoms: Patient diagnosed and hospitalized with COVID-19 while fully vaccinated.

Other Meds:

Current Illness:

ID: 1821073
Sex: M
Age: 71
State:

Vax Date: 10/22/2021
Onset Date: 10/22/2021
Rec V Date: 10/27/2021
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: instead of giving the booster dose, additional dose was given. however, no adverse reaction reported and patient states it is fine with him.

Other Meds:

Current Illness:

ID: 1821075
Sex: F
Age: 30
State: TX

Vax Date: 09/07/2021
Onset Date: 09/07/2021
Rec V Date: 10/27/2021
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: 1821076
Sex: F
Age: 51
State: LA

Vax Date: 10/19/2021
Onset Date: 10/20/2021
Rec V Date: 10/27/2021
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: NA

Allergies: None

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

Symptoms: After the first two doses, I felt fatigued but it went away after just a couple of days. The day after the third dose, I felt extremely fatigued and really confused. I am having a really hard time remembering things. I feel just generally impaired but I have not taken anything to be impaired. I am to the point I don't feel safe driving right now.

Other Meds: Losartan 12.5mg daily, Omeprazole 40mg daily

Current Illness: None

ID: 1821077
Sex: M
Age: 32
State:

Vax Date: 07/15/2021
Onset Date: 08/12/2021
Rec V Date: 10/27/2021
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: Pt reports being vaccinated with pfizer covid vaccine in mid june and again in mid july at a pharmacy. He developed a DVT to his left lower leg less than 1 month after his second vaccine.

Other Meds:

Current Illness: HLD

ID: 1821078
Sex: M
Age: 47
State: OR

Vax Date: 05/05/2021
Onset Date: 09/15/2021
Rec V Date: 10/27/2021
Hospital:

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

Lab Data: Doctor appointment scheduled for December 2021.

Allergies: None known

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

Symptoms: Severe pain right elbow and up to triceps . Lasting 1 1/2 months. Pain is now reduced.

Other Meds: Lisinopril-hctz, Multivitamin

Current Illness: None

ID: 1821079
Sex: F
Age: 51
State: IL

Vax Date: 10/07/2021
Onset Date: 10/08/2021
Rec V Date: 10/27/2021
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: Dairy protein allergy

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

Symptoms: Palpitations and SVT , syncope without collapse 1x for the first 24 hrs (off and on throughout the day). Increased heart rate without exertion for 2 days. Shortness of breath for 3 days. lethargic for 1 week. Spells of light headedness off and on is still on going but decreasing over time. Extreme arm pain the next day lasting only one day.

Other Meds: Tylenol

Current Illness: none

ID: 1821080
Sex: M
Age: 18
State: TX

Vax Date: 09/11/2021
Onset Date: 09/11/2021
Rec V Date: 10/27/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1821081
Sex: F
Age: 60
State: MD

Vax Date: 02/27/2021
Onset Date: 10/25/2021
Rec V Date: 10/27/2021
Hospital:

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

Lab Data: None

Allergies: Amoxicillin, honeydew, cantaloupe, honey

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: No booster received yet. Repeat of reaction after first Moderna shot. Full body skin burning/itching & chills that lasted about 24 hours. I never had this reaction before the Modernat Vaccine. No unusual food was consumed prior to reaction.

Other Meds: Omeprazole 20mg daily & Vitamin D3 400 IU daily

Current Illness: None

ID: 1821082
Sex: M
Age: 38
State: IN

Vax Date: 05/01/2021
Onset Date: 07/01/2021
Rec V Date: 10/27/2021
Hospital:

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

Lab Data: Full blood panel, Lyme disease, HIV, Hep B/C, COVID-19 - all back negative ( September and October 2021)

Allergies: None

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

Symptoms: Extreme fatigue, night sweats, brain fog, lowgrade fever at times

Other Meds: Vitamin C, D, probiotics

Current Illness: None

ID: 1821083
Sex: M
Age: 75
State: TX

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

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: none

Allergies: none known

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

Symptoms: within hour of injection: pain spread throughout left shoulder. Within 12 hrs: headache, lethargy, continued pain around deltoid, slightly elevated body temperature, treatment with ibuprofen. Within 42 hrs: loss of sense of taste, no headache, lessened pain at injection site, normal energy.

Other Meds: low-dose aspirin 81mg, Metoprolol Succinate 50 mg, Atorvastatin 40 mg 2x day, gabapentin 300 mg, Ducusate 100 mg

Current Illness: none

ID: 1821084
Sex: F
Age: 33
State: MN

Vax Date: 03/19/2021
Onset Date: 10/23/2021
Rec V Date: 10/27/2021
Hospital:

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

Lab Data: strep test

Allergies: amlodipine

Symptom List: Unevaluable event

Symptoms: headache, sore throat, cough, chills, body aches, ear pain, sinus congestion, nasal congestion. starting on 10/23/21

Other Meds: Sertraline, Alprazolam, Cryselle birth control

Current Illness: none

Date Died: 10/21/2021

ID: 1821085
Sex: F
Age: 60
State: MT

Vax Date: 03/02/2021
Onset Date: 10/07/2021
Rec V Date: 10/27/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: Patient diagnosed and hospitalized with COVID-19 while fully vaccinated.

Other Meds:

Current Illness:

ID: 1821086
Sex: M
Age: 75
State: IN

Vax Date: 10/25/2021
Onset Date: 10/25/2021
Rec V Date: 10/27/2021
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: None

Symptom List: Injection site pain, Pain

Symptoms: Started with sore throat, frothing at mouth. Severe fatigue. Severe body aches, extreme headache. Similar to reaction to 2nd dose, only with the sweating, and a lot more pain.

Other Meds: None

Current Illness: None

ID: 1821087
Sex: F
Age: 68
State: OH

Vax Date: 10/25/2021
Onset Date: 10/25/2021
Rec V Date: 10/27/2021
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: Patient came in for a booster (.25) but received full dose(.5)

Other Meds:

Current Illness:

ID: 1821088
Sex: M
Age: 58
State: TX

Vax Date: 09/07/2021
Onset Date: 09/07/2021
Rec V Date: 10/27/2021
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: 1821089
Sex: M
Age: 25
State: TX

Vax Date: 09/07/2021
Onset Date: 09/07/2021
Rec V Date: 10/27/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1821090
Sex: F
Age: 68
State: TN

Vax Date: 03/20/2021
Onset Date: 08/01/2021
Rec V Date: 10/27/2021
Hospital:

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

Lab Data: Blood Work 08/2021 Blood Work 09/2021 Blood Work 10/2021

Allergies: Outdoors

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Pt. states that after receiving the 2nd dose of Moderna 03/20/2021, started experiencing symptoms 08/2021 (Visit with Primary for Lupus test results Plalets dropped /White Blood Cells dropped) recommendation for retesting through current September (continuing to White Blood Cells count continue dropped) 10/01/2021 White Blood Cells gradually began to rise.

Other Meds: N/A

Current Illness: N/A

ID: 1821091
Sex: F
Age: 59
State: OR

Vax Date: 10/12/2021
Onset Date: 10/12/2021
Rec V Date: 10/27/2021
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: not known

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

Symptoms: The vial was mixed with bacteriostatic 0.9% Sodium Chloride. Patient didn't have any adverse events.

Other Meds: liothyronine, estradiol, zolpidem

Current Illness: not known

ID: 1821092
Sex: M
Age: 26
State: TX

Vax Date: 09/11/2021
Onset Date: 09/11/2021
Rec V Date: 10/27/2021
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: 1821093
Sex: F
Age: 66
State: MT

Vax Date: 04/27/2021
Onset Date: 10/04/2021
Rec V Date: 10/27/2021
Hospital: Y

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: Patient diagnosed and hospitalized with COVID-19 while fully vaccinated.

Other Meds:

Current Illness:

ID: 1821094
Sex: M
Age: 76
State: VA

Vax Date: 10/25/2021
Onset Date: 10/26/2021
Rec V Date: 10/27/2021
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: Medications - none Some lactose intolerancy

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

Symptoms: About a day after the Moderna booster shot, there was redness and itchiness around the injection site, about a two inch circle that felt firm and warm to the touch. About a day later (today), two days after the shot, the swelling has diminished a bit, not as firm and warm.

Other Meds: Losartan potassium for high blood pressure daily Vitamins B12 and D3 daily

Current Illness: None

ID: 1821095
Sex: F
Age: 67
State: OH

Vax Date: 10/05/2021
Onset Date: 10/09/2021
Rec V Date: 10/27/2021
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: Keflex

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

Symptoms: Hives and measles like rash in underarms, groin and thighs. Swollen lymph nodes

Other Meds: None

Current Illness: None

ID: 1821096
Sex: F
Age: 33
State:

Vax Date: 07/07/2021
Onset Date: 07/08/2021
Rec V Date: 10/27/2021
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: Pt started with constant myalgia and dizziness after taking moderna vaccine.

Other Meds:

Current Illness:

ID: 1821097
Sex: F
Age: 22
State: TX

Vax Date: 09/09/2021
Onset Date: 09/09/2021
Rec V Date: 10/27/2021
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: 1821098
Sex: F
Age: 35
State: DE

Vax Date: 05/04/2021
Onset Date: 06/07/2021
Rec V Date: 10/27/2021
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: Blood work through allergist to determine cause. Nothing came back out of the ordinary.

Allergies: Penicillin

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

Symptoms: After a few weeks i developed a swollen occipital lymph node on the left side of my head. A couple of weeks after that I started to experience some minor lip swelling. By beginning of July I was having severe hives full body, with angioedema. My swelling and hives did not respond to allergy medication and there was no cause of it in my blood tests. I ended up having to start allergy shots to try and stop them.

Other Meds: Birth control

Current Illness: Psoriasis

Date Died: 10/21/2021

ID: 1821100
Sex: F
Age: 83
State:

Vax Date: 10/20/2021
Onset Date: 10/21/2021
Rec V Date: 10/27/2021
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: Aspirin, Ace Inhibitors

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

Symptoms: Resident passed away day after receiving vaccine. No signs or symptoms of allergic reaction that were reported.

Other Meds:

Current Illness: None

ID: 1821101
Sex: F
Age: 44
State: IL

Vax Date: 10/05/2021
Onset Date: 10/06/2021
Rec V Date: 10/27/2021
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: Asthenia, Chills, Headache, Myalgia

Symptoms: Patient reports lower back pain and pelvic pain that started the day after her second dose of Moderna Covid-19 vaccination. She also reports that this pain has not improved.

Other Meds:

Current Illness: ovarian cyst rupture post 1st Moderna dose

ID: 1821102
Sex: M
Age: 49
State: VA

Vax Date: 03/23/2021
Onset Date: 07/23/2021
Rec V Date: 10/27/2021
Hospital:

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

Lab Data: No

Allergies: No

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

Symptoms: Minor achiness

Other Meds: Celexa, Cialis, Clomid, Vitamin E, multivitamin

Current Illness: No

ID: 1821103
Sex: M
Age: 36
State: TX

Vax Date: 09/09/2021
Onset Date: 09/09/2021
Rec V Date: 10/27/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1821104
Sex: F
Age: 80
State: MT

Vax Date: 02/26/2021
Onset Date: 10/04/2021
Rec V Date: 10/27/2021
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: Pain in extremity

Symptoms: Patient diagnosed and hospitalized with COVID-19 while fully vaccinated.

Other Meds:

Current Illness:

Date Died: 10/27/2021

ID: 1821105
Sex: F
Age: 74
State: OH

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

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

Lab Data:

Allergies: adhesive tape, bee stings, , celebrex, chromium, codeine, erythromycin, opioids, nickel, pentazocine, tetanus toxoid

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

Symptoms: Patient died the night after receiving vaccine. Coroner's office refuses autopsy because of COVID so cause is not knowable.

Other Meds: ropinorole, glipizide,glargine,metformin,pantoprazole,sertraline, simvastatin, atenolol, HCTZ, trazodone, tricor, gabapentin, wixela, singulair,albuterol,vitamin d

Current Illness: none

ID: 1821106
Sex: F
Age: 32
State: MN

Vax Date: 03/19/2021
Onset Date: 10/26/2021
Rec V Date: 10/27/2021
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-19 virus by PCR positive test

Allergies: amoxicillin

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

Symptoms: Patient asymptomatically tested positive for COVID-19

Other Meds: unknown

Current Illness: unknown

ID: 1821107
Sex: F
Age: 41
State: MN

Vax Date: 04/12/2021
Onset Date: 10/27/2021
Rec V Date: 10/27/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: fever, vomiting, possible sepsis

Other Meds:

Current Illness:

ID: 1821108
Sex: M
Age: 32
State: TX

Vax Date: 09/07/2021
Onset Date: 09/07/2021
Rec V Date: 10/27/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

Date Died: 10/25/2021

ID: 1821109
Sex: F
Age: 69
State: MO

Vax Date: 10/24/2021
Onset Date: 10/24/2021
Rec V Date: 10/27/2021
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: aspirin

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: After receiving the Moderna COVID-19 booster at 11:15am on 10/24/21, she felt normal until 10pm that evening. The she was chilling slightly, headache and general body aches. On 10/25/21, at around 10am, she became short of breath and experienced pain in her left side. She measured her O2 and was a 94; after using some auxilary oxygen (her husband's machine) at 3 liters, she reached 97. General malaise continued and at approximately 8pm, she suddenly collapsed and died.

Other Meds: Because this was an unattended death in her home, police were called. They photographed the body and took all of her prescriptions for a medical investigation.

Current Illness: breast surgery - 9/30/2021

ID: 1821110
Sex: F
Age: 57
State: KY

Vax Date: 03/31/2021
Onset Date: 10/23/2021
Rec V Date: 10/27/2021
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: Tested Positive for Covid

Other Meds:

Current Illness:

ID: 1821111
Sex: M
Age: 69
State: IN

Vax Date: 10/25/2021
Onset Date: 10/25/2021
Rec V Date: 10/27/2021
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: Headache, joint pain, nausea, extreme fatigue, no appetite.

Other Meds:

Current Illness: None

ID: 1821112
Sex: M
Age: 27
State: TX

Vax Date: 09/11/2021
Onset Date: 09/11/2021
Rec V Date: 10/27/2021
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: Chills, Diarrhoea, Fatigue, Feeling abnormal, Headache

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1821113
Sex: F
Age: 38
State: OK

Vax Date: 10/18/2021
Onset Date: 10/19/2021
Rec V Date: 10/27/2021
Hospital:

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

Lab Data: LIVER BLOOD WORK CT SCAN

Allergies: NONE

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

Symptoms: DARK URINE THEN TURNED BRIGHT RED FEVER BODY ACHE BLOOD IN URINE ELEVATED LIVER ENZYMES FATIGUE VOICE COMES AND GOES

Other Meds: ALLEGRA CITALOPRAM AMITRIPTYLINE

Current Illness: NONE

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am