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: 1821641
Sex: F
Age: 35
State: NC

Vax Date: 03/17/2021
Onset Date: 03/19/2021
Rec V Date: 10/27/2021
Hospital: Y

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

Lab Data: The hospital gave me breathing treatments, steroids to open my throat to help breathe and ran test. Then the had me go to my physician for a follow-up. My physician made a referral to thr Allergy clinic. I went to the alergy clinic and they ran tests on me and that is where I recieved the results that I was allergic to two chemicals that are found in the Moderma and Pfizer vaccinations.

Allergies: Trimadol, Penicillin, and two chemicals in the Moderma and Pfizer vaccine.

Symptom List: Dysphagia, Epiglottitis

Symptoms: I was ok when I had waited 15 mins after the shot. The next day I noticed a rash appearing in the middle of my chest. Then on Friday (two days later) I was getting ready to go to work and my throat closed up to where I couldn't even breathe or drink water. I immediately went to the hospital.

Other Meds: Metoprolol ER Succinate 200mg, Lisnopril HCT 20/12.5mg, and birth control implant

Current Illness: No.

Date Died: 10/25/2021

ID: 1821642
Sex: M
Age: 74
State:

Vax Date: 03/13/2021
Onset Date: 10/22/2021
Rec V Date: 10/27/2021
Hospital: Y

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: death I63.9 - Cerebrovascular accident (CVA), unspecified mechanism

Other Meds:

Current Illness:

ID: 1821643
Sex: M
Age: 60
State: TX

Vax Date: 10/24/2021
Onset Date: 10/24/2021
Rec V Date: 10/27/2021
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: Wrong Dose of Vaccine - Too High-

Other Meds:

Current Illness:

ID: 1821644
Sex: F
Age: 80
State: MO

Vax Date: 10/26/2021
Onset Date: 10/26/2021
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: No.

Allergies: Penicillin.

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Arm was hot and swollen at the injection site. Also redness.

Other Meds: Celebrex.

Current Illness: No.

ID: 1821645
Sex: F
Age: 75
State: NY

Vax Date: 10/22/2021
Onset Date: 10/25/2021
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: see above all bloods normal. i don't have access yet

Allergies: pcn- hives cipro- disoriented

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

Symptoms: 3 days after vaccine pt was working as a social worker telehealth and developed sudden loss of speech and understanding of what she was writing. lasted about 15 minutes. but also had trouble using her cell phone to get help, eventually called her cousin who came over and walked her to ER. pt was admitted overnight, had CT and MRI both normal and saw neurologist and diagnosed with aphasia and TIA. was given baby aspirin, eloquis and atorvastatin to go home. has follow up scheduled for EEG and neurology and echo and heart monitor.

Other Meds: armour thyroid 15 mg, metformin 500 qd, very long list of supplements that she has been on for many years

Current Illness:

ID: 1821646
Sex: M
Age: 63
State: UT

Vax Date: 10/20/2021
Onset Date: 10/21/2021
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: N/A

Allergies:

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

Symptoms: Had Flublok vaccine. Some strange things going on. Not sure if from shot or else. I was a little spacy (best way to put it) and mild lighthead after shot but dealt with it. As days went on was still feeling bit Spacy and Lightheaded, then started to feel some Nausea 3 days later, and Eyesight focus very bad on Saturday. But kept trying to do my DIY activities. I did spray Lysol disinfectant on some mouse droppings in garage before picking up and had garage door open bit, so not sure if this came into play. Previous year did same vaccine and only felt bit ill next day.

Other Meds: Allegra 12hr, Astelin and NeilMed nasal sprays, Vit-C,

Current Illness:

ID: 1821647
Sex: M
Age: 52
State: TX

Vax Date: 10/22/2021
Onset Date: 10/23/2021
Rec V Date: 10/27/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Lesion/rash on scalp with formication on left to center forehead. Tenderness behind left ear in two spots.

Other Meds:

Current Illness:

ID: 1821649
Sex: F
Age: 49
State: AL

Vax Date: 09/14/2021
Onset Date: 09/14/2021
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:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: First shot: (left arm) Soar throat (same side as injection), back pain ( same side as injection), chills off and on for a three to four days. Second shot: (right arm) Back pain and swelling in lower back ( same side as injection), bizarre dreams for several days, irregular heart rhythm, anxiety, paranoia

Other Meds: Advair Diskus Albuterol Vitamin D3 Magnesium Cholesterol medicine Allergy medicine

Current Illness:

ID: 1821650
Sex: M
Age: 55
State: TX

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

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Error: Wrong Dose of Vaccine - Too High-

Other Meds:

Current Illness:

Date Died: 10/24/2021

ID: 1821651
Sex: F
Age: 56
State:

Vax Date: 03/27/2021
Onset Date: 10/03/2021
Rec V Date: 10/27/2021
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:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: death R56.9 - Unspecified convulsions E87.1 - Hypo-osmolality and hyponatremia D69.6 - Thrombocytopenia, unspecified R56.9 - Seizure J18.9 - Pneumonia

Other Meds:

Current Illness:

ID: 1821652
Sex: F
Age: 47
State: MI

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: Penicillin

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

Symptoms: Extremely sore joints, exhaustion

Other Meds:

Current Illness: None

ID: 1821653
Sex: F
Age: 59
State:

Vax Date: 03/26/2021
Onset Date: 10/23/2021
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: COVID 19

Other Meds:

Current Illness:

ID: 1821654
Sex: M
Age: 39
State: MI

Vax Date: 05/11/2021
Onset Date: 05/11/2021
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: LA

Lab Data: n/a

Allergies: none

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

Symptoms: It happened after the second dose. I waited the 20-30 minutes that they make you wait and then i was maybe 10 minutes into my drive home. The recurring heart issue seems to be short, i would estimate less than 20 seconds each time. No shortness of breath or other symptoms come with the pain. I am not positive on the frequency, I would estimate it to be once or twice a week. Its not super painful, its probably a 4 on the scale to 10. Kind of a dull ache for a while, enough to get your attention, and then it goes away.

Other Meds: none

Current Illness: none

ID: 1821655
Sex: F
Age: 50
State: NY

Vax Date: 10/21/2021
Onset Date: 10/26/2021
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: None

Allergies: Amoxicillin

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

Symptoms: itching of feet,palms of hands, and hairline at nape of neck

Other Meds: Xanax,Protonix

Current Illness: None

ID: 1821656
Sex: F
Age: 49
State: NV

Vax Date: 09/28/2021
Onset Date: 09/30/2021
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: Allergy Asthma & Immunology clinic ordered labs to check my thyroid which it came back normal.

Allergies: N/A

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

Symptoms: The vaccination gave me soreness on my arm, I was doing my daily routine and I started feeling Hives coming back on my cover and chest, Now is starting spread all over my neck, I have never had a reaction to anything. The rash has gotten worse. I got a steroid shot and a histamine, I was also told to take Benadryl and it should help with this burning and itching sensation. it is very painful to have any fabric over my skin. I was also advise to see Dr. in Allergy Asthma & Immunology clinic in town. He did blood work to check my thyroid but everything came back normal.

Other Meds: I take medication for Migraine which is Topiramhed 25MG I take this once a day and my daily vitamin.

Current Illness: N/A

ID: 1821657
Sex: M
Age: 70
State: TX

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

Lab Data:

Allergies:

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

Symptoms: Error: Wrong Dose of Vaccine - Too High-

Other Meds:

Current Illness:

ID: 1821658
Sex: M
Age: 65
State: AZ

Vax Date: 10/18/2021
Onset Date: 10/18/2021
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: None

Allergies: Unknown

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

Symptoms: Patient was given .5ml instead of the recommended .25ml of moderna

Other Meds: Unknown

Current Illness: None

ID: 1821659
Sex: F
Age: 64
State: TX

Vax Date: 10/26/2021
Onset Date: 10/26/2021
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: n/a too soon

Allergies: no

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Blood in urine - probably a UTI

Other Meds: lamotrigine, arimadex

Current Illness: no -

ID: 1821660
Sex: F
Age: 17
State: TX

Vax Date: 10/26/2021
Onset Date: 10/26/2021
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:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Booster shot given to 17yo. Booster approved for 18 and up. No adverse reaction reported.

Other Meds:

Current Illness:

ID: 1821661
Sex: M
Age: 22
State:

Vax Date: 04/24/2021
Onset Date: 10/24/2021
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:

Allergies:

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

Symptoms: COVID 19

Other Meds:

Current Illness:

Date Died: 10/24/2021

ID: 1821662
Sex: M
Age: 60
State:

Vax Date: 06/15/2021
Onset Date: 10/20/2021
Rec V Date: 10/27/2021
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:

Allergies:

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

Symptoms: death N17.9 - AKI (acute kidney injury) (CMS/HCC)

Other Meds:

Current Illness:

ID: 1821663
Sex: M
Age: 76
State: OH

Vax Date: 01/16/2021
Onset Date: 02/20/2021
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: FULL PANEL BLOOD TEST, TILT TABLE, BRAIN SCAN, HEART SCAN, XRAYS OF CHEST AND HEART, NEUROLOGIST EXAM, ENT TESTS AND ALL WERE WITHIN NORMAL RANGES OR NO SIGN ON PROBLEMS

Allergies: NONE

Symptom List: Unevaluable event

Symptoms: DIZZINESS, VERY TIRED, ALMOST CONSTANT HEADACHES,

Other Meds: SEE CONTINUING PAGE

Current Illness: NONE

ID: 1821664
Sex: F
Age: 46
State: WA

Vax Date: 10/11/2021
Onset Date: 10/11/2021
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: Benzodiazepines.

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

Symptoms: Excruciating bone pain began the evening of the injection. Bone pain to that degree lasted approximately one week, followed by an additional 8 days of bone pain. Bone pain finally resolved on day 17. Use of Tylenol/Ibuprofen did not relieve bone pain. Other symptoms included sporadic stabbing head pain through day 12. Swollen mouth, body aches, nausea, metallic taste in mouth, overall feeling poorly continue to present off and on through today (day 17).

Other Meds: Novolog, Vitamin B, C and D, zinc, calcium/magensium.

Current Illness: NA

ID: 1821665
Sex: F
Age: 84
State: TX

Vax Date: 10/27/2021
Onset Date: 10/27/2021
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: N/A

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Pt. states that after receiving the 3rd Booster of Moderna 10/27/2021 (High-Dose Influenza 10/27/2021), started experiencing symptoms that evening of swollen/sore arm (Covid Left), headache, nausea, vomiting and fatigue. (High-Dose Influenza) arm no symptoms. No noted Primary visit/communications.

Other Meds:

Current Illness:

ID: 1821666
Sex: F
Age: 19
State: WV

Vax Date: 10/11/2021
Onset Date: 10/12/2021
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: After receiving flu vaccine, patient had a scattered, generalized rash and received an injection of dexamethasone 10mg while in the ED.

Other Meds:

Current Illness:

ID: 1821667
Sex: F
Age: 18
State: CA

Vax Date: 10/07/2021
Onset Date: 10/08/2021
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: Friday, Oct 8th after being taken to the hospital by ambulance they ran urine, pregnancy and blood tests. They did not find any non-vaccine related cause for the episodes.

Allergies: None

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

Symptoms: Felt fine Thu after injection. Friday between 9-10am she started to feel "off". She was in her college class and blacked out. She would wake up start spasming then black out again. This happened numerous times. The professor called an ambulance to take her to the hospital after numerous rounds of spasms and blackouts. They took her to the hospital where they ran urine, pregnancy and blood tests. They did not find any non-vaccine related cause for the episodes.

Other Meds: Birth Control Pills

Current Illness: None

ID: 1821668
Sex: F
Age: 21
State:

Vax Date: 06/03/2021
Onset Date: 10/21/2021
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: COVID 19

Other Meds:

Current Illness:

ID: 1821669
Sex: F
Age: 61
State: TX

Vax Date: 10/23/2021
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: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Error: Wrong Dose of Vaccine - Too High-

Other Meds:

Current Illness:

ID: 1821670
Sex: F
Age: 49
State: TX

Vax Date: 09/17/2021
Onset Date: 09/18/2021
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: None

Allergies: Ciprofloxacin

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

Symptoms: Employee reports pain when raising arm above head and laterally above shoulder height. It was recommended that the employee see their primary care provider. Employee has not yet seen provider. For treatment, the employee tried Ibuprofen 3 pills two times a day for a week. She now takes it as needed for pain.

Other Meds: Zonisamide Lisinopril Clonazepam Docusate

Current Illness: Seizures

ID: 1821671
Sex: F
Age: 59
State: MN

Vax Date: 01/29/2021
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: RA

Lab Data: Positive COVID test through employer

Allergies:

Symptom List: Nausea

Symptoms: Developed symptoms of fever, Headache and body/joint aches, evening of 10/26/21. Tested on 10/27/21 brand name Covid-19 with results Positive.

Other Meds:

Current Illness:

ID: 1821672
Sex: M
Age: 56
State: KY

Vax Date: 05/22/2021
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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: Tested Positive for Covid

Other Meds:

Current Illness:

ID: 1821673
Sex: F
Age: 43
State:

Vax Date: 04/09/2021
Onset Date: 10/13/2021
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 induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: COVID 19.

Other Meds:

Current Illness:

ID: 1821674
Sex: M
Age: 36
State: WI

Vax Date: 10/22/2021
Onset Date: 10/23/2021
Rec V Date: 10/27/2021
Hospital:

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

Lab Data: electrocardiogram, troponin level, and inflammatory markers such as C-reactive protein and erythrocyte sedimentation rate

Allergies: N/A

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

Symptoms: intermittent chest discomfort

Other Meds: N/A

Current Illness: N/A

ID: 1821675
Sex: M
Age: 35
State: TX

Vax Date: 10/23/2021
Onset Date: 10/23/2021
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: Error: Wrong Dose of Vaccine - Too High-

Other Meds:

Current Illness:

Date Died: 10/26/2021

ID: 1821676
Sex: F
Age: 98
State: IA

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

Lab Data: full autopsy, tryptase study

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: Patient experienced chills & weakness following the vaccine. Patient died the following day. No gross anatomical findings of anaphylaxis at autopsy. Tryptase study pending.

Other Meds:

Current Illness: None

Date Died: 10/24/2021

ID: 1821677
Sex: F
Age: 73
State:

Vax Date: 04/19/2021
Onset Date: 10/14/2021
Rec V Date: 10/27/2021
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:

Allergies:

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

Symptoms: death N17.9 - Acute renal failure (ARF).

Other Meds:

Current Illness:

ID: 1821678
Sex: F
Age: 28
State:

Vax Date: 10/06/2021
Onset Date: 10/06/2021
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: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: Administered a dose of expired J&J vaccine. The vaccine was stored in accordance with manufacturer's storage requirements but was beyond its expiration date at the time of administration. Exp date 9/21/2021.

Other Meds:

Current Illness:

ID: 1821679
Sex: F
Age: 25
State: TN

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

Lab Data: none

Allergies: NKA

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Patient presented to health department to receive second dose in COVID vaccine series. Informed COVID contract nurse she had received Moderna as her first dose primary series. Was given Moderna by COVID contract nurse for her second dose of the primary series. When completing her vaccine card, COVID nurse noticed she had received Pfizer as her first dose and not Moderna. Patient was made aware of the error. Was monitored for 15 minutes without any reactions or incidences.

Other Meds: unknown

Current Illness:

ID: 1821680
Sex: F
Age: 48
State: NC

Vax Date: 10/01/2021
Onset Date: 10/12/2021
Rec V Date: 10/27/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: rash on arm starting from injection site

Other Meds: none

Current Illness: none

ID: 1821681
Sex: F
Age: 89
State: MS

Vax Date: 10/21/2021
Onset Date: 10/22/2021
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: 10/22 CT - abnormal increased density apex Rt post. parietal region. I can not exclude a mass. Hemorrhage less likely but can't completely be excluded. CTA neck/head - the lesion in the cortex Rt post parietal region does not enhance. MRI necessary for further evaluation of lesion. 10/22/21 H/H 9.2/28.3, ANC 7,600, PT/INR 12.4/1.0

Allergies: NKDA

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

Symptoms: On 10/22/21, resident noted with unclear, jumbled speech, nausea and vomiting. Sent to local ER. Returned at family request. Family declines aggressive treatement including MRI.

Other Meds: Vit c 500 mg bid, Pepcid 20 mg dly, Senna 8.6 mg bid, Namenda 10 mg bid, Zocor 40 mg q hs, Iron, 325 mg qod, Losartan 50 mg dly, Miralax dly, MVI with minerals dly,

Current Illness: ---

ID: 1821682
Sex: M
Age: 58
State: WA

Vax Date: 04/18/2021
Onset Date: 04/24/2021
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: See 18.

Allergies: none

Symptom List: Pain in extremity

Symptoms: o 4/18/2021 - Immunization COVID o 4/24/2021 - 1st nerve crash in upper back, Extreme neck and back pain, Emergency Room o 4/29/2021 - Neck and Spine Exam, Scheduled MRI o 5/4/2021 ? MRI, Results: Cervical spondylosis upper left extremity numbness o 5/6/2021 - Follow-up to MRI, C7&C8 weakness but MRI does correlate to C7&C8 PE numbness findings. Ordered EMG/NCV study of left arm o 5/9/2021 - Emergency Room - Kidney Stones See Continuation Page

Other Meds: Vit C, D and Men's multi-vitamin

Current Illness: none

ID: 1821683
Sex: M
Age: 41
State: TX

Vax Date: 10/23/2021
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: 2
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: Error: Wrong Dose of Vaccine - Too High-

Other Meds:

Current Illness:

ID: 1821684
Sex: F
Age: 57
State:

Vax Date: 04/06/2021
Onset Date: 10/08/2021
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: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: COVID 19

Other Meds:

Current Illness:

ID: 1821685
Sex: F
Age: 48
State: FL

Vax Date: 04/23/2021
Onset Date: 09/10/2021
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: Radiologist: Blood hematoma (blood clot) usually evaporates into the skin, but it hasn't.

Allergies: None

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

Symptoms: I noticed a lump a week prior to mammogram (Sept 3rd). Feels itchy. lump on top of breast.

Other Meds: Duloxetine HCL ER 60 mg-1 capsule. 2x daily, Amlodipine-Benazepril 5-20 mg capsule. 1x day , Zanax Alprazolan-ER 1 mill 1 x day mouth, Cevineline HCL 30mg capsule 3xday, Pravastatin sodium 40mg 1 tablet daily, Percocet 10-325 mg as neede

Current Illness: Sjogrens syndrome -autoimmune illness, Migraines daily

ID: 1821686
Sex: F
Age: 54
State: CA

Vax Date: 04/26/2021
Onset Date: 07/29/2021
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: blood work done x-ray of my chest 08/04/2021 COVID-19 Test- results were positive. (08/06/2021)

Allergies: penicillin erythromycin codeine Keflex shellfish

Symptom List: Vomiting

Symptoms: I was diagnosed with COVID-19 ON 08/06/2021-COVID-10 test- positive. The doctor was calling me once a week and messaging me almost daily and I had video appointments with him. Symptoms: having horrible headaches, lost sense of smell, chills, fatigue, body weakness, fever, really bad nausea, and a cough, and laryngitis. I had laryngitis for over a week. The doctor put me on doxycycline. I wound up taking 2 doses from it, 14 days total. I was given albuterol, Zofran for the nausea, and Excedrin for the headache, and taking my prescription medication when the Excedrin did not help. It would at least take the edge off of it, but would not relieve it. I was also alternating Tylenol and ibuprofen for my fever. I had my symptoms for like 45 days total.

Other Meds: gabapentin 100 mg bd Wellbutrin ER 300 mg od Propranolol 20 mg bd Fetzima 80 mg od dicyclomine 20 mg bd

Current Illness: no

Date Died: 10/24/2021

ID: 1821687
Sex: F
Age: 84
State:

Vax Date: 02/15/2021
Onset Date: 10/15/2021
Rec V Date: 10/27/2021
Hospital: Y

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: death COVID

Other Meds:

Current Illness:

ID: 1821689
Sex: M
Age: 50
State: TX

Vax Date: 10/24/2021
Onset Date: 10/24/2021
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: Error: Wrong Dose of Vaccine - Too High.

Other Meds:

Current Illness:

ID: 1821690
Sex: F
Age: 65
State: AZ

Vax Date: 10/09/2021
Onset Date: 10/10/2021
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: biopsy - rash - that was diagnosed as hives

Allergies: aspirin - aggravates asthma Boniva - that upset my stomach - had to go to ER

Symptom List: Injection site swelling, Limb discomfort

Symptoms: 30 hours after I got the shot, I got a lump under my left arm and a rash started up. It was very tender to touch. It took about 5 days for it to go away, the lump started dissipating; the rash spread to the left breast a bit. It was tender but after about 5 days it was gone. During that time, though, I had started with an RA flare up before the vaccine and that rash started getting worse with different red spots and stuff. I had gone on 9/17/2021 (woke up with my hands red and itching but no rash at that time) went to RA doctor's PA - she had given me methylprednisolone - 400 mg - RA flare up and the last pill I took was 9/23.) That helped with the itching and redness. 0n the 9/24, I noticed a red disc spot on my right shin but I thought it would go away. I still had my 3rd COVID shot on the 9th, but that rash on the shin started getting worse. I called my RA doctor to see what to do and she said to contact my dermatologist - (just got married as has a new name). She thought I was having a hive like reaction to something that irritated my immune system. She did a biopsy and it came back that I had hives. She has me on a hives treatment plan and I will follow with her on 11/17/2021. By then, she said they should be gone. Zyrtec - 2 times a day and Benadryl before I go to bed at night. She also ordered me a cortisone cream - I haven't used it yet because the spots haven't itched that bad - Triamcinolone Acetonide .01% Cream. I am still getting spots - primarily on torso and extremities (none on face) - I get 6 or 7 on my stomach; a couple on my arm - they are worse in the morning and redder in the morning (they get fainter) but I wake up in the morning and I have a fresh batch in the morning. She told me to keep taking the Zyrtec and Benadryl until I no longer have symptoms. I am scheduled to get my regular RA doctor blood tests done ( on 11/2/2021) so that I can see her (RA doctor) on the 18th.

Other Meds: Methotrexate - 15 mg one time a week; Salsalate - 750 mg 2 times a day as needed ( I take it when I have RA symptoms bad); Adver - for asthma - 250/50 dosage - 1 puff as needed every 12 hours (I take that seasonal); Albuterol Sulfate - 90 m

Current Illness: RA flare up going on

ID: 1821691
Sex: M
Age: 68
State: AZ

Vax Date: 10/18/2021
Onset Date: 10/18/2021
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: None

Allergies: None

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

Symptoms: Patient given .5ml instead of the recommended .25ml of moderna

Other Meds: Unknown

Current Illness: None

Date Died: 10/24/2021

ID: 1821692
Sex: M
Age: 93
State:

Vax Date: 10/07/2021
Onset Date: 10/20/2021
Rec V Date: 10/27/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: death U07.1, J12.82 - Pneumonia due to COVID-19 virus

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am