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: 1271815
Sex: M
Age: 29
State: CA

Vax Date: 04/28/2021
Onset Date: 04/28/2021
Rec V Date: 04/29/2021
Hospital:

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

Lab Data: BP dropped to 107 after moved in wheelchair. 97.6 temperature. 97% O2

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Dizzy, faint, blurred vision, headache started 5 minutes after shot. I was wheelchaired to fresh air and moved to a cot for 30 minutes of monitoring. I slowly recovered over the 30 minutes. The following day I had a 99.6 fever, headache, chills and weakness. The vaccination site is sore.

Other Meds:

Current Illness:

ID: 1271816
Sex: F
Age: 32
State: NV

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 04/29/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data: MRI of the lumbar spine.

Allergies: Codeine, penicillin

Symptom List: Anxiety, Dyspnoea

Symptoms: I experienced after my second dose, pain in my left arm which radiated to my left hand and also pain to my right shoulder and arm. I experienced swelling to my left arm. I had nausea lasted several weeks. Now I have right leg pain with numbness and tingling sensation. I have difficulty ambulating at times. An MRI of the MRI of the lumbar spine was performed at Diagnostics. I also have an ultrasound of the right leg to be scheduled to evaluate for any blood clots, pain.

Other Meds:

Current Illness:

ID: 1271817
Sex: F
Age: 68
State: MN

Vax Date: 04/29/2021
Onset Date: 04/29/2021
Rec V Date: 04/29/2021
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: nothing listed on her file.

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

Symptoms: PATIENT WAS ACCIDENTALLY GIVEN A 3RD DOSE OF MODERNA COVID VACCINE RATHER THAN HER 2ND DOSE OF SHINGRIX. NO ADVERSE EVENT REPORTED YET. PATIENT WILL WAIT 2 WEEKS TO RECIEVE 2ND SHINGRIX DOSE.

Other Meds: Lisinopril 5mg; Metformin 500mg; Metoprolol er succinate 100mg, bupropion XL 300mg, Atorvastatin 20mg.

Current Illness: none

ID: 1271818
Sex: M
Age: 28
State: DC

Vax Date: 04/19/2021
Onset Date: 04/27/2021
Rec V Date: 04/29/2021
Hospital:

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

Lab Data: None

Allergies: None

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: COVID arm. Red, firm, splotch around injection. 2-3 in diameter

Other Meds: SSRI

Current Illness: None

ID: 1271819
Sex: F
Age: 55
State: WI

Vax Date: 04/29/2021
Onset Date: 04/29/2021
Rec V Date: 04/29/2021
Hospital:

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

Lab Data:

Allergies: Phenergan Iodine

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

Symptoms: 4/21/2021 2:05 pm: Injection given, 2:35 pm: rash/hives developed on patients neck on the left side (same side as injection). 2:40 pm: patient given Benadryl 75mg by mouth (3 capsules x 25 mg each), 2:55pm: Rash/hives continues to spread to chest and back. Patient decides to go to Emergency Room. 3:10 pm: Pharmacist called and confirmed patient's successful arrival to Emergency Room.

Other Meds:

Current Illness:

ID: 1271820
Sex: F
Age: 48
State: CA

Vax Date: 04/01/2021
Onset Date: 04/15/2021
Rec V Date: 04/29/2021
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:

Allergies: Bactrim antibiotic

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

Symptoms: I have started very sharp pains on my breasts and my breasts became very dense and bigger after 2 weeks of the first shot, pain still continues after 19 days of the 2nd shot, also after 2 weeks of the second shot I started my period eventhough it was not due till another 2 weeks so in between bleeding started . It has been 3 days so far medium flow my period hasn?t stopped yet.

Other Meds:

Current Illness:

ID: 1271821
Sex: M
Age: 53
State: NY

Vax Date: 04/28/2021
Onset Date: 04/28/2021
Rec V Date: 04/29/2021
Hospital:

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

Lab Data: n/a

Allergies: N/A

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Vaccine vial was not properly reconstituted and patient was ultimately getting only the diluent ( Sodium Chloride 0.9%) administered.. Patient was contacted later same day about incident and was given properly reconstituted vaccine dose. No adverse reactions were reported by patient when they returned to get the satisfactory vaccination dose,

Other Meds: N/A

Current Illness: N/A

ID: 1271822
Sex: M
Age: 43
State: PA

Vax Date: 12/19/2020
Onset Date: 12/23/2020
Rec V Date: 04/29/2021
Hospital:

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

Lab Data: 12/23/20 1630 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 12/23/20 0926 | Final result | Specimen: Swab from Nares COVID-19 SARS-CoV-2 Overall Result DetectedCritical 12/23/20 1630 COVID-19 PCR Collected: 12/23/20 0926 | Final result | Specimen: Swab from Nares

Allergies: Sulfamethoxazole-trimethoprimRash

Symptom List: Pharyngeal swelling

Symptoms: Fever or Chills Cough Muscle or body aches Headache Sore throat Congestion or running nose

Other Meds: zolpidem (AMBIEN) 10 mg tablet

Current Illness: NONE

ID: 1271823
Sex: F
Age: 22
State: LA

Vax Date: 03/19/2021
Onset Date: 03/20/2021
Rec V Date: 04/29/2021
Hospital:

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

Lab Data: Had blood drawn but there wasn't any abnormal findings

Allergies: No Allergies

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: I Passed out in store while grocery shopping, 08/10/2021

Other Meds: Prenatal vitamins

Current Illness: None

ID: 1271824
Sex: M
Age: 28
State: OH

Vax Date: 04/29/2021
Onset Date: 04/29/2021
Rec V Date: 04/29/2021
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: None

Symptom List: Diarrhoea, Nasal congestion

Symptoms: After completing the 15 min monitoring, pt stated he had a sensation of increasing his heart rate. EMS took his vital signs BP 108/80, HR 78, OxSat:100%. After evaluation , pt stated he feels better. Pt was with his partner and he was escorted by her to his car. Pt was advised to inform his PCP about this.

Other Meds: None

Current Illness: None

ID: 1271825
Sex: F
Age: 20
State: CA

Vax Date: 04/27/2021
Onset Date: 04/27/2021
Rec V Date: 04/29/2021
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: Vaccination site erythema, Vaccination site pruritus, Vaccination site swelling

Symptoms: Dizziness - gradual improvement. Heavy feet. Vitals wnl.

Other Meds:

Current Illness:

ID: 1271826
Sex: F
Age: 37
State: CA

Vax Date: 04/29/2021
Onset Date: 04/29/2021
Rec V Date: 04/29/2021
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: Bactrim Beta Blockers Botox Chlopromazine HCL Compazine Contrast Dye Doxycycline Imitrex Metronidazole Morphine Nortriptyline Tramadol Xolair Reglan

Symptom List: Rash, Urticaria

Symptoms: redness, rash and itching to upper torso and upper extremities

Other Meds: Adderall XR 10 mg, Venlafaxine 150 mg, Mylanta, Hydoxyzine HCL 25 mg, Benadryl 50 mg

Current Illness: None noted

Date Died: 03/21/2021

ID: 1271827
Sex: M
Age: 82
State: OK

Vax Date: 03/05/2021
Onset Date: 03/21/2021
Rec V Date: 04/29/2021
Hospital:

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

Lab Data: passed away with in minutes

Allergies: none

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

Symptoms: lungs shut down from 95 to 0 in a blink of an eye

Other Meds: lipitor,thyroxine,furosemide,carvedilol,minoxidil

Current Illness: copd

ID: 1271829
Sex: F
Age: 49
State: IL

Vax Date: 04/19/2021
Onset Date: 04/01/2021
Rec V Date: 04/29/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data: CT scan lungs 4/23/2021 positive for pulmonary embolism US venous lower legs negative for DVT.

Allergies: Fetzima-sweating.

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

Symptoms: Patient had pulmonary embolism right around the time of her second vaccine patient also had a rash on her left arm after her second vaccine.

Other Meds: ALPRAZolam (XANAX) 0.25 MG tablet, TAKE ONE TABLET BY MOUTH DAILY AS NEEDED , Disp: 30 tablet, Rfl: 0 ? atorvastatin (LIPITOR) 10 MG tablet, TAKE ONE TABLET BY MOUTH DAILY for cholesterol, Disp: 90 tablet, Rfl: 0 ? buPROPion (WELLBUTRIN X

Current Illness:

ID: 1271830
Sex: F
Age: 44
State: ID

Vax Date: 04/27/2021
Onset Date: 04/28/2021
Rec V Date: 04/29/2021
Hospital:

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

Lab Data: No medical or laboratory tests taken

Allergies: Percocet

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

Symptoms: Severe body aches within 4 hours lasting for at least 2 days (still aching, but not as severe 2 days later), treated with Ibuprofen 800 mg every 8-12 hours as needed Fever - mild, beginning at 24 hours after shot and breaking about 12 hours later High Heart Rate - ongoing from 24 hours, treated with Metroprolol - heart rate up to 130 bpm when sitting, doing nothing Anxiety - high heart rate and fever contributed to an anxiety attack about 29 hours after immunization, other contributing factors were high blood pressure and dehydration caused from not taking normal meds and not drinking adequate fluids; taking meds and drinking water and lemonade helped relieve the anxiety Dizziness - extreme dizziness occurred at the same time as the fever and lasted until after the anxiety attack; it seemed to ease after eating dinner and drinking lemonade but never completely disappeared until the next morning

Other Meds: Lisinopril, Metroprolol, Cymbalta, Metformin, Daily Vitamin, Turmeric Supplement, Ibuprofen - as needed

Current Illness: Post Covid Syndrome, including tachycardia, fatigue, headaches, body aches, brain fog

ID: 1271831
Sex: M
Age: 61
State: IL

Vax Date: 03/30/2021
Onset Date: 04/13/2021
Rec V Date: 04/29/2021
Hospital:

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

Lab Data: 3/26/2021

Allergies: None

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

Symptoms: Developed ear infection and hole in eardrum.

Other Meds: Amlodipiene Benaz, metoprol, atorvastatin, hydrochlotnaize.

Current Illness: None

ID: 1271832
Sex: M
Age: 43
State: IN

Vax Date: 04/27/2021
Onset Date: 04/27/2021
Rec V Date: 04/29/2021
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:

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

Symptoms: Mental and physical fatigue, headache, pain in both jaws and at injection site, sleepless night after shot due to headache and inability to get comfortable

Other Meds: Allopurinol, Odefsy

Current Illness:

ID: 1271833
Sex: F
Age: 44
State: CA

Vax Date: 04/24/2021
Onset Date: 04/27/2021
Rec V Date: 04/29/2021
Hospital:

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

Lab Data: normal PT/PTT, CBC, ESR, CRP. Mild elevation of LFTs and bilirubin similar to when checked 8/2020

Allergies: penicillin

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Patient woke up on 4/27/21 with ecchymosis on left side of torso/axillary line, above hip, approx. 10cm x 15cm, non-tender. Denies history of injury.

Other Meds: Celebrex 100mg, Depo-Provera 150mg, Quvar Redihaler 80 mcg 2 puffs BID, Ventolin HFA prn

Current Illness:

ID: 1271834
Sex: F
Age: 49
State: CA

Vax Date: 03/22/2021
Onset Date: 04/05/2021
Rec V Date: 04/29/2021
Hospital: Y

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

Lab Data: Contract Pulmonary scan, ultrasound, echo cardio gram blood test.

Allergies: none

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Blood Clot and pulmonary embolism from first shot.

Other Meds: Nuvaring and Lisinepral

Current Illness: none

ID: 1271835
Sex: F
Age: 22
State: MA

Vax Date: 04/28/2021
Onset Date: 04/29/2021
Rec V Date: 04/29/2021
Hospital:

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

Lab Data: None.

Allergies: Codeine, Reglan

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

Symptoms: Woke up at midnight with a severe panic attack (thought I was dying). Felt pressure on my chest, breathing very fast, hard to catch my breath, felt my heart beating out of my chest. Lasted for a good hour. About 20 minutes in I decided to take a 20mg Paxil and 0.5mg of Ativan. After about 30 minutes meds seemed to help and I was able to go back to bed. If not for my meds I would have gone to the hospital.

Other Meds: Paxil 20mg, Topiramate 50mg, birth control

Current Illness: No

ID: 1271836
Sex: M
Age: 27
State: TX

Vax Date: 04/28/2021
Onset Date: 04/28/2021
Rec V Date: 04/29/2021
Hospital:

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

Lab Data:

Allergies: no

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

Symptoms: He was sitting on a chair for 15 mins, and around 14 mins he felt light headed and rolled over from the chair. He came back after 15-30 seconds and felt dizzy. We unbuttoned his pants and let him sit for 30 mins and had some water. After 30 mins, he had little numbness on his arm but he felt fine.

Other Meds: no

Current Illness: no

ID: 1271837
Sex: F
Age: 17
State: MN

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/29/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: Patient was under the age of 18 years old at time of vaccination.

Other Meds:

Current Illness:

ID: 1271838
Sex: M
Age: 75
State: MN

Vax Date: 02/10/2021
Onset Date: 03/17/2021
Rec V Date: 04/29/2021
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 presented to the ED and was subsequently hospitalized within 6 weeks of receiving COVID vaccination.

Other Meds:

Current Illness:

ID: 1271839
Sex: F
Age: 25
State: HI

Vax Date: 04/21/2021
Onset Date: 04/24/2021
Rec V Date: 04/29/2021
Hospital:

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

Lab Data: none yet but I will be going to a dermatologist soon

Allergies: No allergies

Symptom List: Injection site pain, Pain

Symptoms: hive like reaction. Itching/ burning / and swelling of skin. My skin from head to toe will swell up when scratched even if lightly it then becomes insanely itchy and burns. lasts a few hours.

Other Meds: None

Current Illness: none

ID: 1271840
Sex: F
Age: 32
State: TX

Vax Date: 04/21/2021
Onset Date: 04/21/2021
Rec V Date: 04/29/2021
Hospital:

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

Lab Data:

Allergies: Azithromycin - swelling in bilateral upper and lower eyelids

Symptom List: Injection site pain, Menorrhagia

Symptoms: Patient has a history of shingles on face, first episode was around 2014. Typically, when she gets a rash, the shingles shows up on lower left cheek near jawline. Patient has chronic nerve pain on left side of face because of the shingles, which she is taking gabapentin for it as needed. She is also on suppressive valacyclovir. Patient had her second dose of COVID-19 vaccine on 4/21/21 (Moderna) on left arm. About 6 hours after the vaccination, patient developed a facial rash (flat, red) on bilateral cheeks that lasted until 4/23/21. Patient took tylenol for the rash. On 4/24/21, patient began to have episodes of severe nerve pain (sharp, shooting) on the left temple area, lasting 10-30 seconds at a time. Patient took gabapentin and tylenol for this. On 4/25/21, the left temple sharp pain became less intense. The left side of face (temple area, jaw area) is sensitive to touch. Pain is still present (constant) in the left temple and left jaw area, some days are worse than others. Patient states there was one blister that showed up on left jaw area on 4/25/21. Patient states it looked like her shingles rash. Patient has been having difficulty sleeping at night because of the pain. Patient is taking valacyclovir 1500 mg BID for this outbreak of shingles (started on 4/24/21; told by PCP to take this dose). Patient is taking gabapentin 300 mg three times a day for the pain.

Other Meds: Sertraline 100 mg Daily Valacyclovir 500 mg once daily ERRIN TAB 0.35MG daily

Current Illness: None

ID: 1271841
Sex: M
Age: 66
State: GA

Vax Date: 04/24/2021
Onset Date: 04/24/2021
Rec V Date: 04/29/2021
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: none

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

Symptoms: Joint pain in feet, ankles, knees, hands , elbows, back shoulders. fatique, nausea, lethargy. fever over 100 - 102. low blood oxygen level which fell into the 70's at some points. Pain at injection site

Other Meds: none

Current Illness: none

ID: 1271842
Sex: F
Age: 84
State: IL

Vax Date: 04/22/2021
Onset Date: 04/22/2021
Rec V Date: 04/29/2021
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: No

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Radical mental confusion, dementia became worsened within a couple of hours after injection.

Other Meds: Furosemide 20mg Cephalexin 250mg Lisinopril 10mg Spironolactone 25mg Levothyroxine .05mg Atenolol 100mg Eliquis 2.5mg Alendronate 70mg Fish oils 1150mg Melatonin 3mg Rosuvastatin 20 mg Omeprazole 20mg

Current Illness: No

ID: 1271843
Sex: F
Age: 56
State: CA

Vax Date: 04/27/2021
Onset Date: 04/27/2021
Rec V Date: 04/29/2021
Hospital:

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

Lab Data:

Allergies: bactrim

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: low back pain that radiates to abd

Other Meds:

Current Illness: unknown

ID: 1271844
Sex: F
Age: 86
State: WI

Vax Date: 02/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/29/2021
Hospital: Y

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

Lab Data: Covid PCR positive 4/23/2021

Allergies: unknown

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

Symptoms: Admitted to hospital 4/23/2021 with syncopal episode. Discharged to home 4/25/2021. Covid vaccination history: Pfizer 2/1/2021 and 2/23/2021. Covid PCR positive on 4/23/2021. Submitter does not have access to further vaccine or hospital medical records.

Other Meds: unknown

Current Illness: unknown

ID: 1271845
Sex: M
Age: 34
State: CA

Vax Date: 04/29/2021
Onset Date: 04/29/2021
Rec V Date: 04/29/2021
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: Nausea

Symptoms: Client received the 1st COVID vaccine Moderna Lot #007C21A expiration date 10/12/2021. Client reported cold sweat, nausea, and slight headache to our Medic and requested for a blood pressure check. Client was sitting in chair and also stated to Medic "I participate in intermittent fasting, last time I ate was yesterday. I felt dizzy 8 minutes into my 15 minute waiting period." Medical history includes history of anxiety and bipolar disorder, currently takes medication lamictal. Interventions done for client include laying down in gravity chair and vital signs were taken at 12:03 PM: BP 158/96; pulse 78, respirations 18. Orthostatic vital signs were taken at 12:08 PM BP 162/100; pulse 78. Client was alert and oriented x4 during whole interaction with Medic . Client refused 911 call. At 12:16 PM client verbalized symptoms resolved and nurse recommended for stable vitals before being able to leave facility. Final vital signs were taken at 12:25 PM: BP 148/82; pulse 76; oxygen saturation of 99%. Client left facility walking safely with steady gait at 12:30 PM.

Other Meds: Lamictal

Current Illness: None

Date Died: 04/26/2021

ID: 1271846
Sex: F
Age: 77
State: NC

Vax Date: 04/20/2021
Onset Date: 04/25/2021
Rec V Date: 04/29/2021
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 presented to ED on 04/25/2021 with complaints of abdominal pain, abdominal distension, and AMS. Patient was admitted to ICU with following diagnoses: 1) Septic Shock, 2) A/C hypoxic/hypercapnic respiratory failure, 3) Acute metabolic encephalopathy, 4) Palliative care patient, 5) AE COPD, 6) ARF w/ATN on CKD3, 7) CAD, 8) Chronic sys/dia CHF, 9) Malnutrition/Failure to thrive. Patient died on 04/26/2021 at 1826. Patient was also previously admitted to hospital on 03/23/2021-03/29/2021 for sepsis.

Other Meds:

Current Illness:

ID: 1271847
Sex: F
Age: 17
State: WI

Vax Date: 04/28/2021
Onset Date: 04/28/2021
Rec V Date: 04/29/2021
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: Moderna administered and patient is 17.

Other Meds:

Current Illness:

ID: 1271848
Sex: F
Age: 27
State: HI

Vax Date: 03/31/2021
Onset Date: 04/23/2021
Rec V Date: 04/29/2021
Hospital: Y

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

Lab Data: CT angio/CXR: right pleural effusion, no pulmonary embolism, compressive atelectasis CBC: normal including normal WBC count and lymphocyte count CMP: normal LDH: normal CRP: 30.15 Ferritin: 717.48 Troponin: 0.028 and then 0.031 Fibrinogen 821 D-dimer: 2.61 Pleural effusion drained: protein 5.5, LDH 1728, glucose 37, 7510 cells with 5000 RBCs, 77% lymphocytes

Allergies: none

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

Symptoms: Patient has been admitted to the hospital with pleural effusion, possible pericarditis and is positive for coronavirus, ongoing workup unclear if pleural effusion is secondary to covid 19 as this is atypical.

Other Meds: none

Current Illness: none

ID: 1271849
Sex: F
Age: 29
State: NY

Vax Date: 04/21/2021
Onset Date: 04/22/2021
Rec V Date: 04/29/2021
Hospital:

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

Lab Data: CMP CBC

Allergies: N/a

Symptom List: Tremor

Symptoms: Dizziness , nausea , migraine , body ache , shivers

Other Meds: N/a

Current Illness: N/a

ID: 1271850
Sex: M
Age: 73
State: AZ

Vax Date: 04/09/2021
Onset Date: 04/22/2021
Rec V Date: 04/29/2021
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: blood draw, ultrasound, EKG, CT scan

Allergies: none

Symptom List: Erythema, Pruritus

Symptoms: shortness of breath, blood clots in lungs, blood clot in right thigh, blood clot behind right knee

Other Meds: 1 daily: amlodipine besylate 5 mg, atorvastatin 20 mg, buproprion XL 300 mg, doxazosin 2 mg, venlafaxine hydrochloride ER 75 mg, glipizide 5 mg, Garden of Life probiotics 3 daily: gabapentin 600 mg. hydrocodone/acetaminophen 7.5/325 mg, m

Current Illness: none

ID: 1271851
Sex: F
Age: 31
State: CA

Vax Date: 04/16/2021
Onset Date: 04/18/2021
Rec V Date: 04/29/2021
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:

Allergies: N/A

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

Symptoms: Pressure under the left eye, headache (day 1) diarrhea/loose stoole daily for 2 weeks

Other Meds: marlissa (BC) Nusa Pure L-glutamine dr ohhira's probiotics natural cure premium immune support

Current Illness: N/A

ID: 1271853
Sex: F
Age:
State: SC

Vax Date: 03/01/1966
Onset Date: 04/29/2021
Rec V Date: 04/29/2021
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: macrolides

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

Symptoms: started with localized pain/discomfort that migrated to shoulder with numbness in shoulder and neck

Other Meds: buspirone, propranolol, zolpidem, duloxetine, adderall

Current Illness:

ID: 1271854
Sex: F
Age: 38
State: WI

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/29/2021
Hospital:

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

Lab Data: 4/14/2021 Bloodwork; TSH - 4.9 ulu/ml; T4 FREE - 1.26 mg/dL; Thyroid peroxidase Antibody <9IU/ml

Allergies: None

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: COVID Vaccine #1 on 3/9/2021; Unusual Menstrual spotting began 3/27/2021; Early Heavy Menstrual Bleeding Began on 3/31/2021; COVID Vaccine #2 on 4/1/2021; Heavy Menstrual Bleeding Continues daily through today's date 4/29/2021

Other Meds: None

Current Illness: None

ID: 1271855
Sex: F
Age: 11
State: IL

Vax Date: 04/26/2021
Onset Date: 04/26/2021
Rec V Date: 04/29/2021
Hospital:

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

Lab Data: None

Allergies: Augmentin

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

Symptoms: Patient reported numbness down her right arm to her wrist and pain at injection site that started around 4pm on 4/26/21 and lasted to 4/27/21. When I spoke with mom today on 4/28/21, she stated that her daughter denied any complaints of pain and numbness in her right arm.

Other Meds: Zyrtec 10 mg daily Flonase 50mcg/act 1 spray each nostril daily Albuterol Sulfate HFA 108 (90) MCG/ACT 2 puffs PRN for wheezing

Current Illness: none

ID: 1271856
Sex: M
Age: 56
State: NJ

Vax Date: 04/27/2021
Onset Date: 04/28/2021
Rec V Date: 04/29/2021
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: None

Allergies: None.

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

Symptoms: Pain, and swelling of lft. arm, and hand. Some numbness, and tingling sensation in both lft. and rt. hands. Lingering numbness, tingling, and pain in lft hand. On day of 04/29/21. Level of pain scale 1-10. An eight (8). Some body stiffness the morning of 04/29/21. All events happened day(s) after vaccinated. Took day of work next day 04/28/21.

Other Meds: Excedrin ES, Advil, and Tylenol PM.

Current Illness: None

ID: 1271857
Sex: M
Age: 18
State: OR

Vax Date: 04/29/2021
Onset Date: 04/29/2021
Rec V Date: 04/29/2021
Hospital:

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

Lab Data:

Allergies: No known allergies

Symptom List: Pain in extremity

Symptoms: Scratchy throat, lip numbness. Symptoms faded adn PT refused further assesment

Other Meds: No current medications

Current Illness: No known illnesses

ID: 1271858
Sex: F
Age: 42
State: KS

Vax Date: 04/27/2021
Onset Date: 04/27/2021
Rec V Date: 04/29/2021
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: Chills, fever, muscle aches (back and chest), cough, and fatigue.

Other Meds:

Current Illness:

ID: 1271859
Sex: F
Age: 32
State: NV

Vax Date: 12/30/2020
Onset Date: 12/31/2020
Rec V Date: 04/29/2021
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: Codeine, penicillin

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

Symptoms: For my first vaccine I experienced pain in my left arm which radiated to my fingers. I also had difficulty lifting my left arm up. These symptoms lasted 3 weeks. I also experienced nausea and headaches that lasted few weeks.

Other Meds:

Current Illness:

ID: 1271860
Sex: M
Age: 46
State: WI

Vax Date: 04/15/2021
Onset Date: 04/28/2021
Rec V Date: 04/29/2021
Hospital:

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

Lab Data: Visit to ER on 4/28

Allergies: No e

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

Symptoms: Right side of face muscle nerve weakening. Got diagnosed with Bell?s Pallsey

Other Meds: None

Current Illness: None

ID: 1271861
Sex: F
Age: 46
State: TX

Vax Date: 04/20/2021
Onset Date: 04/25/2021
Rec V Date: 04/29/2021
Hospital:

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

Lab Data: Went to dr office

Allergies: none

Symptom List: Vomiting

Symptoms: shingles a week later with no other underlying conditions

Other Meds: none

Current Illness: none

ID: 1271862
Sex: F
Age: 40
State: WA

Vax Date: 04/29/2021
Onset Date: 04/29/2021
Rec V Date: 04/29/2021
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: Sulfa drugs

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Moderate itchiness of the entire arm that received the injection. Itchiness is very distracting and is preventing me from being able to concentrate on my work. All I can do is scratch. Minor itchiness of lower left leg and left side of face. All the itchiness is on the left side of the body. No visible rash. Injection site is not swollen. No other symptoms. It's been four hours since the injection.

Other Meds:

Current Illness: None

ID: 1271863
Sex: F
Age: 29
State: MI

Vax Date: 04/16/2021
Onset Date: 04/23/2021
Rec V Date: 04/29/2021
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: Eye Exam 4-28-21 all normal, no problems seen

Allergies: none known

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

Symptoms: 1 week after 2nd vaccine my vision started getting weird, lines through it, fuzzy vision, , felt the world was spinning around me, head fog, made me feel weir dand out of it. So far its been 7 days of it. I had an eye exam and they said everything looked good and normal and my glasses prescription had not changed. But they have seen about 5 other patients with similar symptoms after they had got their vaccines too. They are wondering if its linked to the vaccine, I have not had eye issues or symptoms like this ever! My eye Dr. had called another local eye doctor in our area asking if he had also seen this happening too and he said yes, and is taking 2-3 months to resolve.

Other Meds: Probiotic omeprazole sprintec birth control prenatal vitamins (for hair, skin and nails)

Current Illness: Feb. had severe masitis and a breast infection that took a month to clear up on antibiotics

ID: 1271864
Sex: F
Age: 36
State: CA

Vax Date: 04/27/2021
Onset Date: 04/27/2021
Rec V Date: 04/29/2021
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: Chest pain. History of anxiety with chest pain. Pain gradually improved.

Other Meds:

Current Illness:

Date Died: 03/20/2021

ID: 1271865
Sex: F
Age: 55
State: TX

Vax Date: 03/16/2021
Onset Date: 03/18/2021
Rec V Date: 04/29/2021
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: Patient spouse came to our clinic on 4/29/2021 to report that on 3/18/2021 patient had a "brain bleed" and required emergency treatment. Patient died on 3/20/2021. Death certificate list cause of death as subarachnoid hemorrhage due to ruptured aneurysm

Other Meds:

Current Illness:

ID: 1271866
Sex: M
Age: 59
State:

Vax Date: 01/27/2021
Onset Date: 02/11/2021
Rec V Date: 04/29/2021
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: Patient was admitted to the hospital twice within 6 weeks of receiving covid vaccination. DOS: 2/11/21 and 2/16/21.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am