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: 1336646
Sex: M
Age: 40
State: IN

Vax Date: 05/19/2021
Onset Date: 05/19/2021
Rec V Date: 05/21/2021
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: Flu symptoms, achiness, nausea, headache for about 24 hours. Went away with the rest and Tylenol

Other Meds:

Current Illness:

ID: 1336647
Sex: F
Age: 14
State: MA

Vax Date: 05/18/2021
Onset Date: 05/18/2021
Rec V Date: 05/21/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Error: Wrong Dose of Vaccine - Too High

Other Meds:

Current Illness:

ID: 1336648
Sex: M
Age: 24
State: VT

Vax Date: 05/17/2021
Onset Date: 05/17/2021
Rec V Date: 05/21/2021
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: Vaso Vagal response, vomiting

Other Meds:

Current Illness:

ID: 1336649
Sex: M
Age: 17
State: IN

Vax Date: 05/19/2021
Onset Date: 05/19/2021
Rec V Date: 05/21/2021
Hospital:

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

Lab Data:

Allergies: Nuts, Peanuts, Seafood, Eggs, Coconut, and Strawberries.

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Chills, Muscle Soreness, fever and Severe Headache from about 5:30 p.m. 05-19-2021 - 1:30 p.m. 05-20-2021. Less severe chills, fever, and severe headache from 1:30 p.m. 05-20-2021 - 6:30 a.m. 05-21-2021. Less severe headache continues after shower finished 6:30 a.m. 05-21-2021 until present 05-21-2021.

Other Meds: Zyrtec

Current Illness: None

ID: 1336650
Sex: F
Age: 15
State: SC

Vax Date: 05/19/2021
Onset Date: 05/19/2021
Rec V Date: 05/21/2021
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

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

Symptoms: Patient had no reaction or side effects for 15 minutes after the shot. After 15 minutes, patient started experiencing uncontrollable movement of her upper arm and shoulder. The uncontrollable movement was mainly in the upper arm. Patient did have some uncontrollable movement in her fingers. Patient also had uncontrollable laugh as well which was not so significant. Patient's caregiver (mom) also indicated that she had trouble forming a sentence, but as per patient it was due to her being nervous. Patient stayed in the pharmacy for over an hour. Over the time, her symptoms had subside. The uncontrollable laughter was almost gone. Uncontrollable movement of her upper arm had also reduce significantly and patient was very calm after sometime. Patient was alert and able to understand and conscious. Patient was advised to see PCP or pediatrician for further evaluation.

Other Meds: No known

Current Illness: No known

ID: 1336651
Sex: F
Age: 15
State: MA

Vax Date: 05/18/2021
Onset Date: 05/18/2021
Rec V Date: 05/21/2021
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:

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

Symptoms: Error: Wrong Dose of Vaccine - Too High

Other Meds:

Current Illness:

ID: 1336653
Sex: M
Age: 35
State: NY

Vax Date: 05/20/2021
Onset Date: 05/20/2021
Rec V Date: 05/21/2021
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: Approximately 2-5 minutes after receiving vaccine patient fainted. Patient was pale, sweaty and unresponsive. Patient regained consciousness shortly after but was still pale and sweaty for some time. Patient was given water, ice pack and closely monitored for 30 minutes. Patient and family with him stated that he does not do well with shots and this is a common occurrence. After approximately 15 minutes color came back to patient and he stated he was fine although monitoring continued until 30 minutes.

Other Meds:

Current Illness:

ID: 1336654
Sex: F
Age: 37
State: OH

Vax Date: 05/20/2021
Onset Date: 05/20/2021
Rec V Date: 05/21/2021
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: Systemic: Allergic: Swelling of Face / Eyes / Mouth / Tongue-Medium, Additional Details: Patient felt tongue swell and face felt itchy and numb. Patient was conscious, talking and able to swallow water. Gave her 25 mg of benadryl. Called 911, medics transported to hospital. Patient called and said hospital gave her more benadryl and steroids.

Other Meds:

Current Illness:

ID: 1336655
Sex: M
Age: 13
State: MA

Vax Date: 05/18/2021
Onset Date: 05/18/2021
Rec V Date: 05/21/2021
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:

ID: 1336656
Sex: M
Age: 64
State: MA

Vax Date: 02/12/2021
Onset Date: 03/01/2021
Rec V Date: 05/21/2021
Hospital:

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

Lab Data: None

Allergies: Bacrtim, Losartin, Oregano

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Tinnitus. Continuous. No treatment that I know of

Other Meds: Zinc, Vit B, Magnesium, Co Q10

Current Illness:

ID: 1336657
Sex: F
Age: 28
State: NC

Vax Date: 05/20/2021
Onset Date: 05/20/2021
Rec V Date: 05/21/2021
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: Systemic: Allergic: Difficulty Swallowing, Throat Tightness-Mild, Systemic: Allergic: Itch (specify: facial area, extremeties)-Mild, Additional Details: patient states her tongue and throat feel tingly similar to when she has reactions to peanuts, she states no difficulty breathing at this time.

Other Meds:

Current Illness:

ID: 1336658
Sex: F
Age: 63
State: OH

Vax Date: 05/18/2021
Onset Date: 05/19/2021
Rec V Date: 05/21/2021
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: The patient states she woke up the morning after the vaccination and was in A-Fib. She states she has a pacemaker and has been in A-Fib before, but has not had an episode in "quite a while" She wondered if the episode could be related to the vaccine.

Other Meds:

Current Illness:

ID: 1336659
Sex: F
Age: 14
State: MA

Vax Date: 05/18/2021
Onset Date: 05/18/2021
Rec V Date: 05/21/2021
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: Wrong Dose of Vaccine - Too High

Other Meds:

Current Illness:

ID: 1336660
Sex: F
Age: 44
State: IN

Vax Date: 05/18/2021
Onset Date: 05/19/2021
Rec V Date: 05/21/2021
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:

Allergies: Zoloft. Aleve, arothrymiacin, zithromiacin, sulfa drugs

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

Symptoms: Headache, fatigue, sore throat

Other Meds: Wellbutrin

Current Illness:

ID: 1336662
Sex: M
Age: 16
State: MA

Vax Date: 05/18/2021
Onset Date: 05/18/2021
Rec V Date: 05/21/2021
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: Error: Wrong Dose of Vaccine - Too High

Other Meds:

Current Illness:

ID: 1336663
Sex: F
Age: 50
State: NC

Vax Date: 04/21/2021
Onset Date: 04/22/2021
Rec V Date: 05/21/2021
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: MRI Spine Lumbar WO contrast/ MRI Spine Cervical WO contrast/ MRI Head WO Contrast- Normal 4/30/21 Echocardiogram- Normal 4/30/21 CT Angio neck/ CT Angio head W/WO contrast/ CT Head WO contrast- Normal 4/30/21 Triglycerides- 210mg

Allergies: none

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

Symptoms: 4/22/21- Fever, Chills, night sweats, body aches 4/23/21- Fever, Chills, Body aches 4/24/21- Body aches, numbness and weakness on right side of body 4/29/21- Went to healthcare facility complaining of numbness and weakness on the right side of the body. Was seen by a doctor and did a neuro assessment. She then decided that she was having a ?stroke? or a ?brain bleed?. While at ER the PA did another neuro assessment and said could be having a stroke and was admitted into the hospital on 4/29/21

Other Meds: Multi-Vitamin Vitamin D, C Magnesium Zinc

Current Illness: none

ID: 1336664
Sex: F
Age:
State: TN

Vax Date:
Onset Date:
Rec V Date: 05/21/2021
Hospital:

Vax Type: DTAPHEPBIP
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: DTAP + HEPB + IPV (PEDIARIX)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies: None

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

Symptoms: Fever, headache, body ache, fatigue, loss of appetite, nausea, loss of sense of taste, sneezing, congestion, runny nose, coughing

Other Meds: None

Current Illness: None

ID: 1336665
Sex: F
Age: 40
State: HI

Vax Date: 05/20/2021
Onset Date: 05/20/2021
Rec V Date: 05/21/2021
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: Wrong Dose of Vaccine - Too Low

Other Meds:

Current Illness:

ID: 1336666
Sex: F
Age: 26
State: ND

Vax Date: 05/19/2021
Onset Date: 05/20/2021
Rec V Date: 05/21/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Pfizer-BioNTech COVID-19 Vaccine EUA. Woke up around 2 am day after vaccine was administered with a fever and nausea. Nausea went away, but developed headache and body aches. Fever continued throughout the day. Woke up next day feeling fine.

Other Meds: N/A

Current Illness: N/A

ID: 1336667
Sex: M
Age: 26
State: NV

Vax Date: 05/20/2021
Onset Date: 05/20/2021
Rec V Date: 05/21/2021
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: Site: Pain at Injection Site-Medium, Systemic: Fainting / Unresponsive-Medium, Systemic: Flushed / Sweating-Mild, Systemic: Headache-Mild, Systemic: Hypotension-Mild, Systemic: Nausea-Mild, Systemic: Seizure-Mild, Systemic: Shakiness-Mild, Systemic: Visual Changes/Disturbances-Mild, Systemic: Weakness-Mild, Additional Details: Patient passed out within 5 minutes of receiving the shot. He had some convulsions and 911 was called. BP was 106/70. Pt stated he felt weird, his arm hurt, everything went white, and he felt numb before passing out and had a headache. Pt has history of passing out when giving blood and did not disclose that information. Pt was taken care of by paramedics that sent him home.

Other Meds:

Current Illness:

ID: 1336668
Sex: F
Age: 63
State: MD

Vax Date: 03/19/2021
Onset Date: 05/07/2021
Rec V Date: 05/21/2021
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: C-Peptide - <0.1

Allergies: No known allergies Sensitive to morphine and some antibiotics

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

Symptoms: On or around May 7th I started to experience a significant decrease in blood glucose levels. Insulin requirements drastically were reduced over the following 7 days. Long acting insulin was reduced by 35% and short acting insulin by 75% within a 7 day period. I reported this phenomenon to my endocrinologist, on May 11. I also reported this to where I am a research participant in their study. Neithe researchers or my endocrinologist were able to provide an explanation. Therefore, I requested a C-Peptide test which came back negative. I wanted to report this as a possible correlation between the building of Covid antibodies/immune cells and depletion of glucose in type 1 diabetes. Thank you.

Other Meds: Humalog Insulin Basaglar Insulin Plaquenil 200mg Pravastatin 20mg Metanx Vitamin B Complex Levothyroxine 120mcg Valtrex 500mg Ubiquinol Pilocarpine 5mg

Current Illness: No illness at time of vaccination

ID: 1336669
Sex: F
Age: 62
State: MD

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

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

Lab Data: 5/1/21 CT, blood work and urinalysis- client indicated the CT was clear, blood work was good, urinalysis showed some bacteria and she was started on antibiotics. 5/9 xrays- stated okay for age, and urine screen looked okay

Allergies:

Symptom List: Unevaluable event

Symptoms: Individual received her second moderna vaccine at 9:30 on 4/29/21- 12 hours later she went to bed and had right hip, groin and lower back pain that was described as extreme and she was unable to sleep. She did not take any medication at this time because she was afraid to due to the vaccine. On 5/1/21 she went to healthcare facility because she was having severe pain in her abdominal right lower quadrant, and stated she was worried she had appendicitis. 5/1/21 CT, blood work and urinalysis- client indicated the CT was clear, blood work was good, urinalysis showed some bacteria and she was started on antibiotics. 5/9/21 Went to healthcare facility due to not being able to walk, pins and needles sensation with stabbing hot pain in her groin and back. Her urine screen was clear, xrays were taken but looked okay considering her age. Stated She was started on prednisone, muscle relaxers and anti inflammatory medications. Stated she had never taken the meds they prescribed but they did not help. She went back to her PCP on 5/13 - was referred for Physical therapy. Individual stated she has gone to two therapy appointments and pain is lessening but is elicited with standing. pain continues to be localized in groin and upper leg.

Other Meds: Zetia, Vitamin D

Current Illness:

ID: 1336671
Sex: F
Age: 34
State: SC

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 05/21/2021
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: None

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

Symptoms: After 1st vaccine: within 1hr of vaccine Hives on face that lasted until the next morning. And recurrent pop up hives prior for 3 weeks After 2nd vaccine: Around 2am woke up with hives , Large raised wheals all over my body that did not go away until the next morning. Recurrent small hives for a week

Other Meds: None

Current Illness: None

ID: 1336672
Sex: F
Age: 34
State: IN

Vax Date: 05/19/2021
Onset Date: 05/19/2021
Rec V Date: 05/21/2021
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: N/A

Symptom List: Injection site pain, Pain

Symptoms: Headache, extreme fatigue, body and joint aches.

Other Meds: OTC vitamins, and fiber

Current Illness: N/A

ID: 1336673
Sex: F
Age: 86
State: NJ

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 05/21/2021
Hospital: Y

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

Lab Data: March 19, 2021 first hospital stay. Many tests done. Second hospital stay and more tests done.

Allergies: none

Symptom List: Injection site pain, Menorrhagia

Symptoms: The day after the first shot, my mother had bad knee pain in her left knee. It went on for days/week. After the second dose, days out she started feel very tired and bad pain in her feet that went to her hands and she couldn't get out of bed or urinate properly. Her facility doctor gave her Gabepentin for the pain but it did not help. She declined over a week or so and then She was admitted into the hospital for dehydration (March 19, 2021). The put a catheter in her to get urine out and bring her kidney function back to her normal (she does have kidney disease). Gave her more Gabepentin (which does not help pain in feet an hands) and released her to rehab. and she is now on oxygen. Rehab was bad so I got her out and released to her facility so she could receive rehab there. She declined again with the same reaction: extreme fatigue, can't walk and now urinates and defecates in an adult diaper and now breathing is very labored. She was admitted to the hospital and they can't find out why she is in this way. They did blood work, tests, scan and X-rays without any answers. They switched up meds on her and then released her to rehab since she hasn't walked in weeks/month at this point. She is regaining strength but now on oxygen even when sitting. She is 86 and walked with a walker all around her facility and when going to doctor appointments. Now she is in a wheelchair for doctor appointments since she has no strength and needs oxygen to walk. Her facility saw her decline after the second shot and my mom is very vocal and each day told them how she felt awful and it is because of the shot. She still has neuropathy in her feet and hands but it is not as painful as it originally was and it peaked and now just painful about a 5-6 on a scale of 0-10.

Other Meds: 2 high blood pressure meds, furosemide, vitamin C, montelukast, pepcid, hydroxurea, Zoloft, busbar, another anxiety med, levothyroxine

Current Illness: none

ID: 1336674
Sex: M
Age: 16
State: ME

Vax Date: 05/18/2021
Onset Date: 05/19/2021
Rec V Date: 05/21/2021
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: Systemic: Dizziness / Lightheadness-Medium, Systemic: Flushed / Sweating-Medium, Systemic: Hypotension-Medium, Systemic: Weakness-Medium, Additional Details: Patient started to get lightheaded while sitting in a chair during his post vaccine observation time. He was hypotensive and had lost the color in his face. His mother and I were able to get him over to a bench to lay down, where he also drank a bottle of water. After roughtly 45 minutes he felt strong enough again to walk around and leave.

Other Meds:

Current Illness:

ID: 1336675
Sex: F
Age: 18
State: PA

Vax Date: 05/20/2021
Onset Date: 05/20/2021
Rec V Date: 05/21/2021
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: Systemic: Fainting / Unresponsive-Medium, Systemic: Headache-Mild, Additional Details: got emotionally excited after shot fainted for 25 seconds, patient was tired bur responsive

Other Meds:

Current Illness:

ID: 1336676
Sex: M
Age: 34
State: MA

Vax Date: 05/17/2021
Onset Date: 05/17/2021
Rec V Date: 05/21/2021
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: Systemic: Stroke-Severe, Additional Details: pt says he experienced a stroke ~5 hours after receiving the second pfizer shot. pt did not mention experiencing a stroke after the first shot

Other Meds:

Current Illness:

ID: 1336677
Sex: M
Age: 58
State: IL

Vax Date: 03/13/2021
Onset Date: 03/15/2021
Rec V Date: 05/21/2021
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: SED rate 52

Allergies:

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

Symptoms: Swollen ankles

Other Meds: Hydrochlorothiazide 25mg, Metoprolol 50mg, Vit B12, Vit D3, MultiVitamin

Current Illness: High Blood Pressure, rash, eye infections

ID: 1336678
Sex: F
Age: 51
State: IL

Vax Date: 01/21/2021
Onset Date: 01/29/2021
Rec V Date: 05/21/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Nausea

Symptoms: Ringing in left ear

Other Meds: None

Current Illness: None

ID: 1336679
Sex: M
Age: 41
State: GA

Vax Date: 05/20/2021
Onset Date: 05/21/2021
Rec V Date: 05/21/2021
Hospital:

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

Lab Data: NONE, OBSERVATION

Allergies: None

Symptom List: Injection site pain

Symptoms: REPORTED FAINTING BY WITNESSES, NURSE VISUALIZED DIAPHORESIS, DRY HEAVING, PT REPORTED WEAKNESS.

Other Meds: None

Current Illness: None

ID: 1336681
Sex: F
Age: 65
State: NC

Vax Date: 04/29/2021
Onset Date: 04/29/2021
Rec V Date: 05/21/2021
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: Site: Pain at Injection Site-Mild, Systemic: right arm has been sore since first shot see below for more details-Mild, Additional Details: Her right arm has been sore, she can still feel where the needle went into her arm from the first Covid vaccination. This arm waxes and wanes with different severities of pain and the pain,sensations, and uncomfortableness has lasted 21 days. I told patient if the pain continues for another week or if the pain gets worse, seek medical attention for it.

Other Meds:

Current Illness:

ID: 1336682
Sex: F
Age: 22
State: IN

Vax Date: 05/19/2021
Onset Date: 05/20/2021
Rec V Date: 05/21/2021
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: Menthol

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

Symptoms: Dizziness, lump at injection site, muscle soreness

Other Meds: Birth control, Zoloft, Ibuprofen

Current Illness: Stomach virus

ID: 1336683
Sex: F
Age: 18
State: IN

Vax Date: 05/19/2021
Onset Date: 05/20/2021
Rec V Date: 05/21/2021
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: n/a

Symptom List: Tremor

Symptoms: weakness, nausea, headache, faintness all lasting all day the day after

Other Meds: Buspar and Prozac

Current Illness: n/a

ID: 1336684
Sex: F
Age: 19
State: NJ

Vax Date: 05/20/2021
Onset Date: 05/20/2021
Rec V Date: 05/21/2021
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: Site: Swelling at Injection Site-Medium, Systemic: Allergic: Difficulty Breathing-Medium

Other Meds:

Current Illness:

ID: 1336685
Sex: M
Age: 54
State: WI

Vax Date: 05/20/2021
Onset Date: 05/20/2021
Rec V Date: 05/21/2021
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:

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

Symptoms: No adverse outcome. Patient received 2nd dose of Pfizer at 14 days rather than 17 days. Instructed by provider to give 2nd dose early due to patient being transferred.

Other Meds:

Current Illness:

ID: 1336686
Sex: F
Age: 70
State: TX

Vax Date: 02/06/2021
Onset Date: 02/09/2021
Rec V Date: 05/21/2021
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: None

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

Symptoms: Three days after getting my first vaccine I started having swelling and soreness under both arms. It has been 3 1/2 months and these symptoms still exist. I did wait 2 weeks after last shot (3-1-2021) and had a DTP vaccine also.

Other Meds: Crestor, Trilipix, Benicar, D3, Probiotic, Miralax, Nystatin Ointment, Nifedipine/Lidocaine, Nutrafol, Omega 3 with CoQ10, Tylenol, Metronidazole

Current Illness: Anal Fissure

ID: 1336687
Sex: M
Age: 36
State: MD

Vax Date: 05/20/2021
Onset Date: 05/20/2021
Rec V Date: 05/21/2021
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: Penicillin

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: I would not describe as adverse, merely a side effect, and doing due diligence to report. I began tasting and smelling small amounts of smoke periodically. Confirmed with my spouse that she didn't smell anything. Started at ~18:00 and continued on until I'd gone to bed, ~23:00. No noted lasting effects the morning after.

Other Meds: Zyrtec

Current Illness:

ID: 1336688
Sex: F
Age: 26
State: MD

Vax Date: 05/20/2021
Onset Date: 05/20/2021
Rec V Date: 05/21/2021
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:

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

Symptoms: Site: Pain at Injection Site-Mild, Systemic: Bell's Palsy-Medium, Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Mild, Systemic: Flushed / Sweating-Medium, Systemic: Hyperventilation-Medium, Systemic: Shakiness-Medium

Other Meds:

Current Illness:

ID: 1336689
Sex: M
Age: 74
State: PA

Vax Date: 05/20/2021
Onset Date: 05/21/2021
Rec V Date: 05/21/2021
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: no allergies

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

Symptoms: Elevated temperature of 103.5

Other Meds: Atorvastatin Metoprolol Lantus insulin aspirin Plavix gabapentin lasix

Current Illness: diabetic wounds to bilateral heels

ID: 1336690
Sex: F
Age: 29
State: IN

Vax Date: 05/19/2021
Onset Date: 05/19/2021
Rec V Date: 05/21/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: Fever, body aches, headache, fatigue, painful rash near injection site. Symptoms last 48 hours after injection. Treated with rest and pain reliever.

Other Meds:

Current Illness:

ID: 1336691
Sex: F
Age: 71
State: NY

Vax Date: 05/18/2021
Onset Date: 05/19/2021
Rec V Date: 05/21/2021
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: Site: Redness at Injection Site-Mild, Site: Swelling at Injection Site-Mild, Additional Details: Patient came in Thursday and showed me her arms. She received her Pfizer Covid vaccination on Tuesday, 5/18 and noticed her left arm where the vaccination was given was a bit swollen and red a day after. She came in today for consultation and I recommended her to take some oral Benadryl and offered to call her doctor for her, but she said she is seeing him on Monday. She will update us on the outcome.

Other Meds:

Current Illness:

ID: 1336692
Sex: M
Age: 91
State: OK

Vax Date: 05/14/2021
Onset Date: 05/15/2021
Rec V Date: 05/21/2021
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: Cirpofloxacin hcl, celexa, contract dye

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

Symptoms: Leg and hip weakness, Swelling of leg and feet. Acking legs, cramping legs and feet. Shortness of breath, eyes not focusing

Other Meds: Sodium Bicar 650 mg, Finasteride 5 mg, warfin 5 mg, Lisloipril 5 mg, multi vitamin, probotic

Current Illness:

ID: 1336693
Sex: M
Age: 62
State: VA

Vax Date: 04/01/2021
Onset Date: 05/11/2021
Rec V Date: 05/21/2021
Hospital:

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

Lab Data: I have not been tested as yet, I thought initially that it was a food allergy, but I have systematically eliminated those things in my normwl diet to no avail.

Allergies: None prior to getting the 2 Moderna shots.

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

Symptoms: A Hive like rash appeared on my left arm approximately 2 weeks after my 2nd shot, and now appears over various parts of my body such as, both arms, my torso, my legs, and my back, however, it comes and goes throughout the course of the day with minimal itching.

Other Meds: Centrum 50+ for Men, Boost Nutritional Drink

Current Illness: None

ID: 1336694
Sex: M
Age: 16
State: NC

Vax Date: 05/08/2021
Onset Date: 05/09/2021
Rec V Date: 05/21/2021
Hospital:

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

Lab Data: ekg Echocardiogram

Allergies: n/a

Symptom List: Vomiting

Symptoms: 05/09 Woke up with Chest pain/fever/headache 05/17 went to urgent care due to chest pain/diagnosed with Pericarditis 05/20 pericarditis diagnosis confirmed by cardiologist No other contributing factors

Other Meds: n/a

Current Illness: n/a

Date Died: 04/21/2021

ID: 1336695
Sex: F
Age: 78
State: WI

Vax Date: 03/25/2021
Onset Date: 04/11/2021
Rec V Date: 05/21/2021
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: Patient presented to the ED and was subsequently hospitalized within 6 weeks of receiving COVID vaccination. Diagnoses were pneumonia, A-fib and hyponatremia. Patient died on 4/21/2021

Other Meds:

Current Illness:

ID: 1336697
Sex: F
Age: 28
State: IN

Vax Date: 05/19/2021
Onset Date: 05/19/2021
Rec V Date: 05/21/2021
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: Sulfa and betadine

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

Symptoms: Bad headache, mild fever and chills, intense body aches, arm/arm pit pain near injection site, very tired.

Other Meds: Tri-Sprintec

Current Illness: None

ID: 1336698
Sex: F
Age: 27
State: TX

Vax Date: 05/20/2021
Onset Date: 05/20/2021
Rec V Date: 05/21/2021
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: Systemic: Allergic: Swelling of Face / Eyes / Mouth / Tongue-Medium, Additional Details: Called EMS as soon as swelling in arms started. EMS arrived as patient's lips and tongue started to swell. EMS took her to ER. Unaware if she received epinephrine or diphenhydramine.

Other Meds:

Current Illness:

ID: 1336700
Sex: F
Age: 24
State: PA

Vax Date: 05/18/2021
Onset Date: 05/18/2021
Rec V Date: 05/21/2021
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: Wrong Vaccine Formulation (ex. different manufact. initial and booster).

Other Meds:

Current Illness:

ID: 1336701
Sex: F
Age: 21
State: NJ

Vax Date: 04/09/2021
Onset Date: 04/12/2021
Rec V Date: 05/21/2021
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: Xrays

Allergies: Tree nuts

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

Symptoms: 4 days after first shot, she called me complaining of bad back pain. She was going to her family doctor the next day for her 21 yr old well visit and was going to get it checked out then. She had a complete physical and was cleared even her lungs were clear and she was good. Tuesday night April 13th at 10pm, she told me she had "air bubbles" in her chest. I said you mean indigestion, take tums I said. She said not mom, actual air bubbles and they are popping in my chest. I said you just got your physical, you are fine. They Thursday night April 15th she started having difficulty breathing and was out of breath. She went to urgent care on April 16th because she felt awful and they saw in an X-ray that she had a "cyst" in her upper right part of her lung and her lung was about to collapse. Sent her home on bed rest with a stereos and 2 inhalers. We got her Friday night from college because the pain in her back and now her chest was worse. Took her to ER and she had a collared lung and pneuomothroax. She was admitted to the hospital and they tried to see if the lung would heal itself. It did not. They had to do surgery to repair the hole. When they were in there they saw a cobblestone texture where the hole was an they removed that texture and repaired the hole. She has never had a lung issue. Ever. She is also the 3rd person in my family to have had an adverse reaction to the shot. 6 of us vaccinated and 3 with injuries.

Other Meds: Lo Loestrin FE

Current Illness: none

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am