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: 1457201
Sex: F
Age: 35
State: TN

Vax Date: 02/10/2021
Onset Date: 04/30/2021
Rec V Date: 07/08/2021
Hospital:

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

Lab Data: MRI, EEG

Allergies: None

Symptom List: Dysphagia, Epiglottitis

Symptoms: Seizures

Other Meds: None

Current Illness: None

ID: 1457202
Sex: F
Age: 70
State:

Vax Date: 06/30/2021
Onset Date: 07/01/2021
Rec V Date: 07/08/2021
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: Patient called to report "bouts of confusion" starting ~24 hrs post vaccination. Patient reported already improving at time of call.

Other Meds:

Current Illness:

ID: 1457203
Sex: F
Age: 65
State: AZ

Vax Date: 03/31/2021
Onset Date: 04/02/2021
Rec V Date: 07/08/2021
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: Latex, eggs, iodine

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

Symptoms: Notes: The Frequency, Duration and Intensity of all my preexisting symptoms, plus 9 new symptoms, increased exponentially on the 3rd day after I received the 2nd Moderna coronavirus vaccination on March 31, 2021. For five weeks the symptoms were every day; now they wax and wane randomly every 2-3 days. The symptoms present randomly (i.e. not in the constellation of symptoms I would normally get with an MCAS flareup), which initially was confusing and disorienting. It feels as though something got turned on in my brain and hasn't turned off. This has seriously and detrimentally affected my quality of life. I now carry a medical Alert device because I have fallen due to the disequilibrium. Symptoms listed in alphabetical order: Items marked with @ are new, never before experienced symptoms. ? Anxiety ? @ Breathing, sometimes dysregulated ? Brain fog ? @ Cognitive: Word finding, rambling, losing track of conversations. 1st shot during acute phase; 2nd shot acute phase then continuing intermittently ? @ Delirium: ? Symptoms: ? Confusion: 1 Day ? @ Emotions, Heightened, sudden onset with no provocation ? @ Hallucinations, Auditory: 1/2 day ? Lightheaded: 1 day. Only during acute phase of delirium (feeling disconnected) ? Onset: Began with heightened emotions (anger, fear, crying/tearful, depression, joy) late afternoon. The next morning auditory hallucinations, disequilibrium, and confusion; insomnia (slept 2:30-8:30am and intense anger the night before followed by fear then paranoia. The acute phase ended as suddenly as it began about 10:00am - total acute episode lasted about 12 hours. However the heightened emotional state - anger, fear, paranoia, - continued. My handwriting was large, loopy for 2 days. ? Complication: followed by fear of repetition, concern because cause unknown, and anxiety dreaming for 2 weeks ? History: I had disequilibrium, confusion and cognitive symptoms in combination only once before, when I had the flu in 2019; duration 1 day ? Disequilibrium ? Emotionally labile, random: tearful, sad, depressed, scared. Began with delirium but has continued intermittently with flare-ups ? Fingers, Icy cold: began during acute phase on same day as delirium, and lasted 4 weeks; continues wit cold fingers during intermittent flare-ups ? @ Heart rate, resting, rapid - 10-14 beats above normal for 2 weeks ? Incontinence and urgency: urinary and gastro ? Senses Heightened or changed: ? Light (photophobia) and Sound (hyperacusis) sensitive ? @ Smell heightened (hyperosmia) ? Taste, Metallic ? Sexual arousal, low level, random and unexpected: briefly for a few minutes several times during acute phase; a few times during intermittent flare-ups ? Sleep, disrupted: Insomnia and Insufficient ? @ Swallowing, difficulty: suddenly unable to swallow water (it got 'stuck') usually on days I have dysregulated breathing ? Tinnitus, increased exponentially: Volume, Duration and Spiking; began fter 1st shot and became even worse after the 2nd shot. I have not yet returned to baseline ? @ Tremors, hands and arms: after mild exertion and/or fine work such as sewing or using mouse to edit photos. ? Vision: Blurred, Diplopia (I have Adie's Tonic Pupil): Increases during acute phase; intermittent with flareups. Other: ? Sudden onset Sinus Congestion, edema, itching and sneezing 12 hours after 1st and 2nd shots and lasted about 4-5 days. ? Fatigue, edema, joint pain, muscle pain, Rosacea flare, canker sores flare all continuing during flareups. ? To reiterate: Symptoms became exponentially heightened in Frequency, Intensity and Duration, and occur randomly - not in the constellation that I'm used for MCAS or Dysautonomia or Tinnitus.

Other Meds: Current Supplements: ? Vit C 1,000mg daily: Recommended by Allergist for MCAS taken in 4 (250mg) doses ? Potassium chloride 200mg daily: for muscle cramps and restless leg, 100mg in the morning, 100mg in electrolyte fluids. ? Electrolyte f

Current Illness:

ID: 1457204
Sex: F
Age: 59
State:

Vax Date: 06/17/2021
Onset Date: 06/27/2021
Rec V Date: 07/08/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: I experienced extreme fatique and as of today, July 7, 2021, I am just starting to feeling somewhat normal energy level. As far as the vertigo, I am a hiker and whan I went to hike an area that I had hiked in the past, vertigo kicked in and I was unable to complete the hike. It was terrifying. I have never had vertigo in the past.

Other Meds:

Current Illness:

Date Died: 05/05/2021

ID: 1457205
Sex: F
Age: 73
State: TX

Vax Date: 05/04/2021
Onset Date: 05/04/2021
Rec V Date: 07/08/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Reportedly "didn't feel well" after vaccine but didnt want to seek medical treatment.

Other Meds: Tramadol, Metoclopramide hydrochloride, Clonidine, Famotidine, Lisinopril, Clonazepam, Amlodipine besylate, Solifenacin, Hydrocodone bitartrate and acetaminophen,

Current Illness:

ID: 1457206
Sex: F
Age: 59
State:

Vax Date: 06/17/2021
Onset Date: 06/27/2021
Rec V Date: 07/08/2021
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: I experienced extreme fatique and as of today, July 7, 2021, I am just starting to feeling somewhat normal energy level. As far as the vertigo, I am a hiker and whan I went to hike an area of the Grand Canyon that I had hiked in the past, vertigo kicked in and I was unable to complete the hike. It was terrifying. I have never had vertigo in the past.

Other Meds:

Current Illness:

Date Died: 07/03/2021

ID: 1457207
Sex: F
Age: 96
State: MT

Vax Date: 01/14/2021
Onset Date: 06/21/2021
Rec V Date: 07/08/2021
Hospital:

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

Lab Data: Positive COVID-19 PCR test on 6/21/21 and 6/28/21.

Allergies: Adhesive bandage, amoxicillin, cortisone

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Patient was fully vaccinated. Doses on 1/14/21 and 2/4/21. Diagnosed with COVID-19 on 6/21/2021 and passed away on 7/3/2021.

Other Meds: unknown

Current Illness: unknown

ID: 1457208
Sex: F
Age: 57
State: FL

Vax Date: 07/01/2021
Onset Date: 07/03/2021
Rec V Date: 07/08/2021
Hospital:

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

Lab Data: I didn't do any laboratory tests, didn't visit to the doctor because I am not insured and the severe pain disappeared the next day

Allergies: no

Symptom List: Pharyngeal swelling

Symptoms: 48 hours after vaccination of 1st dose (Phizer), I felt discomfort in my feet: numbness, tingling, pulling pains. Within 2 hours after the first symptoms, the pain in the left foot began to increase and became so severe that it was not possible to step on the left leg or make any movements with the foot. This state continued for a whole day (about 24 hours). After that, the sharp pain in left foot disappeared, but unpleasant sensations in the legs still remained - heaviness, tension, numbness, periodic pulling pain (not severe)

Other Meds: no

Current Illness: no

ID: 1457209
Sex: M
Age: 30
State: IN

Vax Date: 06/25/2021
Onset Date: 06/25/2021
Rec V Date: 07/08/2021
Hospital:

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

Lab Data: none

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: about 2 hours afterwards i had slight problem breathing. Chest pains have been on and off ever since. Sometime i feel like my heart is thumping.

Other Meds:

Current Illness:

Date Died: 03/14/2021

ID: 1457210
Sex: M
Age: 70
State: NC

Vax Date: 03/12/2021
Onset Date: 03/13/2021
Rec V Date: 07/08/2021
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: Peaches

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Caller stated that she was contacted by Sherriff department that father called 911. When ambulance arrived they did CPR. When they took him to the hospital they perform CPR again. Father was pronounced dead at 1am.

Other Meds: Caller stated that she can get a list of medication.

Current Illness:

ID: 1457211
Sex: M
Age: 41
State: CA

Vax Date: 01/07/2021
Onset Date: 07/06/2021
Rec V Date: 07/08/2021
Hospital:

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

Lab Data: SARS-CoV-2 nasopharyngeal PCR test positive on 7/7.

Allergies:

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

Symptoms: Breakthrough COVID-19 case despite vaccination in Jan 2021. Current symptoms began July 6,2021. Exposure to unvaccinated individuals over the July 4 weekend. Symptoms are mild consisting of cough, sinus congestion, sore throat. No fevers, shortness of breath, diarrhea. SARS-CoV-2 nasopharyngeal PCR test positive on 7/7.

Other Meds:

Current Illness:

ID: 1457212
Sex: F
Age: 59
State: MA

Vax Date: 12/23/2020
Onset Date: 07/06/2021
Rec V Date: 07/08/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data: PCR Covid test positive on 7/7/21 in fully vaccinated individual

Allergies: not known

Symptom List: Rash, Urticaria

Symptoms: PCR Covid 19 Positive test on 7/7/21 with symptoms of nasal congestion on 7/7/21

Other Meds: not known

Current Illness: not known

ID: 1457213
Sex: F
Age: 76
State: FL

Vax Date: 05/20/2021
Onset Date: 05/23/2021
Rec V Date: 07/08/2021
Hospital:

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

Lab Data: none

Allergies: I am allergic to nicotine, Codeine, caffeine, Penicillin, Tetracycline.

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

Symptoms: My right leg, hip and groin all hurt all the time, it is very bad pain all the way down that leg. This has been going on since May 23rd, 2021 and is till happening. My dr is having me go to PT soon. Also about three weeks ago I am now having hot flashes.

Other Meds: I take Allegra and Flonase.

Current Illness: none

ID: 1457214
Sex: M
Age: 52
State: FL

Vax Date: 06/17/2021
Onset Date: 06/25/2021
Rec V Date: 07/08/2021
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: on 6/29/21--increasing troponin; Cardiac ECHO; Cardiac Cath

Allergies: Wellbutrin

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

Symptoms: Reports hot/cold shivering started 6/25 then started with nausea, vomiting & Diarrhea. Chest pain/pressure started 6/29 and went to hospital. MD reports increasing Troponin so admitted to hospital for ECHO & Cardiac Cath. Discharged on 6/30. Still reports Fatigue

Other Meds: Aspirin; Crestor' Testosterone Cypionate

Current Illness: none

Date Died: 06/28/2021

ID: 1457215
Sex: M
Age: 82
State: MN

Vax Date: 03/03/2021
Onset Date: 06/28/2021
Rec V Date: 07/08/2021
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: No known allergies

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

Symptoms: Patient passed away on 06/28/2021

Other Meds: Singulair, albuterol, Prilosec, multi vitamin, Tylenol, Calcium 500, vitamin D3, cyanocobalamin

Current Illness:

ID: 1457216
Sex: F
Age: 52
State: CA

Vax Date: 04/02/2021
Onset Date: 04/09/2021
Rec V Date: 07/08/2021
Hospital:

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

Lab Data: No

Allergies: No

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

Symptoms: A week after, I stated to have tendon pain in my left thumb/wrist and I don't have a carpal tunnel syndrome type job or do anything that would make that happen. It started happening at night and it progressively got worse and I made a appt with Dr. (about two weeks ago) and she had me do a mobility test which was uncomfortable for me. She gave it a name but I can't remember it. She prescribed thumb splint and resting my hand. It's in the splint now. I have been in the splint now for a week and I will wear it for four to six weeks. It stays on all the time except to take a shower or wash dishes.

Other Meds: No

Current Illness: No

ID: 1457217
Sex: M
Age: 54
State: MN

Vax Date: 05/17/2021
Onset Date: 06/10/2021
Rec V Date: 07/08/2021
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:

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

Symptoms: My heart has been pounding hard with some pain. Shortness of breath. Coughing. Pain in left chest. Breast bone hurts

Other Meds: Sumitriptan, 10ml Emitrex

Current Illness: none

ID: 1457218
Sex: M
Age: 75
State: CT

Vax Date: 01/12/2021
Onset Date: 02/09/2021
Rec V Date: 07/08/2021
Hospital:

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

Lab Data: 4/9 and 4/29/2021 CBC, CMP, ANA, HIV, tick panel, autoimmune panel, quantiferon, ESR CRP Only moderate elevation in ESR and CRP other workup negative

Allergies: NKDA

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Severe Night sweats

Other Meds: aspirin, atorvastatin, ezetimibe, MVI, flomax, trazodone

Current Illness: none

ID: 1457219
Sex: F
Age: 74
State: MA

Vax Date: 04/01/2021
Onset Date: 04/02/2021
Rec V Date: 07/08/2021
Hospital:

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

Lab Data: Blood work Apr 6, 2021

Allergies: Codeine

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: April 2-3 2021: fever up to 103. Strongly swollen, red left ankle and lower leg; swollen painful knuckle of 4th finger, right hand. All symptoms except left leg subsided April 3-4. Consulted urgent care physician about left ankle Apr 6, 2021; cellulitis diagnosed. The injury related to the cellulitis had taken place many days earlier. I have to suppose that the infection was dormant until the vaccine distracted my immune system (sorry, I don't know the right terminology). An ongoing stomach infection, which abated prior to the date of the vaccine, returned after the vaccine.

Other Meds: Vitamin D 1000 IU, aspirin 81 mg

Current Illness: Stomach distress with bloating. Cellulitis: unknown at time of vaccination but diagnosed later

ID: 1457220
Sex: F
Age: 41
State: NJ

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 07/08/2021
Hospital: Y

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

Lab Data: Cath Lab Echo Troponin levels high MRI

Allergies: No

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

Symptoms: About 4 hours after receiving the vaccine, I felt really tired and got a headache. I went to bed and profusely sweat throughout the night, but my feet were freezing. I woke up the next morning, and all my joints hurt. My knees, elbows, but especially my spine. It hurt to move in bed. I continued to experience the pain and hot flashes. On Sunday I finally felt normal. Everything seemed fine for a while and then in April I had some chest pains. I went to the ER where they saw my troponin levels were elevated. They did a catheter. An MRI showed there was no scarring or signs of damage. I do not have a history of high cholesterol, blood clots, high blood pressure or anything like that. My doctors are struggling to find an answer to this because I have no pre cursors for these conditions. I was not taking any medications; I had no other illnesses. I am a nurse, but I always wear appropriate PPE when dealing with patients. Since then, everything has remained normal to this point. I now take a baby aspirin every day, cholesterol medication and About 4 hours after receiving the vaccine, I felt really tired and got a headache. I went to bed and profusely sweat throughout the night, but my feet were freezing. I woke up the next morning, and all my joints hurt. My knees, elbows, but especially my spine. It hurt to move in bed. I continued to experience the pain and hot flashes. On Sunday I finally felt normal. Everything seemed fine for a while and then in April I had some chest pains. I went to the ER where they saw my troponin levels were elevated. They did a catheter. An MRI showed there was no scarring or signs of damage. I do not have a history of high cholesterol, blood clots, high blood pressure or anything like that. My doctors are struggling to find an answer to this because I have no pre cursors for these conditions. I was not taking any medications; I had no other illnesses. I am a nurse, but I always wear appropriate PPE when dealing with patients. Since then, everything has remained normal to this point. I now take a baby aspirin every day, cholesterol medication and plavix.

Other Meds: No

Current Illness: No

ID: 1457221
Sex: F
Age: 14
State: IN

Vax Date: 07/06/2021
Onset Date: 07/07/2021
Rec V Date: 07/08/2021
Hospital:

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

Lab Data: None

Allergies: None

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

Symptoms: Headache, 102.2 temp, body aches, vomiting, nausea

Other Meds: None

Current Illness: Sinus infection two weeks prior, took DayQuil day and night as treatment.

ID: 1457222
Sex: F
Age: 45
State: LA

Vax Date: 01/05/2021
Onset Date: 03/03/2021
Rec V Date: 07/08/2021
Hospital: Y

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

Lab Data: MRI; EKG; CT.

Allergies:

Symptom List: Unevaluable event

Symptoms: I have tremors, full body conviction, and paralysis in lower body since June 8th. I have severe headaches, vision loss, and light flashes. I have numbness in both lower and upper extremities. I had brain fog and memory lost. I was hospitalized for 5 days. They diagnosed with bilateral leg weakness. They did an MRI of complete spine, EKG, and a CT of brain with no contrasts. Everything came back normal.

Other Meds: Multivitamin.

Current Illness:

ID: 1457223
Sex: F
Age: 15
State: TX

Vax Date: 06/06/2021
Onset Date: 06/07/2021
Rec V Date: 07/08/2021
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: none

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

Symptoms: patient received first Pfizer vaccine and starting 1 day later developed easy bruising and petechiae found to be thrombocytopenic with platelet count of 30 then further progressed along with hemolytic anemia ADAMTS13 activity 0% , clinical picture consistent with acquired thrombotic thrombocytopenia purpura (TTP) requiring therapy with high dose steroids, plasmapheresis and rituximab

Other Meds: none

Current Illness: none known

ID: 1457224
Sex: F
Age: 37
State: MA

Vax Date: 02/08/2021
Onset Date: 07/07/2021
Rec V Date: 07/08/2021
Hospital:

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

Lab Data: PCR Covid 19 Vaccination

Allergies: unknown

Symptom List: Injection site pain, Pain

Symptoms: Fully vaccinated individual developed COVID 19 symptoms of fever, cough, nasal congestion on 7/7/21

Other Meds: unknown

Current Illness: unknown

ID: 1457225
Sex: M
Age: 73
State: AZ

Vax Date: 05/21/2021
Onset Date: 05/22/2021
Rec V Date: 07/08/2021
Hospital:

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

Lab Data: None

Allergies: NONE

Symptom List: Injection site pain, Menorrhagia

Symptoms: Sweats, chills and gastro issues, headaches and couldn't eat a lot.

Other Meds: Alixs; hypothyroid; medications for renal insufficiency; neuropathy; low back spinal pain; gastric problems; extended pulse

Current Illness: None

ID: 1457226
Sex: F
Age: 60
State: TX

Vax Date: 04/24/2021
Onset Date: 05/11/2021
Rec V Date: 07/08/2021
Hospital:

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

Lab Data: 7/6/2021 - because of VERTIGO, i blacked out and fell 06/22/2021. Chest pains and breathing issues, went to hospital ER

Allergies: None

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

Symptoms: BPPV VERTIGO, NO TREATMENT, BUT MANEUVERS. IN GOOD HEALTH UNTIL I TOOK VACCINE. Last shot 4/24/2021 - BPPV VERTIGO - 5/11/2021

Other Meds: None! I was healthy!

Current Illness: None

ID: 1457227
Sex: M
Age: 34
State: MI

Vax Date: 06/16/2021
Onset Date: 07/07/2021
Rec V Date: 07/08/2021
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: none

Allergies: None known

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Patient presented to receive 2nd dose of Pfizer, did not have vaccine card. We used a database to verify the apparent 1st dose. This is when it was discovered that the patient had received Johnson and Johnson in March 2021 and Pfizer from 6/16/2021 (which we did administer). We did not proceed with another dose.

Other Meds: None known

Current Illness: None known

ID: 1457228
Sex: M
Age: 51
State: MO

Vax Date: 07/07/2021
Onset Date: 07/07/2021
Rec V Date: 07/08/2021
Hospital:

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

Lab Data:

Allergies: NONE

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Patient stated that after he received his vaccine he had headaches, and arm pain. Patient also said that his right jaw is numb. Patient didn't seek medical attention yet, Patient stated that he is still having Adverse Event.

Other Meds: NONE

Current Illness:

ID: 1457229
Sex: F
Age: 53
State: HI

Vax Date: 05/11/2021
Onset Date: 07/07/2021
Rec V Date: 07/08/2021
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: Component 7/7/2021 SARS-COV-2 NAA (COVID-19) Detected (A)

Allergies: None

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

Symptoms: +COVID infection after completing vaccine series

Other Meds: Losartan 50mg daily

Current Illness: None

ID: 1457230
Sex: F
Age: 19
State: VA

Vax Date: 05/19/2021
Onset Date: 05/21/2021
Rec V Date: 07/08/2021
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: Fever, chills and shaky muscles the night of my second dose. Three days later, I had swollen lips and lymph nodes as well as body aches and a closed throat. Took Benadryl and symptoms went away within a week.

Other Meds: Birth control

Current Illness: Sore muscles, chills, high fever

ID: 1457231
Sex: F
Age: 22
State: CA

Vax Date: 03/19/2021
Onset Date: 05/04/2021
Rec V Date: 07/08/2021
Hospital:

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

Lab Data: MRI of brain(June 2021), cervical spine( June 2021), chest x-ray(June 2021), X-ray of neck (may 2021), blood draw (may 2021), urine test (may 2021), EMG and EKG (June 2021)

Allergies: Norco, z-pack

Symptom List: Injection site pain

Symptoms: Dizziness and lightheadedness, turned into neck pain, nerve pain down right and left arm, back pain, loose hip joints, hip pain, cervical headaches

Other Meds: Zoloft, 50 mg upped to 75mg in mid-may Notrel 1/35

Current Illness: Depression and anxiety

ID: 1457232
Sex: F
Age: 76
State: FL

Vax Date: 04/22/2021
Onset Date: 04/23/2021
Rec V Date: 07/08/2021
Hospital:

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

Lab Data: None

Allergies: I am allergic to Caffeine; Nicotine; Tetracycline; Penicillin; Codeine

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

Symptoms: I woke up feeling nauseous, dizziness and challenging to walk and a lot of coughing. I went to the dr and he gave me prednisone.

Other Meds: I take Flonase; Allegra

Current Illness: None

ID: 1457233
Sex: M
Age: 52
State: NJ

Vax Date: 04/06/2021
Onset Date: 04/28/2021
Rec V Date: 07/08/2021
Hospital:

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

Lab Data: I was taken to where I had a series of blood work done, MRI of my brain and cervical vertebral column. chest x-rays and several Neurological tests preform by several Neurologist.

Allergies: none

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

Symptoms: I have severe pain in my leg muscles and bi-ceps in both arms, I'm extremely lethargic at all times of day. I also have burning sensation in my leg calf nerves and forearms. I have also slight pain in my chest. I also have finger cramping when I wake up in the morning. slight lost in memory.

Other Meds:

Current Illness: none

ID: 1457234
Sex: M
Age: 25
State: IA

Vax Date: 01/28/2021
Onset Date: 02/20/2021
Rec V Date: 07/08/2021
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: none

Symptom List: Tremor

Symptoms: about a month later i got a weird ringing in my ear I went to the Ent and doctors and they couldn't find any infection

Other Meds: QUICKAPLINE, zydrophic, ibuprofen

Current Illness: none

ID: 1457235
Sex: F
Age: 59
State: CO

Vax Date: 06/17/2021
Onset Date: 06/17/2021
Rec V Date: 07/08/2021
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: None

Symptom List: Erythema, Pruritus

Symptoms: Sudden severe tinnitus.

Other Meds: Vitamin D, multi vitamin.

Current Illness: None

ID: 1457236
Sex: M
Age: 18
State: VA

Vax Date: 06/18/2021
Onset Date: 06/18/2021
Rec V Date: 07/08/2021
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: Sycopal episode. BP 110/60 pulse 59 Resp 16.

Other Meds:

Current Illness:

ID: 1457237
Sex: M
Age: 12
State: MN

Vax Date: 05/20/2021
Onset Date: 05/20/2021
Rec V Date: 07/08/2021
Hospital:

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

Lab Data: COVID-19 Pfizer vaccine (first dose)

Allergies: none

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

Symptoms: Within two hours after having the first dose of the vaccine, he broke out in hives (small red bumps) on his back and upper arms. There were several bumps, but mostly concentrated on his upper back. He said it was itchy. We gave him benadryl. The bumps stopped itching within about an hour and were gone the next morning (we looked at around 8am).

Other Meds: none

Current Illness: none

ID: 1457238
Sex: F
Age: 55
State: VA

Vax Date: 03/13/2021
Onset Date: 05/31/2021
Rec V Date: 07/08/2021
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: Codeine

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Chills Fever Hot Flashes Headache Dizzy Nauseous Hand felt frostbite Fatigue Visions of me helping someone roll away the boulder at the tomb

Other Meds: Ramipril Plavix Metoprolol MegaRed COQ10 Vitamins C D E Iron Aspirin Welchol Collagen Peptids Pantoprazole Probiotics

Current Illness: None

ID: 1457239
Sex: M
Age: 47
State: TX

Vax Date: 06/21/2021
Onset Date: 06/21/2021
Rec V Date: 07/08/2021
Hospital:

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

Lab Data: n/a

Allergies: n/a

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

Symptoms: Moderna was given to patient 1 day after expiration day on vial. Called manufacture and they recommended no need to revaccinate patient.

Other Meds: n/a

Current Illness: n/a

ID: 1457240
Sex: F
Age: 37
State: OH

Vax Date: 05/17/2021
Onset Date: 05/19/2021
Rec V Date: 07/08/2021
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: BLOOD WORK

Allergies: CODINE LATEX EUCALYPTUS ZOMIG OMICILLIAN

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

Symptoms: SPOTTING COVID TONGUE

Other Meds: IUD BIRTH CONTROL CELEXA MELATONINE VITAMIN D3 TYLENOL GARLIC BIOTINE MULTI VITAMIN MAGENESUIM CALCIUM POTASSIOM TUMERICK

Current Illness: NONE

ID: 1457241
Sex: M
Age: 29
State: NJ

Vax Date: 07/07/2021
Onset Date: 07/08/2021
Rec V Date: 07/08/2021
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: N/A

Symptom List: Pain in extremity

Symptoms: Patient is having arm pain and swelling at injections site. he is experiencing shooting and burning sensations from injection to the elbow recommended tylenol, cold pack and talk in primary md

Other Meds: N/A

Current Illness: N/A

ID: 1457242
Sex: M
Age: 50
State: TN

Vax Date: 07/01/2021
Onset Date: 07/02/2021
Rec V Date: 07/08/2021
Hospital:

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

Lab Data: None

Allergies: NKDA

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

Symptoms: Achiness, chills, headache over several days, resolved in part by Tylenol 1000mg, q 4 hr p.o. daily

Other Meds: Meloxicam, testosterone, anastrazole, trazodone.

Current Illness: None

ID: 1457243
Sex: F
Age: 41
State: TX

Vax Date: 06/14/2021
Onset Date: 06/16/2021
Rec V Date: 07/08/2021
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: Patient claimed that a mess or swollen tissue developed gradually during the a few days after she received the first dose on 06/14/2021. The mess was under the skin on the upper left chest (she got the shot on left arm). There was never any side effects around the inject site on the left arm. The mess was about the size of a chicken egg and she could feel pain if you touch or sqeeze it. She received the 2nd dose on the other side (right arm) 07/03/2021. I called her to follow up on 07/08/2021 and she said there had been no adverse effect from the 2nd dose, also the mess from the first dose was getting better. She did not seek any medical attention for this issue likely due to cost/insurance concern.

Other Meds:

Current Illness:

ID: 1457244
Sex: F
Age: 54
State: FL

Vax Date: 03/20/2021
Onset Date: 07/07/2021
Rec V Date: 07/08/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Pt hospitalized with COVID 19 post vaccination.

Other Meds:

Current Illness:

ID: 1457245
Sex: F
Age: 54
State: OR

Vax Date: 03/18/2021
Onset Date: 06/23/2021
Rec V Date: 07/08/2021
Hospital:

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

Lab Data: positive covid 19 NAAT ( cepheid) on June 23

Allergies: lisinopril

Symptom List: Vomiting

Symptoms: positive covid test with cough and headache, fatigue: resting at home, elective procedure canceled for at least 3 weeks, treatment for headache and cough; did not require any ER or hospital treatment. Several virtual telehealth visits

Other Meds: atorvastatin 20 mg q day; gabapentin 100 mg AM and 300 mg HS, losartan 100 mg q day, HCTZ 25 mg daily, Liraglutide 1.8 cc q day; vit D 50000IU once a month, diclofenac gel prn, hydrocortisone cream 1% prn, miralax prn, acetaminophen prn

Current Illness: DM, obesity, low back and right knee pain, hyperlipidemia, Biceps femoris tendon strain at knee Fecal occult blood positive

ID: 1457246
Sex: F
Age: 41
State: FL

Vax Date: 07/06/2021
Onset Date: 07/07/2021
Rec V Date: 07/08/2021
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: Penicillin

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Patient called today (7/8/21) complaining of shortness of breath and rapid heart rate

Other Meds:

Current Illness: Patient has a pacemaker

ID: 1457247
Sex: F
Age: 58
State: NJ

Vax Date: 03/15/2021
Onset Date: 07/01/2021
Rec V Date: 07/08/2021
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: PCR 7/5/2021 positive for Covid

Allergies: none known

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

Symptoms: Also received COVID19 Pfizer vaccine #2 on April 5 at same location. On July 1, client had nasal congestion and loss of taste and smell. Tested positive PCR on 7/5 for Covid. VAERS report submitted because client is fully vaccinated and tested positive with symptoms for Covid.

Other Meds: none known

Current Illness: none known

ID: 1457248
Sex: F
Age: 46
State: WI

Vax Date: 01/28/2021
Onset Date: 04/26/2021
Rec V Date: 07/08/2021
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: Based on documentation from case investigation interview on 04/29/2021, "Case only got tested because she was scheduled to have surgery done. She is asymptomatic and fully vaccinated."

Other Meds:

Current Illness:

ID: 1457249
Sex: M
Age: 32
State: TX

Vax Date: 06/21/2021
Onset Date: 06/21/2021
Rec V Date: 07/08/2021
Hospital:

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

Lab Data: N/A

Allergies: n/a

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

Symptoms: Moderna was given to patient 1 day after expiration day on vial. Called manufacture and they recommended no need to revaccinate patient.

Other Meds: n/a

Current Illness: n/a

ID: 1457250
Sex: F
Age: 57
State: WI

Vax Date: 04/05/2021
Onset Date: 04/06/2021
Rec V Date: 07/08/2021
Hospital:

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

Lab Data: none

Allergies: drug allergies

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

Symptoms: i felt dizzy had a fever, ache and pains

Other Meds: asterdoile, hydrocide, D3, fish oil, magnesium, one a day, clairtin, migraine medication

Current Illness: none

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am