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
46,870MODERNA
532GLAXOSMITHKLINE BIOLOGICALS
353PFIZER\BIONTECH
231MERCK & CO. INC.
221UNKNOWN MANUFACTURER
62SEQIRUS, INC.
25DYNAVAX TECHNOLOGIES CORPORATION
13EMERGENT BIOSOLUTIONS
12SANOFI PASTEUR
9NOVARTIS VACCINES AND DIAGNOSTICS
5PFIZER\WYETH
5PAXVAX
2TEVA PHARMACEUTICALS
2PROTEIN SCIENCES CORPORATION
1BERNA BIOTECH, LTD.
1INTERCELL AG
1CSL LIMITED

COVID19 Lot Number

VAX LOT Total
2S9CL1,906
1,575
289
IMM209286
252
236
229
s029456178
171
UT7065MA166
155
149
145
S034636133
107
U62828AA103
100
98
P10025327596
U6737AA85
UJ446AA79
78
78
59
57
4BH3254
4F47253
52
27656352
50
PP9L548
49TM346
42
40
38
MENVEO38
4F47237
R1B252M36
34
C5763AA30
93362229
25
300057A24
UNK24
22
CW311621
18
17
15
UH894AB15
3Y7NL12
R1B743M12
EJ168611
el128410
10
10
10
9
ARBA141A9
UNK9
8
UNK8
8
1F4EB8
Unknown7
7
No batch number6
5
5
UJ090AA5
5
5
4
4
4
UNK4
JEV18K95E4
UNK3
A115A3
Z127A3
3
3333324181073
2
2
2
TAR352
1
1
1
1
1
A739081
1
1
1
1
1
037K20A68,542
EL128447,700
133

Incidents per State

State Total
15,185
CA14,096
NY7,507
TX7,196
FL6,939
IN5,527
PA4,560
IL4,179
OH4,054
AZ3,856
MI3,771
NJ3,411
MA3,278
VA3,208
NC3,114
WA3,034
GA2,864
MD2,652
MN2,534
CO2,532
WI2,457
MO2,029
OR1,943
TN1,715
CT1,693
KY1,603
OK1,226
AL1,201
KS1,162
IA1,157
SC1,106
NM1,065
UT973
AR951
LA945
NE829
NV797
ME795
MT789
NH756
ID674
AK661
WV661
PR650
MS585
HI536
RI510
VT441
SD361
ND356
DE350
DC239
WY209
GU32
AS16
VI13
MP9
MH3
FM2
QM1
XB1

ID: 0970643
Sex: F
Age: 64
State: PA

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: none.

Allergies: Penicillin

Symptoms: About 3 hours before bedtime she started having decreased sensation of her left hand. Involved her entire left hand from the wrist down. By morning, her numbness had resolved entirely.

Other Meds: Lipitor, Synthroid, Effexor, and Ambien

Current Illness: None

ID: 0970644
Sex: F
Age: 49
State: IN

Vax Date: 01/23/2021
Onset Date: 01/25/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: None yet. I have contacted my doctor, but have not heard back from her yet.

Allergies: N/K

Symptoms: Swollen lymph node/gland w/ tenderness in the left arm Pitt

Other Meds: 600 mg of Ibuprofen right before injection and every 6-8 hrs after injection

Current Illness: N/K

ID: 0970645
Sex: F
Age: 22
State: MD

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: n/a

Allergies: nuts

Symptoms: 6:40: complains of tingling 5 mins after shot, continued for 15 mins on and off; informed MD; stayed another 15 mins for observation, developed a rash on arm; received 25 mg IM of Benadryl. Symptoms resolved by 1855.

Other Meds: n/a

Current Illness: none

ID: 0970646
Sex: F
Age: 53
State: GA

Vax Date: 01/15/2021
Onset Date: 01/18/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: COVID test negative 12/24/21

Allergies: NKDA

Symptoms: First day after does I felt fine. A little soreness at injection site. But overall fine. Did yard work all weekend kind Sat and Sunday. Went to work on Monday was fine. Came home did peloton 45 min and then did more yard work with my husband. That night I became extremely sore and tired went to bed at 9 pm. That next day would be Tuesday the 19th I was tired all morning very low energy. Then by 130pm it hit me like a ton of bricks, extreme fatigue and chills. Drove myself home, almost did not think I could drive the entire way home ( about a 20 min ride). Made it home went straight to bed, body ache, chills, fever101.6 and smashing headache. Called out of work for Wed Jan 20th. I am an RN at an outpatient orthopedic facility. I have not missed a work day in 9 years. I exercise 6-7 days per week. I am never sick! I continue to run fever until Thursday pm. No fever on Friday the 22nd. Just continue with extreme fatigue, smashing headache and dizziness. I decide by Sunday January 24th to go get tested for COVID and did a rapid test and it came back negative. I was told to report my adverse reaction. Today I feel better, first day I have not woken up with a headache. Have developed a slight headache not as bad. Continue with the fatigue. I would like to report this and have someone contact me. I do not know what to do about the second does! This has hit me so hard. Thank you!

Other Meds: Allegra, vitamin C, D3, Zinc

Current Illness: None

ID: 0970647
Sex: F
Age: 46
State: MD

Vax Date: 01/08/2021
Onset Date: 01/09/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: n/a

Allergies: sulfa

Symptoms: redness, swelling, pain within 24 hours of injection. Swelling & pain subsided with in 2 days. Raised red mark (approx. 2 inches around was present for almost 2 weeks. Raised mark has subsided, but still faint redness.

Other Meds: multivitamin, Advil prn

Current Illness: n/a

ID: 0970648
Sex: M
Age: 58
State: CA

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: None

Allergies: Gluten, Vicodin.

Symptoms: 100F fever from 2pm - 6pm. 98F at bedtime. Normal temperature in the morn upon awaking at 6:30am.

Other Meds: None

Current Illness: None

ID: 0970649
Sex: F
Age: 22
State: MD

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: n/a

Allergies: nuts

Symptoms: 6:40: complains of tingling 5 mins after shot, continued for 15 mins on and off; informed MD; stayed another 15 mins for observation, developed a rash on arm; received 25 mg IM of Benadryl. Symptoms resolved by 1855.

Other Meds: n/a

Current Illness: none

ID: 0970650
Sex: F
Age: 40
State: FL

Vax Date: 01/12/2021
Onset Date: 01/13/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies: Mushrooms, Singulair, mold, cockroach and dust allergies

Symptoms: Patient experienced welt , warm area of vaccine and large reaction on injection sit the following morning after the vaccine was given. She was started on a daily dose of Allegra in the am Pecid around lunch time and Xyzal at night symptoms started to get worse around the fourth day after injection her local reaction increased in size it became about the size of a large orange it became a welt and was very hot to touch. She was applying cold compress as instructed and started applying one percent hydrocortisone cream with no relief. Throughout the following week she noticed when she forgot to take her antistamine at night she could not stop coughing and was sneezing and clearing her throat and the vaccine area had become extremely itchy and had flared up in size and warmness she took flonase nasal spray, 40mg of prednisone and took xyzal to help with the symptoms. She immediately reported the reaction to MD this am.

Other Meds: Flonase sensimist, Allegra, Pepcid, Xyzal, Otc Iron Supplement, took Motrin after the vaccine due to patient feeling warm after vaccine but no fever.

Current Illness: Anemia

ID: 0970651
Sex: F
Age: 51
State: IA

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: none

Allergies: NKDA

Symptoms: Hives - treated with Benadryl oral and epinephrine 1:1000, 0.5 mg IM. After 10 minutes, she had significant improvement in her symptoms, though some persistent urticaria yet (they are fading more anteriorly than posteriorly). This dose was repeated with essential resolution of her symptoms.

Other Meds: None

Current Illness: none

ID: 0970652
Sex: F
Age: 42
State: NJ

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies: Avelox, Doxycycline, Influenza Vaccine, Tdap, Valtrex, nuts, and seafood

Symptoms: Vaccine recipient received vaccine on 1/21/2021. Approximately 5 minutes after receiving the vaccination developed scratchy throat, hoarseness, and a rash over entire body. Patient self-medicated with diphenhydramine, cimetidine, and a steroid from her own emergency kit. She was sent to the emergency department and she was given an additional diphenhydramine 25 mg and epinephrine 0.3 mg. She has a history of adverse reactions to vaccines in the past. In the ED when she was reexamined her condition improved and she was discharged to home.

Other Meds: Diphenhydramine, prednisone, cimetidine, and epinephrine as needed for allergic reactions.

Current Illness: None

ID: 0970653
Sex: F
Age: 41
State: NY

Vax Date: 01/19/2021
Onset Date: 01/20/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: Covid rapid test on 1/24/21-negative, PCR pending

Allergies: None

Symptoms: Following the 1st dose- arm soreness and pain at injection side. 2nd dose- axilla pain on the right, flu like symptoms, headache, joint pain followed by migraine headache on day 3 post second dose. On Saturday day 4 hives, itching all over the body. Treated with oTC Benadryl 50mg q 6hrs. On day 5 the rash was more severe. Contacted PCP and was prescribed prednisone 20mg daily. Day 6- today, rash slightly improved but still present and itchy. Feeling weak and dizzy.

Other Meds: Vesicare

Current Illness: None

ID: 0970654
Sex: F
Age: 31
State: NH

Vax Date: 01/12/2021
Onset Date: 01/13/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: no treatment

Allergies: mild allergy pineapple

Symptoms: Day after injection on 1/13/21 Left arm became "looked like bee sting" red, swollen, sore, hardened area at injection site, day 2 c/o itchiness.

Other Meds: allegra and omiprizole

Current Illness: no

ID: 0970655
Sex: M
Age: 53
State: NJ

Vax Date: 01/13/2021
Onset Date:
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies: Nothing

Symptoms: Jaw pain it?s random for 5 days

Other Meds: Nothing

Current Illness: Nothing

ID: 0970656
Sex: F
Age: 38
State:

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: extreme back pain, paralysis down arms

Other Meds:

Current Illness:

ID: 0970657
Sex: F
Age: 43
State: MD

Vax Date: 01/13/2021
Onset Date: 01/24/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies: Sulfas

Symptoms: Large elliptical rash, raised and itchy, developed 1 inch below injection site.

Other Meds: None

Current Illness: DAY OF VACCINATION: 5 minutes post vaccination, I experienced tingling in my left hand (vaccination was in left arm) then my right hand. Tingling resolved within 2-3 minutes. I also experienced mild swelling in back top of throat. Swelling lasted aprox. 30 mins and remained mild, then resolved.

ID: 0970658
Sex: M
Age: 62
State: FL

Vax Date: 01/14/2021
Onset Date: 01/18/2021
Rec V Date: 01/25/2021
Hospital: Y

Lab Data: I had a CAT scan. I had a chest x-ray. I had many blood tests. This may not be the complete number of medical tests I had. I do not have access to the results of these tests. If necessary, I will follow whatever procedures are necessary for me to obtain them from the hospital.

Allergies: Benadryl

Symptoms: On January 18, 2021, I experienced extreme weakness of both legs to the extent that I was unable to stand. I experienced an exacerbation of baseline numbness over many areas of my body. I had an elevated resting heart rate of over 108 bpm. I was transported by ambulance to that afternoon. I was admitted in the early morning hours of January 19, 2021. I was diagnosed with, "Exacerbation of multiple sclerosis; SIRS (systematic inflammatory response syndrome). I was given multiple intravenous antibiotics. I had a CAT scan. I had a chest x-ray. I had many blood tests. The adverse event resolved on its own. I was discharged January 16, 2021.

Other Meds: Gabapentin Oxybutynin Flomax Vitamin B-12 Ocrevus

Current Illness:

ID: 0970659
Sex: F
Age: 54
State: OH

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: Nine

Allergies: None

Symptoms: Started to get hives on my right hand/knuckles, behind my right ear and on the ear/had them on my neck. Also, had a headache.

Other Meds: None

Current Illness: None

ID: 0970660
Sex: F
Age: 60
State: IN

Vax Date: 01/10/2021
Onset Date: 01/10/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: blood work

Allergies: none

Symptoms: pt stated she is agitated, brain is foggy, severe bone pain, joint pain, right arm completely swollen (this symptom subsided after a little over a week), muscle weakness, both hands are extremely weak, has excruciating pain in left arm and limited range of motion, intensified neuropathy.

Other Meds: Norco 10-325, meloxicam 15mg, trazadone 100 mg, methocarbamol, gabapentin300 mg, walnut-calcium-magnesium-zinc vitamin

Current Illness: nasal allergies

ID: 0970661
Sex: F
Age: 54
State: AL

Vax Date: 01/13/2021
Onset Date: 01/20/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: Went to urgent care 1/24/2021. They refused to treat due to it being COVID-19 vaccine related.

Allergies: All antibiotics except doxicycline

Symptoms: Extreme pain with swelling of left upper arm at injection site. Pain and swelling continues down arm to hand. Started 1/20/2021 and continues to worsen. Pain unbearable.

Other Meds: bisoprolol norco xanex levathyroxine

Current Illness: none

ID: 0970662
Sex: F
Age: 55
State: MI

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 01/25/2021
Hospital: Y

Lab Data: Echo the ultra sound of heart was normal Blood test that showed Potassium was low 3.2

Allergies: No allergies

Symptoms: I had vaccine at 8:30 and 11 i started having palpitations and chest pressure and light headed and diaphoretic while i was at work. i continued to work and didn't go home until close to 4pm, i thought it would go away like the first time but it didn't, i went home and laid down and took a zanax and it didn't go away. the next morning i went to the ER and they put me on a telemetry monitor and i was having bigeminy and palpitations and i thought my heart was going to come out of my chest and was hurting they gave me 4mg of morphine, 2 hrs they gave me more morphine, i was nauseated they gave me Zofran then it finally subsided later but till had bigeminy and chest pressure, they admitted me and i stayed overnight. i had the PVC and bigeminy slowed down i had an echo and it was normal the potassium was low and they gave me kedar, i was still ight headed and nauseated they gave me Zofran prn it was 4-5 doses they gave me IV fluid, my fever with up to 100.4, i was not really eating that 24 hrs because i was afraid to throw up. the doctor gave me meds to take home to manage light symptoms . i went home and felt tired and had more palpitations when i move around too much and I'm still having issues today. i have not gone back to work since the vaccination and have an appointment with cardiologist 2:pm tomorrow and today I will see my PCP at 1pm. I have not recovered and still having issues and very tired.

Other Meds: Norvasc 5mg pm, Neurontin 300mg pm, vitamin c, magnesium 300mg pm, fish oil 2000mg, once a day vitamin, lipoic acid , NAC 600mg

Current Illness: None

ID: 0970663
Sex: F
Age: 58
State:

Vax Date: 01/25/2021
Onset Date: 01/25/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: 9:20 Feeling Itchy Heart rate 80 Blood pressure 112/68 9:30 symptoms better, apple juice given 9:37 heart rate 80 blood pressure 108|68 symptoms have stopped 9:40 No rash, hives or difficulty breathing. Works at hospital to inform supervisor for any further problems

Other Meds:

Current Illness:

ID: 0970664
Sex: M
Age: 34
State: PR

Vax Date: 01/15/2021
Onset Date: 01/22/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies: nka

Symptoms: after 7 days of received the 1 dose irritation start to show up at up left arm, pain in joints and itching

Other Meds:

Current Illness:

ID: 0970665
Sex: F
Age: 69
State: FL

Vax Date: 01/14/2021
Onset Date: 01/21/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies: sulfa drugs

Symptoms: Approximately one week after receiving the vaccine my upper arm started to itch quite a bit. Now, although it doesn't itch too much, the upper arm is covered in what appears to be a red rash.

Other Meds: none

Current Illness: none

ID: 0970666
Sex: F
Age: 29
State: NY

Vax Date: 01/24/2021
Onset Date: 01/25/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies: gluten garlic

Symptoms: I received the COVID Vaccine yesterday (1/24/21) around 12:10pm. I experienced no effects while waiting the allotted 30 minutes. The next morning, January 25th 2021, I started to experience arm soreness and blurry vision. The blurry vision is worse in my left eye. My vision has not improved after waking up, taking a shower and putting saline drops in both eyes. The best way to describe the sensation is hazy, blurry and sometimes double vision.

Other Meds: Melatonin Buspirone Tri-Sprintec Tablets 28s

Current Illness: N/A

ID: 0970667
Sex: F
Age: 57
State: FL

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies: Sulfa, PCN

Symptoms: Supraclavicular lymphadenopathy

Other Meds: Lisinopril

Current Illness:

ID: 0970668
Sex: F
Age: 53
State: PA

Vax Date: 01/18/2021
Onset Date: 01/19/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Abdomoinal Pain, Nausea and vomiting, body aches and fatigue.

Other Meds:

Current Illness:

ID: 0970669
Sex: F
Age: 29
State: MA

Vax Date: 12/24/2020
Onset Date: 01/21/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: I was about due to start menstruation around the time of dose 1. I have not menstruated since late november/early december at this point in time. There is no possibility of this delay in menstruation being pregnancy related. I have no other known GYN issues.

Other Meds: Chaste Tree Berry Milk Thistle Magnesium 250mg Vitamin D 2000 mu Phytomulti multivitamin Allergra

Current Illness: none

ID: 0970670
Sex: F
Age: 81
State: GA

Vax Date: 01/13/2021
Onset Date: 01/23/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: patient states that initially she had no issued other than a sore arm. 11 days after she received the vaccine the arm she received the vaccine in stated to itch. Patient states that she had been taking Benadryl but arm is still itching. patient states that arm is red but that she doesn't notice an actual rash. Advised patient to contact her primary care doctor to notify him of reaction and for his recommendation of how she needs to treat it. Patient voiced understanding.

Other Meds: Atenolol, HCTZ, Amlodipine, Escitalopram, Baby Asprin, Levethoroyxine, Simvistatin (Since 2001)

Current Illness: None per patient

ID: 0970671
Sex: M
Age: 32
State: PA

Vax Date: 01/24/2021
Onset Date: 01/24/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: N/A

Allergies: N/A

Symptoms: Chills, Headache, Body Aches, Fatigue occurred around 5PM. Fever (103) began around 7:30PM.

Other Meds: Vitamin D, Goli gummies, multivitamin, sertraline, fish oil

Current Illness: N/A

ID: 0970672
Sex: F
Age: 50
State:

Vax Date: 01/23/2021
Onset Date: 01/23/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Employee c/o of itchy throat within 15 minutes of vaccine administration. Employee was observed a total of 45 minutes. After 45 minutes, states throat itchiness is gone. No other symptoms noted. Vital signs = BP 141/86, HR= 72, Puls Ox = 99%

Other Meds:

Current Illness:

ID: 0970673
Sex: F
Age: 77
State: RI

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies: occasionally if I eat shellfish I can get a combination

Symptoms: About 10 minutes after receiving the vaccine, I was sitting in a well organized waiting area I started feeling flames in my throat. My throat was literally on fire. I raised my hand as I was instructed to do. I asked for water, they brought me a bottle water, I started to drink it. My throat was having a difficult time swallowing. They brought me over to nursing area. I went into this area and the nurses were there. They made me take my mask off, they took my blood pressure was way lower then normal (110/30). Then they gave me 50MG Benadryl. They called EMS and I refused to go. I had to wait at the clinic until the Benadryl took effect. The "flame" feeling began to lessen. When I got home I took another dose of Benadryl. The "flame" feeling went away but then I was left with a sore throat for the rest of the night and the following morning. It felt like there was an actual fire in my throat that the Benadryl put out but then it felt as if the after effects of a burn in my throat. I do have a call in to my primary care provider and still waiting for a call back.

Other Meds: Norvasc 10 mg once a day,

Current Illness:

ID: 0970674
Sex: F
Age: 45
State: OH

Vax Date: 01/12/2021
Onset Date: 01/18/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies: n/a

Symptoms: Immediately after receipt of the vaccine, I experienced significant arm pain that lasted about three - four days. This was not concerning because I also have arm pain when I receive the flu shot. Nearly a week after the injection, I noticed my arm was warm and I also had a rash that was contained to the upper part of my arm. This lasted about two days and then it became itchy as the rash went away. It was not significant enough to seek medical treatment, although I did report it to employee health as directed and they advised over the counter remedies.

Other Meds: Sprintec birth control.

Current Illness: n/a

ID: 0970675
Sex: F
Age: 65
State: GA

Vax Date: 01/01/2021
Onset Date: 01/24/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: None yet

Allergies: Tetanus vaccine

Symptoms: Distortion in hearing. Feeling of clogged ears. Sounds are amplified

Other Meds: Estradiol and Norethindrone acetate tablets 0.5mg/0.1mg Pepcid AC Multi vitamin Fish oil, Vitamin D , flaxseed oil, vitamin B12, coq 10, magnesium, calcium, glucosamine chondroitin, probiotic

Current Illness: GERD

ID: 0970676
Sex: F
Age: 34
State: MS

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies: Sulfa, Penicillin, dairy

Symptoms: Big red welt on arm at injection site that started the day I got the shot. Hot to the touch. I took Claritin during the day and Benadryl hat night. It grew overnight and was the size of a tennis ball the next day. It was hard and hot to the touch. Over the course of the weekend it grew to the size of a softball and was tender, hard, red and hot to the touch. It is currently still red and itches. It is not as hard and it is still big. I did take Benadryl every night to try and calm it down. I also iced my shoulder.

Other Meds: None

Current Illness: None

ID: 0970677
Sex: F
Age: 0
State: CA

Vax Date: 01/25/2021
Onset Date: 01/25/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies: PCN

Symptoms: Left arm redness and swelling. Nine days after vaccine given

Other Meds: Lisinopril Prilosec

Current Illness: n/a

ID: 0970678
Sex: F
Age: 78
State: CT

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: Pt followed up with allergist

Allergies: Crustacean shellfish (e.g. crab, lobster, shrimp);Medication(s).Penicillins.I am able to tolerate cefuroxime

Symptoms: Pt received her first dose of COVID19 vaccine on 1/13/2021 at the health department clinic. Pt then called the health department on 1/19/2021 stating once she got home her bottom lip swelled up and so did her eye lids. On 1/19/2021 the pt reported she could not speak with me (RN) further as she was about to go on a zoom meeting with her allergist to discuss the event. RN asked pt to call the LHD back. 1/20/2021 RN called pt to discuss further, pt stated she is in the grocery store and cannot speak. RN asked pt what the allergist recommended. Pt stated the allergist recommended getting the 2nd dose of the vaccine however with additional pre-medications. Pt stated she could not speak with RN further and would call me back. 1/25/2021 - pt did not call clinic back. RN called pt to get more details on the event. Pt reported her allergist would like her to get the 2nd injection in the hospital, while taking Singulair the night before and Zyrtec and Benadryl the day of. RN advised the pt her allergic reaction is a contraindication to receiving the 2nd dose per CDC guidelines. Pt verbalized understanding and will discuss with her allergist further. Pt also mentioned possible allergy to Polysorbate during call on 1/25/2021 however she reports because she tolerates Miralax on a regular basis her allergist does not believe it to be a true allergy. Pt did not mention this in VAMS. I was not the vaccinator.

Other Meds: none documented in VAMs other than penicillin? Which I believe the pt documented accidently as she stated it as an allergy over the phone.

Current Illness: None

ID: 0970679
Sex: F
Age: 35
State: CO

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies: NKA

Symptoms: Right facial numbness from cheek to jaw line. Weakness to jaw. Symptoms lasted 9 hrs and then reoccurred 9 days later.

Other Meds: multivitamin and goli

Current Illness: NA

ID: 0970680
Sex: F
Age: 78
State: MN

Vax Date: 01/22/2021
Onset Date: 01/23/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: nausea, chills, leg aches. Tylenol, ibuprofen and Benadryl. Lasted 48 hours

Other Meds: None

Current Illness: None

ID: 0970681
Sex: F
Age: 57
State: TX

Vax Date: 01/23/2021
Onset Date: 01/23/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: N/A

Allergies: N/A

Symptoms: Tiredness, chills, headache, body aches, loss of appetite, vomiting

Other Meds: Vitamin C, B12, multi-vitamin, Lipoflavonid, D3, collegen, biotin

Current Illness: N/A

ID: 0970682
Sex: M
Age: 68
State:

Vax Date: 01/07/2021
Onset Date: 01/19/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: 01/19/2021 developed chest pain, shortness of breath and fever 100.8. Went to ER and was diagnosed with acute pericarditis

Other Meds:

Current Illness:

ID: 0970683
Sex: F
Age: 49
State: GA

Vax Date: 01/05/2021
Onset Date: 01/11/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: none

Allergies: None

Symptoms: Approximately 1 week after receiving the vaccine I started to have a 50 cent size red rash that since has improved but is still visible.

Other Meds: Meloxicam

Current Illness: Joint pain

ID: 0970684
Sex: M
Age: 77
State: AL

Vax Date: 01/22/2021
Onset Date: 01/23/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Weak, dizziness, painful

Other Meds: Vit. B , fish oil, hha

Current Illness:

ID: 0970685
Sex: F
Age: 37
State: IN

Vax Date: 01/23/2021
Onset Date: 01/23/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: N/A

Allergies: Amoxicillin, tramadol, darvacet, gluten intolerance

Symptoms: injection site pain and swelling - 8 hours post injection and continued through time of form submission (1/25) Fever and chills - 12 hours post injection and continued through time of form submission (1/25) fever has been up to 100.6 and Tylenol has been taken to help.

Other Meds: Probiotic, Vitamins D and C, elderberry, Tylenol

Current Illness: N/A COVID early December

ID: 0970686
Sex: F
Age: 52
State: FL

Vax Date: 01/20/2021
Onset Date: 01/21/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: None.

Allergies: Flu vaccine caused hives about 30 years ago.

Symptoms: Received vaccine afternoon of 1/20. I am a hospital pharmacist and expected potential adverse reaction on 2nd vaccine based on moderna studies. I felt fatigued that evening and was starting to get a headache, so took 2 extra strength Tylenol and went to bed. Woke 1/21 with a headache, took 2 extra strength tylenol that morning. At noon, developed fever of 100F, chills, and worsening headache. Fever did not break until around 2am the following morning. Headache remained until 1/22 afternoon, then subsided.

Other Meds: Multivitamin, ASA 81mg, Tylenol, Coreg 3.125mg, Ortho-cyclen.

Current Illness: None

ID: 0970687
Sex: F
Age: 34
State: PA

Vax Date: 01/07/2021
Onset Date: 01/14/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: none ordered by urgent care

Allergies: Azithromycin

Symptoms: 1/14/21 Developed aching to my left underarm/armpit area while at rest. Aching has been ongoing and intermittent. 1/17/21 Developed left ear "fullness". On 1/20/21 went to GYN for exam, explained left underarm pain, told that my breast exam appeared normal, but she questioned if my left ear fullness and left under arm pain were related. 1/21/21 Left Ear "fullness" began to radiated causing left temporal pressure, spreading across forehead. Pressure developed behind both eyes. Sudden onset of dizziness occurred. Went to urgent care where they said I had swollen lymph nodes and believed I was having a auto immune response to something. Told I received the vaccine on 1/7/21, they said the symptoms could be related to the vaccine. 1/22/21 Notice I would occasionally feel like I had a "lump or pressure" to the side of my throat. As of present I am continuing to have Left Ear "fullness", left underarm aching, and bilateral eye pressure has bee intermittent yet ongoing.

Other Meds: Yaz birth control pill, Wellbutrin, Singulair, Asmanx

Current Illness: none

ID: 0970688
Sex: F
Age: 31
State: NH

Vax Date: 01/12/2021
Onset Date: 01/13/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: On 1/13 the day after the injection her left arm became swollen, hard, red like a bee sting and itchy.

Other Meds: Omiprazole, allegra

Current Illness: none

ID: 0970689
Sex: F
Age: 36
State: WI

Vax Date: 01/19/2021
Onset Date: 01/20/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies: NONE

Symptoms: NUMBNESS AND TINGLING ON LEFT LEG. IT STARTED ON LEFT HIP AND WENT DOWN TO LEFT FOOT.

Other Meds: NONE

Current Illness: NONE

ID: 0970690
Sex: F
Age: 64
State: VA

Vax Date: 12/30/2020
Onset Date: 01/03/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: None.

Allergies: none

Symptoms: Approximately 4 days after my first vaccine dose I experienced tinnitus in my ears, especially the left one. It is a loud, high pitched hissing noise. I have had tinnitus before but not this loud. It has persisted to this date.

Other Meds: Ziac, Omeprazole, Ativan, Benadryl, Multivits,Vit. B and D

Current Illness: High bp, anxiety, depression

ID: 0970691
Sex: F
Age: 62
State: ID

Vax Date: 01/21/2021
Onset Date: 01/22/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: "Moderna COVID-19 Vaccine EUA". Fever - 101.4, chills, headache, nausea, aches. Arm extremely sore. Fever lasted a few hours, other symptoms lasted over 2 days from start.

Other Meds:

Current Illness:

ID: 0970692
Sex: F
Age: 70
State: FL

Vax Date: 01/14/2021
Onset Date: 01/23/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: none

Allergies: iodine

Symptoms: 8 inch welt, red, swollen,itchy

Other Meds: estradiol 0.1mg patch, alprazolam 0.25mg tab, Advair 250/50

Current Illness: none

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm