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: 0971553
Sex: F
Age:
State: NC

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

Lab Data:

Allergies:

Symptoms: Dizziness; Tachycardia; This is a spontaneous report from a contactable other HCP. This other HCP reported for self that the 38-year-old female patient received first dose of bnt162b2 (BNT162B2, COVID-19 Vaccine, Lot#: EL0140, Expiry Date: 31Mar2021), via an unspecified route of administration on 05Jan2021 13:15 on Deltoid, Right at single dose for covid-19 immunisation. Medical history included she did get a monthly allergy injection about 3-4 weeks prior to the COVID-19 Vaccine. She said she did not have any reaction to the allergy shot, clarifying she has always done well with her allergy shots. Concomitant medications were none. She said she got dizzy for about 30 minutes afterwards, and then was all better. Caller asked if Pfizer has any guidance on how she should proceed with the second COVID-19 Vaccine dose. Caller was advised she would be transferred to Pfizer Medical Information for further assistance. Reported she got really dizzy approximately 10 minutes after receiving the COVID-19 Vaccine, and the dizziness lasted for about 30 minutes after that. She said the dizziness completely resolved. Reported she also got a little tachy (clarified as tachycardia) during the time period she was dizzy. She said she wasn't sure if she became tachycardic because she was worried when she became dizzy. She said the tachycardia resolved with the dizziness. No treatment was received. The events stared from 05Jan2021 and considered as Medically significant. The outcome of the events was recovered on 05Jan2021. Vaccination Facility Type was Hospital. No Vaccine Administered at Military Facility. History of all previous immunization with the Pfizer vaccine considered as suspect (or patient age at first and subsequent immunizations if dates of birth or immunizations are not available) was none. Additional Vaccines Administered on Same Date of the Pfizer Suspect was none. No AE was require a visit to: Emergency Room or Physician Office. Prior Vaccinations (within 4 weeks) was none. Relevant tests was none.; Sender's Comments: Based on the compatible temporal association, the vaccination with BNT162B2 might play a contributory role in triggering the onset of dizziness and tachycardia. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees and Investigators, as appropriate.

Other Meds:

Current Illness:

ID: 0971554
Sex: F
Age:
State: CT

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

Lab Data:

Allergies:

Symptoms: fell out of bed; This is a spontaneous report from a Pfizer-sponsored program Pfizer First Connect from a contactable consumer (patient's daughter). A female patient of unknown age received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, on 30Dec2020 at single dose for COVID-19 immunisation. Medical history and concomitant medications were unknown. After getting shot she fell out of bed and had to be hospitalized. Caller said had nothing to do with shot felt nursing home unsafe and moved to another home once released from hospital. New nursing home not scheduled to give 2nd shots until 28 days and wants to know if ok to wait that extra 8 days. Outcome was unknown. Information on the batch/lot number has been requested.

Other Meds:

Current Illness:

ID: 0971555
Sex: M
Age:
State: NC

Vax Date: 01/11/2021
Onset Date: 01/12/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Passed out; massive diarrhea; fell and hit his face; fell and hit his face; This is a spontaneous report from a contactable consumer. An 85-year-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 11Jan2021 at single dose for covid-19 immunisation. Medical history included epilepsy from an unknown date and unknown if ongoing (Caller says her father in law hasn't had seizure in years, it was diagnosed when he was a kid, 60-70 years ago). There were no concomitant medications. The reporter is calling on behalf of her father in law. She said he had his first dose of the COVID vaccine recently, she pulled this number off of the paperwork today. She says that she believes he had a side effect for it, and also he was rescheduled for his second dose. She says his second dose was supposed to be in 21 days but they rescheduled him for it at 18 days instead. She says he got the first dose on 11Jan, and they rescheduled his next for the 29th. She says she wanted to know if this was correct or ok. The reporter says that the following day he ended up having massive diarrhea, that it caused him while he was on the commode to pass out and he fell and hit his face, the best she can tell he was alone at the time. She says he did not go to the hospital for that, he got up and cleaned himself off and took a nap, and the nurse next door checked on him later on. The outcome of the events was unknown. Information on the lot/batch number has been requested.

Other Meds:

Current Illness:

ID: 0971556
Sex: F
Age:
State:

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

Lab Data:

Allergies:

Symptoms: Anaphylaxis; Persistent cough; This is a literature report were authors reported 21 cases listed in table 1. This is the 20th of the 21 patients. This report summarizes the clinical and epidemiologic characteristics of case reports of allergic reactions, including anaphylaxis and nonanaphylaxis allergic reactions, after receipt of the first dose of Pfizer-BioNTech COVID-19 vaccine during December 14-23, 2020, in the United States. As of 23Dec2020, a reported 1,893,360 first doses of Pfizer-BioNTech COVID-19 vaccine had been administered and reports of 4,393 (0.2%) adverse events after receipt of Pfizer BioNTech COVID-19 vaccine had been submitted to the Reporting System. Among these, 175 case reports were identified for further review as possible cases of severe allergic reaction, including anaphylaxis. Anaphylaxis is a life-threatening allergic reaction that does occur rarely after vaccination, with onset typically within minutes to hours. Twenty-one cases were determined to be anaphylaxis (a rate of 11.1 per million doses administered), including 17 in persons with a documented history of allergies or allergic reactions, seven of whom had a history of anaphylaxis. The median interval from vaccine receipt to symptom onset was 13 minutes (range = 2-150 minutes). Among 20 persons with follow-up information available, all had recovered or been discharged home. A 29-year-old female patient who received the 1st dose of the bnt162b2 (BNT162B2 vaccine, unknown lot number) at single dose in Dec2020 for covid-19 immunisation. Medical history included allergy to sulfa drugs. The patient had no prior history of anaphylaxis. The patient's concomitant medications were not reported. The patient experienced anaphylaxis (signs and symptoms: generalized urticaria) and persistent cough, 54 min after vaccination, in Dec2020. It was determined to be Brighton level 2 of diagnosis. The patient received treatment at emergency department and received treatment with epinephrine. At the time of the report, the outcome of the events was recovered. Information on the lot/batch number has been requested.; Sender's Comments: A possible contributory role of the suspect products cannot be excluded for the reported event anaphylaxis based on the known safety profile and temporal association ,Linked Report(s) : US-PFIZER INC-2021043915 same article/drug, different patient;US-PFIZER INC-2021043908 same article/drug, different patient;US-PFIZER INC-2021043909 same article/drug, different patient;US-PFIZER INC-2021043916 same article/drug, different patient;US-PFIZER INC-2021043911 same article/drug, different patient;US-PFIZER INC-2021043910 same article/drug, different patient;US-PFIZER INC-2021043912 same article/drug, different patient;US-PFIZER INC-2021043913 same article/drug, different patient;US-PFIZER INC-2021043914 same article/drug, different patient;US-PFIZER INC-2021043597 same article/drug, different patient

Other Meds:

Current Illness:

ID: 0971557
Sex: M
Age:
State:

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

Lab Data:

Allergies:

Symptoms: Pancytopenia; This is a spontaneous report from a contactable consumer via a Pfizer-sponsored program IBCC (Inbound Call Center for HCPs). A male patient of an unspecified age received first dose of COVID-19 vaccine (UNSPECIFIED TRADE NAME), via an unspecified route of administration on an unspecified date at single dose for COVID-19 immunization. The patient's medical history and concomitant medications were not reported. The patient experienced pancytopenia on an unspecified date with outcome of unknown. It was reported that there was a patient who was hospitalized to had Covid vaccine, number 1, 3 days prior to the hospitalization, he came into the hospital. The patient had Pancytopenia and the reporter was trying to find out what are Pfizer recommendation for Covid vaccine related Pancytopenia. Information about lot/batch number has been requested.

Other Meds:

Current Illness:

ID: 0971558
Sex: U
Age:
State: KS

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

Lab Data:

Allergies:

Symptoms: Pericarditis; This is a spontaneous report from a contactable pharmacist. A patient of unspecified age and gender received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on an unspecified date at single dose for COVID-19 immunization. The patient's medical history and concomitant medications were not reported. The patient previously took the first dose of BNT162B2 on an unspecified date for COVID-19 immunization. The pharmacist had an ICU patient that received the COVID vaccine dose 2. On day 3 after the vaccine, the patient was admitted to ICU with pericarditis. It was not a confirmed diagnosis. Outcome of the event was unknown. Information on Lot/Batch number has been requested.; Sender's Comments: The information provided is limited and doesnot allow a full medical assessment. Considering a temporal relationship, a possible contribution role of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) to the onset of pericarditis cannot be fully excluded. The case will be reassessed should additional information become available. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics committees and Investigators, as appropriate.

Other Meds:

Current Illness:

Date Died: 01/19/2021

ID: 0971559
Sex: F
Age:
State: TX

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

Lab Data:

Allergies:

Symptoms: her mother passed away 7-8 days after receiving the vaccine; This is a spontaneous report from a contactable consumer, the daughter of the patient. A female patient of an unspecified age received the first dose of COVID-19 mRNA VACCINE (MANUFACTURER UNKNOWN), via an unspecified route of administration in Jan2021 as a single dose for COVID-19 immunization. The patient's medical history and concomitant medications were not reported. On 19Jan2021 about 7-8 days after receiving the vaccine, the patient passed away. The patient was fine before she received the vaccine and then passed away 7-8 days later. The cause of death was not reported. It was not reported if an autopsy was performed. The reporter thought her mother's death had everything to do with the COVID-19 vaccine. The lot number for the vaccine was not provided and will be requested during follow up.; Reported Cause(s) of Death: Death

Other Meds:

Current Illness:

ID: 0971560
Sex: M
Age:
State:

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

Lab Data: Test Name: AST/ALT; Result Unstructured Data: Test Result:183; Test Name: Alkaline Phosphate; Result Unstructured Data: Test Result:241; Test Name: Creactive; Result Unstructured Data: Test Result:44; Test Name: Had previous Chemistry panel; Result Unstructured Data: Test Result:normal

Allergies:

Symptoms: Liver function test abnormal; This is a spontaneous report from a contactable other HCP reporting for himself A 61-years-old male patient received the second dose of bnt162b2 (BNT162B2) vaccine , via an unspecified route of administration on 12Jan2021 at single dose for Covid-19 immunisation . The patient medical history and concomitant medications were not reported. The patient received the first dose of BNT162B2 on an unknown date. The patient experienced liver function test abnormal on an unspecified date with outcome of unknown. The patient stated he is getting worse everyday. Chemistry AST/ALT 183, Alkaline Phosphate 241, C reactive 44. Had previous Chemistry panel normal. The patient is asking for treatment recommendations. HCP ordered infectious hepatitis test.. The patient stated: "Being passed around. Your vaccine is killing me". The patient underwent lab tests and procedures which included ast/alt ratio: 183, blood alkaline phosphatase: 241, C-reactive protein: 44. Information about lot/batch number has been requested.; Sender's Comments: A causal association between BNT162B2 and the reported events cannot be excluded based on a compatible temporal relation. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to RAs, Ethics Committees, and Investigators, as appropriate.

Other Meds:

Current Illness:

Date Died:

ID: 0971562
Sex: U
Age:
State: NY

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

Lab Data:

Allergies:

Symptoms: died; acute immune thrombocytopenia; This is a spontaneous report from two contactable consumers. A patient of unspecified age and gender received BNT162B2(lot number and expiration date not provided) via an unspecified route of administration on unspecified date at single dose for COVID-19 immunization. The patient's medical history and concomitant medications were not reported. The patient died after receiving the covid vaccine on an unknown date. The patient developed acute immune thrombocytopenia on an unknown date. It was unknown if autopsy was performed. The cause of death was unknown. The outcome of the event "died" was fatal and of the event " acute immune thrombocytopenia" was unknown. The reporter wondered if a platelets blood problem may lead to death and if who have a blood platelets condition like essential thrombocytosis should not risk taking the vaccine. Information on the lot/batch number has been requested.; Reported Cause(s) of Death: Died

Other Meds:

Current Illness:

ID: 0971563
Sex: F
Age: 64
State: CA

Vax Date: 01/16/2021
Onset Date: 01/24/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: none

Allergies: cats, dust

Symptoms: After the vaccine on Jan 16, 2021, I had a sore arm with minor inflammation for 3 days. This subsided without any over the counter medications. Yesterday at about 5 pm, my arm started to itch slightly at the site of the shot. Upon waking up this morning, my upper arm has a red circle and is inflamed and it hurts again. I applied prescription cortisone and will continue to apply throughout the day. The soreness seems about the same pain level as the first 3 days after receiving the shot. There is no evidence of bug bite and it would be very strange if I got bit in the exact same location as the shot.

Other Meds: SAM-E, D3, B complex, Magnesium/Calcium vitamin

Current Illness: none

ID: 0971564
Sex: F
Age: 68
State: NJ

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

Lab Data:

Allergies: Codeine

Symptoms: Severe pain in head, and sinuses. My teeth, ears, and eyes were throbbing with pain. Sinuses filled with mucous. Vomiting from 11:00PM to 6:00 AM. My body was wrenching from nothing to vomit from dry heaves. I used hot compresses, cold compresses, boiling water with Vicks vapor rub, Mucinex DM and 2 Aleve at 6AM and finally got some relief from the pain in my head. All mucous was clear. I came off quarantine of Coronavirus on January 20. Onset of virus was January 5, 2021.

Other Meds: Eliquis, Valsartan, flecainide, Amlodipine, carvedilol, Ditropan, Cymbalta, Vitamin D, Immune vitamin, multiple vitamin, biotin, calcium.

Current Illness: Coronavirus

ID: 0971565
Sex: M
Age: 3
State:

Vax Date: 01/04/2021
Onset Date: 01/06/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Severe pain, edema, erythema, and induration. Also had a fever of 102 for more than 2 days.

Other Meds:

Current Illness:

ID: 0971566
Sex: F
Age: 61
State: MI

Vax Date: 01/19/2021
Onset Date: 01/21/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: None

Allergies: Penicillin

Symptoms: Diarrhea, loss of appetite, nausea lasting 3 days as of this writing

Other Meds: Sertraline, zyrtec, prilosec, vitamin d, calcium, multivitamin

Current Illness: None

ID: 0971567
Sex: F
Age: 54
State: VA

Vax Date: 01/07/2021
Onset Date: 01/16/2021
Rec V Date: 01/25/2021
Hospital: Y

Lab Data: Too many to list. Will provide via different media

Allergies: None

Symptoms: Developed Rhabdomyolysis after working out out on 1/15/21. Was hospitalized on 1/19/20 due to Rhabdomyolysis.

Other Meds: Trazodone 100mg Wellbutrin 300mg Buspar 10mg Synthroid 88mcg HRT

Current Illness: No

ID: 0971568
Sex: F
Age: 49
State: OH

Vax Date: 12/28/2020
Onset Date: 01/04/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: None

Allergies:

Symptoms: Right upper arm became red, warm, swollen (size of an avacado) about 7 days after vaccination. No side effects from vaccine until then. Pt. worried it is infected so recommended to see primary care provider to evaluate and get treatment if needed.

Other Meds:

Current Illness:

ID: 0971569
Sex: M
Age: 82
State: CA

Vax Date: 01/23/2021
Onset Date: 01/24/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: chills sore arm

Other Meds:

Current Illness:

ID: 0971570
Sex: F
Age: 56
State: FL

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

Lab Data: EKG, IV fluids and Benadryl 50 mg IV push administered. Patient transported to Hospital.

Allergies: nka per patient

Symptoms: Patient informed medic while sitting in the observation area that she was experiencing chest pain, difficulty breathing and throat tightness. Patient was taken to medic area vs=179/89, pulse 121, o@ sat 99%

Other Meds: Lisinopril, Albuterol

Current Illness: None

ID: 0971571
Sex: M
Age: 32
State:

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

Lab Data:

Allergies:

Symptoms: Headache, chills, body ache, fever

Other Meds:

Current Illness:

ID: 0971572
Sex: F
Age: 74
State: WY

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

Lab Data: none

Allergies: unknow

Symptoms: Sore arm, and red rash 6x4 inch patch, can see white dot where injection was given. Rash is flat and light to medium pink. Denies heat in rash.

Other Meds: unknown

Current Illness: unknown

ID: 0971573
Sex: F
Age: 28
State: PR

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

Lab Data: ELECTROCARDIOGRAM IN NORMAL LIMITS.

Allergies: no allergies reported

Symptoms: PATIENT REPORTS TACHYCARDIA AFTER THE VACCINE ADMINISTRATION. ELECTROCARDIOGRAM COMPLETED WITH NORMAL LIMITS. PATIENT WAS PLACED IN MONITOR FOR A SPACE OF 1HRS. AT NO TIME UNDER OBSERVATION, DID PRESENT TACHYCARDIA.

Other Meds: None

Current Illness: N/A

ID: 0971574
Sex: F
Age: 58
State: CA

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

Lab Data: None

Allergies: None according to the patient

Symptoms: 2:03PM: nausea, light headed and visual changes (light became brighter) 2:16PM: Zofran 4mg tab po given. 02:25PM: discharged: pt no longer experiencing symptoms. 03:05 PM: contacted pt to let pt know that we will report the adverse effect. Pt states "am fine". E. R if symptoms return. Pt aware.

Other Meds: None according to the patient

Current Illness: None according to the patient

ID: 0971575
Sex: F
Age: 35
State: PA

Vax Date: 12/31/2020
Onset Date: 01/06/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies: NKA

Symptoms: One week post-vaccine, I woke up with a sore throat (that never turned into anything and was gone within 24 hours) and I noticed a hard, tender and swollen lymph node over L bicep. Swelling has gone down, but remains hard to date of this report (1/25/2021).

Other Meds: Multi-vitamin, iron supplement, and vitamin D supplement

Current Illness: None

ID: 0971576
Sex: F
Age: 32
State: AL

Vax Date: 08/01/1991
Onset Date: 08/01/1991
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: I was starting my nursing clinicals in 1991 and was required to get a tetanus vaccine, this was done by my family physician. The vaccine was given in my left arm. Within a few hours my left arm, from my elbow up to my shoulder, became extremely sore and swollen. During the night I could not move my arm away from my body because of intense pain upon moving and had to use my right arm to turn myself over and get out of bed. The swelling was extreme. I called my physicians office over the period of a few days only to be told that tetanus vaccines cause soreness and some slight swelling (this was not what I was experiencing). When I saw my fiance (now husband) he was appalled at the pain I was in and described the swelling as the size of a small nerf football. I just showed up at my physicians office (phone calls were not working), the nurse took one look at my arm and got my doctor, I was still standing at the desk. He came out and said "This is NOT what we mean by soreness and swelling." He then took me back and personally injected my arm in at least 4 areas with cortisone injections. The swelling, pain, soreness, and difficulty of movement were helped by the injections, but continued on a lesser scale for months.

Other Meds: Tenormin, Maxide

Current Illness: Hypertension

ID: 0971577
Sex: M
Age: 65
State: MO

Vax Date: 12/26/2020
Onset Date: 01/03/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Patient received vaccine on 12/26/2020; on 1/3/2021 patient experienced rash covering chest and part of back. Patient took a couple of bendaryl capsules for relief.

Other Meds:

Current Illness:

ID: 0971578
Sex: F
Age: 72
State: UT

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

Lab Data: none

Allergies: none

Symptoms: 1/22/21 - 6:30 p.m. extreme chills; temp 101.8 - bundled up and went to bed under electric blanket; arm sore and hot 10:00 p.m. sweating, nausea: temp 101.9 - Tylenol 500 mg 1/23/21 - 4:00 a.m. sweating; temp. 101.6 - Tylenol 500 mg - took lots of naps; arm sore and hot with rash 1/24/21 - 9:00 a.m. felt almost normal - temp 97.8 - which is my normal; arm still sore and hot with rash 1/25/21 - 9:00 a.m. arm still sore and hot with rash

Other Meds: Nexium; multi-vitamin; calcium; vitamin C

Current Illness: Allergy - cedar fever

ID: 0971579
Sex: M
Age: 49
State: GA

Vax Date: 01/08/2021
Onset Date: 01/15/2021
Rec V Date: 01/25/2021
Hospital: Y

Lab Data:

Allergies: None until this reaction

Symptoms: Allergic reaction that occurred 7 days after receiving the first vaccination. Treated for anaphylactic shock at local ER and released. Anaphylactic shock returned within 24 hours causing second visit to the ER. I was then transported to hospital for ICU admission. Body broke out with hives rash for several days followed by severe joint swelling. Remained in ICU 3 days and was released to see Allergist.

Other Meds: Insulin, aspirin, advil

Current Illness: none

ID: 0971580
Sex: F
Age: 82
State: CA

Vax Date: 01/16/2021
Onset Date: 01/22/1921
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies: codiene,percodan ,contrats dyes

Symptoms: 5x3 in localize redden area at injection site wildly itching

Other Meds: lipitor toprol, asa, lisinopril

Current Illness: none

ID: 0971581
Sex: F
Age: 9
State:

Vax Date: 01/06/2021
Onset Date: 01/07/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Severe pain (unrelieved by Tylenol) at the injection site with accompanying erythema. No fever.

Other Meds:

Current Illness:

ID: 0971582
Sex: F
Age: 39
State: TX

Vax Date: 01/12/2021
Onset Date: 01/17/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: none

Allergies: Ibuprofin

Symptoms: Itchiness, red spot that got raised, large red spot the size of two palms

Other Meds: Levothyroxine

Current Illness: none

ID: 0971583
Sex: F
Age: 85
State: CA

Vax Date: 01/14/2021
Onset Date: 01/22/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies: Cipro; Codeine

Symptoms: MODERNA Vaccine results: Headache on day 2,3,4 after administered on Jan. 14; Itchy and red patch appeared on left arm at vaccine site that was about 1 inch square that appeared on day 8 after administerd, on day 9 the red had doubled in size, on day 10 the size had tripled, continuing to be itchy and bright red, with a temp of 99.3 to 99.5. On day 11, the red was diminishing, no fever noted.

Other Meds: Wixela; Amlodipine Besylate; Levothyroxine; Venalafaxine; Simvastatin; Clonidine; Clopidogrel; Celebrex; Pantoprazole; Olmesartan; Vitamin D3; Krill Oil; Citracal Plus + D3; Move Free Ultra; Vit. B-Cfomplex

Current Illness:

ID: 0971584
Sex: F
Age: 30
State: MD

Vax Date: 01/15/2021
Onset Date: 01/23/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: N/A

Allergies: NKDA

Symptoms: Swelling in the Arm at sight of Vaccine. Sore and Warm to touch

Other Meds: Paroxetine

Current Illness: None

ID: 0971585
Sex: F
Age: 39
State: NY

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

Lab Data:

Allergies:

Symptoms: "I got my second dose around 1pm on 1/22. At 3am I woke up with chills and fever 100.8. I took Tylenol every 6 hours. The highest my temp got was 101.8 on Saturday around 4pm. At that time I had body aches and headache too. Since then I?m been fatigued with a powerful headache, temps ranging 99.1 to 99.8. Taking Tylenol for the headache."

Other Meds:

Current Illness:

ID: 0971586
Sex: M
Age: 40
State:

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

Lab Data:

Allergies:

Symptoms: 12 hours late Fever 102-103 , sweats, pain at injection site, myalgia, chills , shivering went away 12 hours later

Other Meds:

Current Illness:

ID: 0971587
Sex: F
Age: 57
State: CO

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

Lab Data: None

Allergies: Bactrim, Macrobid, Penicillin, Salmon

Symptoms: soreness at injection site for 36 hours pains to joints to fingers, toes and bones in both feet to ankle headache, sinus pressure, severe nausea for 4 -days, fatigue for 3 days Meds : Tylenol 500 mg -1000 mg every 6 hours as needed, Sinex tabs daily for 3 days, as needed, Zofran 4 mg prescribed by radiology oncologist

Other Meds: Atenolol daily at bedtime, Benadryl at bedtime, as needed

Current Illness: Radiation for breast cancer treatment - daily - had 4 treatments prior to receiving vaccination and will continue to receive for additional 3 weeks after vaccine.

ID: 0971588
Sex: M
Age: 71
State: FL

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

Lab Data:

Allergies:

Symptoms: 1/22/21, the next morning after shot, left arm at the injection site was a little sore. That lasted two days. No other issues to report after receiving shot #1 of Moderna vaccine.

Other Meds:

Current Illness:

ID: 0971589
Sex: M
Age: 45
State: SC

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

Lab Data: None

Allergies: Minor food allergies - strawberries

Symptoms: Low grade temp (100 deg f) beginning about 3 hours after receiving shot. Became very tired and loss of appetite followed by diarrhea about 8 hours after shot followed by mild headache through the next 24 hours. I am reporting this mainly because my reaction was unexpected and happened on the first dose. I have not yet received my second dose.

Other Meds:

Current Illness: None

ID: 0971590
Sex: F
Age: 68
State: GA

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

Lab Data:

Allergies: unknown

Symptoms: "Pfizer-Bio-Tech COVID-19 Vaccine EUA" Individual was given vaccine at 3:30 pm. 20 minutes after receiving the vaccine individual developed itchy flushed on face cheeks, chest, and back. She was given Benadryl 50 mg IM in Right arm at 3:55 pm. 4:12 pm the itchy skin was less intensified and vitals were stable. Individual went home with family

Other Meds: unknown

Current Illness: unknown

ID: 0971591
Sex: F
Age: 27
State: MI

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

Lab Data:

Allergies: None

Symptoms: Administered injection to high; Dose was administered into shoulder joint; Followed up with a OH clinic provider. Was referred to a specialist

Other Meds: N/a

Current Illness: unknown

ID: 0971592
Sex: F
Age: 76
State: IN

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

Lab Data: I have not gone to the doctor.

Allergies: Penicillin, Sulfa, Clindamycin HCL, Lactose intolerant, Soy,

Symptoms: Evening: around 8:00 p.m. headache, arm sore, body aches, sleepy. I slept all night Saturday night, all day Sunday except for a few minutes three or four times, slept all night Sunday night. Monday I?m still tired and sleepy, now I?m nauseous..

Other Meds: Cetirizine. 10mg, Fluticasone USP 50 mcg, Flovent HFA. 44mcg, Lisinopril 40mg, Hydrochlorot 25 mg, Levothyroxin 100 mcg, Omeprazole delay release 40mg, Restasis 0.05% drops, Latanoprost 0.006%.

Current Illness: None

ID: 0971593
Sex: F
Age: 9
State:

Vax Date: 01/06/2021
Onset Date: 01/07/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Severe pain at the injection site (unrelieved by Tylenol) with accompanying erythema. No fever.

Other Meds:

Current Illness:

ID: 0971594
Sex: F
Age: 44
State: FL

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

Lab Data: n/a

Allergies: penicillin, bactrim

Symptoms: 1/23 morning at 10 am symptoms started 1/25 7 am arm was red, itchy, warm, redness left arm, body aches, chills, headache

Other Meds: Breo, Singulair, Zyrtec, Tylenol, Motrin, Excedrin

Current Illness: n/a

ID: 0971595
Sex: F
Age: 68
State: OK

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

Lab Data: On 1.12.2021, EMS monitored my BP for about 2 hours. It only decreased slightly. When I got home, I contacted my physician and he advised me that it was a temporary reaction and it would last about 3 days. I followed up with an in office visit on 1. 16.3021. At that time it was 129/85.

Allergies: Penicillin-rash Aspirin - flu like symptoms

Symptoms: Within 5 minutes began swearing and became extremely warm. The nurse checked my blood pressure. It had gone to 170/90. My BP is always on the low side of normal range and I'm usually cold. The raised blood pressure lasted 4 days.

Other Meds: Synthetic Omeprazole ShakleeMultivitamins Shaklee Vitamin D Shaklee Immunity Shaklee Tumeric Shaklee probiotic

Current Illness: None

ID: 0971596
Sex: F
Age: 46
State: TX

Vax Date: 01/15/2021
Onset Date: 01/23/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: N/A

Allergies: Sulfas, Latex

Symptoms: Swelling, redness and itching starting 9 days after injection. (I also had redness, itching and pain on day of injection but went away two days later then returned a week later) The rash/redness has gotten lighter since I've been taking Benadryl but it has spread a bit more (about half an inch of border)

Other Meds: Levothyroxin, Liothyronine, Fluoxitene, Zyrtec, Colase, Montelukast, Symbicort

Current Illness:

ID: 0971597
Sex: F
Age: 33
State: CA

Vax Date: 12/21/2020
Onset Date: 12/27/2020
Rec V Date: 01/25/2021
Hospital:

Lab Data: COVID - negative

Allergies: Augmentin; penicillin; shrimp; egg white; cow's milk; fungi

Symptoms: After vaccination - I was noticing eczema flare up - but not bad; and then 27th, I got blisters on left cheek likes pins and needles poking my face; next day the blisters popped and created crater on my skin and area was getting bigger and it was oozing and I felt that stinging poking on that affected area. Next day after that, I went to my dermatologist for a consultation and he said it was Herpes Simplex. Along with that, 2 days after the blisters started appearing on my face, before I went to my dr's office - was having 101. fever, chills, body aches , and severe cough with vomiting and not able and so I got tested the day I went to my Dr. and it was a negative COVID test. Treatment: Antiviral medication for one week; Topical ointment: Bacteralban ointment; I still have the face color with the Herpes was.

Other Meds: Topical - Betamethasone creme Injection - Kenalog - when eczema flares Benadryl - when I'm itching eczema- as needed

Current Illness: no

ID: 0971598
Sex: F
Age: 35
State: PR

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

Lab Data: None

Allergies: Seafood

Symptoms: Dizziness, chills and tremors.

Other Meds: Vit c

Current Illness: None

ID: 0971599
Sex: F
Age: 88
State:

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

Lab Data:

Allergies:

Symptoms: Left face and arm felt numb--monitoring, but no other treatment

Other Meds:

Current Illness:

ID: 0971600
Sex: F
Age: 69
State: GA

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

Lab Data:

Allergies: Penicillin and morphine type drugs like Demerol

Symptoms: I received the injection around 2:30 I felt fine. It did not hurt going in. I stopped by a restaurant to get some take out and must of started feeling disorientated and completely forgot I had this folder with the VSAFE information. I started feeling chills all over my body, I kept taking my temperature it was 95.7, I started having a headache top of my head, the temporal, the back of my neck. They were all over the place. I went to bed and I couldn't sleep. It was like my brain was going crazy, it wasn't like an anxious feeling. I finally feel asleep around 4am and kept waking up remembering fragments of valid dreams. The dreams were fragment with such dread and anxiety in them. It was like a huge wave of depression and anxiety. By about 9am I was fully awake, but my body hurt, my muscles ached I felt fatigued. The chills and headaches were through. I was still having weird racing thoughts. About 10pm it all went away and I slept fine and woke up the next morning and I was fine. My arm is still sore at the injection site but all the other symptoms went away. Saturday morning I was talking with a friend on the phone, and she reminded me of the folder I received the folder. I completely forgot about this folder. I found this folder later that day and then I tried to access VSAFE. It made me realize how disorientated I was.

Other Meds: Melatonin at bedtime, turmeric in the AM, folic acid in the AM, lysine in the AM, flex seed oil in the AM, and probiotic in the AM

Current Illness: I do not know, I did feel well, but know I do think it was an infection some post nasal drainage (clear) off and on for a couple of months. I thought it was normal for this type of year. December 15th I had a COVID test and it was negative.

ID: 0971601
Sex: M
Age: 83
State: WA

Vax Date: 01/16/2021
Onset Date: 01/23/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies: allopurinol, calcium, levothyroxine

Symptoms: redness, itching and swelling at vaccine site starting 1 week after injection. starting resolving 2 days later without further treatment needed.

Other Meds:

Current Illness:

ID: 0971602
Sex: F
Age: 27
State: CO

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

Lab Data:

Allergies: Ceftin, cedax, Augmentin, latex, sulfa.

Symptoms: Nausea onset 3 hours following vaccine on 1/22/21. Vomit onset 12 hours following vaccine lasting 1 hour.

Other Meds: Celexa 20mg, bupropion XL 150mg, spironolactone 50mg, Mirena IUD, ibuprofen 600mg at 16:00 day of vaccine.

Current Illness: None

ID: 0971603
Sex: F
Age: 76
State: AZ

Vax Date: 01/14/2021
Onset Date: 01/19/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies: Sulfur

Symptoms: RED, BLISTER TOP SORE. USED HYDROCORTISONE WITH NO CHANGE F0R 3 DAYS, NOW NO BLISTER, BUT SKIN STILL RED AND DRY

Other Meds: Amitriptyline, Lipitor, estradiol, sertaline, Florastor probiotic, Optivite fiber, Vit B1,B6,B12, Vit D3

Current Illness: none

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm