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: 0975365
Sex: F
Age: 41
State: OH

Vax Date: 12/28/2020
Onset Date: 12/28/2020
Rec V Date: 01/26/2021
Hospital:

Lab Data: no

Allergies: plain metformin

Symptoms: 5 minutes after my body begin to feel warm and I begin to get light headed and my upper brow began to swell. I was laid down and my BP and BS wd elevated so I was take to the ED where I was given benedryl, pepcid and tylenol . I was released with a Epi pen and while at home my tongue starting feeling a little furry and swole a little but I continued to take benedryl for that but I had a bad headache that lingered for the next 2 weeks after wards

Other Meds: Lipitor 40mg, Glipizise-metformin/500, Truilicity 1.5 mg injection (wkly), flynd 4mg., probiotic, zoloft 25mg

Current Illness: no

ID: 0975366
Sex: F
Age: 65
State: ND

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 01/26/2021
Hospital:

Lab Data: No tests were done; I have been in contact with my primary doctor and my specialist by messaging and by telephone with this adverse reaction information.

Allergies: No known allergy to any medication; no allergy diagnosis but have a low tolerance for caffeine - do not drink coffee or soda, occasionally eat chocolate; No allergy diagnosis but developed a reaction to the sulfate in my shampoo and have since changed my shampoo; I have an allergy diagnosis to certain trees, dog, cat, dust mites, ragweed, molds.

Symptoms: Moderna COVID-19 Vaccine EUA. Received first COVID vaccination Fri., Jan. 22 at 1:56pm. I was not anxious about the shot at all and was playing solitaire on my cell phone when around 2:15pm it was like a switch turned on and I felt my heart racing and pressure on my chest. I notified the nurse and she took my blood pressure and it was 200/90, HR 98, Oxy 100%. At 2:25pm it was 140/80, HR 96, Oxy 96%. And at 2:39pm it was 132/88 and the nurse felt it was OK to return home. My chest felt better at home around 4:15pm that same day. I definitely had no anxiousness about taking the COVID vaccine, and was not worried about a reaction at all. Having that high of a blood pressure was a surprise because my blood pressure is usually around 117/74, and I don't get anxious about allergy shots or vaccinations. I have been taking allergy shots for over 15 years every month. I had taken my allergy shots in both arms 2 days prior to the COVID vaccination that was ok'd by my clinic.

Other Meds: Pramipexole taken previous night. Pantoprazole taken morning of vaccine. Took allergy shots 2 days prior to the COVID vaccination per recommendation by the provider.

Current Illness: No prior illness

ID: 0975367
Sex: M
Age: 77
State: TN

Vax Date: 12/29/2020
Onset Date: 12/30/2020
Rec V Date: 01/26/2021
Hospital:

Lab Data: Heart monitor and normal rhythm, checked oxygen states 96 , blood glucose was 112 ,

Allergies: No

Symptoms: Next day diarrhea all morning, imodium , he was cold, clammy, wet with sweat, week pulse at 40 , in profound shock, Stimulated him by shaking and hitting and had him take deep breaths . Pulse was 120/82 pulse up to 60 20 minutes into the event he was stable and alert .

Other Meds: Lisinopril 5 mg, Htcg 12.5 mg, Aspirin 80 mg twice weekly, AREDS2 2twice a day, Magnesium with Vitamin D

Current Illness: No

ID: 0975368
Sex: M
Age: 37
State: CA

Vax Date: 01/21/2021
Onset Date: 01/22/2021
Rec V Date: 01/26/2021
Hospital:

Lab Data:

Allergies: Lactose intolerant

Symptoms: EE reports he received pfizer vaccine on 1/21/21. He noted extreme fatigue on 1/22/21 and today 1/23/21 noted an inability to form words and talk while on the phone, dizzy, tongue is half numb, and notes sweating. EE advised to f/u with ER for assessment. Consult with Dr. e-mail was sent alerting her to this reaction. MAJ follow up on 1/26: ED record reviewed. EE had vaccine injected on 1/21 and experienced chills and nausea on 1/22. On 1/23 he had 1-2 minutes of aphasia and R jaw numbness. ED evaluation that afternoon revealed a well-appearing adult with normal vital signs and neurologic exam. Assessment by ED physician was that this was not a stroke or transient ischemic attack but might be a vaccine-related adverse event. The ee was referred for follow-up with his PCP, Dr. , who can be emailed if further follow up information is needed. I suspect the ee became dehydrated from vaccine-related nausea and that this was the cause of his transient neurologic symptoms.

Other Meds: ? Lactase Fast Acting 9,000 unit Oral Tab Take 1 to 3 tablets orally with first bite of food containing dairy ? Genvoya 150-150-200-10 mg Oral Tab Take 1 tablet by mouth daily with food ? Flunisolide (NASALIDE) 25 mcg (0.025 %) Nasl Spray

Current Illness: Inflamed EIC (dermatology)

ID: 0975369
Sex: F
Age: 79
State: NC

Vax Date: 01/15/2021
Onset Date: 01/21/2021
Rec V Date: 01/26/2021
Hospital:

Lab Data:

Allergies: sulfa (extremely allergic to it), codeine, white potatoes

Symptoms: Began itching and swelling at site and then down and up my arm. Increased enough that I took a Benadryl on Friday, 1/22, to try to stop it. It continued the next day, so I started taking Benadryl and Pepcid, and finally yesterday (Monday, 1/25, I took 2 Benadryl and 2 Pepcid at the same time and then a Benadryl last night. It is much better now, so I have taken only 1 Benadryl with 1 Pepcid at midday, today.

Other Meds: multi-vitamins, d-ribose, l-carnitine, UBQH (Kaneka Ubiquinol),

Current Illness: none

ID: 0975370
Sex: F
Age: 51
State: MO

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 01/26/2021
Hospital:

Lab Data:

Allergies: Keflex, erythromycin, propranolol, lisinopril, amlodipine, bee stings, steri strips, rosemary oil

Symptoms: Tightness in throat then going into chest, Burning with cough and deep breath, fatigue, body aches. Sought ER treatment per my doctor, ER was back up for over 5 hours, left went home, took benedril. Still having some issues with tightness in chest, burning when taking a breath and cough.

Other Meds:

Current Illness:

ID: 0975371
Sex: M
Age: 64
State: CT

Vax Date: 01/20/2021
Onset Date: 01/21/2021
Rec V Date: 01/26/2021
Hospital:

Lab Data: Na

Allergies: NKA

Symptoms: Temp 102.1, shakes, body aches headache

Other Meds: Tamsulosin, glopizide, amlopdipine besylate, chlorthalidone, rosvastatin, fenofibrate, bupropion xl, omega-3acid ethyl esters, famotidibe, iron

Current Illness: None

ID: 0975372
Sex: M
Age: 38
State: NC

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 01/26/2021
Hospital:

Lab Data: None at this location

Allergies: H1N1 Vaccine

Symptoms: Anaphylactic reaction (flushing, erythema of skin on arms, chest, and neck, tachycardia, diaphoresis, AMS, weakness); received 0.3mcg epi (Epi-pen) in right thigh after being placed on a litter. EMS contacted. Patient improved prior to EMS arrival and was evacuated for further eval and treatment.

Other Meds: Naproxen

Current Illness: None

ID: 0975373
Sex: F
Age: 48
State: OK

Vax Date: 01/23/2021
Onset Date: 01/24/2021
Rec V Date: 01/26/2021
Hospital:

Lab Data:

Allergies:

Symptoms: fatigue started on 01/24/2021

Other Meds:

Current Illness: bronchitis

ID: 0975374
Sex: F
Age: 32
State: MD

Vax Date: 01/21/2021
Onset Date: 01/23/2021
Rec V Date: 01/26/2021
Hospital:

Lab Data: N/A

Allergies: None

Symptoms: Anterior cervical lymph node enlargement; mobile, non-tender No axillary nodes palpated; slight swelling and tenderness in left axillary Advised follow-up

Other Meds: None

Current Illness: None

ID: 0975375
Sex: F
Age: 55
State: NJ

Vax Date: 01/02/2021
Onset Date: 01/09/2021
Rec V Date: 01/26/2021
Hospital:

Lab Data: None

Allergies: Nickel

Symptoms: Swelling, redness and itching at injection site

Other Meds: None

Current Illness: No

ID: 0975376
Sex: F
Age: 64
State: ID

Vax Date: 01/13/2021
Onset Date: 01/25/2021
Rec V Date: 01/26/2021
Hospital:

Lab Data:

Allergies: Eggs, bees, penicillin, ibuprofen, Clindamycin, Novocain, Demerol

Symptoms: Mild symptoms the first two days after the shot such as headache, sore arm. Twelve days after the shot I noticed a large red patch at the injection site that was very red, hot and itchy.

Other Meds: AReds vitamins, Vitamin D, Fish oil, CoQ10, turmeric, B-vitamins, Magnesium

Current Illness: Sore throat a few weeks prior

ID: 0975377
Sex: M
Age: 59
State: AZ

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 01/26/2021
Hospital:

Lab Data:

Allergies:

Symptoms: None

Other Meds:

Current Illness:

ID: 0975378
Sex: F
Age: 11
State: TX

Vax Date: 01/13/2021
Onset Date: 01/14/2021
Rec V Date: 01/26/2021
Hospital:

Lab Data: n/a

Allergies: NKDA; no known food allergies

Symptoms: swelling, redness, itch of left deltoid ~ 24 hours after vaccination

Other Meds: none

Current Illness: not applicable

ID: 0975379
Sex: F
Age: 37
State: NJ

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

Lab Data: n/a

Allergies: Latex 03/23/2016 Prolonged usage Latex Condom Levaquin [levofloxacin] 01/15/2016 Hives, Rash, Shortness of Breath Redness and heat Loperamide 01/08/2021 Tape 03/23/2016 Clear PlasticTape & BandAids

Symptoms: mild bells palsy symptoms effecting right side face

Other Meds: albuterol 108 (90 BASE) mcg/act inhaler Inhale 1 puff every 4 hours as needed for shortness of breath. atorvaSTATin 40 mg tablet Take 1 tablet by mouth daily at bedtime. budesonide-formoterol (SYMBICORT) 160-4.5 MCG/ACT inhaler Inhale 2 puf

Current Illness: 1/7/21 gastritis symptoms

ID: 0975380
Sex: F
Age: 74
State: GA

Vax Date: 01/12/2021
Onset Date: 01/24/2021
Rec V Date: 01/26/2021
Hospital:

Lab Data: None

Allergies: Allergic to all vespids - carry an Epi-Pen

Symptoms: On Jan 25 a large red spot appeared on arm that went from shoulder to elbow. Took antihistamine and applied cold ice pack. Have continued that method. Called Health Dept on Mon Jan 25 and reported. As of today, Jan 26 spot is still there but not as red

Other Meds: Levothyroxine 75mcg, Atorvastatin 40 , Vitamin C 2000mg., Vit D3 6000IU, One a day vitamin, Aspirin 81, Turmeric 2000mg.,

Current Illness: None

ID: 0975381
Sex: F
Age: 16
State: MN

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 01/26/2021
Hospital:

Lab Data:

Allergies:

Symptoms: NOT an adverse event- patient is under 18 years old- reporting this as an error

Other Meds:

Current Illness:

Date Died: 01/23/2021

ID: 0975382
Sex: M
Age: 83
State: FL

Vax Date: 01/20/2021
Onset Date: 01/22/2021
Rec V Date: 01/26/2021
Hospital:

Lab Data: 01/20/21-Routine labs ordered, BUN elevated and BNP at 55, 01/22/21-Stat labs ordered-WBC-23, BNP-1426, Xray- 01/22/21-Right lung opacities

Allergies: none

Symptoms: 01/22/20When transferring resident from bed to W/C Resident became unresponsive to voice with eyes fix open and point up to the right. Placed resident back in bed found 82% o2 sats B/P 110/106 pulse 110 resp below 16 placed o2 via non rebreather with 20 l/min 02 up to 90% then stabilized at 89% Resident following all commands encouraged to take do breathing exercises, with some compliance, continues ABT/pneumonia , no s/s adverse 1/23/2021 16:48 Discharge Summary Note Text: Resident found unresponsive with no pulse or respirations in bed with emesis on gown. Time of death verified at 1645 with LPN. Funeral Home called at 1900 and body released at 2000.

Other Meds: Acetaminophen Tablet 325 MG Give 2 tablet by mouth every 4 hou

Current Illness: Anemia, Dementia, COPD

ID: 0975383
Sex: F
Age: 79
State: NV

Vax Date: 12/20/2020
Onset Date: 01/25/2021
Rec V Date: 01/26/2021
Hospital: Y

Lab Data: CT Angio Chest obtained on 01/26/21 at 2:02 am: 1. Small acute embolus within left lower lobe pulmonary artery branch. No saddle embolus or right heart strain. 2. Mild multifocal pneumonia compatible with known Covid infection. This is most prominent in the lung apices. There are also changes in the lung apices suggesting prior granulomatous disease. 3. No pulmonary artery embolus or aortic dissection. Chest Xray obtained on 01/25/21 at 19:01: -Cardiac size is normal. The lungs are normally inflated and clear. There is no appreciable pleural effusion or pneumothorax ECG obtained on 01/25/21 at 18:47: - SINUS RHYTHM - INTRAVENTRICULAR CONDUCTION DELAY LAB RESULTS 01/25/21 at 18:53: All WNL except; D-Dimer= 631, troponin= 0.037, RDW= 17.7, Neutr%= 76.7, Lymph%=15.5, K+= 4.7, Glucose= 119, SrCr= 1.42

Allergies: Seasonal allergies (pollen), motrin, sulfa, plaquenil

Symptoms: Acute onset of SOB presented to ED and diagnosed with a pulmonary embolism. Tested positive for SARS-Co-V-2 on 01/25/21 using NAT.

Other Meds: Aspirin, lisinopril, fludrocortisone, loperamide, prednisone, simvastatin

Current Illness:

ID: 0975384
Sex: F
Age: 58
State: FL

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 01/26/2021
Hospital:

Lab Data: N/A

Allergies: N/A

Symptoms: Felt Lightheaded with fast Heart rate.

Other Meds: Green Tea in Morning.

Current Illness: N/A

ID: 0975385
Sex: F
Age: 35
State: CA

Vax Date: 01/08/2021
Onset Date: 01/09/2021
Rec V Date: 01/26/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: I am a 35yo G2P1, was 29 weeks pregnant at the time of vaccination (due 3/25/21), completely normal pregnancy so far. CDC Vsafe called and asked me to report as an adverse event though I wouldn't consider more serious than most. Had low grade fever (99-100) on tylenol, chills, rigors, myalgias and joint pains starting about 12 hours after vaccination. Went to work the following day (I am an physician) and by about 10 am had a presyncopal event and was unable to stand/continue working. Was unable to stand without feeling faint for about the next 6 hours. Was febrile until about 8pm 1/9, never over 100 while taking tylenol. Symptoms completely resolved by 1/10 AM except fatigue for the next 4 days or so, though I developed axillary lymphadenophathy on the side of vaccination starting 1/12 for about 5 days. No effect whatsoever on the fetus.

Other Meds: Prenatal vitamins

Current Illness: None

ID: 0975386
Sex: F
Age: 71
State: MI

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

Lab Data: None

Allergies: None

Symptoms: I am experiencing symptoms similar to that when I had Covid in October,2020. My head is aching, sinuses aching and ears aching. I?m extremely tired but the pain keeps me from sleeping much.

Other Meds: Lyrica, thyroid and cholesterol meds are my daily meds

Current Illness: None

ID: 0975387
Sex: M
Age: 59
State: MO

Vax Date: 12/23/2020
Onset Date: 12/23/2020
Rec V Date: 01/26/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Employee experience redness at the injection site that was very hot to the touch. Employee had a Virtual Visit in which antibiotics were prescribed.

Other Meds:

Current Illness:

ID: 0975388
Sex: F
Age: 61
State: MA

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

Lab Data:

Allergies: Amoxil/ penicillin, Tagamet none

Symptoms: Pain in the arm

Other Meds: Omeprazole 20mg.

Current Illness: None

ID: 0975389
Sex: F
Age: 42
State: VT

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 01/26/2021
Hospital:

Lab Data: tested covid positive on 1/19/21 after prolonged s/s

Allergies: none known

Symptoms: same evening HA cough sorethroat, myalgia, arthralgia, congestion

Other Meds: none

Current Illness:

ID: 0975390
Sex: F
Age: 43
State: IL

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 01/26/2021
Hospital:

Lab Data: SARS cov 2 antibody.

Allergies: None

Symptoms: Sever pain at the injection site and arm, chills, sever fatigue, arthralgia.

Other Meds: None

Current Illness: None

ID: 0975391
Sex: F
Age: 67
State: NC

Vax Date: 01/11/2021
Onset Date: 01/11/2021
Rec V Date: 01/26/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: I received the shot in my left arm and immediatley I felt an odd feeling in my left wrist and hand. I then went outside and in 10 minutes my lips began to tingle and become numb. In several more minutes the left size of my lips were very numb and the right size somewhat numb. In just.a couple of more. minutes the location under my entire left jaw became somewhat numb and then I felt like I had something small in. my throat. I asked my husband to look at my face to notice and swelling, drooping, or was I slurring my words. He said no. I could breath and swallow ok so I sat in the car in case I got worst and needed to go back inside the health department. I waited outside for one hour and 15 minutes (until 5;00) and during that time I improved significantly. The next day a area under my left eye switched several times. Then 10 days later I had pain in my left eye and for the next two days my eye was sore. I need help in knowing if I should take the next shot or can I wait for the Johnson and Johnson vaccine and take it.

Other Meds: Rosuvastin 10 mg baby aspirin

Current Illness: no

ID: 0975392
Sex: F
Age: 57
State: MA

Vax Date: 01/23/2021
Onset Date: 01/24/2021
Rec V Date: 01/26/2021
Hospital:

Lab Data:

Allergies: no

Symptoms: 100.4 Fever fro 24 hours , Teeth chattering, body aches, head aches, jittery feeling

Other Meds: no

Current Illness: no

ID: 0975393
Sex: F
Age: 30
State: CA

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 01/26/2021
Hospital:

Lab Data:

Allergies:

Symptoms: patient began to experience incontrollable shivering. stated she was freezing cold. no other symptoms. given warm packs and blankets. 2 25mg po benadryl ordered and given. patient assessed by the provider for 30 minutes. improved and d/c'd home.

Other Meds:

Current Illness:

ID: 0975394
Sex: F
Age: 70
State: CA

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

Lab Data:

Allergies:

Symptoms: Tingling in the left arm, feeling warm, anxious. No shortness of breath, chest pain, headache, swelling of the tongue or throat. During the 15 minute observation period following the administration of the vaccine

Other Meds:

Current Illness:

ID: 0975395
Sex: F
Age: 26
State:

Vax Date: 01/14/2021
Onset Date: 01/17/2021
Rec V Date: 01/26/2021
Hospital:

Lab Data: None

Allergies:

Symptoms: Loss of taste and smell

Other Meds:

Current Illness:

ID: 0975396
Sex: F
Age: 56
State: NY

Vax Date: 01/05/2021
Onset Date: 01/14/2021
Rec V Date: 01/26/2021
Hospital:

Lab Data: Amoxicillin-clav 875-125 mg tab 2 time a day

Allergies: Lactose

Symptoms: Rash, redness, pain

Other Meds: Aspirin, vitamins c, echinacea

Current Illness:

ID: 0975397
Sex: F
Age: 50
State: MO

Vax Date: 12/31/2020
Onset Date: 01/10/2021
Rec V Date: 01/26/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Patient reports arm soreness for 3 days after receiving the vaccine on 12/31/2020. On 1/10/2021 patient reports that after taking a warm, longer than normal shower (due to shaving her legs) the injection site remained very red. Message left on 1/13/2021.

Other Meds:

Current Illness:

ID: 0975398
Sex: F
Age: 17
State: MN

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 01/26/2021
Hospital:

Lab Data:

Allergies:

Symptoms: no adverse effects- vaccine error- patient is 17

Other Meds:

Current Illness:

ID: 0975399
Sex: F
Age: 54
State: SD

Vax Date: 01/12/2021
Onset Date: 01/13/2021
Rec V Date: 01/26/2021
Hospital: Y

Lab Data: 1/15 MRI and CAT scan CAT scan was repeated x 1 while hospitalized. There was a fluid filled sack found between her spinal cord/throat. Pain was a 10 on the scale of 1-10. Follow up with ENT

Allergies: none

Symptoms: 1/13/21 woke at 4am with neck pain 1/14 Pain worse, could not move neck, radiated on both sides of neck to back of head, saw doctor, was given a muscle relaxant, pain worsened, went to ER was given valium and sent home 1/15 called doctor, was given hydrocodone, increased pain, went to ER due to pain, was hospitalized 1/19 discharged from hospital, off work till 2/3/2021 per PCP

Other Meds:

Current Illness: none

ID: 0975400
Sex: F
Age: 87
State: OH

Vax Date: 01/21/2021
Onset Date: 01/22/2021
Rec V Date: 01/26/2021
Hospital:

Lab Data: None

Allergies: No known allergies

Symptoms: Day after vaccine patient reported headache, trouble breathing, numbness in hands and feet, and high fever. Patient states she does have COPD and it felt more of an exacerbation, but she states her COPD has been controlled for a while and has not had trouble breathing like this in a long time. Patient has recovered from all symptoms besides numbness in hands. Patient did not seek treatment becuase "she didn't want to".

Other Meds: unknown

Current Illness: No current illnesss

ID: 0975401
Sex: F
Age: 38
State: NY

Vax Date: 01/11/2021
Onset Date: 01/19/2021
Rec V Date: 01/26/2021
Hospital:

Lab Data:

Allergies:

Symptoms: 01/12/21 body aches x 24hrs 01/19/21 Rt back pain, rt chest/torso pain, weakness, headache. 01/23/21 blisters developed with burning pain and was diagnosed with Shingles at the urgent care Center and more headache

Other Meds:

Current Illness:

ID: 0975402
Sex: M
Age: 42
State: IA

Vax Date: 01/06/2021
Onset Date: 01/25/2021
Rec V Date: 01/26/2021
Hospital:

Lab Data: None.

Allergies: None.

Symptoms: On January 25 I noticed a rash/hives on my chest and abdomen area. It has been almost 24 hours and they have not resolved. The severity is about a 3 out of 10, they have remained localized and are only mildly itchy. I have no other symptoms and I have not altered my daily routine or interacted with anything which could explain the hives. I have not been ill for over 6 months but the rash reminds me of after recovering from a virus when it is shedding. I spoke with a healthcare provider and he suggested I file a report.

Other Meds: None.

Current Illness: None.

ID: 0975403
Sex: F
Age: 17
State: MN

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 01/26/2021
Hospital:

Lab Data:

Allergies:

Symptoms: no adverse reaction-- reporting vaccine error, patient was 17 at time of vaccination

Other Meds:

Current Illness:

ID: 0975404
Sex: F
Age: 57
State: AR

Vax Date: 01/05/2021
Onset Date: 01/05/2021
Rec V Date: 01/26/2021
Hospital:

Lab Data: Received Dexamethasone at 9:36AM and Epinephrine at 11:21AM on 1/6/21 1-7-21 received Pepcid 40mg @ 2:04PM, Zofran 4mg @ 2:09PM, and Prednisone 60mg @ 2:04PM

Allergies: Rocephin

Symptoms: Starting itching, then face and lips started tingling. Took Benadryl and Pepcid. Next morning started having difficultly swallowing, went to ER-1-6-21 On 1-7-21 started itching from all over, blood pressure was 262/106, went back to ER

Other Meds:

Current Illness: None

ID: 0975405
Sex: M
Age: 41
State: MO

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 01/26/2021
Hospital:

Lab Data:

Allergies:

Symptoms: About 11 hours after dose I started to get intense chills and a headache that lasted throughout the night.

Other Meds:

Current Illness:

ID: 0975406
Sex: F
Age: 74
State: PA

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

Lab Data: N/A

Allergies: NKA

Symptoms: Light headaches. Redness and inflammation.

Other Meds: See 2nd page in additional information.

Current Illness: N/A

ID: 0975407
Sex: F
Age: 31
State: WA

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

Lab Data:

Allergies: None known

Symptoms: Was fine immediately post vaccine. Drove home and proceeded with a normal rest of the day at home. Went to sleep around 10 pm. Woke up at 4 am with my arm very sore. Got up to take meds for my arm pain and once I got to the bathroom felt pale, sweaty, nauseous and had chills, very weak - an overwhelming sense of not feeling right and strong fatigue. I sat on the toilet and went to the bathroom (urination and defecation) but did not have the energy to wipe properly. I stood up and turned on the sink faucet, took my meds with a few sips of water and next thing I remember is me laying on the bathroom floor confused and with my ears ringing. I figured I had laid down but then I realized the toilet was running and the sink faucet water was still running and I looked in the mirror and had a cut bleeding on my chin that I had no idea was there. Then I realized that I must have passed out while standing at the sink. I put a bandaid on the cut and went back to bed. In the morning when I was able to assess my self better, I realized during my fall/ fainting episode I had bitten my lip, cut my chin, had abrasions on my right thigh and left shoulder and bruised my right knee and some poop in my underwear I hadn't wiped properlyat the time, that's how out of it I was. I have never fainted or passed out ever before in my 31 years of life. I live alone and it was a very scary incident for me. Luckily my injuries were minor and I have recovered but I felt like I might die during the episode. My body had a very strong adverse reaction 12 hours post vaccine.

Other Meds: Estarylla birth control Zitsticka skin discipline supplement Ipratropium bromide nasal spray 0.03% Ibuprofen 400 mg right after vaccine at 4 pm Loratadine 10 mg about 1 hour after vaccine around 5 pm Naproxen 500 mg around 4 am at time of r

Current Illness: None known, healthy

ID: 0975408
Sex: F
Age: 51
State: NJ

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 01/26/2021
Hospital:

Lab Data:

Allergies: Bactrim. Ceftin

Symptoms: Complete dose not given. I?m an experienced RN of 30 yrs. pharmacist who administered pulled syringe to early and some of dose streamed down my arm I contacted CDC asking questions out of concern of not receiving full dose and they told me to fill this form out and that they are trying to fix the problem of ?administrator error?

Other Meds: Toprol

Current Illness:

ID: 0975409
Sex: F
Age: 44
State: AZ

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

Lab Data: None

Allergies: Codeine, adhesive, teslon perls

Symptoms: Shortness of breath 1/26/21 @7:30am Headache 1/26/21 @ 11:15am Fever 1/26/21 @11:30 98.9 ? Fever 1/26/21 @12:30pm 99.5?

Other Meds: Propranolol

Current Illness: Cold covid negative 1/11/21 1/13/21

ID: 0975410
Sex: F
Age: 44
State: PA

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 01/26/2021
Hospital:

Lab Data:

Allergies: Ancef Levaquin

Symptoms: Headache 2 hours after vaccine took Tylenol to relieve Chills 2 hours after vaccine Lightheadedness began about 2 hours after vaccine and continues. Sore left arm

Other Meds: Adderall Synthroid Wellbutrin Valium Fish Oil Multi vitamin Milk Thistle Vitamin D Vitamin B Complex

Current Illness: none

ID: 0975411
Sex: F
Age: 55
State: PA

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 01/26/2021
Hospital:

Lab Data: None

Allergies: Allergy to Flexoril (hives) Latex sensitive (contact dermatitis)

Symptoms: Fever 102, chills, body aches, headache, fatigue, nausea, vertigo, weakness, injection site erythema and swelling and pain Fever lasted 24 hours. Vertigo resolved within 12 hours of onset of symptoms. Body aches, headache, fatigue improved after 24 hours and resolved by 72 hours. Nausea was intermittent over the first 72 hours. Localized injection site symptoms resolved within 72 hours.

Other Meds: Levothyroxine, Viactiv calcium soft chews, MegaRed Krill Oil

Current Illness: None

ID: 0975412
Sex: F
Age: 30
State: NJ

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 01/26/2021
Hospital:

Lab Data:

Allergies: PENICILLIN

Symptoms: ACHES AND TINGLES. @12:45AM WOKE UP FREEZING WITH A FEVER. WEDNESDAY MORNING WOKE UP WITH A COLD SWEAT. WEDNESDAY NIGHT- SAME SYMPTOMS BUT 10X WORSE. UNCONTROLLABLE SHAKES, FEVER, FREEZING, ENTIRES BODY ACHES. TOOK TYLENOL, NYQUIL AND ADVIL.

Other Meds: LOESTIN FE

Current Illness: NONE

ID: 0975413
Sex: F
Age: 48
State: OK

Vax Date: 01/23/2021
Onset Date: 01/24/2021
Rec V Date: 01/26/2021
Hospital:

Lab Data:

Allergies:

Symptoms: fatigue lasting 3 days starting day after receiving the vaccination

Other Meds:

Current Illness: bronchitis

ID: 0975414
Sex: F
Age: 46
State: FL

Vax Date: 01/18/2021
Onset Date: 01/21/2021
Rec V Date: 01/26/2021
Hospital:

Lab Data: i spoke to urgent care and being seen by them on 1/26/21

Allergies: n/a

Symptoms: headaches and a hot arm at injection site that the site is raised and puffy and hot like infection and heart raced

Other Meds: xanax birth control

Current Illness: none

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm