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: 0975720
Sex: F
Age: 37
State: OH

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

Lab Data: None

Allergies: None

Symptoms: Swelling and redness surrounding the injection site (the whole upper arm area), some itching, and what seems to be a painful/swollen lump (lymph node) in my lower left armpit.

Other Meds: None

Current Illness: None

ID: 0975721
Sex: F
Age: 49
State: VA

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

Lab Data:

Allergies: None

Symptoms: I became very tired after receiving the injection, followed by severe chills that evening, started running a fever during the night. I believe it got up to 100.9. The next day (Sunday) I slept a lot while continuing with the chills and fever. Monday was better, just very weak, temp was about 99.5. Today was good. No fever, a little sluggish, but much better.

Other Meds: Zoloft

Current Illness: None

ID: 0975722
Sex: F
Age: 38
State: CO

Vax Date: 01/05/2021
Onset Date: 01/17/2021
Rec V Date: 01/26/2021
Hospital:

Lab Data: January 17th - urgent care. Said reaction to vaccine and take Benadryl Rash continued to spread noticed other symptoms January 22 went to altitude family medicine gave steroids January 24 went back to urgent care, did a urine sample came back negative but prescribed antibiotics.

Allergies: Amoxicillin and penicillin

Symptoms: Rash 12 days after injection around injection site. Severe back ache chills. Inflammation of whole body. Rash spread to neck and left side of face. Then I started having worse back pain, pelvic pain, incontenance, painful to pee, urge to pee all the time. Abdominal swelling. Tests came back all negative for infection but steroids and antibiotics are helping.

Other Meds: Daily vitamins

Current Illness: None

ID: 0975723
Sex: M
Age: 98
State: CA

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

Lab Data: BP taken 89/60, Pt taken to ED for observation

Allergies: None

Symptoms: Pt began to lose consciousness during a conversation with observation RN.

Other Meds: None

Current Illness: None

ID: 0975724
Sex: F
Age: 17
State: CA

Vax Date: 09/15/2007
Onset Date: 09/15/2007
Rec V Date: 01/26/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Had Gardasil shot in 2006/2007 (late reporting - probably had original Gardasil shot). Immediately after getting shot, had extreme shooting pains in spine for approximately 10 seconds, followed by a numbness and inability to move left leg and left arm for approximately 1/2 day. Felt fine and had no symptoms the day after. Tried to report issues to nurse at the time of the vaccination, but they did not seem to be concerned.

Other Meds: None

Current Illness: None

ID: 0975725
Sex: F
Age: 74
State: TX

Vax Date: 01/16/2021
Onset Date: 01/25/2021
Rec V Date: 01/26/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Hot, red raised area in vaccination area

Other Meds: Levothyroxine Zinc Fish oil Vitamins B C D3

Current Illness: None

ID: 0975726
Sex: M
Age: 88
State: NJ

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

Lab Data:

Allergies: none

Symptoms: Vial was thawed on 1/11/21 and due to expire on 1/16/21 - patient was immunized with this expired vaccine on 1/22/21.

Other Meds:

Current Illness:

ID: 0975727
Sex: F
Age: 48
State: CA

Vax Date: 01/19/2021
Onset Date: 01/20/2021
Rec V Date: 01/26/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Fever body aches

Other Meds:

Current Illness:

ID: 0975728
Sex: F
Age: 54
State: PA

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

Lab Data:

Allergies: NONE

Symptoms: 102F FEVER, CHILLS

Other Meds: SYNTHROID 50MG, HYDROCHLOROTHIAZIDE 25MG, INVOKANA 100MG, LISINOPRIL 10MG, METTFORMIN HCL 10MG, CETIRIZINE 10MG, THYRIXINE 75MCG, ATENOLOL 50MG, ALLOPURINOL 100MG, CYCLOBENZAPRINE HCL 10MG

Current Illness: MIGRAINE

ID: 0975729
Sex: M
Age: 44
State: CA

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

Lab Data: None

Allergies: Penicillin

Symptoms: Felt light headed after vaccine and has continued to have "dizzy spells" and vertigo up to several times a day, especially on arising. Gives a history of "low blood pressure," but unsure of what the numbers typically are. Has had two events of nausea and headache on other days in the past two weeks since vaccine but doesn't believe it's related to the vaccine. States that events have gotten better over time. Encouraged to see his PCP.

Other Meds: Synthroid

Current Illness:

ID: 0975730
Sex: F
Age: 34
State: OR

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

Lab Data:

Allergies: Surgical adhesion tape Cephalexin

Symptoms: Pregnancy hx: currently pregnant, 1 prior pregnancy resulting in live birth EDD for current pregnancy: 7/2/2021 ADEs: likely robust immune response. Extreme fatigue, pounding headache, and reduced appetite X 36 hours. Onset about 6 hours after immunization. Also had very sore deltoid at site if immunization. No fever / rash / swelling. Symptoms relieved with APAP.

Other Meds: Prenatal vitamin

Current Illness: None

ID: 0975731
Sex: M
Age: 76
State: CA

Vax Date: 01/16/2021
Onset Date: 01/16/2021
Rec V Date: 01/26/2021
Hospital:

Lab Data:

Allergies:

Symptoms: initially, nausea and "weird" feeling for approximately 12 hours.Tthe injection site continued to be uncomfortable , and on 8th day after injection, the injection site began to itch. On 9th day, there was intense itching, and injection site began to swell. by 10th day (today), the swelling and itching is subsiding, but not gone.

Other Meds: altorvastatin 10mg, dosazosin mesyl 2mg, thyroxine 112mcg, metoprolol tartrate 25mg, furosemide 20mg, vitamin d, baby aspirin

Current Illness:

ID: 0975732
Sex: F
Age: 22
State: VT

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

Lab Data:

Allergies:

Symptoms: Called out of work over weekend

Other Meds:

Current Illness:

ID: 0975733
Sex: M
Age: 50
State: CA

Vax Date: 01/15/2021
Onset Date: 01/22/2021
Rec V Date: 01/26/2021
Hospital:

Lab Data: COVID Positive Abbott Now

Allergies: Bee Stings

Symptoms: COVID Positive.: Fatigue body aches

Other Meds: Glyburide 5mg, Losartan 50mg

Current Illness:

ID: 0975734
Sex: F
Age: 44
State: WI

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

Lab Data: None

Allergies: Penicillin and levaquin

Symptoms: Severe muscle aches, shaking chills, fever, severe pain at injection site all started 12 hours after immunization. Not relieved by Tylenol or ibuprofen.

Other Meds: None

Current Illness: None

Date Died: 01/25/2021

ID: 0975735
Sex: F
Age: 83
State: AR

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

Lab Data:

Allergies: Aricept, codeine, hydrocodone, sulfa abx

Symptoms: VACCINE ADMINISTERED 01/06/21 ACQUIRED COVID 19 01/10/21 RESIDENT HAD MULTIPLE CO MORBIDITIES AND WAS DECLINING PRIOR TO VACCINE. RESIDENT EXPIRED ON 01/25/2021

Other Meds: zinc, acidophylis, albuterol inhaler, vitamin d, mirtazapine, Pepcid, vitamin c, Lasix, magnesium oxide, Depakote, cranberry, melatonin, Zoloft, folic acid, pericolace, simethicone, xarelto, asa, mvi with mineral, synthroid, evista,

Current Illness: COVID 19 01-10-2021 GERD DELUSIONS VASCULAR DEMENTIA WITH BEHAVIORS INSOMNIA CHRONIC DVT LEFT LOWER EXTREMITY HEMOCHROMATOSIS PSYCHOSIS MAJOR DEPRESSIVE DISORDER WITH ANXITY IMPULSE DISORDER VITAMIN DEFICIENCY EDEMA CONSTIPATION HALLUCINATIONS HYPOTHYROIDISM HX OF SKIN CANCER CARPAL TUNNEL LT HAND DYSTHYMIC HTN

ID: 0975736
Sex: F
Age: 36
State: WY

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

Lab Data:

Allergies: Allergic to Demerol

Symptoms: Localized reaction. Area of about 4 inches wide by 2 inches tall, warm to the touch, redness, hardened

Other Meds: No medications were being taken at the time of vaccination

Current Illness: None

ID: 0975737
Sex: M
Age: 60
State: TX

Vax Date: 01/22/2021
Onset Date: 01/25/2021
Rec V Date: 01/26/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Headache and nasal congestion like a sinusite

Other Meds: Olmesartana Medoxomila 40mg Anlodipino 5mg

Current Illness: None

ID: 0975738
Sex: F
Age: 21
State: AZ

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

Lab Data:

Allergies: N/A

Symptoms: Migraine set in within 2-3 hours, sore arm immediately after for about an hour and a half

Other Meds: Vyvanse, Imitrex, Promethazine HCl, Venlaflaxine HCL, Amphetamine-Dextroamphetamine

Current Illness: N/A

ID: 0975739
Sex: M
Age: 17
State: OR

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

Lab Data:

Allergies:

Symptoms: Minor age 17 received Moderna vaccine. no adverse effects reported.

Other Meds:

Current Illness:

ID: 0975740
Sex: M
Age: 63
State: SC

Vax Date: 11/10/2020
Onset Date: 11/10/2020
Rec V Date: 01/26/2021
Hospital:

Lab Data: None

Allergies: none

Symptoms: Patient reported 1-26-21 that he has maintianed a hard knot at the sight of shingrix vaccine five 11-10-2020 had never reported any adverse effect up to this date

Other Meds: none

Current Illness: none

ID: 0975741
Sex: M
Age: 50
State: PA

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

Lab Data: I was sent for a Covid Rapid test on 01/21/2021 by Doylestown Hospital . I received my results an hour later and it was Negative

Allergies: Penicillin Sulfa

Symptoms: Loss of taste approximately 12 hours after my second dose.

Other Meds: Multi Vitamin Escitalopram 10mg

Current Illness: None

ID: 0975742
Sex: F
Age: 57
State: MA

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

Lab Data: No

Allergies: Penicillin, and Sulfur

Symptoms: Arm was tender and started the same day in evening , Blinding pounding head arch 12/31/2020. Message her Dr. and asked if she could take the headache Napicine Sodium 1 550 mg. Day 8 arm swelled up at injection site, hot, and itchy and slight fever, body was warm , day 9 went to talk with nurse and was given ice pack . Following day was not able to lift to extend to work . Recommended to take an allergy pill, she left half day of work and she rested and illness subside.

Other Meds: High Blood Pressure Losartan 100mg , Naproxen Sodium 550 mg as needed, vitamin C

Current Illness: No

ID: 0975743
Sex: F
Age: 27
State: MN

Vax Date: 08/01/2020
Onset Date: 08/01/2020
Rec V Date: 01/26/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Nausea, vomiting, stomach cramping, diarrhea. 7 months pregnant

Other Meds: Prenatal vitamin, vitamin D

Current Illness:

Date Died: 01/15/2021

ID: 0975744
Sex: F
Age: 87
State: CA

Vax Date: 01/07/2021
Onset Date: 01/15/2021
Rec V Date: 01/26/2021
Hospital: Y

Lab Data: UA, CBC, CMP

Allergies: NKA

Symptoms: See initial report

Other Meds: Atorvastatin Calcium 10mg, Ceftriaxone 1GM, Famotidine, Hydrocodone-Acetaminophen 5-325mg, Levothyroxine 25mcg, Senna, ASA, Docusate

Current Illness: The resident was febrile on 1/9/2021 after receiving the Pfizer vaccine on 1/7/2021. On 1/9/2021 UA, CBC, and CMP ordered indicating she had UTI. SARS-CoV-2 testing was performed using POCT GeneXpert on 1/9/2021. No SARS-CoV-2 was detected. The resident continued to decline and on 1/15/2021 she became tachycardiac and was having trouble breathing. She was transferred to ER where she later died.

ID: 0975745
Sex: M
Age: 37
State: CA

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

Lab Data:

Allergies:

Symptoms: chills with fever of 101. Now down to 100.7, bad heart burn. Woke up early due to coughing due to Heart Burn.

Other Meds:

Current Illness:

ID: 0975746
Sex: F
Age: 60
State: NY

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

Lab Data: Blood sugar level was performed and patient was given O2 to help.

Allergies: None

Symptoms: The patient experienced syncope within 30 minutes after receiving the covid-19 vaccine. At 2:30pm, she felt dizziness, her head was spinning, weakness of the arms, and slurred speech. Her FS was at 108 (Normal), BP 195/105 (Extremely high), Pulse 91, O2 saturation was at 100%. At 2:48PM, her BP lowered to 167/92. At this time, she can smile, she can put her hands up, she can kick her feet and she can opened/closed her eyes. Due to her high BP, Doctor requested that the should go to the ER via the ambulance.

Other Meds: None

Current Illness: None

ID: 0975747
Sex: M
Age: 92
State: NJ

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

Lab Data:

Allergies: vancomycin, Ceftin, iodine, Fortaz

Symptoms: Vial was thawed on 1/11/21 and due to expire on 1/16/21 - patient was immunized with this expired vaccine on 1/22/21.

Other Meds:

Current Illness:

ID: 0975748
Sex: M
Age: 87
State: MN

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

Lab Data:

Allergies:

Symptoms: sore and black and blue 4 inch long

Other Meds:

Current Illness:

ID: 0975749
Sex: F
Age: 38
State: CA

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

Lab Data: Blood panel taken Sunday. My white blood cell count is very high, 26.

Allergies: None

Symptoms: I have huge red itchy hives from head to toe. I went to the ER Saturday and Sunday. Nothing is helping. I?m taking prednisone, Pepcid, benedryl, ibuprofen, Allegra and Zyrtec. I am so miserable.

Other Meds: Minocycline

Current Illness: None

ID: 0975750
Sex: F
Age: 39
State: IA

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

Lab Data: None

Allergies: None

Symptoms: I received the vaccine on 1/20/21 at 2pm. At 10pm, my right arm was sore, and my temp was 100.8. I woke up at 12:30 am feeling very hot, temp at that time was 105.3, with body aches, chills, and an excruciating headache. At 1:30 am it was 103.1, 3:30 am 100.7 after taking Tylenol and Ibuprofen. By 7am it was down to 98.9. At 1100 am it was 99.2. I continued alternating Tylenol with Ibuprofen throughout the entire day. At 12:50 pm it was 100.8, and I could feel it spike up again around 4pm, although I did not take my temp. I took Tylenol at that time, temp 99.7 at 5:30pm. I continued with body aches, and a severe headache that entire next day. All symptoms with exception of sore arm were gone on 1/22/21

Other Meds: None

Current Illness: None

ID: 0975751
Sex: F
Age: 36
State: MO

Vax Date: 01/22/2021
Onset Date: 01/23/2021
Rec V Date: 01/26/2021
Hospital:

Lab Data:

Allergies: Penicillin

Symptoms: Migraine, muscle cramps, fever, chills, fatigue. Seen in ER for migraine after 4 days

Other Meds: Singulair, allegra, azo cranberry, vitamin d, lexapro

Current Illness: None

ID: 0975752
Sex: F
Age: 67
State: NJ

Vax Date: 01/21/2021
Onset Date: 01/24/2021
Rec V Date: 01/26/2021
Hospital:

Lab Data: none.

Allergies:

Symptoms: Quarter-sized soreness at injection site for two days following the shot. Some swelling on the third day, and by the 4th, physical therapist thought the area looked infected. It was hot to the touch, and roughly 10cmx10cm. Recommended seeing a doctor immediately. Family physician later that day prescribed Cephalexin.

Other Meds: Arimidex, Fosamax, Lexapro, calcium, Vitamin D

Current Illness:

ID: 0975753
Sex: M
Age: 37
State: CA

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

Lab Data:

Allergies:

Symptoms: 01.06.21 Fever of 100.3 with chills for 12 to 36 hours.

Other Meds:

Current Illness:

ID: 0975754
Sex: F
Age: 85
State: FL

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 01/26/2021
Hospital:

Lab Data: I?m having an Ultrasound on my right leg 1/27 and an appointment to see a Dermatologist 2/4. I was unable to reach my primary until last week.

Allergies: No food allergies. I?m allergic to Cortizone and Cipro

Symptoms: I have a rash on my face primarily around my eyes and it?s continued since 1/4. I also had a black and blue big right toe and my veins in my lower leg are dark as well. I did not injure my toe or leg.

Other Meds: Levothyroxine, Hydroclorothyazide, Magnesium Oxide, Omeprazole

Current Illness: I?ve been in good health.

ID: 0975755
Sex: F
Age: 51
State: IL

Vax Date: 01/19/2021
Onset Date: 01/20/2021
Rec V Date: 01/26/2021
Hospital:

Lab Data: None

Allergies: Sulfa

Symptoms: With dose #1, some HA, arm pain (in particular arm pit pain). With this dose #2, uncontrollable rigors at about 12 hours post-dose for at least 1-2 hours, Tm to 103.3F, HA, myalgias, right leg pain, weakness and again, significant, severe arm pit pain on same side as injection site. At 34 hours, much improved (almost 100%), but arm pit pain did not dissipate until about day 5.

Other Meds: None

Current Illness: None

ID: 0975756
Sex: F
Age: 35
State: TX

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

Lab Data:

Allergies: seafood, bee stings (carries epipen but did not have it today | may be expired)

Symptoms: Patient seated in observation area reported itchiness & burning at right shoulder 4:24 patient self ambulated to private observation area, accompanied by RN and EMT 4:26 VS 124\97 | HR 86 | PO2 98% ice bag provided to help with itchiness\ redness noted at left neckline | no redness noted on back 4:31 husband arrived in private observation (he is a cardiologist MD) 4:33 Benadryl 25mg given with water | 50 mg declined recommended that patient premedicate w/Bendryl prior to 2nd vaccine dose, also recommended she bring her epipen & husband 4:35 itchiness improved | additional redness noted at chest husband and patient took baseline pictures & RN shared medication time | family confirmed that Benadryl available at home 4: VS38 132\98 | HR 83 | PO2 99% family declined transport \ need for emergency care | husband MD signed VAERS form patient discharged and self ambulated with husband to car

Other Meds: Metformin

Current Illness: n/a

ID: 0975757
Sex: M
Age: 1
State: NJ

Vax Date: 03/15/2019
Onset Date: 03/15/2019
Rec V Date: 01/26/2021
Hospital:

Lab Data: None I never went back to see the doctor nor did I ever take my son to get any more vaccines, I don?t trust these doctors that only want to see you if you vaccinate your children.

Allergies: None that I am aware of

Symptoms: My son broke out in hives all over his body the day after vaccines on the 2nd or 3rd day the hives were so bad I called the doctors office and was told to give tylenol and benadryl and a warm bath he had marks that look like bite marks he immediately started to regress and started doing circles in the floor, extreme tantrums and non stop crying I knew it had to be the vaccines because it was the only thing we had done in those days, there were no new foods or anything like that. He also stopped eating he only wanted milk.

Other Meds: Just tylenol at times for teething

Current Illness: When my son received vaccines on 3/15/2019 he broke out in hives all over his body it spread about 2 days later and I called the office and spoke to nurse and was told to give benadryl and tylenol I was also told that it was weird that my son broke out in hives because vaccines don?t cause it. I followed the recommendations from the office.

ID: 0975758
Sex: F
Age: 53
State: NC

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

Lab Data:

Allergies:

Symptoms: Patient is a staff member at a LTC facility. After receiving the vaccine she stated that got very dizzy and nauseous within 5 minutes of receiving the vaccine. Stated that her head was pounding and that she was very cold. Family came and took her home. Have not heard from the family or patient since.

Other Meds:

Current Illness:

ID: 0975759
Sex: F
Age: 40
State: KS

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

Lab Data:

Allergies: sulfa

Symptoms: on 1/9/21 started having muscle aches in left shoulder and neck, then proceeded to feeling extreme fatigue. on eve of 1/9/21 began to have nausea, continued fatigue. 1/10/21 had a headache and had a 99 temp and felt feverish thoughout the day and also with continued shoulder and neck pain that lasted through 1/11/21. Fatigue continued until 1/14. on 1/13 had cramping and menstrual bleeding when it was not during time of normal period.

Other Meds: birth control

Current Illness: none

ID: 0975760
Sex: M
Age: 82
State: AZ

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

Lab Data:

Allergies: none

Symptoms: dizziness 4 days post vaccine

Other Meds: metoprolol; tamsulosin; gabapentin; asa; vit c; vit d

Current Illness: none

ID: 0975761
Sex: F
Age: 22
State: KY

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

Lab Data:

Allergies:

Symptoms: Moderna COVID-19 Vaccine EUA Fever, chills, headache, sore throat, nausea, injection site pain, body aches, fatigue

Other Meds:

Current Illness: COVID-19

Date Died: 01/24/2021

ID: 0975762
Sex: F
Age: 57
State: ID

Vax Date: 01/20/2021
Onset Date: 01/24/2021
Rec V Date: 01/26/2021
Hospital:

Lab Data:

Allergies: - Fish containing products - Kale - PCN

Symptoms: Pt deceased

Other Meds:

Current Illness: N/A

ID: 0975763
Sex: F
Age: 31
State: VT

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

Lab Data:

Allergies:

Symptoms: Called out of work over weekend

Other Meds:

Current Illness:

ID: 0975764
Sex: M
Age: 62
State: AL

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

Lab Data: No

Allergies: Cosine

Symptoms: Five days after receiving Maderna I became very symptomatic with the a for mentioned symptoms

Other Meds: Amlodipine, bystolic, nexium, Celebrex,Olmasartin,

Current Illness: None

ID: 0975765
Sex: F
Age: 45
State: OH

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

Lab Data: Monitoring BP

Allergies: History of anaphylactic shock due to Sulphas

Symptoms: 05:04PM Pt c/o nausea, lightheaded, for about 1-2 minutes. BP 92/62, SPO2: 98%, HR: 77 Pt took some water. 05:18PM Pt states she feels better. BP: 140/85. Pt left the facility asymptomatic.

Other Meds: Botox, Odactra (immunotherapy sublingual tablet for house dust mite-induced allergies), Botox injections for migraine, Zyrtec, Fluovent.

Current Illness: None

ID: 0975766
Sex: F
Age: 52
State: NC

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

Lab Data:

Allergies: nonenone

Symptoms: Approximately 5-10 minutes after it was administered, I felt a weird sensation in my throat. I could breathe fine, but it felt as if it was swelling and it felt weird to swallow. I didn't want to overreact so I waited a total of 30 minutes and symptoms subsided. My throat still felt weird, but I could breathe so I felt it was fine to leave. Symptoms subsided more once I got home 30 minutes later, but I took Benadryl. Symptoms eased completely and did not return.

Other Meds: anastrozole 1 mg; fluoxetine 10 mg; calcium, vit D

Current Illness: none

ID: 0975767
Sex: F
Age: 77
State: CA

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

Lab Data:

Allergies:

Symptoms: epigastric pain 4/10 with elevated blood pressure 170/72, HR 75

Other Meds:

Current Illness:

ID: 0975768
Sex: F
Age: 30
State: TX

Vax Date: 12/18/2020
Onset Date: 12/18/2020
Rec V Date: 01/26/2021
Hospital:

Lab Data: I wore a Holter Monitor for the week of 01/04/2021 through 01/12/2021. I also had an Echo on 01/25/2021.

Allergies: I am not allergic to foods or medications.

Symptoms: I had a fast heart rate, light headedness and cold extremitits.

Other Meds: I take a daily multivitamin.

Current Illness: No

ID: 0975769
Sex: M
Age: 69
State: CA

Vax Date: 01/22/2021
Onset Date: 01/23/2021
Rec V Date: 01/26/2021
Hospital:

Lab Data: Glucose, influenza A/B, SARS-COV-2 Rapid,

Allergies: Statins, diludid, contrast dyes

Symptoms: Wheezing, nausea, diarrhea, muscle aches, severe headache. Rx?s albuterol, azithromycin, Mesronian pack and ondansetron.

Other Meds: Asa, praluent, tradgenta, irbestartan, vasecpa, duloxetine, trazadone,gemfibrozil

Current Illness: None

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm