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: 0977825
Sex: M
Age: 44
State: OR

Vax Date: 01/23/2021
Onset Date: 01/23/2021
Rec V Date: 01/27/2021
Hospital:

Lab Data: normal ESR/CRP/EKG

Allergies: none

Symptoms: pt had brief palpations 20 minutes after vaccine, pain in left arm spreading across the chest to right side 5 hrs later. Felt like someone had punched him repeatedly in the chest the next day and that night he was profoundly fatigued and couldn't take a deep breath, was winded with simple physical tasks ie walking across the room. The next day 1/24/21 the pain resolved but was easily winded. Improving since then

Other Meds: mesalamine that morning, 1.2 mg 2 tabs

Current Illness: none

ID: 0977826
Sex: M
Age: 78
State: NJ

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 01/27/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: Vaccine was thawed on 1/11/21, use by date 1/16/21, but was used to immunize patient on 1/22/21.

Other Meds:

Current Illness:

ID: 0977827
Sex: F
Age: 60
State: NY

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 01/27/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Pt's heart rate increased exponentially post vaccine (169). EKG was done at office and patient was sent ER through ambulance. Pt has hx of panic attacks with similar sx. Pt was monitored for 15 minutes, heart rate dropped to 125. SEnt to ER for fruther evaluation. Intensity Min-0.

Other Meds:

Current Illness:

ID: 0977828
Sex: F
Age: 88
State: MA

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 01/27/2021
Hospital:

Lab Data: Patient was sent to ER for further evaluation.

Allergies: Amoxicillin, Clemastine, Codeine, Diphenhydramine, Clemastine-phenylprop, Coconut oil, erythromycin base, Macrolide Antibiotics, Mango Flavor, Nitrofurantoin Macrocrystalline, Sobrerol

Symptoms: Patient noted with increase lethargy, fever of 102.5,RR=20, and a pulse of 115.

Other Meds: Zoloft 50mg daily, Protonix 40 mg daily, Ramelton 8mg daily, Senna 8.6mg PRN, Norvasc 2.5mg daily, Oxycodone 5mg PRN, Trazodone 25mg at HS , vIT D3 1000 unit daily, Lidocaine Patch 5% to lowe back daily.

Current Illness: None

ID: 0977829
Sex: F
Age: 47
State: CA

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

Lab Data:

Allergies:

Symptoms: 1st night 01.25.20, Fever 101. now .low grade all day. Dizzy, Body Aches. Feeling of ?stabbing? Pins and needles in fingers and toes, felt like fainting, blacking out during this time. Loss of taste today, 01.27.21.

Other Meds:

Current Illness:

ID: 0977830
Sex: M
Age: 58
State: CA

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 01/27/2021
Hospital:

Lab Data: transfer to Urgent Care

Allergies: Tree Nuts

Symptoms: Patient developed itchy arms bilaterally within monitoring time post vaccine, referred patient to Urgent Care for evaluation

Other Meds: Hydrocodone, Iron, Lasix, Wellbutrin, Cymbalta, Potassium, Losartan, Atenolol, Prilosec, Nortriptyline, Baclofen, Alvesco, Atorvastatin

Current Illness: denies

ID: 0977831
Sex: F
Age: 23
State: LA

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 01/27/2021
Hospital:

Lab Data:

Allergies: N/A

Symptoms: I started yesterday about 8 p.m. with an upset stomach, diarrhea and nausea, this morning about 7 a.m. I started getting hot and cold flashes, lightheaded, dizzy, extreme head ache and I just felt not myself.

Other Meds: Slynd

Current Illness: N/A

ID: 0977832
Sex: F
Age: 68
State: AR

Vax Date: 01/19/2021
Onset Date: 01/27/2021
Rec V Date: 01/27/2021
Hospital:

Lab Data:

Allergies: Sulfa Keflex Sensitivity to several BP meds.

Symptoms: After one week, awoke with very itchy arm at injection site and red skin irritation.

Other Meds: Armour Thyroid, Trazodone, vaginal DHEA, MVI, L-theanine, Vit B, C, D, zinc, calcium.

Current Illness: None.

ID: 0977833
Sex: M
Age: 66
State: PA

Vax Date: 01/04/2021
Onset Date: 01/05/2021
Rec V Date: 01/27/2021
Hospital:

Lab Data: n/a

Allergies: none reported

Symptoms: Patient reports persistent numbness in the left forearm starting the day after shot (1/5/2021) and still present on (1/27/2021). Patient states that numbness is present 90% of the time and extends to fingers. Patient reports also experiencing pain above and below elbow characteristic of tendonitis.

Other Meds: none reported

Current Illness: none reported

ID: 0977834
Sex: F
Age: 56
State: WA

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 01/27/2021
Hospital:

Lab Data: none

Allergies: None

Symptoms: About after 10 mins of the shot, Pt was in lobby being monitored for the adverse reaction. She started having burning pain in the whole left arm, Sweat and Chills, she felt something stuck in the throat and medicine taste in her mouth. Called 911, Paramedics evaluated and said, she can go home and watch for the symptoms.

Other Meds: None

Current Illness: None

ID: 0977835
Sex: F
Age: 38
State: LA

Vax Date: 12/18/2020
Onset Date: 12/18/2020
Rec V Date: 01/27/2021
Hospital:

Lab Data: Covid test

Allergies: No

Symptoms: At the vaccination day only soreness at the injection site. I started feeling bad on 12/27/20 with a sore throat. Monday I had a bit of sinus congestion and Tuesday 12/29/20 no sense of smell or taste. I was tested that day on 12/29/20 and was positive.

Other Meds: Lexapro, orthotrysprintex (birth control), Vitamin C and a multivitamin as well, iron, Biotin

Current Illness: No

ID: 0977836
Sex: F
Age: 63
State: ME

Vax Date: 12/22/2020
Onset Date: 12/22/2020
Rec V Date: 01/27/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Erythema, warmth, edema, and pain starting within several hours of vaccination and continuing for more than one week. Appears most concerning for cellulitis, but cannot rule out an inflammatory reaction to vaccine or one of its components/diluents. Antibiotic therapy initiated. No other symptoms to suggest hypersensitivity or allergic response. Treatment ONGOING.

Other Meds:

Current Illness:

ID: 0977837
Sex: F
Age: 72
State: IN

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

Lab Data: none

Allergies: Sulfa drugs and derivatives, Versed

Symptoms: Drowsiness and headache. I slept three hours after I arrived home from 2:30-5:30 and took tylenol.

Other Meds: Fluconazole 200mg 2x weekly. Dietary supplements: One a day multiple vitamin for women, Vitamin D3 1000IU, Calcium 1600mg, Vitamin C 100mg, Vitamin B12 1000mcg, Biotin 5000mcg

Current Illness: none

ID: 0977838
Sex: F
Age: 44
State: WI

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 01/27/2021
Hospital:

Lab Data: None.

Allergies: Bee stings and morphine

Symptoms: Complained of blurred vision, and feeling lightheaded and dizzy. Vital signs were within normal limits. O2 saturation normal. Started about 15 minutes after vaccination and lasted another 15 minutes. No medications or other interventions needed. Will follow up with their physician.

Other Meds:

Current Illness: None known

ID: 0977839
Sex: F
Age: 59
State: TN

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 01/27/2021
Hospital:

Lab Data: None

Allergies: Compazine

Symptoms: 14 hours later had 103 fever with chills, joint pain, migraine x 16 hours. The next day fever down, but has joint pain and dull headache.

Other Meds: Triamterene 37.5mg/HCTZ 25mg and Diazepam 2mg

Current Illness: None

ID: 0977840
Sex: M
Age: 16
State: CA

Vax Date: 01/14/2021
Onset Date:
Rec V Date: 01/27/2021
Hospital:

Lab Data: n/a

Allergies: none

Symptoms: 16 year old

Other Meds: unknown

Current Illness: unknown

ID: 0977841
Sex: F
Age: 64
State: TX

Vax Date: 01/19/2021
Onset Date: 01/26/2021
Rec V Date: 01/27/2021
Hospital:

Lab Data:

Allergies: no, do get itchy red skin often, so I use the body cream that my dermatologist recommends

Symptoms: My arm was sore next day, red and swollen around injection site, but disappeared next day. Then 7 days later in the evening, the injection site began to itch. The area around the injection site is raised and slightly red again, It is not painful like the first time, but now itchy. It had totally disappeared and is back again. Is this normal and nothing to worry about?

Other Meds: Levothyroxine 50 mg once daily,, atorvastatine 20 mg daily, multivitamin supplement (women 50+), Calcium citrate +D3, omeprazole 20 mg

Current Illness: none

ID: 0977842
Sex: F
Age: 40
State: IN

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

Lab Data:

Allergies:

Symptoms: Per internal event report: Pt received 1st dose COVID vaccine Pfizer on 1/4/21. Pt returned to clinic to receive 2nd dose of Pfizer, but was given Moderna instead. Pt noticed while waiting in waiting area after vaccine administered, and notified clinic staff. State department of health was notified, and recommendation was to not further vaccinate (i.e. no 3rd dose warranted). Per email with follow up information: Reviewed with pt and with RN that administered the vaccine. Check in staff did not have memory of the event. Patient recollection of events: Pt reported that she was asked about if it was her first or second dose and confirmed it was her second dose and had her CDC card with her. She was here for her second Pfizer. During check in the pt stated that she was given a card for room 7 and the card was blue (Moderna). Pt stated that she had a conversation with the administering RN about it being her second dose and stated she was to have Pfizer. She does not recall is she had her card out in the administration bay. Pt stated she received the vaccine and was in the waiting area when she received the text from the state thanking her for getting her Moderna vaccine. At this point she approached registration and informed them of the issue. She spoke with Dr. X, who was volunteering in the clinic at the time. Pt was told that she did not need to receive another shot at that time (this has been confirmed with the state). Reviewed with the pt that she would not need to get another shot and that we would be reporting the issue. She was appreciative of the call and understood to let me know if she had any other questions or concerns RNs recollection of events: RN recalls giving the vaccine but does not recall verifying the card (CDC) or in Zotec about the brand of the second dose. She recalls that the pt had the blue (Moderna) card for the room. She was on the Moderna hallway at the time of the admin. Process review: Typically, when we are administering 2 different vaccines, the clinic is evenly divided, with one row being Moderna (blue) and with the other row being Pfizer (red). On 1/25/21, due to high volume of Pfizer second doses, we opened rooms in our Moderna row for Pfizer vaccine. These rooms have red cards placed in them to match the red room number cards and the red flags on the vaccine. The remaining Moderna rooms had blue cards to match the blue room numbers and blue flags on the Moderna Vaccine. Vaccine administration staff only give one brand of vaccine at a time. Room 7 was one of the rooms that had been converted earlier in the day. At the time of the admin, the room was being operated as a Moderna room. Gaps: -At check in when the pt was given a Moderna colored card and placed in a Moderna room. The check in person likely still thought room 7 was a Pfizer room and did not recognize the wrong colored card. -In the admin room, the administrator did not validate the prior vaccine, or did not recognize that the vaccine was not the same as what she was administering. Actions: -Follow up completed with administering RN on verifying prior dose, both using the CDC card and in the Zotec system. -Reviewed process for assigning room based on type of vaccine with admin staff and clinic leads to review daily with volunteer staff. -Pt was called and updated and informed to call if any issues or questions.

Other Meds:

Current Illness:

ID: 0977843
Sex: F
Age: 44
State: MT

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 01/27/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Pt given Td before the 2 week recommended time period

Other Meds:

Current Illness: Covid - 19 vaccination given on 1-14-21

ID: 0977844
Sex: M
Age: 19
State:

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 01/27/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Urticaria 30 post vaccination

Other Meds:

Current Illness:

ID: 0977845
Sex: F
Age: 58
State: NY

Vax Date: 01/06/2021
Onset Date: 01/21/2021
Rec V Date: 01/27/2021
Hospital:

Lab Data: none performed except IM Benadryl and decadron

Allergies: pyridium, Bactrim, iv Phenergan, clindamycin

Symptoms: received moderna 1/6/21 left arm on Jan21 at 630 am, starting developing rash down left arm, quickly spread thru entire upper body, and localizing in the joints, spread down to legs, was a flat rash, not raised, burning my skin. called my local MD, took Claritin with some relief from rash. within a half hour developed tachycardia, severe shortness of breath, diff. swallowing and throat started closing up. Was unable to make it to a ER, made it to Wellnow urgent care and was given IM Benadryl and decadron. . Throat opened up after 15 minutes. remained SOB for several days, was put on prednisone. both covid tests, quik test and longer test were negative. there was no other explanation to these symptoms as nothing new contributed to these side effects

Other Meds: levothyroxine, cytomel, vitamin c, zinc , HCTZ, famotidine

Current Illness: none

ID: 0977846
Sex: F
Age: 80
State: GA

Vax Date: 01/18/2021
Onset Date: 01/25/2021
Rec V Date: 01/27/2021
Hospital:

Lab Data:

Allergies: mild rash after streptomycin, declomycin and darvocet N

Symptoms: site of injection became itchy and slightly red on 01/25/2021 - one week after the vaccination - and itchiness decreased over the following two days

Other Meds: amlodopine, prilosec, multivatim, ubiquinol

Current Illness: None

ID: 0977847
Sex: F
Age: 29
State: IN

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

Lab Data:

Allergies: Bactrim Strawberries

Symptoms: Approximately 10 hours after receiving 2nd dose of vaccine, onset of moderate joint pain, headache, body aches and chills noted. Symptoms persisted for 16 hours without intervention of medication. After 16 hours, symptoms were alleviated with 2 doses of 1000mg acetaminophen taken 6 hours apart. 1st dose at 11am on 1/26/21 and second dose at 5pm on 1/26/21

Other Meds: Aspirin 81mg Multivitamin

Current Illness: None

ID: 0977848
Sex: F
Age: 68
State: NE

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

Lab Data:

Allergies: keflex

Symptoms: slight headache. reddish/purple bruise dime size around injection site

Other Meds:

Current Illness: none

ID: 0977849
Sex: F
Age: 36
State: NH

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

Lab Data: None

Allergies: Tetracycline, savella

Symptoms: Chills on the evening of injection. The next day 1/26/21 - 100.2 fever, headache, body aches- 600mg of ibuprofen taken once around 8 AM. Fever and body aches improved post ibuprofen, headache persisted. Evening of 1/26/21 fever seemed to return at 99.1 but resolved the morning of 1/27/21. Injection site reaction of warm, red, slightly raised bump noted on the AM of 1/27/21- no action taken at this time

Other Meds: Herbal remedy- essential oils- turmeric, frankincense, copaiba, grapefruit, orange

Current Illness: None

ID: 0977850
Sex: F
Age: 33
State: NY

Vax Date: 01/15/2021
Onset Date: 01/16/2021
Rec V Date: 01/27/2021
Hospital:

Lab Data:

Allergies: Penicillin

Symptoms: Body aches, no treatment, 8-10hrs malaise, no treatment, 12-24hrs

Other Meds: Adderall rx Lexapro

Current Illness: ADHD Generalized anxiety

ID: 0977851
Sex: F
Age: 38
State: LA

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 01/27/2021
Hospital:

Lab Data: None

Allergies: No

Symptoms: Soreness at the injection site

Other Meds: Tri Sprintec (birth control) and Lexapro, Vitamin C and a multivitamin as well, iron, Biotin

Current Illness: No

ID: 0977852
Sex: F
Age: 24
State: IN

Vax Date: 12/31/2020
Onset Date: 12/31/2020
Rec V Date: 01/27/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Ringing in ears

Other Meds: None

Current Illness: None

ID: 0977853
Sex: U
Age: 28
State:

Vax Date: 01/26/2021
Onset Date: 01/01/2021
Rec V Date: 01/27/2021
Hospital:

Lab Data:

Allergies:

Symptoms: High fever, chills, headache, weakness, fatigue, arm pain, body aches

Other Meds: testosterone gel

Current Illness:

ID: 0977854
Sex: F
Age: 39
State:

Vax Date: 01/18/2021
Onset Date: 01/19/2021
Rec V Date: 01/27/2021
Hospital:

Lab Data:

Allergies: Tetracycline

Symptoms: Large red "patch" beneath the injection site. Approximately a week later, the patch turned into a red, itchy rash.

Other Meds: Singulair, QVAR, Ventolin (as needed), Allegra, Flonase, Trazadone, Vitamin C, Folic Acid, and Hair/Nail multivitamin

Current Illness: N/A

ID: 0977855
Sex: F
Age: 30
State: WA

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

Lab Data: Tryptase * 3.3 ng/mL Complement C4 * 45 mg/dL

Allergies: HYDROmorphone Hydrochloride (Anaphylaxis) Latex (Anaphylaxis, Hives) Other (Non-Drug) (bleach wipes) Pepper-Veg (Anaphylaxis) contrast media (iodine-based) (Anaphylaxis) omalizumab (Anaphylaxis) Ativan (nausea) LORazepam (hallucinations, abdominal pain, N/V) amLODIPine (sob) budesonide nasal (Pain, Nosebleed) contrast media (gadolinium-based) (Wheezing, swelling) Chlorhexidine Gluconate (Rash, Rash) Pork (UNKNOWN) Purel Hand Sanitizer (Hives) amoxicillin (Anaphylaxis) codeine (Anaphylaxis) morphine (Anaphylaxis) penicillins (Anaphylaxis)

Symptoms: Nasal congestion, uvular edema/erythema, stridor. Received 2 doses of epi followed by oral benadryl 50 mg and 32 mg methylprednisolone; albuterol. Needed an additional 2 doses of epinephrine. Monitored for 3 hours.

Other Meds: acetaminophen 325 mg oral tablet, 650 mg= 2 tab(s), PO, Q6 Hours, PRN Aimovig SureClick Autoinjector-aooe 140 mg/mL subcutaneous solution, 140 mg, SUB-Q, Q30 Days, 6 refills albuterol 2.5 mg/3 mL (0.083%) inhalation solution, 2.5 mg= 3 mL

Current Illness: See chronic illnesses

ID: 0977856
Sex: F
Age: 31
State: NY

Vax Date: 01/05/2021
Onset Date: 01/05/2021
Rec V Date: 01/27/2021
Hospital:

Lab Data:

Allergies: peach fuzz, lasix, codeine

Symptoms: Patient reports onset of "ball in throat" sensation and metallic tasted in mouth after 1 minute of vaccine injection. This was followed approximately one minute later with tongue numbness, tingling, swelling. She did not report difficulty breathing and dismissed her symptoms as "anxiety". She continues with sensory loss on the right side of her face with paresthesia around the right eye. She has seen her PCP for this condition at time of call.

Other Meds: metoprolol

Current Illness: none

ID: 0977857
Sex: F
Age: 30
State: CA

Vax Date: 01/16/2021
Onset Date: 01/21/2021
Rec V Date: 01/27/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: swelling in L arm pit and neck

Other Meds: LarinFE

Current Illness: none

ID: 0977859
Sex: F
Age: 45
State: PA

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 01/27/2021
Hospital:

Lab Data: none

Allergies: Bacitracin Penicillin Prophylene Glycol Diacetate Erythromycin

Symptoms: Reported feeling dizzy, lightheadedness adn tingle and thick in the throat. BP 135/65 SP02100%, HR 66 bpm. Given apple juice and didn't feel lightheadeness or tnling. Then expressed waves of episodes reported by the patient. Monitored for 117 minutes. PRovider called 1 hour after monitoring symptoms that were not worsening. Still felt shakey. Given option to go to ED or be transported by ambulance. Went via ambulance to ED. Did not receive any additional treatment in the ED. ED noted that it did not appear to be anaphylactic reaction.

Other Meds: unknown

Current Illness: unkonwn

ID: 0977860
Sex: F
Age: 53
State: NE

Vax Date: 01/23/2021
Onset Date: 01/23/2021
Rec V Date: 01/27/2021
Hospital:

Lab Data: NONE

Allergies: CODEINE

Symptoms: Day 1 Within 10 min of shot ? pain at sight Within 1 hr of shot ? pain at sight, nausea 7 pm in bed Day 2 Had hot/cold spells, body aches in night while sleeping Nausea Headache Tiredness Developed bright redness around both eyelids with burning Biceps and Quads felt numb 8 pm in bed Day 3 Called in sick to work due to the excessive nausea Backache All other symptoms gone 9 pm in bed Day 4 Still had slight nausea and was going to come to work but missed due to weather 9 pm in bed Day 5 Back at work Very very slight nausea

Other Meds: NONE

Current Illness: NONE

ID: 0977861
Sex: F
Age: 33
State: CT

Vax Date: 12/31/2020
Onset Date: 01/26/2021
Rec V Date: 01/27/2021
Hospital:

Lab Data: CBC, test for tick-borne disease (1/26/21) - pending results

Allergies: no known

Symptoms: developed presentation of cherry angioma with sudden onset on trunk/upper legs/forearms - not itchy, not blanching, no other symptoms

Other Meds: sertraline, orsythia (OCP)

Current Illness: none

ID: 0977862
Sex: M
Age: 53
State: OH

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 01/27/2021
Hospital:

Lab Data:

Allergies: Levaquin, Elavil.

Symptoms: Stomach Pain, Nausea, Diarhhea, Hot Flashes and Cold Chills. No Fever.

Other Meds: vitamin d

Current Illness: none

ID: 0977863
Sex: F
Age: 49
State: CA

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

Lab Data:

Allergies: No known allergies

Symptoms: Patient received her 2nd Pfizer vaccination dose around 11:45. Was observed for 15 minutes and then left the clinic. She returned to the clinic 30 minutes later with complaints of dizziness, chest pressure, and tingling on her tongue. She ambulated in with her husband. She also stated she has a history of anxiety and was not sure if this was related to that or not. Due to the ongoing chest pressure, she was advised to go to the ED for further assessment. Per ED note, patient left the ED prior to receiving a medical screening exam by provider.

Other Meds: Not available

Current Illness: Not available

ID: 0977864
Sex: F
Age: 64
State: VA

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 01/27/2021
Hospital: Y

Lab Data: 1/22/21, serial cardiac enzymes normal, CXR normal, repeat EKGs which normalized after being given Nitroglycern SL x 2 and IM Tramadol. For prophylaxis during hospitalization, placed on subqu Lovenox, ASA 81mg and Metroprolol (dose unknown). Discharged next day.

Allergies: None known

Symptoms: Developed Left sternal chest pain with radiation to L upper arm with numbness and tingling of 3 fingers on left hand (Vaccine was administered in Right arm). Presented to ER, EKG showed inferior lead changes suggestive of ischemia. Was admitted overnight onto telemetry floor, no adverse s/s noted. Labs normal. CXR normal. Discharged next day, 1/23/21, with recommendation for cardiology follow up. Stress test, echo, and potentially cardiac MRI recommended, awaiting scheduling. Cardiology follow up scheduled Mon, 2/1/21.

Other Meds: OTC vitamins, calcium supplements, melatonin sleep, Benadryl sleep

Current Illness: None known

ID: 0977865
Sex: F
Age: 46
State: NE

Vax Date: 01/01/2021
Onset Date: 01/13/2021
Rec V Date: 01/27/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: After 5 minutes mouth had metallic taste, tongue and face started itching. Temp 99.9 tympanic. Flushed, red, hives on face, trunk, severe Itching.

Other Meds: synthroid effexor Clonazapam Vitamins

Current Illness: none

ID: 0977866
Sex: F
Age: 31
State: KY

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 01/27/2021
Hospital:

Lab Data:

Allergies: Navy beans

Symptoms: Nausea, Vomiting, Diarrhea, fatigue, muscle soreness, body aches, headache, small fever

Other Meds: Zoloft 50mg, buspirone 15mg

Current Illness: None

ID: 0977867
Sex: U
Age:
State: IN

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

Lab Data:

Allergies:

Symptoms: Reporting an administration error - NOT an ADR Per internal event report: Pt received 1st dose COVID vaccine Pfizer on 1/4/21. Pt returned to clinic to receive 2nd dose of Pfizer, but was given Moderna instead. Pt noticed while waiting in waiting area after vaccine administered, and notified clinic staff. State department of health was notified, and recommendation was to not further vaccinate (i.e. no 3rd dose warranted). Per email with follow up information: Reviewed with pt and with RN that administered the vaccine. Check in staff did not have memory of the event. Patient recollection of events: Pt reported that she was asked about if it was her first or second dose and confirmed it was her second dose and had her CDC card with her. She was here for her second Pfizer. During check in the pt stated that she was given a card for room 7 and the card was blue (Moderna). Pt stated that she had a conversation with the administering RN about it being her second dose and stated she was to have Pfizer. She does not recall is she had her card out in the administration bay. Pt stated she received the vaccine and was in the waiting area when she received the text from the state thanking her for getting her Moderna vaccine. At this point she approached registration and informed them of the issue. She spoke with Dr. who was volunteering in the clinic at the time. Pt was told that she did not need to receive another shot at that time (this has been confirmed with the state). Reviewed with the pt that she would not need to get another shot and that we would be reporting the issue. She was appreciative of the call and understood to let me know if she had any other questions or concerns RNs recollection of events: RN recalls giving the vaccine but does not recall verifying the card (CDC) or in Zotec about the brand of the second dose. She recalls that the pt had the blue (Moderna) card for the room. She was on the Moderna hallway at the time of the admin. Process review: Typically, when we are administering 2 different vaccines, the clinic is evenly divided, with one row being Moderna (blue) and with the other row being Pfizer (red). On 1/25/21, due to high volume of Pfizer second doses, we opened rooms in our Moderna row for Pfizer vaccine. These rooms have red cards placed in them to match the red room number cards and the red flags on the vaccine. The remaining Moderna rooms had blue cards to match the blue room numbers and blue flags on the Moderna Vaccine. Vaccine administration staff only give one brand of vaccine at a time. Room 7 was one of the rooms that had been converted earlier in the day. At the time of the admin, the room was being operated as a Moderna room. Gaps: -At check in when the pt was given a Moderna colored card and placed in a Moderna room. The check in person likely still thought room 7 was a Pfizer room and did not recognize the wrong colored card. -In the admin room, the administrator did not validate the prior vaccine, or did not recognize that the vaccine was not the same as what she was administering. Actions: -Follow up completed with administering RN on verifying prior dose, both using the CDC card and in the Zotec system. -Reviewed process for assigning room based on type of vaccine with admin staff and clinic leads to review daily with volunteer staff. -Pt was called and updated and informed to call if any issues or questions.

Other Meds:

Current Illness:

ID: 0977868
Sex: F
Age: 37
State: NY

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 01/27/2021
Hospital:

Lab Data: None.

Allergies: None.

Symptoms: About 9:30 started getting right facial numbness and right arm numbness. Resolved within a couple of hours.

Other Meds: Adderall as needed, Xanax as needed.

Current Illness: None.

ID: 0977869
Sex: F
Age: 76
State: LA

Vax Date: 01/08/2021
Onset Date: 01/09/2021
Rec V Date: 01/27/2021
Hospital: Y

Lab Data: Multiple Covid test- all negative (first being done on 1/9/2021) X ray- 1/9/2021

Allergies: Invokana, Rocephin, Vancomycin

Symptoms: 1/9/21 At 3:50 am started with nausea, weakness, and complaints of body aches. Required more assistance with ADL's than previous. @ 4:28 am: complaints of SOB, O2 sats 85% on room air. Required supplement O2, with tremors noted. PRN Zofran administered for nausea. 7:42 am noted with fever, decreased O2 sats, Tylenol administered for fever. Fever continue to climb despite Tylenol, supplemental O2 increased to 4L, rapid covid test negative, new orders to start Rocephin IM x 3 days and stat Xray which showed pneumonia. Temperature continues to remain elevated- O2 status continues to decline. Sent to ER 1/9/2021 @ 4:53 pm via ambulance. Admitted to Hospital with ABT tx for pneumonia and UTI. Respiratory status continued to decline- pulmonology consulted- Placed in ICU 1/13/21 and started on steroids. Required BiPap and was eventually weaned to supplemental O2. Multiple Covid tests- all negative. GI complaints addressed with GI consult- unremarkable. Started on PPI and Linzess. Eventually was placed on telemetry floor, closely monitored by pulmonology, and was cleared for discharge on 1/19/2021 back to nursing home.

Other Meds:

Current Illness:

ID: 0977871
Sex: F
Age: 41
State: NM

Vax Date: 01/22/2021
Onset Date: 01/24/2021
Rec V Date: 01/27/2021
Hospital:

Lab Data: Vitals obtained daily

Allergies: fentanyl, bananas

Symptoms: Dizziness, Lightheaded, Low blood pressure, low blood sugar every day from 9pm-noon.

Other Meds: phentermine

Current Illness: N/A

ID: 0977872
Sex: M
Age: 91
State: OH

Vax Date: 01/22/2021
Onset Date: 01/24/2021
Rec V Date: 01/27/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Sore armpit region, right shoulder where vaccine was administered. Cannot raise right arm past horizontal.

Other Meds: Aspirin, vitamin D3, metformin, lisinopril, atorvastatin

Current Illness: None

ID: 0977873
Sex: M
Age: 98
State: NJ

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 01/27/2021
Hospital:

Lab Data:

Allergies: lisinopril

Symptoms: Vaccine was thawed on 1/11/21, use by date 1/16/21, but was used to immunize patient on 1/22/21.

Other Meds:

Current Illness:

ID: 0977874
Sex: F
Age: 22
State: MN

Vax Date: 12/28/2020
Onset Date: 12/28/2020
Rec V Date: 01/27/2021
Hospital:

Lab Data:

Allergies: nickel

Symptoms: I got the vaccine the 28th I was fine until I sat down for dinner I started feeling bad, next day I woke up with a migraine which is not abnormal for me. It went away and I had body aches later that day and the next day. Thursday I had a red spot on my arm below the injection site. The following week my whole upper arm was swollen and I couldn't lift it , I went to the urgent care, they gave me antibiotics 500 mg 4x daily. The meds made me really sick and I quit taking it. and I started feeling better

Other Meds: migraine medication sometimes

Current Illness: no

ID: 0977875
Sex: M
Age: 35
State: IN

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 01/27/2021
Hospital:

Lab Data:

Allergies: No allergies to food or meds, just have seasonal and allergies to items such as dust and pollen.

Symptoms: I have previously had my right eyelid and eye area swell due to an allergic reaction. The last occurrence was about a year prior to this current event. I?m not entirely sure it is related to the vaccine, however my right eye swelled shut over night. I have no other adverse events. Today, I have taken OTC allergy medication, allergy eye drops, Benadryl, Pepcid, and Ibuprofen. The swelling is now going down.

Other Meds: Ibuprofen, Fexofenadine

Current Illness:

ID: 0977876
Sex: F
Age:
State: AZ

Vax Date:
Onset Date: 01/26/2021
Rec V Date: 01/27/2021
Hospital:

Lab Data: None

Allergies: Reglan, Bactrim

Symptoms: Burning sensation in upper stomach, chest, throat. Rapid heartbeat

Other Meds: Escitalopram, estradiol, Prevacid, Claritin, Vit D3, calcium, advair

Current Illness: None

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm