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: 0989661
Sex: M
Age: 51
State: MD

Vax Date: 01/31/2021
Onset Date: 01/31/2021
Rec V Date: 01/31/2021
Hospital:

Lab Data: N/A

Allergies: Denies allergy to medications Denies allergy to food Denies environmental or insect allergies

Symptoms: After 30 minutes, patient reports "tip of tongue feeling numb". Respirations even and unlabored. Secretion controlled. Speech clear.

Other Meds: denies taken OTC, dietary supplements or herbal remedies.

Current Illness: Denies

ID: 0989662
Sex: F
Age: 70
State: FL

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

Lab Data: none

Allergies: penicillin, allergic rhinitis

Symptoms: At the time of the vaccination, I felt some stabbing sensation in some parts of my body. Because it was dark and I was inside of a car, I turned on the lights. I did not notice any rash or redness. That day at night I had a little redness on one part of my back. In the following days, I have itched in different places on my body, but I have not developed any hives or rash, but the inexact itching sensation continues.

Other Meds: metformin ,omeprazole ,levothyroxine, atenolol, crestor rosuvastatin, meloxicam, tizanidine, methocarbamol, omega-3-1000, calcium plus vitamin D3

Current Illness: Diabetes, high blood pressure, hypothyroidism, scars in the lungs, maxillofacial pain radiating to the ear.

ID: 0989663
Sex: F
Age: 50
State: NJ

Vax Date: 01/20/2021
Onset Date: 01/30/2021
Rec V Date: 01/31/2021
Hospital:

Lab Data: Just texted doctor and read an article in the newspaper saying that it happed in various people and not to worry about it. However, I was told to report it so there would be a record of this occurring. As of now the rash is still there and I'm expecting it to go away in a few days. If not I'll reach back out to my doctor and update this information.

Allergies: Dust allergies

Symptoms: On the evening of Jan. 30th I was itching at the site and when I looked there was a large rash the approximately 3 to 4 inches in diameter.

Other Meds: Methformin 500 mg extended release once a day, .5 mcg Levothyroxine, 3.5mg naltrexone daily, iron supplements, vitamin d supplements and melatonin

Current Illness: no

ID: 0989664
Sex: F
Age: 18
State: OR

Vax Date: 01/15/2021
Onset Date: 01/16/2021
Rec V Date: 01/31/2021
Hospital:

Lab Data:

Allergies:

Symptoms: seizure

Other Meds: melatonin Lamotrigine

Current Illness:

ID: 0989665
Sex: F
Age: 49
State: TX

Vax Date: 01/30/2021
Onset Date: 01/30/2021
Rec V Date: 01/31/2021
Hospital:

Lab Data: labs, ekg, not sure what else.. all happened on 01/30/2021

Allergies: Allergy to lime jello - hives

Symptoms: about 6 hours post vaccine I started having chills and a headache. 11 hours post vaccine my hands became paralyzed in severe contracture. My face and feet and legs were number. I could barely breathe. I had to be transferred by Ambulance to Hospital

Other Meds: one a day vitamin tramadol dicyclomine omeprazole Valium Atorvastatin

Current Illness: Arthritis Irritable bowel syndrome Anxiety High cholesterol

ID: 0989666
Sex: F
Age: 67
State: TX

Vax Date: 01/23/2021
Onset Date: 01/31/2021
Rec V Date: 01/31/2021
Hospital:

Lab Data:

Allergies: mild seasonal allergies and maybe other allergies but I don't know

Symptoms: I had redness and swelling at the injection site or 2-3 days, and then everything was back to normal. But then on the 8th day I had slight itching and a rashy redness at the injection site about 2.5 inches long and wide.

Other Meds: bystolic, multi-vitamin, pravastatin, co-q10, buspirone, calcium, vitamin d

Current Illness: none

ID: 0989667
Sex: F
Age: 66
State: MO

Vax Date: 01/30/2021
Onset Date: 01/31/2021
Rec V Date: 01/31/2021
Hospital:

Lab Data: None

Allergies: Seasonal

Symptoms: Muscle pain, joint pain, headache, rapid heartbeat. Took Tylenol. Day after vaccine.

Other Meds: Metformin, Amaryl, Effexor, Crestor, Zestril, Prilosec, Meloxicam, Vitamin D3

Current Illness: Covid 19 12/27/2020

ID: 0989668
Sex: F
Age: 51
State:

Vax Date: 01/26/2021
Onset Date: 01/28/2021
Rec V Date: 01/31/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Moderate pain and swelling at site

Other Meds:

Current Illness:

ID: 0989669
Sex: F
Age: 71
State: NV

Vax Date: 01/30/2021
Onset Date: 01/30/2021
Rec V Date: 01/31/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Severe head pain, not a headache, severe throbbing searing pain in the head, causing nausea still present 14 hours after the head pain started

Other Meds: None

Current Illness: None

ID: 0989670
Sex: F
Age: 44
State: CA

Vax Date: 01/29/2021
Onset Date: 01/30/2021
Rec V Date: 01/31/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: Headache starting 3hrs after vaccine and lasting about 28 hrs, chills starting about 11 hrs later and lasting a few hrs, fatigue the day after, and swollen lymph node left lower cervical lymph node.

Other Meds: Ocella

Current Illness: none

ID: 0989671
Sex: F
Age: 59
State: MI

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

Lab Data: Unknown

Allergies: no

Symptoms: Patient exhibited red and itchy face and eyes. Was given 50 mg of Benadryl P.O. symptoms decreased and B/P 180/104. H/R 120. Discharged 170/98 B/P HR 111 bpm. Discharged with her husband driving. Advised to follow up with hospital and to follow up with her PCP before anymore immunizations.

Other Meds: No

Current Illness: no

ID: 0989672
Sex: F
Age: 57
State: NY

Vax Date: 12/21/2020
Onset Date: 12/23/2020
Rec V Date: 01/31/2021
Hospital:

Lab Data:

Allergies: Kelflex, Remicade, Levothorxine

Symptoms: 2 days after the vaccine I started experiencing numbness and tingling on the left side of my face statring at my lips and moving up to under my eye. This would last up to 1 & 1/2 hrs. I let my Infection Control Nurses know as soon as it happened. It has continued with the left sides of my face sor to touch near my cheekbone & jawbone, teeth both upper and lower contantly aching with the numbness & tingling still prominet. My gums feel swollen and teeth feel loose. They are not. Just the constant tingling that is the real issue. I had my second dose on 01/18/2021 with lot # of 001L20A. Woke up @ 2 am the next morning with a massive headache and ran a 101.3 temp for 2 & 1/2 days. Numbness and tingling continues.

Other Meds: None

Current Illness: None

ID: 0989673
Sex: F
Age: 30
State: IN

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 01/31/2021
Hospital:

Lab Data:

Allergies: Abreva

Symptoms: Severe vomiting and diarrhea for 4 hours

Other Meds: None

Current Illness: None

ID: 0989674
Sex: F
Age: 44
State:

Vax Date: 01/28/2021
Onset Date: 01/31/2021
Rec V Date: 01/31/2021
Hospital:

Lab Data:

Allergies:

Symptoms: moderate headache, body aches

Other Meds:

Current Illness:

ID: 0989675
Sex: F
Age: 40
State: VT

Vax Date: 01/22/2021
Onset Date: 01/30/2021
Rec V Date: 01/31/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: On the morning of day 8, after 5 days of since the initial injection side effect( sore arm), my skin around the injection site started to itch intensely. The area became hard and swollen. By the end of the day, my entire left arm was sore. This morning, day 9, awoke to a large red rash around the injection site, a more swollen arm with pain. Throughout the day, the pain started to radiate throughout both shoulders and into both wrists and hands.

Other Meds: Reishi,chaga,turkey tail mushrooms Tumeric womens daily supplement hair,skin,nails supplement

Current Illness: none

ID: 0989676
Sex: F
Age: 58
State: CA

Vax Date: 01/24/2021
Onset Date: 01/31/2021
Rec V Date: 01/31/2021
Hospital:

Lab Data: none

Allergies: Lactose intolerance

Symptoms: Not a severe adverse event, but I developed a rash to my left arm one week after vaccine. It is about 3 inches, raised red, itchy, and warm to touch.

Other Meds: Estrogen patch

Current Illness: none

ID: 0989677
Sex: F
Age: 22
State: RI

Vax Date: 01/22/2021
Onset Date: 01/30/2021
Rec V Date: 01/31/2021
Hospital:

Lab Data:

Allergies: Sulfa antibiotics, benzoyl peroxide

Symptoms: A ~2 inch circle rash/spot that is pink/red in color formed at the injection site 7 days after receiving the vaccine. Some itching occurred but it has subsided. There is no pain at the spot. This is the first adverse reaction since since arm pain 1 day after receiving the vaccine.

Other Meds: Linzess 144 mcg, cetirizine 10 mg

Current Illness:

ID: 0989678
Sex: F
Age: 48
State: HI

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 01/31/2021
Hospital:

Lab Data: N/A

Allergies: NKA

Symptoms: Fire EMS brought the patient 1ml syringe w/ Hypodermic Safety Needle 25G x 1", lot# P920363X, to be used for Pfizer COVID-19 vaccine. RN when injecting the needle into the client, while plunging the syringe noticed some vaccine leaked from the needle down the client's arm. The client ended up only receiving a partial dose, unable to determine the actually amt of vaccine that the ct received. Two additional nurses prior to this incident had noticed the needle became loose when the cap was removed prior to administration. Both of these nurse realized the needle was loose right before injecting the needle into ct's arm giving them the chance to tighten the needle before administering. Nurse Manager reported to W

Other Meds:

Current Illness:

ID: 0989679
Sex: F
Age: 78
State: CO

Vax Date: 01/20/2021
Onset Date: 01/29/2021
Rec V Date: 01/31/2021
Hospital:

Lab Data: None

Allergies: Sulfa Lyrica

Symptoms: Hot, red, itchy at site of vaccine.

Other Meds: Nexium Atorvastatin Norvasc Hair, skin, nails Multi vitamin

Current Illness:

ID: 0989680
Sex: F
Age: 29
State: NY

Vax Date: 01/30/2021
Onset Date: 01/31/2021
Rec V Date: 01/31/2021
Hospital:

Lab Data:

Allergies: Sulfur

Symptoms: High heart rate Very painful headache Fever Stabbing pain in arm from even small movements Tiredness

Other Meds: None

Current Illness: None

ID: 0989681
Sex: F
Age: 44
State: CA

Vax Date: 01/21/2021
Onset Date: 01/28/2021
Rec V Date: 01/31/2021
Hospital:

Lab Data:

Allergies: Nka

Symptoms: Injection site became raised, itchy, red, hard and warm to touch. The swelling went down within 24 hours but there is still a bruise or mark and it?s still a bit warm. Occasional itching remains

Other Meds: Daily vitamin and probiotic. I usually take a daily allergy pill but I?ve been forgetting lately

Current Illness:

ID: 0989682
Sex: F
Age: 41
State:

Vax Date: 01/29/2021
Onset Date: 01/31/2021
Rec V Date: 01/31/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Mild fever and body aches, moderate fatigue

Other Meds:

Current Illness:

ID: 0989683
Sex: F
Age: 47
State: NM

Vax Date: 01/04/2021
Onset Date: 01/19/2021
Rec V Date: 01/31/2021
Hospital:

Lab Data: None

Allergies: Sulfa and Macrobid?

Symptoms: Had first dose of Moderna 1/4/21. Developed a urinary tract infection on 1/12/21 and started Macrobid the evening of 1/13/21. Finished last dose of Macrobid 1/17/21. Tuesday evening on 1/19/21 started with itching on my scalp. Woke up at 3:00am 1/20/21 with welts/hives around my waist and ribcage area. These hives progressed over the next 24-36 hours and I ended up covered from head to toe. I also developed a low grade fever of 100.4 on 1/21/21 and has some very slight joint swelling/tenderness. I treated the hives with of OTC Benadryl, which helped with the itching but didn't seem to have any affect on the hives. By Saturday 1//23/21 all hives were gone but itching persisted for 4-5 days after and gradually subsided. Was scheduled to get my second Moderna dose on 1/31/21 but the Pharmacist recommended I postpone for now and file a report here.

Other Meds:

Current Illness: Urinary tract infection

ID: 0989684
Sex: M
Age: 82
State: WV

Vax Date: 01/26/2021
Onset Date: 01/30/2021
Rec V Date: 01/31/2021
Hospital:

Lab Data:

Allergies:

Symptoms: passed out

Other Meds: eliquis, 2.5 mg, zocor 20mg, lisinapril 20mg

Current Illness: afib

ID: 0989685
Sex: F
Age: 60
State: FL

Vax Date: 01/30/2021
Onset Date: 01/30/2021
Rec V Date: 01/31/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: Severe bodyaches ,nausea vomiting, headache, left arm pain, chills fever

Other Meds: progesterone multiple vitamins

Current Illness: none

ID: 0989686
Sex: F
Age: 63
State: NC

Vax Date: 01/30/2021
Onset Date: 01/30/2021
Rec V Date: 01/31/2021
Hospital:

Lab Data: N/A

Allergies: sulfa, poison ivy, red ant/bee stings

Symptoms: A red rash about 2"x4" broke out on the underside of my right forearm yesterday about 5 p.m.. I am allergic to poison ivy and it reminds me of that.. It does itch. I read where Moderna can cause a rash but indicated it was on the arm where you receive the shot. The rash has not receded as of 5pm today, Sunday 1/31/2021.

Other Meds: Lisinopril/HCTZ Shaklee Vitamin

Current Illness: N/A

ID: 0989687
Sex: F
Age: 60
State: CA

Vax Date: 01/06/2021
Onset Date: 01/16/2021
Rec V Date: 01/31/2021
Hospital:

Lab Data: None

Allergies: Peanut. Soy, walnuts, peas , chickpeas

Symptoms: Raised rash over chest, entire back, backs of thigh both legs, very little itch. Kind of like keratoses.

Other Meds: Daily vitamin, Allegra, Celebrex, Vagafem

Current Illness: None... Healthy

ID: 0989688
Sex: F
Age: 76
State: CT

Vax Date: 01/18/2021
Onset Date: 01/19/2021
Rec V Date: 01/31/2021
Hospital:

Lab Data:

Allergies: aspirin, sometimes

Symptoms: Following day feeling tired, no fever, no chills, etc. Second day feeling well.

Other Meds: sleepy tea, vitamins C

Current Illness: shingles at right arm

ID: 0989689
Sex: F
Age: 28
State: CA

Vax Date: 01/23/2021
Onset Date: 01/24/2021
Rec V Date: 01/31/2021
Hospital:

Lab Data: None

Allergies: Egg, dairy, and pomello sensitivies or allergies

Symptoms: I experienced excessive twitching in my legs (mostly in the evening) for three days after vaccination

Other Meds: None

Current Illness: None

ID: 0989690
Sex: F
Age: 24
State:

Vax Date: 01/28/2021
Onset Date: 01/29/2021
Rec V Date: 01/31/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Mild fever

Other Meds:

Current Illness:

ID: 0989691
Sex: F
Age: 80
State: CA

Vax Date: 01/14/2021
Onset Date: 01/22/2021
Rec V Date: 01/31/2021
Hospital:

Lab Data:

Allergies: Tetracycline, erythromycin, Clindamycin

Symptoms: No adverse effects day of injection other than mild soreness at injection site for a day or two. Nine days later my arm was swollen, itchy with center being hot, raised and red. I had no fever and no other noticeable symptoms. The next day it had spread over the upper arm and I went to emergency room. ER Dr. said she thought it was cellulitis and prescribed an antibiotic. She advised me to see my primary care provider after the weekend. I went to my primary care provider and the Dr. and the N.P. agreed it was not cellulitis, but an allergic reaction due to it's appearance . In checking CDC site the Dr. found photos of vaccine reactions which looked identical to my arm. I went off antibiotics and took ibuprofhan and it slowly has returned to almost normal within 10 days.

Other Meds: Centrum Silver, Culturelle Probiotics, Calcium pills once a day

Current Illness: UTI mid-December

ID: 0989692
Sex: F
Age: 96
State: CA

Vax Date: 01/23/2021
Onset Date: 01/27/2021
Rec V Date: 01/31/2021
Hospital:

Lab Data: None yet

Allergies: Lorazepam denosumab morphine lansoprazole

Symptoms: Four days side effect free. On the fifth day, woke with very bad headache which continues (1/27-1/30, so far). Acedaminophen (sp?) helps. Rarely have headaches. Two friends, one 105 and one 65+, developed severe backaches 4-5 days after covid vaccine.

Other Meds: Levothyroxin, Eliquis, vit D, multi-vit

Current Illness: Dementia

ID: 0989693
Sex: F
Age: 72
State: NM

Vax Date: 01/31/2021
Onset Date: 01/31/2021
Rec V Date: 01/31/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Swollen lower lip, "head feels funny"

Other Meds:

Current Illness:

ID: 0989694
Sex: F
Age: 46
State: KY

Vax Date: 01/28/2021
Onset Date: 01/29/2021
Rec V Date: 01/31/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: There was normal pain at injection site on the first day. The morning of the second day there was pain, redness, heat, and swelling the size of a half dollar. I took Advil for the pain. That night the welt was 1 1/4 inches and had started to itch. The armpit lymph node had swollen and was tender. The third day the welt was still tender, with redness, itchiness, heat, and was now 2 inches. The lymph node was still swollen. Still taking Advil and Tylenol and now applying a lidocaine cream on the advice of our pharmacist for the itchiness. The fourth day the lymph node is still swollen and tender. The welt is 2 1/2 inches. It is still tender, warm, red, and swollen. Still applying lidocaine cream and taking Advil and Tylenol.

Other Meds: Citrucel; IB Guard; Probiotic; Krill oil; Joint Complex; Elderberry Capsule

Current Illness: None

ID: 0989695
Sex: M
Age: 84
State: CA

Vax Date: 01/23/2021
Onset Date: 01/24/2021
Rec V Date: 01/31/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Few hours after receiving treatment his arm became very sore which is normal, but the next day he had a severe reaction in his back resulting in an unbearable pain. Each day the pain has gotten worse and now a week later he is in the worst shape so far. The primary care Physician has associated the symptoms with the vaccine and on the 25th he saw a cardiologist who again blamed it on the vaccine

Other Meds: Vitamin C, D, Calcium, Fish oil, , multivitamin , stool softener(OTC) Alendronate 70 mg (1x/week); atorvastatin 40 mg, carvedilol 3.1 mg, Eliquis 5mg, levothyroxine 75mcg, memantine 5mg,

Current Illness:

ID: 0989696
Sex: M
Age: 74
State: CA

Vax Date: 01/15/2021
Onset Date: 01/29/2021
Rec V Date: 01/31/2021
Hospital:

Lab Data:

Allergies: No

Symptoms: Rash and swelling in arm near vaccination site 2 weeks after vaccination

Other Meds: Ezetimibe, Benadryl. Calcium. One A Day Mens Vitamin

Current Illness: None

ID: 0989697
Sex: M
Age: 75
State: IN

Vax Date: 01/29/2021
Onset Date: 01/30/2021
Rec V Date: 01/31/2021
Hospital:

Lab Data: none

Allergies: NONE

Symptoms: chills in the early saturday morning shaking in bed . Head ache in the morning, fever on 100.4 No balance. Took two tylenols and fever went down and still not very sturdy on feet. next day felt better but had night sweats and had to change shirts. Night sweat saturday night in to sunday morning. Feeling ok on sunday. The systems are the same as having covid 19 when he had it.

Other Meds: l-THYROXINE 112 ALLOPURINOL 100MG OMEPRAZOLE 40 MG VIT KRILL OIL 350 OMEGA-3 MULTIVITAMIN VIT C ASPIRIN 81MG VIT B 3 5000IU VIT B 12 ZINK 50 PROBIOTIC GARLIC EXTRACT 1000MG FISH OIL 1000 MG

Current Illness: covid 19 in October and with pneumonia one week in hospital and two months with oxygen at home. December got off oxygen.

ID: 0989698
Sex: F
Age: 47
State: MN

Vax Date: 01/22/2021
Onset Date: 01/27/2021
Rec V Date: 01/31/2021
Hospital:

Lab Data: TSH 1.76, CRP < 2.9, Calcium 8.3 (RR 8.5-10.1), Platelets 146 (RR 150-450). Normal chemistries, LDH. Ultrasound: FINDINGS see continuation page.

Allergies: none known

Symptoms: Patient developed large, hard, nonpainful thyroid nodule. Workup is still ongoing, but TSH and CRP normal. Ultrasound is reassuring for malignancy. Date of adverse effect is the date she noticed it, but it is large enough that she couldn't have missed it more for than a day or two. I'm not sure that this WAS an adverse effect, but the timing seemed necessary for reporting.

Other Meds: none known

Current Illness: none known

ID: 0989699
Sex: F
Age: 45
State: CA

Vax Date: 01/31/2021
Onset Date: 01/31/2021
Rec V Date: 01/31/2021
Hospital:

Lab Data: N/A

Allergies: NKA to drug or food

Symptoms: 11:32, RRT called to assess 46 y/o female in post vaccine area with c/o difficulty swallowing and feeling of warmth to bilateral upper arms and bilateral lower extremities, shin area. Husband was present/driver of the vehicle. Pfizer vaccine had been given at 11:09 A.M. and symptoms began at 11:30 A.M. Patient w/no prior medical hx or chronic conditions and does not take any routine medication. PHN assessment revealed: awake, alert and oriented x3, able to participate in assessment interview w/ease, no visual oral swelling/discoloration of mucus membranes, moving all extremities freely/warm to touch, no s/s of SOB, or change in sensorium. Vitals signs WNL. Monitored for an additional 10 in post vaccine area, all symptoms resolved, stable, discharged at 11:50 without further incident.

Other Meds: Does not take any OTC or prescribed medications

Current Illness: No prior hx of medical conditions

ID: 0989700
Sex: M
Age: 53
State:

Vax Date: 01/20/2021
Onset Date: 01/24/2021
Rec V Date: 01/31/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Severe sore throat radiating to the right ear during swallowing With tender thyroid on palpation the symptoms are not regressing till now

Other Meds:

Current Illness:

ID: 0989701
Sex: F
Age: 52
State: VA

Vax Date: 01/30/2021
Onset Date: 01/30/2021
Rec V Date: 01/31/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Chills Headache Soreness in arm

Other Meds: Lisinopril Probiotic

Current Illness: None

ID: 0989702
Sex: F
Age: 68
State: MI

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

Lab Data: Made referral to PCP

Allergies: Multi Allergies and Drug allergies-Sulfa, PCN, Nitrofurmantion

Symptoms: Posterior head and neck tingling and warmth and flushing in cheeks. Resolved at after given 50 mg of Benadryl P.O. Advise to follow up her PCP

Other Meds: Biotin, Calcium with vit. D, Famontidine 40 mg., Metforman ER

Current Illness: No

ID: 0989703
Sex: F
Age: 24
State:

Vax Date: 01/28/2021
Onset Date: 01/29/2021
Rec V Date: 01/31/2021
Hospital:

Lab Data:

Allergies:

Symptoms: mild fever

Other Meds:

Current Illness:

ID: 0989704
Sex: F
Age: 98
State: ME

Vax Date: 01/29/2021
Onset Date: 01/31/2021
Rec V Date: 01/31/2021
Hospital:

Lab Data: CBC Test WBC 12.6 RBC 2.92 L HGB 8.2 L HCT 24.8 L MCV 84.9 MCH 28.1 RDW-SD 48.2 H RDW-CV 15.6 H PLT 425 H MPV 10.3 NEUTROPHIL% 91.0 % LYMPHOCYTE% 3.6 % REACTIVE LYMPH 0 % MONOCYTE% 4.2 % EOSINOPHIL% 0.2 % BASOPHIL% 0.1 % IMM GRAN% 0.9 % METAMYELOCYTE 0 % MYELOCYTE 0 % NRBC% 0.0 % COUNTS NEUTROPHIL# 11.5 H LYMPHOCYTE# 0.5 L MONOCYTE# 0.5 EOSINOPHIL# 0.0 BASOPHIL# 0.0 IMM GRAN# 0.11 H NRBC# 0.0 MANUAL DIFF NOT IND. CELL SCAN NOT IND. CODED COMMENTS: NONE CMP: (COLL: 01/31/2021 12:38) ( MsgRcvd 01/31/2021 13:47) Final results Test Result Flag **(Reference)** GLUC 93 MG/DL (83 - 99) BUN 96 H MG/DL (6 - 20) CREA 5.72 H mg/dL (0.51 - 0.95) EST GFR 7.0 L ml/min/BSA (60.0 - 999) NA 112 LL mmol/L (136 - 145) **CRITICAL VALUE** REPEATED VALUE VERIFIED DATE/TIME 01/31/2021 @ 1318 READ BACK OK K 7.2 HH mmol/L (3.5 - 5.1) SPECIMEN SHOWS SLIGHT HEMOLYSIS MAY AFFECT K+ AND AST RESULTS ER WILL TRY TO DRAWN NON-HEMOLYZED SAMPLE FOR REPEAT VERIFICATION CL 89 L mmol/L (98 - 107) CO2 8 LL mmol/L (22 - 29) A-GAP 15.0 mmol/L (6.0 - 16.0) T-BILI <0.2 L MG/DL (0.4 - 1.2) CALC 8.8 MG/DL (8.6 - 10.2) TP 6.70 G/DL (6.40 - 8.30) ALB 3.6 L G/DL (3.9 - 4.9) GLOBUL 3.1 (2.3 - 4.0) A/G RA 1.2 (1.0 - 2.0) ALKP 92 IU/L (40 - 129) AST/OT 22 IU/L (0 - 32) REPEAT DRAW NOT HEMOLYZED NO CHANGE FOR K+ AND AST ALT/PT 12 IU/L (0 - 33) FASTING? NO GFR INTERPRETATION\par eGFR is calculated using the IDMS-TRACEABLE MDRD equation modified for our laboratory information system. The units are in mL/min normalized for a body surface area (BSA) of 1.73m2. For African Americans, multiply the result by 1.21. Magnesium: (COLL: 01/31/2021 12:38) ( MsgRcvd 01/31/2021 13:42) Final results Test Result Flag **(Reference)** MAGN 1.7 MG/DL (1.6 - 2.6) CRP: (COLL: 01/31/2021 12:38) ( MsgRcvd 01/31/2021 13:13) Final results Test Result Flag **(Reference)** C-REACTIVE PROTEIN 3.55 H mg/dL (0.00 - 0.60) Lactate Panel ED: (COLL: 01/31/2021 12:38) ( MsgRcvd 01/31/2021 12:49) Final results Test Result Flag **(Reference)** POC LACTIC ACID 1.40 mmol/L (0.90 - 1.70) VENOUS BLOOD GASES VENOUS PH 7.13 L (7.31 - 7.41) VENOUS pCO2 25 L mmHG (41 - 51) VENOUS pO2 33 mmHG (25 - 40) VENOUS BASE EXCESS -21.0 L mmol/L (-2.0 - 3.0) VENOUS HCO3 8 L mmol/L (23 - 28) VENOUS TCO2 9 L mmol/L (24 - 29) VENOUS O2 SAT 46.0 % THIS TEST IS PERFORMED ON THE ABBOTT ISTAT, USING THE CG4+ CARTRIDGE METHOD. The cartridge used to perform this test is 510(k) approved by the FDA for use with venous and arterial whole blood samples in a non-waived setting. Portable Chest - Inspirtation 1V: (COLL: 01/31/2021 12:30) ( MsgRcvd 01/31/2021 13:02) Final results Test Result Flag **(Reference)** XR CHEST 1 VIEW PORTABLE Radiology Report Exam: XR CHEST 1 VIEW Date: 01/31/2021 12:02:29 Initial report created on 1/31/2021 1:02:28 PM EST PROCEDURE INFOR

Allergies: Baclofen. Fentanyl. Sulfa Antibiotics. --

Symptoms: 3 days ago patient was started on Cipro for a UTI. Patient received the ModernaCOVID vaccine 2 days ago. The past 48 hours patient has had increased confusion, decreased p.o. intake. Patient was sent to emergency room for evaluation. Patient was found to have a low sodium, 112, high potassium 6.9 with corresponding EKG changes. Patient was bradycardic with a rate between 30 and 40. Patient was also found to be in acute renal failure with a creatinine of 5.6. In ER pt was confused, unable to tolerate PO fluids. Due to severity of illness patient's family has elected to avoid aggressive medical care. Patient has poor prognosis. Patient was returned to nursing home for comfort care only.

Other Meds: Ferrous Sulfate Oral, daily. Hydrocortisone External. Levothyroxine Sodium Oral (Tablet 75 mcg), daily. Metoprolol Tartrate Oral (Tablet 50 mg), 2x a day. Nystatin External. Trimethoprim Oral (Tablet 100 mg), daily at bedtime. Tyl

Current Illness: Recent UTI

ID: 0989705
Sex: F
Age: 75
State: NJ

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 01/31/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Headache, nausea

Other Meds: MetFormin, rosuvastatin

Current Illness: None

ID: 0989706
Sex: F
Age: 24
State:

Vax Date: 01/28/2021
Onset Date: 01/29/2021
Rec V Date: 01/31/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Mild fever

Other Meds:

Current Illness:

ID: 0989707
Sex: M
Age: 73
State: NY

Vax Date: 01/30/2021
Onset Date: 01/31/2021
Rec V Date: 01/31/2021
Hospital:

Lab Data:

Allergies: Tylenol

Symptoms: Rash on low body

Other Meds: Vitamin B-12/ Viatmin D2/ Vemlidy tablet 25mg / Vascepa 1GM capsule / Acarbose 50mg tablet / Magnesium Oxide 400mg tablet / Nephplex rx / Tamsulosin HCL 0.4mg cap / Terazosin hcl 2mg capsule / Xtandi 40mg / Bicalutamide 50mg / Losartan 25mg

Current Illness:

ID: 0989708
Sex: F
Age: 63
State:

Vax Date: 01/28/2021
Onset Date: 01/29/2021
Rec V Date: 01/31/2021
Hospital:

Lab Data:

Allergies:

Symptoms: mild headache, chills, nausea, muscle and body aches

Other Meds:

Current Illness:

ID: 0989709
Sex: F
Age: 38
State: AZ

Vax Date: 12/30/2020
Onset Date: 01/05/2021
Rec V Date: 01/31/2021
Hospital:

Lab Data:

Allergies: No

Symptoms: Swollen lymph node in the right neck with pain for 2 days. Lymph node swollen for 2 weeks with gradual size reduction

Other Meds: Lo loestrin fe

Current Illness: No

ID: 0989710
Sex: F
Age: 33
State: NY

Vax Date: 01/29/2021
Onset Date: 01/30/2021
Rec V Date: 01/31/2021
Hospital:

Lab Data:

Allergies: No

Symptoms: In day one I felt a little off and weak after the injection. This was a few minutes later and lasted about 2 hours. I took a Tylenol PM to sleep, but didn?t sleep well at all. On the second day, in the morning when I woke up the arm where the injection was administered was extremely sore and I couldn?t lift it. It felt almost numb, but I was in pain. I took Advil late morning and felt better but still couldn?t lift my arm above my chest. Around 4-5pm that evening, I was feeling tightness in my chest. Felt like something heavy was sitting on top of me and I developed a headache at this point. I felt super tired so I took an Advil PM to comfortably take a nap. When I woke up I still had a headache and chest tightness. At this point my body started to feel sore. The next day, 1/31/21, I am still feeling fatigued. Headache did not go away or subside. My body still feels sore especially my back, top area (I would say around shoulder blades). I still have chest tightness and had a fever of 101 today. I have taken an Advil for headache and body soreness - after an hour of taking Advil, still feeling the same.

Other Meds: No

Current Illness: Don't know. May have been CoVID-19 positive a few weeks before.

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm