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: 0992056
Sex: F
Age: 34
State: OH

Vax Date: 01/18/2021
Onset Date: 01/29/2021
Rec V Date: 02/01/2021
Hospital:

Lab Data: None

Allergies: Tramadol

Symptoms: Started Friday night with 3 raised red hives at injection site which next day progressed to welts, itching encompassing whole L upper arm from axilla to elbow

Other Meds: None

Current Illness: None

ID: 0992057
Sex: F
Age: 25
State: CA

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 02/01/2021
Hospital:

Lab Data:

Allergies: KNA

Symptoms: Pt states 2 hours post vac. muscles aches, chills, fatigue and resolved in 12 hours. Then Pt states 7 days post vac. Left arm red rash pt took allergy meds. day 10 for rash. Post vac. day 11 rash resolved.

Other Meds: Birth control, Fish oil, Vitamin D3, Vitamin B

Current Illness: None

ID: 0992058
Sex: F
Age: 45
State: NY

Vax Date: 01/23/2021
Onset Date: 01/24/2021
Rec V Date: 02/01/2021
Hospital:

Lab Data: General blood work showed mild LFT abnormalities which have been seen in the past, Rash not yet biopsied.

Allergies: nkda, no food allergies

Symptoms: about 18 hours after the vaccination which she received on the 23rd the patient started getting hives on her arm each lesion would last about 1 or 2 hours but then her whole body became itchy often there are itchy areas with no visible rash but often there are hives as well sometimes the hives when scratched turned into papular lesions, which are visible on her chest and upper arms. Symptoms may have slightly improved but are still very bothersome 3 weeks after onset, taking 2 Xyzal twice a day was also taking Pepcid not sure any of these interventions are making much difference although she does note some slight sedation.

Other Meds: none

Current Illness: none

ID: 0992059
Sex: F
Age: 16
State: MN

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 02/01/2021
Hospital:

Lab Data:

Allergies: Unknown

Symptoms: Patient presented for Covid Vaccination. When nurse asked if she was 18 she said "yes." Nurse did not verify age on registration form and patient was given Moderna Covid vaccination. Talked with nurse and realized she needs to verify age every time even if the client confirms a different age.

Other Meds: Unknown

Current Illness: Unknown

ID: 0992060
Sex: M
Age: 65
State: CA

Vax Date: 01/24/2021
Onset Date: 01/29/2021
Rec V Date: 02/01/2021
Hospital:

Lab Data:

Allergies: unaware

Symptoms: Moderna Covid-19 Vaccine EUA After about 7 days getting vaccine, rash started from the spot where the vaccine was given, then spread to whole body, red, and very itchy. I've been taking Benadryl to help sleep. It has been 4 days and haven't recovered yet.

Other Meds: SIMVATATIN, ASPRIN, melatonin

Current Illness: none

ID: 0992061
Sex: F
Age: 49
State: MO

Vax Date: 01/15/2021
Onset Date: 01/22/2021
Rec V Date: 02/01/2021
Hospital: Y

Lab Data: 1/29/2021 - D-Dimer 2.39 mcg/mL FEU; Lactic acid 2.5 mmol/L; CT PE with bilateral acute pulmonary embolism is identified without evidence of right heart strain. 1/31/2021 - CoV2 IGG = positive 2/1/2021 - venous dopplers (results pending at time of submission)

Allergies: None

Symptoms: Patient began having increasing shortness of breath about a week after receiving first dose of Pfizer COVID-19 vaccine. Symptoms worsened and persisted to the point where patient called her PCP on 1/26/2021, who advised her to report to ED if experiencing worsening symptoms and/or low oxygenation. Patient reported to ED on 1/29/2021 due to tachycardia and O2 sats <90%. On presentation, patient was found to have bilateral pulmonary emboli involving the upper and lower lobe regions bilaterally including segmental branches without evidence of right heart strain.

Other Meds: Alprazolam, Symbicort, Nuvaring, Ventolin, Zolpidem

Current Illness: No acute illnesses

ID: 0992062
Sex: F
Age: 44
State: VA

Vax Date: 01/25/2021
Onset Date: 01/31/2021
Rec V Date: 02/01/2021
Hospital:

Lab Data:

Allergies:

Symptoms: swollen itchy lump at injection site that appeared nearly a week after the shot.

Other Meds: Sertraline Excedrin Migraine

Current Illness:

Date Died: 01/30/2021

ID: 0992063
Sex: M
Age: 80
State: WI

Vax Date: 01/19/2021
Onset Date: 01/29/2021
Rec V Date: 02/01/2021
Hospital: Y

Lab Data: Positive COVID-19 per PCR, 1/29/2021

Allergies: Amoxicillin (N&V), "poison ivy/treatments"

Symptoms: Patient received first dose of the COVID-19 Moderna vaccine on 1/19/2021 at an outside facility (no lot #, route, or site available to me in electronic charting). Pt began having hypoxia, SOB, and a dusky appearance of extremities on 1/29/2021 and was brought by EMS to our hospital. PT is a DNR and family had been looking into a hospice sign up due to dementia and general decline in the weeks prior to hospitalization. Pt tested positive on admission for COVID-19 via PCR test on 1/29/2021. Pt continued to have respiratory decline, was put on comfort care per wishes of family/advanced directives, and he passed away the evening of 1/30.

Other Meds: Tums, folic acid, hydroxychloroquine (pre-existing prescription to pandemic), pain pump, symbicort inhaler, multi-vitamin, albuterol inhaler, duloxetine, nystatin powder, senna-docusate, tofacitinib citrate, probiotic, polyethylene glycol,

Current Illness:

ID: 0992064
Sex: F
Age: 62
State: CA

Vax Date: 01/28/2021
Onset Date: 01/29/2021
Rec V Date: 02/01/2021
Hospital:

Lab Data: None

Allergies: NKDA

Symptoms: Moderna COVID-19 Vaccine EUA Severe joint pain for 36 hours. Treated with anti-inflammatories (Advil PM, Aleve/Tramadol)

Other Meds: Levothyroxine/Furosemide/Lotrel/Calcium/Collagen+C/Turmeric & Ginger supplement/Release dietary Supplement

Current Illness: None

ID: 0992065
Sex: F
Age: 65
State: NC

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 02/01/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Pain at injection site and arm muscleon the evening of shot, dull on day 2 and injection site tender on day 3. Chills overnight of day 1 through day 2, with sweating/overheating while sleeping, feverchecked on day 2 @ 99.2F, lack of energy and tired day 2 with multiple naps, headache beginning day 1 evening treated with 500 mg acetamenophen, dull headache day 2.

Other Meds: benazypryl, atorvastatin, multivitamin, vit D, calcium

Current Illness: None

ID: 0992066
Sex: F
Age: 74
State: TX

Vax Date: 01/24/2021
Onset Date: 01/25/2021
Rec V Date: 02/01/2021
Hospital:

Lab Data: Started 2/1/2021-Zoirex p.o.

Allergies: ASA and Cardizem

Symptoms: Fever 101F. Shingles noted on 2nd day. Took Enbrel injection on01/23/2021

Other Meds: Metoprolol and Crestor

Current Illness: none

ID: 0992067
Sex: F
Age: 66
State: WI

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 02/01/2021
Hospital:

Lab Data: None

Allergies: Penicillin

Symptoms: Numbness and tingling on the left side on the day of vaccination. On the 3rd day, arm began to swell and became reddened.

Other Meds: Advil

Current Illness: Had covid 19 virus 10/10/2020 and was hospitalized from 10/10-10/27/2020. She continues to have breathing issues.

ID: 0992068
Sex: F
Age: 63
State: PA

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 02/01/2021
Hospital:

Lab Data:

Allergies:

Symptoms: She experienced GI symptoms x48+ hours.

Other Meds:

Current Illness:

ID: 0992069
Sex: F
Age: 40
State: KS

Vax Date: 01/13/2021
Onset Date: 01/20/2021
Rec V Date: 02/01/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Large welt/rash about 1 inch below injection site. About 1 inch in diameter. Last for about 3-4 days. Did not hurt or itch.

Other Meds: Birth control pills

Current Illness: None

ID: 0992070
Sex: F
Age: 31
State: PA

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 02/01/2021
Hospital:

Lab Data:

Allergies: Amoxicillin

Symptoms: Immediately after shot felt dizzy and confused about 5 minutes later could not swallow then hives started on face about 10 minutes after felt tingling sensation in right leg

Other Meds:

Current Illness:

ID: 0992071
Sex: F
Age: 48
State: PA

Vax Date: 01/28/2021
Onset Date: 01/29/2021
Rec V Date: 02/01/2021
Hospital:

Lab Data: 1/31/2021 -EKG normal, Labs Normal, Head CT-normal, facila CT- unable to tell if there was a fracture since there was so much swelling and pooling of blood.

Allergies: None

Symptoms: Received vaccine on 1/28@12:30PM. On 1/29 @ 5am woke up with mild headache, whole body chills and shivering, and body aches. Got out of bed to get Motrin and had 2 syncopal episodes. On the 2nd syncopal episode during the fall I hit my chin on the wall and put a hole in the wall. ED on 1/31/2021- unable to determine on facial CT if mandible was fractured due to the amount of swelling and blood pooling in the area. Treating as if is fractured: tetanus shot given, 10 days of antibiotics, and follow up with oral facial surgery if needed.

Other Meds: hyrdochlorothiazide, prilosec, Multi vitamin,

Current Illness: None

ID: 0992072
Sex: F
Age: 65
State: IN

Vax Date: 01/30/2021
Onset Date: 01/30/2021
Rec V Date: 02/01/2021
Hospital:

Lab Data: none

Allergies: Bactrim and PPD skin test

Symptoms: Tongue and upper lip tingling started approximately 19 minutes after the injection and lasted the entire day. I did not experience and difficulty swallowing or breathing and I did not take any other medication until bedtime, at 1130 pm. I took Ibuprofen 800mg.

Other Meds: Daily medications: Metoprolol Tartrate, Triamterene-HCTZ, Fish oil, Magnesium, Vitamin D3, Cinacalcet HCL, Multivitamin at 8:30 AM. Loratadine and Tylenol at 11:00

Current Illness:

ID: 0992073
Sex: M
Age: 78
State: DC

Vax Date: 01/19/2021
Onset Date: 01/23/2021
Rec V Date: 02/01/2021
Hospital:

Lab Data: None as of yet.

Allergies: No

Symptoms: Haven?t been able to stabilize his BP since vaccination. It?s been at 160/85 even with medication. He has suffered 2 strokes so this is concerning. Today he woke up with his BP 176/87.

Other Meds: Nifedipine

Current Illness: No

ID: 0992074
Sex: F
Age: 28
State: IN

Vax Date: 01/30/2021
Onset Date: 01/31/2021
Rec V Date: 02/01/2021
Hospital:

Lab Data: None

Allergies: Lactose intolerant

Symptoms: Malaise, body/joint aches, lymphadenopathy of the left axilla and bilateral cervical lymph nodes (level 1 a/b), mild headache. Onset one day after injection. All symptoms resolved by the next day, with exception of the axillary lymphadenopathy.

Other Meds: Iron supplements

Current Illness: None

ID: 0992075
Sex: M
Age: 69
State: OH

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 02/01/2021
Hospital:

Lab Data:

Allergies:

Symptoms: vaccination was given 23 days after the first dose

Other Meds:

Current Illness:

ID: 0992076
Sex: F
Age: 40
State: MD

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 02/01/2021
Hospital:

Lab Data:

Allergies:

Symptoms: She pretreated with Claritin and tums. About 20 minutes after the injection she began having tingling and numbness in her mouth that persisted all day. The following day the tingling had improved but there was residual numbness. She also noted fatigue and body aches.

Other Meds:

Current Illness:

ID: 0992077
Sex: F
Age: 19
State: MT

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 02/01/2021
Hospital:

Lab Data:

Allergies:

Symptoms: fever, aches, chills, nausea

Other Meds:

Current Illness:

ID: 0992078
Sex: F
Age: 70
State: IN

Vax Date: 01/28/2021
Onset Date: 01/29/2021
Rec V Date: 02/01/2021
Hospital:

Lab Data:

Allergies:

Symptoms: I had the Moderna COVID vaccine on Jan 28. That night my throat was swollen and I had a hard time swallowing. I was fine next day. Saturday I had a rash on both arms that continues.

Other Meds:

Current Illness:

ID: 0992079
Sex: F
Age: 70
State: CO

Vax Date: 01/22/2021
Onset Date: 01/30/2021
Rec V Date: 02/01/2021
Hospital:

Lab Data: none

Allergies: sulfa

Symptoms: day 9 left arm redness, warm, hard

Other Meds: flonase, clobetasol

Current Illness: ehlers danlos syndrome

ID: 0992080
Sex: F
Age: 33
State: IL

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 02/01/2021
Hospital:

Lab Data: NONE

Allergies: NONE

Symptoms: VERY SORE ARM/PAIN AT INJECTION AREA ALONG WITH ITCHINESS, REDNESS, SWELLING AND HEAT IMMEDICATELY AFTER THE INJECTION WHICH LASTED FOR 4 DAYS. I EXPERIENCED CHILLS, SORE THROAT AND FATIGUE THE FOLLOWIND DAY (AROUND 18 HOURS LATER) WHICH LASTED FOR 28 HOURS. AFTER 27 HOURS, I ALSO EXPERIENCED A FEVER OF 100.2 AND SLIGHT BODY ACHES AS WELL AS ALL OF THE ABOVE MENTIONED WHICH LASTED AROUND 12 HOURS.

Other Meds: FLONASE WIXELA INHALER SINGULAIR ZYRTEC BIRTH CONTROL-ENSKYCE AIRBORNE VITAMINS-D, B12, B COMPLEX, MULTIVITAMIN

Current Illness: VOICE WAS GOING OUT/OCCASIONAL SORE THROAT

ID: 0992081
Sex: F
Age: 59
State: MI

Vax Date: 01/20/2021
Onset Date: 01/23/2021
Rec V Date: 02/01/2021
Hospital:

Lab Data: None

Allergies:

Symptoms: Pulse dropped to 35 bpm, starting feeling better within 90 minutes

Other Meds:

Current Illness:

Date Died: 01/28/2021

ID: 0992082
Sex: F
Age: 70
State: GA

Vax Date: 01/24/2021
Onset Date: 01/25/2021
Rec V Date: 02/01/2021
Hospital: Y

Lab Data:

Allergies: NKA

Symptoms: Resident was noted on 1/25 with an increased functional decline as she would not feed herself with utensils, but would eat finger foods if placed in her hand. She was started on Rocephin IM for possible infections. Labs had been obtained on 1/21/21, unremarkable for CBC and CMP. 75,000 colony count on urine. On 1/26/21 she was noted with right sided weakness and further decline. She was sent to Hospital for further evaluation. We were notified that she expired on 1/28/2021. Resident had been noted with a decline in function about 2 weeks earlier when she would not stand or transfer any longer. She was still responsive, taking meds, and feeding herself until 1/26/21. Further information on admitting diagnoses and progress notes from hospital have not been available to date.

Other Meds: Rocephin, depakote sprinkles, metoprolol, trazodone, famotidine, certevite, mylanta, vit D, zocor, keppra, aspirin, tylenol, tricor.

Current Illness: None

ID: 0992083
Sex: F
Age: 56
State:

Vax Date: 12/31/2020
Onset Date: 01/01/2021
Rec V Date: 02/01/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Right after she received her dose, she just had a sore arm. 13 hours after vaccination, patient had a dry cough that woke her up from sleep. She then started to get a headache and took ibuprofen. She spike a temp of 99-102 degrees Fahrenheit. Blood pressure elevated to 165/100. One hour later it was 155/101. Normal baseline is 110-130/55. No visual changes occurred. After 8 hours, the blood pressure normalized. By 01/02/21, all symptoms had dissipated. I referred her to see her cardiologist for approval before second dose.

Other Meds:

Current Illness:

ID: 0992084
Sex: F
Age: 40
State: CO

Vax Date: 01/30/2021
Onset Date: 01/31/2021
Rec V Date: 02/01/2021
Hospital:

Lab Data: none

Allergies: sensitivity to oxycodone

Symptoms: Chest tightness, fever, pain, redness, swelling at injection site, swelling at clavicle and arm pit Left side, hot flashes

Other Meds: unknown

Current Illness: none

ID: 0992085
Sex: F
Age: 24
State: MA

Vax Date: 01/30/2021
Onset Date: 02/01/2021
Rec V Date: 02/01/2021
Hospital:

Lab Data:

Allergies: Pepto bismol - throat closes

Symptoms: After vaccine felt fatigue, then woke up next morning at approx 9 am on 1/31/21, lip itchy/swelling and eye swelling and went to emergency room. Treated with IV Benadyl, Zofran and fluids.

Other Meds: None

Current Illness: (+) COVID19 1/5/21

ID: 0992086
Sex: F
Age: 24
State: OH

Vax Date: 01/26/2021
Onset Date: 01/27/2021
Rec V Date: 02/01/2021
Hospital:

Lab Data:

Allergies:

Symptoms: body aches, fatigue, swelling at injection site, temp 101

Other Meds:

Current Illness:

ID: 0992087
Sex: F
Age: 52
State: MT

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 02/01/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Fatigue, Headache, Body aches

Other Meds:

Current Illness:

ID: 0992088
Sex: F
Age: 49
State: IL

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

Lab Data: Unsure, I was treated at the Emergency Department

Allergies: Penicillin

Symptoms: Vaccine received on 1/25/21, on the evening of 1/26/21 I began having systems of being itchy and having redness. Took Benedryl. On Wednesday, 2/27/21, increased redness, swelling in my face, lips, neck. Rashes spreading over body and face. Took Benedryl and applied caladryl. Began steroid treatment on evening of 2/27/21. Symptoms continue to increase. On the afternoon of Friday, 1/29/21, having a feeling of a lump in my throat. I sought care at the Emergency Department. Received epinephrine, benedryl and pepcid. When that did not clear up the rash, had additional does and they had me stay throughout the night to monitor me. Symptoms are slowly improving but I continue to be on multiple medications to decrease swelling, itchiness, redness. I have a follow up appointment with an allergist on 2/2/21

Other Meds: Birth Control, Vitamin D, Vitamin E

Current Illness: None

ID: 0992089
Sex: F
Age: 63
State: CA

Vax Date: 01/16/2021
Onset Date: 01/29/2021
Rec V Date: 02/01/2021
Hospital:

Lab Data: MRI being scheduled

Allergies: none

Symptoms: Two weeks later, trigeminal nerve pain/facial pain

Other Meds: Wellbutrin synthroid

Current Illness: none

ID: 0992090
Sex: M
Age: 44
State: MD

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 02/01/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: Fever 101, head ache and body pail

Other Meds: Tylenol

Current Illness: none

ID: 0992091
Sex: F
Age: 65
State: NC

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 02/01/2021
Hospital:

Lab Data:

Allergies: Allegra, Benadryl, Codeine, Compazine, Lipitor, Prochlorperazine, Tramadol, Zyrtec, contrast iodinated, Glucosamine, Statins, Hydrocodone, Minocycline, Morphine, shrimp, Wellbutrin, Zoloft, Azithromycin

Symptoms: At 10 minutes after vaccine patient stated lips were tingling - stated that happens a lot. At 30 minutes post injection (1040 am), patient began having tight throat, hoarseness, and cough. Pt self administered Xopenex 2 puffs, Nasal O2 started at 3L (Sp02 98% on 3L) and EpiPen used x1 in left thigh. EMS arrived at 1045. Patient transported to ED at 1102.

Other Meds: Zetia, Buspar

Current Illness: None

ID: 0992092
Sex: F
Age: 52
State: DE

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 02/01/2021
Hospital:

Lab Data: no

Allergies: Allergy - pineapples

Symptoms: In the evening - about 12 hours after vaccine, I got nausea - severe. It lasted throughout that whole night (couldn't sleep it was so bad) until about 10:00 -11:00 morning. And then it went away on it's own. I didn't take anything from it. First dose I had felt extreme fatigue (and that was only symptom that lasted for the same amount of time or 12 hours more). Did not get fatigue with second dose.

Other Meds: Vit D

Current Illness: no

ID: 0992093
Sex: F
Age: 43
State: WV

Vax Date: 01/29/2021
Onset Date: 01/30/2021
Rec V Date: 02/01/2021
Hospital:

Lab Data: none

Allergies: adhesives,vicodine, steri strips,

Symptoms: have a knot in the injection site and it has redness in that area. Also have a knot in the arm pit that is as big as fist. no redness to it.

Other Meds: ,tummeric,tylenol,vitamin c, Prilosec, b,zinc, vitamin d, multivitamin, topiramate,norethindrone,

Current Illness: none

ID: 0992094
Sex: M
Age: 34
State: MI

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 02/01/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Headache, chills, body aches, nausea and the started to have drooping on the left side of his face.

Other Meds: none

Current Illness: None

ID: 0992095
Sex: F
Age: 77
State:

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

Lab Data: EKG, ETCO2

Allergies: NKDA, denies any allergies

Symptoms: Patient arrived at shot table in TCPH w/c, short of breath. Taken straight back to private observation from shot table. EMT on site in attendance. Upon assessment; patient having suprasternal, substernal, intercostal retractions. Patient on home O2 at 2 L/M per NC. Per EMT auscultation patient has inspiratory and expiratory wheezing. Patient has a loose congested cough. Pt's nail beds dusky, no blanching. Hands are cold. Unable to initially obtain O2 sat reading. Patient does not have inhalers with her. Pt. can't recall names of meds. 9:30 BP 132/62; HR 68 strong and regular per palpation. RR 30. 9:40 O2 sat 82% after hands warmed. Patient increased her own O2 to 3 L/m . EMS activated 9:45 O2 sat 84% with 3 L/m per NC. Still having deep retractions. 9:50 EMS arrived along with FWFD. Patient alert/oriented x 4, still labored breathing. Patient denies feeling badly. Med star team evaluating. 0957 O2 97% on 3 l/m per nc. HR 72; BP 104/58; ETCO2 41 1007 O2 97% on 3 L/m per NC; ETCO2 43; HR 112; BP 96/56. EMS recommends transport. Patient refused. Pt. states she will go home and take her own nebulizer treatment. Patient called brother for ride Patient left AMA, patient remains A/O x 4, taken via w/c to brother's car for transport home.

Other Meds: Takes meds for COPD, Afib, CHF, Emphysema but can't recall names of any of the meds.

Current Illness: denies

ID: 0992096
Sex: F
Age: 73
State: IN

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

Lab Data: N/A

Allergies: Tuna, cats

Symptoms: Patient developed a rash and itching about 15 minutes after receiving the Moderna vaccine. Patient was given 25 mg of Diphenhydramine HCI

Other Meds: Lisinopril 10 mg a day

Current Illness: N/A

ID: 0992097
Sex: F
Age: 39
State: PA

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 02/01/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Arm, pain, Fever 10.3-101, chills, body aches, shakes fatique, peristent nausea and one episode of vomiting

Other Meds:

Current Illness:

ID: 0992098
Sex: F
Age: 51
State: TX

Vax Date: 12/31/2020
Onset Date: 12/31/2020
Rec V Date: 02/01/2021
Hospital:

Lab Data: X-ray

Allergies: Albuterol Environmental Allergies

Symptoms: About 10-12hrs later, my right shoulder started hurting and got worse. The night of the 31st it was excruciating, it felt like someone was breaking my bones, it was a 10/10 pain, I wanted to cry the pain was so bad. I took two Advil and put ice on it and I got to where I couldn't move my arm. I had difficulty sleeping as well. In the morning it was just as bad and I couldn't raise my arm it hurt so bad. My husband had noticed the shot given so high in my arm. The next two days is didn't get much better, I tired to move it and lift it up but hard. The 5th day after the shot I called to get into the Orthopedic Dr to see that was going on. it was a little better but still a lot of pain. The Dr. had told me to try to keep moving it, he did an xray and nothing was broken but told me to follow up with him if it didn't get better. He did say to ask to have the second dose injection given a little lower in my arm. It wakes me up once or more at night, I'm not able to do what I use to do. I can move it a little better but my shoulder still hurts, I'm not using it as much. I'm not sure if it's related to the vaccine.

Other Meds: MP Thyroid

Current Illness:

ID: 0992099
Sex: F
Age: 48
State: TX

Vax Date: 01/21/2021
Onset Date: 01/26/2021
Rec V Date: 02/01/2021
Hospital:

Lab Data:

Allergies: sulfa drugs

Symptoms: had pain in arm 12 hours after initial shot, then several days now have noticed a red raised circular area with pinkish red rash. still present on arm.

Other Meds: Anastrozole 1 mg, aspirin 81 mg, Claritin, Vitamin D, C, Zinc

Current Illness:

ID: 0992100
Sex: F
Age: 67
State: IN

Vax Date: 12/04/2020
Onset Date: 12/04/2020
Rec V Date: 02/01/2021
Hospital:

Lab Data: Did hearing tests and checked fluid in ears and everything is okay

Allergies: Demurral, Macrobid

Symptoms: Ringing in my ears that started the night of my injection and still ringing now. I have gone to my primary Dr , and , Went to allergy Dr. twice.

Other Meds: Thyroid pill, cholesterol pill

Current Illness:

ID: 0992101
Sex: F
Age: 59
State: KS

Vax Date: 01/08/2021
Onset Date: 01/17/2021
Rec V Date: 02/01/2021
Hospital:

Lab Data: none

Allergies: latex, Neosporin, and hydrocodone

Symptoms: patient developed redness at the injection site 1 week after immunization followed by an L-shaped rash few centimeters distal to the injection site which lasted for 4 days and required a steroid injection 2 days after appearance. Currently, patient doesn't have any rash and her symptoms have resolved

Other Meds: vitamin C 250 mg, one tablet every other day Vitamin D 50 ?g, one capsule every day Tylenol 500 mg, 2 tablets 3 times daily as needed

Current Illness: none

ID: 0992102
Sex: U
Age: 31
State: OH

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 02/01/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Vaccine administered 23 days after first dose. Headache, fatigue, chills, body aches

Other Meds:

Current Illness:

ID: 0992103
Sex: F
Age: 65
State: NY

Vax Date: 01/31/2021
Onset Date: 01/31/2021
Rec V Date: 02/01/2021
Hospital:

Lab Data: None

Allergies: Shrimp Cantaloupe Horseradish Portabella mushrooms Clindamycin Penicillin

Symptoms: Lump/swelling in throat no problem breathing or eating Started immediately after the vaccine was administered thought it was my nerves but it hasn't gone away it's a day later

Other Meds: Hctz, Probiotics, Amlodipine, Vitamin D, Aspirin, Fish oil, Losartan Potassium, Lipitor, Magnesium, Vitamin C,

Current Illness: None

ID: 0992104
Sex: F
Age: 51
State: MT

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 02/01/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Diarrhea & Nausea

Other Meds:

Current Illness:

ID: 0992105
Sex: M
Age:
State:

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

Lab Data:

Allergies: none

Symptoms: None stated.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm