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: 0997856
Sex: F
Age: 91
State:

Vax Date: 01/31/2021
Onset Date: 02/01/2021
Rec V Date: 02/03/2021
Hospital: Y

Lab Data:

Allergies:

Symptoms: Chest pain; Dehydration; Elevated troponin; Encephalopathy, metabolic; Hypernatremia; Troponin I above reference range; Uremia; Weak; Weakness

Other Meds:

Current Illness:

ID: 0997857
Sex: F
Age: 73
State: CA

Vax Date: 01/24/2021
Onset Date: 02/02/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data:

Allergies: Penicillin, Codeine

Symptoms: Large red itchy welt at injection site

Other Meds: Vitamin D, Lipitor, Flonase

Current Illness: None

ID: 0997858
Sex: F
Age: 33
State: KY

Vax Date: 02/02/2021
Onset Date: 02/02/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data: N/a

Allergies: None

Symptoms: Fever documented at 101.1F approximately 12 hrs after inoculation. In addition, I experienced abdominal pain, chills, fatigue, generalized body aches and nausea.

Other Meds: Claravis, 60 mg x1 daily D mannose 1500 mg as needed

Current Illness: None

ID: 0997859
Sex: M
Age: 75
State: NY

Vax Date: 01/12/2021
Onset Date: 01/29/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data: None

Allergies: none

Symptoms: Apparent lymphadenopathy on top of left shouder measuring ultimately roughly 10 c long, 4 c wide and 2 c high. It may have extended down to just above the clavicle next to the neck (4c away), where it receded over 36 hours from onsetat 8 pmJan 29. Continuing as of this report as soft circular swelling about 5c diameter, 2 c high and sitting just above the clavicle. Clinician recommended no treatment as no other symptoms presented and breathing/swallowing were unaffected. I am likely to recieve chemo from newly recurring (Dec 2020) NHL -a biopsy is pending Feb 8 with diagnosis likely by Feb 16. Treatment TBD.

Other Meds: Fish oil/Omega 3 - 2100 mg daily (.94 oz) + Lotrel 10/40 mg

Current Illness: Non Hodgkin Lymphoma

ID: 0997860
Sex: F
Age: 49
State: OH

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data: NA

Allergies: PCN Sulfa

Symptoms: Red itchy spots on neck and chest. Took antihistamine for 2 days. Tongue blisters on both side and felt like it was burned. Resolved in 3 -4 days Dry mouth. Resolved in 3-4 days

Other Meds: Vit C Synthroid Estradiol ASA Vit D3 Zinc CA with D

Current Illness: None

ID: 0997861
Sex: F
Age: 45
State: CO

Vax Date: 02/02/2021
Onset Date: 02/02/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Patient received Moderna Vaccine at Medical Center on 1/6/21. Was told to self schedule 2nd appointment. Unable to self schedule at Medical Center so selected Hospital. Arrived today to receive 2nd vaccine at Hospital and screener was not aware that receiving 2nd vaccine at Hospital was not appropriate especially if first vaccine at Medical Center was Moderna. Hospital does not have Moderna vaccine. Screener printed Pfizer on Vaccine card and patient continued on into the vaccination area were the nurse did not challenge the 2 different vaccines on the card and administered the 2nd dose with the Pfizer product

Other Meds:

Current Illness:

ID: 0997862
Sex: F
Age: 70
State: FL

Vax Date: 01/16/2021
Onset Date: 01/26/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data: None

Allergies:

Symptoms: Approximately 10 days after the 1st vaccine I developed a red rash on my upper left arm. (just below the site of the injection). It started out as a bright red circular shape and got larger over the next day. At it's biggest size, it was approximately 2 1/2 inches wide and 5 inches long. The rash was slightly swollen and was mildly itchy. Over the next three days it decreased in size and the redness faded. At this time, it is almost gone.

Other Meds:

Current Illness: None

ID: 0997864
Sex: F
Age: 68
State: TX

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Patient reports feeling/having blurry vision (slightly), she states she has history of having blurry vision when she is anxious and she is anxious today. Symptoms stopped before patient left the observation area and after being seen and cleared by EMS. BP 161/87, HR 68. Instructed patient to call PCP, 911, or go to the nearest emergency room for any further issues.

Other Meds:

Current Illness:

ID: 0997866
Sex: F
Age: 49
State: WV

Vax Date: 01/25/2021
Onset Date: 01/27/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data:

Allergies: Penicillin, Bactrim, Sulphur, Cephalexin, Morphine, Lomotil

Symptoms: Red hive, sore left arm, spot warm to touch and itchy. Feel like a tightening on my arm like a blood pressure cuff

Other Meds: Herbal multi vitamins

Current Illness: No other illnesses

ID: 0997867
Sex: M
Age: 28
State:

Vax Date: 01/31/2021
Onset Date: 02/03/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Caller received vaccine 1/31/21. Called today and stated he has a temp of 100.9 and feels achy like he has the flu. He stated he had a sore arm right after the vaccine but that it is gone now. He denies SOB, chest pain, or any other symptoms. RN reviewed taking Tylenol or Advil, which ever he takes when he has pain, drinking plenty of fluids and rest. RN reviewed red flags to call 911. RN stated will follo up with him tomorrow.

Other Meds:

Current Illness:

ID: 0997868
Sex: M
Age: 73
State: KY

Vax Date: 01/26/2021
Onset Date: 01/01/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data:

Allergies: Hay fever

Symptoms: Main and most painful is pain in jaw bones, left & right, pain at & close around dental implant post in lower jaw center-right. Treatment at this time (2/3/21) is (self prescribed,over the counter) 1 Acetaminophen 500 mg pill at bed time. Joint pain left thumb, especially when making a fist. Neck pain more or less continuous , slight but more or less continuous headache.

Other Meds: Fluticasone Propionate, 50mcg 1/day /as needed, 1 per nostril; Simvastatin 40 mg 1/day; Lisinopril 2.5 mg 1/day

Current Illness: Hay fever

ID: 0997869
Sex: M
Age: 37
State: CA

Vax Date: 01/19/2021
Onset Date: 01/26/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data: no

Allergies: no

Symptoms: I was sore after the shot. I waited to exercise for a few days. On Monday I felt a burning sensation in my shoulder muscles. I discovered a lump under my left arm in my armpit area. It is painful. I also had euphoria upon receiving the vaccine.

Other Meds: no

Current Illness: no

ID: 0997870
Sex: F
Age: 28
State: NE

Vax Date: 12/17/2020
Onset Date: 02/01/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data: none

Allergies: no known allergies

Symptoms: bells palsy right sided, started on 2/1/2021

Other Meds: multi vitamin

Current Illness: no

ID: 0997871
Sex: M
Age: 51
State: MT

Vax Date: 01/29/2021
Onset Date: 01/30/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data: COVID test - Positive 02/01/2021

Allergies:

Symptoms: Congestion, Fever, Body aches,

Other Meds:

Current Illness:

ID: 0997872
Sex: F
Age: 50
State: WA

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: 1/1/2021 around 8 pm fatigue and weakness, arm soreness. 1/2/2021 around 8 am body ache, weakness, fatigue 1/2/2021 around 12 pm body ache, weakness, fatigue, headache, chills. Left work went home. 1/2/2021 around 9 pm body ache from head to toes, weakness, chills, fever 102 F. 1/2/2021 around midnight body ache, weakness, chills fever 102 F, dripping sweat. Condition gradually improved. 1/3/2021 Morning temperature normal, Still weak.

Other Meds: Vitamin B, Fish Oil,

Current Illness: None

ID: 0997873
Sex: F
Age: 30
State: NY

Vax Date: 01/23/2021
Onset Date: 01/23/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data: COVID-19 PCR test: negative

Allergies: KNDA

Symptoms: Four hours after receiving second dose of Moderna vaccine patient reported symptoms of facial numbness on the LEFT side (weakness and tingling), muscle aches, fatigue, mild chills. Patient seen on 1/25/2021 symptoms resolved at this point. Patient was referred to neurology by the hospital's employee health department after the employee called in the symptoms to the symptom hotline. Patient did not see neurology. Patient was tested for COVID at the suggestion of employee health. Patient tested negative.

Other Meds: Symbicort and albuterol

Current Illness: Had COVID symptoms in April - not tested for COVID. Pharyngitis in June 2020 - not tested for COVID Tested for COVID on 1/25/21 - PCR negative.

ID: 0997874
Sex: F
Age: 0
State: VA

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data: none

Allergies: Bunch or Pain meds, and Wheat

Symptoms: Took BP meds first thing this morning, normally have no issues, was fine. Went to get 2nd dose and 2 hours after dose, felt very swimmy in my head, took BP and with meds it is 130/99. Not extremely high but I did take my meds at 8 am this morning.

Other Meds: Lisiniprol 20 mg once a day

Current Illness: High BP- but controlled with meds

ID: 0997875
Sex: F
Age: 32
State: RI

Vax Date: 02/02/2021
Onset Date: 02/02/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data:

Allergies: only allergy listed is to latex

Symptoms: Systemic: Other- feeling of "skin crawling"-Medium

Other Meds:

Current Illness:

ID: 0997876
Sex: F
Age: 79
State: NC

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data:

Allergies:

Symptoms: vomited x 2 later that day

Other Meds:

Current Illness:

ID: 0997877
Sex: M
Age: 90
State:

Vax Date: 01/31/2021
Onset Date: 02/01/2021
Rec V Date: 02/03/2021
Hospital: Y

Lab Data:

Allergies:

Symptoms: AS (aortic stenosis); Cardiac syncope; Pancytopenia; Severe aortic valve stenosis; Symptomatic anemia; Syncope; Syncope, unspecified syncope type

Other Meds:

Current Illness:

ID: 0997878
Sex: F
Age: 56
State: TX

Vax Date: 01/31/2021
Onset Date: 02/02/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data: NA

Allergies: Codeine, Compazine, Dilaudid

Symptoms: Large red, warm swollen patches BELOW the injection site. It goes from side to side on the outside of the arm.

Other Meds: Covaryx, Atenolol, Acyclovir, Synthroid, and Calcitriol

Current Illness: NA

ID: 0997879
Sex: F
Age: 69
State: TX

Vax Date: 01/14/2021
Onset Date: 01/22/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data: Saw doc on 1/29 in office. Told to continue antihistmine. Prescribed epi pen to take to second dose appt.

Allergies: Cipro, amoxicillin, sulfa, latex (topical reaction)

Symptoms: Day of injection (1/14), redness. Next day (1/15) redness, swelling, hot about the size of palm. Faded by 1/18. 1/22 itchiness, redness, swelling, warm knot returned and covered much bigger area on arm. Started antihistmine and took 8 days to return to normal.

Other Meds: Hydroxychloroquine, evoxac, cevemeline, clonazepam, valayclovir, Advil

Current Illness:

ID: 0997880
Sex: F
Age: 23
State: NY

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data: N/A

Allergies: NKA

Symptoms: Immediately after receiving the 1sy dose of the Moderna vaccine, patient lost consciousness for approx. 1 minute. Code Blue activated, VS taken, and patient placed in a recumbent position. After regaining consciousness, patient reported "ringing" in her ears and blurry vision. PO fluids and snack encourgaed and tolerated well. Patient refused hospitalization and on-site MD recommended for the patient to be sent home.

Other Meds: N/A

Current Illness: N/A

ID: 0997881
Sex: F
Age: 32
State: IN

Vax Date: 02/01/2021
Onset Date: 02/02/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Body aches, head ache, chills, weakness

Other Meds: None

Current Illness: None

ID: 0997882
Sex: F
Age: 48
State: TX

Vax Date: 12/30/2020
Onset Date: 01/01/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data: Covid tests both at Employee Health and UC

Allergies: Codeine, Lipitor, Crestor, Penicillin, Morphine

Symptoms: I had a very painful injection site and also area got swollen and red. Like a bruise. For about 4 days. I took Ibuprofen and Tylenol and it was hard to sleep because it was very painful. New Years eve I started feeling my throat scratchy so I made me some honey tea. As I sipped the tea, my son entered the room and made a remark regarding the tea smell and then I realized that I could not smell the tea, but could still taste it. Concerned it could be a sign of COVID I sanitized all areas and stayed in my room. Next morning I noticed my smell and taste were compromised. I communicated with the employee health and was tested on the 4th and my rapid test was negative and I could not believe it. So I decided to go to the UC and I was tested for flu, strep and Covid I was tested positive around 4PM on the same day (01/04/2021). On 01/02 I noticed I was nauseated around 6:30PM til 10PM and next morning it was gone. On 01/03 I had headache and chills about the same time, I developed diarrhea on the 4th later in the evening as well. On the 5th, 6th and 7th I had cough and on the 9th I had diarrhea again and after that by the weekend everything had resolved and I felt better.

Other Meds: Pravastatin and Montelukast, Zyrtec, Entrupisulin (migraine)

Current Illness: Sinuses and migraine (come and go, depending on the weather I get it)

ID: 0997883
Sex: F
Age: 39
State: CA

Vax Date: 01/30/2021
Onset Date: 01/30/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data:

Allergies: Multiple

Symptoms: Nausea, vomiting, burping, hiccips, unable to eat, shortness of breath, severe pain to arm.

Other Meds: Multiple

Current Illness: Asthma

ID: 0997884
Sex: M
Age: 65
State: GA

Vax Date: 01/22/2021
Onset Date: 01/30/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data: n/a

Allergies: None at time of vaccination

Symptoms: He c/o of infected tooth on 01/23/21, antibiotics began Swelling in both hand began on 01/30/21. Resident c/o of itching in arm. Antibiotics discontinued, benedryl given as needed. Symptoms resolved 02/02/21

Other Meds: Acetaminophen, acidophilous, Amlodipine, Aspirin, Citalopram, Clindamycin, Epinastine, Lamotrigine, Losartan, Lumigan sol, Metoprolol, Prednisone, Risperdal, Trazodone, Vitamin C, Vitamin D, Xalatan sol, Zinc

Current Illness: Covid

ID: 0997885
Sex: F
Age: 45
State: MN

Vax Date: 01/22/2021
Onset Date: 01/30/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Local tenderness at vaccination site (left deltoid) developed 7 days after vaccine. She developed red, raised, warm area 8 days after the vaccination. Symptoms resolved within 3 days

Other Meds:

Current Illness:

ID: 0997886
Sex: F
Age: 55
State: NE

Vax Date: 01/21/2021
Onset Date: 02/03/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data: none

Allergies: methergine lexapro ketek prednisone

Symptoms: Moderna COVID-19 Vaccine EUA It has been almost 2 weeks since my first injection and I am now having redness and swelling at the injection site. The area is warm and there is a dull ache as well. I had no issues the first week after the injection.

Other Meds: losartan, 100 mg, daily hydrochlorothiazide, 50 mg, daily acyclovir, 400 mg, bid vitamin D, 5000 iu, daily probiotic daily multivitamin, daily nexium, daily

Current Illness: none

ID: 0997887
Sex: F
Age: 63
State: TX

Vax Date: 02/02/2021
Onset Date: 02/02/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data: none

Allergies: latex

Symptoms: pt states her arm is very tender but no rash around the injection site but she woke up during the night w/ extreme joint pain in lower back, hip, knees and ankles. Pt states she will probably not contact her PCP since she was advised that she may have some of these symptoms. Pt stated she started taking ibuprofen before covid vax and is still taking it.

Other Meds: Pristique, Amlodipine, HTCD, Crestor, aspirin, ibuprofen

Current Illness: none

ID: 0997888
Sex: F
Age: 40
State: NY

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data: none

Allergies: gluen

Symptoms: severe neck pain that developed about 10-12 hours after injection. Pain was debilitating and last for about 36 hours. Unable to move neck or lift arm.

Other Meds: none

Current Illness: none

ID: 0997889
Sex: F
Age: 17
State: NJ

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data:

Allergies:

Symptoms: No Adverse event occurred, but patient in retrospective review of data was discovered to have incorrectly been given Moderna vaccine while under 18 year old as approved in the EUA. The manufacturer was contacted and they provided information about an ongoing clinical trial in patients 12-18 years old receiving the same (100mcg) 2 dose series of Moderna COVID-19 vaccine, however this age group is not currently approved. This is being reported as an error having occurred with the Moderna COVID-19 vaccine. Patient/Guardian will be contacted by a prescriber to inform the patient of the historical event and explain when a 2nd dose can be given.

Other Meds:

Current Illness:

ID: 0997890
Sex: F
Age: 61
State: PA

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Fever, chills, achiness started approximately 12 hours after vaccine was given. The chills were more of a tremble and shaking of my whole body. Pain and swelling of lymph nodes under left arm. The fever continued through the next day and evening, as did the lymph node pain and swelling. The lymph nodes are still a little tender and there is still some swelling today, 2/3/21. The only thing I did was take Tylenol for the fever and body aches, and rest.

Other Meds: Vitamin D3, Vitamin C, Calcium w/zinc and magnesium

Current Illness: None

ID: 0997891
Sex: F
Age: 25
State: MT

Vax Date: 01/29/2021
Onset Date: 01/30/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Fever

Other Meds:

Current Illness:

ID: 0997892
Sex: F
Age: 57
State: MS

Vax Date: 01/20/2021
Onset Date: 01/21/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data:

Allergies: Cipro xofluza lunesta

Symptoms: Chills Fever Terrible joint aches Very Tired Headache

Other Meds: Omeprazole 40 mg Duloxetine 60 mg Famotidine 20 mg zyrtex 10 mg

Current Illness: none

ID: 0997893
Sex: F
Age: 36
State: IN

Vax Date: 02/01/2021
Onset Date: 02/02/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data:

Allergies: Sulfa drugs

Symptoms: High fever, body aches, nausea

Other Meds:

Current Illness: Bipolar, htn, allergies

ID: 0997895
Sex: F
Age: 87
State: MN

Vax Date: 01/18/2021
Onset Date: 01/20/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data:

Allergies:

Symptoms: vertigo on 1/26/2021. Swelling, redness and pain at site on 1/31/2021

Other Meds:

Current Illness:

ID: 0997896
Sex: F
Age: 41
State: MN

Vax Date: 01/14/2021
Onset Date: 01/20/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data: I had a chest ultrasound on 1/29/21. It was determined that or was a reactive Lymph node. I was told to monitor it and if it gets larger to come in for another scan.

Allergies: None

Symptoms: Approx 7 days post vaccine, I developed a small jelly bean sized lump near my left clavicle. Im not sure when it appeared, but I noticed it on 1/20/22 in the evening due to pain in that location and on the front on my shoulder near injection site. My seatbelt was rubbing on it.

Other Meds: None

Current Illness: None

ID: 0997897
Sex: F
Age: 39
State: CA

Vax Date: 01/07/2021
Onset Date: 01/15/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data:

Allergies: Penicillin Sulfas

Symptoms: COVID arm, erythema, inflammation and pruritis of deltoid on vaccinated arm which lasted approx 3 days

Other Meds: Symbicort 160/4.5 Albuterol

Current Illness: none

ID: 0997898
Sex: F
Age: 34
State: VA

Vax Date: 01/11/2021
Onset Date: 01/13/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Prolonged vertigo, sense of dizziness, nausea and BP drops with feeling of passing out.

Other Meds: Lamictal, Abilify, prenatal

Current Illness: None

ID: 0997899
Sex: F
Age: 60
State: FL

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data: Denies

Allergies: NKDA

Symptoms: Pt reports feeling "out of body", lightheaded, impending doom, nauseated and diaphoretic.

Other Meds: None

Current Illness: Denies

ID: 0997900
Sex: F
Age: 67
State: NC

Vax Date: 01/30/2021
Onset Date: 01/30/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data:

Allergies: injectable dye; Droperidol; Trileptal; Gabapentin; Lyrica; Amoxicillin; Stadol; Amitriptyline HCl; Ciprofloxacin HCl; Cymbalta; Namenda

Symptoms: odd smell at onset of shot-lasted 14hrs. Other SX started @3pm. In sequence - fatigue, sweat, clammy, myalgia, headache, short of breath w/cough, rash on other arm & chest, upper GI pain, diarrhea, injection site hard & warm, joint & bone pain. O2=90% Fatigue lasted longest Severe myalgia head to toe next longest 14hr.

Other Meds: Ketoprofen-Ketamine-Lidocaine; Zebeta; Vitamin D; Clobetasol Propionate; Lamictal; Magnesium; Clonazepam; Glucosamine Chond; Melatonin; Symbicort; Levsin; Nitroglycerin Er; Lamotrigine; Allegra; Klor-Con; Patanol; Creon; Multi-Vitamin; Vita

Current Illness:

ID: 0997901
Sex: M
Age: 0
State: DE

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data: None

Allergies:

Symptoms: patient given dose of Rotavirus (1st dose) at age 19 weeks & 5 days. Initial dose is supposed to be given between 6-12 weeks of age

Other Meds: NONE

Current Illness: NONE

ID: 0997902
Sex: M
Age: 11
State: LA

Vax Date: 02/01/2021
Onset Date: 02/02/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data: None

Allergies:

Symptoms: Swelling + redness to L deltoid

Other Meds:

Current Illness:

ID: 0997905
Sex: M
Age:
State: TX

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data: 2 blood tests

Allergies:

Symptoms: Loss of consciousness, seizure, Fatigue, body aches, soreness at injection site, feveR

Other Meds:

Current Illness:

ID: 0997907
Sex: F
Age: 22
State: NY

Vax Date: 01/21/2021
Onset Date: 01/22/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data: N/A

Allergies: N/A

Symptoms: One day after the vaccine, I had a horrible sore throat, body aches, joint pain, lymph node swelling under left axilla and left side of throat. Also runny nose, Fatigue and headaches. This only lasted 1 day. I felt better on day 3, after the vaccine.

Other Meds: Duloxetine 60mg

Current Illness: N/A

ID: 0997908
Sex: F
Age: 41
State: NY

Vax Date: 01/20/2021
Onset Date: 01/21/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data: N/A

Allergies: NKDA

Symptoms: Red, Hot, swollen arm @ injection site, temp 100.9, fatigue

Other Meds: bupropion, duloxetine, vitamin D3, calcium carbonate

Current Illness: N/A

ID: 0997909
Sex: M
Age: 65
State:

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Headache, Mylagia, Chills Narrative:

Other Meds:

Current Illness:

ID: 0997910
Sex: F
Age: 35
State: TX

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data:

Allergies: Levaquin/Rash

Symptoms: After receiving the vaccine patient stated that felt warm and shot of Breath Her O2 Metered 100%. She self administered her antianxiety medication (She carry it with her) and went home with no further report of consequence. Today 2/3/21 She declined 2nd dose of Moderna COVID 19 vaccine

Other Meds: Rx Self Administered for Anxiety Attacks

Current Illness: Panic Attacks

ID: 0997911
Sex: M
Age: 73
State:

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Narrative: Patient received Moderna COVID-19 vaccine via drive thru clinic. The patient was in his vehicle with his wife, when he became diaphoretic and passed out for a couple minutes. Rapid response was called. Patient was removed from the vehicle. He was becoming obtunded and was placed on the pavement. 911 was called. He was given EpiPen at 10:41. His vital signs at 1042 were: saturation 98% on room air, pulse 59, blood pressure 138/80. Patient received Solu-Medrol 125 mg IM a couple of minutes after EpiPen. After the EpiPen the patient became more alert, denied shortness of breath or wheezing, he was nauseated without vomiting. His saturation at that point dropped to 88% on room air, he was started on oxygen with nonrebreather mask. Rescue truck arrived at approximately 1047, and the patient was taken to emergency room. Discharged same day.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm