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: 0997912
Sex: M
Age: 82
State:

Vax Date: 01/28/2021
Onset Date: 01/29/2021
Rec V Date: 02/03/2021
Hospital: Y

Lab Data:

Allergies:

Symptoms: Narrative: Patient is 82 years old with cardiovascular disease and fell when bending over to pick something up. Therefore, it is not clear if fall was caused by these risk factors or by the vaccine. However, he had complained of weakness prior to this episode.

Other Meds:

Current Illness:

ID: 0997913
Sex: F
Age: 77
State: VA

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data:

Allergies: erythromycin, iodine contrast, adhesive tape

Symptoms: Approximately 1hr post injection pt rptd. N/V + D X3 episodes. Zofran 4mg po for nausea Imodium 1tab po for diarrhea F/U with Pt 01/29/2021 all symptoms resolved Pt. also had a salad which she attributes to the cause of symptoms, on her f/u appt on 01/29/2021.

Other Meds:

Current Illness: SOB r/t A.Fib

ID: 0997914
Sex: F
Age:
State: VA

Vax Date:
Onset Date: 01/28/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data: None

Allergies: Povidone, Iodine, NSAIDS, eggs, wheat, sulfa drugs, Augmentin,

Symptoms: Office Mngr noticed hives on forehead + neck, chest. Took 3 Allavert Allergy ODT tab, drove home, took Benadryl 50mg + Prednisone 60mg. Severe fatigue Friday Sat + Sun, (01/29 - 01/31/2021), restless, irritable, achy all over, warm + pain @ injection site, + headache Made my PCP aware. Refill from him on Prednisone always have to premedicate with Benadryl + Prednisone Took 40mg Prednisone 01/30/2021 Took 20mg Prednisone 01/31/2021 Took 20mg Prednisone 02/01/2021 Continue with fatigue + dry hacy cough. (-) Rapid COVID test 02/02/2021 per CDC req'mts for Longterm care facilities

Other Meds: Adderall, Clonidine, Vit C, Vit D, Calcium Duloxetine Fioricet

Current Illness: Possible COVID (-) PCR x 2

ID: 0997915
Sex: F
Age: 86
State: VA

Vax Date: 01/28/2021
Onset Date: 01/31/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data:

Allergies: NKNN

Symptoms: Pt rpts h.a., dizziness, nausea, + diarrhea fatigue onset 01/31/2021, progressively worse today. Denies rash/hives SOB, diaphoresis, dysphagia, itching confusion, memory loss, wheezing

Other Meds:

Current Illness: NONE

ID: 0997916
Sex: M
Age: 17
State: MA

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

Lab Data:

Allergies:

Symptoms: Pt broke out in rash on his face - Jaw

Other Meds:

Current Illness: none

ID: 0997923
Sex: F
Age: 38
State: CT

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

Lab Data: N/A

Allergies: Tequin and Reglan

Symptoms: Headache, chills, bodyaches, nausea, fatigue, feverish

Other Meds: MgOx Dexilant Vit D Allegra

Current Illness: N/A

ID: 0997925
Sex: F
Age: 80
State: ND

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

Lab Data: Checked her blood sugar with a reading of 97 mg/dl

Allergies: None

Symptoms: Client complained of "feeling odd" during the nite and slightly disoriented in the morning. Had somewhat strange behavior in the morning of confusion and chills.

Other Meds: Irbesartan 150 mg Metoprolol 100 mg Furosemide 40 mg Simvastin 20 mg Glyburide 2.5 mg Vitamin D Eliquis Novolog Insuline

Current Illness: None

ID: 0997926
Sex: F
Age: 25
State: WA

Vax Date: 01/14/2021
Onset Date: 01/15/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Pt had fatigue yesterday and went to sleep. She woke up on the bathroom floor and was unaware of how she arrived there. She called 911. They came and assessed her. She was stable and was no need to be transferred. She is afebrile and her only symptoms is headache. She will continue to monitor and call back if anything changes. I recommended that she go to urgent care.

Other Meds:

Current Illness:

ID: 0997927
Sex: F
Age: 47
State: MI

Vax Date: 01/27/2021
Onset Date: 01/29/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: Hives.

Other Meds:

Current Illness: none

ID: 0997928
Sex: F
Age: 37
State: IL

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

Lab Data:

Allergies: None

Symptoms: Moderna COVID-19 Vaccine EUA I got a headache which felt similar to a tension headache within 15 minutes of getting the vaccine. Within 2 1/2 hours the headache had become a migraine and I had to lay down.

Other Meds: Levothyroxine 75mcg Seetraline 50mg

Current Illness: None

ID: 0997930
Sex: F
Age: 29
State: OH

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

Lab Data: none

Allergies: Sulfonamides hazelnut

Symptoms: 3-4 minutes after receiving injection patient's caregiver noticed some swelling of patient's left eye. Patient did not complain of any shortness of breath, itching, hives, etc. BP and pulse ox were normal, but some wheezing was noted by a physician in the vaccine clinic. Patient was transferred to our ED for further evaluation. The ED did not hear any wheezing, and the patient's caregiver said that the swelling of her eye appeared to lessen. She was treated in the ED with IV Benadryl, Solu-Medrol, and Pepcid. Was discharged approximately 2 hours later.

Other Meds: Risperidone 1 mg PO daily Lurasidone 40 mg PO qHS Nuedexta 1 cap PO BID Dicyclomine 10 mg PO daily Docusate Sodium 250 mg PO BID Vortioxetine 10 mg PO daily Hydroxyzine HCl 25 mg PO TID PRN anxiety

Current Illness:

ID: 0997931
Sex: F
Age: 32
State:

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

Lab Data:

Allergies: Clarithromycin, Amoxicillin

Symptoms: Itching in lip and nose. Diphenhydramine 25mg po administered. Resolved in 3 hours.

Other Meds:

Current Illness:

ID: 0997932
Sex: F
Age: 59
State: GA

Vax Date: 01/22/2021
Onset Date: 01/25/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data: no

Allergies: Penicillin, erythromycin

Symptoms: My PCP advised I take benedryl and tylenol after the vaccine because of the AE I experienced to the 1st vaccine so I am unsure if because I was extra tired is d/t all of the vaccine or if the benedryl played a part in it. But about 2hr after I begin getting a headache but had already taken tylenol so I didnt take anything. I got a little dizzy and super sleepy but nothing else on the first day. The next morning I was so tired, drained feeling and very fatigued. I got up for a while but had to lay back down because I was feeling foggy, tired and very fatigued causing me to miss work. About 4pm I felt a little better. The next day I had a mild headache and still felt a little tired but was able to go to work and nothing else since.

Other Meds: Lisinopril, Vit. D./Calcium

Current Illness: no

ID: 0997933
Sex: F
Age: 53
State: IN

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

Lab Data:

Allergies: none

Symptoms: Felt increased wooziness/dizziness/feeling off for several hours. Progressed to a migraine (not a person to ever have had migraines)x 24 hrs. Resulted in not going to work the next day. Also a large, raised, redden/inflamed injection site remains on the right deltoid.

Other Meds: none

Current Illness: none

ID: 0997935
Sex: F
Age: 40
State: CA

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

Lab Data:

Allergies: Levaquin, lemongrass

Symptoms: angioedema of face, feet and hands. severe headache started 30 mins after injection, noticed swelling of eyes 1 hour after injection. less than 12 hours later, full facial swelling, hands and feet. continued to worsen for the next 5 days. swelling started to slightly subside day 5. fever until day 4. vomit day 3. chills until day 4. severe headache until day 18.

Other Meds: wellbutrin

Current Illness: none

ID: 0997936
Sex: U
Age:
State: ID

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 02/03/2021
Hospital:

Lab Data:

Allergies:

Symptoms: it was administered after the temp excursion had occurred; This spontaneous report was received from a medical assistant and refers to a patient of unknown age. No information regarding the patient's pertinent medical history, drug reactions or allergies and concomitant therapies was provided. On 29-DEC-2020, the patient was vaccinated with an improperly stored dose hpv rl1 6 11 16 18 31 33 45 52 58 vlp vaccine (yeast) (GARDASIL 9) lot # 1687292, expiration date 25-AUG-2022 (exact dose, anatomical location and route of administration were not reported) for prophylaxis. Digital Data logger was involved. The vaccine was stored at the temperature that was reported as 22.7 degrees of Fahrenheit for 35 minutes on 22-DEC-2020. Previous temperature excursion occurred on 07-DEC-2020 and the vaccine was stored at the temperature of 32.6 degrees of Fahrenheit for 30 minutes. This is one of several reports received from the same reporter. combinationproductreport: Yes; brandname: GARDASIL 9 SYRINGE (DEVICE); commondevicename: HPV rL1 6 11 16 18 31 33 45 52 58 VLP vaccine (yeast); productcode: FMF; devicetype: SYRINGE, PISTON (FMF); manufacturername: Merck Sharp & Dohme Corp.; devicelotnumber: 1687292; expirationdate: 25-AUG-2022; deviceage and unit: 0; malfunction: Unknown; deviceusage: Initial; reasonfornoneval: 81 Other; labeledsingleusedevice: No; mdcpreportability: No; mdcpreprationale: Case information does not meet the criteria for Reportability; Sender's Comments: US-009507513-2101USA001945: US-009507513-2101USA002297: US-009507513-2101USA001792: US-009507513-2101USA001777:

Other Meds: GARDASIL 9 SYRINGE (DEVICE)

Current Illness: Prophylaxis

ID: 0997937
Sex: U
Age: 1
State: KY

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

Lab Data:

Allergies:

Symptoms: No additional AE.; Improperly Stored VAQTA was administered to patient.; This spontaneous report was received from a nurse and refers to a 18-month-old patient. No information regarding the patient's pertinent medical history, drug reactions or allergies and concomitant therapies was provided. On 06-JAN-2021 between 9:30 AM and 12:00 PM, the patient was vaccinated with an improperly stored dose of hepatitis a vaccine, inactivated (VAQTA) lot # T013204, expiration date 03-DEC-2021 (exact dose, anatomical location and route of administration were not reported) for prophylaxis. Digital Data logger was involved. The temperature excursion occurred on 06-JAN-2021 at 1:30AM. The vaccine was stored at the temperature that was reported as 35.2 degrees of Fahrenheit for 45 minutes. There was no previous temperature excursion reported. No additional adverse event reported. This is one of several reports received from the same reporter. combinationproductreport: Yes; brandname: VAQTA SYRINGE (DEVICE); commondevicename: Hepatitis A Vaccine, Inactivated; productcode: FMF; devicetype: SYRINGE, PISTON (FMF); manufacturername: Merck Sharp & Dohme Corp.; devicelotnumber: T013204; expirationdate: 03-DEC-2021; deviceage and unit: 0 ; malfunction: Unknown; deviceusage: Initial; reasonfornoneval: 81 Other; labeledsingleusedevice: No; mdcpreportability: No; mdcpreprationale: Case information does not meet the criteria for Reportability

Other Meds: VAQTA SYRINGE (DEVICE)

Current Illness: Prophylaxis

ID: 0997938
Sex: M
Age: 30
State: IA

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

Lab Data:

Allergies: No

Symptoms: Patient experienced numbness and tingling from the injection site down to finger tips.

Other Meds:

Current Illness: No

ID: 0997939
Sex: U
Age:
State: NJ

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

Lab Data:

Allergies:

Symptoms: Inappropriate schedule of product administration; no adverse event; This spontaneous report was received from a patient's mother and refers to her 18-year-old son. The patient's medical history, concurrent conditions and concomitant medications were not reported. On an unknown date in 2014, the patient was vaccinated with the first dose of hpv rl1 6 11 16 18 31 33 45 52 58 vlp vaccine (yeast) (GARDASIL 9) (exact dose, site an route of administration, lot# and expiration date were not reported) for prophylaxis. The patient's mother decided that she did not want her son to continue the cycle due to research she saw on the vaccine. So, the patient did not get the second or third dose of the vaccine. The reporter thought it was a safe for the patient to get the vaccine as he was 18 years old, so she took him to see his physician. When the physician pulled his records, it stated that he had completed the hpv rl1 6 11 16 18 31 33 45 52 58 vlp vaccine (yeast) (GARDASIL 9) (reported as Gardasil) dosing cycle 6 years ago. The patient's mother stated that she told them 6 years ago she did not want him to continue with the dosing schedule. So, then she wanted to know if there was a titer test that could check to see if her son had the vaccine so he was not vaccinated twice. Currently, her son was not having any complications. No further adverse event was reported.

Other Meds:

Current Illness:

ID: 0997940
Sex: U
Age:
State:

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

Lab Data:

Allergies:

Symptoms: No additional AEs; expired vaccine V AQTA (...) was administered to a patient on 1/12/2021; This spontaneous report was received from a nurse and refers to a patient of unknown age and gender. The patient's medical history, concurrent conditions and concomitant medications were not reported. On 12-JAN-2021, the patient was vaccinated with an expired, 1 ml dose of hepatitis a vaccine, inactivated (VAQTA) intramuscularly, lot# S036494, expiration date 09-JAN-2021 (site of injection was not provided) for prophylaxis. Hepatitis a vaccine, inactivated (VAQTA) had no temperature excursions. No adverse events were reported. combinationproductreport: Yes; brandname: VAQTA SYRINGE (DEVICE); commondevicename: Hepatitis A Vaccine, Inactivated; productcode: FMF; devicetype: SYRINGE, PISTON (FMF); manufacturername: Merck Sharp & Dohme Corp.; devicelotnumber: S036494; expirationdate: 09-JAN-2021; deviceage and unit: 0 ; malfunction: Unknown; deviceusage: Initial; evaluatedbymfr: Not returned to manufacturer; reasonfornoneval: 81 Other; labeledsingleusedevice: No; mdcpreportability: No; mdcpreprationale: Case information does not meet the criteria for Reportability

Other Meds: VAQTA SYRINGE (DEVICE)

Current Illness:

ID: 0997941
Sex: F
Age: 41
State: RI

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

Lab Data:

Allergies: Shellfish Tuna Penicillin Latex Wellbutrin

Symptoms: Numbness and tingling in fingers and hands, shortness of breath, tightness in chest.

Other Meds: Topiratmate Vitamin d Vitamin e

Current Illness: None

ID: 0997942
Sex: U
Age:
State: IN

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

Lab Data:

Allergies:

Symptoms: No additional AE details.; a patient received an expired dose of PROQUAD.; This spontaneous report was received from a nurse and refers to a patient of unknown age and gender. No information regarding the patient's medical history, concurrent conditions, drug reactions or allergies, historical drugs and concomitant medications was provided. On 06-JAN-2021, the patient was vaccinated with an expired dose of measles, mumps, rubella and varicella (oka-merck) virus vaccine live (rHA) (PROQUAD) injection, 0.5 milliliter (ml), lot # S021324, expiration date: 05-JAN-2021 (dose number, route of administration and anatomical location were not reported) for prophylaxis. The nurse was not aware of any temperature excursions for the vaccine administered. No additional adverse event was reported.

Other Meds:

Current Illness:

ID: 0997943
Sex: U
Age:
State: ID

Vax Date: 08/01/2020
Onset Date: 08/01/2020
Rec V Date: 02/03/2021
Hospital:

Lab Data:

Allergies:

Symptoms: No additional AE's reported.; administering an expired VAQTA vaccine; This spontaneous report was received from a medical assistant and refers to a patient of unknown age and gender. No information regarding the patient's medical history, concurrent conditions, drug reactions or allergies, historical drugs and concomitant medications was provided. On an unknown date in August 2020, the patient was unknowingly vaccinated with an expired dose of hepatitis a vaccine, inactivated (VAQTA) lot # s018772, expiration date: 07-JUL-2020 (dose number, dose, route of administration and anatomical location were not reported) for prophylaxis. No additional adverse event was reported. The outcome of medication error is unknown.

Other Meds:

Current Illness:

ID: 0997944
Sex: F
Age:
State: MI

Vax Date: 05/01/2020
Onset Date: 05/01/2020
Rec V Date: 02/03/2021
Hospital:

Lab Data:

Allergies:

Symptoms: who was first admin MMR II in MAY Of 2020 when she was 18 years of age; This spontaneous report was received from a certified medial assistant and refers to an 18-year-old female patient. The patient's medical history, concurrent conditions and concomitant medications were not reported. On an unknown date in May 2020, the patient was vaccinated with the first dose of measles, mumps, and rubella (wistar ra 27-3) virus vaccine, live (M-M-R II) (exact dose, site and route of administration, lot# and expiration date were not reported) for prophylaxis. The patient, who was then 19 years old, came back to get her second dose. The reporter wanted to confirm if they should start the doses over of just complete the series.

Other Meds:

Current Illness:

ID: 0997945
Sex: M
Age: 21
State:

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

Lab Data:

Allergies: None

Symptoms: Fatigue/myalgia about 14 hours post-injection

Other Meds: None

Current Illness: None

ID: 0997946
Sex: U
Age:
State: IA

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

Lab Data:

Allergies:

Symptoms: 2 year old patient inadvertently received PROQUAD and VARlVAX on a same day instead of MMR II and VARlVAX; received PROQUAD and VARlVAX on a same day; This spontaneous report was received from a medical assistant and refers to a 2 years old patient. No information regarding the patient's medical history, concurrent conditions, drug reactions or allergies and concomitant medications was provided. On 25-JAN-2021, the patient was inadvertently vaccinated with measles, mumps, rubella and varicella (oka-merck) virus vaccine live (PROQUAD) 1 dose (formulation, exact dose, route of administration, anatomical location, lot # and expiration date were not reported) and varicella virus vaccine live (oka/merck) (VARIVAX) (formulation, exact dose, route of administration, anatomical location, lot # and expiration date were not reported) both for prophylaxis, on the same day instead of virus vaccine, live (M-M-R II) and varicella virus vaccine live (oka/merck) (VARIVAX) (wrong product administered and accidental overdose). No further information was available.

Other Meds:

Current Illness:

ID: 0997948
Sex: F
Age: 71
State: DE

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

Lab Data:

Allergies: Allergic to poison ivy

Symptoms: Large red rash at site of injection ?ne itchiness. Size of redness about 2 inches.

Other Meds: Letrozol 2.5

Current Illness:

ID: 0997949
Sex: F
Age: 28
State: CA

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

Lab Data: N/A

Allergies: none

Symptoms: Vaccine administered with redness, swelling, pain, likely early cellulitis in area of injection site. Onset day after vaccination and day before evaluation

Other Meds: none

Current Illness: none

ID: 0997950
Sex: M
Age: 22
State: FL

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

Lab Data:

Allergies: NKDA

Symptoms: Day of 2nd Moderna vaccine Zizzo developed sore throat, loss of taste/smell, headache, myalgia, fatigue, fever/chills.

Other Meds: no prescription medications

Current Illness:

ID: 0997951
Sex: F
Age: 45
State: CO

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

Lab Data: N/A

Allergies: Drip anesthesia, type unknown Idiopathic (anaphylaxis in 2015, cause unknown)

Symptoms: Mild allergic reaction (tingling in mouth, splotchy red chest, itchy eyes) approximately 5-10 minutes after receiving the vaccine; itchy eyes and puffiness in face on and off from time of vaccine to present (7 days later); vaccine and/or subsequent mild allergic reaction triggered Functional Neurological Disorder symptoms (involuntary muscle activations in legs, face and neck, dystonic posturing of feet)

Other Meds: Robaxin

Current Illness: Functional Neurological Disorder

ID: 0997952
Sex: F
Age: 47
State: NH

Vax Date: 12/22/2020
Onset Date: 12/26/2020
Rec V Date: 02/03/2021
Hospital:

Lab Data: COVID PCR

Allergies: Sulfur Antibiotics

Symptoms: From 22nd to the 25th sore arm at injection of Dec. 26 -27 Cough, sore through, fever, shortness of breath and body aches then Dec. 27 COVID PCR for covid and 28 DEC the PCR positive

Other Meds: Viibryd 30mg, Multi- Vitamin

Current Illness: No

ID: 0997954
Sex: F
Age: 36
State: AZ

Vax Date: 12/28/2020
Onset Date: 12/30/2020
Rec V Date: 02/03/2021
Hospital:

Lab Data: Blood work - January 6th - my white count was very low and I'm getting it repeated today to check it. January 6th - they did a SED rate (normal) and maybe a metabolic panel (normal)

Allergies: no

Symptoms: Two days after I got the vaccine - muscle and joint aches - lasted a week and increased in severity as days went on; also had a headaches. In the weekend I was getting fatigued and really bad chills and sweats on the second. The 3rd of January, I could barely walk to the bathroom because I was so fatigued. Low fever on the 4th - 99.4. Couldn't have a full visit to dr on the 4th.Tested for COVID on 4th; Negative result. Couldn't go back to work until the 7th. I was completely exhausted, no appetite; muscles aches; had a bit of a headache, too, but the fatigue was so overwhelming that I just slept for those three days 5th, 6th, 7th. I went back to work on the 7th - it was rough but over the weekend I started doing better and the following week was better for me.

Other Meds: no

Current Illness: no

ID: 0997955
Sex: F
Age: 61
State: IA

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

Lab Data: Blood pressure 137/80

Allergies: None

Symptoms: Patient reported stomach cramping and had 5 bowel movements after vaccine. Stated was nervous for the shot. Took blood pressure 137/80. No diarrhea bowel movements were normal. Monitored pt and she felt better and reported still a little cramping but much better.

Other Meds: Blood pressure med. Not sure and is adjustiny

Current Illness: None

ID: 0997956
Sex: M
Age: 75
State: VA

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

Lab Data:

Allergies: None that I know of...

Symptoms: Injection site is very sore like a big bruise upper left arm. Big toe right foot GOUT. I take Allopurinol 100 mg for that

Other Meds: Metoprol Succinate ER 100ng Hydrochloeth 25mg Losartan 5mg Rosuvastain 5mg Allopurinol 100mg Finasteride 5mg Omeprazole 20mg 3 times per week M,W & F Asprin 81mg Cetirizine i per day Multivitamin 1 per day Chondroitin-Glucosamine 1 per day

Current Illness: None

ID: 0997957
Sex: F
Age: 68
State: FL

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

Lab Data: None

Allergies: None

Symptoms: Last evening (2/2/21) the site where I received the injection on my upper left arm began to itch, redden and grow warm. I had experienced that symptom immediately following the injection but it had disappeared some days ago. There is a visible 2? round rash, it?s very itchy, red and warm to the touch.

Other Meds: Prozac Baby Aspirin Kirkland sleep aid

Current Illness: None

ID: 0997959
Sex: F
Age: 30
State: PA

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

Lab Data: normal cmp, tsh 1/29/21, cbc shows normal hemoglobin, wbc, platelets, mpv was 11.9, monocyte 11.1% but absolute mono 0.72

Allergies: NKDA

Symptoms: patient noted dizziness right after vaccine, abated in 30 min, had HA next day, which improved. Since vaccine intermittent dizziness and palpitations which come and go. No rash or swelling I am not sure if from vaccine or anxiety related, but I wanted to report

Other Meds: Multivitamin

Current Illness: none

ID: 0997960
Sex: F
Age: 32
State: IL

Vax Date: 01/16/2021
Onset Date: 01/23/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data: Pending a sonogram test of the swollen lymph node.

Allergies: amoxicillin penicillin G

Symptoms: I received my covid vaccine on Saturday January 16, 2021, at 9:30am. On Saturday January 23, 2021, at 1:00pm I noticed a lump appear by my left collar bone. I went to a doctor on Monday 2/1/21, at 8:45am. The doctor at the walk in clinic told me I needed to report this to the hotline as a adverse effect to the vaccine. The doctor stated it was a swollen lymph node. This swollen lymph node is on the same side as the injection was administered. The doctor is calling it lymphadenopathy supraclavicular. I am waiting to have a sonogram done on the lymph node. I have been extremely fatigued and my appetite has been off since having this vaccine as well.

Other Meds: Atomoxetine Propranolol

Current Illness: None

ID: 0997961
Sex: F
Age: 67
State: FL

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

Lab Data:

Allergies: none

Symptoms: feeling foggy, woozy, a little dizzy and nauseated, racing hearthard to swallow

Other Meds: generic Fosamax once a week

Current Illness: none

ID: 0997962
Sex: F
Age: 60
State: OR

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

Lab Data:

Allergies: Sulfa eye drops- Red swollen eyes

Symptoms: Severe vertigo: onset 1 hour after injection followed by vomiting x3- Benedryl taken

Other Meds: Losartan/HCTZ 100mg/12.5mg Daily, Venlafaxine 75 mg Daily, Medroxyprogesterone daily, Estradiol , Atorvastatin 80mg Daily, Asa 81 mg x2 daily, Krill oil 300mg daily, Metformin 500mg Daily, MVI

Current Illness: none

ID: 0997963
Sex: M
Age: 41
State: NY

Vax Date: 01/27/2021
Onset Date: 01/30/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data: Visit to urgent care and Opthamologist

Allergies: No

Symptoms: Developed Shingles left side of face around eye. Pain along left side of head and face.

Other Meds: Losartan, Vit D, B12, CoQ10, Fish Oil

Current Illness: No

ID: 0997965
Sex: F
Age: 21
State: TX

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

Lab Data:

Allergies: None

Symptoms: I began getting nauseous and had a headache around 6pm and then the chills around 8 pm At 8:30 pm I decided to take my temperature and it was 101.3 this continued all throughout the night with me waking up with aches pains chills or hot flashes every hour. My temperature reached 103.9 around 2 am. the fever finally broke around 4 pm on 01/31/21

Other Meds: Tri-Lo Sprintec (Birth Control)

Current Illness: None

ID: 0997966
Sex: F
Age: 37
State: IN

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

Lab Data: None

Allergies: None known

Symptoms: Nausea, Severe migraine, sensitivity to light, Chills, Low grade fever, Body aches, extreme fatigue, weakness from 2/2/21 at 4:30 am until approximately 8:30 am 2/3/21. 8:30 am to 3:30pm on 2/3/21 only symptoms that remained was mild headache, fatigue.

Other Meds: None

Current Illness: None

ID: 0997967
Sex: F
Age: 45
State: PA

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

Lab Data: CBC w/ diff, CMP, APTT, PT/INR, BNP, Troponin, ECG, CXR, CT of chest r/o Pulmonary Embolism- No significant findings on all test.

Allergies: Ciprofloxacin, Clarithromycin, Doxycycline, Metoclopramide, Additional allergies: Oycodone, Pregabalin, Tetracyclines, Gabapentin, Levoflozacin, Pravastatin, Bactrim, Baclofen, Dicloxacillin,

Symptoms: Pt. presented for her second dose of Covid vaccine and denied having reaction to her first dose. Pt. was vaccinated at 7:22 am and was checked on at 7:45 am, when she indicated a tightness in her chest and throat. First response was called and at 7:48 Benadryl 25mg IM was given and at 7:50 a dose of epi 0.3 sq was provided and pt. was transfered to the ED by Wheelchair. Presented in ED essentially asymptomatic by time she arrived to ED per ED physician. She was given 10 mg Dexamethasone 10 mg IV, Benadryl 50 mg IV, Famotidine 20 Mg IV in the ED. Pt. discharged from ED at 10:42 am the same day. After discharge on 1/29/2021, the patient continued to have symptoms. On 2/2/21 12:44 pm called Covid Medical Command c/o 8/10 mid sternal CP radiating to her back. Also complaining of chest heaviness, advised by Dr. to seek care at the ED. Pt. arrived at the ED at 13:02 and was being worked up for chest pain worsening when taking deep breaths. The pain started yesterday and was worsened at work. Also c/o felling fatigue and chills. Pt. given keteolorac 30mg and Lidocaine patch. Additional pain medication of morphine was given. Worked up for PE with CT of chest. R/O ACS in the ED. CP was found to be reproducible and she was diagnosed with chest wall pain. Still has chest discomfort 2/3/21, but feels able to return to work.

Other Meds: singulair, propanolol, clonazepam PRN, Topamax, prazosin, duloxetine, Trazodone, Omeprazole

Current Illness: Appendectomy

ID: 0997968
Sex: F
Age: 43
State: FL

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

Lab Data: N/A

Allergies: N/A

Symptoms: Lump, swelling redness at injection site. Nausea. Mild headache. Muscle aches exasperated.

Other Meds: N/A

Current Illness: N/A

ID: 0997969
Sex: F
Age: 25
State: IN

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

Lab Data:

Allergies: N/A

Symptoms: Fever up to 103, chills, night sweats, fatigue/exhaustion, nausea.

Other Meds: N/A

Current Illness: N/A

ID: 0997971
Sex: F
Age: 30
State: WI

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

Lab Data: None

Allergies: Banana Kiwi Shellfish Cat Hair Pollen

Symptoms: Patient received 0.3mL second dose of Pfizer COVID-19 vaccine. Lot number above. 11:55 immunization 12:00 patient states she feels "shaky". take to observation room where rescue meds available. 12:05 patient reports lightheadedness. Given 8 oz of water which she took orally. 12:10 patient feels nauseous. BP 122/72 P 92 O2 100% Resp 18 12:15 patient reports she is more lightheaded/dizzy. She is reclined on bed and uses her phone to text her significant other. 12:20 patient reports symptoms are improving. Given another 8 oz of water which she took orally. Reports she did eat breakfast this day, but not lunch. No meds taken. 12:25 patient reports she is feeling better and sits up. BP 110/80 12:30 patient taken to lounge chair and on her phone. 12:40 patient reports all symptoms have resolved and she would like to leave. She is escorted to her car by RN and advised to call PCP or go to ER with any new or returning symptoms. Voices understanding.

Other Meds: None

Current Illness: None

ID: 0997972
Sex: F
Age: 41
State: OH

Vax Date: 01/07/2021
Onset Date: 01/09/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data: None

Allergies: Sulfa drugs

Symptoms: 1st adverse event - Pain at injection site that started approx. 8hrs after first vaccine injection 2nd adverse event (main concern) - Pain at the left fibular head. This pain was noticed as soon as I woke up on Sat. 1/9/21 @ 7:30am. The pain was intense & constant. It felt as if the fibular head was bruised, but there was no bruising & no possible injury to that site. The pain subsided by the time I woke up on Thursday, 1/14/21. No pain in this area since 1/14/21.

Other Meds:

Current Illness: NONE

ID: 0997973
Sex: F
Age: 73
State: CA

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

Lab Data: 2/1/21: EKG 12 lead Transthoracic echo complete 2-D w/ color and doppler CBC with differential CMP Lipid panel Hemoglobin A1c Troponin T CKMB Pro-BNP Prothrombin Time Partial Thromboplastin Time Procalcitonin Lactate TSH SARS-CoV2 screen

Allergies: Augmentin (anaphylaxis) Penicillin G (anaphylaxis) Hydrochlorothiazide (rash) Cimetidine (hives) Bactrim (hives) Nitrofurantoin Sulfanomides (hives) Amlodipine (swelling)

Symptoms: Received vaccine at 1100 on 1/29/21. No symptoms noted during 30 minute post-vaccine observation period. Symptom onset at 0300 on 1/30/21 (16 hours after vaccine administration). Symptoms included chest pain, dyspnea on exertion, weakness, nausea/vomiting, decreased appetite, and diarrhea. Patient presented to Medical Center Emergency Department around 1130 on 2/1/21. Found to have NSTEMI 2/2 Takotsubo's cardiomyopathy with acute congestive heart failure. (of note, coronary angiography in 11/20 showed no coronary artery disease). Patient has never had a reaction to a vaccine or component despite receiving many vaccines due to extensive travel history.

Other Meds: Aspirin 81 mg daily Diltiazem 240 mg daily Hydroxychloroquine 400 mg Pravastatin 10 mg daily Pepcid 40 mg daily

Current Illness: None

ID: 0997974
Sex: M
Age: 73
State: IN

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

Lab Data:

Allergies:

Symptoms: Severe headache beginning around 5:00 PM and lasting through the night. It was mild the next day, but the third day the headach returned. I have not taken anything for the headache since it was advised not to take Tylenol or Advil after the shot.

Other Meds:

Current Illness:

ID: 0997975
Sex: F
Age: 33
State: FL

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

Lab Data: MRI brain, CXR, CT chest, Urinalysis, covid, HIV, flu test,

Allergies: NKA

Symptoms: elevated temp, flushed face, shaking, c/o being cold, shivering- assessed by physician and transferred to ER

Other Meds: Eloquis, calcium/VitD, zyrtec,thoarazine, colace, pepcid, haldol dec, synthroid, lisinopril, lorazapam, magnesium, zyprexa, ditropan XL, mirilax, depakene, tylenol,

Current Illness:

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm