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: 0998546
Sex: F
Age: 50
State: VA

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

Lab Data: unknown

Allergies: NKA

Symptoms: Increased hear rate occurred approx 1 hour after receiving the vaccine, continued for 3-4 days

Other Meds: Lisinopril / HCTZ Vastatin

Current Illness: Unknown

ID: 0998547
Sex: F
Age: 68
State: GA

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

Lab Data:

Allergies: sulfa-rash

Symptoms: Following the Pfizer BionTech Covid 19 EUA, the Patient complained of rash on arms bilaterally, some anxiety related to rash. Vital signs: 11:05 am BP 148/78 HR, 11:10 am 117/79 HR 69, 11:15am BP 129/80 HR 75, Benadryl exlir 12.5mg/5mL administered at 11:15am PO. Vital signs: 11:20am BP 133/79 HR 67, 11:30 amBP 124/76 HR 63 Symptons of rash disappered at 11:30am. Vital signs: 11:45am BP 116/77 HR 63 ). Oxygen saturation stayed at 97 -99% the entire time. Patient reported felling fine. Pateint was released to home at 11:45 with spouse driving car.Pt told to follow up with ER or PCP if symptons reoccur.

Other Meds: immodium, flonase, creon, valsatran, oxbutynin

Current Illness: N/A

ID: 0998548
Sex: F
Age: 36
State: VA

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

Lab Data:

Allergies: Penicillin Mollusks

Symptoms: Chills, fever, body aches

Other Meds: Omeprozole Charlotte Fe 24 chewable Fish oil Women?s one a day Vitamin D3 Super B complex Zyrtec

Current Illness: None

ID: 0998549
Sex: M
Age: 23
State: VA

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

Lab Data: Unknown

Allergies: PCN- hives as a child.

Symptoms: Patient presented with a no health hx except for hives to PCN as a child and "passed out" with a childhood vaccine x 7 years ago. Vaccine given without incident, doctor present to distract patient while I gave vaccine. 3-5 min post vaccine patient c/o of nausea and trash can provided. Patient became silent while talking, head fell forward and clonic tonic posturing noted in upper extremities. Called to doctor and patient lowered to floor and placed in recovery position, MSE lasted approximately 30 seconds, EMS called. Post seizure: Patient very pale and diaphoretic, oriented to person quickly, no signs of facial swelling, resp distress or symptoms of a severe allergic reaction. B/P 134/50 HR 80 and regular, patient at this time shares that he had a MSE 3 or 4 years ago with friends. States came around after eating and drinking. States he did not share this information with his health care provider. Patient was AA&O x3 but with dismissed LOC from pre-vaccine state. 1200-EMS arrived, B/P 110/7, glucose 88/EMS, attempted to sit patient up/EMS, became dizzy and pale. Lowered to recovery position and waited for second team. Attempted to sit patient up again when second team arrived and again he became pale and dizzy. 1212- patient consented to be transported to hospital at this time/EMS.

Other Meds: Denies

Current Illness: Denies

ID: 0998550
Sex: F
Age: 72
State: OH

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

Lab Data:

Allergies: Penicillin Vicodin Erythromycin

Symptoms: Muscle aches, soreness at site of vaccine, diarrhea

Other Meds: Omeprazole Atorvstatin Multi vitamin Garlic extract

Current Illness:

ID: 0998551
Sex: M
Age: 71
State: CA

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

Lab Data:

Allergies:

Symptoms: Four hours after shot I started feeling warm and my left knee started to hurt. 24 hours later while I was taking a walk, my right knee started to hurt . That evening, about 36 hours after getting the shot, my right knee swelled up and hurt alot. The next morning I could barely walk, with much pain. I called a pharmacist and they said I could take Motrin for pain, which I did.

Other Meds:

Current Illness:

ID: 0998552
Sex: F
Age: 93
State: MN

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

Lab Data: none

Allergies: ACE inhibitors, clarithromycin, Chocolate, Fish, Lactose intolerance, Red meat, Red wine extract.

Symptoms: Resident is fatigued and has a 100.1 fever.

Other Meds: Amlodipine, aspirin, losartan, Flintstones multivitamin, patoprazole, risedronate, acetaminophen, and lidocaine patch.

Current Illness: Vascular Dementia, Alzheimer's Disease, Dysthymic disorder, essential hypertension, irritable bowel syndrome, and osteoporosis.

ID: 0998553
Sex: F
Age: 0
State: IN

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

Lab Data:

Allergies:

Symptoms: face flushed, dry mouth & bad taste - last three days other.....headaches, chills & sore arm

Other Meds: simvastin, lisnoprill, vitamin c, b-12, magnisum, one-day vitamins, vitiman d, citracil

Current Illness:

ID: 0998554
Sex: F
Age: 22
State:

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

Lab Data:

Allergies:

Symptoms: presenting today for Sore Throat. Got vaccine on 1/22. Started with sore throat. The started with chills, chest pain, abdominal pain, swollen lymph nodes.

Other Meds:

Current Illness:

ID: 0998555
Sex: F
Age: 48
State: ID

Vax Date: 01/20/2021
Onset Date: 01/27/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Pt then developed redness again about 1 week after getting the vaccine and it has continued to come and go. It is large area of redness, it is raised at times and warm to touch.

Other Meds:

Current Illness:

ID: 0998556
Sex: F
Age: 60
State: PA

Vax Date: 01/20/2021
Onset Date: 01/28/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data:

Allergies: Neosporin

Symptoms: My arm looks like the articles of Covid Arm. It got very big, hot, swollen and itchy and is still big but was getting much lighter in color now today seems darker again. I am now seeing that the ingredients in Moderna are in Neosporin which I am allergic to and had rashes but have not used it in over 20 years. Should I get the second vaccine. I am very upset and scared and would love to talk to someone. Thank you.

Other Meds: Omeprazole, Atorvastatin. Vitamin C,D,E

Current Illness: None

ID: 0998557
Sex: F
Age: 68
State: OR

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

Lab Data: None

Allergies: None

Symptoms: 7 days after receiving vaccine I noticed itching at the injection site. Upon further inspection I saw that my left deltoid had become red, hard, swollen, hot, itchy and painful. This is day two since onset of symptoms, my arm is still red, swollen, warm to touch, itchy and aching but is no longer hardened. I have taken nothing for the symptoms.

Other Meds: Losartin, HCTZ, Fosamax, Vitamin D

Current Illness: None

ID: 0998558
Sex: F
Age: 28
State: SC

Vax Date: 01/04/2021
Onset Date: 01/06/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data: Left supraclavicular ultrasound completed on 1/14/21

Allergies: None

Symptoms: Left-sided supraclavicular lymphadenopathy was appreciated approximately 48 hours after vaccine. Lymphadenopathy was noted on the same side as the vaccine. Ultrasound was performed by PCP and node was 1 cm in diameter. Node is present and has not reduced in size.

Other Meds: Nuva-ring

Current Illness: None

ID: 0998559
Sex: M
Age: 76
State: MA

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

Lab Data: None

Allergies: None

Symptoms: Chills, clammy, extremely fatigued

Other Meds: Fluticasone , Allegra. Diltiazam,lisinphil, symbacourt, montelukast, carvedilo., aspirin, rosvatstarin, albutetol rescue inhaler,metorfurmin

Current Illness: None

ID: 0998560
Sex: F
Age: 7
State: NY

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

Lab Data:

Allergies: none known

Symptoms: 5 hours after receiving the flu shot, pt had diffuse redness of face and swelling of face. mother treated patient with a cool compress and redness improved by the next day. did not seek medical care at the time.

Other Meds: not known

Current Illness: none

ID: 0998561
Sex: F
Age: 25
State: OR

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

Lab Data:

Allergies:

Symptoms: Patient did not receive vaccine at clinic. pt. received at convention center

Other Meds: bupropion , cholecalciferol, Lexapro, Synthroid, Glucophage xr, multivitamin, depo-testosterone

Current Illness: Pt had both covid vaccines 1st injection 12/30/2020, 2nd injection 01/24/2021 received Moderna brand. Pt has no symptoms of covid , but on a pre test for a surgical procedure on 01/30/2021 pt tested positive for covid. Pt is in quarantine for 10days starting 01/31/2021.

ID: 0998562
Sex: M
Age: 36
State: CA

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

Lab Data:

Allergies:

Symptoms: Resting heart rate from 60-120bpm, chest pain, trouble breathing. Lasts 30-60 seconds then heart rate returns to 60?s. Happened 3x on 2/1 and 4x on 2/2.

Other Meds:

Current Illness:

ID: 0998563
Sex: F
Age: 63
State: CT

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

Lab Data: None

Allergies: None

Symptoms: fever : 101.8; chills,

Other Meds: Synthroid

Current Illness: None

ID: 0998564
Sex: F
Age: 46
State: OH

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

Lab Data: Fluids iv, also iv benadryl, steroid and pepcid.

Allergies: Penicillin

Symptoms: Rash started forming on right wrist first around 4pm. Continuing itching right wrist ay night. Took zyrtec and applied1% hydrocortisone and motrin and went to bed. Woke with itching at 4 am took zyrtec, applied hydrocortisone. Tash on right forearm,started on nech. Showered and attempted driving to work, turned around due to worsening rash and went to OSAu ED. Got iv fluids, benadryl, pepcid and steroids iv. Now at home steroids prescribed for 5 more days. Off work today and tomorrow .

Other Meds: Nexplanon

Current Illness: Low vit d

ID: 0998565
Sex: F
Age: 71
State: NC

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

Lab Data:

Allergies: Allergies Pineapple Shortness Of Breath, Dizziness High Allergy Past Updates... Pentazocine-aspirin Other (See Comments) Not Specified 8/18/2018 Past Updates... Reaction unknown Pentazocine Unknown Not Specified Past Updates... Deletion Reason: Erroneous Entry Vancomycin In 0.9 % Sodium Chl Itching Not Specified 10/14/2016 Past Updates... Patient developed itching and slight erythema of the face after dose of IV vancomycin Deletion Reason: Entry miscategorized as an allergy Adverse Reactions/Drug Intolerances Talwin [Pentazocine Lactate] Other (See Comments), Abdominal Pain High Adverse Reaction Past Updates... convulsions

Symptoms: Pt noted after approx 15 minutes a tingling/burning sensation of tongue At 4:45 pm. No associated SOB, facial swelling. She does have prior anaphylaxis reaction to pineapples for which she carries and epi Pen but has never needed to use. Cardiac exam RRR Lungs CTA bilat HEENT, no visible erythema of face or tongue and no noteable facial swelling She was agreeable to 25 mg dose of diphenhydramine and another 15 minute observation. During this time, she began to feel anxious and a mild headache. Vitals at that time were notable for bp 178/81, HR 101 and o2 sat 98%. Still no SOB, facial swelling or other new complaint. She felt improvement in anxiety within 5 minutes, and repeat vitals in 10 min with BP 152/83, HR 89 and O2 sats 96% She still continued with mild sensation change of tongue, but no facial swelling. She does have benedryl at home but I also sent her home with additional 25 mg dose in case she noted recurrent symptoms on the way home . She understands to seek emergency care with any worsening symptoms, or new SOB or facial swelling. She can also use her EPI pen if needed. She felt comfortable returning home- husband picked her up. I will call her to check in this evening and in the morning and will provide updated recommendations regarding second dose of vaccination. I spoke with patient at 8:09 pm - she was at home- feeling much better, however, she did take the second diphenhydramine on the way home, as she began to feel she was having some swelling between her eyes. No SOB Or trouble swallowing. This improved with the second benedryl and has not recurred. She will take an additional 50 mg benedryl before bed, and then she awakes before 6 am- if she has any residual symptoms she will take another dose. Again, she understands to seek emergency care with any worsening symptoms, or new SOB or facial swelling. She can also use her EPI pen if needed. She felt comfortable with this plan. We also reviewed current CDC guidelines and she understands at this time we would not recommend she receive the second Vaccination. She will continue to follow CDC in the event that this recommendation changes. I will submit a VAERS report after following up with her in the morning. ADDENDUM 2/3/21: I spoke with patient again on 2/3/21 at 07:45 am. She is feeling almost completely back to baseline this morning, but planning to take 25 mg diphenhydramine this morning as well. She does note mild headache, which is not abnormal for her. No residual tongue sensitivity or facial swelling. She noted that when she got home last night, she felt very sleepy and sedated from the diphenhydramine and went to bed, and did not take an additional dose of diphenhydramine last night. No SOB, trouble swallowing or any new complaint. No urticaria or itching. We reviewed current CDC recommendations to decline second vaccination given her moderate severe allergic symptoms within first 4 hours of first vaccination. She will follow up with PCP or kidney specialist if she has any continued concern with ongoing symptoms or new issues. She was very appreciative of the followup and care provided.

Other Meds: acetaminophen (TYLENOL) 500 MG tablet amoxicillin (AMOXIL) 500 MG capsule carvediloL (COREG) 25 MG tablet cholecalciferol (VITAMIN D3) 1,000 unit capsule diclofenac (VOLTAREN) 1 % topical gel hydrALAZINE (APRESOLINE) 100 MG tablet

Current Illness: none

ID: 0998566
Sex: F
Age: 75
State: CA

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

Lab Data: none

Allergies: none

Symptoms: Red rash covering about 6 x 3inches at vaccination site. Slight itching. Occurred 12 days after shot. Still there on day 3

Other Meds: Lisinopril, metoprolol, amlodipine, Prilosec, red yeast rice

Current Illness: none

ID: 0998567
Sex: F
Age: 64
State: CA

Vax Date: 01/15/2021
Onset Date: 01/19/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data: None

Allergies: Septra [Sulfamethoxazole W/trimethoprim

Symptoms: pt had the COVID-19 vaccine on 1/15/21 and then had Bells Palsy after 4 days. No changes to the medication or other immunizations with 1 month and no new diagnoses in that time as well. No previous episodes of bells palsy with any other vaccine but positive for bells palsy in the past.

Other Meds: Albuterol, Allopurinol, Amlodipine, Atorvastatin, Metformin

Current Illness: right shoulder, rotator cuff tendonitis subacromial bursitis

ID: 0998568
Sex: F
Age: 58
State: TX

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

Lab Data: none

Allergies: Grass, Morphine, Thermidol

Symptoms: 3 February 2021@1130-Today-HA, itchy upper body, rt deltoid area swollen-she said Reminded to go to the ER if her symptoms get worse-call her PCM also

Other Meds: Metformin, hi B/P medication, water pill

Current Illness: none

ID: 0998569
Sex: F
Age: 38
State: IN

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

Lab Data: none

Allergies: n/a

Symptoms: Extreme body aches, skin hurt to touch, extreme feeling of being cold unable to get warm, stiff joints and joint pain, sleeplessness, all over burning sensation

Other Meds: Took two Aleve pills day after vaccination

Current Illness: n/a

ID: 0998570
Sex: F
Age: 57
State: MD

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

Lab Data: PCP advised to alternate Tylenol/Advil every four hours for headache and cool compresses/Benadryl for swelling. I initially contacted my PCP on 1-25-21. The swelling subsided after two days so Benadryl/compresses discontinued on 1-26-21 and resumed on 2-1-21. The headache subsided 1-28-21 and returned on 2-1-21.

Allergies: Amoxicillan, peppermint

Symptoms: Severe headache within an hour of receiving vaccine which lasted 6 days, arm swollen/tender/red day after and continuing for 4 days. Nose bleeds and/or blood in tissue after blowing nose from 1-24-21 and still present today. Dizzy spells starting on 1-28-21 and continuing infrequently and still present today. Headache returned 2-1-21, recurs infrequently and still present today. Arm swelled again at injection site and tender/red on 2-1-21 and is still present today.

Other Meds: Synthroid, Atorvastatin, Allegra-D, Azelastine, Vitamin D3, Alive! Multivitamin, Trazodone, Advil

Current Illness: None

ID: 0998571
Sex: F
Age: 54
State: OH

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

Lab Data: None. Immunization clinic would not take information from me when I tried to report it to them. They told me to just go on line, they didn't need the information, maybe the CDC did.

Allergies: NKDA, sensitivity to latex.

Symptoms: Started with slight dizziness within minutes of receiving vaccine and progressed to severe dizziness with quick turn of head by the afternoon. Progressed into that evening and night to "bed spins"and nausea. Persisted severe dizziness for the following day. Had to call off sick for work. By day three, dizziness had lessened and could return to work.

Other Meds: celexa, seroquil, naproxen, vitamin D

Current Illness: none

ID: 0998572
Sex: F
Age: 50
State: MO

Vax Date: 01/01/2021
Onset Date: 01/04/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data:

Allergies: Gluten, dairy, peanuts Very sensitive to all medicines

Symptoms: After dose 1 - this is what happened : I was fine during my 15 min wait but as I was driving back home I started to feel a bit nauseous and then there was a warm feeling in the back of my throat. That turned into a burning feeling within minutes. By an hour later I started to feel tightening/ constriction in the back of throat and like something is stuck there. My voice felt very hoarse. I called the nurse she suggested Benadryl but I had a 4 pm kiddo to work with and Benadryl knocks me out so didn?t take it. I think my body was fighting having an allergic reaction. My breathing was a little labored but nothing too bad. I was not terribly surprised because I?m typically allergic to everything. On Tuesday - Everything hurt like a bad flu. Fever, Nausea, headache, fatigue, cough etc. That persisted for several days last wk. By the weekend I felt better just fatigue, phlegm, cough ..... PS - I was fine on Monday prior to vac. Dose 2 - had a slight warming in back of throat but nothing too bad. 7 hours later and +for the next 24 hour - fever 101.5,(even after 800mg ibuprofen) non stop vomiting, inability to eat or drink, terrible headache - like a bad flu. Somewhat better today( in that I can actually sit up in bed and type) but very dehydrated and trying to rehydrate without having to go to ER for fluids.

Other Meds: Levethyroxine - 50 mg Fludrocortisone -0.1 Hydrocortisone - 10 to 30 mg

Current Illness: None

ID: 0998573
Sex: F
Age: 61
State: IN

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

Lab Data: None

Allergies: No

Symptoms: First shot in January temp was 102.8 took Tylenol woke up and temp was 96.5. Second shot two days ago was confined to bed whole body and joints hurt

Other Meds: Aspirin Amlodipine vitamin B12

Current Illness: None

ID: 0998574
Sex: F
Age: 50
State: IA

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

Lab Data:

Allergies: gluten

Symptoms: Floaters in vision; first noticed 2/2/2021 around 0900. First noticed when going outside in the snow and sun. Not any worse today (2/3/21).

Other Meds: Keflex 500mg daily Lansoprazole daily Ozempic weekly 0.5

Current Illness:

ID: 0998575
Sex: M
Age: 45
State: WA

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

Lab Data:

Allergies: None known

Symptoms: 11 days following my first dose, I have developed a 2" by 3" rash on my left arm (at the site of the injection) that is red with a hard nodule present. Increased skin temperature, erythema and site soreness along with tingling into my 4th and 5th digits. General feeling of malaise as well. No previous rash, redness or swelling.

Other Meds: Vitamin D

Current Illness: None known

Date Died: 01/31/2021

ID: 0998576
Sex: M
Age: 86
State: WA

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

Lab Data: 1/1/2021 CMP remarkable for Potassium 5.8, creatinine 3.20, HS troponin 2.2, 310 BNP 12.7, CBC unremarkable, UA++ protein 1+ blood, Blood Cx No growth x5 days, COVID RNA rapid (-), 1/2/21 COVID PCR (-), Influenza A+B (-), No EKG, Partial CXR no acute cardio pulmonary process, no pneumonia, Telemetry Strip (12/31 22:00 atrial fib normal rate. 1/27/21 CMP remarkable for potassium 6.1, Serum Creatinine 4.46, BNP 1080, HS troponin 13.2, CBC with diff unremarkable, COVID PCR (-), EKG sinus tachycardia, QRS algorithm, left axis deviation rate 107 borderline criteria arterial infarct, CXR Bilateral + alveolar opacities compatible with pulmonary edema, small (L) pleural effusion, (L) basilar air space likely atelectasis

Allergies: DIPYRIDAMOLE, ERYTHROMYCIN, TERAZOSIN

Symptoms: Had acute respiratory failure, dysuria NSTEMI after Dose #1 Lot # 025L20A (Moderna) hospitalized same day 12/31/20 administered @ 1040 back to baseline. 2nd Dose on 1/27/21 0950 Lot as above. Unknown exact onset same day, ED by EMS @ 1745, respiratory distress, febrile 39.4 degrees C BP 150/105 RR 29

Other Meds: Med List @ time vaccine # 2: PRN acetaminophen Bisacodyl PRN TUMS Clotrimazole Flonase Loratadine Lorazepam Melatonin Bengay Nitrostat Zofran oxycodone Miralax Scheduled: acetaminophen 500 md QID amlodipine 5mg BID Metoprolol 50 mg BID Pra

Current Illness: NSTEMI after COVID vaccine #1

ID: 0998577
Sex: F
Age: 65
State: FL

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

Lab Data:

Allergies: Lamictal Trileptal Prolia Garlic

Symptoms: Paralyzing fatigue lasting 36 hours

Other Meds: Cevemiline, Risperidone, Zonisamide, Tymlos, Symvastatin, Cyclobenzaprine, Meloxicam, Gabapentin, Pantoprazole, Restasis Vitamin D, Vitamin E, Calcium, Omega 3, Lutein

Current Illness: COVID-19

ID: 0998578
Sex: F
Age: 26
State: WA

Vax Date: 01/12/2021
Onset Date: 01/13/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Employee got 2nd dose of pfizer vaccine on 1/12/21 and on 1/13/21 she started having tachycardia resting 120, walking 150. she did not have this at the time of her first dose. She also feels warm, chills and fatigue but those are improving. She was urged to go to urgent care to get evaluated.

Other Meds:

Current Illness:

Date Died:

ID: 0998579
Sex: M
Age: 82
State: KY

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

Lab Data:

Allergies: Iodine, ACE Inhibitors

Symptoms: Resident passed away 2/2/2021.

Other Meds: Patient is a nursing home resident please notify facility.

Current Illness: Patient is a nursing home resident please notify facility.

ID: 0998580
Sex: F
Age: 64
State: CA

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

Lab Data: I will be getting another Covid test on February 4 at 2 PM

Allergies: None

Symptoms: Symptoms started at 5 PM on February 1, 2021 pain at the injection site then lead to severe headache pain in the neck and shoulders tiredness Fever 100.5Nasal congestion and a dry cough

Other Meds: Levothyroid that morning

Current Illness: I had taken care of four of my family members starting December 16 Who were positive for COVID-19. My father passed away on December 30 I tested negative for Covid during the time I cared for them. I did develop symptoms of Covid on January 3, 2021 and again tested negative for Covid that is the only sickness I had.

ID: 0998581
Sex: F
Age: 20
State: NJ

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

Lab Data:

Allergies: Peanuts, bees, cashews, pistachios, gluten

Symptoms: My throat started to close. I was itchy and had a difficult time breathing until I was given an epi pen.

Other Meds: June?s, Zyrtec,

Current Illness:

ID: 0998582
Sex: F
Age: 68
State: IN

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

Lab Data: None

Allergies: Bactrim, Lorabid and Talwin

Symptoms: Pain at the injection site in the afternoon after my immunization.

Other Meds: None

Current Illness: None

ID: 0998584
Sex: F
Age: 38
State: GA

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

Lab Data: None

Allergies: morphine

Symptoms: Needle administering the dose began to leak resulting in patient receiving a partial dose.

Other Meds: HCTZ and synthroid

Current Illness: N/A

ID: 0998585
Sex: F
Age: 50
State: CA

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

Lab Data:

Allergies:

Symptoms: patient received first dose of Moderna returned for second dose and did not have vaccine card and received second dose pfizer.

Other Meds:

Current Illness: none

ID: 0998586
Sex: F
Age: 67
State: NC

Vax Date: 01/26/2021
Onset Date: 01/30/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data: None

Allergies: unknown

Symptoms: Blisters in mouth and tongue swelling

Other Meds: unknown

Current Illness: unknown

ID: 0998587
Sex: F
Age: 46
State: CT

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

Lab Data: Had full blood panel completed by my MD 3 weeks post and was normal.

Allergies: Bactrim, flu vaccine preservative, bee stings

Symptoms: Extreme body aches for 3 days, fatigue for 32 days, headaches for first week and returned 3rd week, swollen and painful tongue on 3rd day to 6th day. Diarrhea and stomach pain, tinnitus for 7 days post then returned 3rd week. Joint pain post vaccination for 2 weeks. Vertigo for 1 week post vaccination. Nausea 7 days post vaccination. Brain fog for 3 weeks post vaccination.

Other Meds: None

Current Illness: None

ID: 0998588
Sex: F
Age: 58
State: GA

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data: no

Allergies: Penicillin, erythromycin

Symptoms: About 2hr after the shot I got light headed, dizzy and hot. I got my bp taken of 173/100 and I sat for a while to see if it would go down being monitored by 2 NPs in the office. The BP remained elevated for a while and after about 2hrs it came down. I developed a headache that got more profound over time but the dizziness and feeling of being hot left and about 5hrs the headach left and I felt better. Went to work the next day feeling a little better but got a massive headache so I took some advil and after about 4hrs it finally let up. The next day I got a slight headache but it left after about an hour and hasnt had anymore symptoms since.

Other Meds: Lisinopril, Vit. D./Calcium

Current Illness: no

ID: 0998589
Sex: F
Age: 42
State: TX

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

Lab Data: UA-trace ketones, spec gravity=>=1.030, blood 2+, leuko est-trace wbc 1-5, RBC 1-2, bacteria trace GCS-15, NKDA 155/92, HR 103, RR 15 98.6 temp NIH stroke Scale 0 vomited 3 times today. given Ofirmev 1 gram IV in ER, clinical impression-acture periodic headache syndrome-resistant to treatment.no migraine headache or post traumatic headache. Hypertension symptoms were gone at discharge to home. motrin and tylenol OTC.

Allergies: NKDA

Symptoms: She was sent to emergency room Feb 2, 2021 by her PCP after calling him with headache, found elevated BP by school nurse, 163/95, vomited x3, left hand numbness but resolved upon arrival, decreased vision brief right visual disturbance. denies fever nasal congestion, sore throat, cough, chest pain. EKG NSR 95, head CT-no acute intracranial abnormality, UA and blood work completed

Other Meds: Cardizem oral

Current Illness: none

ID: 0998590
Sex: F
Age: 25
State:

Vax Date: 12/28/2020
Onset Date: 01/04/2021
Rec V Date: 02/03/2021
Hospital:

Lab Data:

Allergies:

Symptoms: 7 days after the vaccination, I developed an itchy, red, rash just below the site of injection, about the size of a nickel. The nurses administering the COVID vaccines suggested that I call the on-call allergist. He said not to worry. He recommended that I take an allergy pill each day until the rash/bump went away. He also said to ice the rash/bump and massage the area. 8 days after the vaccination, the rash welted, remained red and itchy, and grew about 6 times larger than the day before. The nurses administering the COVID vaccine called the same on-call allergist that I spoke to the day before and he recommended to take the allergy pill twice a day and continue the ice and massage of the area. 9 days after the vaccination, the rash started to get better. 10 days after the vaccination, the rash was mostly gone. 11 days after the vaccination, the rash was all gone.

Other Meds:

Current Illness:

ID: 0998591
Sex: M
Age: 36
State: NJ

Vax Date: 12/29/2020
Onset Date: 12/30/2020
Rec V Date: 02/03/2021
Hospital:

Lab Data: I had a Strep test on 01/01/2021 with a NEG result.

Allergies: I am allergic to sulpha and all sulpha products and fava beans.

Symptoms: I had entire right side tingling that was worse in my extremities, extreme fatigue, light fever, achy.

Other Meds: I take Vitamin D

Current Illness: No

ID: 0998592
Sex: F
Age: 55
State: IA

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

Lab Data: none

Allergies: none noted

Symptoms: Pt presented for 2nd dose on 02.03.2021. Upon filling out VAR, pt marked they had received an IV for COVID in December, was unsure of the medication. The VAR in January did not ask that question. Confirmed with pt's Dr that pt had bamlanivimab on December 8, 2020. Deferred 2nd dose until 90 days post infusion

Other Meds: none known

Current Illness: COVID 12.08.2020

ID: 0998593
Sex: F
Age: 71
State: WA

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

Lab Data: None

Allergies: NKA

Symptoms: Fatigue, Headache, Joint pain, Lasted about 48 hours, I took Tylenol.

Other Meds: Synthroid Atorvastatin Cytolopram

Current Illness: None

ID: 0998594
Sex: F
Age: 75
State: AZ

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

Lab Data:

Allergies: codine

Symptoms: My wife has glaucoma and the shot has affected her vision.

Other Meds: Kombiglyze xr; Glimepiride

Current Illness: B-12 shot

ID: 0998595
Sex: F
Age: 61
State: CA

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

Lab Data: None

Allergies: PCN, Sulfa, Naproxen

Symptoms: Entire left upper arm became extremely swollen, red, hot to touch, chills, joint pain, transient diarrhea, brain fog with occasional light headedness.

Other Meds: Losartin 50mg daily HCTZ 25mg daily

Current Illness: None.

ID: 0998596
Sex: F
Age: 46
State: PA

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

Lab Data: None.

Allergies:

Symptoms: Fast heartbeat, sharp pain in head, dizziness, slight difficulty breathing for about 5 minutes that passed slowly.

Other Meds: famotidine

Current Illness:

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm