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: 1001546
Sex: M
Age:
State:

Vax Date: 01/20/2021
Onset Date:
Rec V Date: 02/04/2021
Hospital:

Lab Data:

Allergies:

Symptoms: arm is sore; This is a spontaneous report from a contactable consumer, the patient. A male patient of an unspecified age received BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE), via an unspecified route of administration on 20Jan2021 as a single dose for COVID-19 immunisation. Medical history included the patient had a broken clavicle. The patient's concomitant medications were not reported. On an unknown date the patient experienced his arm is sore. The patient stated that he has a broken clavicle that is healing, and he is supposed to have Physical Therapy today for that, and he is wondering if the stretching and pulling that they would do during physical therapy will be okay after getting the vaccine yesterday. The patient stated that his arm is sore, and he anticipated that. The patient also inquired what he can take for the pain. The clinical outcome of the arm is sore was unknown. The lot number for the vaccine, BNT162B2, was not provided and will be requested during follow up.

Other Meds:

Current Illness:

ID: 1001547
Sex: F
Age:
State: NJ

Vax Date: 01/19/2021
Onset Date: 01/20/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data: Test Date: 20210120; Test Name: pulse; Result Unstructured Data: Test Result:normal

Allergies:

Symptoms: Migraine Headache; Body aches; Joint Pain; Chills; Night sweats; Anxiety; Fatigue; feeling as if heart is racing but when pulse was taken it was normal; This is a spontaneous report from a contactable nurse, who is also the patient. A 32-year-old non-pregnant female patient received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE, Lot number EK9231), via intramuscular route of administration in the right arm on 19Jan2021 at 14:30 (at the age of 32-years-old) as a single dose for COVID-19 immunisation. Medical history included anemia and the patient had known allergy to penicillin. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient's concomitant medication included cetirizine hydrochloride (ZYRTEC) and montelukast sodium (SINGULAIR), both from unknown dates, at unknown doses, for an unknown indications. The patient previously received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE, Lot number EH9899), via intramuscular route of administration, in the right deltoid on 29Dec2020 for COVID-19 immunisation. On 20Jan2021 at 06:00 the patient experienced migraine headache; body aches; joint pain; chills: night sweats; anxiety; fatigue; feeling as if heart is racing but when pulse was taken it was normal. The patient did not receive any treatment for the events. The clinical outcomes of the migraine headache; body aches; joint pain; chills: night sweats; anxiety; fatigue; feeling as if heart is racing but when pulse was taken it was normal were recovered with sequelae (reported as "recovered with lasting effects") on an unknown date in Jan2021. It was also reported that since the vaccination, the patient had not been tested for COVID-19.

Other Meds: ZYRTEC [CETIRIZINE HYDROCHLORIDE]; SINGULAIR

Current Illness:

ID: 1001548
Sex: F
Age: 78
State: IN

Vax Date: 01/26/2021
Onset Date: 01/29/2021
Rec V Date: 02/04/2021
Hospital: Y

Lab Data:

Allergies:

Symptoms: COVID vaccine] treatment under Emergency Use Authorization(EUA): patient experienced shortness of breath and chest pain the day following the vaccine. The patient was hospitalized and received a stent. Unable to rule out vaccine playing a role, so it is being reported.

Other Meds:

Current Illness:

ID: 1001549
Sex: M
Age: 61
State: TN

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

Lab Data: none

Allergies: none

Symptoms: Patient reports pain around the injection site that started on the day of vaccination. The pain seems to be getting worse and is spreading. The painful area is approximately 4 inches in diameter centered around the deltoid muscle of the left arm. There is no redness or swelling in the area. The patient has tried to massage the area, but the pain has not resolved. The patient no longer has a family doctor, so he is considering seeing a walk-in clinic for treatment.

Other Meds: cetirizine 10mg, Vitamin D, Vitamin B12, tumeric

Current Illness: none

ID: 1001550
Sex: F
Age:
State: MA

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Chills/Teeth chattering; Phlegm congestion in nose and throat; Phlegm congestion in nose and throat; Felt shaky/nervous; She felt fatigue; Tightening her muscles; Her joints ached; Muscle and body aches; Muscle and body aches; Brain fog; She then started to have a headache after that; This is a spontaneous report from a contactable consumer, the patient. A 52-year-old female patient received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EL8982), via an unspecified route of administration on 19Jan2021 (at the age of 52-years-old) in the left arm as a single dose for COVID-19 immunization. Medical history was not reported. Ongoing concomitant medications included biotin (MANUFACTURER UNKNOWN), fish oil (MANUFACTURER UNKNOWN), vitamin D3 (MANUFACTURER UNKNOWN),and cyanocobalamin (VITAMIN B12); all from unknown dates. The patient also took multivitamins from an unknown date and unknown if ongoing. The patient previously received the first dose of BNT162B2 (at the age of 52-years-old; Lot Number: EL942 or EL0142) on 29Dec2020 in the left arm for COVID-19 immunization and experienced headache and fatigue. The patient did not receive any other vaccines within four weeks prior to the vaccination except the first dose of the vaccine. On 19Jan2021, the patient experienced shaky/nervous, chills/teeth chattering, muscle and body aches, fatigue, tightening her muscles, brain fog, phlegm congestion in her nose and throat, joints aches, and headache. On 20Jan2021, she stayed well hydrated, but she slept a lot. However, she felt fatigue, had the headache off and on, tight and sore from muscle aches. Therapeutic measures were taken for the chills/teeth chattering, muscle and body aches, joint aches, and headache and included treatment with ibuprofen (ADVIL LIQUIGELS). The clinical outcomes of chills/teeth chattering and phlegm congestion in her nose and throat, were recovered on 21Jan2021 and Jan2021, respectively. The clinical outcomes of the felt shaky/nervous, fatigue, tightening her muscles, and joint aches were unknown; while that of the muscle and body aches, headache, and brain fog were not recovered.; Sender's Comments: Linked Report(s) : same reporter/patient, different vaccine dose and event.

Other Meds: BIOTIN; FISH OIL; VITAMIN D3; VITAMIN B12 [CYANOCOBALAMIN]

Current Illness:

ID: 1001551
Sex: F
Age: 84
State: AZ

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

Lab Data:

Allergies: None

Symptoms: Sore arms and hands. Sore stomach muscles........during the night after the shot ....by morning all aches were gone

Other Meds: Levothyroxin 5 mcg, losartan 50 mg , metoprolol tartrate 50mg, hydralazine 50 mg, ropinirole1 mg,atrovastatin 10mg, aspirin81mg, bit D3, Bcomplex, probiotic, turmeric.......this is my daily meds I took hydralazine , losartan and ropinirole

Current Illness: None

ID: 1001552
Sex: F
Age:
State: FL

Vax Date: 01/19/2021
Onset Date:
Rec V Date: 02/04/2021
Hospital:

Lab Data:

Allergies:

Symptoms: got my vaccine yesterday/did have an allergy; my shoulder down to my elbow it is very sore and swollen. It is very sore and swollen for some days but it is just in the area where they gave the shot; my shoulder down to my elbow it is very sore and swollen. It is very sore and swollen for some days but it is just in the area where they gave the shot; This is a spontaneous report from a contactable consumer (patient herself). A 79-year-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number and expiry date not reported), via an unspecified route of administration on 19Jan2021 at single dose for COVID-19 immunisation. Medical history included severe leg cramps. Concomitant medication included gabapentin. The patient previously took tetanus shot (TETANUS VACCINE) and flu shot (FLU VACCINE) on an unspecified date (reported as November) for immunisation. The patient verbalized, "I just wanted to make sure that this is normal. I got my vaccine yesterday. I waited for 30 minutes because I did have an allergy (further clarification was unknown, hence captured as event), to make sure everything was okay. Nothing happened but after I got home within 2 hours my shoulder down to my elbow it is very sore and swollen. It is very sore and swollen for some days but it is just in the area where they gave the shot. So, I just want to make sure that it's normal." When asked about the treatment, the patient stated, "No I did not I thought about taking some Aleve or whatever but my husband and I decided to wait till this morning and call to see that if it is normal like I said like a tetanus shot or flu shot. I am very sore in that area about 5 days but this was little different that it swelled from my shoulder to my elbow. I do not feel sick, I am not dizzy, and I am not short of breath. I read everything that they ask that they said you have a concern to call." Clinical outcome of the events was unknown. Information on the lot/batch number has been requested.

Other Meds: GABAPENTIN

Current Illness:

ID: 1001553
Sex: M
Age:
State: MI

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

Lab Data:

Allergies:

Symptoms: bump at the injection site; bump at the injection site/just a bump and it hurts; This is a spontaneous report from a contactable consumer (patient). A male patient of an unspecified age received the first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE; lot number EL3249), via an unspecified route in the arm of administration on an unspecified date at a single dose for COVID-19 immunization. The patient's medical history and concomitant medications were not reported. The patient had his first COVID Vaccine and right now, he had a bump at the injection site. He was wondering if this is a normal reaction. He said it hurts to the touch or if he moves his arm. It was just a bump and it hurts. It hurts a little bit if he raise his arm up and down but right now it's not as bad as it was as patient had taken some Aspirin. When patient was asked about the lot number, patient stated "She gave me like 2 of them. She ran out of one bottle, so she had to get another bottle, she threw up the thing rest away. You know what I mean?". Outcome of the events was unknown.

Other Meds:

Current Illness:

ID: 1001554
Sex: U
Age:
State:

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

Lab Data:

Allergies:

Symptoms: My injection site has got a bump on it and I got a pain in it; My injection site has got a bump on it and I got a pain in it; It is injection site, it is little swollen up; muscle pain a little bit; This is a spontaneous report from a contactable consumer (patient). A patient of unspecified age and gender received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EL3249, expiry date not reported), via an unspecified route of administration on an unspecified date at single dose for COVID-19 immunisation. Medical history and concomitant medications were not reported. On an unspecified date, the patient verbalized, "My injection site has got a bump on it and I got a pain in it. It seems to be gone away a little bit. I was just wondering if it is something to be concerned about. It is injection site, it is little swollen up. There's muscle pain a little bit. Clinical outcome of injection site bump and pain was recovering, while for the other events was unknown.

Other Meds:

Current Illness:

ID: 1001556
Sex: M
Age: 59
State: KY

Vax Date: 01/18/2021
Onset Date: 01/27/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data:

Allergies: Food sensitivities. Allergic to bee stings and white face hornet. NO ALLERGY TO MEDS

Symptoms: I have had a weekly routine of fasting one day a week for the last 20 years. Sometimes I would extend this to 3 days, water only. I am healthy, 6'1" weight 170-180 all of my adult life. Resting HR <56. 9 days after having my first vaccination, I did a 24 hour fast. I woke at 2 am to go to the bathroom. I became lightheaded and passed out while standing over the toilet. I layed on the floor for over 5 minutes with my head spinning. I then realized I was hypoglycemic. I have never had this issue. I took some orange juice and recovered my strength. I hit my head on the top of the toilet which required my to have 5 sutures in my chin at the ER that night. Today I was working out for 30 minutes on an elliptical. I work out 4 to 5 times weekly. 10 minutes after returning to my room I noticed I was dizzy and checked my pulse from my watch. My HR was 210. this lasted for over 10 minutes. I have never had this issue. I believe it would not be in my best interest to take the second vaccination.

Other Meds: vitamins

Current Illness: none

ID: 1001557
Sex: M
Age:
State: AK

Vax Date: 01/11/2021
Onset Date: 01/01/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data: Test Date: 20200120; Test Name: blood drawn; Result Unstructured Data: Test Result:unknown results; Test Name: heart rate; Result Unstructured Data: Test Result:great; Test Name: oxygen level; Test Result: 98 %; Test Name: breathing; Result Unstructured Data: Test Result:great

Allergies:

Symptoms: second dose of Covid 19 Vaccine on 11Jan2021; little pain around the injection site; some nausea; some bouts of dizziness; This is a spontaneous report from a contactable consumer (patient). A 33-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; Lot Number: EJ1685), via an unspecified route of administration on 11Jan2021 at single dose on right arm, mid bicep for COVID-19 immunization. There were no patient history. Concomitant medications included hepatitis b vaccine on 14Dec2020, colecalciferol (VITAMIN D [COLECALCIFEROL]), calcium and vitamin c [ascorbic acid] (VITAMIN C [ASCORBIC ACID]). The patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; Lot Number:EK5730) on 18Dec2020 (left arm) and he experienced little pain around the injection site, some nausea and some bouts of dizziness. The patient received the Covid 19 Vaccine 4 days after receiving the Hepatitis B vaccination, so he identified this as an error in administration. So the Hepatitis B vaccination was given on 14Dec2020 and the first Covid 19 Vaccine was given on 18Dec2020. He received the second dose of Covid 19 Vaccine on 11Jan2021. Patient stated that originally the prescriber who administered it the first two doses had scheduled him to receive the second dose of Covid 19 Vaccine as the same day as his second Hepatitis B Vaccination and he identified this error last Wednesday and stated "I believe or potentially today, I'm not sure which one I'm sorry I had to check with that". So, he was trying to get this all cleared up. He did report symptoms for both Covid Vaccines as little pain around the injection site, some nausea, some bouts of dizziness. So, patient had already discussed the common adverse reactions with him. Patient was told that co-administration has not been studied yet and referred him to his HCP for continued guidance on how and when to space out the additional Hepatitis B vaccination that he will need. Patient was "32" back in December when this happened. He had his birthday and turned 33. Second shot for the Covid was scheduled the same day the Hep B (Hepatitis B Vaccine) but due to inveigle in-charge of the vaccine, he had lost his paper work and he had been on vacation and stated "had been vaccine was not found they just gave me the second Covid Vaccine and told me to come back by Thursday and I should have found it and have everything cleared up by then but then Wednesday they called me and told me that they have realized that they are not supposed to give vaccine co-administered with 14 days window before or after. I haven't got my second Hep B (Hepatitis B Vaccine) just the first one was administered within the 4 days period of the first shot". Patient work at Dietary Providence. The patient had his blood drawn this morning (20Jan2021). Patient does not have product details for hepatitis B vaccine. Patient stated that the nurse on duty had said that the vaccine they had stocks was "Engerix-B hepatitis B recombinant" but that was not verified as far as definitively is just what she had stocked when he was going on his incident report. Patient further stated, "As far as all things are concerned you know I went to a doctor got checked he said breathing was great, heart rate was great, oxygen level 98 percent, he has drawn blood by then is there anything that I should be doing at this point cataloging thing any other test any other people to contact. What should I do going forward specially what can I do to be helpful for you guys to get this situation clear." Outcome of the events was unknown.

Other Meds: VITAMIN D [COLECALCIFEROL]; CALCIUM; VITAMI C [ASCORBIC ACID]

Current Illness:

ID: 1001558
Sex: F
Age:
State: IL

Vax Date: 01/10/2021
Onset Date: 01/10/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data:

Allergies:

Symptoms: headache; Itchy; prickly skin all over body; This is a spontaneous report from a contactable consumer (patient). A 62-years-old female patient received the second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EL1283, expiration date: unknown), via an unspecified route of administration on the right arm on 10Jan2021 at 09:00 at a single dose for COVID-19 immunization. The patient's medical history and concomitant medications were not reported. The patient previously received the first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE) lot number: EK5730 on 20Dec2020 at 09:00 AM on the right arm for COVID-19 immunization, and Benadryl. The patient took Benadryl before the second dose and throughout the day, and it somewhat helped with the constant skin irritation. On 10Jan2021, the patient experienced headache, itchy and prickly skin all over her body. No admission to hospital involved and no treatment was received. The events resolved on an unspecified date in 2021.

Other Meds:

Current Illness:

ID: 1001559
Sex: F
Age: 59
State: IN

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

Lab Data: None

Allergies: Nka

Symptoms: Woke with lymphadenopathy and tenderness left supraclavicular area

Other Meds: Trintellix, D3, red rice yeast, allergy meds

Current Illness: None

ID: 1001560
Sex: F
Age: 64
State: TX

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data: no

Allergies: sulfa drugs

Symptoms: my arm was swollen, hot and had a red rash. I took Ibuprofin.

Other Meds: metoprolol ER Succinate 100mg in the morning and 50mg at night senosibarte 160mg daily gliticide 5mg twice a day crelon 1200 three times a day vitamin D3 2000mg daily Aspirin 81mg daily nesedipine ER 30mg daily rosuvastatine 5mg daily metf

Current Illness: no

ID: 1001561
Sex: F
Age: 23
State: MD

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

Lab Data: NA

Allergies: No known allergies

Symptoms: Fever, chills, fatigue starting ~4 hrs after 2nd dose. Diarrhea began next morning.

Other Meds: Birth control pill (Junel) Multivitamin (Deva) Vitamin D (4000iu every other day)

Current Illness: None

ID: 1001562
Sex: F
Age: 42
State: CO

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

Lab Data:

Allergies: Neosporin (rash)

Symptoms: severe arm pain with movement (7 out of 10 on pain scale), which began a few hours after the vaccine and lasted until mid-afternoon on 2/3/21. Now it's dull and more consistent with the flu vaccine. Fatigue evening of 2/2 and lasting until mid-afternoon 2/3/21. resolved. Body aches beginning on morning of 2/3 and lasting until mid-afternoon on 2/3. resolved.

Other Meds: Norvasc, oral contraceptives

Current Illness: none

ID: 1001563
Sex: F
Age: 73
State:

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

Lab Data:

Allergies:

Symptoms: SHORTLY AFTER RECEIVING VACCINE, PT STARTED COMPLAINING OF PALPIATIONS AND LIGHT HEADNESS. PT TOOK GLUCAGON TABLET SHE HAD BECAUSE SHE THOUGHT HER SUGAR WAS LOW. PT SYMPTOMS DID NOT IMPROVE. PT HAD HISTORY OF AFIB SO SHE WAS TRANSFERRED TO ER

Other Meds:

Current Illness:

ID: 1001564
Sex: F
Age:
State:

Vax Date: 01/22/2021
Onset Date: 01/29/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data:

Allergies: Pcn

Symptoms: Got Moderna covid vaccine 1/22/21 on 1/29 7 days later arm itching the next day red and itching on same arm as vaccine given. I will not get 2nd dose abd do not recommend vaccine due to delayed unknown reaction.

Other Meds:

Current Illness:

ID: 1001565
Sex: F
Age: 37
State: IA

Vax Date: 01/21/2021
Onset Date: 01/30/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data: None

Allergies: Codeine; reaction was insomnia x3 days

Symptoms: Day 1-3: pain, redness at injection site. 1/30/21 3x3 fire red, raised and bumpy, painful circle around injection site; additional red circle appeared outside initial circle 2/3/21 2nd circle with same characteristics appeared below initial rash site

Other Meds: Aleve 220mg 1 tab OT taken 1 day post-vaccination; reported no additional medications, supplements, herbal remedies

Current Illness: None

Date Died: 02/03/2021

ID: 1001567
Sex: M
Age: 81
State: IL

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

Lab Data: None. Coroner opted against autopsy due to age and significant comorbidities

Allergies: Hay fever

Symptoms: Death

Other Meds: ascorbic acid 500 mg, carbidopa-levodopa 25-100 mg, clopidogrel 75 mg, entacapone 200 mg, finasteride 5 mg, multivitamin, pravastatin, Prevident 5000 Plus 1.1%, propranolol 40 mg, rivaroxaban 20 mg, tamsulosin 0.4 mg.

Current Illness:

ID: 1001568
Sex: F
Age: 59
State: ID

Vax Date: 01/16/2021
Onset Date: 01/18/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data: Blood work done on 1/25/21

Allergies: NKA

Symptoms: shakes, tremors, difficulty walking, back pain, confirmed Cytokine storm by PCP

Other Meds: Atorvastatin

Current Illness: No

ID: 1001569
Sex: M
Age: 35
State: WY

Vax Date: 01/12/2021
Onset Date: 01/13/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data: CBC and CMP normal results.

Allergies: NKA

Symptoms: Client, who is a PA, reports severe gallbladder pain. that started about noon the day after vaccinated. He went to Urgent Care and examined by coworker, received Tordol IM, and had labs drawn which were WNL. He was diagnosed with gallbladder pain.The pain resolved after 5-6 hours.

Other Meds: Vitamin D, Fish Oil, Niacin 250mg,MVI

Current Illness: none

ID: 1001570
Sex: F
Age: 42
State: TX

Vax Date: 01/29/2021
Onset Date: 02/03/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data: Chest xray positive for fluid in lower right lung 2/4/2021 Negative COVID rapid antigen test 2/43021

Allergies: Bee stings

Symptoms: On day 5 post second dose of COVID vaccine- developed fever, headache and muscle aches. Continued on day 6 and required a doctors visit.

Other Meds: Lamictal, Zoloft, Zyrtec, marlissa, singulair, Advil

Current Illness: None

ID: 1001571
Sex: F
Age: 21
State: TX

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

Lab Data:

Allergies:

Symptoms: After receiving the second dosage of my COVID vaccine at 2 PM on 02/03/21, I only had left arm pain near the site of the injection. However, I went to sleep and at 2 AM on 02/04/20, I started having fever, a severe HA, and myalgia that hindered my sleep. I took 500 mg Tylenol at 6 AM and went back to sleep. When I woke up at 8:30 AM, I went to use the restroom and felt dizzy with hot flashes. Immediately afterwards, I noticed that I had fainted and my mother helped me to my bed. After drinking soup and juice and having a bowel movement, I felt normal and alerted my PCP.

Other Meds: iron supplements

Current Illness:

ID: 1001572
Sex: M
Age: 75
State: TX

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

Lab Data:

Allergies:

Symptoms: around 12 hours post Moderna Covid vaccine Patient had a possible delayed anaphylactic reaction, called an ambulance and was brought to hospital with Hypoxia and Hypotensive. He was transferred to hospital and is being treated by Dr.

Other Meds:

Current Illness:

ID: 1001574
Sex: F
Age: 35
State: FL

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

Lab Data: Non, just started.

Allergies: Flax seeds, peanuts, lactose, coffee, green/black tea and potatoes.

Symptoms: L eye sharp pain: happened twice and after that my eye feels " not normal". Dull throbbing pain in L lower abdomen quadrant ( under ribcage )

Other Meds: Levothyroxine, B-12 Complex, iron, Vitamin C, potassium and vitamin D3

Current Illness: Allergic asthma

ID: 1001575
Sex: F
Age:
State: FL

Vax Date:
Onset Date: 01/26/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data:

Allergies: Penicillin Sulfa

Symptoms: Received 2nd Pfizer Covid vaccine on 1/26/21 experienced extreme headaches, nausea, chills, red rash itching on vaccine area which I still have today 2/2/21.

Other Meds: Bupropion XL 300mg Chorthalidone 25mg Lisinopril 20mg Metoprolol 50mg Nifedipine 30mg Simvastatin 20mg Eliquis 5mg twice a day

Current Illness:

ID: 1001576
Sex: M
Age: 76
State: OH

Vax Date: 01/30/2021
Onset Date: 01/31/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data: PT saw Dr. 2/2/21 PT saw Orthopedic Dr. 2/1/21 PT is scheduled to see Neurology 2/5/21

Allergies: Shrimp

Symptoms: day after vaccination pt experiencing leg severe muscle pains, pt is not able to move much without using a walking stick, and has to have assistance to get around

Other Meds:

Current Illness: None

ID: 1001577
Sex: F
Age: 81
State: CA

Vax Date: 01/21/2021
Onset Date: 01/29/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Eight days after the vaccine she had a welting around the vaccine site and it took about 8 days to go away.

Other Meds:

Current Illness:

ID: 1001578
Sex: F
Age: 40
State: MA

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

Lab Data:

Allergies:

Symptoms: states had 2nd covid vaccine yesterday (2/3/21), had cosmetic lip filler in November 2020. Noted/felt lower L lip swelling this am which appears sl better, then noticed upper L lip swelling (nothing on R). No itching or pain. No resp or thrt sx. Does have localized injection site redness and swelling, ? sl generalized body aches, otherwise no sx. Takes Zyrtec daily for other allergies. Did not have any lip reaction with 1st vaccine. 15 yo child at home does not notice any difference in her appearance. did do google search and there was reference to others who had lip filler having similar reaction s/p covid vaccine

Other Meds:

Current Illness:

ID: 1001579
Sex: F
Age: 82
State: GA

Vax Date: 01/20/2021
Onset Date: 02/01/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data:

Allergies:

Symptoms: patient reported a possible injection site reaction. site was itchy a few days after injection and patient noticed a rash developing. patient contacted us on 02/02/2021 to notify us. patient came in on 02/03/2021 where we observed a rash that was about 15cm x 5 cm. the rash was slightly raised, slightly red, and slightly warm. we drew a border around the rash, advised patient to take diphenhydramine and asked the patient to contact us today with the rash's progress.

Other Meds:

Current Illness:

ID: 1001580
Sex: F
Age: 36
State: NY

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 02/04/2021
Hospital:

Lab Data:

Allergies: Trazadone Eucalyptus

Symptoms: About an hour or two after the injection I started to get a medium grade headache. Then it progressed to a serve migraine, I was able to stay at work but went straight home after. I started taking Maxalt for my migraines and it didn't help any, I took this for two days. Mid day on the 31st I wasn't feeling to hot, laying around, couldn't shake the headache. The following day symptoms were the same but I was more ill, sick to my stomach, flu like symptoms I would say. I had chills and night sweats during the evening , this went on for two evenings. Monday the physical effects went away but the headache was still there and concerned me because it was on my left said. I called my Neurologist and let her now my symptoms, she stated it was most likely from the vaccine. She was surprised my medication I was taking did not work but advised me to take Tylenol and it went away completely. About a week and a day my head ace went away and I was ok.

Other Meds: Topamax Effexor Birth control Botox (migraines)

Current Illness:

ID: 1001582
Sex: F
Age: 75
State: CA

Vax Date: 01/25/2021
Onset Date: 02/02/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data: None

Allergies: Penecillin, Soy

Symptoms: Arm sore about 3 days, then at day 9 itching, pain, swelling, and redness of arm muscle at injection site. Feels like needle sticking in muscle. Now day 10 and symptoms persist.

Other Meds: Levothyroxine, Crestor, Vit B-12, Vit. D, Multivitamins, Lipator

Current Illness: none

ID: 1001583
Sex: M
Age: 68
State: MN

Vax Date: 01/20/2021
Onset Date: 01/22/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Increased lethargy, difficulty breathing, low stamina, overall body soreness and weakness.

Other Meds: Eliquis, Lopressor, Vitamin D, CoQ10, Magnesium

Current Illness: Covid, Pneumonia, A-fib

ID: 1001584
Sex: F
Age: 50
State:

Vax Date: 12/23/2020
Onset Date: 01/23/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Received second Moderna Covid-19 shot on 1/22 @ 9:40 am. Around 8 pm that evening started feeling chilled and body felt "heavy". Took ibuprofen 400 mg and went to sleep. With the exception of getting up to urinate, slept 36 hours and woke up on 1/24 with no recollection of previous day. In addition there are small blisters around both corners of mouth.

Other Meds: topiramate, omeprazole, furosemide, hydrochorothiazide, folic acid, lisinopril, ibuprofen, acetaminophen

Current Illness:

ID: 1001585
Sex: F
Age: 56
State: TX

Vax Date: 01/31/2021
Onset Date: 02/01/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data: N/A

Allergies: Ceclor

Symptoms: Fast heartbeat, dizziness, weakness, nausea, fatigue

Other Meds: Atorvastatin

Current Illness: N/A

ID: 1001586
Sex: F
Age: 20
State: CA

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

Lab Data:

Allergies: denies

Symptoms: pt developed sharp chest pain to the right chest 6 minutes post vaccine denied radiation, 1341- 132/79 P-101 sat 99%, pain level 4/10, 1342- 119/86 Sat 98% P-99, 1345- 118/ 76 sat 98% chest pain 0/10, 1348 -administered Benadryl, 25 mg by mouth per protocol, 1349-121/78 sat 98% P-95 chest pain 0/10, 1354- 120/82 sat 99% pain returned 3/10 called emergency medical services for transport, 1400-144/88 P-106 sat 95%, 1401- 129/84 sat 98% chest pain 0/10, 1402 emergency medical services arrived and took over care patient complained of intermittent chest pain with inspiration, pt signed medical waiver, then went to Urgent Care on her own with her clinical instructor (Nursing Student on Clinical Rotation)

Other Meds: denies

Current Illness: denies

ID: 1001587
Sex: M
Age: 46
State: WA

Vax Date: 01/30/2021
Onset Date: 01/31/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data: None

Allergies: Keflex, metformin, wheat, cow dairy, tobacco, non-spicy cruciferous vegetables

Symptoms: I have never had a seizure in my life before or since, but that morning I had five partial focal seizures in y right arm, over the course of six minutes. As I was on the phone (to report the first one to my caregiver) when the second hit, I inadvertently punched myself rapidly and repeatedly in the right side of my head, with the phone handset functioning as an impromptu bludgeon, leaving bruises reminiscent of the victim of a fist fight. Also at the time I had a strong headache, cold chills, a 102 degree Fahrenheit fever and body aches. None of which persisted beyond noon.

Other Meds:

Current Illness: Tested positive for covid-19 on December 21, 2020, quarantined 14 days thereafter

ID: 1001588
Sex: F
Age: 25
State: FL

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

Lab Data: Negative rapid COVID test at urgent care on 2/4/21

Allergies: None

Symptoms: 2/2/21: injection site soreness, nausea, fatigue 2/3/21: same as 2/2/21 plus body aches, chills, stiff neck 2/4/21: none of the above but now a rash on my hands, feet, underarms, thighs

Other Meds: None

Current Illness: None

ID: 1001589
Sex: F
Age: 41
State: IN

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

Lab Data:

Allergies: None

Symptoms: Soreness at vaccine site, low grade fever, body aches, fatigue Improvement with Ibuprofen

Other Meds: None

Current Illness: None

ID: 1001590
Sex: F
Age: 93
State: MN

Vax Date: 02/02/2021
Onset Date: 02/02/2021
Rec V Date: 02/04/2021
Hospital: Y

Lab Data: See 1st page

Allergies: Meclizine

Symptoms: See 1st page

Other Meds: Aspirin 81mg daily Aricept 5mg daily Iron 325mg daily lisinopril 40 mg daily potassium 10MEQ daily Senna-docusate sodium 8.6-50 daily vit d 2000 unit

Current Illness: Low hemoglobin, syncope, received blood transfusion in hospital on 1/4/21. Received 1st dose of covid vaccine on 1/5/21 morning at the hospital. 1/6/21 had involuntary shaking, not seizure like activity roughly 1800. Talking through shaking, did not lose consciousness. MD was aware. No other illnesses. After second injection on 2/2/21 the resident was eating lunch, nurse was notified that something was off. Resident had what was thought to be a stroke, due to high BP left sided weakness, dazed look, then abrupt contracture of the whole body resident then went limp at 1245 and was unresponsive , sent to ED by EMS. Resident CT was negative, however ED stated stroke was not ruled out. Did have 2 tonic seizures in the ED. Resident returned to facility on 2/3/21 on comfort cares/ actively dying.

ID: 1001591
Sex: M
Age: 45
State: CA

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

Lab Data:

Allergies: None

Symptoms: Swollen lymph nodes. Left armpit

Other Meds: None

Current Illness: None

ID: 1001592
Sex: F
Age: 43
State: CO

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

Lab Data:

Allergies: No known allergies

Symptoms: Injection site pain (minor) the following morning. No other side effects.

Other Meds: Adderall 20mg

Current Illness: Sprained ankle (not really an illness)

ID: 1001594
Sex: F
Age: 27
State: CA

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

Lab Data: n/a

Allergies: N/A

Symptoms: Roughly about two hours after receiving the first vaccine, my arm started to get sore. At around 9 p.m. I developed chills but no fever. I kept getting random episodes of chills after that. When I went to bed at 10:45 p.m., I had another episode of the chills. I took one teaspoon(half a recommended dose) of Nyquil to help me sleep. I woke up suddenly again with chills and I had a temperature of 100 degrees. I took another teaspoon of Nyquil to help bring down my fever and that helped.

Other Meds: Vitamin C gummies and Vitamin D3 2,000 IU

Current Illness: None

ID: 1001595
Sex: F
Age: 73
State: WI

Vax Date: 01/28/2021
Onset Date: 01/31/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Symptoms began 1/31, started with feet pain, then achy legs. Pain/muscle aches so bad by 1/1 that she had difficulty walking. Then by 2/2 evening symptoms were completely gone.

Other Meds: Take BP medication, 10 mg daily

Current Illness: None

ID: 1001596
Sex: F
Age: 71
State: OH

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

Lab Data:

Allergies: Clindamycin, zofran, adhesives

Symptoms: 5 hrs after shot, nauseated, then vomited, diarrhea, chills, no fever

Other Meds: cellcept, cyclosporine modified, bactrim, Enalapril maleate, amlodipine, glimepride, Actos (pioglitazone), famotidine, tamoxifen, poly-iron, Montelukast (Singulair), benzonoatate. Metamucil, Fiber Con, B6, B12, Fish Oil / Omega 3, baby asp

Current Illness: None

ID: 1001597
Sex: M
Age: 75
State: FL

Vax Date: 01/28/2021
Onset Date: 01/30/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data: none

Allergies: None

Symptoms: Itchy rash on both left and right forearms. Started about 24 hours after injection. Self treated with Benadryl & OTC 1% Cortisone cream Notified family doctor by phone and he advised it was common reaction and not to worry. VA doctor advised to avoid second shot until cleared by allergist & is arranging for consult.

Other Meds: dilantin lisinopril Masalamine Flomax Lipator Pepsid Co-Enzyme Q10 Glucosamine Krill Oil Curcumin Centrum Vitamin & minerals

Current Illness: None

ID: 1001617
Sex: U
Age:
State:

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data:

Allergies:

Symptoms: No additional AE reported.; The VAQTA expired on 1/6/2021 and was administered on 1/8/2021.; This spontaneous report as received from a consumer referring to a patient of unknown age and gender. Information regarding the patient's pertinent medical history, current condition, drug reactions/allergies and concomitant medication were not provided. On 08-JAN-2021, the patient was vaccinated with expired hepatitis A vaccine, inactivated (VAQTA) (0.5 units not provided, strength, route of administration and anatomical site of vaccination were not reported, lot # was unknown, expiration date reported as 06-JAN-2021) for prophylaxis (expired product administered). No additional adverse events reported.

Other Meds:

Current Illness:

ID: 1001618
Sex: U
Age:
State: PA

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

Lab Data:

Allergies:

Symptoms: patient was diagnosed with Acute Leukemia 1 week after incorrect administration of Proquad with Pentacel; patient was diagnosed with Acute Leukemia 1 week after incorrect administration of Proquad with Pentacel; This spontaneous report was received from a physician and refers to a 4-year-old patient of an unknown gender. There was no information about the patient's concurrent conditions, concomitant therapies or medical history provided. On an unknown date, the patient was vaccinated with Measles, Mumps, Rubella and Varicella (Oka-Merck) Virus Vaccine Live (PROQUAD) (dose, route of administration, anatomical location, lot # and expiration date were not reported) for prophylaxis and Hib conj vaccine (tet toxoid), diphtheria toxoid, pertussis acellular 5-component vaccine, poliovirus vaccine inactivated (MRC-5), tetanus toxoid (PENTACEL) (dose, route of administration, anatomical location, indication, lot # and expiration date were not reported). On an unknown date, 1 week after vaccination, the patient was diagnosed with acute leukemia. The outcome of acute leukemia was unknown. The causal relationship between suspect therapies and acute leukemia was not reported Upon internal review, the event of acute leukemia was considered to be medically significant.

Other Meds:

Current Illness:

ID: 1001619
Sex: U
Age:
State: VA

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

Lab Data:

Allergies:

Symptoms: no additional AE; an expired VAQTA was administered to a patient.; This spontaneous report was received from a nurse and refers to a patient of unknown age and gender. No information regarding the patient's pertinent medical history, concomitant medications, drug reactions and allergies was provided. On 12-JAN-2021, the patient was vaccinated with expired hepatitis a vaccine, inactivated (VAQTA) dose 1 milliliter, lot # S036494, expiration date 09-JAN-2021 (route of administration and anatomical location were not reported) for prophylaxis. There were no prior temperature excursions of that product. Supported disclaimer was provided. No additional adverse event (AE) was reported.

Other Meds: VAQTA SYRINGE (DEVICE)

Current Illness:

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm