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: 1002601
Sex: M
Age: 58
State: TX

Vax Date: 01/29/2021
Onset Date: 01/31/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data: None, employee denied the need for medical treatment

Allergies: NKA

Symptoms: Employee reports that he awoke on Sunday morning 1/31 with "burning in the chest" that was not responsive to his normal medication (pantoprazole). Employee is reporting that pain is still present on 2/4 but is not severe and feels "like a bruise." No other symptoms reported

Other Meds: pantoprozole and hydrochlorothiazine

Current Illness: denies

ID: 1002602
Sex: F
Age: 23
State: MA

Vax Date: 01/23/2021
Onset Date: 02/03/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Rash appeared at injection site about 2 inch width 1.5 inch height. Rash is smooth red slightly raised and itchy. First noticed approximately 11 days after vaccine. Onset unknown.

Other Meds: Apri

Current Illness: None

ID: 1002603
Sex: F
Age: 37
State: CA

Vax Date: 01/26/2021
Onset Date: 01/30/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: Left underarm pain and swelling 4 days after getting vaccine, migraine headache 6 days after vaccine

Other Meds: blisovi birth control

Current Illness: none

ID: 1002604
Sex: F
Age: 28
State: MD

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

Lab Data: N/a

Allergies: Versed Tramadol Codeine Hydrocodone Singular Prevacid Vimpat Lamictal Spironolactone Lidocaine

Symptoms: Rash (scaly spots appeared over the left upper extremity and back - this isn't an uncommon autoimmune response for this patient) Brain fog Word finding difficulties Suspected decreased seizure threshold - unclear if partial seizure was elicited Intense fatigue Increased sleep Treatment: monitored for 30 minutes status post vaccine injection without any notable concerns; routine observation and monitoring given seizure history Time course: Rash lasted for 1 week; Brain fog/word finding difficulties last fully for 10 days, then started to dissipate; Fatigue and increased sleep lasted 1 week

Other Meds: Keppra (1500mg BID) Lexapro (20mg) Loratadine (10mg) Vitamin D

Current Illness: n/a

ID: 1002605
Sex: F
Age: 61
State: CA

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

Lab Data:

Allergies: Seasonal Allergies

Symptoms: 10minutes post vaccine administration, patient complained of itchiness at right deltoid and itchiness to her left hand. Medical provider was called for evaluation, Order given by medical provider to administer Benadryl 25 mg PO. Patient evaluated for 30 additional minutes. At the completion of the observation time, patient denied symptoms, patient ambulated out of observation area and instructed to follow up with PCP. Patient verbalized understanding.

Other Meds: Aspirin, Allergy Shot

Current Illness:

ID: 1002606
Sex: F
Age: 30
State: GA

Vax Date: 01/05/2021
Onset Date: 01/05/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data: labs EKG Echocardiogram Holter monitor CT (of my brain)

Allergies:

Symptoms: Five to ten minutes after the vaccine I got red, head itched/sweaty and face was tingly as well as hands. My heart rate went up to 186 I became Tachycardia. I t came in all of a sudden. I ended up going to the E. They gave me IV fluids, Benadryl thru the IV. They also did a CT scan on my brain. After three hours they discharged me . I felt Tachycardia for about two days after. After the 2-3 day I felt better. I had another Tachycardia episode on January 25,2021- I was scheduled to get my second dose but didn't get it done. It just hit me and my heart rate went up, it has not gone away and have been dealing with it for about two weeks. I have a heart monitor on me. I saw a Gastrologist and they want to do an EGD to rule out ulcers. I'm not able to eat without feeling a hot rush and my heart rate going up. I have lost 12lbs since the 20th.

Other Meds: Levothyroxine

Current Illness:

ID: 1002607
Sex: F
Age: 30
State: IN

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

Lab Data: N/A

Allergies: Nickel

Symptoms: 100.4 fever, fatigue, muscle soreness, arm irritation and soreness

Other Meds: Melatonin

Current Illness:

ID: 1002608
Sex: F
Age: 40
State: SC

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

Lab Data: None

Allergies: Shellfish

Symptoms: Fever up to 100.7. Severe chills. Headache. Body aches. Nausea. Gas/bloating.

Other Meds: None

Current Illness: None

ID: 1002609
Sex: F
Age: 45
State: IL

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

Lab Data: Unknown

Allergies: Unknown

Symptoms: Complain of itching of the mouth, throat, and tongue. Congested chest and ?fuzzy? Blurry in the head. Itching from the chest area to the head.

Other Meds: Unknown

Current Illness: Unknown

ID: 1002610
Sex: M
Age: 66
State: CA

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

Lab Data: xrays of my ribs

Allergies: milk and dairy

Symptoms: Severe chills the night of the shot, teeth chattering, couldn't get warm; next afternoon, chills resumed mid afternoon. Decided to get into bed to warm up. Walking up the stairs and holding both rails - left and right - I blacked out, fell forward and hit my mouth on the edge of one stair, and my ribs on the edge of another stair. Lots of blood,, chipped a tooth, lots of swelling in my mouth, deep laceration on my face and very sore ribs. Saw doctor the next day. No stitches required and ribs are bruised only. I will need dental work done to repair my teeth.

Other Meds: baby aspirin crestor pralulent vitamin d clobazam

Current Illness: none

ID: 1002611
Sex: F
Age: 85
State: PA

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

Lab Data:

Allergies: NKA

Symptoms: SEVERE PAIN IN PELVIC JOINTS, UNABLE TO GET OUT OF BED. SEVERE PAIN ENTIRE LEFT ARM FROM NECK TO FINGERS, UNUSUALLY SEVERE CHILLS, LIGHTHEADEDNESS/DIZZINESS.

Other Meds:

Current Illness:

ID: 1002612
Sex: M
Age: 81
State: WA

Vax Date: 01/17/2021
Onset Date: 01/19/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data:

Allergies: Ionize Tablets, Aflatoxin

Symptoms: two days after vaccination shoulder ache, cough, 4 days after RT calf upper muscle pain which moved into RT ankle, 5 days later previous symptoms gone, 8 days later same calf pain again but in LT, pt also noticed heart arrhythmia's occurring, pt took a beta blocker and symptom subsided

Other Meds: Multivitamins

Current Illness:

ID: 1002613
Sex: F
Age: 72
State: NC

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

Lab Data: Blood Sugar checked prior to patient discharge from clinic and result was 106.

Allergies: motrin, penicillins, shrimp

Symptoms: 30 minutes post vaccine administration the patient became hypotensive, diaphoretic, and had shallow respirations. Patient was on dialysis treatment at the time and was rinsed back with 500 ml NS, placed on 2L O2 via NC, and given 1 dose of epi IM. Patient responded well to interventions and was alert and oriented prior to arrival of EMS. EMS arrived to evaluate the patient. Patient's daughter arrived to take patient to ER to be evaluated.

Other Meds: Patient was on dialysis treatment at time of vaccination.

Current Illness: none

ID: 1002614
Sex: M
Age: 72
State: SC

Vax Date: 01/26/2021
Onset Date: 02/03/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data: no tests done as of today(2/4/2021. Saw the pharmacy that held the clinic. took benadryl.

Allergies: sulfa,penicillin,flexerill,librax,barrium sulfate

Symptoms: redness in left arm; swelling of muscle, itchy,miniscule pain except when raising upper arm..

Other Meds: 81 mg aspirin,occuvite,milk thistle,prostate plus,vitamin D

Current Illness:

ID: 1002615
Sex: F
Age: 31
State: NH

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

Lab Data:

Allergies: None

Symptoms: Starting about 8 hours after shot: Severe headache, nausea, fatigue, diarrhea, muscle cramps, severe arm pain, fever, anorexia for approximately 48 hours. Never experienced adverse reaction from a vaccine prior.

Other Meds: IUD kyleena

Current Illness: None

ID: 1002616
Sex: F
Age: 79
State: MD

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

Lab Data: none

Allergies: feathers, penicillin and sulfa

Symptoms: pt stated that she was fine and then in 2 days seemed to have fatigue. Within in 5 days pt noticed it was sore under the left arm. Within 7 days it became itchy red and swollen. Pt contacted her PCP on 2/3/2021 and she was told to take an antihistamine but she didnt take it since she has dry eyes. She used hydrocortisone to help with the itching.

Other Meds: doxycycline 50mg, Restiasis drop, regener-eyes drops, vitamin B, Centrum Silver Multivitamin, Magnesium, calcium,

Current Illness: no

ID: 1002617
Sex: F
Age: 81
State: UT

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

Lab Data:

Allergies:

Symptoms: Client called to report that she had the COVID vaccine yesterday morning, that she felt a little dizzy after, but she was okay and able to drive home. She stated that around 1pm yesterday that she got really dizzy so she took some medication that she had for dizziness, she had it for a previous fall d/t dizziness. She stated that the medication helped, but around 8pm yesterday her head felt like it was going to explode and her heart was racing, so she called her daughter and her daughter called the ambulance and she was taken to the ER. She said they ran a bunch of tests at the ER, including a CT scan, she is doing okay now, and is at home. She stated that she is calling because she does not want to get the 2nd dose of COVID vaccine because she does not want to go through that again. Client stated that she lives alone but her daughter checks on her frequently.

Other Meds:

Current Illness:

ID: 1002618
Sex: F
Age: 61
State: OH

Vax Date: 01/07/2021
Onset Date: 01/16/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data:

Allergies:

Symptoms: On day 9 after first dose of Moderna COVID vaccine, patient developed a circle around injection site that she describes as red, slightly itchy. States it faded after 2-3 days without treatment.

Other Meds:

Current Illness:

ID: 1002619
Sex: F
Age: 84
State: WI

Vax Date: 01/27/2021
Onset Date: 01/29/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data: none

Allergies: States yes to allergies. "I do get a rash every spring and it goes away when I step into the sun"

Symptoms: Client and husband called health department to report adverse effect: she developed a head-to-toe red, itchy, unraised rash 2 days after her vaccination last Wednesday 1/27 and it is still ongoing (got worse but now improving). Instructed to consult her medical provider and call back for discussion on second dose eligibility

Other Meds: Unknown

Current Illness: Unknown

ID: 1002620
Sex: M
Age: 64
State: OK

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

Lab Data: Unknown

Allergies: Unknown

Symptoms: After receiving Moderna vaccine, client became nauseous and diaphoretic. Laid down and lost consciousness. Came to within seconds. Denied any head injury or headaches. Complained of dizziness. O2 initiated 10L nonrebreather. Declined epinephrine. EMSA called. Client transported to hospital via EMSA for further evaluation.

Other Meds: Atenolol, Lipitor

Current Illness: Unknown

ID: 1002621
Sex: F
Age: 56
State: OK

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

Lab Data: Negative Covid test on 2/3/21

Allergies: None

Symptoms: Day after injection, i experienced 100 temp. Very sore arm, sore throat, body aches, dizzy, severe headache, lethargy, joint pain and some mild nausea. I was sick until 2/4 at around 1:00 pm.

Other Meds: Lamectal, Pantoprazol, Estratest, Trazadone

Current Illness: None

ID: 1002622
Sex: F
Age: 69
State: WI

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

Lab Data:

Allergies: SULFA, ADHESIVES

Symptoms: Received vaccine on 1/27/21. Was doing fine until 2/2/21. On 2/2/21, developed a "little itching and redness at injection site." On 2/3/21, the redness was more pronounced. On 2/4/21, injection site was "hard and baseball-sized lump." Patient went to urgent care at about 1300. Reports that provider said she had "cellulitis and maybe allergic reaction at the site." Provider prescribed Cephalexin 500 mg four times daily for seven days. Also told patient she could take an over-the-counter allergy medication. Will start Loratadine 10 mg once daily. Patient states that the provider stated it would still be OK for her to receive her second dose of Moderna.

Other Meds: GABAPENTIN, INHALER INCRUSE ELLIPTA, MULTIVITAMIN, VITAMIN D, VITAMIN E

Current Illness: EMPHYSEMA

ID: 1002623
Sex: F
Age: 46
State: CA

Vax Date: 01/27/2021
Onset Date: 02/03/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data:

Allergies:

Symptoms: She done okay right after the shot but now having reactions. Rash where she received the injection, red and hot, swollen. her whole arm is painful.

Other Meds:

Current Illness:

ID: 1002624
Sex: F
Age: 37
State: KY

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

Lab Data:

Allergies: N/A

Symptoms: Fever, chills, weakness, flu like symptoms

Other Meds: Sulfasalazine , plaquenil, and adderall

Current Illness: No

ID: 1002625
Sex: M
Age: 63
State:

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

Lab Data:

Allergies:

Symptoms: The patient received his vaccine on Monday 2/1/21. The patient did not complain of any ADRs or fever immediately following the injection. However, the next day he had a temperature of 101.3 F. Since the patient was febrile, he was given rapid COVID tests, which was negative. Patient received acetaminophen. He was not in distress. He had no complaints otherwise.

Other Meds:

Current Illness:

ID: 1002626
Sex: F
Age: 27
State: IL

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

Lab Data: blood sugar 74 blood pressure 90/50 pulse 82

Allergies:

Symptoms: about 5 minutes after receiving her covid Pfizer vaccine pt fainted. her blood pressure was 90/50, blood sugar 74, pulse 82. she was taken to the hospital and discharged without issues.

Other Meds:

Current Illness:

ID: 1002627
Sex: F
Age: 49
State: NH

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

Lab Data:

Allergies: Prochlorperazine Percocet [Oxycodone-acetaminophen]

Symptoms: Approximately 45 minutes after vaccine administration, coughing began. Also had fatigue, headache and some chills. Noted to be flushing, dizzy, and have an increased heart rate, Referred to Urgent Care for evaluation. Diagnosed as Adverse Event to Vaccine Administration

Other Meds: Unknown

Current Illness: unknown

ID: 1002628
Sex: F
Age: 35
State: NJ

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

Lab Data:

Allergies: Diphenhydramine, Augmentin, Latex

Symptoms: Pfizer-BioNTech COVID-19 Vaccine EUA: Vaccine recipient reported that on 1/06/2021 they were administered the vaccine and suddenly developed dry throat, itching at the roof of their mouth and a headache. Thought she needed a drink of water so she didn?t ask for help. She went home. Then her right eye began to itch. Then within the next 20 minutes she developed itchiness all over and her lips became tingly and slightly swollen. Vaccine recipient reported that they had a telehealth appointment occupational health and was prescribed prednisone. Then around 1115 am, she became dizzy and her heart rate increased to the 110s and developed chest tightness. By 1130 am she developed a scratchy throat and dry cough. They became dizzy after the phone call and told a family member to take them to the ED for worsening symptoms. While in the ED they received prednisone and Pepcid. During re-evaluation she improved and was discharge to home.

Other Meds: None

Current Illness: None

ID: 1002629
Sex: F
Age: 35
State: NJ

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

Lab Data:

Allergies: Percocet, apples, pears, apricots

Symptoms: Body aches, low grade temp. 99.9?f, right shoulder pain and hand weakness.

Other Meds: Effexor, bystolic

Current Illness: No

ID: 1002630
Sex: F
Age: 41
State: TX

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

Lab Data: Unknown

Allergies: NKDA; NKA

Symptoms: Pt. stated that she received the COVID vaccine on 1/20/21. On 1/21/21 she felt tired, had loss of appetite. She reported that she went to a store, and apparently "passed out." Employees of the store told her that she had a seizure. Pt. was transported to local ER, where she states that she had a CT of brain, blood work and was told "everything is normal." Stated that she had COVID testing both in the ER and at work, both reportedly negative. This clinic, has thus far been unable to obtain the individuals medical records from the ER. When seen in our clinic on 2/3/21, pt. stated that she is feeling better, but fatigued. No other loss of consciousness reported by pt.

Other Meds: States none

Current Illness:

ID: 1002631
Sex: M
Age: 74
State: IN

Vax Date: 01/30/2021
Onset Date: 02/03/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data: none done to date

Allergies: Penicillin Betadine

Symptoms: Right upper abdominal pain, sharp in nature. No nausea and no fever

Other Meds: Metformin Aloglictin Titalopram SawPalmetto fiber supplement Lantus

Current Illness:

ID: 1002632
Sex: M
Age: 41
State: HI

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

Lab Data:

Allergies: Shellfish, pet dander

Symptoms: Felt dizzy after standing to leave @ 30 min dismissal time. Sat back down and drank water. No other complaints. Alert and no difficulty breathing. VS @ 0923: 130/90, HR 65. Monitored for another 30 minutes. No progression of symptoms. VS @ 0953 125/90, HR 70. No distress. Dismissed @ 1010.

Other Meds: Losartan

Current Illness: None

ID: 1002633
Sex: F
Age: 76
State: OH

Vax Date: 01/29/2021
Onset Date: 01/30/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data: Unknown

Allergies: Unknown

Symptoms: Client stated on 1/30/21 she started to have pain in her left arm. Pain continued and on 2/2/21 she visited the Emergency Room. At the ER she was given a splint for her left arm and instructed to take ibuprofen. She stated she is feeling better today and her left arm is still a "little weak (2/3/21)..

Other Meds: Unknown

Current Illness: Unknown

ID: 1002634
Sex: F
Age: 65
State: VT

Vax Date: 01/23/2021
Onset Date: 01/27/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data: First evaluated for possible DVT, left leg on Friday 1/29/21 at Hospital Emergency Department. US negative for DVT. Spreading pattern of pain and rash broke out between 1/29/21 and 2/1/21, confirming DX Telehealth and in person visits with PCP, on Friday 1/29/21 through 2/4/21

Allergies: fire ants, wasps

Symptoms: Day 4 post vaccination, onset of severe acute shingles progressing to multiple dermatomes over several days; dermatomes L1, L2, L3, and T8, T9 Disabled currently from work and all ADL's since Friday 1/29. Projected to be out of work through 2/21.

Other Meds: none

Current Illness: none

ID: 1002635
Sex: F
Age: 46
State: WI

Vax Date: 01/05/2021
Onset Date: 01/05/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data: none

Allergies: nut sensitivity, ragweed, dust and grass allergy. Dicloxicillin

Symptoms: Moderna COVID-19 Vaccine EUA 1/5/2021- injection site soreness (8/10), stiff muscle in arm and warmth to site. Unable to lift arm fully due to pain/stiffness 1/6/2021- continued as above 1/7/2021- very mild tenderness to injection site only if touched.

Other Meds: Multi vitamin, vitamin D supplement and Tumeric 500 mg daily

Current Illness: none

Date Died: 01/23/2021

ID: 1002636
Sex: F
Age: 90
State: WA

Vax Date: 12/28/2020
Onset Date: 01/17/2021
Rec V Date: 02/04/2021
Hospital: Y

Lab Data: CT 1/17/21 (no acute hemorrhage but mild hypodensity of greater than 1/3 of the MCA territory) and CT Angiogram on 1/17/21 ( distal L M1/M2 occulsion).

Allergies: Oxycodone, Percodan, atenolol, PCN VK

Symptoms: On 1/17/2021 patient woke and began her day as usual, was found down by family member 1 hour later conscious but unable to speak and unable to move her R side. She was admitted to the hospital - Initial NIHSS was 26 and CT imaging showed no acute hemorrhage but mild hypodensity of greater than 1/3 of the MCA territory (TPA not recommended). CTA did show distal L M1/M2 occulsion and she was transferred to larger facility for thrombectomy. Unfortunately the patient had persistent severe neurological deficits after thrombectomy. Was discharged home on hospice care and expired on 1/23/21.

Other Meds: ASA 81 mg, allopurinol, potassium chloride, furosemide, diltiazem, metoprolol, tiotropium, albuterol, diclofenac gel topical

Current Illness: None - had exposure to COVID19 + case on 12/18/2020 but tested negative.

ID: 1002637
Sex: F
Age: 70
State: NC

Vax Date: 01/21/2021
Onset Date: 01/27/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data: None

Allergies: Penicillin

Symptoms: Extensive swelling and itching at site if injection, on 5th day after vaccination, lasting 3 days

Other Meds: Lexapro, 20 mg Zetia, 10 mg Metropolol, 25 mg Enteric aspirin

Current Illness: None

ID: 1002638
Sex: M
Age: 63
State:

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

Lab Data:

Allergies:

Symptoms: The patient received his vaccine on Monday 2/1/21. The patient did not complain of any ADRs or fever immediately following the injection. However, the next day he had a temperature of 101.7 F. Since the patient was febrile, he was given rapid COVID tests, which was negative. He was not in distress. He had no complaints otherwise.

Other Meds:

Current Illness:

ID: 1002639
Sex: F
Age: 25
State: NY

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

Lab Data:

Allergies:

Symptoms: Moderate arm pain at the injection site for 3 days after Chills on evening of vaccine Headache on day 2 of vaccine

Other Meds:

Current Illness:

ID: 1002640
Sex: F
Age: 78
State: CA

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

Lab Data: 02/04/2021 Vital signs taken , HR stable at 60BPM and RR stable at 16. BP as follows: 1108AM 180/80, 1113AM 166/57, 1119AM 163/70, 1127AM 141/65, 1137AM 137/62

Allergies: Omeprazole, Vancomycin, Aspirin, Ranitidine Hcl, Rosuvastatin, Chromium, Cefuroxime,

Symptoms: Pt alerted circulating RN that she was feeling tightening in her throat. Pt mentioned that she wanted to walk to the room because she was not feeling dizzy. Pt was asked about any heart problems and she responded that she has a pacemaker. Pt was taken to a private room for further monitoring and observation. Patient asked about history of this problem, to which she replied that this has never happened before. Patient mentioned that her allergic reactions typically consist of a rash or hives. Vitals were taken and recorded. BP was initially high at 180/80. Pt declined admission to the emergency department. Pt awake and alert, good historian. No difficulty speaking or breathing. No shortness of breath, denied chest pain, reported "tightness" and pointing to neck area. Pt described, "feels like I have phlegm there." Denied water. No drooling & speech clear. No numbness to extremities or aching to shoulders, no nausea, no dizziness. Pt ok to sit up and accepts water at 11:38AM (20 minutes following initial incident), denies food and juice. Swallows multiple sips without difficulty. Pt denied throat tightness or pain. EMTALA Form completed. Pt education performed regarding potential side effects of COVID-19 vaccine and sources of information going forward. 11:43AM pt feels comfortable to walk and wants to go home. Pt discharged to home ambulatory, stable VS and states understanding of plan of care after COVID 19 vaccine today.

Other Meds: Albuterol, Anastrozole, Cholecalciferol, ezetimibe, famotidine, fexofenadine, fluoxetine, fluticasone, ketoconazole, levothyroxine, montelukast, tramodol, triamcinolone

Current Illness: PT eval/MRI of lumbar spine for acute bilateral low back pain with left sided sciatica Chills and headache begun 1/21/21 (no fever, no blurry vision)

ID: 1002641
Sex: F
Age: 45
State: CA

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

Lab Data:

Allergies: No known allergies

Symptoms: 10 minutes post vaccine administration, patient complained of tingling in left arm and left leg. Clinical staff on site conducted assessment of patient and stayed at patient side. Patient revaluated, patient reported tingling in left arm has resolved, patient attempted to stand up and complained of dizziness, patient instructed to sit. Medical provider was called for evaluation. Order provided to observe patient 20 additional minutes, if all symptoms resolve patient can leave. At the end of the observation time, patient denied symptoms, patient ambulated out of observation area and instructed to follow up with PCP. Patient verbalized understanding. Timeline: Vaccine administered 3:15 pm Symptoms presented 3:16 pm Patient re-evaluated 3:25 pm Provider evaluation 3:28 pm Patient discharged 3:40 pm

Other Meds: None

Current Illness:

ID: 1002642
Sex: M
Age: 77
State: CA

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data: Extreme dizziness.

Allergies:

Symptoms: Diagnosed as Benign positional vertigo

Other Meds:

Current Illness:

ID: 1002643
Sex: F
Age: 75
State: CT

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

Lab Data:

Allergies: none

Symptoms: Patient had seizure

Other Meds: Amlodipine

Current Illness:

ID: 1002644
Sex: F
Age: 79
State: VA

Vax Date: 01/23/2021
Onset Date: 01/24/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data: none

Allergies: Allergic to eucalyptus

Symptoms: feet were inflamed. not treated. Got better after three days. Also hand were inflamed. for one day

Other Meds: losarten 25mg

Current Illness: Family history diabetes

ID: 1002645
Sex: F
Age: 62
State: CA

Vax Date: 01/14/2021
Onset Date: 02/04/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data: n/a

Allergies: bug bites

Symptoms: Pt came in for 2nd dose of Pfizer vaccine, pt reported itchiness on right arm. Provider informed, assessed pt's arm and torso and determined that the patient had hives that begin on her neck, and spread throughout her torso. Provider recommended she follow up with urgent care to manage the hives, and reschedule second dose of Pfizer vaccine to a later date.

Other Meds: n/

Current Illness: n/a

ID: 1002646
Sex: M
Age: 89
State: NE

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data:

Allergies:

Symptoms: On the day of the second vaccine dose patient was noted to have a large bruise on left upper arm from the first dose 3 weeks ago. Denied pain. No redness.

Other Meds:

Current Illness:

ID: 1002647
Sex: F
Age: 40
State: MI

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

Lab Data:

Allergies:

Symptoms: employee received second dose of covid vaccine 1 week earlier than planned. 1st dose was on 12.28.20, 2nd dose was scheduled for 1.18.21, received dose on 1.11.21.

Other Meds:

Current Illness:

ID: 1002648
Sex: M
Age: 4
State: NC

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

Lab Data:

Allergies: NKA

Symptoms: The patient skin became blotchy, red, with rash around the area of administration. It was about the side of a silver dollar. Waited 15 min to see if patients rash would spread or other side effect would occur. It faded as quickly as it started. No other side effects had occurred. Skin was back to normal within time frame. Provider confirmed this.

Other Meds: None

Current Illness: None

ID: 1002649
Sex: M
Age: 87
State: NM

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

Lab Data: None

Allergies: Reaction to high dose of asprin-hives all over the body. When trying to be desenitived at Clinic went into anaphylactic shock. No allergies to food/animals/plants

Symptoms: Received vaccine on 1/21/21 1/30/21 caller notified his wife that he had hives on his back and right arm. Wife states it could have happened sooner because he has dementia and has difficulty keeping days and times straight. Itchy and color is not as red as with Aspirin reaction, looks like a small back dot in the center of the hive. They have slowly gotten better as time has gone on and they appear mild now (2/4/21)

Other Meds:

Current Illness:

ID: 1002650
Sex: F
Age: 45
State: VA

Vax Date: 01/27/2021
Onset Date: 02/03/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data: none.

Allergies: Carbamide peroxide, Trazodone

Symptoms: 1 week after vaccine administered, pt developed erythematous rash with warmth to palpation on the L arm deltoid muscle (at the location of the vaccine admin site). Also noted headache and nausea. She was started on treatment for presumed cellulitis of the L arm.

Other Meds: Acyclovir, Amitriptyline, Norethindrone, Omeprazole, Maxalt PRN

Current Illness: None

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm