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: 1003255
Sex: F
Age: 70
State: CA

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

Lab Data: Patient seen in clinic, directed to ER for further work up, CT scan, etc.

Allergies: Adhesive TapeRash Amlodipine Casein Cat Dander Dolophine [Methadone]Hives FentanylRash Fruit Gabapentin Grass Pollen LatexRash MethotrexateOther. Opioid - Non-pharmaceuticalHives ProcainamideRash Rabbit Dander Stadol [Butorphanol Tartrate]Rash TramadolHives Yellow Jacket Venom Protein [Hymenoptera Allergenic Extract]

Symptoms: Possible TIA. Patient had slurred speech and disorientation on Tuesday morning

Other Meds: Temazepam (RESTORIL) 15 mg Oral Cap Diclofenac Sodium (VOLTAREN) 1 % Top Gel tiZANidine (ZANAFLEX) 4 mg Oral Tab Atenolol (TENORMIN) 25 mg Oral Tab DULoxetine (CYMBALTA) 20 mg Oral CPDR SR Cap K-Tab 10 mEq Oral SR Tab Lisinopri

Current Illness: URI (COVID NEGATIVE)

ID: 1003256
Sex: F
Age: 33
State: IN

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

Lab Data:

Allergies: Gluten allergy

Symptoms: Extreme inflammation, nausea, dizziness, fever reaching 101.9 lasting an entire day impacting ability to work, fatigue first day after shot. Mild pain and inflammation over whole body with low grade temp on day two.

Other Meds:

Current Illness:

ID: 1003257
Sex: F
Age: 63
State: NY

Vax Date: 01/15/2021
Onset Date: 01/15/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data: None

Allergies: Sulfa Amoxicillin

Symptoms: Sore arm at injection site, no treatment, resolved in 24 hours

Other Meds: Lexapro 10 mg daily Atorvastatin 40 mg daily Losartan 50 mg daily Daily baby aspirin 80 mg Probiotic CBD gummies 25 mg

Current Illness: None

ID: 1003258
Sex: M
Age: 73
State: AZ

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

Lab Data: none

Allergies: none

Symptoms: Injection site soreness starting 1 hr. after injection, then chills, fever, body shuddering,generalized myalgias, feeling cold all over starting 10-11 hrs. after injection, then night sweats on second night after injection. All symptoms have resolved after 48 hours.

Other Meds: Insulins, perindopril, atorvastatin, levothyroxine,primidone, valacyclovir, multivitamin

Current Illness: none

ID: 1003259
Sex: M
Age: 17
State: TX

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

Lab Data: none

Allergies: unknown

Symptoms: 17 Y.O. Male inadvertently administered moderna cov-19 vaccine.

Other Meds: unknown

Current Illness: none

ID: 1003260
Sex: F
Age: 46
State: CA

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

Lab Data:

Allergies: Adhesive tape, precocet

Symptoms: metallic taste to mouth, thickening of saliva, itching on neck. Benadryl 50 mg PO, transferred to Urgent Care. Monitored and discharged with no further incident

Other Meds:

Current Illness: peripheral neuropathy

ID: 1003261
Sex: F
Age: 12
State: TX

Vax Date: 07/18/2018
Onset Date: 07/18/2018
Rec V Date: 02/04/2021
Hospital:

Lab Data: VS/Observation x 30 minutes.

Allergies: NKA

Symptoms: Within one minute of vaccine, my daughter had a Tonic, Clonic Seizure, and fell off exam table while waiting for wait time protocol. She received a concussion, and blunt force trauma. MD immediately sent her to ER for an MRI which hospital refused to perform.

Other Meds: N/A

Current Illness: None

ID: 1003262
Sex: F
Age: 53
State: ID

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

Lab Data:

Allergies: Penicillin

Symptoms: Flu-like symptoms, migraines, 101 fever, rash and hives. Took over the counter medication. Started day after vaccination, symptoms cleared by day five, still having occasional headaches

Other Meds: None

Current Illness: None

ID: 1003263
Sex: F
Age: 55
State: TX

Vax Date: 01/28/2021
Onset Date: 01/29/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data: N/A

Allergies: Sulfa

Symptoms: Light headache and light body ache. I took Tylenol and put ice bag. It last 1 day 1/2.

Other Meds: Metoprolol

Current Illness: None

ID: 1003264
Sex: F
Age: 44
State: TX

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

Lab Data:

Allergies: Ibuprofen Seasonal allergies

Symptoms: Swollen arm Itchy arm Chills Uncontrollable shivering Fever Sweating Extreme fatigue Bad dreams Remained at hospital for 30 minutes after injection for observation due to history of asthma and ibuprofen allergy. No reactions that that time. Symptoms started approximately 12 hours after injection. Gradually went away and almost gone after 72 hours.

Other Meds: Dupixent Zoloft Singulair Symbicort Vitamin D

Current Illness: Mild asthma Nasal polyps Sensitivity to NSAIDS

ID: 1003265
Sex: M
Age: 79
State: VT

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

Lab Data:

Allergies:

Symptoms: upon administering the vaccine the needle malfunctioned and it is unsure how much was given. it was decided with permission of the patient and guidance from my district manager and patient care coordinator to re administer the dose.

Other Meds:

Current Illness:

ID: 1003266
Sex: M
Age: 38
State: AL

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

Lab Data:

Allergies: No known allergies

Symptoms: No history of severe allergic reactions. Observed for 15 minutes following vaccine injection. Felt fine at that point so I was told that I could leave. About 10-15 minutes after leaving (about 25-30 minutes after vaccine injection), I started to feel tingling in the bottom half of my face (most noticeable in the bottom lip and chin area), slight swelling on back sides of tongue, and slight swelling of area under chin at the top of the throat (right side only). I could still breathe, drink, and talk normally. Although symptoms did not seem to be intensifying, I decided to seek care at a nearby urgent care out of caution. I arrived at the urgent care about 10 minutes after the onset of symptoms (about 45 minutes after vaccine injection). Provider evaluated me, administered pepcid and a Benadryl shot, and notified me that if I went into anaphylactic shock that they would administer an epipen and call an ambulance. Vitals were normal and remained normal throughout observation. Symptoms began to abate about 15 minutes after Benadryl injection. Tongue swelling abated first about 15 minutes after Benadryl injection. Active tingling in the chin abated about 30 minutes after Benadryl injection, although light numbness remained. Swelling under chin abated about 45 minutes after Benadryl injection. Provider or staff checked on me every 15-20 minutes. Provider released me from observation after about 2 hours. At that point all symptoms had abated with the exception of slight numbness on bottom half of face, which persisted for several more hours.

Other Meds: Protonix (acid reflux), Zyrtec (mild seasonal allergies), Sulfasalazine (seronegative arthritis), Folic Acid, Align (probiotic), multivitamin, vitamin D, Fish oil

Current Illness: None

ID: 1003267
Sex: F
Age: 34
State: CA

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

Lab Data: N/A

Allergies: DENIES

Symptoms: AT APPROXIMATELY 12:00, TWO HOURS AFTER RECIEVING HER SECOND MODERNA VACCINE DOSE SHE COMPLAINED THAT HER LOWER LIP STARTED TO SWELL. SHE WAS TAKEN TO THE TREATMENT AND TRIAGE AREA ON WORK GROUNDS WHERE THE DOCTOR THERE TREATED HER WITH BENADRYL AND DEXAMETHASONE. AFTER SHE WAS OBSERVED AND WAS FEELING BETTER SHE LEFT WORK TO GO HOME AND GET SEEN AT A LOCAL URGENT CARE FOR FOLLOW UP.

Other Meds: DENIES

Current Illness: DENIES

ID: 1003268
Sex: M
Age: 75
State: TX

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

Lab Data: none

Allergies: knda

Symptoms: dose was given on day 14 at patient request b/c he was moving, employee who scheduled did not confirm date of prior dose and proceeded to schedule. vaccinator did not confirm date of prior dose to ensure it was within the acceptable time frame. it was 3 days too early.

Other Meds: HCTZ Rosuvasattin Selenium sulfide Valacyclovir lisinopril Triamcinolone acetonide 0.1% ointment propylene glycol asa naproxen

Current Illness: none

ID: 1003269
Sex: F
Age: 34
State:

Vax Date: 01/31/2021
Onset Date: 02/03/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Rash at injection sight. Covers most of left upper arm.

Other Meds: Singular, Zyrtec

Current Illness:

ID: 1003270
Sex: F
Age: 74
State: FL

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

Lab Data:

Allergies: none

Symptoms: Temp 101.4, chills, dizzy and aching all over. I did not seek medical attention. just took Tylenol and rested.

Other Meds: Hydrochlorothiazide, Omeprazole, Metoprolol, Meloxicam , Atorvastatin, Zolpidem, Bayer low dose aspirin, Biotin and Citracal calcium supplement

Current Illness: none

ID: 1003271
Sex: F
Age: 63
State: MN

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

Lab Data: None

Allergies: Sulfa drugs, dust, animal dander, mold

Symptoms: Body aches, fatigue, headache, feverish; lasted about 40 hours; felt like I had COVID again

Other Meds: Buproprion, estradiol, progesterone, lisinopril, hydroxyzine

Current Illness: None

ID: 1003272
Sex: F
Age: 66
State: GA

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

Lab Data:

Allergies: Penicillin, sulfur, latex gloves

Symptoms: None stated.

Other Meds: Advair HFA 230/21, Ventollin HFA

Current Illness: No

ID: 1003273
Sex: F
Age: 66
State: TX

Vax Date: 01/07/2021
Onset Date: 01/13/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data:

Allergies:

Symptoms: rash on lower back at the same time of injection site rash showed up within a week and lasted about 3 or 4 days

Other Meds: Lisinopril Levothyroxine Alive multi-vitamin Vitamin D3 Ester-C Red mineral algae-vegetarian calcium MegaRed

Current Illness:

ID: 1003274
Sex: F
Age: 54
State: AZ

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

Lab Data: None

Allergies: Penicillin, codeine, and anesthesia make me vomit...not necessarily allergic reactions.

Symptoms: 1) Immediately noticed that I was light-headed or dizzy upon receiving shot. 2) My face started to feel numb on the left side (below the eye to the jawline and from below my left ear to my nose area. I was worried about a stroke, so I made sure that I was able to smile in my rear-view mirror. The numbness began to clear up around 8 hours later without any muscular drooping of eye or mouth. I still have tingling or a numb feeling in areas but it is not significant at this time. 3) fatigue, slight nausea, pain in right collar bone area has been present since Monday. All seem to be minor side effects.

Other Meds: None

Current Illness: None

ID: 1003275
Sex: F
Age: 17
State: TX

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

Lab Data: none

Allergies: unknown

Symptoms: 17 Y.O. inadvertently administered moderna cov 19 vaccine

Other Meds: unknown

Current Illness: unknown

ID: 1003276
Sex: M
Age: 65
State: IN

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

Lab Data: None

Allergies: No

Symptoms: At approximately 20 hours following injection developed high fever (102+) rapidly. Fever ceased at 12:00 pm. Accompanied by severe body aches and uncontrollable shivering. Today I have extreme muscle soreness in mid to lower back and in joints of my limbs. Also severe headache that ibuprofen could help. I had covid in July of 2020 with moderate symptoms.

Other Meds: Lipitor

Current Illness: No

ID: 1003277
Sex: F
Age: 30
State: CA

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

Lab Data: NONE

Allergies: NKA

Symptoms: ONE FOREARM DEVELOPED AN ITCHING RASH ABOUT 5 INCHES WIDE. BENADRYL 50MG PO GIVEN WITH GOOD RESULTS.

Other Meds: UNKNOWN

Current Illness: NONE

ID: 1003278
Sex: M
Age: 0
State: NM

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

Lab Data: none

Allergies: no known allergies

Symptoms: wrong vaccine administered.

Other Meds: no current medications,

Current Illness: nasal congestion

ID: 1003279
Sex: F
Age: 22
State: NY

Vax Date: 01/28/2021
Onset Date: 01/29/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data: N/a

Allergies: Penecillin, Peanuts, Dairy

Symptoms: Day 2 - Extreme fatigue, injection sight soreness, nausea, loss of appetite, chills, low fever, muscle aches, he ache Day 3 - fatigue Day 4 - fatigue, sore throat Day 5 - Sore throat, congestion, fatigue Day 6 - Extreme fatigue, migraine, vertigo/dizziness Day 7 - Extreme fatigue, vertigo/dizziness, sore throat

Other Meds: Biotin, Vitamin C, Vitamin D, Calcium Magnesium

Current Illness: N/a

ID: 1003280
Sex: M
Age: 63
State: CA

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 02/04/2021
Hospital:

Lab Data: None

Allergies: Shellfish (crab) if he over indulges - develops hives

Symptoms: Itching behind knee caps, both legs, ribs under armpits, whole back itching and redness all over body and got really bad itchy when he got home but it went away after a few hours with no treatment.

Other Meds: Multi Vitamins

Current Illness: None

ID: 1003281
Sex: F
Age: 42
State: KS

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

Lab Data:

Allergies: aspirin

Symptoms: Severe muscle aches and pains prohibiting sleep. Arm pain at injection site hard and sore preventing sleep as well. Muscle aches and pains subsided within 48 hours.

Other Meds: iud

Current Illness: cold in between vaccines

ID: 1003282
Sex: F
Age: 65
State: CA

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

Lab Data: None

Allergies: Environmental allergies

Symptoms: Initial injection site swelling with redness and itching. Beginning to resolve after three or four days then coming back with a more pronounced reaction on day number eight. Current delayed reaction is more pronounced than the initial reaction.

Other Meds: Olmesartan, rosuvastatin, levothyroxine

Current Illness: None

ID: 1003283
Sex: F
Age: 77
State: GA

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

Lab Data: None

Allergies: corn syrup, chocolate

Symptoms: On 2/3 upon rising my vision was blurry for awhile. At 8PM I had Kaleidoscope Auras in both eyes. I have never experienced either of these events.

Other Meds: Letrozole 2.5mg Calcium 1250mg D3 2000 units Vitamin C 1000mg Pepcid Complete

Current Illness: None

ID: 1003284
Sex: F
Age: 35
State: VA

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

Lab Data:

Allergies: None known

Symptoms: Fever (about 102*), major chills, major headache, fatigue, pain at injection site, redness at injection site, minor nausea. Most of the symptoms were better by 2/4/2021 but still had a headache, redness at injection site, and fever the second day. Took acetaminophen the night of 2/3/2021 for fever and headache which helped a lot

Other Meds: Prenatal vitamins

Current Illness: None

ID: 1003285
Sex: F
Age: 49
State: CA

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

Lab Data: No

Allergies: no

Symptoms: 101.9 -highest fever got; body aches; a little bit of joint pain and dry heaving (didn't have anything in me); diarrhea. Headache. It lasted until about 6 in the morning and then started getting better. By 4:00 pm on 20th I felt better. Just tired. I called in sick on the 20th. No treatment.

Other Meds: no

Current Illness: COVID-19

ID: 1003286
Sex: M
Age: 66
State: KS

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

Lab Data: I have not sought out any medical tests at this time.

Allergies: Pennsyllin, mustard, bar b q sauce

Symptoms: Tuesday night February 2nd 2021 it started with a mild cough that persisted on and off throughout the night. Wednesday morning February 3rd 2021 I woke up with a hoarse voice which continued throughout the day. The hoarse voice remains with me as of today February 4th as I am completing this form. I've gargled my throat with warm water and salt and have been drinking warm lemon and water.

Other Meds: None

Current Illness: None

ID: 1003287
Sex: F
Age: 41
State: CA

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

Lab Data:

Allergies: No

Symptoms: Tightening of throat, Benadryl 50 mg PO, symptoms resolved.

Other Meds:

Current Illness: Obesity

ID: 1003288
Sex: F
Age: 48
State: UT

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

Lab Data:

Allergies: n/a

Symptoms: 1) whole body aches and pains - started 5 am next day (approx 15 hrs post injection) and gone by 6 am 2nd day 2) dizziness - started 5 am next day, lasted for 2-3 hours 3) redness and swelling at injection site - started 5 am next day, an increase was noticed again 5 am 2nd day, continues to be monitored

Other Meds: acyclovir, amitriptyline, propranolol, spironolactone, metformin

Current Illness: n/a

ID: 1003289
Sex: F
Age: 56
State: MA

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

Lab Data: Covid Flu Cat Scan Blood work

Allergies: Tree nut

Symptoms: In the beginning I didn't have any issues, I was fine. I went to bed and woke up at 2am and started vomiting like I never before and had diarrhea , a fever of 101.3. My fever dropped in three hours back to normal which was weird. It was strange. The diarrhea lasted for days, it was uncontrollable . The vomiting lasted for three days, it was non-stop. I had this headache that was unbelievable . Since having Covid I get headaches daily. I had Covid in March 2020. I lost 4lbs in three days and I called my Dr. He said You need to go the ER right now. I went to the ER and had to wait three hours, I had aches and pain like the flu, I was totally out of it. They did a Cat scan, and blood work was normal. They gave me IV fluids, IV Tylenol and Tramadol. They did a Covid and flu test, both were negative. Then they gave me a shot of Fetanal , that took away my headache for 30 minutes. At this point I didn't have any more vomiting or diarrhea . I stayed about 8 hours in the ER and went home. I was told by my Dr. not to get the next shot.

Other Meds: Vitamin E Vitamin C Vitamin D B-12 Emetrozol Levothyroxine Flonase

Current Illness:

ID: 1003290
Sex: F
Age: 63
State: FL

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

Lab Data:

Allergies: none

Symptoms: Moderna COVID-19 Vaccine EUA 8 days after vaccine red rash, swelling, and bruising appeared. Approximately 3-4 inches in radius. Ice and hydrocortisone cream applied to irritated area. As of Friday, still swollen and red after 4 days.

Other Meds: metoprolol 50 mg losartan 50mg

Current Illness: none

ID: 1003291
Sex: M
Age: 33
State: IN

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

Lab Data: None

Allergies: None

Symptoms: Fever > 100.5 for 30 hours with highest temp 103.0, treated with Tylenol 1000mg po q6h with poor effect. Muscle aches, treated with Ibuprofen 400mg 2 tabs po q6h prn, mild relief in muscle pain. Vomiting, 1 episode. Resting tachycardia, HR of 120 while supine lasting approximately 24 hours.

Other Meds: Daily multivitamin

Current Illness: None

ID: 1003292
Sex: F
Age: 51
State: MO

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

Lab Data: The patient was transported via EMS in the afternoon of 2/4/21

Allergies: Salsalate, Bupropion, Petoxifyline, Nifedipine, Erythromycin, Ibuprofen, aspirin, metaxalone, tizanidine, tramadol, hydrocortisone, meloxicam, orphenadrine, prednisone, oxybutynin, bevespi. Cardimon, Curry, Carmel Flavor, Fenugreek, cauliflower.

Symptoms: On 2/4/15, within 15 mins monitoring, Pt started coughing and stated her throat felt tight. EMS was onsite. She later reported they gave her IV Diphenhydramine and a steroid. She thought it was Prednisone. Her blood pressure was elevated and she was still being held at the hospital when we called to check on her about 3 hours after her symptoms started.

Other Meds: unknown

Current Illness: unknown

ID: 1003293
Sex: F
Age: 54
State: MO

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

Lab Data:

Allergies: penicillin

Symptoms: Tingling in the face occurred after both doses of the shot. I didn't know it was an adverse effect after the first dose, but my daughter is in medical school and told me that it could be and I should report it

Other Meds: Citalopram 20mg qhs, multivitamin centrum silver, turmeric supplement, 2000 iu vitamin D, estrogen patch, fish oil supplement

Current Illness:

ID: 1003294
Sex: F
Age: 69
State: CA

Vax Date: 01/24/2021
Onset Date: 01/27/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data: 2/4/2021 Observation by the Doctor: skin reaction to the vaccine. Doctor prescribed TRIMCINOLONE 0.1% cream to apply 2x/day.

Allergies: None

Symptoms: Some soreness and redness for the first few days at the site of the shot. The redness became a rash and it gradually spread over my upper arm and by the 7th day itched a lot for few days. The pain also increased in the area of the shot only. I put Calamine lotion to sooth the itch. By day 11th following the shot, the redness was about 5" long down my upper arm by 3"+ wide. That's when I went to the Urgent Care on 2/4/2021.

Other Meds: Medication AmLoDipine 1/day 5MG tablet (for high blood pressure) Aspirin 1/day 81mg Supplements Calcium 1/day 1200 mg with 25mcg(1000UI)vitamin D3 Magnesium 1/day 500 mg Vitamin E 1/day 180 mg (400 IU) Vitamin C 1/day

Current Illness: none

ID: 1003295
Sex: F
Age: 20
State: FL

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

Lab Data:

Allergies: No known allergies

Symptoms: 4:30pm-8:00am body chills, body aches, fever, headache Treated with oscillococcinum at 4:00 and 12 midnight - did not help with symptoms 10am on 02/04 fever and headache returned Treated with Tylenol - fever went away within the hour but headache remained 2:00pm on 02/04 nausea and diarrhea Treated with tums and water - did not help with nausea Treated with 3 saltine crackers and Gatorade at 5:30pm - nausea subsided

Other Meds: Xulane

Current Illness: None

ID: 1003296
Sex: F
Age: 34
State: MD

Vax Date: 01/14/2021
Onset Date: 01/19/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data: CXR, EKG, CBC and BMP, CTA

Allergies: NKDA

Symptoms: 5 min after shot had flushing, tachycardia and numb lips. 4 days later I developed tachycardia, chest pain, dyspnea, body aches

Other Meds: Zyrtec, Vitamin D and C

Current Illness: None

ID: 1003297
Sex: F
Age: 47
State: NY

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

Lab Data: N/a

Allergies: Biaxin-hives

Symptoms: Fever, chills, dizzy, tired, shakey

Other Meds:

Current Illness: None

ID: 1003298
Sex: F
Age: 61
State: FL

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

Lab Data: None

Allergies: NKA

Symptoms: Approximately 15 mins after she received the vaccine she complained of itching and stated she had hives. She was given 25mg of Benadryl po at 12:50pm. VS 160/90, P 82, R 16, O2sat 99% She was observed in the vaccine clinic for 30 minutes after given the Benadryl. She said she was feeling better. She told RN that she had had hives and rash before receiving the injection for 1 week. She was advised by RN to go to Emergency Department if severe symptoms occur and/or follow up with Employee Health if feel she needs to be seen by a MD. BP prior to leaving clinic 134/86, O2 sat 99%.She remained awake and alert throughout with no signs of shortness of breath or facial swelling.

Other Meds: Synthroid, HCTZ, Lisinopril, Estradiol

Current Illness: None

ID: 1003299
Sex: F
Age: 45
State: IL

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

Lab Data:

Allergies: Penicillin, Tetracycline, adhesive, diflucan

Symptoms: Approximately 18 hours post injection I began running a fever with severe body aches and headache. 24 hours after onset of initial symptoms, I developed diarrhea. 72 hours after injection, I noted a large painful lymph node in the axilla of the injection side. Fever and malaise continue in addition to cough and chest tightness

Other Meds: Effexor XR 75 mg daily, multi vitamin, vitamin D3, zinc, hair/skin/nails

Current Illness: None

ID: 1003300
Sex: U
Age: 35
State: TX

Vax Date: 12/29/2020
Onset Date: 01/02/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data:

Allergies: Cherry

Symptoms: Body aches

Other Meds:

Current Illness:

ID: 1003301
Sex: F
Age: 57
State: LA

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

Lab Data:

Allergies:

Symptoms: CAME TO WORK FEELING OK, AFTER EATING BREAKFAST STARTED FEELING DIZZY AND NAUSEATED AND VOMITED

Other Meds:

Current Illness:

ID: 1003302
Sex: F
Age: 16
State: TX

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

Lab Data: none

Allergies: unknown

Symptoms: 16 Y.O. inadvertently administered moderna cov 19 vaccine .

Other Meds: unknown

Current Illness: unknown

ID: 1003303
Sex: F
Age: 14
State: TX

Vax Date: 11/07/2020
Onset Date: 11/07/2020
Rec V Date: 02/04/2021
Hospital:

Lab Data: N/A

Allergies: NKA

Symptoms: Patient had a Seizure immediately after administration.

Other Meds: None

Current Illness: None

ID: 1003304
Sex: F
Age: 71
State:

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

Lab Data:

Allergies:

Symptoms: Pt c/o throat feeling swollen. VSS. Able to swallow and speak without difficulty. Pt refused to have treatment in the ED.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm