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: 0924927
Sex: F
Age:
State: MN

Vax Date: 12/30/2020
Onset Date: 01/01/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data:

Allergies:

Symptoms: headache; body ache; chills; runny nose; sore throat; diarrhea; This is a spontaneous report from a Pfizer-sponsored program. A contactable consumer (patient herself; occupation/specialty: hospital worker) reported that a female patient of an unspecified age received the first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE, Solution for injection; lot/batch number and expiration date were unknown), via an unspecified route of administration on 30Dec2020 at 18:00 at a single dose for COVID-19 immunization. The patient's medical history and concomitant medications were not reported. The patient mentioned that the paper works she had stated that the side effects would start within an hour, but in her case, she experienced side effects over 24 hours that's Friday on 01Jan2021, such as headache, body ache, chills, runny nose, sore throat, and diarrhea. She wanted to know if she was infected with Covid, because of her job or she was having side effects because of the vaccine. The outcome of all the events was unknown. Information on the lot/batch number has been requested.

Other Meds:

Current Illness:

ID: 0924929
Sex: M
Age:
State: AZ

Vax Date: 12/23/2020
Onset Date: 12/01/2020
Rec V Date: 01/07/2021
Hospital:

Lab Data:

Allergies:

Symptoms: got symptoms of mild cold; running nose; cough; This is a spontaneous report from a contactable physician (patient). A 81-years-old male patient started to the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE), lot number: EH9899, unspecified route to administration on 23Dec2020 (at the age of 81-years-old) as a single dose for COVID-19 immunization. Medical history included hypertension and mild diabetes Concomitant medication included nebivolol hydrochloride (BYSTOLIC), clonidine, hydralazine, losartan, nifedipine. The physician got symptoms of mild cold, running nose and cough in Dec2020. "It just came a last two days and it's been cough and runny nose. I don't have a fever." Outcome of the events mild cold, running nose and cough was unknown.

Other Meds: BYSTOLIC; ; ; ;

Current Illness:

ID: 0924930
Sex: U
Age:
State:

Vax Date: 12/31/2020
Onset Date: 01/01/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data: Test Date: 20210101; Test Name: temperature; Result Unstructured Data: Test Result:95; Comments: was not high

Allergies:

Symptoms: headache; feeling like having a temperature; was not high and it was 95; felt like tired; This is a spontaneous report from a contactable consumer (patient). A patient of unspecified age and gender received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, lot number, expiry date were unknown) via an unspecified route of administration on 31Dec2020 at single dose for Covid-19 immunization. The patient's medical history and concomitant medications were not reported. On 01Jan2021 almost like 11 o'clock, the patient started with headache and was feeling like having a temperature but when checked, temperature was not high and it was 95, the patient felt like tired. The patient stated "I remember they said after you put in this, this is may be what happen. So, is it still in there is it still, so my question is can I take a some medicine or I need to wait till later with no medicine." The outcome of the events headache, body temperature decreased, fatigue was unknown. Follow-up activities are possible, information on the batch number has been requested.

Other Meds:

Current Illness:

ID: 0924931
Sex: M
Age:
State: NJ

Vax Date: 12/21/2020
Onset Date: 12/22/2020
Rec V Date: 01/07/2021
Hospital:

Lab Data: Test Date: 20201209; Test Name: Nasal Swab; Result Unstructured Data: Test Result:Negative; Test Date: 20201214; Test Name: Nasal Swab; Result Unstructured Data: Test Result:Negative; Test Date: 20201216; Test Name: Nasal Swab; Result Unstructured Data: Test Result:Negative

Allergies:

Symptoms: Sore arm at injection site; Fever; Chills; body aches; This is a spontaneous report from a contactable physician (patient). A 47-year-old male patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number and expiration date not reported), via an unspecified route of administration on left arm on 21Dec2020 13:30 at single dose for COVID-19 immunization. Medical history included COVID-19 from Apr2020 to an unknown date and dust allergy. Concomitant medication included ascorbic acid, biotin, calcium pantothenate, cyanocobalamin, folic acid, nicotinic acid, pyridoxine hydrochloride, riboflavin, thiamine hydrochloride, tocopheryl acetate (MULTIVITAMIN). The patient experienced sore arm at injection site, fever, chills, body ache (mini COVID as compared to when he had COVID in early April) on 22Dec2020 03:00 (reported as 12-13 hours later). Symptoms controlled with Tylenol for about 15-20 hours. The patient underwent lab tests and procedures which included nasal swab on 09Dec2020, 14Dec2020, and 16Dec2020, results are all negative. The outcome of the events was recovered. Information about Lot/Batch number is requested.

Other Meds: MULTIVITAMIN [ASCORBIC ACID;BIOTIN;CALCIUM PANTOTHENATE;CYANOCOBALAMIN;FOLIC ACID;NICOTINIC ACID;PYR

Current Illness:

ID: 0924932
Sex: M
Age:
State: CA

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

Lab Data:

Allergies:

Symptoms: Feeling of swelling in throat within 30 minutes of vaccine; This is a spontaneous report from a contactable physician (patient himself). A 56-year-old male patient received his first dose of bnt162b2 (BNT162B2 also reported as COVID 19, brand Pfizer, lot EK9231, expiry date not reported), intramuscularly in the left arm on 02Jan2021 12:00 at single dose, for Covid-19 immunisation. Medical history included seasonal allergy and mild allergic rhinitis. There were no concomitant medications. The patient experienced feeling of swelling in throat within 30 minutes of vaccine, lasted 5+ hours, mostly by 9 hours on 02Jan2021. He took Singulair, Pepcid, Albuterol, Intranasal steroids and Phenylephrine as treatment. The outcome of event was recovering.

Other Meds:

Current Illness:

ID: 0924933
Sex: M
Age:
State:

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

Lab Data:

Allergies:

Symptoms: extreme fever; chills; shortness of breath; This is a spontaneous report from a contactable physician (patient). A 45-year-old male patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, on an unspecified date as a single dose for COVID-19 immunization. Medical history included hospitalization due to COVID-19 (severe case several months prior but less than 90 days). The patient's concomitant medications were not reported. The patient experienced extreme fever, chills, and shortness of breath on an unspecified date. The clinical outcome of extreme fever, chills, and shortness of breath was recovered on an unspecified date. The batch/lot number for the vaccine, BNT162B2, was not provided and has been requested during follow up.

Other Meds:

Current Illness:

Date Died:

ID: 0924934
Sex: M
Age:
State:

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

Lab Data:

Allergies:

Symptoms: green bret syndrome and he died from it; Initial information was received on 05-Jan-2021 regarding an unsolicited valid serious social media case from a consumer. This case is linked to case 2021SA003660 (same reporter). This case involves male patient (of an unknown age) who had green bret syndrome and he died from it (Guillain-Barre Syndrome) after receiving NFLUENZA VACCINE. Medical history, medical treatment(s), concomitant medications, vaccination(s) and family history were not provided. On an unknown date, the patient received a dose of suspect INFLUENZA VACCINE produced by unknown manufacturer (lot number and expiry date not reported) via an unknown route at an unknown administration site for prophylactic vaccination. On an unknown date, the patient developed serious green bret syndrome and he died from it (Guillain-Barre Syndrome) (unknown latency) following the administration of INFLUENZA VACCINE. This event was assessed as medically significant and was leading to death. Details of laboratory data were not reported. It was not reported if the patient received any corrective treatment. On an unknown date, the outcome was reported as fatal for the event Guillain-Barre syndrome. It is unknown if an autopsy was done. The cause of death was reported as Guillain-Barre syndrome. Information on the lot number was requested.; Sender's Comments: This was a poorly documented social media case involves male patient (of an unknown age) who had Guillain-Barre Syndrome and died from it, after receiving INFLUENZA VACCINE. Time to onset is unknown. Additional information regarding patient's relevant medical history, health condition at the time of vaccination, laboratory tests ruling out other alternate etiologies and autopsy results is needed for complete assessment of the case. Based upon the reported information, the role of the vaccine cannot be assessed.; Reported Cause(s) of Death: green bret syndrome

Other Meds:

Current Illness:

ID: 0924935
Sex: F
Age:
State:

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

Lab Data:

Allergies:

Symptoms: vaccination in a pregnant woman with no adverse event; Initial information received on 04-Dec-2020 regarding an unsolicited valid non-serious case received from a healthcare professional (patient). This case involved an unknown age female patient who received INFLUENZA VACCINE while she was pregnant with no adverse event (Exposure during pregnancy). Data regarding this pregnancy were received prospectively, i.e. before pregnancy outcome was known. She was exposed to INFLUENZA VACCINE at an unknown gestation period. The date of last menstrual period was not reported. The estimated due date was not reported. Medical history, medical treatments, vaccinations, concomitant medications and family history, were not provided. Information regarding current pregnancy history was not reported. Information regarding previous pregnancy was not reported. Information regarding maternal drug exposure was not reported. On an unknown date, the patient received a dose of suspect INFLUENZA VACCINE (produced by unknown manufacturer) (lot number not reported) via unknown route at an unknown administration site as prophylactic vaccination. Information regarding pregnancy complication was not reported. It was not reported if infertility treatment was given or not. Information regarding family history of congenital abnormality was not reported. Information regarding prenatal testing was not reported. At time of reporting, the pregnancy was still ongoing. Information on the batch number was requested.

Other Meds:

Current Illness:

ID: 0924936
Sex: M
Age:
State: MI

Vax Date: 10/23/2020
Onset Date:
Rec V Date: 01/07/2021
Hospital:

Lab Data:

Allergies:

Symptoms: patient under required age limit being administered with Quadracel instead of Daptacel; Initial information regarding an unsolicited valid non-serious case received from a health care professional on 15-Dec-2020. This case involves a 15 months old male patient who was under required age limit being administered with quadracel instead of daptacel (product administered to patient of inappropriate age), while he received vaccine DIPHTHERIA-15/TETANUS/5 HYBRID AC PERTUSSIS/IPV (MRC5) VACCINE [QUADRACEL]. The patient's medical history, past medical treatment(s), vaccination(s) and family history were not provided. Concomitant medications included pneumococcal vaccine conj 7v (crm197) (Prevnar); HepB vaccine and hib vaccine conj (tet tox) (Acthib). On 23-Oct-2020, the patient received DIPHTHERIA-15/TETANUS/5 HYBRID AC PERTUSSIS/IPV (MRC5) VACCINE at a dose of 0.5 mL daily via intramuscular route right thigh (lot number: C5772BA; Expiration date: 07-Oct-2022) for prophylactic vaccination. On an unknown date, it was reported that the was under required age limit being administered with quadracel instead of daptacel (product administered to patient of inappropriate age) (non-serious event) (unknown latency) following the administration of DIPHTHERIA-15/TETANUS/5 HYBRID AC PERTUSSIS/IPV (MRC5) VACCINE. No laboratory tests were reported. It was not reported if the patient received a corrective treatment. At the time of report, the outcome was not applicable for the event. Disclaimer: this suspected adverse reaction report is submitted and classified as a medication error solely and exclusively to ensure the marketing authorization holder's compliance with the requirements set out in directive 2001/83/ec and module VI of the good pharmacovigilance practices. The classification as a medical error is in no way intended, nor should it be interpreted or construed as an allegation or claim made by the marketing authorization holder that any third party has contributed to or is to be held liable for the occurrence of this medication error.

Other Meds:

Current Illness:

ID: 0924937
Sex: M
Age: 3
State: OR

Vax Date: 09/18/2020
Onset Date: 09/18/2020
Rec V Date: 01/07/2021
Hospital:

Lab Data:

Allergies:

Symptoms: gave Quadracel to a male patient who is 3 years old; with no AE; Initial information received on 18-Dec-2020 regarding an unsolicited valid non-serious case from a nurse. This case involves a 3 years old male patient who received diphtheria-15/tetanus/5 hybrid ac pertussis/ipv (mrc5) vaccine [Quadracel] (product administered to patient of inappropriate age). The patient's medical history, past medical treatment(s), vaccination(s) and family history were not provided. Concomitant medications included measles vaccine live (enders-edmonston), mumps vaccine live (jeryl lynn), rubella vaccine live (wistar ra 27/3), varicella zoster vaccine live (oka/merck) (Proquad). On 18-Sep-2020, the patient of 3 years old received a dose of suspect diphtheria-15/tetanus/5 hybrid ac pertussis/ipv (mrc5) vaccineat a dose of 0.5 ml once (lot C5688AA, with unknown strength, formulation and expiration date) via unknown route in unknown administration site (product administered to patient of inappropriate age). It is an actual medication error case due to inappropriate age at vaccine administration. At the time of report, no adverse event was reported. There will be no information available on the batch number for this case. This suspected adverse reaction report is submitted and classified as a medication error solely and exclusively to ensure the marketing authorization holder's compliance with the requirements set out in directive 2001/83/ec and module VI of the good pharmacovigilance practices. The classification as a medical error is in no way intended, nor should it be interpreted or construed as an allegation or claim made by the marketing authorization holder that any third party has contributed to or is to be held liable for the occurrence of this medication error.

Other Meds: PROQUAD

Current Illness:

ID: 0924938
Sex: M
Age: 0
State: AZ

Vax Date: 12/17/2020
Onset Date: 12/17/2020
Rec V Date: 01/07/2021
Hospital:

Lab Data:

Allergies:

Symptoms: patient was administered with liquid portion, with no AE; Initial information regarding an unsolicited valid non-serious case was received from a other health care professional via Global Medical Information (Reference number- 00401074) and transmitted to Sanofi on 21-Dec-2020. This case involves a 7 months old male patient who received only the liquid portion of DIPHTHERIA/TETANUS/5 HYBRID AC PERTUSSIS/IPV(MRC5)/HIB(PRP/T) VACCINE [PENTACEL] (Lot number UJ342AAA, expiration date 22-Jun-2021, second dose, strength-standard) via intramuscular route in the right thigh for prophylactic vaccination on 17-Dec-2020 (product preparation issue). The patient's medical history, past medical treatment(s), vaccination(s) and family history were not provided. Concomitant medications included PNEUMOCOCCAL VACCINE CONJ 13V (CRM197) and INFLUENZA VACCINE INACT SPLIT 4V (FLUARIX QUADRIVALENT) for prophylactic vaccination. It was a case of actual medication error due to Inappropriate reconstitution technique (latency-same day). At the time of report, no adverse event was reported. Reporter stated that while training new medical assistant (MA), got box of Pentacel. New MA gave only vial containing liquid portion (IPOL and Daptacel) and reporter did not check Pentacel box for any other components and just injected patient. Reporter discovered this error while documenting the dose when noticed that ActHB component was in the box. Reporter asked if the dose was valid and if patient need to revaccinate and when. This suspected adverse reaction report is submitted and classified as a medication error solely and exclusively to ensure the marketing authorization holder's compliance with the requirements set out in Directive 2001/83/EC and Module VI of the Good Pharmacovigilance Practices. The classification as a medical error is in no way intended, nor should it be interpreted or construed as an allegation or claim made by the marketing authorization holder that any third party has contributed to or is to be held liable for the occurrence of this medication error.

Other Meds: PNEUMOCOCCAL VACCINE CONJ 13V (CRM197); FLUARIX QUADRIVALENT

Current Illness:

ID: 0924939
Sex: M
Age: 34
State: IL

Vax Date: 12/17/2020
Onset Date: 12/18/2020
Rec V Date: 01/07/2021
Hospital:

Lab Data: Cmp 12/23/2020 normal. Neuro exam normal

Allergies: Pcn

Symptoms: Left leg paresthesias. Isolated to lateral aspect of lower leg and stops at ankle. Has been ongoing for about 3 weeks off and on. It is intermittent and did go away for a week or so but recently returned. It has not progressed and appears to be localized.. Evaluated by neurology 1 week after symptoms with a normal neurological exam.

Other Meds: MVI

Current Illness: None

ID: 0924940
Sex: F
Age: 17
State: KS

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data:

Allergies:

Symptoms: "Moderna COVID-19 Vaccine EUA" Vaccine administered to wrong age patient. No known allergies or medical conditions. Nurse who administered vaccine did not know vaccine not approved for anyone under the age of 18.

Other Meds:

Current Illness:

ID: 0924941
Sex: F
Age: 55
State: GA

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/07/2021
Hospital:

Lab Data: none needed

Allergies: only seasonal allergies

Symptoms: About 30 minutes after shot - mouth dryness then slight difficulty swallowing. Took Benedryl and cleared up within the hour

Other Meds: AREDS 2, Centrium multivitamin, B12

Current Illness: cold

ID: 0924942
Sex: F
Age: 45
State: KS

Vax Date: 01/05/2021
Onset Date: 01/06/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data:

Allergies: NKDA

Symptoms: Diarrhea Chills Fever

Other Meds: Losa Losartan Potassium 25 mg 1 tab q daily Bupropion Hydrochloride XR 300 mg 1 tab q daily

Current Illness: None

ID: 0924943
Sex: F
Age: 34
State: NY

Vax Date: 01/05/2021
Onset Date: 01/06/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Fever, aches, headache, Tylenol and rest. Recovered after 1 day

Other Meds:

Current Illness:

ID: 0924944
Sex: F
Age: 55
State: GA

Vax Date: 12/30/2020
Onset Date: 01/07/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data: none

Allergies: seasonal allergies only

Symptoms: Redness, small bumps, soreness and small lump at injection site that was not there the day before. Soreness is compared to the soreness at injection site shortly after getting the vaccine but a little worse.

Other Meds: AREDS 2, Centrium multivitamin, B12

Current Illness: cold

ID: 0924945
Sex: F
Age: 45
State: VA

Vax Date: 01/05/2021
Onset Date: 01/05/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data: NA

Allergies: N/A

Symptoms: My right neck shoulder region started hurting approximately 7 hours after the vaccination and progressively increase in pain. I took Tylenol 1300mg on Tuesday evening. I woke up Wednesday morning with some discomfort and decided to take another dose of Tylenol 1300mg approximately 10:00 am. The pain increased and I took another dose of Tylenol 1300 mg approximately 1500. Tylenol was not relieving my discomfort and approximately at 1800 I took Celebrex 200 mg . I went to bed at 2200. Lying down was difficult. I could not turn my head from side to side without excruciating pain. I finally went to sleep. I woke up Thursday morning pain free.

Other Meds: N/A

Current Illness: N/A

ID: 0924946
Sex: F
Age: 29
State: NJ

Vax Date: 01/04/2021
Onset Date: 01/05/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data:

Allergies: N/A

Symptoms: Onset of fever, chills, muscle aches/joint pain, headache 11 hours after injection. Fever, chills, and severe muscle aches/joint pain lasted for about 24 hours. Milder muscle aches and headache lasted for about 36-48 hours.

Other Meds: Sertraline, Tretinoin, B-12, Lamisil

Current Illness: N/A

ID: 0924947
Sex: F
Age: 53
State: NH

Vax Date: 12/24/2020
Onset Date: 12/25/2020
Rec V Date: 01/07/2021
Hospital:

Lab Data:

Allergies: Vicodin codiene aspirin biaxin percocet

Symptoms: Dizziness muscle aches, chills, fatigue

Other Meds: Levthyroxine lisinopril hctz norvasc

Current Illness: No

ID: 0924948
Sex: F
Age: 57
State: FL

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data: N/A

Allergies: Keflex; sulfa products

Symptoms: 40 minutes post shot - became extremely flush and hot; face and neck redness that lasted about an hr.. 8 hrs. post injection had extreme itching in upper body (stomach, arms, back and head). Also experiencing nausea and headache since onset of itching. Taking Benadryl, Pepcid and Zyrtec.

Other Meds: Multi Vitamin, morainga, tumeric

Current Illness: N/A

ID: 0924949
Sex: F
Age: 55
State: ME

Vax Date: 12/24/2020
Onset Date: 12/31/2020
Rec V Date: 01/07/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Day 7 after vaccine, noted itching and swelling to left deltoid. Day 8 after vaccine, noted increased swelling, redness, itching and heat. Entire left deltoid area affected Day 9 after vaccine, redness extended past margins, itching and heat continued. Swelling subsided somewhat. Seen at Urgent Care. No medications received. Instructed to monitor and call for antibiotics next day if s/s continue or worsen Day 10 after vaccine, swelling subsiding, redness turning pink, continued with warmth and itching Day 11 after vaccine through today Day 14, itching continues, scab at site of injection noted.

Other Meds: Dietary supplements: Mag/Ca, Berberine, Vit D, Probiotic, Omega, B-50 complex

Current Illness: None

ID: 0924950
Sex: F
Age: 30
State: PA

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data: none

Allergies: Latex

Symptoms: Patient c/o dizziness, nausea, diaphoresis, tinitus. Patient states this occurs after every vaccination due to her fear of vaccinations/needles. Patient moved to a cot via wheelchair and placed in trendelenberg for approximately 30 minutes. Offered water, crackers. Symptoms resolved and she exited clinic without difficulty, accompanied by a friend.

Other Meds: Klonopin, Vibrax, B12, Apple Cider Vinegar

Current Illness: None

ID: 0924951
Sex: F
Age: 26
State: NY

Vax Date: 12/24/2020
Onset Date: 12/31/2020
Rec V Date: 01/07/2021
Hospital:

Lab Data:

Allergies:

Symptoms: 12/24 received moderna vaccination had soreness x 48hours which resolved, did not experience redness or swelling 12/31 started to experience pain at injection site again 1/1 noted redness and the development of swelling extending from the axillary region to the elbow Denies fever chills Reports she feels well otherwise12/24 received moderna vaccination had soreness x 48hours which resolved, did not experience redness or swelling 12/31 started to experience pain at injection site again 1/1 noted redness and the development of swelling extending from the axillary region to the elbow Denies fever chills Reports she feels well otherwise Skin: General: Skin is warm and dry. Findings: Erythema present. Comments: Left deltoid region-edema medially extending near axillary to elbow Deltoid region warm to touch Tender to palpation At baseline she has redness of both deltoid regions but the left is significantly more erythematous Infectious Disease Cellulitis of left upper extremity - Primary Given degree of edema tenderness and erythema suggestive of a cellulitis Cephalexin 500 mg 4 times daily x7 days given Tylenol for comfort Relevant Medications cephALEXin (KEFLEX) 500 mg capsule

Other Meds:

Current Illness:

ID: 0924952
Sex: F
Age: 43
State: OH

Vax Date: 01/05/2021
Onset Date: 01/06/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data: n/a

Allergies: n/a

Symptoms: diarrhea, headache,chills,sweats,nausea welt the size of a small orange that is red and hot with a rash

Other Meds: bumetanide, hydrochlorathyzide, synthroid

Current Illness: n/an/a

ID: 0924953
Sex: F
Age: 58
State: NY

Vax Date: 01/05/2021
Onset Date: 01/05/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data:

Allergies: NKA

Symptoms: On my way home, about 30 minutes after the vaccine, my throat became tight and my lips and tongue were tingly. At 4 pm I took a Benadryl. At 7pm I took a second one and went to bed at 7:30. In the morning these symptoms were gone

Other Meds: Pravastatin 40mg, One a Day women's multi vitamin, Caltrate 600+D3, bid, Osteo Bi-Flex, bid, D3 50mcg, B12 500mcg.

Current Illness: NA

ID: 0924954
Sex: F
Age: 57
State: MA

Vax Date: 12/31/2020
Onset Date: 12/31/2020
Rec V Date: 01/07/2021
Hospital:

Lab Data: I did see urgent care due to the rash and raised area over my ear and was advised this was a effect from the covid vaccine.

Allergies: None

Symptoms: Two hours after receiving the vaccine, I had extreme headache, this lasted for over 24 hours, after that the next 2 days was a lighter headache and some light brain fog feeling. The day after the vaccine had some mild chest pain, 5 minutes worth and than went away. Left arm hurt but just the usual with a shot. 6 days after vaccine, I had a rash and bump over my right ear, itchy arms and hands and neck area.

Other Meds: Levothyroxin

Current Illness: None

ID: 0924955
Sex: F
Age: 41
State: PR

Vax Date: 01/04/2021
Onset Date: 01/05/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Fever 104, chills, nauseas, swollen lymph's armpits, severe headaches

Other Meds: Phentermine

Current Illness: No

ID: 0924956
Sex: F
Age: 29
State:

Vax Date: 12/30/2020
Onset Date: 12/31/2020
Rec V Date: 01/07/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Fever, severe chills for around 4 hours

Other Meds: Taytulla

Current Illness:

ID: 0924957
Sex: F
Age: 44
State: NY

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data: vital signs nd observation

Allergies: Latex, Penicillins

Symptoms: Patient felt dizzy 30 minutes post injection, required extra observation and rest time to dissipate. She was slightly hypertensive 145/88 mm/Hg and 147/91 mm/Hg. Heart rate was consistently in the 80 BPM range.

Other Meds:

Current Illness:

ID: 0924958
Sex: M
Age: 35
State: NY

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data: Vital signs and observation

Allergies: Penicillin

Symptoms: Patient developed metallic taste in mouth post vaccination, gingerale helped to alleviate it.

Other Meds:

Current Illness:

ID: 0924959
Sex: F
Age: 29
State: TX

Vax Date: 12/31/2020
Onset Date: 01/07/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data: None sought yet

Allergies: Dairy, gluten

Symptoms: A week after receiving the vaccine I woke up with hives like symptoms at the injection site (right arm) and on my chest. There is also a lump that developed on my right collarbone within the past two days.

Other Meds: None

Current Illness: No

ID: 0924960
Sex: F
Age: 54
State: NC

Vax Date: 12/29/2020
Onset Date: 01/07/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data:

Allergies: penicillin

Symptoms: injection site is swelling and hot to the touch

Other Meds: no

Current Illness: none

ID: 0924961
Sex: F
Age: 49
State: PA

Vax Date: 12/29/2020
Onset Date: 01/06/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data:

Allergies: Disperse blue Dog dander Tree, grass pollen Mold

Symptoms: Swelling, redness, warmth at injection site 8 days after injection, began 01/07/21 and still currently present

Other Meds: Fexofenadine, 180mg once daily Norethindrone, 1 tablet daily Multi-vitamin

Current Illness: Sinus infection

ID: 0924962
Sex: M
Age: 56
State: IA

Vax Date: 12/31/2020
Onset Date: 01/04/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Generalized fatigue, right knee pain and swelling. Muscle pain and weakness around right lower extremity.

Other Meds: lorazepam

Current Illness:

ID: 0924963
Sex: F
Age: 53
State: OH

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

Lab Data:

Allergies: lisinopril

Symptoms: Began with very painful and swollen injection site the first night. Tuesday during the day I took Tylenol and it helped. Tuesday evening I was hit with extreme chills and body aches. Injection site was very hot, painful, red and swollen. Stayed wrapped in a blanket for hours. Lasted into my sleep. Had a low temp in the morning on Wednesday (99.7) Seemed to have the" sweats " most of the day. Injection site was still hot, red and swollen. Today feeling better but injection site is still painful and has a mounded lump.

Other Meds: Metformin Atenolol pravastatin triamterene -hydrochlorothiazide omeprazole glipizide

Current Illness: none

ID: 0924964
Sex: F
Age: 51
State: DE

Vax Date: 01/05/2021
Onset Date: 01/06/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data: none

Allergies: Tea, honey, mushrooms, bactrim DS, neosporin, PCN

Symptoms: Vertigo - started 2 hours after injection and lasted 24 hours

Other Meds: None

Current Illness: none

ID: 0924965
Sex: M
Age: 33
State: CT

Vax Date: 12/29/2020
Onset Date: 01/04/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data:

Allergies:

Symptoms: After the standard soreness after injection lasting approx 3 days, symptoms dissipated. At around 7 days post injection, acute onset of profound redness, swelling and pain was noted to the injection site. Now at 10 days, redness and swelling still present, however symptoms have decreased in severity. Now I have muscle twitching at the injection site as well.

Other Meds:

Current Illness:

ID: 0924966
Sex: M
Age: 18
State: NY

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Was nervous about getting the shot. Felt clammy and hot. Felt weak and had a headache. A Code was called and he was transported to the emergency room for monitoring.

Other Meds:

Current Illness:

ID: 0924967
Sex: F
Age: 33
State: CT

Vax Date: 12/30/2020
Onset Date: 01/06/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: 7 days after, sore arm, red rash approximately size of palm of hand, warm to touch,

Other Meds:

Current Illness: None

ID: 0924968
Sex: F
Age: 41
State: FL

Vax Date: 01/05/2021
Onset Date: 01/06/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data: none

Allergies: Sulfa drugs

Symptoms: woke up 1/6/21 @ 4am with chills and nausea. Took a Zofran. Awoke again at 5am with fever of 100.6 F. Fever did not respond to 600 mg ibuprofen. Later that day developed headache and body aches. Pain at injection site present as well.

Other Meds: none

Current Illness: rhino virus

ID: 0924969
Sex: M
Age: 54
State: SD

Vax Date: 01/05/2021
Onset Date: 01/06/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data:

Allergies: n/a

Symptoms: Rapid onset chills 103 temp injection site tenderness

Other Meds: rosuvastatin 10 mg tablet aspirin 81 mg Multi vitamin

Current Illness: n/a Healthy. Feeling good

ID: 0924970
Sex: M
Age: 34
State: SC

Vax Date: 12/24/2020
Onset Date: 12/24/2020
Rec V Date: 01/07/2021
Hospital:

Lab Data: UA, UCX, Gonorrhea and Chlamydia NAAT -- pending results 01/01/21

Allergies: NKDA

Symptoms: Right testicular pain, diagnosed R epididymititis, treated with levaquin 500 gm qd x10d

Other Meds: amlodipine

Current Illness: none

ID: 0924971
Sex: M
Age: 52
State: PR

Vax Date: 01/05/2021
Onset Date: 01/05/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data:

Allergies: NONE

Symptoms: RASH IN THE LEFT ARM WHERE THE THE VACCINE WAS ADMINISTER. THE EMPLOYEE TAKE ZYRTEC FOR TWO DAYS

Other Meds: LISINOPRINE 10MG

Current Illness: NONE

ID: 0924972
Sex: F
Age: 45
State: MA

Vax Date: 01/04/2021
Onset Date: 01/05/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: Chills and body aches for 24 hours

Other Meds: none

Current Illness: none

ID: 0924973
Sex: F
Age: 37
State: TX

Vax Date: 01/05/2021
Onset Date: 01/05/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data: EKG, CBC, blood pressure, magnesium level

Allergies: Demerol and sulfa

Symptoms: 5 mins after injection heart rate increased ton170 and blood pressure increased to 180/00 showed no signs of anxiety. Symptoms subsided within 2 hours

Other Meds: Tramadol 50mg

Current Illness: Recently had food poisoning

ID: 0924974
Sex: F
Age: 26
State: IN

Vax Date: 12/20/2020
Onset Date: 12/27/2020
Rec V Date: 01/07/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: on 7th day post vaccination, I had left upper arm swelling, rash, and pain where there had previously been none. Freckles on that upper arm scabbed over and peeled. This event lasted less than 2 hours. No medications taken, no medical care received. No further reaction since then.

Other Meds: lexapro 10mg oral birth control pill, daily

Current Illness: none

ID: 0924975
Sex: F
Age: 64
State: FL

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

Lab Data: none

Allergies: none

Symptoms: fever, chills, headache, muscle and joint pain, duration 24 hours

Other Meds: none

Current Illness: none

ID: 0924976
Sex: F
Age: 58
State: KS

Vax Date: 12/30/2020
Onset Date: 01/06/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data: None

Allergies: Sulfa medications cause skin rash

Symptoms: Eight days after shot given woke up with severe headache. About noon that day my left arm started itching real bad and was itching it. One of the nurses I work with said there was welts on my skin. I could feel 3 lumps and was warm to touch and red. I notified my supervisor and was told to contact my doctor's office. They called me later and told me to take anti-histamine and cool compress to the area, which I did. Was very tired and went to bed early.

Other Meds: Centrum Silver daily multivitamin Sertraline 50mg daily Nabumetone 750mg 2 daily Take HUMIRA INJECTION 40 SQ bi weekly and did so on January 1st, 2021

Current Illness: Psoriatic Arthritis and preparing for a right knee revision on January 18th of 2021

ID: 0924977
Sex: F
Age: 41
State:

Vax Date: 01/05/2021
Onset Date: 01/05/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Developed weals on chest and Back. took anti- histamine and condition resolved

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm