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: 1005660
Sex: F
Age: 45
State: GA

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data: unknown

Allergies: unknown

Symptoms: Initial vaccination given 06 January 2021. ?Pounding headache, chest pain, stomach pain, fatigue, fever 103.2*F, (Overall malaise, Emergency Room visit x2, out from 12 January to 25 January). Reaction to prescribed medication - visual hallucinations described.

Other Meds: unknown

Current Illness: unknown

ID: 1005661
Sex: F
Age: 66
State: TN

Vax Date: 02/03/2021
Onset Date: 02/04/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Patient reported experience redness/rash, fever, and pain around the area of administration. Also noted, the issue has gotten better over the last 48 hours , but still experiencing some discomfort.

Other Meds:

Current Illness:

ID: 1005662
Sex: F
Age: 51
State: NY

Vax Date: 12/22/2020
Onset Date: 01/06/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data: CT on 1/6/2021 of Head. CT with Contrast on 1/14/2021 of head and neck. Angiogram-Neck and Lyme test.

Allergies: nka

Symptoms: On 1/6/2021 I had onset of High BP and Double Vision. Diagnosed with a 4th Cranial Nerve palsy on Left by Neurology and Ophthalmology.

Other Meds: metoprolol

Current Illness: none

ID: 1005663
Sex: F
Age: 86
State: WI

Vax Date: 01/26/2021
Onset Date: 01/27/2021
Rec V Date: 02/05/2021
Hospital: Y

Lab Data: ORGANISM IDENTIFICATION (Status: Final 02/02/2021 07:04) History Collected: 01/31/2021 10:30 Posted: 02/02/2021 07:04 Source: BLOOD OTHER (SPECIMEN) Reported by: LAB- Notes: ICD: PNEUMONIA,SEPTICEMIA

Allergies: none

Symptoms: Per report from family member illness started with fever, chills and increasingly progressed to needing emergency care

Other Meds: unknown

Current Illness: unknown

ID: 1005664
Sex: F
Age: 63
State: IN

Vax Date: 01/22/2021
Onset Date: 01/23/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data:

Allergies: Penicillin

Symptoms: Soreness in arm and bump on arm after first day and feeling of slight sickness. Soreness and bump went away after 2 day but returned 2 weeks after. The bump turned in to the size of a silver dollar and the soreness turned into to inching.

Other Meds: Cholesterol medication, High blood pressure medication

Current Illness:

ID: 1005665
Sex: F
Age: 74
State: ME

Vax Date: 01/23/2021
Onset Date: 02/04/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data: None

Allergies: none

Symptoms: I first noticed a small dot of inflammation around 10:00 P.M last night 2/4/21. T his morning the area surrounding the injection site is hot and red. The inflamed area measures about 3x4inches, There is no pain or itchiness associated. I have been icing the area.

Other Meds: levothyroxine 75mcg I per day multi vitamin Calcium 333mg Glucosamine Chondroitin

Current Illness: none

ID: 1005666
Sex: M
Age: 48
State: MD

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

Lab Data: None

Allergies:

Symptoms: When nurse was in the process of administering the vaccine, the fluid leaked out between the needle and the syringe. The impression is that at least half of the dose was lost and therefore not received by the patients. It is unsure how much, if any, was injected to the patient or if it was all lost/leaked. Patient has been self monitoring and reported no side effects besides the site pain. Guidance was sought from Moderna on whether the patient should receive another shot since they did not get a full second dose.

Other Meds:

Current Illness:

ID: 1005667
Sex: F
Age: 70
State: IL

Vax Date: 01/30/2021
Onset Date: 01/31/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data: None.

Allergies: Cardizem, Codeine, Flecainide Acetate, Tuna oil.

Symptoms: The following morning, I experienced a slight fever (99.1), mild headache, and pain to the touch at the injection site. These lasted only one day.

Other Meds: Zyrtec, albuterol sulfate, Wixela Inhub, Flonase, 325mg aspirin, Align, calcium carbonate w/magnesium, multivitamin, potassium gluconate

Current Illness: None

ID: 1005668
Sex: F
Age: 52
State: AL

Vax Date: 01/31/2021
Onset Date: 02/01/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data: Had blood test for antibodies but could not wait for result before the vaccine invitation window would expire. The antibody test was positive (10 months from illness), so I had antibodies at the time of the vaccine. Still feel weak and tired, the lymph nodes are still swollen, and the headache is still acute, but the fever and dizziness, nausea, etc. has subsided.

Allergies: Sensitivity to erythromycin and Norco (not allergy)

Symptoms: Moderna COVID -19 Two days of high fever (104.1 was highest recorded temp), congestion and difficulty breathing (rescue inhaler was sufficient), racing heart rate, dizziness and weakness, aching bones, pain in joints, acute headache, chills, nausea, extreme fatigue, and swollen lymph nodes (the last symptom continues 5 days later, on same side as injection).

Other Meds: Synthroid, Zyrtec, B Complex with Vit C, Multivitamin, magnesium, riboflavin, Motegrity, Flexeril, Estradiol, and Norethindrone

Current Illness: None

ID: 1005669
Sex: F
Age: 67
State: NJ

Vax Date: 01/27/2021
Onset Date: 02/03/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data: None

Allergies: Penicillin, clams, scallops, oysters

Symptoms: A week after the shot, my upper arm became red, sore, and itchy. My gland in the left armpit also seems to be swollen. It has been this way for three days. Other than a little sore at the site of the injection for a day, my arm was fine until a week following the injection.

Other Meds: Atorvastatin 20mg, Vitamin C 500mg, Centrum Women's multi-vitamin, Vitamin D 2000 iu, Magnesium 250mg

Current Illness: None

ID: 1005670
Sex: F
Age: 75
State: SC

Vax Date: 01/14/2021
Onset Date: 01/17/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data: Saw my nurse practitioner, health care provider on 1/20/21. BP was normal in office. Blood tests run that day were unremarkable.

Allergies: none

Symptoms: Episodes of lightheadedness and nausea from Jan 17-21, 2021. Kept bp cuff on so I could measure bp at time of episode. Bp normally about 120/75, but during episodes bp would drop to numbers like 85/60. Within a couple minutes of episode, bp would return to normal.

Other Meds: simvastatin, calcium, Fosamax, Vagifem, Vitamin B, Mobic, Fish oil, magnesium, biotin

Current Illness: none

ID: 1005671
Sex: M
Age: 68
State: NC

Vax Date: 01/27/2021
Onset Date: 01/29/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data: none

Allergies: unknown

Symptoms: Pt. received vaccine 1-27-20 21 and developed itching on Friday 1-29-2021 then noted hives Saturday 1-30-2021 for no apparent reason. Pt. used benadryl cream and was bathing in alcohol that help slow down for a little while. Talked with MD with recommendation of medrol pack, Allegra 180 mg antihistamine on stand by and may add pepcid. Informed may take up to 14 days to go away.

Other Meds: unknown

Current Illness: unknown

ID: 1005672
Sex: F
Age: 57
State: FL

Vax Date: 02/01/2021
Onset Date: 02/03/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data:

Allergies: Bee venom Bactrian Fish

Symptoms: Sore arm almost immediately. Painful red welt for 3 days. Fever of 101 12 hours after vaccination. Fever of102 degrees 24 hours after injection lasting 24 hours. Muscle spasms in my left leg for roughly 12 hours beginning roughly 12 hours after injection.

Other Meds: Multi vitamin Effexor 225 mg

Current Illness: None

ID: 1005673
Sex: F
Age: 69
State: MS

Vax Date: 11/27/2020
Onset Date: 02/06/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data: Rheumatoid factor and X-rays of both hands have been ordered but have not yet been obtained

Allergies: no known allergies

Symptoms: Patient endorses diffuse migratory muscle and joint pain and difficulty with bilateral grip strength since receiving Shingrix and Pneumovax vaccines on 11/27/2020. Has had difficulty making fist with hands despite OT sessions. At one point, pain was so debilitating that she couldn't get out of bed for days. Pain has improved somewhat but still having difficulty making a fist and having intermittent swelling of the joints of her hands.

Other Meds: cholecalciferol, insulin, pravastatin, liraglutide, pyridoxine, tamsulosin, lidocaine patch, metformin, bupropion, celecoxib, fish oil, escitalopram, hydrocodone/acetaminophen, oxybutynin, lorazepam

Current Illness: none

ID: 1005674
Sex: F
Age: 41
State: IN

Vax Date: 02/03/2021
Onset Date: 02/04/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Headache, nausea, loss of energy, brain fog, overall muscle aches

Other Meds: None

Current Illness: None

ID: 1005675
Sex: F
Age: 45
State: CA

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

Lab Data: None

Allergies: Dust

Symptoms: 4:15 pm Client reported feeling warm on the face and headache after getting the vaccine while in 15 min observation. V/S: BP- 124/80, HR 83/min, O2 saturation 98%, and Temp of 99.5 Client A/O, lung sounds clear on auscultation. No respiratory distress noted, no other symptoms observed. 4:40 pm Client released home with cousin, client reported symptoms fully resolved.

Other Meds: Metformin, Glipizide, Albuterol Inhaler as needed

Current Illness: None

ID: 1005676
Sex: M
Age: 49
State: TX

Vax Date: 12/22/2020
Onset Date: 12/22/2020
Rec V Date: 02/05/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Mild Tingling, Shortness of Breath and stuttering

Other Meds:

Current Illness:

ID: 1005677
Sex: F
Age: 26
State: MO

Vax Date: 12/30/2020
Onset Date: 12/31/2020
Rec V Date: 02/05/2021
Hospital:

Lab Data: Covid test (results negative)

Allergies: No

Symptoms: The next day giant red spot on right arm at the injection site lasted 3 days, body aches for 1 day, and possible fever (dint check temp).

Other Meds: Fluoxetine 20 mg

Current Illness: No

ID: 1005678
Sex: F
Age: 56
State: FL

Vax Date: 01/21/2021
Onset Date: 02/04/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data:

Allergies: sulfa, codiene

Symptoms: Initial Dose 01/21/21 - arm was sored and slight fatigue for 2 /3 days. Then 14 days after injection on 2/4/21, developed rash on left arm. It is hot , slightly swollen and tender to the touch. On 2/5, rash remains and artificial left shoulder is painful.

Other Meds: trazodone, mobic, sertraline, tylenol

Current Illness: none

ID: 1005679
Sex: M
Age: 15
State: NM

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

Lab Data: None

Allergies: No known allergies

Symptoms: Patient identified himself as 19 years of age and appropriate for vaccine at an offsite drive through mass immunization event . Upon returning to the clinic to enter the information into the computer it was found by the injector that the patient was actually 15 years and 8 months old rather than the 16 years required for the Pfizer COVID-19 vaccine. No adverse problems from the vaccine administration. This RN called the mother of the patient and verified birthdate and informed her that he will not be eligible for the second dose until after he turns 16 years old. Mother verbalized understanding.

Other Meds:

Current Illness:

ID: 1005680
Sex: F
Age: 33
State: CO

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

Lab Data: COVID-19 test

Allergies: Penicillins

Symptoms: Fever 102.5, Severe body aches, chills, Nausea, vomiting and diarrhea. All symptoms lasted consistently for 2 days. on days 3-7, symptoms continued to come in waves. I would feel better than worse and so on. It was a cycle. Was given anti-nausea medication and pain reliever/fever reducer medication and sent home from work x2 days. Symptoms resolved 100% after 7 days. After symptoms resolved, I did not notice my arm where I received the injection was very sore. This lasted another 3-4 days after feeling better, so about 10-12 days after the vaccine was given.

Other Meds: None

Current Illness: None

ID: 1005681
Sex: F
Age: 45
State: OH

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data: None.

Allergies:

Symptoms: Nausea x 24 hours, ongoing severe R frontal headache, L upper arm (injection site) was red, raised, with severe itching. Headache persisted for almost a month.

Other Meds:

Current Illness:

ID: 1005682
Sex: M
Age: 74
State: CA

Vax Date: 01/30/2021
Onset Date: 01/31/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Right cheek swelling (looks like cellulitis) started 1 day after first vaccine dose, submandibular, drainage to ear area, throbbing and aching. Seen in Urgent Care and prescribed Kelfex 500 mg BID, along with Valacyclovir (for Herpes Zoster).

Other Meds:

Current Illness:

ID: 1005683
Sex: F
Age: 70
State: NC

Vax Date: 01/22/2021
Onset Date: 02/04/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data:

Allergies: asprin,seasonal allergies

Symptoms: Yesterday I noticed a large patch of red on my left arm extending of the site of the vaccination. It is warm to the touch

Other Meds: Paroxetine,fluitcasone,probiotic,elderberry,vitamin d3,multivitamin,flax oil,glucosamine,tumericcurcumin,cinnamon,ginkgo biloba

Current Illness: none

ID: 1005684
Sex: F
Age: 46
State: CT

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data: N/A

Allergies: Shellfish, Contrast Dye, Penicillin

Symptoms: Fever up to 104, Chills, Body Ache, Left arm with approx 3 inch reddened raised welt type of area marked and noted to be painful and itchy. Fevers started at approx 2230 and lasted until the next day. Alternating taking Tylenol and Ibuprofen. Then fatigue and headache until approx 3 days later. My APRN was contacted on day 3 and told her about the symptoms and welt on the arm which appeared to have increased. Doxycycline 100mg started for possible cellulitis. As of today the left arm no longer with large welt, but no size of bee sting and remains itchy.

Other Meds: Yes

Current Illness: none

ID: 1005685
Sex: M
Age: 73
State: AZ

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data: none

Allergies: unknown

Symptoms: per patient he was vaccinated in a drive through clinic and the vaccinator had him outstretch his arm outside the car. He said that he felt his deltoid muscle contract during the immunization...with discomfort. A week after the vaccination his arm is still very tender at the injection site, with redness and a bruise.

Other Meds: unknown

Current Illness: unknown

Date Died: 02/04/2021

ID: 1005686
Sex: M
Age: 89
State: KS

Vax Date: 02/03/2021
Onset Date: 02/04/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data: n/a

Allergies: n/a

Symptoms: death. No known symptoms or complaints. found unresponsive in bed. Released to funeral home as the Medical Examiner will not perform and autopsy. Dr. will sign the DC.

Other Meds: 1. Jardiance 10 mg - take 1 tablet PO QAM 2. Xarelto 20 mg - take 1 tablet PO QAM 3. Metoprolol Succinate ER 25 mg - take 1 tablet PO QAM 4. Potassium Cl ER 20 mEq - take 1 tablet PO (M,W,F) 5. Gabapentin 100 mg - take 1 tablet PO QAM, 2 ta

Current Illness: n/a

ID: 1005687
Sex: F
Age: 65
State: MA

Vax Date: 01/26/2021
Onset Date: 02/03/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data: seen by ophthalmology on 02/04/2021 have appointment w neuro ophthalmology for 02/12/2021

Allergies:

Symptoms: On 01/26/2021 I received my second dose of COVID vaccine. 02/04/2021 I awoke at 3am and could see fine. At 7am I awoke again and was seeing double from my left eye. Was seen my an ophthalmologist and dx w 4th nerve palsy- Left eye. I have no underlying medical conditions to explain this, ie no diabetes, HTN etc.. At this time 02//05/2021 I continue to have double vision , the image is sloping downward, head movement and keeping my left eye open results in this woozy feeling of imbalance and nausea.

Other Meds: Vit D3 2,000u daily Cetirizine hcl (allergy)

Current Illness: none

ID: 1005688
Sex: F
Age: 61
State: WA

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 02/05/2021
Hospital:

Lab Data: CBC CMP other lab tests

Allergies: hazelnuts

Symptoms: severe vomiting and diarreah initially, later in evening-Chills, shakes,

Other Meds: none

Current Illness: diarreah and stomach ache

ID: 1005689
Sex: F
Age: 65
State: NY

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

Lab Data: None

Allergies: multiple skin allergies; allergic to sulfa, keflex, e-mycin eye ointment and gentamicin eye ointment.

Symptoms: Profound nausea, splitting headache (8 on a scale of 1-10), vertigo and swelling and soreness at injection site.

Other Meds: Claritan

Current Illness: None

ID: 1005690
Sex: F
Age: 84
State: PA

Vax Date: 01/29/2021
Onset Date: 01/31/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data: none

Allergies: azithromycin, sulfa, novacaine

Symptoms: Nausea the next day which persisted with vomiting 48 hours later, nausea resolved Headache, dizziness, fatigue, arthralgia, chills but no fever began approx 16 hours after vaccine and persisted for 4-5 days in "waves" (described by patient) Sore arm for couple days.

Other Meds: Lisinopril 20mg daily, omeprazole 20 mg daily, verapamil 120 mg daily

Current Illness: none

ID: 1005691
Sex: F
Age: 77
State: CT

Vax Date: 01/27/2021
Onset Date: 02/03/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Red, swollen, and itchy at injection site.

Other Meds: Atorvastin Atenalol Low dose aspirin Losarten

Current Illness: None

ID: 1005692
Sex: F
Age: 39
State: ID

Vax Date: 01/27/2021
Onset Date: 02/02/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: A very distinct rash where I got the vaccine. It took almost a week to appear. The rash is in the shape of a triangle outlining my deltoid muscle. It was puffy for a few days and now it is a red outline around my muscle.

Other Meds: none

Current Illness: non

ID: 1005693
Sex: F
Age: 53
State: ID

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: I got the vaccine at 9:30 am, by 5 pm I started to have a sore arm. By 10:30 pm I had horrible chills and started to feel achy. The next morning I was still feeling the same chills and ached and had cold symptoms as well. Around noon I started to have a temp that went to 102.5. The aches in my body were horrible, my legs being the worst. I slept on and off from 6 pm on, my O2 levels were 89-90 and my pulse was high. I woke up this morning at 6 am in a pool of sweat, my fever broke and I am feeling better. My aches are going away as well. I am tired, still feel a little weak and my chest feels a little heavy.

Other Meds: Prozac, hydrochlorothiazide, vit d, multi vit, advil

Current Illness: none

ID: 1005694
Sex: F
Age: 88
State: MI

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data:

Allergies:

Symptoms: weak, fatigue day after vaccine Went to ER was told it was a reaction to vaccine and sent me home

Other Meds:

Current Illness:

ID: 1005695
Sex: F
Age: 37
State: RI

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

Lab Data:

Allergies:

Symptoms: Heart palpitations/nausea

Other Meds:

Current Illness:

ID: 1005696
Sex: F
Age: 51
State: PA

Vax Date: 01/07/2021
Onset Date: 01/20/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data:

Allergies: penicillin, iodine

Symptoms: 13 days after receiving 1st vaccine in right arm, severe deep bone pain in arm. 8/10 - 10/10 pain x 5 days. Pain still there - 2/10 - 3/10.

Other Meds: Lasix, Wellbutrin, Celexa, Metoprolol, Synthroid, Meripex

Current Illness: None

ID: 1005697
Sex: F
Age: 58
State: WI

Vax Date: 01/26/2021
Onset Date: 01/27/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Headache

Other Meds:

Current Illness:

ID: 1005698
Sex: F
Age: 37
State: TX

Vax Date: 01/27/2021
Onset Date: 02/04/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data:

Allergies: Tramadol and Tecfidera

Symptoms: On day 7 my shot arm was sore again, swollen and warm and on day 8 I have a red rash on that arm.

Other Meds: Copaxone, famotidine, probiotics, fish oil, multi vitamin, ALA, quercitin with bromolin, magnesium, Zyrtec, Flonase, vitamin d, vitamin b12, calcium, folic acid

Current Illness: None

ID: 1005699
Sex: F
Age: 59
State: OH

Vax Date: 01/25/2021
Onset Date: 01/25/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data: COVID-19 PCR TEST ON 1-28-21. THE RESULT WAS NEGATIVE.

Allergies: oral clindamycin and latex

Symptoms: AT APPROXIMATELY 11PM ON 1-25-21, I EXPERIENCED CHILLS, HEADACHE, AND BODY ACHES AND PAIN. AT AROUND 2AM, I STARTED EXPERIENCING NAUSEA. THE SYMPTOMS PERSISTED THROUGH THE NEXT DAY UNTIL ABOUT 6PM. THE FOLLOWING DAY, I HAD VERTIGO AND CONTINUED STOMACH UPSET.

Other Meds: ibuprophen, metoprolol, Gaviscon tablets, Vit D, Claritan non-drowsy, simvastatin, hydrochlorothiazide-triampterine, probiotic, protonix, Nutrilite Women's Pack daily vitamin

Current Illness: yes, viral infection

ID: 1005700
Sex: F
Age: 66
State: IN

Vax Date: 02/03/2021
Onset Date: 02/04/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Headache next day. Started 0900. No prior history chronic headaches

Other Meds: None during the time. Take at bedtime

Current Illness: High cholesterol

ID: 1005701
Sex: F
Age: 36
State: WA

Vax Date: 02/02/2021
Onset Date: 02/03/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Low grade fever for one day Chills for one day Fatigue for one day (All after dose 2)

Other Meds: Ortho tri cyclen lo Vitamin D

Current Illness: None

ID: 1005702
Sex: F
Age: 65
State: NY

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

Lab Data: Covid test

Allergies: Sulfur drugs

Symptoms: Extreme chills, nausea, extreme headache, and stomachache, treated with Tylenol with minimal relief

Other Meds: Lansoprazole, metochloropramide,vitD,krill oil, calcium, biotin, cranberry extract

Current Illness: None

ID: 1005703
Sex: F
Age: 29
State:

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data:

Allergies: seasonal

Symptoms: Right eye swelling, eye itchiness lasting 12+ hours.

Other Meds: Biotin,Trazadone,Citalopram

Current Illness:

ID: 1005704
Sex: F
Age: 82
State: NC

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 02/05/2021
Hospital: Y

Lab Data: unknown

Allergies: UNKNOWN

Symptoms: Pt's son called and reported that pt had COVID vaccine on 1-25-21 and was taken to the hospital via EMS due to confusion and memory loss. Pt's son states that pt was diagnosed with "TIA" and stayed in the hospital x 3 days. Pt states that the physicians at facility was not sure if TIA was related to vaccine but encouraged him to report adverse event. Pt's son states that pt has short term memory loss and has since moved in with him after this event happened.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1005705
Sex: F
Age: 29
State: CA

Vax Date: 01/19/2021
Onset Date: 01/20/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data: none.

Allergies: NKA.

Symptoms: erythematic rash to torso, itching, T 103, body aches. Saught tx with urgent care, tx oral steroids. Then resolved after 2 days sterids tx felt much better.

Other Meds: NOne.

Current Illness: None.

ID: 1005706
Sex: M
Age: 68
State: MD

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data: SPECIMEN INFORMATION COLLECTED: 02/03/2021 07:15AM PST RECEIVED: 02/03/2021 REPORTED: 02/05/2021 03:06AM ET PATIENT INFORMATION AGE: 68 GENDER: Male FASTING: Unknown Clinical Info: Test Name Result Flag Reference Range Lab SARS-CoV-2, NAA SARS-CoV-2, NAA Detected ABNORMAL Not Detected 01 This nucleic acid amplification test was developed and its performance characteristics determined by Laboratories. Nucleic acid amplification tests include RT-PCR and TMA. This test has not been FDA cleared or approved. This test has been authorized by FDA under an Emergency Use Authorization (EUA). This test is only authorized for the duration of time the declaration that circumstances exist justifying the authorization of the emergency use of in vitro diagnostic tests for detection of SARS-CoV-2 virus and/or diagnosis of COVID-19 infection under section 564(b)(1) of the Act, 21 U.S.C. 360bbb-3(b) (1), unless the authorization is terminated or revoked sooner. When diagnostic testing is negative, the possibility of a false negative result should be considered in the context of a patient's recent exposures and the presence of clinical signs and symptoms consistent with COVID-19. An individual without symptoms of COVID-19 and who is not shedding SARS-CoV-2 virus would expect to have a negative (not detected) result in this assay.

Allergies: None

Symptoms: Body and Joint pain, headache, stuffy nose, chest discomfort, chills,

Other Meds: Multi Vitamins, Vitamin D3, Fish Oil 1000mg, Aspirin 81mg

Current Illness: None Please note: My Dr. advised me to get tested for COVID and I did Feb 3 2021 that showed Positive

ID: 1005707
Sex: M
Age: 55
State: NJ

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

Lab Data:

Allergies: Nka

Symptoms: Chills fever body aches right arm pain at injection site

Other Meds: Lisinopril

Current Illness: None

ID: 1005708
Sex: F
Age: 41
State: TX

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

Lab Data:

Allergies:

Symptoms: Symptoms - ?Patient reports around 04:00 while at work began with back pain, chills. Patient reports she took Tylenol at 0400. Patient reports after her shift went home and went to bed and when she woke up around 11:00 am took her temperature at fever Tmax 101.6 and took Tylenol at 11:00 am. Patient reports + congestion but endorses she has hx of asthma and allergies and takes Zyrtec daily. Patient denies COVID-19 exposure and travel. Last day of work and shift - ?2/4/21 Home remedies? - Tylenol at 11:00 and rest Any improvement? ? mild improvement Recommendation? Patient educated to continue to monitor symptoms at home and to take Tylenol and motrin as directed in the Medical Directive and to increase fluid intake. Patient educated to manage her symptoms and to adhere to the Workplace Policy. Patient verbalized back understanding and denied further questions at this time. Patient educated to contact vaccine support line if worsening of symptoms, Patient verbalized back understanding.

Other Meds:

Current Illness:

ID: 1005709
Sex: F
Age: 28
State: SC

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data: No

Allergies: Tephalcephoson antibiotics

Symptoms: In the evening had chills, shaking, could not get warm, low grade fever, 01/13/2021next day all over body aches, 99.9 and then arm pain at injection site nausea and diarrhea 01/14/2021 nausea and diarrhea disappeared on 01/14 or 01/15/2021. Nausea and diarrhea with first dose for two days.

Other Meds: Nexplanon birth control, Probiotics

Current Illness: No

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm