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: 1006391
Sex: M
Age: 29
State:

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

Lab Data:

Allergies:

Symptoms: Fever 103 f. Chills Muscle aches Headache

Other Meds:

Current Illness:

ID: 1006392
Sex: F
Age: 45
State: OR

Vax Date: 01/23/2021
Onset Date: 01/30/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data: None

Allergies: None known

Symptoms: Slightly sore red, warm to the touch, itchy patch of skin below injection site that developed 7 days after Covid vaccine injection. Itchy, red and warm for two days.

Other Meds: Levothyroxin, sertraline, women?s multivitamin.

Current Illness: None

ID: 1006393
Sex: F
Age: 27
State: TX

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

Lab Data:

Allergies:

Symptoms: Report fever of 101.2, chills, HA began next day after vaccination. Treatment: Tylenol with improvement of HA and chills and fever resolved. Outcome: Does not interfere with ADLs.

Other Meds:

Current Illness:

ID: 1006394
Sex: M
Age: 87
State: FL

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

Lab Data: None

Allergies: Prednisone

Symptoms: Intense Pain in both knees - 2 hours plus lesser pain continuing Weakness in legs and in general - still a little Sweating - no fever - has stopped

Other Meds: Omeprazole Naproxen Pravastatin Tramadol Gabapentin Bupropion Alfuzosin Vitamin B-12 Vitamin D-3 Vitamin C Ferrous sulfate

Current Illness: None

ID: 1006395
Sex: F
Age: 61
State: ND

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data: None.

Allergies: sulfa atarax

Symptoms: Patient stated that 45 min. after receiving her first Maderna COVID-19 vaccination she experienced some drainage in the back of her throat and was unable to speak for an unspecified amount of time.

Other Meds: protonix, proair, zofran, advair, vit d, HTZ, metoprolol, escitalopram, metaxalone, montelukast

Current Illness: unknown

ID: 1006396
Sex: F
Age: 45
State: PR

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

Lab Data: Solumedrol 125mg, Benadryl 50 mg, Albuterol, Vaponephrine

Allergies: Symbicort

Symptoms: throat tightness, couhg

Other Meds: Singulair, Allegra, Flovent

Current Illness: none

ID: 1006397
Sex: F
Age: 69
State: FL

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

Lab Data: none

Allergies: pistachios,latex

Symptoms: Dizzy,lightheadedness within minutes. Was told I could stay longer if needed but all they had was the same epipen that I had. Was taken home by daughter. Lightheadedness continued and some trouble focusing continued and desire to fall asleep. Took my bp ,it was 85/61.pulse 109.I hydrated with 3 bottles of water and ate olives to increase sodium level. an hour later bp was up to 107/67,pulse 67. I continued to monitor my bp through the next 24 hrs. I skipped my blood pressure meds for that night and continued with them the next day when my pressure was back to normal range. I did not use my epipen. Would have gone to ER if I was unable to control my hypotension. I am an RN.

Other Meds: Tikosyn,candesarden,xarelto,amlodipine,levothyroxine,crestor

Current Illness: none

ID: 1006398
Sex: F
Age: 82
State: NY

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

Lab Data:

Allergies:

Symptoms: red and swollen vaccine site

Other Meds:

Current Illness:

ID: 1006399
Sex: F
Age: 61
State: MA

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

Lab Data: N/A

Allergies: Levaquan, Unasyn Strawberries and Nightshades

Symptoms: On Day 8 post vaccine injection, Site of injection became extremely itchy, red, swollen and warm. Ebbed and flowed for 48 hours . size of a half dollar bill. Used Hydrocortisone cream to relieve itch, cool compresses. Took Benadryl 2x. Now, 2 days later, beginning to disappear. Did not contact MD, since it did not expand after initial appearance, and is now going away..

Other Meds: Magnesium, Vitamin D, Collagen

Current Illness: none

ID: 1006400
Sex: F
Age: 30
State: CA

Vax Date: 01/10/2021
Onset Date: 01/10/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data:

Allergies: z-pack, environmental: cats, dogs, horses (anaphylactic), anything with dandruff, seasonal allergies, and grass.

Symptoms: 1st vaccine: Injection site tingling. Felt lightheaded, dizziness, nauseated, vomiting. Developed headache. HR: 84, BP 106/68. Rash all along arm, back and neck. Applied hydrocortisone. Went away within 1 day. Throughout the week body chills, headaches, sinus pains, low grade fever. Recovered in about 1 week. Took Benadryl and Dayquil. Extended observation and sent home. Advised to notify PCP.

Other Meds: phentermine (took first week of dec. for 2 weeks), Claritin, pro-air, iron, multivitamin and B12, and probiotics.

Current Illness: 1 week prior to vaccine had a cold (negative COVID test)

ID: 1006401
Sex: F
Age: 26
State: NY

Vax Date: 01/08/2021
Onset Date: 01/17/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data: N/A

Allergies: Penicillin, amoxicillin

Symptoms: Hard, baseball sized bump under vaccine site and round red circle appeared approximately 8 days after getting the injection, which two days later turned into a large, splotchy red rash that traveled down my arm along with itchy hives

Other Meds: Birth control

Current Illness: None

ID: 1006402
Sex: F
Age: 50
State: TX

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

Lab Data:

Allergies:

Symptoms: Evening of 2nd dose (same day) experienced redness to site, fatigue, body aches and chills. The following day (2/2) experienced shortness of breath with ANY exertion. Heart palpitations and tachycardia noted. Complaint of weakness to legs. The shortness of breath, palpitations and tachycardia are continuing on 2/5 (4 days post vaccination) Pt. states the symptoms are frequent and exacerbated with any exertion including just walking short distances.

Other Meds:

Current Illness:

ID: 1006403
Sex: M
Age: 46
State: MA

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

Lab Data: None

Allergies: None

Symptoms: Fever, chills, myalgias, fatigue, headache. Began 8 hours after the vaccine and lasted for 48 hours.

Other Meds: None

Current Illness: Mild cough for about 3 weeks, no other symptoms

ID: 1006404
Sex: M
Age: 43
State: NY

Vax Date: 01/21/2021
Onset Date: 01/31/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data: POSITIVE FOR 2019 nCoV

Allergies:

Symptoms: TESTED POSITIVE FOR COVID19 ON 01/31/21

Other Meds:

Current Illness:

ID: 1006405
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: Penicillin, erythromycin

Symptoms: Chills, aches, sensitive skin, headache, slight fever

Other Meds: Vitamin D, loratadine

Current Illness: N/A

ID: 1006406
Sex: F
Age: 17
State: MN

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

Lab Data: None

Allergies: None

Symptoms: No adverse events from the above vaccination, other than a sore arm that last approximately 24 hours. However the reason for this report is, this individual who is 17 yo was given a Moderna Covid vaccination which has an Emergency Use Authorization for those 18 years old and older.

Other Meds: Quetiapin Fumarate, Venlafaxine, Trazadone, Multi-vitamin, Vitamin D

Current Illness: None

ID: 1006407
Sex: F
Age: 74
State: CA

Vax Date: 01/25/2021
Onset Date: 02/03/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data:

Allergies: None known

Symptoms: On 9th day after injection( Feb 3) felt itching to injection site on upper left arm. Observed approx 1.5 inch diameter red circle, warm to touch and muscle area felt slightly swollen, but not painful to touch. Day 9 and 10 applied a cold wet compress for 5 minutes about 2 times a day. Circle remains, however, redness receding in center with red margins. Because I felt no side effects or discomfort to site in first days, I did not look at injection site not visible when facing a mirror. Thus, I do not know if red circle has been present the entire time since receiving injection or if it suddenly appeared on Day 9. I did photograph the site today, Day 11. I have had no other adverse symptoms.

Other Meds: 1000 IUs Vitamin D 4 x's a week

Current Illness: None

ID: 1006408
Sex: F
Age: 32
State: PA

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

Lab Data:

Allergies:

Symptoms: Arm soreness/redness/swelling

Other Meds:

Current Illness:

ID: 1006409
Sex: F
Age: 76
State: OH

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

Lab Data:

Allergies: none

Symptoms: patient called reporting a rash at injection site today (date 8) patient is not signed up for vsafe.

Other Meds: unknown

Current Illness: unknown

ID: 1006410
Sex: F
Age: 72
State: MS

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

Lab Data:

Allergies: PENICILLIN

Symptoms: Five minutes after taking the vaccine, patient c/o facial burning, face turning red, facial tingling, and feeling shaky. Admin Benadryl 25 mg PO. Patient c/o tongue numbness. B/P 180/94. HR 70;. EMS arrived for transport but patient declined. Symptoms resolved. F/U with patient confirmed that she went to ER. Admin Decadron

Other Meds: MUTIVITAMINS, CELEBREX, EVISTA

Current Illness:

ID: 1006411
Sex: F
Age: 33
State: MD

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

Lab Data:

Allergies:

Symptoms: Flush & Feeling warm

Other Meds:

Current Illness:

ID: 1006412
Sex: M
Age: 32
State: TX

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

Lab Data:

Allergies: Codeine, Celebrex

Symptoms: Fever up to 101.1* F: Tylenol 320mg q 4 hrs x 3 doses, resolved after 12 hours Headache, onset at 5:00 a.m. morning after injection, resolved 18 hours later Muscle aches, onset 12 hours post injection, resolved after 24 hours Diarrhea, onset 40 hours post injection

Other Meds: Testosterone Cypionate

Current Illness: None

ID: 1006413
Sex: F
Age: 81
State: MD

Vax Date: 01/19/2021
Onset Date: 01/21/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data: n/a

Allergies: erythromycin

Symptoms: rash consistent with shingles, T4 dermatome, on same side, with muscle pain

Other Meds: albuterol inhaler, ascorbic acid, aspirin 81 mg, atorvastatin 40 mg, levocetirizine 5 mg, mometasone inhaler, montelukast 10 mg, multivitamin, preservision areds

Current Illness: environmental allergies hyperlipidemia

ID: 1006414
Sex: F
Age: 48
State: NY

Vax Date: 01/27/2021
Onset Date: 01/31/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Vaccination site is swollen and very itchy. Patient is taking Benadryl to treat the symptoms.

Other Meds:

Current Illness:

ID: 1006415
Sex: M
Age: 75
State: VA

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

Lab Data:

Allergies:

Symptoms: this event is being reported for the following reason: the patient was inadvertently given the 2nd dose shingrix today when he had 1st Covid vaccine on 1/26/21. this would be 10 days past admin of Covid vaccine and not the required 14 days wait. Patient was observed for 30 minutes post vaccine while remaining in clinic and no adverse reaction was noted while patient still in clinic. Covid-19, mRNA, LNP-S, PF (Pfizer-BioNTech) 0.3ml IM given in Left deltoid on 1/26/21. NDC 59267-1000-1 Lot # 1111-20-EL9262 exp date 5/31/21

Other Meds:

Current Illness:

Date Died: 01/31/2021

ID: 1006416
Sex: M
Age: 53
State: CA

Vax Date: 01/13/2021
Onset Date: 01/31/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Patient died of a heart attack on 1/31/21, 2.5 weeks after vaccination

Other Meds:

Current Illness:

ID: 1006417
Sex: F
Age: 55
State: NY

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

Lab Data: none

Allergies: None

Symptoms: Extreme fatigue fever- 100.3 highest chills headaches rash on site of injection

Other Meds: None

Current Illness: none

ID: 1006418
Sex: F
Age: 77
State: TN

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

Lab Data:

Allergies: docucycilin

Symptoms: started hurting same day of shot. i cried. i cant lift my arm at all. i cant dress or bath or anything. my shoulder is swollen. I can only lift it with my other arm. pain goes up my shoulder to the back of my neck and up my head. The shot was given in the muscle and joint. It was am immediate pain.

Other Meds: Probiotics, culterel, Vitamin D3

Current Illness:

ID: 1006419
Sex: F
Age: 47
State: CT

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

Lab Data: sent to ED for eval

Allergies: idiopathic anaphylaxis

Symptoms: itchiness - benadryl, no relief. sent for observation in ED

Other Meds:

Current Illness: none known

ID: 1006420
Sex: M
Age: 55
State: PA

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

Lab Data: unknown

Allergies: zero

Symptoms: fever, chills, headache, dirraha

Other Meds: zero

Current Illness: zero

ID: 1006421
Sex: F
Age: 50
State: KY

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

Lab Data: none

Allergies: NKDA

Symptoms: flu like symptoms, chills, fever, aches, headache, nausea, dizziness, arm red and swelling

Other Meds: adderal, robaxin, wellbutrin, protonix, pravastatin

Current Illness: none

ID: 1006422
Sex: F
Age: 61
State:

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

Lab Data:

Allergies:

Symptoms: I experienced muscle aches the spread across my entire back starting at about 8 PM on 2/4/21. At 2:30 AM on 2/5/21, I passed out three times after rising from the toilet, resulting in a split lip. I was covered with sweat the third time I "came to" and soon got the chills.

Other Meds:

Current Illness:

ID: 1006423
Sex: F
Age: 71
State: MS

Vax Date: 01/29/2021
Onset Date: 01/30/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data: No test. ,just visual test

Allergies: Bactrim DS Penicillin

Symptoms: Tingle in left side of face, chin, and Burning in Back from Right arm to left arm, Treatment, with Doxycline and Predisone, second day some re-leaf.

Other Meds: Crestor Systane eye drops Calcium One a Day Vitamins Bausch & lomb Ocuvite Probiotic Co Q 10 Cranberry soft gel pill

Current Illness: none

ID: 1006424
Sex: M
Age: 79
State: OH

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

Lab Data: none

Allergies: PCN Medication: Syncope

Symptoms: Moderna COVID-19 Vaccine EUA. 02/04/2021: Patient called to report adverse side effects following receipt of Moderna COVID-19 vaccine on February 3, 2021, 9:05 AM. 02/03/2021, 1 hour after vaccine, patient stated left arm pain at site of injection. 02/04/2021: patient had worsening Left arm pain, vaccination site redness, inflammation, and skin warm to touch at vaccination site. Patient notified health department approximately 3 PM. Nurse provided assessment questions via phone. In addition to previous stated symptoms: client stated slight numbness and tingling at site of injection (denied radiation down arm and to fingers), and rated pain ?4 or 5? (according to 1-10 pain scale). He was advised to: use cool compress 10-15 minutes per hour (vaccination site on the arm), contact his PCP to determine for evaluation, and determine if able to take ibuprofen or acetaminophen. 02/05/2021: Patient notified by health department nurse (9:00 AM) for cont. evaluation: identical evaluation as provided on 02/04/2021. Client stated he had contacted PCP office this AM and spoke with receptionist/nurse. He stated he was waiting for return call. 02/05/2021 (2 PM). Client again contacted byRN. Client had message to NP and had not received return call. RN explained, from evaluation, arm soreness was localized. RN stated that RN would notify client on 02/06/2021 to review symptoms. It was explained to client that if there was an increase in pain severity, swelling, redness, or transmission of tingling or numbness extending to fingers that he should go to the nearest Emergency Dept. for evaluation. Client verbalized his understanding.

Other Meds: Xarelto Allopurinol Lisinopril Furosemide Glipizide Atenolol Metformin

Current Illness: none

ID: 1006425
Sex: F
Age: 27
State: IN

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

Lab Data:

Allergies: Latex

Symptoms: Sore right arm Headaches Muscle aches Right armpit painful Tiredness Irritability Lack of appetite

Other Meds: None

Current Illness: None

ID: 1006426
Sex: F
Age: 42
State: SC

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

Lab Data:

Allergies: Sulfa PNC

Symptoms: Vaccine 1: flu like symptoms, severe headache, rash, severe body aches, fatigue for about 4 days. Vaccine 2: Nausea, diarrhea, fatigue, severe body and muscle and joint aches, headache, temporary loss of taste and smell again. Lasted about 30 hours. Diarrhea persisted for 6 days.

Other Meds: Tizanidine Zinc Magnesium Basic 9 vitamin Bio Plus probiotic

Current Illness: 1st vaccination 12.23.2020 Positive for COVID 01.05.2020

ID: 1006427
Sex: F
Age: 40
State:

Vax Date: 12/23/2020
Onset Date: 12/24/2020
Rec V Date: 02/05/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Fast heart rate, sought treatment at the ER, dc paperwordkstated orthostatic hypotension

Other Meds:

Current Illness:

ID: 1006428
Sex: F
Age: 77
State: IN

Vax Date: 01/25/2021
Onset Date: 02/04/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data:

Allergies: shellfish, tetracyclene

Symptoms: an extremely itchy, red, sore, slightly swollen patch on my upper left arm (but not the exact site of the injection) about 2" x 1". So far, symptoms have subsided after 22 hours except for redness.

Other Meds: levothyroxine, amlodopene, areds 2 suuplement, calicium citrate supplement

Current Illness:

ID: 1006429
Sex: F
Age: 62
State:

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

Lab Data: Baseline vital signs, repeat vital signs at 10 minutes and 15 minutes.

Allergies: Pt denies

Symptoms: Pt stated she felt like she had a "tickle" in her throat. She was given a bottle of water. She felt as though that was helpful. She denied itchiness, shortness of breath, dizziness, lightheadedness, tachypnea, dysphagia, facial, tongue or lip swelling. She denies feeling like her throat is closing. No visible rash or urticaria noted.

Other Meds: Pt denies

Current Illness: Pt denies

ID: 1006430
Sex: F
Age: 74
State: FL

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

Lab Data:

Allergies: Sulfa Wasp and bees bites

Symptoms: First dose : Second day of vaccination very mild fatigue , moderate pain in arm Second dose : pain in the arm began the day of vaccination, second day at noon began chills, fatigue, joints pain and and fever at around 4 pm , highest reading 100.4 Third day feeling good for

Other Meds: Carvedilol 12.5 mg twice daily Amlodipine 5 mg twice daily Atorvastatin 20 mg daily Citalopram 40 mg daily Hydrochlorothiazide 25 mg daily Lisinopril 10 mg daily COq10 300 mg daily

Current Illness: UTI

ID: 1006431
Sex: M
Age: 84
State: NJ

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

Lab Data: none

Allergies:

Symptoms: Patient's daughter feels as though some of the vaccine was not injected into deltoid therefore did not receive adequate dosing.

Other Meds:

Current Illness: Parkinsons

ID: 1006432
Sex: F
Age: 51
State: NJ

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

Lab Data: Telehealth visit Blood work scheduled for 2/8 -scheduled COVID pcr test 2/6 - scheduled

Allergies: PCN

Symptoms: Fever at max 39.7, body aches, chills, headache, nausea Severe lymph node swelling armpit on the side of injection ( size of a ping pong ball)

Other Meds: Levothyroxine Fioricet Advil Vit D3

Current Illness: Hypothyroidism Hep C Migraine Varicose veins Adhesive Capsulitis/rotator cuff tear

ID: 1006433
Sex: F
Age: 26
State: NJ

Vax Date: 01/21/2021
Onset Date: 01/22/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: 1.Fever 2.Headache 3.Bodyaches

Other Meds: None

Current Illness: None

ID: 1006434
Sex: U
Age: 66
State:

Vax Date: 01/14/2021
Onset Date: 02/04/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Hair loss started 4 days after 1st vaccine, had chicken pox type lesions when had active positive covid and lesions reappeared after vaccine.

Other Meds:

Current Illness:

ID: 1006435
Sex: F
Age: 72
State: FL

Vax Date: 01/22/2021
Onset Date: 01/30/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data: N/A

Allergies:

Symptoms: Itchy and swollen rash at injection site began the evening of the eighth day after receiving the shot.

Other Meds: Aleve, senior multi vitamin, immune support herbals

Current Illness:

ID: 1006436
Sex: M
Age: 47
State: MI

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

Lab Data:

Allergies: Novavaine

Symptoms: Patient stated that he had some lip tingling after first time dose after leaving from observation. That did diminish on its own. 3:00pm Tongue tingling. 25mg of Benadryl given. BP, P, 02 through out observation. VS WNL normal and all symptoms resolved prior to leaving at 3:35pm. Patient verbalized feeling comfortable to leave. Director of Nursing and PCP will be notified.

Other Meds: Insulin Solostar 18 unit, Metformin 1000mg , Montulocast, Allegra, HCTZ, and one other for potassium (unknown name), Thyroxine, Statin medication

Current Illness: none

ID: 1006437
Sex: M
Age: 57
State:

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

Lab Data:

Allergies:

Symptoms: Subjective 57 y.o. male who was seen at COVID Vaccine Clinic today for his second dose of the COVID 19 vaccination. He was given the Moderna vaccination in the right deltoid muscle. During his 15 minute waiting period after the injection, the patient began to experience Right sided chest discomfort, mild shortness of breath and intermittent dizziness. He denied rash, hives, welts, difficulty breathing, difficulty swallowing, wheezing, throat tightness, hoarseness, stridor, itching, lightheadedness, dizziness, facial swelling, lip swelling and tongue swelling. This provider was notified of patient reaction and he was then assessed in the emergency area. Monitored patient for severe reaction symptoms, including but not limited to abdominal pain, blood pressure abnormality , chest pain, collapse, drooling, hypotension, increased swelling, rapid progression of symptoms, respiratory distress, skin changes, tongue swelling and vomiting. patient denies any previous cardiac history but does have Asthma. Chest discomfort did not worsen with activity and actually improved some per his report. ALLERGY REVIEW OF SYSTEMS: Patient complains of chest tightness (Right side, no radiation) and dizziness (Intermittent) Previous Reactions: None Objective Vitals Vitals: 02/05/21 1009 02/05/21 1019 BP: 136/83 130/83 Pulse: 70 62 Resp: 14 SpO2: 98% 98% Physical Exam Vitals signs reviewed. Constitutional: General: He is not in acute distress. Appearance: He is not diaphoretic. Cardiovascular: Rate and Rhythm: Normal rate. Heart sounds: Normal heart sounds. No murmur. Pulmonary: Effort: Pulmonary effort is normal. No respiratory distress. Breath sounds: Normal breath sounds. No wheezing. Neurological: Mental Status: He is alert. Assessment/Plan Treatment included: albuterol, water and Acetaminophen Follow up response to treatment: Excellent Patient discharge: Stable to go home and follow up with PCP. Differential Diagnosis: Vaccine-Related Anxiety (include misc mental health) and Local reaction (arm pain, bleeding/bruising, mechanical irritation, localized rash) Symptoms developed just prior to patient leaving, started visit at 10:05 am, self administered albuterol at 10:10am. Self administered Acetaminophen 1,000 mg at 10:24 AM, Symptoms resolved and patient discharged around 10:30 AM. History of anxiety. Showed great relief of symptoms with use of his personal Albuterol inhaler and 1,000 mg of Acetaminophen (also his own). Symptoms completely subsided prior to discharge.

Other Meds:

Current Illness:

ID: 1006438
Sex: F
Age: 58
State: FL

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

Lab Data: none

Allergies: none

Symptoms: Increasing sore left deltoid. Muscle ache in bilateral lower extremities, chills, night sweats. Developed a rash at and just below injection site on 2/3/21.

Other Meds: Seretriline, Multi Vit, Vit D, Fish Oil, Thyroid, Trazadone, Hormone

Current Illness: GI upset, loose stools

ID: 1006439
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: 2/4/2021 330pm 22 hours post vaccine, sweat running down my neck and back, stomach cramps, felt like I could get diarrhea any minute, fever of 100.2, pounding headache 2/5/2021 1230am horrendous muscle cramps in my legs, back hurts so bad couldn't get out of bed 2/5/2021 11am felt dizzy and lightheaded, pounding headache came back

Other Meds: Trintellx, requip, nexium

Current Illness: None

ID: 1006440
Sex: U
Age: 22
State:

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

Lab Data:

Allergies: Eggs and coconuts

Symptoms: Got vaccine 02/02/21 starting feeling fatigued immediately 11am, around 5pm started feeling fever, at 7pm started having chills, fever and pain and keep getting worse, by 11pm or 12am fever was 102.6 with lower back pain and all muscles felt weak even with tylenol continued, 3-4 am started getting headache and fever starting going down after tylenol and pain reduced and chills stopped. Now pt contined tylenol and is feeling better tried eating breakfast almost passed out, does not have appetite

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm