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: 1006542
Sex: F
Age: 56
State: OH

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

Lab Data:

Allergies:

Symptoms: patient had an anaphylactic reaction to the second dose of covid vaccine and was given 2 Benadryl and 2 doses of epi pen before being take by EMS to hospital

Other Meds:

Current Illness:

ID: 1006543
Sex: F
Age: 36
State: KY

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

Lab Data:

Allergies:

Symptoms: Fever 103.5, whelp on injection site , migraine, muscle tightness in neck and back, soar throat, dry cough

Other Meds:

Current Illness:

ID: 1006544
Sex: M
Age: 52
State: MN

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

Lab Data: Pulse Ox 96-97; sx could be from active COVID; will continue enhanced monitoring while active case and afterwards

Allergies: nkda

Symptoms: COVID positive on 1/29 w/isolation through 2/6. Presented to mass vaccination event on 2/4 and denied being positive on entry and on screening. Upon documentation entry noticed pt was positive. Chart review also revealed recent dx of pneumonia. Enhanced ADR surveillance initiated w/Tele Health visit on 2/5. Pt reported slight cough, body aches, SOB, trouble sleeping, decreased appetite, and pain at injection site.

Other Meds: omeprazole, chlorthalidone, apap, kcl, z-pak, motrin

Current Illness: HTN, hyperlipidemia, GERD, nicotine dependence

ID: 1006545
Sex: F
Age: 40
State: NC

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

Lab Data:

Allergies:

Symptoms: Rough night. Fever, chills, headache, nausea. Started at about 11pm. Took some Aleve before bed then at 3 am too Tylenol and that helped more. Got up at 7 and came to work. Took more tylenol this AM, so other than a mild headache, doing fine.

Other Meds:

Current Illness:

ID: 1006546
Sex: F
Age: 35
State: PA

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

Lab Data:

Allergies:

Symptoms: Body aches, chills,fever,nausea, arm soreness/redness/swelling

Other Meds:

Current Illness:

ID: 1006547
Sex: M
Age: 75
State: CO

Vax Date: 01/28/2021
Onset Date: 01/29/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data: During emergency department encounter: CTA head/neck, MR brain: no acute intracranial abnormality, no evidence of large vessel occlusion or aneurysm, unchanged postsurgical changes consistent with prior surgeries in frontal lobe EEG: rhythmic activity that could be concerning for seizures Electrocardiogram: sinus tachycardia, left anterior block Chest x-ray: no evidence of pneumonia, effusion, or pneumothorax COVID-19 RNA: negative Blood lactate: within normal range Complete blood count: within normal ranges except hematocrit 50.8% Serum electrolytes: within normal ranges except carbon dioxide 20 mmol/L and creatinine 1.32 mg/dL Troponins: within normal ranges PT/INR: within normal ranges Blood glucose: within normal range

Allergies: prochlorperazine

Symptoms: Moderna COVID- 19 Vaccine EUA: the next morning after receiving vaccination patient woke and spouse reported patient had problems with balance, word finding, weakness, and potentially hit head and hip when fell getting out of bed. Patient experienced fever and body aches overnight. On arrival to the emergency department patient's vital signs were blood pressure 165/75 mmHg, pulse 107 beats per minute, repiratory rate 20 breaths per minute, temperature 38.3 degrees Celsius, and oxygen saturation 92%. Physical exam documented a well-appearing patient with mild difficulty with word finding. Cardiovascular, pulmonary, and abdominal exams were unremarkable. Neurological exam reports cranial nerves intact, strength and sensation to light touch normal in all extremities. Patient declined medications for fever and body aches. Patient observed and repeat vital signs within normal ranges except blood pressure 137/78 mmHg. Symptoms improved and patient was discharged with prescription for anti-epileptic medication and scheduled for follow-up visit with neurology clinic.

Other Meds: cholecalciferol, glucosamine-chondroitin, hydrocortisone, ketoconazole, melatonin, meltivitamin, omega-3 fatty acids, pramipexole, simvastatin

Current Illness: none reported

ID: 1006548
Sex: F
Age: 47
State: MA

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

Lab Data:

Allergies:

Symptoms: Body pain Diarrhoea Numbness of right arm Weak and tired

Other Meds:

Current Illness: Body pain Diarrhoea Numbness of right leg Weak and tired

ID: 1006550
Sex: F
Age: 37
State: MA

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

Lab Data: None

Allergies: None

Symptoms: Vasovagal syncope while walking after getting out of bed at night. This occurred approximately at the onset of chills/rigors.

Other Meds: None

Current Illness: None

ID: 1006551
Sex: F
Age: 54
State: NJ

Vax Date: 01/15/2021
Onset Date: 01/15/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data: Allergy test- blood work 1/21/21 Scope of throat 1/29/21

Allergies: None

Symptoms: About 10 min after vaccine felt fuzzy around my neck and alerted the vaccinator. I was exhorted to a curtained room where vitals were checked. I was given Benadryl 25mg and salumedrol IV. Before the 30 min mark I had tingling on the tip of my tongue and lips. I was monitored for 2+ hours and was sent home. The doctor prescribed 40mg prednisone for 4 days an Epipen, and antihistamines, recommended I see an allergist. I saw APN 1/18/21 after the tingling and throat tightness persisted, she prescribed a taper of the prednisone. Went to allergist 1/21/21 where we discussed continued symptoms and longer taper of prednisone and she asked me to call her 1/25/21. We spoke 1/25/21 and she recommended I see an ENT. Saw ENT on 1/29/21 who examined my throat with no concerns there. We discussed the ?burning mouth syndrome? symptoms and he recommended I return for medicated mouth wash if the symptoms continue. I am no longer taking any medication. I still have mild tingling on the lips and tongue, slight peppery feel/taste and occasional tightness at the base of my throat. We

Other Meds: 4000IU vitamin D per day

Current Illness: None

ID: 1006552
Sex: M
Age: 77
State: WA

Vax Date: 01/24/2021
Onset Date: 01/27/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data: Covid-19 test February 2nd. Results negative.

Allergies: None

Symptoms: Starting at day three after the vaccination, I experienced significant fatigue. I also have experienced significant and rather violet chills, shakes and teeth chattering. The fatigue lasts all day. The chills come on each afternoon and last for about an hour. My temperature is 101 to 103 during the event, but it is normal the rest of the day. The fatigue and chills continue through today.

Other Meds: None

Current Illness: None

ID: 1006553
Sex: F
Age: 52
State: NY

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

Lab Data:

Allergies: n/a

Symptoms: well I had sorness and red rash of small bumps around injection site Up to today I still feel soreness in my arm 1 week later

Other Meds: n/a

Current Illness: n/a

ID: 1006554
Sex: F
Age: 55
State: IA

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

Lab Data: n/a

Allergies: "evergreen" (environmental)

Symptoms: Pt developed tingling/numb feeling of lips, tongue felt "thick", feeling weird to swallow about 10 minutes after receiving vaccine. Felt dizzy/lightheaded, but attributes alot of this to increased dose of gabapentin, although it did seem worse than before. She was roomed in clinic and vitals monitored. She had no worsening symptoms and this sensation had resolved within approx 30 min.

Other Meds: Anastrozole 1 mg, cholecalciferol, gabapentin 100 mg, Tramadol, vitamin E

Current Illness: Unsure

ID: 1006555
Sex: M
Age: 36
State: KS

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

Lab Data: heat CT Scan Brain Bleed Blood Work

Allergies: Sulfa

Symptoms: Really Severe Headache , Pain at the injection site

Other Meds: None

Current Illness: None

ID: 1006556
Sex: F
Age: 90
State: SC

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

Lab Data: N/A

Allergies: Penicillin, Sulfa Antibiotics

Symptoms: Redness, swelling, pain and heat at injection site

Other Meds: Aspirin Tablet Chewable 81 MG Calmoseptine Ointment 0.44-20.6 % (Menthol-Zinc Oxide) Cholecalciferol Tablet 1000 UNIT Cyanocobalamin Tablet 1000 MCG Escitalopram Oxalate Tablet 5 MG GlycoLax Powder (Polyethylene Glycol 3350) Imodium A-D Ta

Current Illness: FRACTURE OF OTHER PARTS OF PELVIS, SUBSEQUENT ENCOUNTER FOR FRACTURE WITH ROUTINE HEALING

ID: 1006557
Sex: F
Age: 48
State: TX

Vax Date: 01/15/2021
Onset Date: 01/17/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data: NA

Allergies: Bactrim

Symptoms: Big red circle on arm around injections site. Spread longer on arm and became lighter in color over time. Cleared up after two weeks.

Other Meds: Janumet- prescribed, Women's One-A-Day and Aller-Zyr

Current Illness: none

ID: 1006558
Sex: F
Age: 52
State: IN

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

Lab Data: None

Allergies: Zyrtec, Flexaril

Symptoms: Itching at site, swelling, muscle pains, headache, fatigue, nausea, diarrhea, fever, joint pain, neck pain. I have been taking Tylenol.

Other Meds: Claritin, Flonase, Sertraline, Triamterene/hctz, ginger, garlic, multivitamins

Current Illness: None

ID: 1006559
Sex: F
Age: 42
State: VA

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

Lab Data:

Allergies: PCN, Latex, Ants, Eggs

Symptoms: Patient began experiencing hives on face after vaccine administration. Benadryl 50 mg PO administered. Patient monitored for 30 minutes after administration and hives resolved. No other adverse reactions observed or reported. Patient ambulatory from clinic.

Other Meds: Benadryl 50 mg PO administered during time of reaction

Current Illness:

ID: 1006560
Sex: M
Age: 92
State: CT

Vax Date: 01/28/2021
Onset Date: 01/29/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data:

Allergies: n/a

Symptoms: Woke up morning after vaccine injection with fever of 102? Did not immediately respond to Tylenol within first hour. By 12 noon, fever subsided Normal body temperature by 1pm.

Other Meds: Atorvastatin, Hydralazine, Metoprolol, Losartan, Furosemide, Finasteride, Myrbetriq

Current Illness:

ID: 1006561
Sex: M
Age: 65
State: MT

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

Lab Data: None.

Allergies: None known.

Symptoms: Moderna COVID- 19 Vaccine EUA There is no adverse event at this time. After the client left, it was discovered that he had a Shingrix on 01/20/2021, 13 days before the Moderna vaccination on 02/02/2021. He had told staff doing the scheduling the wrong date of the immunization. The client did call us today. He did not sign up for V-Safe. He is not having any side effects from the Moderna immunization.

Other Meds: Blood thinner.

Current Illness:

ID: 1006562
Sex: F
Age: 65
State: CA

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

Lab Data: None

Allergies: egg, codeine,lidocaine, penicillin

Symptoms: Patient receive COVID vaccine 1, went to observation area and "jerking upper and lower extremities" after sitting. Code Assist called, patient was hypertensive at 182/108, with saturations of 100% on RA. Was transported to Urgent Care in same facility. By that time, she was alert, appropriate, seemed to have a left facial droop. Secondary to apparent seizure and hypertension, decision to transport by 911 was made. Patient did leave the Urgent Care area with paramedics but later decided to go home instead. She spoke with her primary care provider today, 2/5/21.. At that time patient revealed that she was taking zonisamide but not keppra, as prescribed

Other Meds: aceamnophen, amlodpine, aspirin, atovastatin, carvedilol, cymbalta, dicofenac topical, folic acid, furosemide,zonisamide

Current Illness: report of seizure (known epilepsy) 2 weeks earlier

ID: 1006563
Sex: F
Age: 75
State: NC

Vax Date: 01/26/2021
Onset Date: 02/04/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data:

Allergies: no allergies

Symptoms: 9 days after the vaccine, both she and her daughter developed a red pruritic rash at the site of of injection. Fever and chills last night, February 4th. No shortness of breath. Cool compresses. Cephalexin. otc antihistamines. Go to ER of breathing affected. Follow up with primary care.

Other Meds: plaquinil and methotrexate

Current Illness: no

ID: 1006564
Sex: M
Age: 28
State: VA

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

Lab Data: none

Allergies: unknown

Symptoms: Dose given from partial vial that was under continuous refridgeration at temp of 42 degrees, greater than 6 hours after inital opening.

Other Meds: unknown

Current Illness: unknown

ID: 1006565
Sex: F
Age: 70
State: CA

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

Lab Data:

Allergies:

Symptoms: Dizzy when standing up, quickly felt better. BP 131/71 (pulse 65, O2 sat 98%), 106/56 (pulse 61, O2 sat 100%). Discharged to home.

Other Meds:

Current Illness:

ID: 1006566
Sex: F
Age: 77
State: NC

Vax Date: 01/15/2021
Onset Date: 01/17/2021
Rec V Date: 02/05/2021
Hospital: Y

Lab Data: CT brain 1/18 hypodensity in right basal ganglia. MRI brain 1/18 subacute infart in left external capsule; older ischemic changes right anterior limb internal capsule, right corona radiata and left corona radiata.

Allergies: codeine

Symptoms: unknown if it was moderna or pfizer. Vaccine administered elsewhere so details are not known to me. Pt received vaccine on Friday and was admitted to hospital Sunday 1/17 with CVA, right sided weakness.

Other Meds: fluoxetine 40mg 1 qd, gabapentin 300mg 2 tab tid, leflunomide 20mg 1 qd, ramipril 5mg 1 qd,

Current Illness: none

ID: 1006567
Sex: F
Age: 30
State: AZ

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

Lab Data:

Allergies: Nut products

Symptoms: Fever, headache, body ache - duration approx 18 hours, starting 12 hours after time of vaccination.

Other Meds: Zoloft (sertraline), Erinn (noretindrone)

Current Illness: N/A

ID: 1006568
Sex: M
Age: 47
State: NJ

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

Lab Data: Pt was seen in the emergency room.

Allergies: none

Symptoms: PT had a bloody nose, it resolved quickly, then had a funny sensation in the back of the neck.

Other Meds: none

Current Illness: none

ID: 1006569
Sex: F
Age: 64
State: WI

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

Lab Data:

Allergies: CodeineOther (See Comments) Gabapentin Latex, Natural RubberItching, Other (See Comments) Moderna Covid-19 Vaccine (Eua) [Covid-19 Vacc,mrna(moderna)-pf] Venom-waspSwelling MilkOther (See Comments)

Symptoms: Reports symptoms of severe body aches, migraine type headache, memory loss, nausea, slurred speech, dizziness and vomiting. Symptoms occurred towards the end of her shift on 2/2. Called in ill to work on 2/3. Got the COVID-19 Moderna vaccine on Monday. On Tuesday, symptoms occurred. As the afternoon progressed, things got worse. By 4 or 5 PM, had severe nausea and felt dizzy. Then started having trouble thinking. Then vomited and had her son pick her up from work. Didn't go into work yesterday due to symptoms. States that when son picked her up, she was slurring her speech. Co-workers said that she seemed as though she was confused. Son reported that she had difficulty with buckling her seat belt. Son reports that she feel to sleep in the car on the way home.Did not know if she had a fever. Woke up yesterday morning all clammy and wet. Did not remember what had happened at work on Tuesday afternoon or after her son picked her up. Her first memory was waking up on Wednesday morning. Had COVID back in May. Went into work today. Still feels a little nausea, but other symptoms have resolved.

Other Meds: Take 1,000 mg by mouth Every 8 (Eight) Hours As Needed for Pain. aspirin 81 MG EC tablet 1 capsule by mouth Daily . cholecalciferol (VITAMIN D3) 2,000 unit Cap Take 1.5 tablets by mouth Daily. ferrous sulfate 325 (65 FE) MG EC tablet T

Current Illness: Unknown

ID: 1006570
Sex: F
Age: 50
State: NC

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

Lab Data:

Allergies: Shellfish allergy

Symptoms: About 18 hours after vaccine, became very hot and felt odd. and fainted. At day 7 after vaccination, still have 2" of redness around perimeter of vaccination site. A little tender still but not bothersome.

Other Meds: None

Current Illness: None

ID: 1006571
Sex: M
Age: 76
State: IL

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

Lab Data:

Allergies: NKA

Symptoms: BELLS PALSY SYMPTOMS ON LEFT SIDE OF FACE . Start PredniSONE Tablet, 20 MG, 3 tablets, Orally, Once a day, 7 days, 21 Tablet, Refills 0 Start Valacyclovir HCl Tablet, 1 GM, 1 tablet, Orally, Three times a day, 7 days, 21 Tablet, Refills 0

Other Meds: NONE

Current Illness: Prostate cancer ,Coronary artery disease

ID: 1006572
Sex: F
Age: 32
State: WI

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

Lab Data:

Allergies:

Symptoms: Body aches, chills, headache, sweats, sore throat, arm redness, fatigue

Other Meds:

Current Illness:

ID: 1006573
Sex: F
Age: 68
State: CA

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

Lab Data:

Allergies: Mold, banana, tomato. NKDA

Symptoms: A few minutes after receiving the Moderna Covid vaccine, Patient reported a flushing feeling in her face along with tingling around her mouth. She was monitored by a RN closely. After five minutes, Patient reported a stiff feeling in her neck and tightening around her throat, as well as a scratchy feeling in her throat. The RN administered 0.3mg epinephrine IM and activated EMS. Patient was transported by ambulance to a local hospital, where she was treated with IV diphenhydramine, solu-medrol and fluids. Patient was discharged from hospital same-day. Patient reported itching and upper-body flushing again the next day (February 4) and was told to go back to the emergency department for evaluation by clinic staff. Treatment at this visit is unknown, but patient did discharge the same-day.

Other Meds: mirtazapine, melatonin, fluticasone, acyclovir, divalproex, albuterol, montelukast, vitamin D, levothyroxine, lithyronine, cyclobenzaprine, meloxicam, restasis,

Current Illness: Recent surgery (Mohs) on face, about one month prior to vaccine.

ID: 1006574
Sex: M
Age: 56
State: CA

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

Lab Data:

Allergies: Erythromycin

Symptoms: Fatigue, Headache, sore injection site as of 2/5/2021@1324 PST.

Other Meds: Lisinopril 20 MG Tab, Vitamin D3 1500 IU

Current Illness:

ID: 1006575
Sex: F
Age: 63
State: FL

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data: Saw provider who put her on antibiotics as above.

Allergies: Sulfa

Symptoms: On the next day had redness and swelling around the injection site. Painful to move the arm, but that subsided. Had a pretty big bump on her arm at the injection site. Still like that on Friday, 2 days later. Went to her internist and he put her on Zyrtec and Cortisone cream. She did that until it had nearly subsided which took about a week. She stopped this treatment, and then 24 hours after that it all returned worse. She took a picture and sent it to her internist which she saw yesterday, 2/4/21. He put her on an antibiotic and felt that it could be an infection at the injection site. He put her on Doxycycline. He told her to get the 2nd vaccine despite the side effects. States that she never felt any headache, nausea or internal side effects, just the symptoms at the injection site. He told her to continue with Zyrtec and Cortisone until the symptoms are gone.

Other Meds: AripiprSazole, Amphetamine salts ER, Escitalopram, Miralax, calcium.

Current Illness: None

ID: 1006576
Sex: F
Age: 43
State: IL

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

Lab Data: EKG - normal

Allergies: Allergy to Sulfa drug Dairy sensitivity - no dairy diet

Symptoms: Palpatations, increased heart rate (double normal resting heart rate), elevated blood pressure, dizziness, shaky, throat became increasingly sore, voice hoarse. Treated with 50 mg benedryl and saline IV drip after sitting in the ER waiting room for an hour+ Heart rate returned to 80-90 beats per within 90 minutes, dizziness subsided, throat returned to normal

Other Meds: N/A

Current Illness: N/A

Date Died: 01/31/2021

ID: 1006577
Sex: F
Age: 94
State:

Vax Date: 01/04/2021
Onset Date: 01/31/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Patient passed away within 60 days of receiving a COVID vaccine

Other Meds:

Current Illness:

ID: 1006578
Sex: M
Age: 79
State: TX

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

Lab Data: None

Allergies: None

Symptoms: Rash on lower back. Treated with Triamcinolone acetonide cream 0.1%.

Other Meds: Valsartin-HCTZ Pravastatin Vitamin D

Current Illness: None

ID: 1006579
Sex: M
Age: 92
State: AR

Vax Date: 12/29/2020
Onset Date: 02/04/2021
Rec V Date: 02/05/2021
Hospital: Y

Lab Data: Hyperglycemia w/ glucoses 400, no other abnl on labs/imaging.

Allergies: Dairy

Symptoms: Patient received dose 1 moderna 12/29/20, and dose 2 moderna 1/25/21. Admitted to hospital for fall, altered mental status, hyperglycemia on 2/4/21.

Other Meds: Gabapentin

Current Illness: Cellulitis of foot

ID: 1006581
Sex: F
Age: 60
State: KY

Vax Date: 12/29/2020
Onset Date: 12/30/2020
Rec V Date: 02/05/2021
Hospital:

Lab Data: n/a

Allergies: none

Symptoms: Larm at injection site swelled up and very red and painful for 4 days

Other Meds: multi vitamins, estrace, lexapro

Current Illness: none

ID: 1006582
Sex: M
Age: 46
State:

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

Lab Data:

Allergies:

Symptoms: First vaccine was Pfizer on 1-15-21 and 2nd dose was Moderna on 2-5-21

Other Meds:

Current Illness:

ID: 1006583
Sex: F
Age: 46
State:

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

Lab Data: Notable" potassium: 2.6 WBC: 13 LA: 6.3

Allergies: None

Symptoms: During the 15 minute observation period post-vaccination, patient was noted to have hives on her neck. Patient was taken to ER. Arrival Vital Signs were WNL. Patient c/o itching, erythema, swollen tongue, changed voice, breathing "a little tight". Epinephrine and DuoNeb ordered. Seizure like episode at 02.04.21 at 1240 BP 209/81, HR 111, RR 24, Pulse Ox 100% on 15% Non-rebreather mask, Rectal temp 98.4 ED MD wrote: "At approximately 12:40pm this afternoon the patient was having what appeared to be a seizure versus severe rigors. She was not verbally responsive and appeared to be apneic with her head shaking in her arms flailing rigidly in an up and down motion. Symptoms lasted approximately less than 2 minutes and patient was not postictal. She was not incontinent. Blood sugar is in the 180s and her rectal temp is normal. I believe this patient is having a severe reaction to her moderna vaccine that she received earlier today. Her 1st vaccine was January 7th and today was her 2nd vaccine for COVID." Teleneurology consult conducted, no documented recommendations. Patient was transferred to higher level of care.

Other Meds: Zyrtec 10mg oral tab 1 tab once a day citalopram 40mg oral tab 1 tab once a day amitriptyline 50mg oral tab 1 tab at bedtime losartan 50mg oral tab 1 tab once a day Symbicort 80-4.5mcg/actuation inhalation HFAA 2 puffs once a day albuterol

Current Illness: None

ID: 1006584
Sex: F
Age: 74
State: MN

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

Lab Data: None. Consulted with physician by phone and advised to lay down, rest, and take Tylenol.

Allergies: None

Symptoms: Numbness of lips and nose, upper back pain, light headedness, fatigue, soreness at injection site, and headache.

Other Meds: Sotalol Xarelto Atorvastain Premarin Vitamin D Low dose aspirin Tylenol (took today after vaccination)

Current Illness: None

ID: 1006585
Sex: M
Age: 35
State: MT

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

Lab Data:

Allergies: none

Symptoms: Member developed a rash, starting the evening after receiving the vaccine, first below his waist to his lower extremities,then to his upper torso the next morning. He reported having dizziness,eye irritation along with tongue tingling the following day, prompting a visit at a local walk in clinic. The member was treated with Benadryl which reportedly resolved his symptoms.

Other Meds: none

Current Illness: none

ID: 1006586
Sex: F
Age: 68
State: OH

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

Lab Data: BP 130/94mmhg, HR 70bpm

Allergies: NKA

Symptoms: c.o. "racing hear and the need to cough" approx. 10 mins after vaccine. feels it may have been from her excitement as she was added on to the clinic at the end of the day and rushed to facility. BP 130/94mmHg, HR 70bpm, no diaphoresis. A&O x3. felt better w/i few mins. husband accompanied her to appt and will drive her home. declined to go to ED. ambulated out w/o assistance.

Other Meds: Synthroid, Meloxicam, Losartan, Vitamin D, Omeprazole, Amlodipine, atorvastatin

Current Illness: none

ID: 1006587
Sex: F
Age: 45
State: AR

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

Lab Data:

Allergies:

Symptoms: Fever, Body aches, chills, fatigue, headache

Other Meds:

Current Illness:

ID: 1006588
Sex: F
Age: 28
State: WI

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

Lab Data:

Allergies:

Symptoms: Body Aches, chills, headache, light sensitivity, tired, nausea.

Other Meds:

Current Illness:

ID: 1006589
Sex: M
Age: 74
State: FL

Vax Date: 01/13/2021
Onset Date: 01/18/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: I received the two doses of the Pfizer COVID-19 vaccine. I was given the second dose (2/3/21) three weeks after the first dose (1/13/21). Some time after receiving the first dose, I noticed a subtle but definite strange feeling all around my mouth and tongue, like a "film" over everything. I also noticed a loss of taste. I suffered from anosmia and dysgeusia many years ago, but through medical intervention, I gained back over 90% of smell and 80% of taste. Now I've noticed more loss of taste again, and I don't think it's coincidence that it's happened while getting vaccinated. I just hope that I regain taste (which is only 45-50% now maybe) as time goes by.

Other Meds: Eliquis, 5 mg. (1 every 12 hrs.) Diltiazem, 120 mg. (1 in the a.m., 1 in the p.m.) Allopurinol, 300 mg. (1 a day) Theophylline ER Tab, 600 mg. (1 during breakfast) Theophylline ER Tab, 400 mg. (1 during dinner) Stiolto Respimat, 2.5 mcg/2.5

Current Illness: none

ID: 1006590
Sex: F
Age: 20
State: AR

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

Lab Data:

Allergies: penicillen

Symptoms: fever, body aches, chills, nausea, vomitting, headache

Other Meds: Birth control and probiotics

Current Illness:

ID: 1006591
Sex: F
Age: 69
State: IL

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

Lab Data: Blood pressure, oxygen levels, exam of throat And breathing passage manually. Observation 2 hrs after meds administered.

Allergies: Radioactive iodine

Symptoms: Face flush and hot Throat, chest burning Slight tightness in throat and chest Took Benadryl and Pepcid Burning went away before taking benedril in about 45 min. Flush face remained about 2 hrs after taking Benadryl. Tightness in chest subsided after taking Benadryl. Continuing with Benadryl every 6 hrs for 5 days, Pepcid 2x/ day 5 days.

Other Meds: Metroprolol succinate Amlodpine Levothyroxine

Current Illness: None

ID: 1006592
Sex: F
Age: 68
State: PA

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

Lab Data: Labs ordered today: CMP, lipid panel, TSH

Allergies: Morphine

Symptoms: Pt came into office today due to rash and lab work - noted by PCP to have petechial rash on injected arm from area of injection down to hand. pt reported this started about 1 day after injection and is present today when reported to PCP.

Other Meds: Vitamin D, Magnesium 250mg, fish oil, glucosamine, multivitamin.

Current Illness: N/A one month prior.

ID: 1006593
Sex: M
Age: 94
State: OH

Vax Date: 01/28/2021
Onset Date: 02/03/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data: Unkown

Allergies: Unknown

Symptoms: Client had some lumps in his throat. They were bothering him on 2/4/21. He did take some Tylenol and gargled with salt water but lumps were still there. He also complained of some chilling but stated that went away. His daughter took him to his primary care doctor on 2/4/21. He stated the doctor told him to continue taking the Tylenol, gargling, and encouraged him to keep walking. He is supposed to contact his PCP if needed.

Other Meds: Unknown

Current Illness: Unknown

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm