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: 1006694
Sex: F
Age: 64
State: NM

Vax Date: 01/30/2021
Onset Date: 02/03/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data: 1st dose Moderna on 01/03/2021 Lot O11L2OA 2dn dose Moderna on 01/30/2021 Lot O11M2O8

Allergies: Penicillin

Symptoms: Vault saliva test taken on 2/03/2021 results Positive. No symptoms

Other Meds: Atorvastatin 20 mg; Pioglitazone 30 mg 1/2 tab daily; Glyburide 5 mg; Calcium 500 mg/Vitamin D 200 unit tab

Current Illness: None

ID: 1006695
Sex: F
Age: 23
State: VT

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

Lab Data:

Allergies: Bee Sting

Symptoms: Pt returned to clinic after leaving the site and sitting in her car for 1-2 minutes. Per pt, she began to feel "itchy" in her right arm (vaccine administered in left) and returned to clinic c/o concern for allergic reaction. Pt initially presented to RN, who notified This RN for further assessment of the patient. Upon initial assessment, pt appeared anxious and was c/o itching in her bilateral arms, pressure and "tightness" in her chest. Approximately 3 in x 3 in area of erythema visualized to upper right arm, with 3 hives surrounding the area. No erythema visualized to vaccine site, however, 2 hives were visualized to right upper arm. No diffuse erythema or hives noted. Lungs CTA bilaterally, HR 76 w/palpation. Site Manager, and RN to pt's side. EMS contacted. This RN waited at pt's side for continued assessment while awaiting EMS. Electronically signed by RN at 2/5/2021 16:00

Other Meds: unknown

Current Illness:

ID: 1006696
Sex: F
Age: 29
State: CA

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

Lab Data: No

Allergies: No

Symptoms: 2/2/21; fever, body aches, chills, nausea, sore arm Patient is still very fatigues, but no fever

Other Meds: No

Current Illness: No

ID: 1006697
Sex: F
Age: 78
State: VA

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

Lab Data:

Allergies:

Symptoms: chest pain with throat irritation 1 day after receiving vaccine. no anaphylaxis. symptoms resolved.

Other Meds:

Current Illness:

ID: 1006698
Sex: F
Age: 76
State: CA

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

Lab Data: none

Allergies: none I'm aware of

Symptoms: 1. Very sore arm diminishing over 36 hours 2. diarrhea around 36 hours after 3. mildly lethargic for about 4-5 days 4. Mild headache for about a week. 5. after one week a large red, itchy, swollen area appeared at the injection sight (approx. 2" x 4") reduced over 12 hours to small area swollen and red at injection sight and that still exists 2 weeks later.

Other Meds: methamizole

Current Illness: none

ID: 1006699
Sex: F
Age: 54
State: TN

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

Lab Data: EKG normal 1/29/21 by EMS

Allergies:

Symptoms: Patient started to have chest pain, SOB, dizziness, and feeling as if tongue were swelling 5 minutes after receiving 1st Moderna dose.

Other Meds:

Current Illness:

ID: 1006700
Sex: M
Age: 39
State: WI

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

Lab Data:

Allergies:

Symptoms: FEVER, CHILLS, MUSCLE PAIN

Other Meds:

Current Illness:

ID: 1006701
Sex: M
Age: 76
State: GA

Vax Date: 01/23/2021
Onset Date: 01/25/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data:

Allergies: NKDA

Symptoms: Beginning approximately 72 hours after receiving his first dose of the Moderna, he noted redness around the injection site of the left arm. He said the area felt warm to the touch and was slightly itchy. This lasted for 3-4 days before it resolved on its own without treatment. Today (13 days post vaccination) he noted the rash on the left arm return but it was fainter than when it first came up around 72 hours after vaccination. He states the area today is 3.5 inches by 1.5 inches in size on the left arm only. He denies other symptoms or changes in skin care routine.

Other Meds: clopidogrel, doxazosin, atorvastatin, vasepa, amlodipine, HCTZ, pantoprazole, docusate, fluticasone (intranasal)

Current Illness: None

ID: 1006702
Sex: F
Age: 71
State: NC

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

Lab Data: none

Allergies: none

Symptoms: chills, fever, headache, body aches, dizzy,

Other Meds: probiotic, esomeprazole 20mg, levothyroxine

Current Illness: none

ID: 1006703
Sex: F
Age: 72
State: VA

Vax Date: 01/28/2021
Onset Date: 01/31/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data:

Allergies: Macrobid;Oxycodone

Symptoms: I had no side effects from the vaccine, but 2 days later I started getting a severe pain in my right groin area that spread to the left side also by the next day. The pain was severe and I wasn't able to walk for two days and even now, 9 days later, it still is giving me some pain. I don't remember hurting myself and I have no idea if the vaccine has anything to do with what happened, but I was told to report it . I called my healthcare provider and they told me to call the health dept and the health dept told me to go online and fill out this form.

Other Meds: Lumigan eye drops for glaucoma

Current Illness: none

ID: 1006704
Sex: F
Age: 51
State:

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

Lab Data:

Allergies:

Symptoms: fatigue, headache achy

Other Meds:

Current Illness:

ID: 1006705
Sex: F
Age: 92
State: NE

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

Lab Data: EKG, IV lopressor, digoxin, cardiac monitoring, cardiology consult and amiodarone drip---all on 2/5/21

Allergies: berries, cipro, levofloxacin, macrobid, strawberries, penicillin, sulfa, nickel

Symptoms: Present to ED for chest pain, nausea, chest heaviness, mild headache and slight SOB with lower extremity swelling, Hospitalized starting today 2/5. EKG shows Afib with RVR (new oneset). Still in hospital at this time

Other Meds: Vitamin C, Mirabegron, loratadine, methenamine, tylenol, glimeiride, vitamin d, levothyroxine, chydrochlorothiaide, valsartan, bisoprolol, zetia, aspirin, bacillus coagulans

Current Illness: UTI, pancytopenia

ID: 1006706
Sex: M
Age:
State: AZ

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

Lab Data: N/A

Allergies: none

Symptoms: Vomiting and chest pain. Patient was transported to ED

Other Meds: none

Current Illness: Hypertension

ID: 1006707
Sex: M
Age: 75
State: KS

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

Lab Data: Neurology consult

Allergies: none

Symptoms: On January 22nd to at 9:27 a.m. He received the Pfizer Covid-19 vaccine in his right arm. By 3:00 p.m. That day he had soreness at the injection site and by 10:00 p.m. he noticed difficulty using his arms to the transfer. There was particular difficulty with the proximal left upper extremity and bracing himself and he fell to the floor. He feels that both arms are weaker since the injection. He had some pain in the arms particularly at the injection site initially but that has resolved. He had dry mouth up until February 2nd. By February 2nd he could start to transfer a bit better from a chair to his driver seat in the van. He is still not back to his baseline function.

Other Meds: Aspirin, atenolol, atorvastatin, empagliflozin, multivitamin, gabapentin, Norco, losartan, omeprazole, sildenafil, Flomax, zolpidem

Current Illness:

ID: 1006708
Sex: F
Age: 53
State: VA

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

Lab Data: None

Allergies: Bactrim

Symptoms: Slightly itchy and painful generalized rash around my entire torso and up my neck. Some itchiness in my limbs but no visible rash. Pt took Benadryl 25mg PO without any relief. 5 Feb: rash is spreading around chest area lower abdomen and around back side. No reports of dyspnea.

Other Meds: Welbutrin, Nexium, Trazadone, Collace, Singulair, Breo

Current Illness: None

ID: 1006709
Sex: F
Age: 30
State: IL

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

Lab Data:

Allergies:

Symptoms: Pain in back of neck left side. Comes and goes. Able to move neck around.

Other Meds:

Current Illness:

ID: 1006710
Sex: F
Age: 79
State: IN

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

Lab Data: None

Allergies: Augmentin Morphine Statins Zyrtec

Symptoms: Severe headache 4 hours after shot, generalized muscle weakness all over 12-15 hours after shot (felt paralyzed), fever (100.5) 12-15 hours after shot, nausea and moderate abdominal cramping morning after shot, extreme fatigue for 1 week following shot

Other Meds: Amlodipine 10 mg once a day Vitamin C 500 mg once a day Biotin 10000 mcg once a day Buspirone 10 mg twice a day Calcium 500 + D 500 mg once a day Centrum Silver once a day Clonazepam 0.5 mg twice a day Donepezil 10 mg once a day Gabapentin

Current Illness: Diarrhea- ? Colitis

ID: 1006711
Sex: F
Age: 75
State: UT

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

Lab Data: No

Allergies: none known

Symptoms: 1am this morning chills, later 6am tried to get up severe chills, nausea, very dizzy, and joint pain. Husband laid her down on the floor for about 15-20 minutes, also extremely weak. By 8am symptoms lifted slightly and was able to rest most of the day.

Other Meds: Estoril, Tylenol,

Current Illness: no

ID: 1006712
Sex: F
Age: 35
State:

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

Lab Data:

Allergies:

Symptoms: chest tightness, rash on neck/chest with itchiness

Other Meds:

Current Illness:

ID: 1006713
Sex: F
Age: 19
State: PA

Vax Date: 01/30/2021
Onset Date: 02/03/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data:

Allergies: NKA

Symptoms: Swelled lymph nodes in left neck and left axilla. Treatment-PCP notified. naproxen for discomfort and warm compresses applied to sites. Nodes still swelled, not as painful on 2/5/2021

Other Meds: Atenolol 25 mg daily. Effexor 75 mg daily

Current Illness:

ID: 1006714
Sex: F
Age: 76
State: NY

Vax Date: 01/20/2021
Onset Date: 02/04/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data: NA

Allergies: FISH, ERYTHROMYCIN

Symptoms: DELAYED INJECTION REACTION :RASH/WARM /RED

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1006715
Sex: F
Age: 73
State: IL

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

Lab Data: none

Allergies: lidocaine

Symptoms: severe dizziness, followed by vomiting, continued dizziness for several hours

Other Meds: none

Current Illness: none except fluid in ears

ID: 1006716
Sex: F
Age: 19
State:

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

Lab Data:

Allergies:

Symptoms: sore arm, achy

Other Meds:

Current Illness:

ID: 1006717
Sex: F
Age: 36
State: VA

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

Lab Data:

Allergies: Amoxicillin, Cantaloupe, tree allergies

Symptoms: Cough- but the type of cough is not uncommon for me due to allergies Puffy eyes/face started around 2:30-3pm Tight throat, felt restricted started around 3:30pm Took Benadryl at 4:30pm Went to Urgent Care at 5:30pm Took Prednisone at urgent care Got a prescription to continue prednisone for the next two days & an epi pen to have at home in case it was needed

Other Meds: Adderall, Magnesium, multi vitamin *taken the day/night before

Current Illness:

ID: 1006718
Sex: F
Age: 41
State: CA

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

Lab Data:

Allergies:

Symptoms: Headache chills coughing this is still going on since the 25th of January.

Other Meds:

Current Illness:

ID: 1006719
Sex: F
Age: 46
State: MI

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

Lab Data: I haven?t gone to the doctor but I did a teledoc appt. He said although it seems long since I had gotten better and symptoms returned it?s just taking my body time to process it.

Allergies: None

Symptoms: I have a metallic taste in my mouth and my arm still looks like covid arm and it?s been 2 weeks. It?s still warm to the touch

Other Meds: Metformin, glizpide, ashwiganda, sunflower adrenal support

Current Illness: None

ID: 1006720
Sex: F
Age: 25
State: IN

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

Lab Data:

Allergies:

Symptoms: Low grade fever, muscle aches in lower back and legs, fatigue experienced less than 24 hours after time of vaccination, worsening throughout the day. Marked improvement by 30 hours post-injection - only arm soreness and lack of mobility in arm experienced at that time. Recovered fully approximately 72-96 hours later.

Other Meds:

Current Illness:

ID: 1006721
Sex: F
Age: 44
State: NC

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

Lab Data: Troponin, CBC, CMP, Lipase, BNP, Chest XRAY, CTA Chest to rule out PE, EKG's

Allergies: Sulfa, Codeine

Symptoms: It began with right arm soreness and progressed to aches and low grade fever within the first 24 hours. Then it moved on to mid-sternal chest pain that radiated to my back and I had shortness of breath that increased with deep breathing after about 48 hours.

Other Meds: Losartan, Hydrochlorthiazide, Metoprolol, Protonix, Neurontin, Nortrel, Magnesium, Tylenol, Motrin, Vitamin D

Current Illness: I had my normal post COVID S&S but was not ill otherwise that I know prior to injection.

ID: 1006722
Sex: F
Age: 87
State: CA

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

Lab Data:

Allergies: None

Symptoms: Abdominal pain and discomfort (pain level 0-10=10) nausea and vomiting. Calling doctor for advice.

Other Meds: Cozaar, Levothroid, Simvistatin, glipizide, vitamins

Current Illness: None

ID: 1006723
Sex: M
Age: 79
State: FL

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

Lab Data:

Allergies: None

Symptoms: Patients wife, noticed a red and slightly swollen, slightly warm spot on Patients right arm this morning around 9am. located in the spot where he received his shot. He did not complain of discomfort. He did not not complain of being tired. We do not know when it first appeared. It was not there the first few days, then we quit checking. As of now, 5pm, it seems less red than earlier today.

Other Meds: tamsulosin 0.4mg; finasteride 5mg; multivitamin 50+; Vit C 1000mg; Vit D3 5000IU; Docusate sodium 100 mg; Ca 300mg/Mg 150mg/ Zc 5mg/ D3 200IU

Current Illness: none

ID: 1006724
Sex: F
Age: 73
State: CA

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

Lab Data: none

Allergies: Tetanus horse-toxin (1950s), Codeine, Compazine

Symptoms: Extreme chills 3 hours. Used weighted blankets; achieved slow warm up and chills stopped Elevated temperature 101.8 - 100.8 -- Days 2- 4 in evenings after normal temp all days.- Took acetaminophen. Brain fog , physical clumsiness of movements.

Other Meds: Verapamil, Synthroid, Carvedio, Ramipril, Atorvastatin, Elavil

Current Illness: none

ID: 1006725
Sex: M
Age: 38
State: AZ

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

Lab Data:

Allergies:

Symptoms: Allergic reaction, including tingling sensation on tongue and cheek that lasted 24 hours, reddening of the face that lasted for three days, and itchy feeling on head for three days.

Other Meds:

Current Illness:

ID: 1006726
Sex: F
Age: 51
State: NM

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

Lab Data:

Allergies:

Symptoms: nausea, SOB, tachycardia, gave epi injection and oxygen with non-rebreather, EMS took pt to ER

Other Meds:

Current Illness:

ID: 1006727
Sex: F
Age: 40
State: NY

Vax Date: 12/18/2020
Onset Date: 12/19/2020
Rec V Date: 02/05/2021
Hospital:

Lab Data: None

Allergies: penicillin

Symptoms: With the 1st dose I had myalgia, arthralgia and pain at the injection site which began the next morning when I woke up at around 10:00 am and lasted 48 hours. For the 2nd dose, the reaction was more profound. I had pain at the injection site within 6 hours of the injection and by the next day around 11:00 am I woke up with myalgia, arthralgia, fever of 101.2 F, fatigue, headache, and sore throat. Symptoms lasted for 4 days and I missed 2 days of work.

Other Meds: gabapentin, amitriptyline, tylenol

Current Illness: None

ID: 1006728
Sex: F
Age: 68
State: TX

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

Lab Data: None

Allergies: Penicillin, codeine

Symptoms: Headache, sore throat, fatigue, low grade fever, small rash on face.

Other Meds: Insulin, Synthroid

Current Illness: None

ID: 1006729
Sex: F
Age: 63
State: GA

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

Lab Data:

Allergies: unknown

Symptoms: "Pfizer-Bio-Tech COVID-19 Vaccine EUA" ??????????????????Individual came in Clinic for 2 nd dose of Covid-19 Vaccine. When individual was asked if this is visit for the second dose of Pfizer vaccine she said yes. She did not have her vaccination card for the first dose on hand. Her vaccine card was misplaced. I give the Pfizer vaccine then proceeded to complete the client vaccine card. I went to computer to get the 1 st information that is when I noticed she had received Moderna as the 1st dose. Patient did not report any reaction to the vaccine during her 30-minute wait period.

Other Meds: unknown

Current Illness: unknown

ID: 1006730
Sex: M
Age: 41
State: NJ

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

Lab Data:

Allergies: Seasonal allergies

Symptoms: Cold sore inside part of lip, single angiodema type rash/hive on outside part of lip directly opposite cold sore, elevated resting heart rate at 95-105 (normal 71-80

Other Meds: Atorvastatin

Current Illness: N/A

ID: 1006731
Sex: F
Age: 87
State: FL

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

Lab Data: None

Allergies: Latex, contrast dye

Symptoms: Huge red mark on right arm below the vaccination. Began small the next day, has been getting worse every day since. Now, a WEEK later it is even larger, painful and have even begun to get better. (I have pics from Monday and again today.) She had a fever that did go away the next day. She totally lost her appetite for 5 days and would barely drink anything at all.

Other Meds: Citalopram, 81 mg aspirin

Current Illness: Alzheimer?s, vascular dementia, kidney disease

ID: 1006732
Sex: F
Age: 44
State: AK

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

Lab Data: None.

Allergies: no known

Symptoms: 1/30 08:00 Severe chills, weakness, fever. Slept for approx. 10 hrs. Symptoms began to ease in the evening with full recovery to baseline 1/31. 2/1 05:00 Upon waking, I noticed I could feel cold sores beginning on my lips. I occasionally experience A SINGLE cold sore after extreme exposure to elements, but not usually after illness. This morning I could feel MANY cold sore forming on my lips (top and bottom) as well as insides of my cheeks and gums. I can count at least 15 different sores that all came on simultaneously. Treating sores as usual with frankincense and balm to reduce cracking and bleeding. Sores taking usual clinical course, not healed yet.

Other Meds: Avastin q 3wks, Lynparza qd, letrozole qd, omeprazole qd, Vitamin D qd, ibuprofen qd, Excedrin Migraine prn, Zofran prn, Ocrevus q 6mo, meclizine prn

Current Illness:

ID: 1006733
Sex: F
Age: 41
State: OR

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

Lab Data: Labs, nothing significant. My Vitamin D level was low.

Allergies:

Symptoms: I felt like I was about to pass out within 10 minutes. I stood up and continued to feel like I was about to pass out. I felt more comfortable staying at work where I could get immediate help. I had an extreme case of brain fog. That lasted about 3 hours. I started to have the feeling that you get when your limb is asleep. On day 4, I started to exhibit the symptoms again. I felt like I do when I have thyroid issues, so I went to see my endocrinologist, but he didn't do anything. I did have labs done. I started having blood pressure increases as well. I haven't been able to work out like usual since the vaccine and my sleep has been very poor. I wake up in the middle of the night and am unable to go back to sleep. I am now on heart medication, which is what I was taking previously for thyroid flare ups. I go back to see my endocrinologist in March.

Other Meds: Probiotic and magnesium tablet

Current Illness: Ear infection a couple weeks before vaccination

ID: 1006734
Sex: F
Age: 70
State: NC

Vax Date: 01/20/2021
Onset Date: 01/23/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data: Dr. visual exam

Allergies: n/a

Symptoms: Shingles, Top of left shoulder up into hairline on left side of head, behind ear steriod injection and antiboitic RX

Other Meds: losortan 50mg

Current Illness: n/a

ID: 1006735
Sex: M
Age: 41
State: CA

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

Lab Data: N/A

Allergies: nickel

Symptoms: anaphylactic shock

Other Meds: carbamazepine, Pepcid

Current Illness: N/A

ID: 1006736
Sex: F
Age: 57
State: AZ

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

Lab Data: None

Allergies: Vancomycin - Rash Aspirin - Bronchospasm Bactrim - Headache

Symptoms: Patient developed chest tightness, palpitations, and SOB approximately 8 min after vaccination. At 12min post-vaccination patient developed throat tightness/itching. 0.3mL epinephrine auto-injector was administered at the vaccination site and the patient was transported to the emergency department for further treatment. Patient reported epinephrine made her symptoms worse. Emergency Department provider diagnoses symptoms as anxiety and gave a dose of lorazepam which improved the patient's condition. The patient was discharged from the ED after being monitored for 4 hours with improvement in symptoms. No further treatment was given.

Other Meds: None

Current Illness: None

ID: 1006737
Sex: M
Age: 87
State: GA

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

Lab Data: n/a

Allergies:

Symptoms: Injection given too early. First dose administered 1/25/21; second dose administered 2/5/2021

Other Meds:

Current Illness:

ID: 1006738
Sex: F
Age: 60
State: MI

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

Lab Data: N/a

Allergies: Tomatoes, salmon Penacillion

Symptoms: Fever, lethargic, Headache 6 days later, swelling and large red rash on arm and face. Mild throat swelling or irritation

Other Meds: Advair 500 Singulair Hydro

Current Illness: None

ID: 1006739
Sex: F
Age: 56
State: FL

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

Lab Data:

Allergies: None

Symptoms: Body aches, headache, nausea, sore injection site.

Other Meds: Amalodipine, lasix

Current Illness: None

ID: 1006740
Sex: F
Age: 38
State: CA

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

Lab Data: Component 1/28/2021 NA 139 K 3.4 (L) CL 105 CO2 19 (L) ANION GAP4 SERPL 15 BUN 11 GLUC 126 CREAT 0.65 GFR NONAFR AMER >60 GFR-AFRAM >60 COMMENT, GLOMERULAR FILTRATION RATE SEE NOTE WBC 8.1 RBC'S 4.46 HGB 12.4 HCT 38.0 MCV 85 RDW, RBC 13.4 PLT 279 DIFF PANEL AUTO DIF NEUTROPHILS % AUTO 40 (L) LYMPHS % AUTO 49 (H) MONOS % AUTO 8 EOS % AUTO 1 BASO'S % AUTO 1 ANC 3.3 TRYPTASE, SERPLAS QN 3.8

Allergies: benadryl, codeine, dilaudid, vicodin, pineapple

Symptoms: Patient received her second dose of Moderna COVID-19 vaccine on 1/28/21 at 11:39AM. Patient took cetirizine 30 mg the night prior to her dose and cetirizine 20 mg the morning before her dose. At 11:44 AM patient reported symptoms of pruritus, nausea, dry heaving, elevated respiratory rate and feeling hot. Patient was given pepcid, additional cetirizine 10 mg and zofran. She was brought to the ED, reported feeling sob, numbness and tingling in her bilateral hands and feet. No rash but itching. Given epinephrine IM and Solumedrol with good response. Discharged to home on prednisone, zyrtec, pepcid and epipen. At home she felt well the first night. Next night she woke up with fever 103.2F. Took Tylenol. Temperature was 101F for next 2 days, controlled with Tylenol. Also diarrhea x 2 days.

Other Meds: zyrtec, trazodone, protonix

Current Illness: n/a

ID: 1006741
Sex: F
Age: 66
State:

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

Lab Data:

Allergies:

Symptoms: PHANTOSMIA, CHILLS, HEADACHE, BODY ACHES

Other Meds:

Current Illness:

ID: 1006742
Sex: F
Age: 66
State: TX

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

Lab Data:

Allergies: peanuts and peanut oil

Symptoms: 1/27 noticed redness at site, later that day noticed redness was spreading down arm and was about 3 inches long. Called 24 hour nurse line and was advised to get some hydrocortisone cream. Started cream on 1/28, was cleared up on 1/31. 2/4 arm started itching and later that evening noticed redness had returned. 2/5 called and got doctor appointment. Was advised to continue cream thru weekend and if did not get better begin medrol pak.

Other Meds: premarin cream, atorvastatin 10 mg, latanoprost drops daily, vitamin D3, prolia injections - every 6 months, calcium 1,200, B12,

Current Illness:

ID: 1006743
Sex: F
Age: 39
State: IN

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

Lab Data: None

Allergies: None

Symptoms: After the first injection there was a localized reaction. After the second vaccine at about 3am I experienced severe chills, fever, body aches and fatigue. I took Tylenol 500mg,2 tabs every 4 hours .

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm