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: 1007147
Sex: F
Age: 50
State: WA

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

Lab Data:

Allergies: Codiene, Benedryl Mushrooms, milk Latex

Symptoms: Broke out in Hives even inside mouth, ears & nose. Itch every where from head to toe

Other Meds: Pain meds - Oxycodone, Baclofen Vitamin D, Zrytecs allergy meds

Current Illness:

ID: 1007148
Sex: F
Age: 71
State: FL

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

Lab Data: None

Allergies: Penicillin

Symptoms: Rash on left arm where shot was given

Other Meds: Simvastatin Ezetimibe Escitotalopram Low dose aspirin Areds 2 Blink

Current Illness: NA

ID: 1007149
Sex: F
Age: 33
State: CA

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

Lab Data: Saw PA. No labs. Prescribed benadryl and over the counter pill for the itching.

Allergies: prednisone, shellfish

Symptoms: Patient experienced dizziness following administration of the COVID vaccine. She states she woke up and found it hard to lift her arm. She said the arm was pained. She stated she was

Other Meds: no meds were taken

Current Illness: cold during the month

ID: 1007150
Sex: F
Age: 57
State: FL

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

Lab Data: PT STATED DEVELOPMENT OF ITCHING ALL OVER LEGS AND BACK. AFTER RECEIVING THE VACCINE. PRESENTED TO URGENT CARE FOR TREATMENT AT 10:30 AM Office Visit 2/5/2021 Urgent Care Main Family Medicine Allergic reaction to drug, initial encounter Dx Respiratory Distress , itching all over Reason for Visit Progress Notes Expand All Collapse All Subjective Patient ID: 57 year old female. Patient had second Covid vaccination today, afterwards she developed itching all over the body, mostly on the legs and on the back skin, also feels mildly short of breath, She had first Covid vaccine and did not had any allergic reaction, Modifying factors worse after the vaccine shot, Symptoms have been persistent. Prior h/o similar complain- not sure, may be No new pets/soap/detergents/cream This is a new problem to me. Review of Systems With the exception of pertinent +/- in the HPI above, a complete review of systems was reviewed and are negative. Constitutional: Negative for fever, weight loss, malaise/fatigue and diaphoresis. HENT: Negative for nosebleeds, congestion, sore throat and ear discharge. Eyes: Negative for blurred vision, double vision, photophobia, pain, discharge and redness. Respiratory: Negative for cough, hemoptysis Cardiovascular: Negative for chest pain and palpitations. Gastrointestinal: Negative for heartburn, nausea and vomiting. Genitourinary: Negative for dysuria, urgency, frequency and hematuria. Musculoskeletal: Negative for myalgias, joint pain and falls. Neurological: Negative The following have been updated as appropriate in this visit:- Tobacco | Allergies | Meds | Problems | Med Hx | Surg Hx | The following have been reviewed- Medical History History reviewed. No pertinent past medical history. has a current medication list which includes the following prescription(s): aspirin, atorvastatin, clopidogrel, diltiazem, furosemide, metformin, and triamcinolone. No family history on file. Social History Socioeconomic History ? Marital status: Not on file Spouse name: Not on file ? Number of children: Not on file ? Years of education: Not on file ? Highest education level: Not on file Occupational History ? Not on file Social Needs ? Financial resource strain: Not on file ? Food insecurity Worry: Not on file Inability: Not on file ? Transportation needs Medical: Not on file Non-medical: Not on file Tobacco Use ? Smoking status: Current Every Day Smoker ? Smokeless tobacco: Never Used Substance and Sexual Activity ? Alcohol use: Not on file ? Drug use: Not on file ? Sexual activity: Not on file Lifestyle ? Physical activity Days per week: Not on file Minutes per session: Not on file ? Stress: Not on file Relationships ? Social connections Talks on phone: Not on file Gets together: Not on file Attends religious service: Not on file Active member of club or organization: Not on file Attends meetings of clubs or organizations: Not on file Relationship status: Not on file ? Intimate partner violence Fear of current or e

Allergies: TRAMADOL PENICILLIN LYRICA AMITRIPTYLINE CINOBAC

Symptoms: PT STATED DEVELOPMENT OF ITCHING ALL OVER LEGS AND BACK. AFTER RECEIVING THE VACCINE. PRESENTED TO URGENT CARE FOR TREATMENT AT 10:30 AM Office Visit 2/5/2021 Urgent Care Main Family Medicine Allergic reaction to drug, initial encounter Dx Respiratory Distress , itching all over Reason for Visit Progress Notes Expand All Collapse All Subjective Patient ID: 57 year old female. Patient had second Covid vaccination today, afterwards she developed itching all over the body, mostly on the legs and on the back skin, also feels mildly short of breath, She had first Covid vaccine and did not had any allergic reaction, Modifying factors worse after the vaccine shot, Symptoms have been persistent. Prior h/o similar complain- not sure, may be No new pets/soap/detergents/cream This is a new problem to me. Review of Systems With the exception of pertinent +/- in the HPI above, a complete review of systems was reviewed and are negative. Constitutional: Negative for fever, weight loss, malaise/fatigue and diaphoresis. HENT: Negative for nosebleeds, congestion, sore throat and ear discharge. Eyes: Negative for blurred vision, double vision, photophobia, pain, discharge and redness. Respiratory: Negative for cough, hemoptysis Cardiovascular: Negative for chest pain and palpitations. Gastrointestinal: Negative for heartburn, nausea and vomiting. Genitourinary: Negative for dysuria, urgency, frequency and hematuria. Musculoskeletal: Negative for myalgias, joint pain and falls. Neurological: Negative The following have been updated as appropriate in this visit:- Tobacco | Allergies | Meds | Problems | Med Hx | Surg Hx | The following have been reviewed- Medical History History reviewed. No pertinent past medical history. has a current medication list which includes the following prescription(s): aspirin, atorvastatin, clopidogrel, diltiazem, furosemide, metformin, and triamcinolone. No family history on file. Social History Socioeconomic History ? Marital status: Not on file Spouse name: Not on file ? Number of children: Not on file ? Years of education: Not on file ? Highest education level: Not on file Occupational History ? Not on file Social Needs ? Financial resource strain: Not on file ? Food insecurity Worry: Not on file Inability: Not on file ? Transportation needs Medical: Not on file Non-medical: Not on file Tobacco Use ? Smoking status: Current Every Day Smoker ? Smokeless tobacco: Never Used Substance and Sexual Activity ? Alcohol use: Not on file ? Drug use: Not on file ? Sexual activity: Not on file Lifestyle ? Physical activity Days per week: Not on file Minutes per session: Not on file ? Stress: Not on file Relationships ? Social connections Talks on phone: Not on file Gets together: Not on file Attends religious service: Not on file Active member of club or organization: Not on file Attends meetings of clubs or organizations: Not on file Relationship status: Not on file ? Intimate partner violence Fear of current or ex partner: Not on file Emotionally abused: Not on file Physically abused: Not on file Forced sexual activity: Not on file Other Topics Concern ? Not on file Social History Narrative ? Not on file Objective BP (!) 133/84 | Pulse 80 | Temp 97.1 ?F | Resp (!) 22 | Ht 5' 4.8" (1.646 m) | Wt 169 lb (76.7 kg) | SpO2 99% | BMI 28.30 kg/m? Constitutional: oriented to person, place, and time. well-developed, well-nourished and in no distress. HENT: Head: Normocephalic. Eyes: Pupils are equal, round, and reactive to light. Neck: Normal range of motion. No tracheal deviation present. Ear- Normal Mouth- Tongue, uvula- Normal, No oral rash Cardiovascular: Normal rate, regular rhythm and normal heart sounds. Exam reveals no gallop and no friction rub. No murmur heard. Pulmonary/Chest: Effort normal and breath sounds normal. NO W/R/R, noticed to be breathing fast, Abdominal: Soft. There is no tenderness. S/NT/ND Musculoskeletal: No edema and no tenderness. Lymphadenopathy: has no cervical adenopathy. Neurological: Neurological: Pt displays no motor weakness, no tremor, normal facial symmetry, and normal speech. Psychiatric: Affect normal. Skin, noticed erythematous skin all over the body, with rash mostly noted on the legs, on the trunk, also on the arm Impression/Plan Patient was seen today for respiratory distress and itching all over. Diagnoses and all orders for this visit: Allergic reaction to drug, initial encounter - Sodium Chloride 0.9% infusion 1,000 mL - famotidine (PEPCID) injection 20 mg - diphenhydrAMINE (BENADRYL) injection 25 mg - albuterol 2.5 mg /3 mL (0.083 %) nebulizer solution 2.5 mg - ipratropium (ATROVENT) 0.02 % nebulizer solution 0.5 mg - methylPREDNISolone sod suc(PF) recon soln 125 mg Other orders - triamcinolone (KENALOG) 0.5 % ointment; Apply topically 2 (two) times a day. Patient evaluated and worked up for over 50-minute during urgent care visit. Time was spent was for preparing to see the patient by reviewing patient's medical history and previous test results,directly obtaining information regarding today's encounter, evaluating the patient, performing an examination, communicating test results, placing orders. Patient was seen second time and discussed the finding of lab results and assessment plan is discussed in detail. Patient was put on the monitor chair, given IV fluid with Benadryl and Pepcid, also given DuoNeb treatment, watched for over 60-minute, patient felt better but continues to have itching on the skin, also has mild redness, symptoms had improved, but still had itching all over, Therefore Solu-Medrol was given, Breathing improved, patient did not had any shortness of breath, Discharged home on Claritin, Benadryl, Pepcid, New patient complain to me Symptoms improved treatment here, Stable at d/c- no SOB/Wheezing, No throat swelling, Cool compresses to the skin will help. Claritin or Zyrtec once a day Benadryl 25-50 mg every 8 hours for 1st day & then as needed If the symptoms flare again,go to Nearest emergency STAT Reviewed prior labs, diagnostic test & prior visit notes. Reviewed current medication and management planned considering current prescription/meds. Please note this clinic note was performed utilizing voice recognition software. Due to the natural inherent tendency of voice recognition software there may be grammatical errors inadvertently enclosed that do not reflect the nature of the visit. For worsening of symptoms, Patient is instructed to return sooner either to ER or urgent care/PCP. Patient is instructed to follow up in 1-2 weeks with PCP I have educated patient on supportive care therapy. Patient agreed with plan and voiced understanding. No barriers to adherence perceived by myself. Department of Urgent Care

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1007151
Sex: F
Age: 34
State: MN

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

Lab Data:

Allergies:

Symptoms: body aches

Other Meds:

Current Illness:

ID: 1007152
Sex: F
Age: 34
State: CA

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

Lab Data:

Allergies: None

Symptoms: Found sitting, short of breath, pale, shaky, tight chest. Initially with HR 150s, o2 sat 88%. Transferred to a gurney. Repeat vitals and color improved within 10 minutes, HR 100, 37.2, 142/95, o2 sat 100%. Employee was monitored for 1 hour. Still felt slightly dizzy so transferred to the emergency department for further observation.

Other Meds: Adderall daily, claritin.

Current Illness: None

ID: 1007153
Sex: F
Age: 47
State: IN

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

Lab Data:

Allergies: Haldol

Symptoms: Severe arm pain and arm sensitivity changes

Other Meds: Xeljanz vitamin D pristiq singular. Protonix topomax. TramadolXR. Diclofenac magnesium. Doxipen Breo Proair

Current Illness: Rheumatoid Arthritis Asthma

ID: 1007154
Sex: F
Age: 40
State: IN

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

Lab Data: None

Allergies: Penicillin

Symptoms: Fever of 102.8 Chills Body aches

Other Meds: Cosenty, Adderall, Welbutrin, Xanax

Current Illness: None

ID: 1007155
Sex: F
Age: 50
State: OR

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

Lab Data:

Allergies:

Symptoms: itchiness/redness of hands and face; given benadryl 50mg po with improvement in symptoms after 30-min

Other Meds:

Current Illness:

ID: 1007156
Sex: F
Age: 18
State: MO

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

Lab Data:

Allergies: Treenut allergy, coconut allergy, codeine allergy

Symptoms: I had a sore arm that restricted movement, but that left after two days. I had a lot of abdominal pain, nausea, loss of apatite. I had diarrhea and a headache as well.

Other Meds: Escitalopram 20mg, Bupropion 150 XR

Current Illness: The night after I had the shot, I had a severe allergic reaction to pesto, which contained cashew oil.

ID: 1007157
Sex: F
Age: 72
State: GA

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

Lab Data: None

Allergies: None

Symptoms: 3-4 inch diameter circle at injection site with trailing redness of skin about 1 inch below red circle. Very itchy. COVID arm

Other Meds: Timolol eye drops, estradiol, norethendrone, caltrate, multivitamin, krill oil, turmeric, biotin, D3, joint enhancer

Current Illness: None

ID: 1007158
Sex: F
Age: 65
State: TN

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

Lab Data: None

Allergies: Codeine, Erythromycin, and Sulphur

Symptoms: 1) The right portion of my lower lip started to swell on Tuesday (Feb2) or Wednesday (Feb3); I don?t remember which day. It?s been getting a little worse every day, including today (Friday). I?ve been regularly putting petroleum jelly on my right, lower lip to relieve the discomfort. I?ve also been putting petroleum jelly all over my lower and upper lips, because both lips have become unusually dry since the swelling began. 2A) Part of my skin (near the needle?s point of entry on my arm) came off when I removed band-aid at end of my shower on Tuesday (Feb2) morning. The narrow, skin-missing area on my arm is a little less than the size in length of the width of the band-aid that I removed. (I have a photo if you?d like to see it.) Although I turned shower water off before removing the band-aid, that raw skinless part of my arm started to sting and burn profusely, immediately after I removed band-aid. The steam (not water) from the shower stall is what burned so badly. When looking in mirror to investigate source of pain, I was puzzled as to why my skin was missing. 2B)Wednesday (Feb3) morning, my husband attempted to put Neosporin on that small portion of my skinless arm to prevent infection from setting in. But it was so painful, I had to stop him. The area burned for more than an hour. So now I keep the band-aid on that spot and don?t remove it. It?s still very sensitive, and I feel discomfort while taking a shower. But since I leave band-aid on, it doesn?t burn and sting like before. And It wasn?t until Thursday (Feb4), after looking online at missing skin, that I realized that my skin apparently came off when I removed the bandage. I also read, when looking online, that skin removal with bandages can happen more often with older folks like myself. I?m not sure if this is an adverse reaction to the vaccine or not but thought I?d report it just in case.

Other Meds: Atorvastatin, Clonidine, Furosemide, Losartan, Potassium, and Verapamil - Allegra and Zyrtec - AnthroMax with TheaFlavins & ApresFlex (I had taken AnthroMax for about a month but hadn't gotten around to ordering more. So I don't think I t

Current Illness:

ID: 1007159
Sex: F
Age: 51
State: IL

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

Lab Data:

Allergies: NKDA

Symptoms: Right facial/neck numbness and pain, right eye twitching

Other Meds: Linzess Methocarbamol Famotidine Pantoprazole Ibuprofen

Current Illness:

ID: 1007160
Sex: M
Age: 31
State: IL

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

Lab Data: None

Allergies: Avacado

Symptoms: Near Fainting and stiff neck. He was assisted from the chair to the bed and laid down. Vitals monitored for 30 min. No other complaints or reactions. Alert entire time and related to feeling much better after water and the time monitored. He did not want any further assistance and left under his own ability.

Other Meds: None

Current Illness: None

ID: 1007161
Sex: F
Age: 37
State: PA

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

Lab Data:

Allergies: None

Symptoms: Rash on shoulder chest arms and legs. Itchy everywhere. Sore muscles and fatigue

Other Meds: Prozac, levothyroxine, melatonin,

Current Illness: None

ID: 1007162
Sex: F
Age: 66
State: WI

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

Lab Data: None

Allergies: None

Symptoms: Fever. 101 degrees Fatigue Ache

Other Meds: Omeprisole High cholesterol meds

Current Illness: None

ID: 1007163
Sex: F
Age: 71
State: FL

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

Lab Data: None

Allergies: None

Symptoms: Headache, tiredness, muscle pain, chills, joint pain, soreness at injection site and nausea caused from the really bad headache.

Other Meds: None

Current Illness: None

ID: 1007164
Sex: F
Age: 28
State: OH

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

Lab Data: None

Allergies: None

Symptoms: Generalized body tingling at time of injection - current (getting less since lymphadenopathy) Painful, sore arm 8p (02/04/21) - current Lymphadenopathy left cervical (painful) 7:45p (02/05/21)- current

Other Meds: None

Current Illness: None

ID: 1007165
Sex: F
Age: 45
State: AK

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

Lab Data: 2-3-21 - blood work done at the facility

Allergies: Wheat/gluten/soy

Symptoms: On January 27, 2021 at around noon I received the first dose of the Pfizer/BioNTech Covid-19 vaccine. After approximately 10-15 minutes I noticed a reaction. I was really lightheaded , short of breath, and shaking. It felt like I was going to pass out. I was given water and a bar to eat, and eventually I got to a place where I felt that I could drive. I went for a walk with a couple of friends, but was having a hard time walking because of shortness of breath, and was still lightheaded plus I had skin tingling on both sides of my face. I ate something afterward the walk and felt better within an hour. The next day I seemed to be fine, but then Friday (two days after the shot) I became increasingly lightheaded/dizzy and nauseous. Additionally, I had issues on Friday and Saturday with anxiety and trying to hold off mild panic attacks plus depression and nausea. I was still lightheaded/dizzy and had shortness of breath for a week after the shot. which has extend to today (February 5, 2021), over a week after the shot.

Other Meds: Tarina Fe 1/20 EQ oral tablet (birth control)/Vitamin D/Magnesium Complex/Trizomal glutathione

Current Illness: None

ID: 1007166
Sex: F
Age: 64
State: CA

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

Lab Data: none

Allergies: SULFA- severe reaction-, Lidocaine

Symptoms: WAS TOLD THAT MY ARM WOULD BE MORE SORE AFTER THIS SECOND SHOT BECAUSE i CHOSE TO GET IT IN THE SAME ARM AS THE 1ST DOSE. WHILE I DIDNT FEEL THAT SORE IN MY SHOULDER on 2/3 THE FOLLOWING DAY AFTER A HIGH FEVER AND GENERAL/ALL OVER MUSCLE ACHE, CHILLS my left armpit began to hurt like I'd pinched or been punched in it, today my armpit is swollen with a knot under the skin and very sore to the touch and slightest movement (injection site is red and swollen with a knot in that area as well. *my son also received his second shot on same day & he is reporting to me the exact same issue.* icing the area is not helping.

Other Meds: synthyroid, phentermine, gabapentin, amlodipan, losartan, jardiance Vitamins: A,b12,b6, C,D3, E, selenium, garlic, cinnamon, chromium Pic, biotin, collagen

Current Illness: none, all medical conditions were properly treated and in control ( I felt great)

ID: 1007167
Sex: F
Age: 40
State: TX

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

Lab Data: None

Allergies: None

Symptoms: On 02/03 I got red bumps on the injection site. On 02/04 the injection site became completely red and itchy, I have also noticed a change in my vision.

Other Meds: Levothyroxine 112mcg

Current Illness: Retinitis Pigmentosis

ID: 1007168
Sex: F
Age: 48
State: HI

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

Lab Data: None

Allergies: Shrimp; Albuterol

Symptoms: C/O "feeling tired and warm." Responsive but drowsy. Breathing clear. Vitals stabilized. no other s/s. Laid down on cot to rest @11:55. C/O "head hurts" d/t hitting metal part on cot. No bump or bleeding, gave ice pack x2 for comfort. Denies dizziness. Sat up @11:59 verbalized felling less tired. Appeared more alert. Ambulated without assistance @12:02. "Felling okay" after moving around. Water offer and accepted. Patient will call son to pick up.

Other Meds: None

Current Illness: None

ID: 1007169
Sex: F
Age: 65
State:

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

Lab Data:

Allergies:

Symptoms: Body aches, joint pain, muscle ache, headache, flu like symptoms.

Other Meds:

Current Illness:

ID: 1007170
Sex: F
Age: 53
State: OH

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

Lab Data: None

Allergies: Topical antibiotic ointment, Tami flu, levaquin, doxycycline, celexa, hydrochlorothiazide

Symptoms: First exhaustion and mild headache, then stomach upset, then freezing and shaking with chills. At 10 hours post I noticed red blotchy rash at administration site.

Other Meds: Lisinopril, atorvastatin, vitamin D, fexofenadine, singular, famotidine, levocertrizine, immunotherapy injections

Current Illness: No illnesses.

ID: 1007171
Sex: F
Age: 23
State: IL

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

Lab Data: Fever: 8:05pm : 101.8 degrees Fahrenheit.

Allergies: Amitriptyline, cyclobenzaprine

Symptoms: I started to have chills around 6:15ish pm, then developed a fever between 7:30-8:05 pm. I took Tylenol and now waiting for the fever to resolve.

Other Meds: Birth control (Camrese Lo)

Current Illness: None

ID: 1007172
Sex: F
Age: 32
State: WV

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

Lab Data: Ambulance came. Checked vitals. Started to get better

Allergies: None

Symptoms: I got sudden sob, had trouble swallowing my water was driving on way back to work. Got pulled over. Heart was racing. Got hot starting shaking. Sob. Hands feet and face started to get numb. And almost passed out.

Other Meds: None

Current Illness: None

ID: 1007173
Sex: M
Age: 37
State: TX

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

Lab Data: N/a

Allergies: No known allergies

Symptoms: Vaccine administered 2/4@1030. Small grape sized lump noted to left armpit 2/5@0800. By noon, lump had increased in size. The lump was the size of the palm of my hand. It is painful to touch. No redness or erythema noted. Taking Tylenol and Motrin

Other Meds: None

Current Illness: None

ID: 1007174
Sex: M
Age: 75
State: NY

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

Lab Data: none

Allergies: lisinopril angioedema ragweed. timothy grass roses

Symptoms: day after vaccine 2-4-21, chills. about 24 hours after vaccine sob at rest and ambulation very difficult, which is unusual w/ episodes of at fib. fatigue, which is also a sx of a fib. improvement w/ dyspnea after flecaide and nsr next am when awakening. arose 2x during night as unable to sleep, still in a fib. the next day, around noon, another run of a fib which responded after several hour after flecainide. fatigue all day and napped. i usually am unable to nap during daylight. sx of a fib i.e; dyspnea stage 4 chf was more severe evening 2-4 and it is very unusual to have runs of a fib 2 days in a row

Other Meds: bistolic, flecanide, eliquis, tamsulosin, atorvastatin, irbesartin, prn furosemide/KCl

Current Illness: cellulitis r foot rx'd cephalexin 2 weeks prior

ID: 1007175
Sex: F
Age: 53
State: NC

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

Lab Data: none

Allergies: None

Symptoms: "covid arm", itchy localized rash around injection site that began a couple of days ago. Also noted elevated heart rate and mild flushing the day of the vaccine, appx 10 minutes after injection. Symptoms quickly cleared.

Other Meds: pantoprazole, baby aspirin, multivitamin, vitamin D, Iron, Biotin

Current Illness: None

ID: 1007176
Sex: M
Age: 88
State: CA

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

Lab Data:

Allergies:

Symptoms: Felt dizzy - BP 126/71 (supine), 110/70 (sitting), HR 90, O2 sat 98%. Patient rested then felt better.

Other Meds:

Current Illness:

ID: 1007177
Sex: M
Age: 52
State: NY

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

Lab Data:

Allergies: none

Symptoms: Violent vomiting

Other Meds: advil

Current Illness: none

ID: 1007178
Sex: F
Age: 29
State:

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

Lab Data:

Allergies: Amoxicillin

Symptoms: Chest pain that started the evening of the vaccine administration, intensity 6/10 on the evening of and all of the next day. Has persisted more mildly with waxing and waning intensity since for the last 2 days.

Other Meds: None

Current Illness: None

ID: 1007179
Sex: F
Age: 25
State: NC

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

Lab Data:

Allergies: nsaids - angioedema

Symptoms: Patient experienced a rash and itching in the upper right arm. Ice was applied and Benadryl 25mg PO was given with good effect. Within 10-15 minutes rash had resolved.

Other Meds: Prozac, klonopin, atarax

Current Illness: anxiety, depression, insomnia

ID: 1007180
Sex: F
Age: 65
State: FL

Vax Date: 01/23/2021
Onset Date: 02/03/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data:

Allergies: Sulfa, codine, Levaquin, and shell seafood

Symptoms: Light headed and mild heart arrhythmia (fast beat). After 10 days, chills, joint pain and sore throat

Other Meds: Metoprolol tartrate 25 mg, Vitamin C Complex, Iron, Vitamin B+C complex, Vitamin E 400 iu, Vitamin D-3, Zinc, Echinacea, Calcium, Tylenol PM, Alprazolam, Gabapentin 300 mg, Collagen complex

Current Illness: Heart arrhythmia - Sinus Bradycardia with 1st degree atrioventricular block Diverticulitis Anxiety

ID: 1007181
Sex: F
Age: 42
State: WA

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

Lab Data: On 2/4 I sought medical care at urgent care and they did an ekg, chest xray, covid test and bmp. I was sent to the ER to rule out pulmonary embolism. At the ER they did a CT scan of my lungs, ekg and more labs

Allergies: none

Symptoms: 12 hours after the 2nd vaccine, I experienced severe dizziness, body aches and fever. 17 hours after the vaccine I experienced a heartrate in the 150's, fever, chills, sweating and shortness of breath. 24 hours after i still had a fever, hr was 110 at rest and oxygen 99% at rest. While walking HR increased to 120's and oxgen saturation decreased to 86%. This persisted throughout the day.

Other Meds: none

Current Illness: none

ID: 1007182
Sex: F
Age: 38
State: CA

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

Lab Data: NA

Allergies: latex (rash)

Symptoms: Rash on arm below injection site (both times) Chills, headache, muscle pain, nausea (second shot)

Other Meds: methylphenidate 27mg melatonin 10mg eletriptan 20mg

Current Illness: NA

ID: 1007183
Sex: M
Age: 51
State: OR

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

Lab Data: None

Allergies: Hydrocodone, opiates

Symptoms: Headache. Neck stiffness, all over body aches, chills, abdominal pain, fever, faint.

Other Meds:

Current Illness: None

ID: 1007184
Sex: M
Age: 79
State: NV

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

Lab Data: None so far

Allergies: Possibly penicillin (1960?s) ? hives

Symptoms: Area of facial numbness about 2 inches in diameter on left mandibular distribution. No motor loss. Persistent to present, unchanged.

Other Meds: Lisinopril, Lipitor, Finasteride, vit C, Co Q 10, vit D

Current Illness: Hypertension, decreased renal function (eGFR is 55-60), previous local ablation therapy for prostate cancer, kidney stone

ID: 1007185
Sex: F
Age: 34
State: WI

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

Lab Data: No labs done

Allergies: Cephalexin

Symptoms: Rapid heart rate of 116-120 about 15 min post vaccine. Scratchy throat about 30 min post vaccine. Sensation of throat closing (lump in throat and getting harder to swallow). My husband dropped me at Emergency room. I was triaged into a room within a few minutes. Started to have a little shortness of breath. Exam performed and 1 liter normal saline given IV. 25mg Benedryl given IV about 3pm. Certirizine HCL 10mg given orally 3:46pm. Prednisone 40mg tab given orally 3:47 pm. Monitored for 4 hours and then discharged home to continue certirizine orally daily for next 2 days along with 40mg pred orally for next 2 days if needed. I took some sunday but not Monday. Did okay with on off hot/cold chills monday and tuesday but now ongoing hives.

Other Meds: Flovent inhaler, albuterol inhaler, otc multivitamin

Current Illness: No other illnesses that I am aware of. Did have elevated heart rate and blood pressure after the 1st vaccine 3 weeks earlier

ID: 1007186
Sex: F
Age: 21
State: MA

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

Lab Data: Gave an epipen.

Allergies: None

Symptoms: Probably about ten seconds after receiving my second dose of the vaccine I stood up and walked out of the room and all of a sudden I felt my face get very hot and go numb and tingly and then my I started having trouble breathing. I went back into the room and still couldn't breathe so they sat me down and told me my whole body was bright red and they stuck me with an epipen. The whole reaction probably lasted a little less than a minute from the time it happened to when they stuck me with the epipen.

Other Meds: None

Current Illness: None

ID: 1007187
Sex: F
Age: 74
State: NJ

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

Lab Data: NONE AS OF NOW.

Allergies: Ibuprofen, Levaquin, Codeine, Morphine

Symptoms: MILD CHILLS FOR SEVERAL HOURS. SEVERE RASH ALL OVER THE BODY. BUMPS, REDNESS & ITCHING. SEEN AT PRIMARY PHYSICIANS OFFICE BY NURSE PRACTITIONER, GIVEN AN INJECTION AND RX FOR METHYLPREDNISOLONE 4mg DOSEPK, CLOBETASOL 0.05% CREAM AND EPINEPRINE 1.3MG AUTO-INJECT. ALSO TAKE CLARATIN AND PEPCID.

Other Meds: Vitamins A, D, C, BIOTIN, FISH OIL, FLAXSEED, POTASSIUM, MAGNESIUM, FOLIC ACID, CALCIUM, ALIGN PROBIOTIC, E, B12, CoQ10

Current Illness: NONE

ID: 1007188
Sex: F
Age: 68
State: NM

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

Lab Data: None

Allergies: none

Symptoms: New onset erythematous and intensely pruritic rash appearing as a hypersensitivity reaction. Extension the next day to about 14 centimeters in diameter. No fever or other systemic findings.

Other Meds: claritin, metformin, vitamins

Current Illness:

ID: 1007189
Sex: F
Age: 74
State: TX

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

Lab Data:

Allergies: none

Symptoms: MODERNA COVID-19VACCINE EUA.... 2 Hours after it was administered, I had a severe vertigo-like dizzy spell, vomited 3 times.

Other Meds: ibuprofen (200 MG), CBD CAPSULE

Current Illness: none

ID: 1007190
Sex: F
Age: 51
State: PA

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

Lab Data: Cat scan EKG Complete blood work up

Allergies: Erythomycin

Symptoms: Began with symptoms for and was diagnosed with Bell's Palsy on 2/3/2021. Right eye will not close. Lips and bottom of face droop.

Other Meds: Ibuprofen 600 mg Lexapro 20 mg Losartan 25mg/12.5 hztc

Current Illness: None

ID: 1007191
Sex: F
Age: 53
State: IL

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

Lab Data: None

Allergies: Most HTN meds, no allergies to foods

Symptoms: Headache 3-5/10 for DAYS 1-5 Itchiness of the face, scalp and right hand DAYS 1-5 Itchiness of lips and tongue DAY 1 and DAY 5 Bilateral Hip and Knee pain DAYS 1 and DAYS 3-5 Flank Pain DAYS 3-5

Other Meds: Hydrochlorothiazide 12.5 mg QD, Vitamin D3 50mcg/2000U QD

Current Illness: None

ID: 1007192
Sex: M
Age: 82
State: CA

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

Lab Data:

Allergies:

Symptoms: Shortness of breath and tachypneic before and after vaccine. BP 178/71, repeat 154/63. HR 75, then 54. Respiratory rate 30. Given albuterol, resolved.

Other Meds:

Current Illness:

ID: 1007193
Sex: F
Age: 30
State: MN

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

Lab Data: ER at work- 1/5/21 0900? Ekg normal, tachycardia ER Doctor claimed vasovagal/panic attack cyclic pattern Saw psychiatrist 1/6 prescribed ativan prn temporarily

Allergies: Keflex- red facial flushing

Symptoms: Within 15 minutes chest felt like it was burning, then chest pain, felt short of breath, and tachycardia. Notified monitoring staff. Hooked up to a bf cuff, pulse ox, heart rate. HR elevated and can't remember bp. Started to feel better then chest pain worsened, felt faint. Thought I was vasovagalling so I laid down and put feet on a chair. Same symptoms continued occur in a cyclic fashion, continuing to worsen. Brought to ER waiting area then left arm went numb, hand turned white, and began spasming. They rushed me back to an er room. Ekg normal, waited an hour and released me home. The doctor said it may have been a vasovagal triggering panic attack in a cyclic runaway manner. Not a clear explanation. I continued to have chest pain and elevated heart rate /anxiety issues for weeks that I did not have ever before. I also experienced chest pain and shortness of breath after the first round in the middle of the night and I assumed it was just heart burn. Then experienced the same symptoms but exponentially worse with the 2nd shot 15 minutes after.

Other Meds: None

Current Illness: None

ID: 1007194
Sex: F
Age: 37
State: FL

Vax Date: 01/29/2021
Onset Date: 02/03/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data: None to date

Allergies: Penicillins, latex

Symptoms: Ancillary lymph node swelling and pain starting on day 5 after injection given, followed by a red, warm hive-like rash all around the injection site on day 7. Photos taken.

Other Meds: Topiramate Rosuvastatin

Current Illness:

ID: 1007195
Sex: F
Age: 24
State: IN

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

Lab Data:

Allergies: none

Symptoms: Pain at injection site-lasted 3 days Muscle aches especially backache, and fever for 24 hours highest was 100.6 celsius Headache on the 3 day Fatigue

Other Meds: desogestrel + EE (bcp)

Current Illness: none

ID: 1007196
Sex: F
Age: 64
State: TX

Vax Date: 01/11/2021
Onset Date: 01/11/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data: none

Allergies: latex demerol,

Symptoms: Intense pain at injection when I went to bed. Developed chills/fever, dry cough, sore throat, headache, body aches, fatigue, red eyes, sleeplessness, anxiety, fever dreams. Felt like I had Covid all over again for 3 days. Injection site was red, feverish, and raised. At 6 days, red circle was no longer raised, but 5 inches in diameter. Treated by alternately taking Tylenol and Ibuprofen, just as I had with Covid. Circle was gone on7th. day. Extreme fatigue and cough lasted for about 3 weeks.

Other Meds: Losartan 50 mg once a d Vitamin D, zinc, C, multivitamin

Current Illness: Exposed to Covid Dec. 15, 2020. Symptoms full on Dec. 18. mostly recovered by December 31.

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm