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: 1011010
Sex: F
Age: 31
State: IN

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 02/08/2021
Hospital:

Lab Data:

Allergies: N/a

Symptoms: Headache, growing inflammation under injection site-bottom of muscle

Other Meds: Sertraline, trazodone

Current Illness: N/a

ID: 1011011
Sex: F
Age: 72
State: TN

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 02/08/2021
Hospital:

Lab Data:

Allergies: Morphine, Codeine, most pain meds

Symptoms: headache, rapid heart rate for several hours (160s), nausea, joint aches, chills, dizziness, weakness. Worst part lasted 48 hours. The nearest ER is an hour away so just pushed thru it.

Other Meds:

Current Illness: none

ID: 1011012
Sex: F
Age: 67
State: FL

Vax Date: 02/07/2021
Onset Date: 02/07/2021
Rec V Date: 02/08/2021
Hospital:

Lab Data: n/a

Allergies: Pcn, Sulphur and shrimp

Symptoms: 15 minutes after client received vaccine client stated that she felt dizzy and weak. Vital signs obtained by EMS BP 119/72, Pulse 72, Temp 99, O2 sat 96% Blood Sugar 107 at 1:43 pm. Client was wearing 2 face masks. She removed the mask and stated she feels better. States she was hungry. After EMS obtained 2 sets of vitals within normal limits, patient stated she felt better and was discharged home by EMS at 1:45 pm.

Other Meds: Yes, BP meds.

Current Illness: none

ID: 1011013
Sex: F
Age: 58
State: PA

Vax Date: 02/02/2021
Onset Date: 02/06/2021
Rec V Date: 02/08/2021
Hospital:

Lab Data: Valcyclovir 1000mg tied x 7 days

Allergies: Codeine Fluroquinalones Macrolides PCN Cephalosporins

Symptoms: Developed shingles 6 days post second vaccine

Other Meds: Zinc 50mg Vitamin C 500mVit D 2,000mg Losartan 50mg Atorvastatin 10mg

Current Illness: None

ID: 1011014
Sex: F
Age: 45
State: OH

Vax Date: 01/30/2021
Onset Date: 01/30/2021
Rec V Date: 02/08/2021
Hospital:

Lab Data: None

Allergies: Nuts

Symptoms: Monitor 9RN) checked on pt at 15 min check. Pt stated to RN that she was feeling warm, lightheaded and slightly dizzy. POD leader + supervisor was informed. Supervisor informed EMS staff of current situation. Pt was monitored for 15 min more at that time water was given + vitals were taken. BP 140/75, HR 105,SPO2 94% RA & 20 respirations. 09:15 Pt reassessed by (RN) & (EMS), pt showed no changes, and stated that she felt the same. Pt was removed to a private area to be further evaluated and await until squad arrived. Pt. also stated to staff that she typically experiences these symptoms whenever she takes in any form of nuts. Pt stated she does have an epipen injection. 0922 squad arrived. BP 148/90, HR 83, SPO2 99% RA, RR 20. Pt lung sounds were clear stated by EMS staff. Pt refused to be rescue by squad/ EMS but instead taken by her husband. Pt was informed that if anything went wrong on her way to TCH to call 911 right away. Pt agreed and was discharged at 0921AM.

Other Meds: None

Current Illness: NA

ID: 1011015
Sex: F
Age: 39
State: MN

Vax Date: 01/30/2021
Onset Date: 02/06/2021
Rec V Date: 02/08/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Injection site became warm to touch, raised/swollen and itchy.

Other Meds:

Current Illness:

ID: 1011016
Sex: M
Age:
State: AL

Vax Date: 01/01/2015
Onset Date:
Rec V Date: 02/08/2021
Hospital:

Lab Data:

Allergies:

Symptoms: post-herpetic neuralgia in his upper body, particularly the shoulders; skin lesions developed on his head and forehead; Information has been received from a lawyer referring to a male patient of unknown age regarding a case in litigation. Information about concurrent condition, history condition and concomitant medication was not reported. In or around January 2015, the patient was vaccinated with zoster vaccine live (ZOSTAVAX) (strength, dose, route, lot# and expiration date unknown) for routine health maintenance and for its intended purpose: the prevention of shingles (herpes zoster). Subsequent to the zoster vaccine live (ZOSTAVAX) being administered, the patient developed skin lesions developed on his head and forehead, and this resulted in post-herpetic neuralgia in his upper body, particularly the shoulders, that also persists to the present. The patient first learned of the link between zoster vaccine live (ZOSTAVAX) and injuries such those from which he (conflict information, also reported as she) suffered, on or about February 2019. As a direct and proximate result of zoster vaccine live (ZOSTAVAX), the patient's symptoms have resulted in physical limitations not present prior to using the vaccine. The patient also experiences mental and emotional distress due to resulting physical limitations and seriousness of his condition. As a result of the manufacture, marketing, advertising, promotion, distribution and/or sale of zoster vaccine live (ZOSTAVAX), the patient sustained severe and permanent personal injuries. Further, as a tragic consequence of zoster vaccine live (ZOSTAVAX), the patient suffered serious, progressive, permanent, and incurable injuries, as well as significant conscious pain and suffering, mental anguish, emotional distress, loss of enjoyment of life, physical impairment and injury. As a direct and proximate result of zoster vaccine live (ZOSTAVAX), the patient has suffered and incurred damages, including medical expenses; the loss of accumulations; and other economic and non-economic damages. All damage proximately caused by the aforementioned characteristics of the zoster vaccine live (ZOSTAVAX) that rendered the product unreasonably dangerous, arose from the reasonably anticipated use of the product by the patient. The outcome of the events skin lesions developed on his head and forehead and post-herpetic neuralgia in his upper body, particularly the shoulders was considered to be not recovered and causal relationship was assessed as related. The lawyer considered the events skin lesions developed on his head and forehead and post-herpetic neuralgia in his upper body, particularly the shoulders to be disability.

Other Meds:

Current Illness: Routine health maintenance

ID: 1011017
Sex: U
Age:
State:

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 02/08/2021
Hospital:

Lab Data:

Allergies:

Symptoms: No further AE details; PROQUAD was stored in the refrigerator instead of the freezer since 01DEC2020 and has since then been administered to patients; PROQUAD was also administered concomitantly with VARIVAX; This spontaneous report was received from a nurse referring to a patient of unknown age and gender. The patient's concomitant medication, pertinent medical history and drug allergies or reactions were not reported. It was reported that measles, mumps, rubella and varicella (oka-merck) virus vaccine live (PROQUAD) was stored in the refrigerator instead of the freezer since 01-DEC-2020. On 28-JAN-2021, the patient was vaccinated with measles, mumps, rubella and varicella (oka-merck) virus vaccine live (PROQUAD) (strength and route of administration were not reported, lot # T025221, expiration date 19-JAN-2022, therapy type: recombinant Human albumin (rHA)) at a dose of 0.5 milliliter for prophylaxis and varicella virus vaccine live (oka/merck) (VARIVAX) (strength, route of administration, lot # and expiration date were not reported) at a dose of 0.5 milliliter for prophylaxis (product storage error and inappropriate schedule of product administration). It was reported that measles, mumps, rubella and varicella (oka-merck) virus vaccine live (PROQUAD) vaccine was exposed to a temperature of 44 Fahrenheit (F) for a time frame of 1506 hours. There was no previous temperature excursion and the call was not due to a data logger. No further adverse event (AE) details were provided. This is one of the several reports reported by the same reporter.; Sender's Comments: US-009507513-2102USA000941: US-009507513-2102USA001248: US-009507513-2102USA001301: US-009507513-2102USA001487: US-009507513-2102USA001266:

Other Meds:

Current Illness:

Date Died: 02/02/2019

ID: 1011018
Sex: M
Age:
State: CA

Vax Date: 05/16/2014
Onset Date: 02/02/2019
Rec V Date: 02/08/2021
Hospital:

Lab Data:

Allergies:

Symptoms: amyotrophic lateral sclerosis/ severe pain/ full body-wide fasciculations; death; Information has been received regarding a case in litigation from a lawyer and referred to a male patient of unknown age. No information was provided regarding medical history, concurrent conditions, or concomitant medications. On or around 16-MAY-2014, the patient was vaccinated with zoster vaccine live (ZOSTAVAX) for routine health maintenance and for its intended purpose: the prevention of shingles (herpes zoster) (strength, dose, route, lot# and expiration date were not reported). Shortly after receiving zoster vaccine live (ZOSTAVAX), the patient suffered full body-wide fasciculations and amyotrophic lateral sclerosis. As a direct and proximate result of these injuries, the patient suffered painful injuries and damages, and required extensive medical care and treatment. As a further proximate result, the patient suffered significant medical expenses, severe pain and suffering, other damages, and ultimately death on 02-FEB-2019. As a direct and proximate result of zoster vaccine live (ZOSTAVAX), the patient suffered serious and dangerous side effects, including death, as well as other severe and personal injuries which were permanent and lasting in nature, physical pain and mental anguish, emotional distress, loss of enjoyment of life, physical impairment and injury. As a direct and proximate result of zoster vaccine live (ZOSTAVAX), the patient had suffered and incurred damages, including medical expenses, the loss of accumulations and other economic and non-economic damages. The cause of death was unknown. It was unknown if an autopsy was performed. The outcome of the event amyotrophic lateral sclerosis was considered as not recovered. The causality assessment between the events death and amyotrophic lateral sclerosis and zoster vaccine live (ZOSTAVAX) was considered as related by the lawyer. The lawyer considered the event amyotrophic lateral sclerosis to be disability. Upon internal review, amyotrophic lateral sclerosis was determined to be medically significant.

Other Meds:

Current Illness: Prophylaxis; Routine health maintenance

ID: 1011019
Sex: F
Age: 76
State: FL

Vax Date: 09/26/2020
Onset Date:
Rec V Date: 02/08/2021
Hospital:

Lab Data: Test Date: 2020; Test Name: Covid; Test Result: Negative

Allergies:

Symptoms: her arm (where the injection was given) was sore / soreness/achiness / little soreness left; This case was reported by a consumer and described the occurrence of injection site pain in a 76-year-old female patient who received Herpes zoster (Shingrix) for prophylaxis. Previously experienced adverse reactions included cholesterol. Concurrent medical conditions included irritable bowel syndrome. Concomitant products included INFLUENZA VACCINE (INFLUENZA SHOT). On 26th September 2020, the patient received the 1st dose of Shingrix (intramuscular). On an unknown date, less than 3 months after receiving Shingrix, the patient experienced injection site pain. On an unknown date, the outcome of the injection site pain was recovered/resolved. The reporter considered the injection site pain to be related to Shingrix. Additional details were provided as follows: The patient received 1st dose of Shingrix in unknown arm. After receiving 1st dose of Shingrix, the patient experienced arm (where the injection was given) was sore. The pharmacist suggested she get tested for Covid and result came back negative. The reporter was the patient. The reporter consent to follow up. This is 1 of the 6 cases, reported by same reporter.; Sender's Comments: US-GLAXOSMITHKLINE-US2020245582:same reporter US-GLAXOSMITHKLINE-US2020245580:same reporter US-GLAXOSMITHKLINE-US2020AMR246337:same reporter US-GLAXOSMITHKLINE-US2020AMR246336:same reporter

Other Meds:

Current Illness: Irritable bowel syndrome

ID: 1011020
Sex: F
Age:
State: FL

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

Lab Data:

Allergies:

Symptoms: Flu-like symptoms; This case was reported by a consumer and described the occurrence of influenza-like symptoms in a female patient who received Herpes zoster (Shingrix) for prophylaxis. Previously administered products included Shingrix (1st dose received on an unknown date). On an unknown date, the patient received the 2nd dose of Shingrix. On an unknown date, less than a day after receiving Shingrix, the patient experienced influenza-like symptoms. On an unknown date, the outcome of the influenza-like symptoms was recovered/resolved. The reporter considered the influenza-like symptoms to be related to Shingrix. Additional information was reported as follows: The case was reported by patient's a friend The age at vaccination was not reported. The patient was vaccinated with Shingrix. The patient had flu-like symptoms begin within 12 hours after the shot and resolved after 1-2 days. The reporter did not feel comfortable giving her friends' initials or their ages. The reporter provided limited information. This was 1 of 5 cases reported by same reporter.; Sender's Comments: US-GLAXOSMITHKLINE-US2020245582:same reporter US-GLAXOSMITHKLINE-US2020245591:same reporter US-GLAXOSMITHKLINE-US2020AMR246336:same reporter US-GLAXOSMITHKLINE-US2020AMR246110:same reporter US-GLAXOSMITHKLINE-US2020245580:same reporter

Other Meds:

Current Illness:

ID: 1011021
Sex: F
Age:
State: NV

Vax Date: 12/01/2020
Onset Date: 12/01/2020
Rec V Date: 02/08/2021
Hospital:

Lab Data:

Allergies:

Symptoms: injection site reaction including swelling and blisters under the skin; injection site reaction including swelling and blisters under the skin; injection site reaction including swelling and blisters under the skin; arm was hot to the touch and red.; arm was hot to the touch and red.; was nauseous; trouble walking/ difficulty walking; her legs ache; hips hurt; balance issues; This case was reported by a nurse and described the occurrence of injection site reaction in a 91-year-old female patient who received Herpes zoster (Shingrix) for prophylaxis. In December 2020, the patient received the 1st dose of Shingrix. In December 2020, less than a day after receiving Shingrix, the patient experienced injection site reaction, injection site blisters, injection site swelling, extremities hot feeling of, erythema of extremities, nausea, walking difficulty, leg pain, pain in hip and balance difficulty. On an unknown date, the outcome of the injection site reaction, injection site blisters, injection site swelling, extremities hot feeling of, erythema of extremities and nausea were unknown and the outcome of the walking difficulty, leg pain, pain in hip and balance difficulty were not recovered/not resolved. It was unknown if the reporter considered the injection site reaction, injection site blisters, injection site swelling, extremities hot feeling of, erythema of extremities, nausea, walking difficulty, leg pain, pain in hip and balance difficulty to be related to Shingrix. Additional details were provided as follows: The reporter was patient's relative who reported for her aunt. The patient received first dose of Shingrix 8 days before the date of reporting. On the night of vaccination the patient developed an injection site reaction including swelling and blisters under the skin and had trouble walking and was nauseous. The next day it was noted that patient's arm was hot to the touch and red. It had been 8 days and the patient still had some difficulty walking, hips hurt, legs ache and she had some balance issues. The reporter did not have any lot or expiry date information. The reporter consented to follow up.

Other Meds:

Current Illness:

ID: 1011022
Sex: F
Age: 91
State: NY

Vax Date: 04/01/2020
Onset Date:
Rec V Date: 02/08/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Itching at Injection site; Swelling, and Itching at Injection site; Redness, Swelling, and Itching at Injection site; This case was reported by a consumer and described the occurrence of injection site itching in a elderly female patient who received Herpes zoster (Shingrix) for prophylaxis. In April 2020, the patient received the 2nd dose of Shingrix (intramuscular). On an unknown date, less than 9 months after receiving Shingrix, the patient experienced injection site itching, injection site swelling and injection site erythema. On an unknown date, the outcome of the injection site itching, injection site swelling and injection site erythema were not recovered/not resolved. It was unknown if the reporter considered the injection site itching, injection site swelling and injection site erythema to be related to Shingrix. Additional details were reported as follows: The age at vaccination was not reported. The reporter consented to follow up. All information was not available.

Other Meds:

Current Illness:

ID: 1011023
Sex: F
Age: 68
State: CA

Vax Date: 12/23/2020
Onset Date: 12/01/2020
Rec V Date: 02/08/2021
Hospital:

Lab Data: Test Date: 20201223; Test Name: body temperature; Result Unstructured Data: (Test Result:100.7,Unit:degree F,Normal Low:,Normal High:)

Allergies:

Symptoms: Fever of 100.7; throbbing Sinuses; severe Headache; generalized Achiness/Soreness; injection site Soreness; Myalgia; This case was reported by a consumer and described the occurrence of injection site pain in a 68-year-old female patient who received Herpes zoster (Shingrix) for prophylaxis. On 23rd December 2020, the patient received the 2nd dose of Shingrix (intramuscular). In December 2020, less than a week after receiving Shingrix, the patient experienced myalgia. On 23rd December 2020, the patient experienced injection site pain, fever, sinus pain, headache and generalized aching. On an unknown date, the outcome of the injection site pain, myalgia, fever, sinus pain, headache and generalized aching were not recovered/not resolved. It was unknown if the reporter considered the injection site pain, myalgia, fever, sinus pain, headache and generalized aching to be related to Shingrix. Additional details were reported as follows: The patient received Shingrix intramuscularly on left arm and had severe headache, throbbing Sinuses, fever of 100.7, generalized achiness, and injection site soreness that started the day of the vaccine and continued. The reporter consented to follow up. All information was not available.

Other Meds:

Current Illness:

ID: 1011024
Sex: M
Age:
State:

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

Lab Data: Test Name: COVID-19; Test Result: Positive ; Result Unstructured Data: COVID-19 POSITIVE

Allergies:

Symptoms: COVID-19 positive; different taste in mouth; Initial information received on 30-Jan-2021 regarding an unsolicited valid non-serious case received from a consumer (patient). This case involved an 81-year-old male patient who experienced covid-19 positive (sars-cov-2 test positive) and different taste in mouth (taste disorder), while patient received vaccines INFLUENZA VACCINE. Medical history, past medical treatment(s), vaccination(s) and family history were not provided. Concomitant medications were not reported. On an unknown date, the patient received INFLUENZA VACCINE [lot number: unknown and expiration date: unknown] at an unknown dose via unknown route in an unknown administration site for prophylactic vaccination. On an unknown date, patient who experienced covid-19 positive (sars-cov-2 test positive) and different taste in mouth (taste disorder) (latency: unknown) following the administration of suspect vaccine. It was not reported if the patient received a corrective treatment. Outcome of the event was unknown. There will be no information available regarding batch number in this case.

Other Meds:

Current Illness:

ID: 1011025
Sex: M
Age: 74
State: PA

Vax Date: 02/03/2021
Onset Date: 02/04/2021
Rec V Date: 02/08/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: it severely aggravated my restless legs

Other Meds: creon,trazadone,metformin,b12,atorvasatin,magnesium,buspirone,vitd3,vitaminc,areds2,glipizide,babyaspirin,pramipexole,tamsulosin,ferroussulfaye,sertraline,empagliflozin

Current Illness: Diabetes and restless legs

ID: 1011026
Sex: F
Age: 43
State: OH

Vax Date: 01/30/2021
Onset Date: 01/30/2021
Rec V Date: 02/08/2021
Hospital:

Lab Data: Nonoe

Allergies: Seasonal

Symptoms: Three min after vaccine, pt started feeling SOB racing heart. BP 148/100, HR 80, SPO2 100% RA, T:97 Six minutes after: dose, lethargic, sleepy, eyes dropped (look tired) & dizzy & c/o anxiety. Friend P/U to take her to ER. BP 144/92

Other Meds: HCTZ, amlodipine, VIt B, tumeric

Current Illness: none

ID: 1011027
Sex: M
Age: 42
State:

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 02/08/2021
Hospital:

Lab Data: None sought.

Allergies: none

Symptoms: Initial onset at time listed- fever, severe myalgias, rigors, sweating, headache, anorexia, thirst, lethargy. Felt like severe flu. No pulmonary symptoms or GI symptoms. Symptoms improved with first ibuprofen dosing on 6Feb2021. Fever and myalgias recurred after Ibuprofen dosing subsided evening of 6 Feb2021. Full resolutions of symptoms on 8Feb2021

Other Meds: Nexium

Current Illness: none

ID: 1011028
Sex: M
Age: 58
State: NJ

Vax Date: 01/23/2021
Onset Date: 02/02/2021
Rec V Date: 02/08/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Bell' Palsy . Right side facial weakness. Sudden onset ten days after vaccine.

Other Meds: None

Current Illness: None

ID: 1011029
Sex: F
Age: 55
State: OH

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

Lab Data:

Allergies: Codeine ASA

Symptoms: 1st vaccine, next day fever, severe headache, joint pain-severe. Lasting 2 days 2nd. vaccine, next day fever , achy and fatigue x 5 days. (fever lasting longer than expected) 5th day-diarrhea and fatigue

Other Meds: Zoloft

Current Illness: No

ID: 1011030
Sex: F
Age: 40
State: IN

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 02/08/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Fever, extreme headaches, stomach cramps, and nausea.

Other Meds: None

Current Illness: None

ID: 1011031
Sex: F
Age: 31
State: PA

Vax Date: 02/06/2021
Onset Date: 02/06/2021
Rec V Date: 02/08/2021
Hospital:

Lab Data: None

Allergies: Augmentin

Symptoms: Moderna COVID-19 vaccine EUA 9pm: began feeling cold, a little out of it, like an illness was coming on 11pm - 11am: chills and sweats throughout the night, possibly had a fever but didn?t take my temperature. Very restless sleep 11am (2/7) - 9pm: alight body aches and headache throughout the day. Much better than the night before but not 100%. 7am (2/8): headache, but no body aches or other symptoms

Other Meds: Retin-a micro 0.06% (topical RX) Onexton (topical RX) NatureMade prenatal vitamin with DHA

Current Illness: N/a

ID: 1011032
Sex: F
Age: 64
State: NJ

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 02/08/2021
Hospital:

Lab Data: None

Allergies: lisinopril, pill form vitamin C

Symptoms: Rigors, fever, body aches, headache, nausea and vomiting.

Other Meds: None

Current Illness: None

ID: 1011033
Sex: F
Age: 37
State: WA

Vax Date: 01/15/2021
Onset Date: 01/15/2021
Rec V Date: 02/08/2021
Hospital:

Lab Data: ER visit on January 20th- Labs WDL; January 20th inability to walk in a straight line without holding on to something.

Allergies: Zofran

Symptoms: Nausea/vomiting with movement of head-3 hours after shot; loss of balance with inability to walk; nausea/vomiting while sitting or attempting to stand-2 days; leg cramps/charlie horses- 3-5 days; general weakness in arms and legs- weeks/current; difficulty with fine motor movements in fingers and weakness in arms and hands-current

Other Meds: Metoprolol 50 mg Daily; Escitalopram 10mg; Claritin 5 mg

Current Illness: COVID19

ID: 1011034
Sex: F
Age: 40
State: PR

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 02/08/2021
Hospital:

Lab Data: NONE

Allergies: PENICILLIN

Symptoms: CHILLS, FEVER 40 DEGREES CELSIUS, HEADACHE, ACUTE LEFT AXILLARY PAIN AND EDEMA, RIGHT AXILLARY PAIN, GREY COMPLEXION, MALAISE, GENERALIZED JOINT PAIN. DIFFICULTY RAISING UPPER EXTREMITIES DUE TO PAIN AN MUSCLE WEAKNESS,

Other Meds: TYLENOL, ADVIL, ASA, HCTZ, LOPRESSOR, COZAAR

Current Illness:

ID: 1011035
Sex: F
Age: 68
State: TX

Vax Date: 01/28/2021
Onset Date: 02/06/2021
Rec V Date: 02/08/2021
Hospital:

Lab Data: None.

Allergies: None.

Symptoms: Severe itching began in entire upper left arm. Redness subsided somewhat overnight, but left a large red patch on arm (midway between shoulder and elbow.) No treatment so far.

Other Meds: None.

Current Illness: None.

ID: 1011036
Sex: F
Age: 23
State: MD

Vax Date: 02/04/2021
Onset Date: 02/06/2021
Rec V Date: 02/08/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Under my tongue hurt/ is very sore hurts to stretch tongue

Other Meds:

Current Illness:

ID: 1011037
Sex: F
Age: 57
State: PA

Vax Date: 01/10/2021
Onset Date: 01/15/2021
Rec V Date: 02/08/2021
Hospital:

Lab Data:

Allergies: Neosporin, Band-Aids

Symptoms: Red raised swollen area covering the upper right arm. Was tender and hot to touch- Appeared to be cellulitis??? Reported the concern to my MD and was prescribed antibiotics, did not mention the COVID injection (DID NOT correlate the symptoms until shot #2)

Other Meds: Propranolol, topiramate, Lasix, Emgality, Stelara, fish oil, hair, skin and nails gummy

Current Illness: none

ID: 1011038
Sex: M
Age: 42
State: NY

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

Lab Data: None

Allergies: None

Symptoms: Prior to vaccination, patient admitted to taking 25MG of benadryl PO. 3:30 PM: patient received his 2nd dose of the Pfizer COVID-19 vaccine. 3:48 PM: Onset of throat itching and tingling sensation of the right lower extremity. 3:48 PM vitals: BP 137/76, spO2 100%, HR 108, T 98.3F 3:48 PM: Benadryl 25MG IM was given in the left deltoid. 4:03 PM vitals: BP 116/67, spO2 98%, HR 95, T 98.4F. Patient said that he felt a headache that was 2/10 on the pain scale, reported less tingling in his his leg that was mostly felt in his R big toe, and felt some tingling left in his throat but says that "it's nothing." 4:50 PM: Patient's hands felt cold compared to his arms. Patient reported feeling cold in his arms and very tired. 4:55 PM: Patient was transported to the emergency department for further evaluation.

Other Meds: Fenofibrate Plavix Multivitamins

Current Illness: None

ID: 1011039
Sex: F
Age: 35
State:

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

Lab Data:

Allergies:

Symptoms: began to feel chest and throat tightness. 25mg Benadryl and symptoms went away

Other Meds:

Current Illness:

ID: 1011040
Sex: F
Age: 50
State: NJ

Vax Date: 02/06/2021
Onset Date: 02/07/2021
Rec V Date: 02/08/2021
Hospital:

Lab Data: None

Allergies: No

Symptoms: Fever 99.9 at 8:00 am next day, And also at 8:00 pm 99.4 Fatigue/ SOB around noon and for the rest of the day. Leg cramps at night for the next two nights

Other Meds: Tylenol Green tea

Current Illness: No

ID: 1011041
Sex: M
Age: 49
State: NY

Vax Date: 02/07/2021
Onset Date: 02/07/2021
Rec V Date: 02/08/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Fever, headache, chills,

Other Meds:

Current Illness:

ID: 1011042
Sex: F
Age: 60
State: OK

Vax Date: 01/30/2021
Onset Date: 02/03/2021
Rec V Date: 02/08/2021
Hospital:

Lab Data: Influenza rapid test on February 4th was negative.

Allergies: Amoxicillin

Symptoms: Had a very mild case of COVID in November. Slight muscle tenderness for 1 day after first shot. Have had same symptoms as COVID but much worse after 2nd shot. Symptoms started Day 4 after vaccine and continue today. Running fever for 5 days now. Still sick. Flu test was negative although I doubted it was anything else since I rarely get sick and when I do it only lasts a day or two. Will have a few hours where I finally think I am getting better and then another wave hits.

Other Meds: None

Current Illness: Had COVID19 on November 8th, 2020 and first COVID vaccine on 1/9/2021

ID: 1011043
Sex: F
Age: 47
State: NY

Vax Date: 02/07/2021
Onset Date: 02/07/2021
Rec V Date: 02/08/2021
Hospital:

Lab Data: None at this time

Allergies: Naproxen, cefdinir, oranges, pineapples

Symptoms: Headache Pain/soreness at injection site & arm Body aches Tiredness

Other Meds: Synthroid, multivitamin. Xyzal

Current Illness: Hypothyroidism, allergies

ID: 1011044
Sex: F
Age: 51
State:

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

Lab Data:

Allergies:

Symptoms: After vaccine given, lip tingling, then swelling, angioedema noticed, Benadryl & epi given, pt taken to emergency room. Patient observed in ED, vitals stabile and resolution of condition.

Other Meds:

Current Illness:

ID: 1011045
Sex: F
Age: 57
State: PA

Vax Date: 02/03/2021
Onset Date: 02/04/2021
Rec V Date: 02/08/2021
Hospital:

Lab Data: none

Allergies: Neosporin, Band-aids

Symptoms: Symptoms started day 2- Shaking chills, aches, left arm swelling with redness/rash?/cellulitis? extending down upper arm toward elbow, tender to touch Contacted Employee Health Office this am 2/8/21 for follow-up. Will follow their recommendations

Other Meds: Propranolol, Topiramate, Emgality, Stellara, Lasix, fish oil, hair, skin and nail gummy

Current Illness: ? Cellulitis on R arm

ID: 1011046
Sex: F
Age: 49
State: VA

Vax Date: 01/29/2021
Onset Date: 01/30/2021
Rec V Date: 02/08/2021
Hospital:

Lab Data: No tests have been run. ER visit on 2/7/2021. Suggested following up with a family doctor & come back if worsens. Suggested it is some type of allergic reaction.

Allergies: PCN, Cipro, Morphine, stinging insects

Symptoms: Initially fatigue, headache, heavy limbs & watering puffy eyes. Progressed to extreme facial swelling. Used ice packs, Tylenol, Zyrtec. On 2/7/2021 went to ER because eye swell increased. They did not treat me. Suggested I contact CDC & come back if worsens. Suggested Benedryll & continue ice packs. Woke up this morning (2/8) with continued swelling.

Other Meds: Valtrex, Zyrtec, Lisinopril, one a day multivitamin for women

Current Illness: None

ID: 1011047
Sex: F
Age: 84
State: IN

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

Lab Data:

Allergies: Sulfa

Symptoms: Fever, headache, nausea, weakness, dizziness

Other Meds: Synthroid, Valsartan, forlic acid, omeprazole, probiotics,

Current Illness: Psoriasis, hypothyroidism, high blood pressure

ID: 1011048
Sex: M
Age: 55
State: AZ

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 02/08/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: Next day had fever ,throat was scratchy, sleepy

Other Meds: symbicort

Current Illness: none

ID: 1011049
Sex: F
Age: 57
State: NC

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 02/08/2021
Hospital:

Lab Data: none

Allergies: Dermabond

Symptoms: Chills, fever, muscle aches, joint pain in all joints.

Other Meds: None

Current Illness: None

ID: 1011050
Sex: F
Age: 33
State: NC

Vax Date: 01/08/2021
Onset Date: 01/11/2021
Rec V Date: 02/08/2021
Hospital:

Lab Data:

Allergies: Benzoyl peroxide, gluten

Symptoms: Positive pregnancy test 1/10/21. EDD 9/18/21 based on LMP (12/12/21). Woke up extremely dizzy and could not get out of bed without almost falling over and very nauseated. Symptoms eventually subsided around 10:00 am. Did not have dizziness again. Had a confirmatory Ultrasound on 2/4/21 which measured 5weeks, 5 days and no yolk sac. Was supposed to be 7 weeks, 5 days. Determined that I miscarried.

Other Meds: Prenatal vitamin, acetaminophen, B12, Vitamin D, VSL#3 Probiotic

Current Illness: None

ID: 1011051
Sex: F
Age: 60
State: NJ

Vax Date: 02/03/2021
Onset Date: 02/06/2021
Rec V Date: 02/08/2021
Hospital:

Lab Data: N/A

Allergies: None

Symptoms: 3 Days after vaccine I had itchiness at the vaccine site that developed into red raised rash that started at site and spread to my entire body

Other Meds: Was taking bactrim for an infection diagnosed as cellulitis which I started 3 days prior to vaccine and completed on Sunday 2/7 Other than that I take multi vitamins and hydrochlorothiazide for high potassium

Current Illness: Cellulitis on my finger

ID: 1011052
Sex: M
Age: 74
State: FL

Vax Date: 02/07/2021
Onset Date: 02/07/2021
Rec V Date: 02/08/2021
Hospital:

Lab Data: n/a

Allergies:

Symptoms: After client received vaccine he stated that he has tingling sensation around his mouth. Vital signs obtained by EMS BP 161/101, pulse 55, temp. 99.4. Client sent home by EMS. Second BP 162/82, Blood Sugar 125 at 4:20 pm. Client states he is feeling well (better).

Other Meds: Yes, on cholesterol meds

Current Illness: PCN, Heprin

ID: 1011053
Sex: F
Age: 51
State: PA

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 02/08/2021
Hospital:

Lab Data: none

Allergies:

Symptoms: chills, Bilateral Axillary lymphadenopathy, Headache, Pain at injection site..... all symptoms lasted approximately 48 hours with pain at injection site still present as of today

Other Meds:

Current Illness:

ID: 1011054
Sex: F
Age: 41
State: NJ

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 02/08/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Itchy painful hot rash approx 2 in in diameter at injection site from that evening through today, still not resolved 3 days later. Muscle aches moderate and constant from 6 hours post injection through approx 33 hours post injection. Joint pain hips and knees same duration as muscles pain.

Other Meds: None

Current Illness: None

ID: 1011055
Sex: F
Age: 62
State: TX

Vax Date: 02/06/2021
Onset Date: 02/07/2021
Rec V Date: 02/08/2021
Hospital:

Lab Data: None so far

Allergies: NSIDs, thimerasol

Symptoms: A day after the vaccine, a large baseball size knot appeared at vaccine site, later that evening it grew to softball size, hot, and very painful. When I got the first dose, was not as drastic as this second dose. After the first does, it lasted around 10 days.

Other Meds: Lasarton, flecinine, Zyrtec, levothyroxin, levothyrine, gabapentin, methacarbomal, vitamin D, hctz, CBD capsule, singular, biotin.

Current Illness: None

ID: 1011056
Sex: M
Age: 39
State: NH

Vax Date: 01/20/2021
Onset Date: 01/21/2021
Rec V Date: 02/08/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: Moderate flue-like symptoms (malaise, anergia, headaches, myalgia, chills, skin hypersensitivity) throughout the day following the second dose of the Moderna vaccine.

Other Meds: none

Current Illness: none

ID: 1011057
Sex: F
Age: 48
State: MT

Vax Date: 01/01/2021
Onset Date: 02/07/2021
Rec V Date: 02/08/2021
Hospital:

Lab Data:

Allergies: PCN,Latex, coconut, walnuts, pecans

Symptoms: Itching and swelling at injection site 9 days after receiving the shot. Rash on right check as well. Was very sore for 2 days after getting injection as well.

Other Meds: B12, vitamin D

Current Illness:

ID: 1011058
Sex: F
Age: 91
State: TX

Vax Date: 02/03/2021
Onset Date: 02/07/2021
Rec V Date: 02/08/2021
Hospital:

Lab Data: 2 Tylenol, twice, sleep

Allergies: none

Symptoms: 4 days after injection, I experienced chills, slight fever (99.1), drop in oxygen level (96), aches all over, intestinal distress, extreme fatigue, lasted over 12 hours. Temperature and oxygen level back to normal, but am still shaky this morning, so I'm returning to bed.

Other Meds: Multi vitamin; calcium

Current Illness: none

ID: 1011059
Sex: U
Age: 17
State:

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 02/08/2021
Hospital:

Lab Data:

Allergies:

Symptoms: No adverse effects. Pt was vaccinated 3 days prior to turning 18 years of age, which is the recommended age for administration.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm