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: 1017614
Sex: F
Age: 33
State: ME

Vax Date: 12/31/2020
Onset Date: 12/31/2020
Rec V Date: 02/09/2021
Hospital:

Lab Data: 1/12/21: CT scan (negative), lumbar puncture (WBC=about 500), COVID test (negative)

Allergies: Pencillin Ceclor

Symptoms: Several hours after vaccine administration, I began to get a headache. That headache intensified over the next 24-36 hours. A severe headache resulted with a painful, stiff neck, occasional fever, occasional diarrhea, confusion, vision changes, and increased imbalance. These symptoms lasted for about 1 week before I sought medical treatment at a virtual urgent care appointment on 1/5/21. They referred me to an in-person urgent care facility that day. At that facility, they said my symptoms were very concerning and said I needed to seek immediate medical assistance at the ED and offered to call me an ambulance. My husband drove me to the ED from the urgent care facility. At the ED, they treated me with a migraine work-up but eventually discharged me with instructions to follow-up as I was "diagnostically unclear" at discharge. After a week, my symptoms had not improved at all and so my previous ED physician suggested that I return to the ED (after being unable to get care in a timely manner in an outpatient setting). At the ED on 1/12/21, they again treated me with a migraine workup but also conducted a CT scan and a COVID test. When both tests came back negative, they conducted a lumbar puncture procedure. Those results came back positive for viral meningitis. As I had no other illness or known exposure to any other virus at that time - and given the timeframe of the vaccine administration - my care team concluded that this was a rare reaction to the COVID vaccine. I was discharged with instructions to follow up with my PCP and a neurologist. My follow-up neurology consult is scheduled for 2/19/21.

Other Meds: None

Current Illness: None

ID: 1017615
Sex: F
Age: 39
State: WA

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 02/09/2021
Hospital:

Lab Data:

Allergies: sulfa

Symptoms: Friday night my arm was so sore that I was unable to move it. Muscle aches also began Friday night. Night sweats throughout the night. Saturday joint and muscle pain as well as 100.7 fever throughout the day. I slept all day Saturday and through Saturday night as well.

Other Meds: Venlafaxine Singular Allertec

Current Illness:

ID: 1017616
Sex: F
Age: 57
State: MS

Vax Date: 02/09/2021
Onset Date: 02/09/2021
Rec V Date: 02/09/2021
Hospital:

Lab Data: none

Allergies: ERYTHROMYCIN, SULFONAMIDE ANTIBIOTICS, AND SOME FOODS

Symptoms: Patient received her vaccine about 11:50 AM and waited in the parking lot (because she is under quarantine and not allowed to enter the facility) for the appropriate 15 minutes. Within about 10 minutes she began experiencing shortness of breath, throat felt restricted and severe nausea. Myself, another pharmacist, and several members of the staff met them in the parking lot and assessed her condition. Because of her symptoms, we determined it was appropriate to go ahead and administer the EpiPen 0.3mg and call 911 at that time. About 10 minutes later we gave her a 25mg oral dose of Benadryl while we waited on the ambulance to arrive. The ambulance arrived within the next 10 minutes and by then the patient stated she was feeling much better. The EMT examined her and declined any further medical assistance. I called the patient at her home 2 hours later and she said she had some light itching and dizziness. I told her the dizziness could be due to the after-effects of the EpiPen but if it worsened or there were any other signs of an allergic reaction to report to the ER immediately or call 911. This may have been more of an anxiety related reaction due to there being no signs of swelling around the lips or mouth, but we decided it would be best to be overly cautious in this situation.

Other Meds: ALEVE ONLY WHEN NEEDED; VITAMIN C, VITAMIN D3, B12 ORAL, ZINC

Current Illness: NONE

ID: 1017617
Sex: F
Age: 72
State: NC

Vax Date: 01/30/2021
Onset Date: 02/02/2021
Rec V Date: 02/09/2021
Hospital:

Lab Data: None

Allergies: Penicillin, sulfur and levaquin.

Symptoms: Four days after my initial injection I began to itch all over my body. This began about 30 minutes after I drank a cup of liquid yogurt. I did not have hives. This lasted about three hours. Three days later I started to experience the same thing about half an hour after eating a piece of baked chicken and half of an orange. The itching was more severe. I call my pcp and she told me to take Zyrtec and Benadryl. I have been taking both since Friday February 5. The itching continues it gets better at times, not as severe and not all over my body, but it has not subsided completely during that time.

Other Meds: Latanoprost, atorvastatin calcium, vitamin d, biotin, CoQ 10, B12.

Current Illness: Glaucoma

ID: 1017618
Sex: F
Age: 25
State: NC

Vax Date: 02/09/2021
Onset Date: 02/09/2021
Rec V Date: 02/09/2021
Hospital:

Lab Data: None

Allergies: None, per patient report

Symptoms: About 20 minutes after receiving vaccine, burning arm and neck, hurting; head starting hurting, became very tired and dizzy; feeling weak and cold; temperature was normal throughout this time; side effects are not worse at this time (about 2 hours after vaccination), but about the same

Other Meds: Wellbutrin, Trintellix, Lamictal, Synthroid

Current Illness: None, per patient report

ID: 1017619
Sex: M
Age: 49
State: AZ

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 02/09/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Pt describes limited range of motion and pain in joint area of shoulder.

Other Meds:

Current Illness:

ID: 1017620
Sex: F
Age: 27
State: OH

Vax Date: 02/01/2021
Onset Date: 02/03/2021
Rec V Date: 02/09/2021
Hospital:

Lab Data: - Trichomonas vag DNA Probe (2/5/21): Negative for Trichomonas vaginalis by DNA Probe - Gardnerella vag DNA Probe (2/5/21): Negative for Gardnerella vaginalis by DNA Probe - Candida sp DNA Probe (2/5/21): Negative for Candida species by DNA Probe - Herpes Simplex Virus Type 1, HDA (2/5/21): Negative for Herpes Simplex virus Type 1 by Molecular Detection (specimen source lesion) - Herpes Simplex Virus Type 2, HDA (2/5/21): Negative for Herpes Simplex virus Type 2 by Molecular Detection (specimen source lesion) - Varicella Zoster Virus, HDA (2/5/21): Negative for Varicella Zoster virus by Molecular Detection - GC Amplification (2/5/21): Negative for Neisseria gonorrhoeae by amplification (specimen source cervix) - Chlamydia Amplification (2/5/21): Negative for Chlamydia trachomatis by amplification (specimen source cervix) - HIV 12 Combo (Ag/Ab) (11/25/20): Non Reactive (No evidence of HIV-1 or HIV-2 infection)

Allergies: - Tree nuts (except cashews and almonds)

Symptoms: I received dose 1 on 1/4/21 with relatively few side effects (no side effects I was not expecting). After receiving dose 2 on 2/1/21, I experienced more severe systemic side effects (fatigue, chills, muscle aches, headache) that started the next day on 2/2/21. On 2/3/21, I noticed I had some discomfort while sitting down. By 2/4/21, I had noticed vaginal ulcerations that had formed on the vulva. I immediately made an appt to be seen by my Obgyn the next day on 2/5/21. I shared the following information with my obgyn during the appt: this was the first time I had ever noticed this, I have rheumatoid arthritis and am currently on Rituxan (rituximab) and get every 6 months, and I have been in a monogamous relationship for 2+ years. My Obgyn and I suspected that this was herpes and possibly had been dormant for many years. However, herpes tests came back negative. I was then referred to an Obgyn who specializes in ID, and she was able to tell me by looking at the lesions that this was not an STI. She highly suspects the vulvar ulcerations are autoimmune in nature, and she mentioned that it was a Lipschutz ulcer. While the trigger is not clear at this time, I am thinking there is a possibility that the second COVID vaccine dose could be what triggered the formation of these ulcers.

Other Meds: - Spironolactone 100 mg PO daily - Synthroid 75 mcg PO daily (weekdays ONLY) - Rituxan (receive infusion 4x year in total; receive 2 infusions every 6 months [2 infusions are separated by 2 weeks]) - Lo Loestrin Fe PO QPM - Aleve 220 mg onc

Current Illness: N/A

ID: 1017621
Sex: M
Age: 53
State: KY

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

Lab Data: NA

Allergies: None known

Symptoms: Pt woke near 12AM w/ intense nausea/stomach cramps. No fever - nothing new in diet. Got up to vomit, woke up on bathroom floor later in his own vomit. Intense watery stools after he came to along w/ pain/nausea all night - no other loss of counsciousness. Felt like he should go to ER, had no one to drive him. Felt somewhat better in AM, still intense nausea but no vomiting. No fever, no headache, no pain in neck/sign of head trauma from previous night. Heart rate slightly elevated 91 bpm - 113/73 at time of visit - 3:20 2/9/2021 Referred to primary care physician for a follow-up. Pt had minor issues with the first injection on 1/11/21 - palpable 1" knot around injection site for 1 week, pain & fatigue, night sweats.

Other Meds: omeprazole, zrytek, sucralfate, Vit D, Vit C, Zinc

Current Illness: Plantar fascitis, GERD

ID: 1017622
Sex: F
Age: 25
State:

Vax Date: 02/02/2021
Onset Date: 02/03/2021
Rec V Date: 02/09/2021
Hospital:

Lab Data: Strep A negative 2/8/21

Allergies: peanuts (anaphylaxis)

Symptoms: 2/3/21; Approximately 12 hours post vaccine, injection site swelling and stiffness, 18 hours headache and body aches that were not diminished by 500mg ibuprofen. 2/4/21; whole body muscles aches and headaches that went away 6:00pm. 2/5/21; sore throat began pm, large and small white patches seen on tonsils 2/5/21 11:00 pm to 2/8/21 am. Care team took throat culture 2/8/21 to determine strep recurrence, culture returned as negative. White spots on tonsils diminished 2/8/21. 2/9/21 hives on extremities with certainty to no possible allergens or new product exposure.

Other Meds: birth control

Current Illness: Strep A began 12/29/2020

ID: 1017623
Sex: F
Age: 64
State: OR

Vax Date: 02/05/2021
Onset Date: 02/01/2021
Rec V Date: 02/09/2021
Hospital:

Lab Data:

Allergies: Gluten Sensitive

Symptoms: Vial had been removed from deep freezer and placed into cooler longer than prescribe timeline outlined by Pfizer. Administered into patient (employee) prior to issue being identified. Pfizer states unlikely to have harmful effect, however cannot guarantee effectiveness. ID physicians recommend offering 3rd dose ~3-4 weeks, which will be done

Other Meds:

Current Illness:

ID: 1017624
Sex: M
Age: 71
State:

Vax Date: 01/28/2021
Onset Date: 02/02/2021
Rec V Date: 02/09/2021
Hospital: Y

Lab Data:

Allergies:

Symptoms: bilateral numbness, tingling Narrative: Pt had received Moderna Lot 029L20A on 1/28/21. Pt endorses that he began to feel tingling in his hands, bilaterally on 2/2/2021. Pt presented to hospital on 2/4/2021 w/ CC that his arms and legs were weak and he has been having difficulties going up stairs and getting out of bed and these symptoms are not normal for patient. Pt also noticed double vision in horizontal plane lasting up to 30min and resolves spontaneously and then returns a few hours later. Pt is currently being worked up to rule out GBS

Other Meds:

Current Illness:

ID: 1017625
Sex: F
Age: 41
State:

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 02/09/2021
Hospital:

Lab Data:

Allergies:

Symptoms: whole body aches, bones and skin, everything hurt, HA fatigue, hands and head cold but body burning up.

Other Meds:

Current Illness:

ID: 1017626
Sex: M
Age: 86
State: NE

Vax Date: 02/06/2021
Onset Date: 02/07/2021
Rec V Date: 02/09/2021
Hospital:

Lab Data:

Allergies: PCN, NSAIDS, Aspirin, Bactrim, Diuretic-AP-ES

Symptoms: Body aches 24 hours post vaccine and resolved within 24 hours

Other Meds: Eliquis 2.5mg, Hydrochlorothiazide 25mg, Metoprolol 25mg ER, Latanoprost Sol, Protonix 40mg, Tamsulosin 0.4mg

Current Illness: none

ID: 1017627
Sex: F
Age: 71
State: MO

Vax Date: 02/02/2021
Onset Date: 02/04/2021
Rec V Date: 02/09/2021
Hospital:

Lab Data: n/a

Allergies: Codeine, Lipitor, Lisinopril, metformin, amoxicillin

Symptoms: Shingles outbreak developed <48 hrs after vaccination

Other Meds: Protonix, rosuvastatin, Bentyl, Amlodipine, Xanax, Aspirin

Current Illness: none

ID: 1017628
Sex: F
Age: 51
State: VA

Vax Date: 01/15/2021
Onset Date: 01/15/2021
Rec V Date: 02/09/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: About 45 minutes after the injection, I began to feel tingling in my tongue. It also looked like I had a sunburn. I was pink from head to toe.

Other Meds: Levothyroxine

Current Illness: None

ID: 1017629
Sex: F
Age: 42
State: OH

Vax Date: 02/05/2021
Onset Date: 02/09/2021
Rec V Date: 02/09/2021
Hospital:

Lab Data: n/a

Allergies: fluconazole

Symptoms: pt noted red, raised rash at injection site, approximately 2 inches x 2 inches. Area does not have increased warmth.

Other Meds: singular, xyzal, birth control,

Current Illness: n/a

ID: 1017630
Sex: M
Age: 68
State: NM

Vax Date: 02/06/2021
Onset Date: 02/06/2021
Rec V Date: 02/09/2021
Hospital:

Lab Data: CBC, comprehensive metabolic panel, BNP, troponin, Quad test (RSV, Flu A/B, SARS)

Allergies: Hospitalized overnight for anaphylactic shock 2/4-2/5/2021, unknown trigger.

Symptoms: Urticaria.

Other Meds: metformin, lisinopril, furosemide, carvedilol, atorvastatin, amlodipine, NPH/regular insulin, albuterol MDI (Received epinephrine IV, famotidine, methylprednisolone, diphenhydramine in ED on 2/4/2021 for anaphylactic shock)

Current Illness: lized overnight for anaphylactic shock 2/4-2/5/2021, unknown trigger.

ID: 1017631
Sex: M
Age: 54
State:

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 02/09/2021
Hospital:

Lab Data:

Allergies:

Symptoms: HA, nausea, body aches, very sore arm. Worse on day 2.

Other Meds:

Current Illness:

ID: 1017632
Sex: F
Age: 27
State: PA

Vax Date: 01/15/2021
Onset Date: 01/15/2021
Rec V Date: 02/09/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Received Moderna Covid -19 vaccine to the LD at 8:27 a.m. At 8:39 a.m. patient complaint of "tight" left arm. At 8:44 a.m. complaint of a sore left arm and the need to take deeper breaths, stated chest felt heavy. RN in practice consulted with Nurse practitioner and directed PO Benadryl 25 mg (10ml) administered at 8:47 a.m. At 8:52 a.m. bilateral hands are tight, swollen, bilateral upper arms are red, blotchy, and itchy. Patient reports a "weird" taste in her mouth perhaps from the oral Benadryl suspension. 9:02 a.m. patient ambulated to the ED with the RN, who was present with the patient through the duration of the above incident until she was taken to a room in the Hospital ED. Patient did have a co-worker present before she was taken to the ED.

Other Meds:

Current Illness:

ID: 1017633
Sex: F
Age: 44
State: NY

Vax Date: 02/09/2021
Onset Date: 02/09/2021
Rec V Date: 02/09/2021
Hospital:

Lab Data:

Allergies: n.k.d.a

Symptoms: pt was observed for 15 minutes after receiving moderna covid-19 vaccination and was discharged home. Pt states as she was driving home she noticed hives devloping over face and chest and returned to clinic i8mmediately after (about 25 min total after receiving vaccine)

Other Meds: Biotin in the AM

Current Illness:

ID: 1017634
Sex: F
Age: 66
State: MO

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 02/09/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: area of firm induration to left upper arm, overlying skin is red with vesicle formation. Area of induration is approx 10 cm in diameter. Area of redness is approx 15 cm in diameter. Vesicle patch is approx 1.5 cm in diameter.

Other Meds: protonix losartan clonidine HCTZ

Current Illness: none

ID: 1017635
Sex: F
Age: 33
State:

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

Lab Data:

Allergies:

Symptoms: Caregiver received first Pfizer dose and immediately started to feel bad. Started having racing heart, nausea, abdominal pain, shaky and "pins and needles feeling." CG vitals taken, HR noted to be in 1-teens but reduced to 80s shortly after, BP was 120/80, O2 sat 99%. CG stayed for 1 hour post vaccine and states her symptoms resolved. Today just has a sore arm and a little nausea.

Other Meds:

Current Illness:

ID: 1017636
Sex: F
Age: 54
State: NY

Vax Date: 12/28/2020
Onset Date: 01/26/2021
Rec V Date: 02/09/2021
Hospital:

Lab Data:

Allergies: Cefuroxine Axehl, Clarithromycin, fenfoxidine, psuedophedrine

Symptoms: Patient was given 2nd dose of Moderna by employer, Health on 1/25/21. She informed her PCP the 24 hours after receiving 2nd dose she developed right jaw pain,and shooting sensation. She was seen by dentist with no cause found. On 1/29/21 she saw a provider who placed her on an antibiotics for possible sinusitis due to facial/ear pain. Was seen by PCP on 2/5/21 and diagnosed with trigeminal neuralgia and started on gabapentin and referred to neurology.

Other Meds: None

Current Illness: None

ID: 1017637
Sex: F
Age: 59
State: WA

Vax Date: 01/27/2021
Onset Date: 02/08/2021
Rec V Date: 02/09/2021
Hospital:

Lab Data: None

Allergies: None Known

Symptoms: Day 12 Itching, warm to touch and red, ringed rash around injections site. Previous reactions on day 2 subsided about day 7.

Other Meds: Metformin, Spironolactone, Multi-vitamin, fish oil, Vit D, Wellbutrin

Current Illness: None

ID: 1017638
Sex: M
Age: 38
State: OR

Vax Date: 02/05/2021
Onset Date: 02/01/2021
Rec V Date: 02/09/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Vial had been removed from deep freezer and placed into cooler longer than prescribe timeline outlined by Pfizer. Administered into patient (employee) prior to issue being identified. Pfizer states unlikely to have harmful effect, however cannot guarantee effectiveness. ID physicians recommend offering 3rd dose ~3-4 weeks, which will be done.

Other Meds:

Current Illness:

ID: 1017639
Sex: F
Age: 41
State: WA

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 02/09/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Received 2nd dose of Moderna COVID-19 vaccine on Fri. 1/22/2021 at 13:00. By 19:00 that evening, I started to feel hot and my body started to ache. Then the chills and headache started shortly after, along with a rapid heart rate followed by bouts of fatigue. It intensified overnight and continued all day Sat. 1/23. I took Tylenol and Advil to relieve some pain and reduce the fever, but it didn't help much and I just stayed in bed. It was difficult to get up. On Sun. 1/24, I could finally manage to get up without help, but felt dizzy and weak. I continued to take Tylenol to reduce my fever. At it's peak, it was 102.5 and it stayed between 101.5 - 102.5 from Friday night until Sunday morning. Then it started to range from 100.5 - 101.3 for most of the day Sun. 1/24. By Mon. 1/25, I could tolerate the aches and pains, but still had a fever for most of the day. I stopped taking Tylenol to see if my fever would finally break and it did by that Mon. 1/25 night. I returned to work on Tues. 1/26. I woke up symptom free finally.

Other Meds: Bupropion SR 150 MG 12 hour tablet - 1 a day Buspirone 5 MG tablet - 1 a day Cetirizine 10 MG tablet - 1 a day Estradiol 1 MG tablet - 1 a day Hydrochlorothiazide 12.5 MG tablet - 1 a day Omeprazole 40 MG capsule - 1 a day Triamcinolone 0.1

Current Illness:

ID: 1017640
Sex: M
Age: 31
State: NJ

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

Lab Data:

Allergies: n/a

Symptoms: pt stated he was having chest pains, high pulse...111, high blood pressure, and felt winded

Other Meds: n/a

Current Illness: n/a

ID: 1017641
Sex: M
Age: 37
State:

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

Lab Data:

Allergies:

Symptoms: Narrative:

Other Meds:

Current Illness:

ID: 1017642
Sex: F
Age: 19
State: TX

Vax Date: 01/29/2021
Onset Date: 02/07/2021
Rec V Date: 02/09/2021
Hospital: Y

Lab Data:

Allergies:

Symptoms: TTP flare, child with history of acquired TTP that had been on remission and off treatment for 5 years

Other Meds:

Current Illness:

ID: 1017643
Sex: M
Age: 78
State: PA

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 02/09/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: 1) Vomit; 2) long lasting stiffness a mussel aches

Other Meds: Aspirin 81 mg Azelastine HCL (Astelin) 30ml/137mcg Guaifenesin (Mucinex) 600 mg Hydrochlorothiazine (HCTZ) 12.5 mg Losartan (Cozzar) 50 mg Levothyroxine (Synthroid) 50 mcg Montelukast (Singulair) 10mg Pantoprazole (Protonix) 40 mg Rosuvasta

Current Illness: Post nasal drip with cough. Perhaps cough cause by acid reflux

ID: 1017644
Sex: F
Age: 49
State: PA

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 02/09/2021
Hospital:

Lab Data: Didn't get any done

Allergies: Morphine

Symptoms: Received sore blisters in underarm area. Very itchy

Other Meds: Amlodipine Atorvastatin HCTZ Potassium Losartan Novolin 70/30 Aspirin Colace Fish oil Cinnamon Tumeric

Current Illness: N/A

ID: 1017645
Sex: M
Age: 61
State: AZ

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 02/09/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Fever chills and a little vomiting

Other Meds: None

Current Illness: None

ID: 1017646
Sex: F
Age: 67
State: AZ

Vax Date: 02/04/2021
Onset Date: 02/06/2021
Rec V Date: 02/09/2021
Hospital:

Lab Data: No tests were performed at Urgent Care

Allergies: None

Symptoms: Saturday (2/4/21) morning the patient noticed that her arm ( shoulder/deltoid area) was hot to touch, red and pain radiating from the area. Saturday around noon the Redness started to spread to 1 inch above the elbow. Saturday around 4pm the redness has spread past beyond the elbow. Inform patient to go to urgent care. At urgent care the patient received a steroid shot and a Rx for Keflex. Sunday (2/5/21) morning contacted patient the symptoms of pain has decreased to a minimal level. The shoulder/ deltoid area still had some redness but the redness started to subside around her elbow area. Tuesday (2/09/21) The patient came in to follow up in person. The patient is no longer experiencing any signs or symptoms of the adverse event. No redness upon visual inspection.

Other Meds: Metoprolol ER 25mg, Atorvastatin 40mg, gabapentin 100mg, levothyroxine 100mcg

Current Illness: None

ID: 1017648
Sex: M
Age: 75
State: CA

Vax Date: 02/04/2021
Onset Date: 02/08/2021
Rec V Date: 02/09/2021
Hospital:

Lab Data:

Allergies: N/A

Symptoms: Headache, neck pain Unusual general fatigue next morning

Other Meds: blood pressure medicine

Current Illness: None

ID: 1017649
Sex: F
Age: 33
State: WI

Vax Date: 02/09/2021
Onset Date: 02/09/2021
Rec V Date: 02/09/2021
Hospital:

Lab Data: None

Allergies: Penicillins, Bee, Peanut

Symptoms: Patient received vaccination and after approximately 20 minutes reported dizziness and "tongue feeling weird". Vital signs were obtained with BP 120/76, HR 120, RR 16, and SPO2 99%. Patient was taken via wheelchair to the emergency department where diphenhydramine, famotidine, methylprednisolone, and lorazepam was administered. Patient was monitored in the emergency department and then discharged home.

Other Meds: Ciprofloxacin 500 mg, esomeprazole 40 mg, ferrous sulfate 325 mg (65 FE)

Current Illness: Unknown

ID: 1017650
Sex: M
Age: 67
State: VA

Vax Date: 12/30/2020
Onset Date: 01/02/2021
Rec V Date: 02/09/2021
Hospital:

Lab Data:

Allergies:

Symptoms: I experienced dry mouth really bad. My breath has been really rough on me, very dry. I called my PCP to follow up with him on my situation. I used Biotine mouth wash since the vaccine. I will see my PCP on 02-11-2021 for follow up status. I will be going to see my dentist Monday 02-15-2021.

Other Meds: Medicine for the VA clinic (but does not remember the names)

Current Illness:

ID: 1017651
Sex: F
Age: 72
State: NC

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

Lab Data: none/unknown

Allergies: meperidine (hallucinations), oxycodone (hallucinations), Clona

Symptoms: On 2/8/2021, 72yr old female with depressive disorder, GAD, HTN, hyperlipidemia, osteopenia was administered COVID-19 Pfizer vaccine 0.3mL in right deltoid (LOT # EM9810). Patient has several documented allergies including meperidine (hallucinations), oxycodone (hallucinations), clonazepam (hives) and prednisolone (itching). Patient initially tolerated injection without incident and was sent for post-injection 15min observation. During 15min observation period, patient developed "difficulty swallowing". Patient brought back to room to be seen by provider. Patient noted issue was "mild" and denied any difficulty breathing. Patient able to talk in complete sentences without any evidence of wheezing or stridor.

Other Meds: aspirin, atorvastatin, buspirone, cholecalciferol, Fish Oil,

Current Illness: unknown

ID: 1017652
Sex: F
Age: 89
State: OH

Vax Date: 02/09/2021
Onset Date: 02/09/2021
Rec V Date: 02/09/2021
Hospital:

Lab Data: ER visit, including labs and CT scan of the head

Allergies: Codeine

Symptoms: Patient remained in the monitoring room for an hour after her vaccine. She had no adverse events for the first 15 minutes, but staff found her responsive only to sternal rub, slumped in her chair 1 hour after vaccine.

Other Meds: Baby aspirin, centrum silver MVI, diltiazem ER, loratadine, Senna, "MightyShakes chocolate liquid," atorvastatin, mirtazapine, Xarelto.

Current Illness: N/A

ID: 1017653
Sex: M
Age: 59
State: WI

Vax Date: 01/05/2021
Onset Date: 01/05/2021
Rec V Date: 02/09/2021
Hospital:

Lab Data:

Allergies:

Symptoms: 2:45pm less than ten minutes post vaccination c/o severe headache. BP elevated above normal greater than 180/ denies dizziness. Hx of DM currently on holter monitor. Hx of MS 2:50pm BP 179/81HR 69 SPO2 99% 2:55pm BP 180/81 HR 66 SPO2 99% 3:08pm BP 171/76 HR 64 SPO2 99% 3:25pm BP 185/79 HR 62 SPO2 100% 3:30pm EE verbalized feeling much better able to ambulate per self went home.

Other Meds:

Current Illness:

ID: 1017655
Sex: M
Age: 83
State: OH

Vax Date: 02/09/2021
Onset Date: 02/09/2021
Rec V Date: 02/09/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Patient at facility stated that he had already received both doses of the vaccine. The pharmacist consulted with the nursing staff and reviewed the vaccine administration card. Both the staff and the card did not have record of him receiving the second dose so the pharmacist administered the vaccine. The pharmacist returned to the store for processing and found that the patient had documented both doses and was mistakenly dosed for a 3rd time.

Other Meds:

Current Illness:

ID: 1017656
Sex: F
Age: 59
State: CO

Vax Date: 01/17/2021
Onset Date: 01/30/2021
Rec V Date: 02/09/2021
Hospital:

Lab Data: None. The side effects did not require medical attention. I did not visit a healthcare professional or call anyone, but thought this might be an important event to report.

Allergies: None known.

Symptoms: Moderna COVID-19 Vaccine EUA - I had swelling, itching and redness from the upper L arm to just above the elbow on the outside of the arm. There was no pain and the symptoms subsided by the next day around midday. I had no other issues that I could discern.

Other Meds: Metforman; Lisinopril; Avorastatin; Vivascal

Current Illness: N/A

ID: 1017657
Sex: F
Age: 41
State: VA

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 02/09/2021
Hospital:

Lab Data: None

Allergies: Wheat, Latex, Certain wine, Nickel

Symptoms: After receiving the vaccination I had tingling in my left arm. I had a rapid heartbeat with skipped beats that took a long time to subside. Saturday and Sunday they would come in spurts. Medication was taken to help. It helped some, however the skipped beats and the rapid heart rate continued. By Monday, the 8th my heart rate was back to normal.

Other Meds: Tirosent Magnesium L-Theorate Cortistop Probiotic/Prebiotic Omegas Selenium Zinc Milk Thistle Vit. D & C

Current Illness: None known

ID: 1017658
Sex: M
Age: 28
State: ID

Vax Date: 02/09/2021
Onset Date: 02/09/2021
Rec V Date: 02/09/2021
Hospital:

Lab Data:

Allergies: Bactrim Penicillin Seasonal allergies

Symptoms: Bumps and redness both hands. Dry mouth and tingling in roof of mouth

Other Meds: None

Current Illness: none

ID: 1017659
Sex: F
Age: 44
State:

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 02/09/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Slight nausea, fever of 102, severe chills, sever aches and joint pain.

Other Meds:

Current Illness:

Date Died:

ID: 1017660
Sex: M
Age: 94
State: NY

Vax Date: 01/10/2021
Onset Date: 01/26/2021
Rec V Date: 02/09/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Patient contracted COVID and was hospitalized. He later died- respiratory failure secondary to COVID-19 pneumonia. This was not related to a vaccine adverse event, but reporting based on requirements.

Other Meds:

Current Illness:

ID: 1017661
Sex: F
Age: 58
State: NE

Vax Date: 02/06/2021
Onset Date: 02/09/2021
Rec V Date: 02/09/2021
Hospital:

Lab Data:

Allergies: Morphine

Symptoms: Vomiting and diarrhea started a little over 48 hours post vaccine and still not resolved as of 2/9 at 3:30pm. APRN for resident has been faxed.

Other Meds: Artificial tears, Aspirin 81mg, Lipitor 40mg, Docusate 100mg, Flonase, Gabapentin 300mg, Norco 5-325mg, Latuda 40mg, Levemir, Novolog, Lisinopril 20mg, Loratadine 10mg, Melatonin 3mg, Prilosec 20mg, Zoloft 100mg, Timolol, sevelamer 800mg, T

Current Illness:

ID: 1017663
Sex: F
Age: 64
State: AZ

Vax Date: 02/09/2021
Onset Date: 02/09/2021
Rec V Date: 02/09/2021
Hospital:

Lab Data:

Allergies: ATENOLOL, CEPHALEXIN, CODEINE, COVID-19 VACCINE, ELM, ERYTHROMYCIN, GLIPIZIDE, INDOMETHACIN, METFORMIN, PENICILLIN, PROCHLORPERAZINE, REGULAR INSULIN PORK, SULFAMETHOXAZOLE,

Symptoms: Itchiness and hives within 15 min of vaccine. Took (2) 25 mg Benadryl and symptoms were improving after 30 min. Patient left feeling better.

Other Meds: ACETAMINOPHEN 325MG TAB AMLODIPINE 5MG TAB ASPIRIN 81MG ENTERIC COATED TAB BACLOFEN 10MG TAB CETIRIZINE 10MG TAB CHOLECALCIFEROL5MCG (1,000UNIT) TAB CYANOCOBALAMIN 1000MCG TAB CYCLOBENZAPRINE 10MG TAB DOCUSsate

Current Illness: DM, migraine, hypothyroid

ID: 1017664
Sex: F
Age: 48
State: WA

Vax Date: 01/07/2021
Onset Date: 01/14/2021
Rec V Date: 02/09/2021
Hospital:

Lab Data:

Allergies: Wellbutrin

Symptoms: Typical "COVID vaccine arm" symptoms 1/14/21 - woke up with injection site swollen and itchy with hives. 1/15/21 - 2 inch, well demarcated hard, red, very hot. Located more in the skin than deep. No pain. Treated with ice, tylenol, 1% hydrocortisone topical cream. 1/16/21 - area still hard, HOT, redness spread toward armpit, mild joint and injection site pain. Treated with ice. 1/17 - 1/18/21 - decrease in all symptoms, though redness continued to spread toward armpit. Site now swollen deep to site rather than in skin. Treated with ice. 1/19/21 - faint redness, less swelling and heat. 1/20/21 - symptoms mostly resolved at injection site. Still some warmth and pinkness in area near armpit. Site soft.

Other Meds: Simpesse

Current Illness:

ID: 1017665
Sex: M
Age: 46
State: OH

Vax Date: 01/23/2021
Onset Date: 01/24/2021
Rec V Date: 02/09/2021
Hospital:

Lab Data: N/A

Allergies: maple trees

Symptoms: Possible symptom 1: Within approximately a day or two of the shot, I developed a severe and persistent lower abdominal/groin pain. The pain was very pin point in location and lasted for approximately 10 days before easing up. Very small isolated pain severe enough to go to the DR, but I could not afford to on account of my wife having severe unknown abdominal pain and being in the ER and DR multiple times herself (she got the same vaccine an hour before me?). Possible symptom 2: 4-5 days after the shot I developed an isolated and severe pain in a preexisting nodule/mass (lymph node?) located on my mid right thigh, it has never had any sensation before. The pain was persistently severe for approximately 7 days before easing up.

Other Meds: none

Current Illness: none

ID: 1017666
Sex: F
Age: 71
State: NV

Vax Date: 01/20/2021
Onset Date: 01/28/2021
Rec V Date: 02/09/2021
Hospital:

Lab Data: Blood test at the ER showed my white blood count was normal.

Allergies: Pennicillian, Night shades, mold, pollen, dust

Symptoms: Arm swollen, hot to the touch. Went to the ER. Was given steriods, benadryl and pepsid through IV. Then a 4 day prescription for 40 mgs of steriods. Arm is back to normal. Saw PCP. He said I should have a serology blood test to see if I need the second dose.

Other Meds: Benezapril, Nature Thyroid, Trazadone

Current Illness:

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm