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: 1019568
Sex: F
Age: 75
State: SC

Vax Date: 01/27/2021
Onset Date: 02/02/2021
Rec V Date: 02/10/2021
Hospital:

Lab Data: Feb 8 rapid COVID test....negative

Allergies: codeine erythromycin levaquin

Symptoms: Feb 2nd and 3rd had flushed feeling on face. Feb. 4th to present red, hot, itchy blotch on left arm. During the course of this I experienced occasional chill and poor appetite. However I could taste and smell food. Was tested on Feb 8 for COVID-19. Test negative.

Other Meds: atorvastatin levothyroxine losartan B12 D low dose aspirin

Current Illness:

ID: 1019569
Sex: F
Age: 45
State:

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 02/10/2021
Hospital:

Lab Data:

Allergies:

Symptoms: fever, chills, head/body aches. called in sick to work.

Other Meds:

Current Illness:

ID: 1019570
Sex: F
Age: 54
State: NY

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

Lab Data: Vital signs and enhanced observation.

Allergies: Penicillin. milk

Symptoms: Immediately post vaccine patient complained of metallic taste in mouth, itchy tongue, diaphoresis and shortness of breath. On VS Heart rate and blood pressure were elevated O2 sat was WNL. Patient w as placed in a supine position and VS were repeated after 15 min and she felt better and VS were now WNL

Other Meds:

Current Illness:

ID: 1019571
Sex: F
Age: 42
State: AR

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 02/10/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Patient reported nausea and was treated with Zofran ODT 4mg x 2. Resolved in 30 minutes.

Other Meds:

Current Illness:

ID: 1019572
Sex: F
Age:
State: AZ

Vax Date: 01/05/2021
Onset Date: 01/26/2021
Rec V Date: 02/10/2021
Hospital:

Lab Data:

Allergies: Normally suffer high inflammation due to dietary food sensitivity

Symptoms: Next day bad headache, two days later bad GI upset, stomach pain inflammation ; 2nd vaccine Psfizer

Other Meds: Armour 50 mg, Losartan 50mg daily,

Current Illness: HTN, cholesterol , sleep apnea , obese, hypothyroidism , neuropathy, osteoarthritis, food sensitivity inflammation , tinnitus, kidney lesion

Date Died:

ID: 1019573
Sex: F
Age: 81
State: SD

Vax Date: 01/18/2021
Onset Date: 01/19/2021
Rec V Date: 02/10/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Systemic: Blood Disorder (diagnosed by MD)-Severe, Systemic: Cardiac Disorder (diagnosed by MD)-Severe, Systemic: Other- Acute Kidney Injury, Hypoxia; lasted 10 days

Other Meds:

Current Illness:

ID: 1019574
Sex: F
Age: 82
State: FL

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

Lab Data:

Allergies: Latex, Epinephrine

Symptoms: Client stated that she was experiencing sudden headache, jittery, and slightly lightheaded. She voiced that the feeling of getting lightheadedness was not unusual but the sudden headache was. Pt was seen and assessed by EMT. VS as followed BP 150/89, HR 76, O2 97. Pt cleared by EMT to go home.

Other Meds: Senamet Capodopa 25 mg.

Current Illness:

ID: 1019575
Sex: F
Age: 35
State: KS

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 02/10/2021
Hospital:

Lab Data:

Allergies: Biaxin, Penicillin, Monistat, Bactrim

Symptoms: Difficulty swallowing and lip swelling, given Benadryl, Zyrtec and Prednisone at 8:05. Swelling went down by 10 am. Has some tingling in hands and feet through out that day, but stopped after 24 hrs. Had some pain in left armpit on Sunday and Monday. No more symptoms today.

Other Meds: Clonazepam, Loestrin, Spironolactone, omeprazole.

Current Illness:

ID: 1019576
Sex: F
Age: 59
State: NH

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 02/10/2021
Hospital:

Lab Data: BP: 200/110 Pul: 136 O2: 99 Temp: 97.6

Allergies: PCN, Bactrim

Symptoms: 59 y/o Female PT was administered COVID Vaccine at 1800. PT states started to notice her heart rate was increasing at a very rapid pace according to her smart watch. General impression:f PT showed no signs difficulty breathing, skin is warm and dry to the touch, no sweating. PT does present with mild tremor in her hands. PT states that she has a history of getting raised heart rates after digesting food with a high sodium content. PT states has a feeling of "panicie" and has a dry mouth / denies any difficulty breathing or tightness in her throat or chest. No blurred vision. Vitals where obtained at 1810 EMS was called. PT refused medical care, and signed off with them

Other Meds:

Current Illness:

ID: 1019577
Sex: M
Age: 82
State: DE

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

Lab Data: CTA chest - showing small PE 2/9/21 UA - multiple white blood cells and bacteria (culture pending) 2/9/21 CBC with WBC count slightly elevated at 11.3 - 2/9/21 COVID PCR test negative - 2/9/21 Other labs and EKG unremarkable / stable

Allergies: none

Symptoms: Pt awoke on 2/8 feeling tired and weak. On 2/9 patient developed fever to 102 and shortness of breath and vomiting. Was seen in ER and admitted for presumed UTI as well as small PE.

Other Meds: escitalopram, fludrocortisone, gabapentin, Klor-con, mestinon, northera, pravastatin, valacyclovir, velcade, zofran, centrum silver, vitamin B12, metamucil, caltrate plus D

Current Illness: no acute illness; undergoing treatment for multiple myeloma

ID: 1019578
Sex: F
Age: 48
State: CT

Vax Date: 01/20/2021
Onset Date: 01/21/2021
Rec V Date: 02/10/2021
Hospital:

Lab Data:

Allergies: Sulfa drugs, monsels solution, Emycin, cefzil, zithromax, gynazole, benzonatate

Symptoms: Still cant use my arm more that 80%, very hard to lift and extend. Arm extremely sore and gets tingly. Don't have full range of motion. Aches extend to neck, back. Still extremely achy and edgy. No appetite.

Other Meds: Topamax, calcium, vit c

Current Illness:

ID: 1019579
Sex: F
Age: 47
State: TX

Vax Date: 02/04/2021
Onset Date: 02/06/2021
Rec V Date: 02/10/2021
Hospital:

Lab Data: NONE

Allergies: NONE

Symptoms: HEAD TO TOES HIVES, PAINFUL SKIN BURNING AND HORRIBLE ITCHING - FEELS LIKE NEEDLES STICKING HER, SWOLLEN LIPS

Other Meds: NONE

Current Illness: NONE

ID: 1019580
Sex: M
Age: 73
State: VA

Vax Date: 02/06/2021
Onset Date: 02/06/2021
Rec V Date: 02/10/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Public health nurse administered vaccine. The hub of the needle was loose and an unknown amount of vaccine ran down the recipient's arm. Followed up with recipient the following day 2/7/2021. Recipient verbalized arm was sore from the vaccine.

Other Meds:

Current Illness:

ID: 1019581
Sex: F
Age: 83
State: AZ

Vax Date: 01/22/2021
Onset Date: 01/25/2021
Rec V Date: 02/10/2021
Hospital: Y

Lab Data: CT Scans Blood Work XRays

Allergies: None

Symptoms: Lost consciousness, couldn't breathe, Kidney GFR dropped. Fluid in the lungs, Kidney damage. Still in hospital. No diagnosis at this time.

Other Meds: One A Day 50+ Aspirin 325mg Senakot 8.6mg latanaprost .005% Levemir Flextouch Pen 3ml 5s100 u/ml Novolog Flexpen 5x3ml100 u/ml Rosuvastatin Tabs10 mg Olmesartan Medoxomil Tabs40 mg Furosemide Tabs20 mg Clonidine Hcl Tabs0.1 mg Bupropion Hcl

Current Illness: None

ID: 1019582
Sex: F
Age: 63
State: LA

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 02/10/2021
Hospital:

Lab Data: CBC, CMP, Troponin adv. level, ECG 12 lead

Allergies: Ampicillin, codeine, morphine, sulfa drugs

Symptoms: Patient is a 63 y/o female with itchiness to her back of her throat, tongue tingling and having trouble swallowing.

Other Meds: Xanax 0.5 mg

Current Illness:

ID: 1019583
Sex: F
Age: 49
State: NV

Vax Date: 02/06/2021
Onset Date: 02/06/2021
Rec V Date: 02/10/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Systemic: Nausea, Systemic: Other- Shortness of breath.

Other Meds:

Current Illness:

ID: 1019584
Sex: M
Age: 85
State: IN

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

Lab Data: none

Allergies: Cortizone shots. Some form of Pennicillin

Symptoms: Body got a little achy. Noticed I had a slight fever the next day so I took an ibuprofen tablet.

Other Meds: Atorvastatin, Vit. D, Vit. C, Vit. E, Fish oil, Ginko Biloba, Saw Palmetto & Sage

Current Illness:

ID: 1019585
Sex: F
Age: 32
State: AR

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 02/10/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Patient experienced swelling in face hands and arms. Patient was treated with 50mg IM Benadryl and issue resolved in 20 minutes.

Other Meds:

Current Illness:

ID: 1019586
Sex: F
Age: 47
State: NY

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

Lab Data:

Allergies:

Symptoms: "Chills, soreness at injection site fever 99-101.3 chills, body aches ." "Motrin for the fever" "woke up feeling great" on 1/4/21

Other Meds:

Current Illness:

ID: 1019587
Sex: F
Age: 31
State: MI

Vax Date: 01/19/2021
Onset Date: 01/20/2021
Rec V Date: 02/10/2021
Hospital:

Lab Data: Unknown

Allergies: NKMA, Reports slight reaction to aluminum in earrings

Symptoms: Client reports that she had soreness and tenderness for 1-2 days in her left Deltoid where the vaccine was administered and then felt a lump in the same area. Then 10-11 days later she reported that her left Deltoid become red and itchy, and she developed a welt. She went to Urgent Care and the Physician diagnosed her with Cellulitis. She said they measured the welt as 4 1/2" x 6 1/2 " and treated her with topical Benadryl and oral antibiotics. She reported that the antibiotics were helping and the redness and swelling were decreasing.

Other Meds: Unknown

Current Illness: Unknown

ID: 1019588
Sex: M
Age: 64
State:

Vax Date: 02/08/2021
Onset Date: 02/09/2021
Rec V Date: 02/10/2021
Hospital:

Lab Data:

Allergies:

Symptoms: The patient received his 2nd dose of covid vaccine on Monday 2/8/21. The patient did not complain of any ADRs or fever immediately following the injection. However, the next day he had a temperature of 100.4 F. Since the patient was febrile, he received acetaminophen 650mg x1 at 7:46pm. The repeat temperature at 10pm was 98.8 F. He was not in distress. He had no complaints otherwise.

Other Meds:

Current Illness:

ID: 1019589
Sex: F
Age: 72
State: TX

Vax Date: 10/08/2020
Onset Date: 10/10/2020
Rec V Date: 02/10/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Patient reported right shoulder injury that started shortly after vaccination. She states she went to an ortho specialist after about two months and was told her injury was from the vaccine.

Other Meds:

Current Illness:

ID: 1019590
Sex: F
Age: 35
State: CA

Vax Date: 02/03/2021
Onset Date: 02/04/2021
Rec V Date: 02/10/2021
Hospital:

Lab Data:

Allergies: penicillin

Symptoms: Fever (102.0 F). Chills. Headache. Body aches. Skin sensitivity to touch. Rash. Painful large hive-like welts. Fever, chills, body aches lasted about 12 hours. Rash/hives still present after 1 week.

Other Meds: Lexapro 10 mg PO daily

Current Illness: none

ID: 1019591
Sex: F
Age: 62
State: NY

Vax Date: 01/17/2021
Onset Date: 01/17/2021
Rec V Date: 02/10/2021
Hospital:

Lab Data:

Allergies: Sulfa

Symptoms: After receiving 1st vaccine dose (01/17/2021)- developed rash of the arms "covid arm" After receiving 2nd vaccine dose on 2/7/2021- rash on both arms intensified in color

Other Meds: None noted

Current Illness: No active medical problem

ID: 1019592
Sex: F
Age: 77
State: OH

Vax Date: 01/28/2021
Onset Date: 02/07/2021
Rec V Date: 02/10/2021
Hospital:

Lab Data: None.

Allergies: Levaquin, Cephalosporin, Penicillin, Sulfa, latex.

Symptoms: Started 10 days after she received the vaccine, 2/7/21, found while washing her head, bumps on her head. This progressed to her neck and on Monday 2/8/21, noticed that it was behind her ear. Yesterday and today she has noticed that it has traveled more to her throat area. She has taken Tylenol and this seems to have helped. The symptoms seem to subside while on the Tylenol, but after 6 hours she then notices that the feeling is coming back.

Other Meds: Simvastatin, Flax seed, baby aspirin, Multivitamin.

Current Illness: Hysterectomy December 7, 2020.

ID: 1019593
Sex: F
Age: 58
State: MI

Vax Date: 01/25/2021
Onset Date: 01/28/2021
Rec V Date: 02/10/2021
Hospital:

Lab Data: Was seen in Metro Health ED on 02/02/2021, normal testing Have seen PCP and taken off of work

Allergies: Too many to list

Symptoms: Pfizer COVID vaccine, symptoms still evolving and mimic COVID but negative COVID test. Have lost ability to walk without a walker, severe weakness, fatigue, dizzy, distortion in hearing, metellic taste, body aches and joint pain, intermittent headache and nausea. No fever no cough.

Other Meds: Acyclovir 500 mg, buspirone 10 mg, calcium 600 mg, Restasis, diltiazem 180 mg, estradiol 1 mg, levothyroxine 50 mcg, lisinopril 40 mg, magnesium 250 mg, montelukast 10 mg, multi-vitamin, Nexium 40 mg, Olmesartan 20 mg, potassium 20 mEq, su

Current Illness: Lymphadenopathy

ID: 1019594
Sex: M
Age: 34
State: VA

Vax Date: 01/19/2021
Onset Date: 01/27/2021
Rec V Date: 02/10/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: At day 8, my arm began feeling itchy and hot at the injection site. The injection site began to become sore again and devoloped a red circular rash.

Other Meds: none

Current Illness: none

ID: 1019595
Sex: F
Age: 51
State: NY

Vax Date: 02/07/2021
Onset Date: 02/07/2021
Rec V Date: 02/10/2021
Hospital:

Lab Data: None

Allergies: Sulfa

Symptoms: Extreme fatigue (began about 11:00 pm 2/7/21 but still ongoing although lessened Fever (began about 8:00 am 2/8/21 100.6 and with two extra strength Tylenol went to 99.6 broke in 24 hours Chills (before fever and during) All over body aches (continues but lessoned) Injection site sore (ongoing) Injection site red and itchy (2/10 at 10:00 am)

Other Meds: None

Current Illness: None

ID: 1019596
Sex: F
Age: 31
State: OH

Vax Date: 02/06/2021
Onset Date: 02/06/2021
Rec V Date: 02/10/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Error: Diluent Administered Instead of Vaccine

Other Meds:

Current Illness:

ID: 1019597
Sex: F
Age: 82
State: TX

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 02/10/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Fever: 102*F, Flu like symptoms.

Other Meds:

Current Illness:

ID: 1019598
Sex: F
Age: 41
State: IN

Vax Date: 02/08/2021
Onset Date: 02/09/2021
Rec V Date: 02/10/2021
Hospital:

Lab Data:

Allergies:

Symptoms: severe headache, fever, tiredness, body aches lasted about 24 hours

Other Meds: none taken at time of vaccination but started taking tylenol at beginning of symptoms after 2nd dose

Current Illness: diagnosed with covid between my 1st and 2nd dose...1st dose date was 1/15/21, covid positive diagnosis was 1/24/21 with symptom onset of 1/21/21....second covid dose received on 2/8/21

ID: 1019599
Sex: F
Age: 41
State: NC

Vax Date: 02/07/2021
Onset Date: 02/07/2021
Rec V Date: 02/10/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: Received the first vaccine 1/10/21 and had no side affects. Received the second vaccine 2/7/21 @ 0830. At 1500, had a 101.0 fever, full body aches, chills, and all over body shaking. Concentrated, Dark, malodorous urine. Lasted on and off until 0700 2/9. Extreme Fatigue following on 2/9. At 2100 on 2/9, noticed bilateral hand swelling and discoloration (Purple and blue hands, with visible veins, ) BP taken on home BP cuff 159/95, HR 80 (no history of HTN).

Other Meds: Prenatal Vitamin, Vitamin C, Vitamin D

Current Illness: none

ID: 1019600
Sex: F
Age: 37
State: MN

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

Lab Data:

Allergies: No known allergies

Symptoms: Redness and marked swelling at injection site 1 week after receiving the vaccine. Patient has a history of delayed allergic reactions.

Other Meds: Cyclobenzaprine 10 mg, Fluticasone HFA inhaler 110 mcg/act, Mirena IUD, levothyroxine 25 mcg, omeprazole 40 mg.

Current Illness: None known

ID: 1019601
Sex: F
Age: 22
State: MD

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/10/2021
Hospital:

Lab Data:

Allergies: clams

Symptoms: c/o CP during 15 minute monitoring period. No SOB. No airway involvement.

Other Meds:

Current Illness:

ID: 1019602
Sex: M
Age: 77
State: MA

Vax Date: 01/27/2021
Onset Date: 02/01/2021
Rec V Date: 02/10/2021
Hospital:

Lab Data: MRI with and without contrast showed no abnormality related to the 6th nerve.

Allergies: none

Symptoms: Acute left 6th nerve ocular palsy.

Other Meds: atenolol, PRN ibuprofen

Current Illness: none

ID: 1019603
Sex: F
Age: 59
State: RI

Vax Date: 02/06/2021
Onset Date: 02/06/2021
Rec V Date: 02/10/2021
Hospital:

Lab Data:

Allergies: NONE

Symptoms: very sore arm, had to take tylenol, very tired, very itchy body rash

Other Meds: PURPLE RICE CBD OIL MELOXICAN, SERTRALINE

Current Illness: NONE

ID: 1019604
Sex: F
Age: 39
State: RI

Vax Date: 01/23/2021
Onset Date: 02/06/2021
Rec V Date: 02/10/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Mild Facial swelling: nose and under eyes, mild nasal congestion, mild fatigue, mild frontal headache, decreased appetite Duration ~7 days, began improving slightly after 5 days

Other Meds: Lamotrigine 100mg daily

Current Illness: None

ID: 1019605
Sex: M
Age: 73
State: TX

Vax Date: 10/08/2020
Onset Date: 10/10/2020
Rec V Date: 02/10/2021
Hospital:

Lab Data:

Allergies:

Symptoms: The patient's wife reported he had shoulder pain that began shortly after vaccination.

Other Meds:

Current Illness:

ID: 1019606
Sex: F
Age: 67
State: NH

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/10/2021
Hospital:

Lab Data: none

Allergies: codeine, flexeril, shellfish

Symptoms: VR developed lightheadedness, warmth and nausea several minutes after injection. HR-86, BP: 140/90, SP02: 98%. Pt improved with out treatment. EMS services/ ER evaluation were offered and pt declined. She elected to drive home as she felt much better after appx 45 minutes of observation in total.

Other Meds: pramipexol, Sinemet, docusate, biotin, propranolol

Current Illness: none

ID: 1019608
Sex: F
Age: 72
State: WI

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 02/10/2021
Hospital:

Lab Data: Per chart note from Doctor on 2/2/2021 for Assessment and Plan: Reassuring vitals and exam. Clinically well-appearing. Reassurance provided. Follow-up as needed.

Allergies: none known

Symptoms: The patient called questioning potential side effects of the second Shingrix vaccine around January 29th. We discussed all of the potential side effects, as documented by GSK. The patient stated she felt really tired, achy and just felt flu-like. She stated it was slowly getting better day by day. I told her if it is bothersome, then she should definitely contact her provider. She said she would if she still felt sick on Monday 2/1. She called her provider and made an appointment. In the chart notes, it states that everything appears to be within normal limits. No treatment was given. On 2/9, the patient called for copies of her receipts for her insurance. It was then that is was discovered that she had received the two series vaccines 4 weeks and 5 days apart. Patient was made aware and was told we will call the prescriber to see what he recommends. According to CDC, the vaccine should be re-administered if there is less than a 4 week interval. Doctor was made aware. He said that is the patient would like to receive another one, then that is fine, but he thinks she should be ok. I informed the patient of the doctor's recommendations on 2/10/2021. She declined another vaccine at this time, because she stated she doesn't want to go through that again. A Risk report has been filled out.

Other Meds: Alendronate 70mg, Trazodone 100mg, Lovastatin 20mg

Current Illness: None stated

ID: 1019609
Sex: F
Age: 31
State: CO

Vax Date: 01/28/2021
Onset Date: 02/04/2021
Rec V Date: 02/10/2021
Hospital:

Lab Data: None

Allergies: NKDA, NKFA

Symptoms: On February 4th, I noticed a slight discoloration of the injection site. It appeared to have a light red ring around the injection site. On Sunday Feb 7th, the discoloration started getting darker around the injection site. On Tuesday, Feb 9th the discoloration moved down my arm and looked like a blotchy redness. Today, Feb 10th, the color became darker and got bigger. There is no pain. There is "pins and needles" feeling, and some very minor numbness on my right forearm.

Other Meds: Trazodone 25 mg QHS

Current Illness: None

ID: 1019610
Sex: F
Age: 43
State: WI

Vax Date: 02/04/2021
Onset Date: 02/07/2021
Rec V Date: 02/10/2021
Hospital:

Lab Data: 2/8/21: Amylase 46, CBC: Hemoglobin 16/3, HCT 47.5, platelets 214, White Count 16.1 (with left shift) Manual Diff: bands 2, Lymphs 4, Monos 6, Seg 88, ANC 14,46, Glucose 173, Kidney Panel BUN 15, creatinine 0.7, GFT >60, potassium 3.9, sodium 140, Bilirubin total 1.7, Covid 19 negative, Labs done on 2/9/21 CBC White count 8.9, Hematocrit 40.4, Hemoglobin 13.9 platelets 187, Ablsolute Granulocyt or Neutrophils 6.6

Allergies: None

Symptoms: Patient got her 2nd covid shot on Thursday am. Felt fine Friday other then possibly a little achy and totally fine Saturday. Felt somewhat fatigued Sunday afternoon. Woke early Monday am around 1am with sudden vomiting and diarrhea. Noted multiple loose stools and multiple episodes of vomiting and unable to tolerate eating or drinking. Also noted feeling cold. Noted feeling dizzy and lightheaded. Continues to feel achy. Came into Urgent care for fluids on Monday 2/8 and Tuesday 2/9.

Other Meds: Depo-Provera 150 MG/ML Suspension 1 ml Intramuscular every 3 months. Metformin HCl 1000 MG Tablet 2 tablets Orally Once a day with biggest meal. Atorvastatin Calcium 40 MG Tablet 1 tablet Orally Once a day. Losartan

Current Illness: None

ID: 1019611
Sex: M
Age: 23
State: WA

Vax Date: 01/29/2021
Onset Date: 01/30/2021
Rec V Date: 02/10/2021
Hospital:

Lab Data:

Allergies: No known drug allergies

Symptoms: Date of Vaccines: #1 on 1/4/21, #2 on 1/29/21 Adverse event: On 1/5/21 had nasal congestion, rhinorrhea, allergy flareup. On 1/30/21 for 1 week had fatigue, chest pain, then had shingles at Left chest starting 2/4/21. Took Zyrtec for symptoms and is on Valacyclovir for shingles

Other Meds:

Current Illness:

ID: 1019612
Sex: M
Age: 52
State: KS

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 02/10/2021
Hospital:

Lab Data: N/A

Allergies: Bee stings

Symptoms: Chills, aches, and fever

Other Meds: N/A

Current Illness: N/A

ID: 1019613
Sex: F
Age: 53
State: KY

Vax Date: 01/06/2021
Onset Date: 02/08/2021
Rec V Date: 02/10/2021
Hospital:

Lab Data: COVID PCR swab 2/8/21 positive

Allergies: NKA

Symptoms: 2nd vaccine on 1/6/21. on 2/3/21 had a high risk exposure ( husband tested (+) for COVID) and was asymptomatic. on 2/8/21 tested positive for COVID

Other Meds:

Current Illness:

ID: 1019614
Sex: M
Age:
State:

Vax Date:
Onset Date: 01/22/2021
Rec V Date: 02/10/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Weak in my legs, headache, and fatigue

Other Meds:

Current Illness:

ID: 1019615
Sex: F
Age: 32
State: IN

Vax Date: 02/08/2021
Onset Date: 02/09/2021
Rec V Date: 02/10/2021
Hospital:

Lab Data: None

Allergies: Ceclor, septra

Symptoms: Migraine, redness, pain, and large lump at injection site, runny nose, fatigue

Other Meds: Lamictal, propanelal, trazadone, prozac

Current Illness: None

ID: 1019616
Sex: F
Age: 24
State: CA

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 02/10/2021
Hospital:

Lab Data: Unknown

Allergies: PCN

Symptoms: At 11:23 pt began to c/o having a hard time breathing and that her chest felt "tight". Doctor oversaw evaluation of pt. Vitals: 150/83; P-99-109; SpO2- 99% on RA. Pluse decreased to 81-82 as Doctor spoke to her. Paramedics checked lung sounds- Clear. 11:36 vitals repeated: 145/83; P-87; SpO2- 100% on RA. Vitals repeated at 11:48: 138/72; P-87; SpO2- 99% on RA. Stated that she was feeling better. Pt instructed to go to ER if s/s worsened; and encouraged to let her PMD know that she had noted s/s following her vaccination.

Other Meds: Unknown

Current Illness: Unknown

ID: 1019617
Sex: F
Age: 80
State: IN

Vax Date: 02/08/2021
Onset Date: 02/09/2021
Rec V Date: 02/10/2021
Hospital:

Lab Data: DID NOT SEEK MEDICAL ATTENTION. SIDE EFFECTS EXPECTED.

Allergies: NONE

Symptoms: SORE ARM AND SHOULDER, HEADACHE, LETHARGIC

Other Meds: LISINOPRIL, ZOCOR

Current Illness: NONE

ID: 1019618
Sex: M
Age: 41
State: IL

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

Lab Data: None

Allergies: penicillin, ceclor

Symptoms: Pain in the injection site 15 after the shot was given. At 1pm fever of 101 started with chill. Around 3pm muscle weakness and tiredness started.

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm