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: 1020922
Sex: F
Age: 53
State: AL

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

Lab Data:

Allergies: None

Symptoms: Mild nausea, chills began 12 hours after injection, fever 99.9 F, unable to sleep aching joints and fatigue. Next day about 24hrs stuffy nose dry mouth dry eyes and headache continued aching joints and fatigue. Unable to go to work

Other Meds: Amitiza, Lexapro, atorvastatin, trazodone

Current Illness: IBS-C, anxiety, high cholesterol

ID: 1020923
Sex: F
Age: 23
State: MI

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

Lab Data: None

Allergies: None

Symptoms: Fever, chills, leg muscle aches, and shortness of breath. Took 500 mg Tylenol and fever, muscle aches, and chills resolved. However, shortness of breath has started on 2/10 and has not resolved. I have to take deep breaths.

Other Meds: None

Current Illness: None

ID: 1020924
Sex: F
Age: 98
State: CA

Vax Date: 02/06/2021
Onset Date: 02/07/2021
Rec V Date: 02/10/2021
Hospital: Y

Lab Data: Recorded 2/7/21 SBP 170s HR 140s

Allergies: Allergies Bactrim [Sulfamethoxazole W/trimethoprim] Interacted with Amio Doxylamine nauseous Multaq [Dronedarone] Nausea, emesis Mupirocin, Pseudomonas Fluorescens

Symptoms: Pfizer vaccine, she presents with tremors, hypertension, tachycardia. Pt has a h/o Afib, and she tells me that she has had tremors in her RLE x6 months or so, but that it worsened today. Denies precipitating events. She also had SBPs up to 170's (150's/90's on my interview) and is tachy to 140's in sinus tach. Denies any caffeine today or anxiety or behavioral contributors today, no pain or other stimuli. Pt admits she is feeling jittery when she talks with me, and that taking deep breaths slows her heart rate to 70's-80's. Patient has notable history of cHF with associated LE edema in the past and should strongly be considered as part of this ADE assessment.

Other Meds: acetaminophen (TYLENOL) 325mg Tab amiodarone (CORDARONE, PACERONE) 200mg Tab Take one Tab by mouth every other day Indications: Paroxysmal Atrial Fibrillation ascorbic acid (VITAMIN C) 500mg TABS Tab Calcium Carb-Cholecalciferol (CA

Current Illness: None known

ID: 1020925
Sex: F
Age: 73
State: CO

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

Lab Data: NA

Allergies: Shellfish All Tetracyclines Erythramycin, Percodan, Percocet, Vicadan

Symptoms: Headache starting 1/29/21 in the evening, continuing for approximately 4 days. On Tuesday, 2/2/21, I woke up to a rash that was welted (hives?) and itchy all around my neck and shoulders as well as a prickly, stinging sensation on my face. I have not contacted the doctor again.

Other Meds: Mylan-Levothyroxine 112 mcg Losartan 50 mg OneADay Women's 50+ Supplement

Current Illness: NA

ID: 1020926
Sex: F
Age: 69
State: PA

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

Lab Data:

Allergies: Latex, Penicillin

Symptoms: 2/2 vaccinated , 2/9 all around vaccination site round red/hot/itchy

Other Meds:

Current Illness:

ID: 1020927
Sex: F
Age: 68
State: TX

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

Lab Data: none

Allergies: no

Symptoms: Mild tenderness after shot. Nurse pinched arm to inject which I thought was unusual. I had some itchiness. I think it was seven days later that I noticed redness about the size of a silver dollar around the site. It had been itching. Today is day ten and the redness is still there. I have very slight pain at site but was concerned that it was still "red" - more pink and after ten days. Just wanted to report it to see if it's normal. My next vaccine is scheduled for March 1, 2021. Thank you

Other Meds: Levothyroxine Tamoxifine Mucinex Flonase Tylenol PM

Current Illness: none

ID: 1020928
Sex: M
Age: 67
State: NY

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

Lab Data: n/a

Allergies: n/a

Symptoms: full body, pruritic, urticarial rash beginning 2 hrs after vaccine administration. Given Benadryl IM and prednisone PO

Other Meds: levothyroxine, losartan-hctz, nifedipine, metoprolol

Current Illness: n/a

ID: 1020929
Sex: F
Age: 70
State: MD

Vax Date: 01/29/2021
Onset Date: 01/31/2021
Rec V Date: 02/10/2021
Hospital:

Lab Data: none

Allergies: none known

Symptoms: Hives-like rash beginning several days after injection, lasting now ten days. All over the body except face and feet

Other Meds: Propanolol, multivitamin

Current Illness: breast cancer treatment (radiation)

ID: 1020930
Sex: F
Age: 40
State: IA

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

Lab Data:

Allergies: Dust

Symptoms: Injection site higher than intended deltoid region, resulting in arm pain and numbness.

Other Meds: Wellbutrin, Ajovy, Mirena, Aldactone, Vitamin D

Current Illness: None

ID: 1020931
Sex: M
Age: 75
State: SC

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

Lab Data: ALT test high 124 ul

Allergies: None

Symptoms: Had the vaccination, dose #1 on January 26th and 12 days later had sharp abdominal pains just below the breast bone and they lasted for about 4 hr. After that I had soreness in the abdominal area and back for several days. The day after the pain I was shocked to see my urine was brown. The was Saturday so saw by PCP on Monday February 2nd for testing. My ALT liver test came back at 124 ul (normal range is 0-30). Since indicates liver problems liver follow-up testing is being scheduled.

Other Meds: 1 Atorvastatin 10 mg 2 Amlodipine Besylate 10 mg 3 Clopidogrel 75 mg 4 Citalopram 20mg 5 Doxazosin 8 mg 6 Hydrochlorothiazide 12.5 mg 7 Losartin Potassium 100 mg 8 Metoprolol Succinate 25 mg 9 Trazodone 50 mg 10 Aspirin 81 mg 11 CoQ10 12

Current Illness: None

ID: 1020932
Sex: F
Age: 73
State: SC

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

Lab Data:

Allergies: N/A

Symptoms: experiencing a twitching sensation in her shoulder blades after having first covid shot. The feeling is intermittent, throbbing and annoying. Sensation continues and has not subsided.

Other Meds: Latuda, Quetiapine, Aporvaspapin, Alprazolam, Centrum, Fish oil, Biotin and Vitamin C

Current Illness: Neuropathy

ID: 1020933
Sex: F
Age: 45
State: NH

Vax Date: 01/27/2021
Onset Date: 02/03/2021
Rec V Date: 02/10/2021
Hospital:

Lab Data:

Allergies: Bromine

Symptoms: Chilblainlike lesions on hands and sparse eczema- like rash on rest of body with onset 8 days from vaccination

Other Meds: Multivitamin, 3000 IU Vitamin D3, 1000 mg Vitamin C, Zyrtec, Glucosamine Chondroitin 750/600mg, diclofenac sodium 75 mg, benadryl

Current Illness: Left hip osteoarthritis

ID: 1020934
Sex: F
Age: 56
State: CO

Vax Date: 01/13/2021
Onset Date: 01/20/2021
Rec V Date: 02/10/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Client was seen on 1/13/21 for dose #1 of Moderna Covid vaccine. She stated on 1/20/21 she developed an oval, red, itchy rash about 3" x 2" around injection site that was warm to the touch. She stated she placed hydrocortisone cream on the area and the rash went away by the next day.

Other Meds: Unknown

Current Illness: None

ID: 1020935
Sex: F
Age: 65
State: TX

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

Lab Data: None

Allergies: Adhesive Tape Certain eye contact solutions

Symptoms: Rash, hardness on Left Upper Arm Body chills for 12 hours Fatique Slight Headache Nausea

Other Meds: Estradiol patch 0.0375mg/day Progesterone caps 100mg /day Calcium supplements Glucosamine and Chondroitin Zinc Vitamin C Collagen Peptide powder supplement

Current Illness: None

ID: 1020936
Sex: F
Age: 82
State: CA

Vax Date: 02/06/2021
Onset Date: 02/07/2021
Rec V Date: 02/10/2021
Hospital:

Lab Data: None

Allergies: Clindomycin, Dilaudid, Lipitor

Symptoms: Large deep bruise at injection site and redness about 2 inches from site of needle entry. Small lump where redness appeared and tender to the touch

Other Meds: Thyroid, HCTZ, Simvastatin

Current Illness: None

ID: 1020937
Sex: F
Age: 39
State: IA

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

Lab Data:

Allergies: grapes

Symptoms: Patient reported headache after receiving 2nd dose of Moderna vaccine that has lasted for 7 days and is ongoing. Patient has tried to treat with tylenol/ibuprofen and drinking more fluids to hydrate with no relief. Patient was advised to speak with primary care physician.

Other Meds: unknown

Current Illness: unknown

ID: 1020938
Sex: F
Age: 33
State: UT

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

Lab Data: Gave 25mg Benadryl at 2:00 pm and another 25mg at 3:00 pm on 2/10/21

Allergies: Penicillin Milk Eggs Soy

Symptoms: Throat closure

Other Meds: Armor thyroid 30mg Wellbutrin 150mg Metformin 500mg Vitamin D Magnesium

Current Illness: None

ID: 1020939
Sex: M
Age: 0
State: CA

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

Lab Data:

Allergies:

Symptoms: no adverse reaction patient received too early 19days from first dose 1/15/2021

Other Meds:

Current Illness:

ID: 1020940
Sex: F
Age: 70
State:

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

Lab Data:

Allergies: None

Symptoms: 20 minutes after injection patient complained of itching to her face. blood pressure 144/81 pulse 66 O2 100% patient given Benadryl 25mg @0823 Vital signs repeated 127/78 pulse 62 O2 100% per patient she feels better released home

Other Meds: None

Current Illness: Hypertension

ID: 1020941
Sex: F
Age: 17
State: MN

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

Lab Data: none deemed

Allergies: no allergies to medications food or vaccines

Symptoms: Patient was contacted post vaccination when the error was discovered she was 17 years of age vs 18 years for approved Moderna vaccination. She reported NO adverse events, treatment or outcomes. She provided her medical doctor and we contacted the doctor to relay the information and the patient reporting. (was told to submit report by our corporate as no adverse effects happened to patient - no field to put that)

Other Meds: none known

Current Illness: none stated on VAR

ID: 1020942
Sex: F
Age: 26
State: FL

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

Lab Data:

Allergies: Ceftin Singular Melon Cucumbers

Symptoms: Tired, sore arm- started about 10:00am Not OTC or medication treatment needed, took nap and rested

Other Meds: Optimum nutrition multivitamin Vitamin D 6MP

Current Illness: None

ID: 1020943
Sex: F
Age: 21
State: RI

Vax Date: 01/22/2021
Onset Date: 01/23/2021
Rec V Date: 02/10/2021
Hospital:

Lab Data:

Allergies: amoxicillin, vicodin

Symptoms: dark bruise, hot to the touch, lasted about 5 days

Other Meds: Novolog kwikpen, Basaglar, sertraline, loratadine, valacyclovir

Current Illness: n/a

ID: 1020944
Sex: F
Age: 57
State: TN

Vax Date: 01/06/2021
Onset Date: 01/07/2021
Rec V Date: 02/10/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Severe hip joint and back pain, vomiting, high fever, headache, extreme fatigue all lasting 4 days. I was not able to take care of myself. I had two such reactions after the first dose and two following the second dose with a 24 hour bout with milder symptoms as the third after the second dose. It comes on with no warning and lasts from 3-4 days.

Other Meds: Metformin

Current Illness: None

ID: 1020945
Sex: F
Age: 36
State: WA

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

Lab Data: none

Allergies: n/a

Symptoms: Approximately 10 hours s/p 2nd dose COVID vaccine #2 for me, I felt very tired. About hour 11 s/p vaccine I felt like I got hit by a semi truck. Chills so bad my teeth were chattering uncontrollably, body aches all over, joint pain, my skin hurt to be touched everywhere, and a mild headache. I did not sleep all night due to being unable to get comfortable. Tylenol did not help. I never call out sick to work, but I did the next day because I felt so awful, and hadn't slept a wink all night. around noon on 02/02/2021 the symptoms were more tolerable, and by the end of 02/02/2021 they were mostly gone except mild lingering HA. by 02/03/2021 I was able to return to work. Still didn't feel quite myself, but the worst of the symptoms had subsided.

Other Meds: n/a

Current Illness: n/a

ID: 1020946
Sex: F
Age: 72
State: CA

Vax Date: 02/05/2021
Onset Date: 02/07/2021
Rec V Date: 02/10/2021
Hospital:

Lab Data: physical exam

Allergies: none

Symptoms: Shoulder injury from vaccination, presents with shoulder bursitis, that started 2 days after vaccine, cannot move arm more than 5 degrees laterally or anteriorly. . No change in strength

Other Meds: magnesium, centrum, b complex, calcium with Vit D 3. Red yeast rice, and spirinulina

Current Illness: none

ID: 1020947
Sex: F
Age: 24
State: WI

Vax Date: 01/04/2021
Onset Date: 01/05/2021
Rec V Date: 02/10/2021
Hospital:

Lab Data: n/a

Allergies: none

Symptoms: Frequent severe migraine attacks (only one previous severe migraine attack more than 3 years ago) starting after 1/4/21 that have not yet resolved. 4 urgent care visits, 1 ER visit, chiropractor office visits, and neurologist visit. Currently taking 1000mg Magnesium/day, 60mg ER propranolol, PRN tramadol, PRN PO toradol, PRN ondansetron, PRN promethazine (oral and suppository), PRN sumatriptan 100mg tablets. Took two different 5-day steroid bursts both not resolving migraine (5 days of prednisone (20mg 2x/day) starting Jan 15th, 5 days of Dexamethasone starting Jan 22nd (4mg 2x/day). Still continuing care and seeking treatment for migraines (today 2/10/21)

Other Meds: Metformin 1000mg 2x/day, Magnesium 200mg, Multivitamin

Current Illness: none

ID: 1020948
Sex: F
Age: 22
State: NJ

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

Lab Data:

Allergies: Omnicef

Symptoms: Rash with raised bumps

Other Meds: Birth control

Current Illness:

ID: 1020949
Sex: F
Age: 66
State: GA

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

Lab Data:

Allergies: Iodine

Symptoms: Rash redness at injection site swollen lymph gland in same arm painful happened 9 days out and lasted more then 5 days

Other Meds: Zinc. Vitamins C And D and Multi Vitamins stool softener and fiber Losartan 100 mg Hydrochlorthiazide 25 mg Rosuvastatin 10mg

Current Illness: None

ID: 1020950
Sex: F
Age: 50
State: NJ

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

Lab Data: None

Allergies: None

Symptoms: After 6 hours heaviness in left arm with soreness at injection sight - during the night pain level 7, the need for Tylenol, inability to sleep due to pain throughout the night - Felt relief from Tylenol but Wednesday night again in pain for the second night resulting level 8 - Thursday woke up with level 4 pain, no range of motion - Arm felt like slowly returning back to normal on Sunday but Monday the level of pain came back to 7 and considering an MRI...waited a day or so and slowly back to normal... NOTE: Injection site - prior history of injury (partial tear)

Other Meds:

Current Illness: None

ID: 1020951
Sex: F
Age: 39
State: TX

Vax Date: 01/20/2021
Onset Date: 01/22/2021
Rec V Date: 02/10/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Vomiting and diarrhea. Resolved after less than 12 hours.

Other Meds: NP-thyroid, bykyree, Probiotics, krill oil, CoQ10, Zyrtec, chlortab, fluoxetine inhaler, fluoxetine nasal spray

Current Illness: None

ID: 1020952
Sex: F
Age: 58
State:

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

Lab Data:

Allergies:

Symptoms: left arm itchiness 15 minutes after vaccine. No other reactions. No rash, sob, chest tightness etc

Other Meds:

Current Illness:

ID: 1020953
Sex: F
Age: 28
State: CT

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

Lab Data:

Allergies:

Symptoms: Body chills, aches and pains, congestion, and headache the night of second dose of vaccine. Symptoms lasted for several days. Tested positive for Covid four days after second vaccine.

Other Meds:

Current Illness:

ID: 1020954
Sex: F
Age: 74
State: IA

Vax Date: 01/29/2021
Onset Date: 02/05/2021
Rec V Date: 02/10/2021
Hospital:

Lab Data: Did not see a doctor

Allergies: Penicillin

Symptoms: Covid arm occurred 7th day Itching, slight swelling and redness in 2? diameter circle, at injection site, very warm to touch, no pain Went away completely after 3 days.

Other Meds: Metoprolol, lisinopril,,hydalizine, propafenone,, Eliquis, rosuvastatin Multivitamin, calcium

Current Illness: None

ID: 1020955
Sex: F
Age: 22
State: FL

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

Lab Data:

Allergies: none

Symptoms: around 11 pm on the day of the vaccine I started to feel body aches throughout my whole body as well as a headache, and joint pains. Took 2 advil every four hours to help sleep and the symptoms are still present at 6 pm the next day

Other Meds: escitalopram, drospirenone ethinyl-estradiol, zyrtec

Current Illness: none

ID: 1020956
Sex: F
Age: 65
State: OH

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

Lab Data:

Allergies:

Symptoms: Pt received 3 doses of vaccine in 3 visits to Facility Pt had been discharged and family member told to bring pt back to complete series. Facility unable to find pt's record. Family unable to locate vaccine card. Discovered pt had 3rd dose when returned to pharmacy to enter administration information.

Other Meds:

Current Illness:

ID: 1020957
Sex: F
Age: 67
State: OK

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

Lab Data: N/A

Allergies: NKA

Symptoms: Inadvertently administered Pfizer as a second dose to client whose first does was Moderna. I was looking up all vaccines in the computer prior to administering and I was looking at her husband's information when I though I was looking at hers. I entered the vaccine in the computer and saw her first dose was Moderna. I did tell the client of the issue and she expressed no concern and was insistent as was her husband she had received Pfizer for her first dose. She said she would email a copy of her card upon her return home - email showed Moderna as first dose.

Other Meds: unknown

Current Illness: none reported

ID: 1020958
Sex: M
Age: 77
State: CO

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 02/10/2021
Hospital:

Lab Data: During visit with primary care provider: Electrocardiogram: sinus rhythm Serum electrolytes: within normal limits Complete blood count: within normal limits except red blood cell count 4.37 10*9/L, hemoglobin 13.9 gm/dL, and platelets 127 10*9/L

Allergies: pollen extracts

Symptoms: Moderna COVID- 19 Vaccine EUA: soon after vaccination patient reported feeling warm and naseated. Symptoms resolved within one day. Six days after vaccination patient developed an itchy rash on the face that is warm to the touch, stomach cramping, dizziness, and chest discomfort. Physical exam remarkable only for rash: patient presented alert and oriented, well-appearing. Patient prescribed hydrocortisone cream.

Other Meds: aspirin, atorvastatin, azathioprine, calcium carbonate-vitamin D3, calcium-magnesium, cyanocobalamin, latanoprost, nitroglycerin, pyridostigmine, simethicone, vitamin C-zinc-copper-leutin-zeaxanthin, ivermectin

Current Illness: dermatitis

ID: 1020959
Sex: F
Age: 37
State: MI

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

Lab Data:

Allergies: none

Symptoms: Very sore arm, headache, generally not feeling well and fatigued

Other Meds: Prozac, xanax, buprenorphin, gabepenton, zyrtec, omeprazol, pepcid, levothyroxine, singulair,

Current Illness: none

ID: 1020960
Sex: F
Age: 31
State: MO

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

Lab Data: BMP and cardiac rhythm strip order, echocardiogram 2D with doppler

Allergies: NKDA

Symptoms: Syncope and passing out;admitted and received potassium chloried 40 mEq tablet, for hypokalemia and DVT prophylaxsis with subcutaneous heparin. Was discharged after admission for overnight (from 01/07/21 to 01/08/21. Admitted for electrolyte abnormality. Of note, patient had one other syncope event a long time ago from a blood draw.

Other Meds: Adderall XR 20 mg capsule (2 C QAM), Albuterol HFA inhaler, bupropion XL 300 mg, fluoxetine 20 mg tablet, ondansetrom ODT 8mg tab, Potassium Chloride 10MeQ tab, rizatriptan 10 mg ODT tab, scopolamine 1 mg patch

Current Illness:

ID: 1020961
Sex: M
Age: 46
State: CA

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

Lab Data:

Allergies:

Symptoms: nausea coughing sneezing sore and numb arm

Other Meds:

Current Illness:

ID: 1020962
Sex: F
Age: 50
State: MO

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

Lab Data:

Allergies: Erythromycin/Azithromycin

Symptoms: Patient begin having itchy reaction after receiving the vaccination about 40 minutes after the vaccination. 20 mg oral benadryl was given to the patients for the itchiness.

Other Meds: Symbicort 80/4.5 mcg (2 P BID), Jardiance 25 mg QD, Flonase 2

Current Illness:

ID: 1020963
Sex: F
Age: 39
State: MI

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

Lab Data: None

Allergies: None

Symptoms: 2/5 1:30pm Palpitations(198-201bpm)3-4 hrs, fatigue headache 2/6 fatigue 2/7 fatigue

Other Meds: None

Current Illness: None

ID: 1020964
Sex: F
Age: 24
State: MO

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

Lab Data:

Allergies: Cefprozil (Rash)

Symptoms: Patient experienced itching and was administered 25 mg benedryl by mouth. She was observed in waiting room for 30+ minutes.

Other Meds: Citalopram 20 mg: 2 T QD, Cyclobenzaprine 10 mg: 1 t TID PRN, Duloxetine 20 mg BID, Seasonique 0.15-0.03 /0.1 mg QD, tramadol 50 mg: 1-2 t q6h prn pain, zolpidem ER 12.5mg QHS prn,

Current Illness:

ID: 1020965
Sex: F
Age: 66
State: AL

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

Lab Data:

Allergies:

Symptoms: pt complained of being flushed. face red. vss. 97.4; 107/58; 17 80. will continue watching pt x 15 min; 99% 115/72 86 98 pt denies wanting to go to er; feels fine; wants to go home

Other Meds:

Current Illness:

ID: 1020966
Sex: F
Age: 76
State: MO

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

Lab Data: SPO2 interpretation

Allergies: Augumentin, clarithromycin, codeine, CT iodinated contrast dye

Symptoms: Patient states she received the COVID-19 vaccine approximately 10:00 A.M. this morning and within minutes after that she noticed a tingling sensation to her tongue and her throat, she then felt her tongue and throat were swelling. She is given intramuscular Benadryl and referred immediately to the emergency room. On arrival to the ER, she states her symptoms are mostly resolving, she denies any swelling in the throat, tongue swelling, shortness of breath, wheezing, abdominal pain, diarrhea, or rash. D/C with cetirizine and recommended follow up with primary care doctor before receiving the second dose of the COVID-19 vaccine.

Other Meds: Albuterol 2.5mg/3ml nebulizer solution,

Current Illness:

ID: 1020967
Sex: F
Age: 44
State: AR

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

Lab Data:

Allergies: Aspirin, Bactrim, Reglan, shellfish, wasps

Symptoms: I received the second dose of my vaccine yesterday morning. I waited 15 minutes and then left to go home. It took me 25 minutes to get home. As soon as I walked in the door, I noticed itching all over my body. I looked in the mirror and noticed a red rash with some hives, that covered my throat and chest area. My eyes were itching as well. I have had severe anaphylactic reactions in the past that required several hours in the emergency room, so I knew to take an antihistamine right away. The rash took at least a couple of hours to fade away; however, the itching of the eyes and body lasted until this morning. I did experience some occasional wheezing until 3 or 4 this morning. I am okay now.

Other Meds: Flovent, Albuterol, estradiol, metoprolol, Lexapro

Current Illness:

ID: 1020968
Sex: F
Age: 43
State: NJ

Vax Date: 01/07/2021
Onset Date: 01/08/2021
Rec V Date: 02/10/2021
Hospital:

Lab Data: Negative pregnancy test

Allergies: Codeine, Milk, Lactose, Chocolate

Symptoms: For 4 days following the injection I experienced tiredness, intermittent nausea, and tenderness to both breasts. I woke from sleep dry heaving multiple times. On the 4th day after injection, it was severe enough that I took a pregnancy test because they symptoms matched that. It was negative. The following, or 5th day, all the symptoms stopped.

Other Meds: Vitamin D 5000iu daily Symbacort inhaler 2 puffs BID Protonix 40mg Daily Singular 10mg daily MVI gummies- 2 daily

Current Illness: NONE

ID: 1020969
Sex: M
Age: 51
State: TN

Vax Date: 12/23/2020
Onset Date: 12/23/2020
Rec V Date: 02/10/2021
Hospital:

Lab Data: Ran a covid test - negative.

Allergies: Penicillin, alltaste, neutrosweet.

Symptoms: GI upset, spiked fever after the first shot. Was ten days before I could leave the house. After second shot had flu like symptoms( 2 days after) Had hives and had angioedema event.

Other Meds: Tylenol

Current Illness:

ID: 1020970
Sex: F
Age: 28
State: MO

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

Lab Data: CT HEAD WO CONTRAST o XR CERVICAL SPINE 4 OR 5VW o CBC W AUTO DIFFERENTIAL o COMPREHENSIVE METABOLIC PANEL o TROPONIN I o TROPONIN I o HCG BETA BLOOD QUANTITATIVE o EKG 12-LEAD o 0

Allergies: NKDA

Symptoms: Syncope. Per ED note, patient has experienced syncope epsoides before Diagnosis:Syncope and collapse, Injury of head, initial encounter Vasovagal episode

Other Meds: Nasonex, YAZ OR

Current Illness: NA

ID: 1020971
Sex: F
Age: 42
State: MO

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

Lab Data: XR CHEST 1VW PORTABLE, CBC W AUTO DIFFERENTIAL, COMPREHENSIVE METABOLIC PANEL

Allergies: NKDA

Symptoms: -ADR: Allergic reaction (SOB and throat tingling/swelling -Inpatient - 0.9% NaCl Bolus, famotidine (PEPCID) injection 20 mg ,diphenhydrAMINE (BENADRYL) injection 25 mg, methylPREDNISolone sod succ (SOLU-Medrol) injection 125 mg, diphenhydrAMINE (BENADRYL) injection ADS Med, famotidine (PEPCID) injection ADS Med -Treatment: discharged with Benadryl and Medrol Dose pack

Other Meds: Vitamin D (Ergocalciferol) 1 tablet by mouth daily, CBD oil

Current Illness:

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm