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: 1023042
Sex: F
Age:
State: VA

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

Lab Data:

Allergies: Codeine, meloxicam, metformin, mushroom

Symptoms: 02/08/2021 onset headache, fatigue 02/10/21 fever, & diarrhea. Reports "terrible headache" & "just felt weak & tired". Took Tylenol for headache & went to bed, slept all day & night. Next day onset fever & diarrhea.

Other Meds:

Current Illness: None Known

ID: 1023043
Sex: F
Age: 32
State: CA

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 02/11/2021
Hospital:

Lab Data: covid test on 1/4 , came back negative

Allergies: no

Symptoms: 12/29 nausea, headache. 12/30 runny nose, sore throat, cough. All symptoms lasted a week

Other Meds: multivitamin, vitamin d, fish oil, vitam b complex, biotin

Current Illness: no

ID: 1023044
Sex: F
Age: 70
State: FL

Vax Date: 01/29/2021
Onset Date: 02/09/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data: none

Allergies: aspirin, penicillin

Symptoms: Co-vid arm Treated with ice- no further swelling 2 days later, still itches

Other Meds: Levothyroxine

Current Illness: none

ID: 1023045
Sex: M
Age: 84
State: IL

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data: Vitals were taken regularly and close monitoring

Allergies: None known

Symptoms: Resident received a Moderna vaccine from Clinic on 1/13/2021. Sixteen days later, on 1/29/2021 he received a 2nd vaccine of Pfiser at Nursing home. There have been no noted signs or symptoms as it relates to vitals etc. Everything has been stable.

Other Meds: Famotidine Tablet 20mg, Terazosin JCI captule 1mg, Spironolactone Tablet 25mg, Mirtazapine Tablet 15mg, Finasteride Table 5mg, Bumetanide Tablet .5mg, Atorvastatin Calcium Tablet 40mg, Aspirin Low Dose Tablet 81mg

Current Illness: UTI, behavioral changes

ID: 1023046
Sex: F
Age: 44
State: CA

Vax Date: 02/03/2021
Onset Date: 02/11/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data: None

Allergies: Kiwi Red Peppers

Symptoms: Several hours after receiving the first dose of the Moderna I started loosing feeling in my left pointer finger. The incident lasted a few minutes and returned to normal. Eight days after the initial vaccination my left middle finger turned yellow from the knuckle to the fingertip and I lost all sensation. The right hand, middle finger also felt tingling, but it was not as significant. This incident lasted less then 5 minutes and everything returned to normal.

Other Meds: Lisinopril Methimazole Daily Vitamin Omega Vitamin D Collagen

Current Illness: None

ID: 1023047
Sex: F
Age: 65
State: TX

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Left arm was sore to move for one day after the shot. I began developing a dull headache and low grade fever around 1:00 pm the day after the shot. My fever started at 100.3 degrees F and rose to 101.9 degrees F by 10:00 pm. I did not take any pain reliever until midnight. The fever was gone by 3:00 am on 2/6/21, and the headache dissipated by noon the same day. My left arm has continued to be sore to the touch and pressure (like a bruise) at the shot site, but there has never been any redness or swelling. This pain is going away slowly each day.

Other Meds: 2000 IU Vitamin D3 daily 1000 mg Vitamin C daily 30 mg Chelated Zinc daily 300 mg Elderberry Extract daily 10 mg Cetirizine Hydrochloride daily

Current Illness: None

ID: 1023048
Sex: F
Age: 22
State:

Vax Date: 02/04/2021
Onset Date: 02/11/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data: EKG done on 2/11/2021

Allergies: none

Symptoms: Within 2 hours of getting the shot my heart rate shot up when I was in resting position. It would go back and forth between normal heart rate and the highest it got was 175bpm. After a week of this going on I followed up with my PCP had an EKG done and saw I had sinus Tachycardia. They put me on a Beta blocker from now until 2 weeks after my second dose to see if that slows my heart rate down.

Other Meds: cyclobenzaprine, FLUoxetine, minocycline

Current Illness: none

ID: 1023049
Sex: F
Age: 52
State: OR

Vax Date: 12/31/2020
Onset Date: 01/03/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data: Blood tests - everything was okay on these tests (January 5th)

Allergies: no

Symptoms: On the 3rd - I started noticing my left eye swollen; on the 5th day day it felt weird - and it's getting bigger. My voice changed like a horse - hoarse throat. And when I swallowed it was like a piece of food in my throat. At work, my left eye is swollen and my lower lip was swollen too and they took me to patient room at work and examined me. Asked me to go home from work and my husband took me to ED on January 5th- I had gotten hives - started feeling itchy all over my body. At Emergency room they gave me Prednisone to stop the swelling. My throat was swollen and they gave me blood tests, too. Prednisone helped some - took that for one week. (Still missed work on the sixth because my eyes were still swollen.) Had a previously scheduled doctor appt for something else and my doctor told me the hives will come back after Prednisone so he told me to take Claritin for two weeks. All my symptoms resolved after that.

Other Meds: High blood pressure - Losartan - 25 mg a day; Anti-cancer - Tamasofen 20 mg

Current Illness: no

ID: 1023050
Sex: F
Age: 19
State: MN

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data: None at this time.

Allergies: Peanut allergy, mold, dust allergy

Symptoms: Had soreness and joint pain after the first injection (1/13/21). She received her second vaccine yesterday, 2/10/21 (1pm CST). At 11pm, last night began feeling rapid change in body temperature. Severe joint pain and headache. Currently reporting prickly skin feeling, throughout her entire body (2/11/21 - 11am CST.

Other Meds: Uncertain of the medications

Current Illness: No known illnesses before the vaccine.

ID: 1023051
Sex: F
Age: 30
State: CA

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data: N/A

Allergies: none

Symptoms: at 3am on 2/10/21 My arm was extremely sore and it radiated to my back and legs. I had body aches and chills. I had a really bad headache. Symptoms lasted about 10 hours.

Other Meds: none

Current Illness: none

ID: 1023052
Sex: M
Age: 56
State: OH

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data: none

Allergies: poultry

Symptoms: fatigue, extreme headache, body ache only lasted one day feel much better after a day

Other Meds: omeprazole (PRILOSEC) 20 MG CPDR,topiramate 50 MG TABS, magnesium gluconate (MAGONATE) 500 MG TABS, RIBOFLAVIN PO, Vitamin D3 5,000 IU

Current Illness: none

ID: 1023053
Sex: F
Age: 87
State: OH

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data:

Allergies: MSG

Symptoms: Chills, weakness, lack of appetite

Other Meds: Protonix , Losartan, Calcium supplement, CoQ 10

Current Illness: HTN, Osteopenia

ID: 1023054
Sex: F
Age: 52
State: IN

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data:

Allergies: Penicillin-hives at age 17 Cow's milk?-stomach cramps, diarrhea

Symptoms: As to be expected several hours after vaccine my arm become sore. Then at 12:30am I woke to severe chills, slight headache, sweats as well, body aches all over my body and I took my temperature and it was 103.4. I don't think I have ever had a fever that high before. I took some Tylenol extra strength and tried to go back to sleep but I couldn't I was afraid. This went on for several hours and my temp ranged from 102.3-103.6. I tried to drink liquids too. I called off of work. That day I laid around hot and cold, body aches, my chest hurt a little to take a deep breath, fatigue and weakness were unbearable at sometimes. My fever spikes probably that high 3-4 times yesterday. I had fluids and soup. I alternated Motrin and Tylenol all day. I tried to rest and maybe sleep but just couldn't close my eyes despite being tired/weak. By 7-8pm I was still weak but felt better My temp was around 99-100. I went to be around 10pm and woke up at 2am with really bad heartburn that I couldn't lay down I had to sit in my recliner chewing 4 Galvascon tabs. Sipping water and felt my chest hurt and wondered if I was having a heart issue. But i relaxed and finally by 5 am when my alarm went off.. I took my temp it was 100.2. I called off work again today and I laid down to sleep a few more hours. Now I feel better and still weak My temp has gone down.

Other Meds: Prozac 40 mg Levothyroxine 100mcg

Current Illness: N/A

ID: 1023055
Sex: F
Age: 23
State: CT

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

Lab Data:

Allergies:

Symptoms: ABOUT 15MIN AFTER VACCINE PATIENT C/O FEELING FLUSHED, ANXIOUS,SHAKING AND OVERALL NOT FEELING WELL.

Other Meds:

Current Illness:

ID: 1023056
Sex: F
Age: 51
State:

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

Lab Data:

Allergies:

Symptoms: Facial pressure, anxiety/adrenaline surge

Other Meds:

Current Illness:

ID: 1023057
Sex: F
Age: 60
State: CA

Vax Date: 02/10/2021
Onset Date: 02/11/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Chills; achy; fatigue.

Other Meds:

Current Illness:

ID: 1023058
Sex: F
Age: 89
State: DE

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

Lab Data: NA

Allergies: Prevnar vaccine, Versed, multiple ABX (names unknown)

Symptoms: At approx. 11:42, pt. reported "burning on inside." Pt. was taken to first aid area of clinic. Pt. denies any rash, puritis, difficulty breathing, or throat irritation. V/S @ 1148: 97.9, 80, 180/95. Pt. started to report worsening of symptoms ("burning on the inside.") Benadryl 25mg PO administered per standing order at 11:52. Additional Benadryl 25mg PO given per standard order @ 1202. Nursing staff continued to monitor patient and @ approx. 1207, pt. developed shortness of breath and throat tightening. Epi 0.3mg IM administered per MD order at 1208. Pt. started to show improvement of symptoms at approx. 1210. Pt. reported that throat tightening was subsiding. EMS contacted. BP: 193/107 @ 1213, 181/95 @ 1219. Paramedics arrived at 1223 and patient transported. Daughter followed.

Other Meds: Unknown.

Current Illness: none

ID: 1023060
Sex: M
Age: 68
State: GA

Vax Date: 01/15/2021
Onset Date: 02/05/2021
Rec V Date: 02/11/2021
Hospital: Y

Lab Data: MRI brain w/o contrast (2/7/2021): Scattered areas of acute ischemic infarct in the left MCA territory. No large area of infarct is identified. No significant mass effect or hemorrhagic transformation. CT head w/o contrast (2/7/2021): No acute intracranial abnormality. Chronic microangiopathic change noted. Carotid ultrasound (2/8/2021): Abrupt termination of flow in the proximal left ICA just after its origin. Less than 50% stenosis at the right carotid bifurcation.

Allergies: No known allergies

Symptoms: Patient developed right sided hemiparesis on 2/5/2021. He presented to hospital on 2/7/2021 with these symptoms and diagnosed with an acute CVA and internal carotid artery occlusion. He was admitted to the hospital and discharged to inpatient rehab on 2/11/2021.

Other Meds:

Current Illness:

Date Died: 02/08/2021

ID: 1023061
Sex: M
Age: 74
State: CA

Vax Date: 01/30/2021
Onset Date: 02/08/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Pt received the vaccine on 1/30/21 Pt reported symptoms of left armpit pain to wife on 2/7/21, went to work 4 am 2/8/21 and found face down, dead at work later that morning. Pt worked at a pet store, per wife he did complete his tasks and generally comes home by 7:30 am. Wife called when pt did not come back home and he was found dead.

Other Meds: Levothyroxine 100 mcg tab once a day

Current Illness: pt had teeth pulled for possible dental implants , non ulcer dyspepsia, treated for diverticulitis 1/6/21

ID: 1023062
Sex: F
Age: 75
State: PR

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

Lab Data:

Allergies: Iodine contrast dye, Tuberculin.

Symptoms: Presented dizziness with hypoactivity.

Other Meds: Plavix, Atenolo, Tegretol, Indur.

Current Illness: CAD, HIPERTENSION, CIRCULATORY PROBLEMS, EPILEPSY/CONVULSIONS, CATARACT ON BOTH EYES.

ID: 1023063
Sex: F
Age: 25
State: VA

Vax Date: 02/03/2021
Onset Date: 02/11/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data: None

Allergies: Clove

Symptoms: Red, itchy, hot lump at injection site. Hives/red blotches down left arm

Other Meds: None

Current Illness: None

ID: 1023064
Sex: F
Age: 43
State: IL

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data: none

Allergies: Pork

Symptoms: My face turned red. it looked like I had a sunburn. It lasted for a few hours on Thursday evening. It went away in the morning of Friday 02/05/2021, but it returned in the evening. It didn't hurt, burn, nor was it itchy. I just felt hot. My cheek temp was 100 degrees while the rest of my body was normal body temp 97-98 degrees.

Other Meds: Zertc levothyroxine

Current Illness: none

ID: 1023065
Sex: F
Age: 30
State: NJ

Vax Date: 01/21/2021
Onset Date: 01/22/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data:

Allergies: N/A

Symptoms: FEVER CHILLS BODY ACHES

Other Meds: TYLENOL IBUPROFEN

Current Illness: FEVER CHILLS BODY ACHES

ID: 1023066
Sex: F
Age: 53
State: IL

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

Lab Data:

Allergies: Zithromax

Symptoms: Approximately 12 hours post injection developed severe bilateral leg weakness (inability to walk on my own) headache, body aches, dizziness. I also developed a twitch in my left hand, pinky, index finger and thumb. Developed sharp intermittent pain under my right arm day 4 post injection for several days.

Other Meds: Vitamin B Collagen Vitamin D Lisinopril

Current Illness: None

ID: 1023067
Sex: F
Age: 66
State: MD

Vax Date: 01/27/2021
Onset Date: 02/10/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data: none

Allergies: penicillin

Symptoms: 3 Weeks after vaccine injection site hot and red circle big as an orange

Other Meds: Daily multivitamin , Vitamin C, calcium, turmeric, aller-tec allergy pill

Current Illness: none

ID: 1023069
Sex: F
Age: 71
State: WA

Vax Date: 01/31/2021
Onset Date: 02/07/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Red swelling and itchiness at vaccine site. Progressing to rash. At day 10, some rash on RT upper arm as well.

Other Meds:

Current Illness:

ID: 1023070
Sex: M
Age: 25
State: AZ

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data:

Allergies: N/A

Symptoms: For the entire next day I had body aches, chills, headache, and loss of appetite.

Other Meds: N/A

Current Illness: N/A

ID: 1023071
Sex: F
Age: 59
State: AZ

Vax Date: 02/09/2021
Onset Date: 02/09/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data:

Allergies: Levoflixan 500mg, Methylprednisolone 4mg, Promet/cod 6.25-10mg/5ml sup, Mortongeo 5m/s

Symptoms: On the night of the shot, I had trouble sleeping, my heart would stop so I was awake most of the night in fear of not waking up, when I did get some sleep, I was having nightmares, I also had a metallic taste in my mouth and could smell it. My Dr. is having me take 600 mg Ibuprofen, and 650 mg in Tylenol rotating them.

Other Meds: Losartin 50mg, Spironolactone 25mg, Cetirizine 10mg, Metoprolol 50mg, Atorvastatin 40mg, Escitalopram 5mg, Gabapentin 600mg, Pantoprazole 40mg, Vitamin C 1000mg, B12 5000mg, Iron 65mg, Vitamins

Current Illness:

ID: 1023072
Sex: F
Age: 75
State: MN

Vax Date: 01/26/2021
Onset Date: 01/29/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data:

Allergies: No known allergies

Symptoms: Resident experienced a red, inflamed, raised rash at injection site.

Other Meds:

Current Illness:

ID: 1023073
Sex: F
Age: 34
State: TX

Vax Date: 02/10/2021
Onset Date: 02/09/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data:

Allergies: Vancomycin

Symptoms: None stated.

Other Meds: No

Current Illness:

ID: 1023074
Sex: F
Age: 49
State: OR

Vax Date: 01/20/2021
Onset Date: 01/21/2021
Rec V Date: 02/11/2021
Hospital: Y

Lab Data: CBC, CMP, stool samples to rule out C-diff, etc

Allergies: Latex, Morphine, Dilaudid, Avocados, Gluten

Symptoms: First week had headache, nausea, dizziness with room spinning. Starting the second week had a Crohn's flare with abdominal pain and diarrhea, which has continued. Hospitalized due to dehydrating and low potassium, given steroids, fluids, and potassium supplement.

Other Meds: Humira, Levothyroxine, Cytomel, Singular, Omeprazole

Current Illness: None

ID: 1023075
Sex: M
Age: 76
State:

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Sore arm at injection site Achiness & chills Tired

Other Meds:

Current Illness:

ID: 1023076
Sex: M
Age: 55
State: OR

Vax Date: 02/01/2021
Onset Date: 02/04/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: This was my 2nd shot. (1st shot was 3 weeks prior). Four days after 2nd shot, I developed wheezing and congestion. On my 6th day, I had an asthma attack. I obtain an albuterol inhaler and used it occasionally for the next 3 days. Today, after 11 days, I still have a slight cough but feel like I'm getting my energy back.

Other Meds: None

Current Illness: None

ID: 1023077
Sex: U
Age: 53
State: CA

Vax Date: 02/10/2021
Onset Date: 02/11/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Body aches fatigue feverish 101.6 flushed

Other Meds:

Current Illness:

ID: 1023078
Sex: M
Age: 31
State: GA

Vax Date: 02/10/2021
Onset Date: 02/11/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data:

Allergies: None known

Symptoms: Sever chills the night I took the vaccine. I received it at 1445 (245 in the afternoon) I woke up all throughout the night and was unable to sleep well. I was very light headed when I woke up and slept through most of the morning. I had a headache and soreness at the injection site.

Other Meds: None

Current Illness: None

ID: 1023079
Sex: F
Age: 33
State: NC

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

Lab Data: No

Allergies: No

Symptoms: I exp low grade fever,fatigue, body ache and chills lasing 4-5 days. The highest my fever got was 102.

Other Meds: Lexapro,Tylenol( after vaccine)

Current Illness: 2 or 3 days low grade fever tested Covid(results negative)

ID: 1023080
Sex: F
Age: 61
State: GA

Vax Date: 02/08/2021
Onset Date: 02/09/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data:

Allergies: Iodine Ace inhibitors PCN Coding

Symptoms: Redness, swelling pain,hardness, fever at site of injection one day after vaccine.

Other Meds: Lorsartan,Estradiol Vitamin D

Current Illness:

ID: 1023081
Sex: F
Age: 42
State: CA

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data: Did not seek medical care. Symptom improving.

Allergies: none

Symptoms: Fever 104 an bleeding around left pupil with red vessels of eye. No changes in vision, no nausea, no vomiting, no swelling

Other Meds: none

Current Illness: none

ID: 1023082
Sex: F
Age: 46
State: FL

Vax Date: 02/09/2021
Onset Date: 02/09/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data: Accucheck FSBG (2/9): 190mg/dl 12-lead EKG (2/9): NSR, rate 60 bpm, no ST elevation, no ectopy

Allergies: NKDA

Symptoms: Within 15-minutes of vaccination, the patient had a witnessed syncopal episode. The patient was not in respiratory distress and sustained no injuries. Patient told EMS that she has a history of syncopal episodes and hypotension, also has been very stressed and did not eat breakfast. EMS managed patient's condition on-site. Patient was hypotensive (104/71) with a pulse of 60bpm. Accucheck FSBG noted at 190mg/dL. Patient passed orthostatic BP test. EMS recommended transport to hospital for evaluation, but the patient refused and left with husband.

Other Meds: None reported

Current Illness: None reported

ID: 1023083
Sex: M
Age: 56
State: WA

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data: none

Allergies: Penicillin, walnuts

Symptoms: Approximately 15 hours after the vaccination was given at 11:00 PM started to feel ill, body aches, fever, chills, very similar to flu like symptoms only not quite as bad. This lasted for approximately 5 hours, and by 04:30 AM I started feeling better and by 06:00 I was perfectly fine and felt completely normal.

Other Meds: Blood Pressure medicine amlodipine and hydrochlorothiazide, ibuprofen for headaches, men's health daily vitamin supplement.

Current Illness: none

ID: 1023084
Sex: F
Age: 71
State: TX

Vax Date: 02/01/2021
Onset Date: 02/09/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data: none at this time.

Allergies: Hydrocodone

Symptoms: Injection site pain, tiredness, headache, joint pain, swelling, redness, feeling unwell, fast heart beat, dizziness and weakness. nausea.

Other Meds: Olmesartin40, Vitamin c, D3, fish oil, fish oil supplement 100, pain gel for arthritis.

Current Illness: none

ID: 1023085
Sex: M
Age: 57
State: TX

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data: Blood sugar via freestyle libre - and blood pressure home machine

Allergies: None

Symptoms: I had my first shot on January 13th, my blood sugar levels stayed above 200 for almost two weeks. Yesterday I had my second dose and my blood sugar level jumped to over 500 at 11PM last night and until just a few hours ago has dropped down to 134, I feel light headed and my blood pressure is elevated.

Other Meds: Atorvastatin - 10 MG Trulicity 0.75 MG/0.5 ML Pen Injector Propranolol ER 80 MG Capsule Extended Release 4 Hr Metformin HCL ER 500 MG

Current Illness: None

ID: 1023086
Sex: F
Age: 70
State: CO

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data: Covid 19 test - Tues. 2/9/21 - Negative

Allergies: IV Iodine Dye

Symptoms: Body aches, Abdominal pain, diarrhea, nausea, headache, chills, low temp 99.8 Thurs 2/4 & continuing thru Thurs 2/11

Other Meds: Famitidine, Lyrica, Diclofenac, Atorvastatin 40 mg, Percocet 5 mg, and Vitamin. Also was on 9th day of Neomycin.

Current Illness: None

ID: 1023087
Sex: F
Age:
State: IN

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data:

Allergies: Shrimp

Symptoms: Chills, migraine, fever, fatigue, swollen and sore arm

Other Meds: None

Current Illness: None

ID: 1023088
Sex: F
Age: 30
State: NC

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data:

Allergies: NKA

Symptoms: She reports with a few minutes she felt light headed, dizzy and mentally disconnected. Symptoms included feeling nonspecific discomfort, hot, cold, palpitations, nausea. She states her chest cavity felt strange and can best describe it as internal burning. She states breathing was strange, and was 'almost' SOB. She felt palpitations. They seated her in a chair for 15 minutes and observed her for 35-45 minutes. Her VS were normal. She denies pruritis, urticaria, flushing, sweating, cough, wheeze, oral/facial/throat/tongue swelling, red/watery eyes. She went home and continued to feel uncomfortable and restless. She had one emesis. She took a Tylenol pm at 19:00 and slept until about midnight. She reports the restlessness and discomfort stopped, but she then felt flulike symptoms (malaise, myalgias) for the next 3 days. She noted onset of edema at the injection site day 1, but no erythema or dermatitis.

Other Meds: - Cyclobenzaprine HCl 5mg PO TID - Naproxen 250mg PO TID - Famotidine 10mg PO BID - Fluoxetine 10mg PO q day - Valacyclovir 500mg PO q day

Current Illness: None

ID: 1023094
Sex: F
Age: 46
State: MO

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data: None

Allergies: LATEX - RaSH

Symptoms: - THINK JUST STRONG IMMUNE RESPONSE: - Headache, dizzy, nauseated, weak, Pelvic pain - Enlarged lymph node on Ipsilalent side of shot - Concentration off BLOOD SUGARS SLIGHT Elevation (129-132 fasting) Decrease in Blood Pressure to 104/76 (usually 120s to 130s/80s

Other Meds: Quar, Ventolin, Zyrta. PRN Ibuprofen

Current Illness: MILD GLUCOSE Intole ,Had Covid Illness in Dec 2020

ID: 1023101
Sex: F
Age: 73
State: PA

Vax Date: 02/10/2021
Onset Date: 02/11/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data: none ordered

Allergies: Lipitor

Symptoms: Resident uneventful evening/night. Ate breakfast, baseline status. Found by staff to be unresponsive at 0945 this AM, almost 25 hrs after vaccine administration. BP at that time 77/30, recheck 81/35. No respiratory distress, oxygen saturations WNL. Remianed afebrile. Over the next hour, she did open her eyes once, but remianed non responsive to staff. Daughter at bedside. Over the next few hours, slowly responding. Was awake and responsive, eating ice cream. PCP has been notified, ongoign onitoring to occur. Spoke to Physican associated with RCAT Care Center. She does infact feel this was an adverse/significant side effect of the vaccination as manifested thru extreme fatugue and exhaustion.

Other Meds: Meloxicam, Floic acid, Fluoxetine, Omeprazole

Current Illness: none noted

ID: 1023102
Sex: F
Age: 64
State: MD

Vax Date: 11/18/2020
Onset Date: 11/19/2020
Rec V Date: 02/11/2021
Hospital:

Lab Data: NA

Allergies: NKDA

Symptoms: patient described pain lasting several weeks at injection site. Large softball size red mark at injection site, No other symptoms reported

Other Meds:

Current Illness:

ID: 1023104
Sex: F
Age: 56
State: IN

Vax Date: 02/08/2021
Onset Date: 02/09/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data: N/A

Allergies: NKA

Symptoms: Rt side body swelling. Rt eye swelled shut. Hearing loss Rt. ear. Headache

Other Meds: prozac, buspar

Current Illness: N/A

ID: 1023337
Sex: M
Age:
State: VA

Vax Date: 01/13/2021
Onset Date: 01/29/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data:

Allergies:

Symptoms: 1st and 2nd dose given 16 days apart; A spontaneous report was received from a pharmacist concerning a male of unknown age, who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced "1st and 2nd dose given 16 days apart". The patient's medical history was not provided. No relevant concomitant medications were reported. On 13 Jan 2021, the patient received their first of two planned doses of mRNA-1273 (Lot number: 013L20A) intramuscularly for prophylaxis of COVID-19 infection. On 29 Jan 2021, the patient received their second of two planned doses of mRNA-1273 (Lot number: 007M20A) intramuscularly for prophylaxis of COVID-19 infection It was reported that the patient was administered 1st and 2nd dose of Moderna covid-19 vaccine with in 16 days. Action taken with mRNA-1273 in response to the events was not reported. The outcome of the event "1st and 2nd dose given 16 days apart" was considered as resolved on 29 Jan 2021.; Reporter's Comments: This case concerns a male patient of unknown age who received his two planned doses of mRNA-1273 (Lot number: 013L20A and Lot number: 007M20A) within 16 days apart. There were no reported adverse events after the vaccines were administered in this case of inappropriate schedule of product administration

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm