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: 1027002
Sex: M
Age: 86
State: KY

Vax Date: 02/03/2021
Onset Date: 02/12/2021
Rec V Date: 02/12/2021
Hospital:

Lab Data: 02/12/21 ABNORMAL ABG 02/12/21 BNP 2130.0 02/12/21 ABNORMAL CHEST XRAY 02/12/21 ABNORMAL PELVIC XRAY AND CT

Allergies: PENICILLINS

Symptoms: RECEIVED FIRST DOSE OF PFIZER COVID VACCINE ON 02/03/21. REPORTED ER FALLING ON ICE WITH RIGHT HIP PAIN. ALSO HIT HEAD. IS ON BLOOD THINNER. IN ER O2 SAT DROPPED AND WAS PLACED ON 4L OXYGEN. ADMITTED INPATIENT AFTER BEING DIAGNOSED WITH HYPOXIA, CHF, AND PELVIC FRACTURE

Other Meds: ELIQUIS

Current Illness:

ID: 1027003
Sex: F
Age: 51
State: IL

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

Lab Data: MRI of Brain w/ wo contrast on 2/11/21 FINDINGS: PROCEDURE: MRI BRAIN W WO CONTRAST. COMPARISON: CT brain on the same date CLINICAL INDICATION: facial numbness TECHNIQUES: The MR scan was performed using departmental protocol for MRI BRAIN W WO CONTRAST. 15 cc MultiHance was infused. FINDINGS: The ventricles and cortical sulci are compatible with patient's age. The brain parenchyma demonstrates normal MR signal characteristics without evidence acute intracranial hemorrhage, acute stroke, mass, midline shift, abnormal fluid collections, or abnormal enhancement. The craniocervical junction is unremarkable. Empty sella is seen. Normal signal flow voids are identified image of branches of intracranial vessels. IMPRESSION: Unremarkable MRI brain with without contrast. Electronically Signed by: MD Signed on: 2/11/2021 9:24 PM CT head completed : 2/11/21 Results EXAM: Head CT without contrast. COMPARISON: None. CLINICAL INDICATION: facial numbness TECHNIQUE: Multiple axial scans were obtained from the base of the skull to the vertex. Adjustment of KV/mA was done based on patient size. FINDINGS: Bone windows are unremarkable, visualized paranasal sinuses and mastoid air cells on both sides are unremarkable. There is no evidence of intracranial hemorrhage, focal abnormality within the brain, mass effect or extra-axial collections. IMPRESSION: Unremarkable head CT without contrast. Electronically Signed by: MD Signed on: 2/11/2021 7:15 PM CBC 2/11/21 performable only) Order: 15155146777 - Part of Panel Order 15155146762 Status: Final result Visible to patient: Yes (Patient Portal) Ref Range & Units 1d ago WBC 4.2 - 11.0 K/mcL 7.6 RBC 4.00 - 5.20 mil/mcL 4.63 HGB 12.0 - 15.5 g/dL 13.5 HCT 36.0 - 46.5 % 41.6 MCV 78.0 - 100.0 fl 89.8 MCH 26.0 - 34.0 pg 29.2 MCHC 32.0 - 36.5 g/dL 32.5 RDW-CV 11.0 - 15.0 % 13.7 RDW-SD 39.0 - 50.0 fL 45.6 PLT 140 - 450 K/mcL 296 NRBC <=0 /100 WBC 0 Neutrophil, Percent % 53 Lymphocytes, Percent % 37 Mono, Percent % 7 Eosinophils, Percent % 2 Basophils, Percent % 1 Immature Granulocytes % 0 Absolute Neutrophils 1.8 - 7.7 K/mcL 4.0 Absolute Lymphocytes 1.0 - 4.0 K/mcL 2.8 Absolute Monocytes 0.3 - 0.9 K/mcL 0.6 Absolute Eosinophils 0.0 - 0.5 K/mcL 0.2 Absolute Basophils 0.0 - 0.3 K/mcL 0.0 Absolute Immmature Granulocytes 0.0 - 0.2 K/mcL 0.0 Resulting Agency Hosp Narrative Performed by: Hosp This is an appended report. These results have been appended to a previously verified report. Specimen Collected: 02/11/21 18:34 CMP 2/11/21 Contains abnormal data Comprehensive Metabolic Panel Order: 15155146764 Status: Final result Visible to patient: Yes (Patient Portal) Ref Range & Units 1d ago Fasting Status Sodium 135 - 145 mmol/L 139 Potassium 3.4 - 5.1 mmol/L 4.2 Chloride 98 - 107 mmol/L 103 Carbon Dioxide 21 - 32 mmol/L 29 Anion Gap 10 - 20 mmol/L 11 Glucose 65 - 99 mg/dL 96 BUN 6 - 20 mg/dL 24High Creatinine 0.51 - 0.95 mg/dL 0.97High Glomerular Filtration Rate >90 mL/min/1.73m2 68Low Comment: eGFR 60 - 8

Allergies: No Known Allergies

Symptoms: Shortly after receiving vaccine; whole right side of her face went numb. Pt took Benadryl after injection afraid it was an allergic reaction. Pt seen by MD in office; noted with right facial dropping .

Other Meds: buPROPion HCl ER (XL) 300 MG Oral Tablet Extended Daily levothyroxine (Tirosint) 100 MCG capsule Daily acyclovir (ZOVIRAX) 400 MG tablet 5 times per day for 7 days (Started on 2/9/21)

Current Illness: Anxiety Hypothyroidism

ID: 1027004
Sex: F
Age: 73
State: OK

Vax Date: 02/02/2021
Onset Date: 02/03/2021
Rec V Date: 02/12/2021
Hospital:

Lab Data: Only called PCP office, did not go in due to weather issues; no tests run

Allergies: Codeine Sulfa Prednisone Statins

Symptoms: Day 1-Moderna vaccine (Feb 2, 2021) Day 2-pain at injection site, red size of half dollar Day 3-injection site swollen, hot, and itching but no pain Day 4-injection site enlarged doubled in size no pain Day 5-injection site enlarged to 7" long x 3.5" wide, itching painful to touch, skin red and hot (took 100 mg Benedryl, used CeraVe cream Day 6-injection site continues red, hot and intense itching (took 100 mg Benedryl, used CeraVe cream ) Day 7-injection site continues to grow in size, red, hot painful, raised bumps, most intense itching I've ever had (used CeraVe cream) Day 8-left arm (site of injection) is red from near shoulder stretching to within 1" of elbow, wrapping around arm about 6" (used CeraVe cream) Day 9- redness fading, itching and pain subsiding some (used CeraVe cream) Day 10- redness continues to fade, itching getting better - no pain (no treatment) Day 11-no redness, rash remains rough, but little itching no pain (no treatment) Day 12-no itching, redness, pain or signs of rash (no treatment)

Other Meds: Leflunomide (10mg), Vit D3 (5000IU), Estradiol patch( .0375mg) Tylenol XStrength (morning of vaccine) Amlodopine Besylate (10mg), Folic Acid (1mg), Progesterone (100mg) (evening before vaccine)

Current Illness: RA HTN (controlled)

ID: 1027005
Sex: F
Age: 66
State: PA

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

Lab Data: Pt seen in ED following reaction. Laboratory results unknown.

Allergies: bee venom (pt reported) ketorolac

Symptoms: Pt was administered COVID-19 Pfizer vaccine on 2/12/2021 at approximately 1415. At 1440 pt was observed to be coughing. Pt stated, "It feels like there is something in my throat". POX remained 98% on RA with HR 105-112. Pt observed by nursing staff until 1445 when she was taken to the ED from the vaccination tent. At this time pt exhibited increasing SOB with notable tongue swelling. Pt reports previous anaphylaxis reaction to bee venom.

Other Meds: unknown

Current Illness: unknown

ID: 1027006
Sex: F
Age: 65
State: IL

Vax Date: 01/14/2021
Onset Date: 02/05/2021
Rec V Date: 02/12/2021
Hospital:

Lab Data: History and physical exam, no labs or x-rays were done.

Allergies: Latex sensativity

Symptoms: Pain that felt like a muscle spasm initially and progressed from left of spine in upper back to around ribs to under arm and across chest, including numbness and itching , progressed to a few red, non-draining lesions noted on the chest and back along the painful areas. Progression of pain led to an urgent care visit on 2/10/21 at which Shingles was diagnosed and Valtrex, muscle relaxer, and lidocaine gel were ordered for the lesions that were noted.

Other Meds: atorvastatin 20mg PO QHS, Latanaprost 1gtt/eye Q HS

Current Illness: none

ID: 1027007
Sex: F
Age: 75
State: FL

Vax Date: 01/15/2021
Onset Date: 01/17/2021
Rec V Date: 02/12/2021
Hospital:

Lab Data: MRI and CT Scan

Allergies:

Symptoms: Patient received the vaccination on Friday and by Sunday patient developed tingling of the mouth and slurred speech. EMS brought patient to hospital for a possible TIA. Hospitalist did a CT and MRI. The conclusion was negative for TIA. Not sure of Bell's Palsy diagnosis.

Other Meds: Eliquis and Aspirin 81mg

Current Illness:

ID: 1027008
Sex: F
Age: 67
State: FL

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

Lab Data: None yet

Allergies: Sulfa, codeine and latex,

Symptoms: Fever, joint aches, sore arm, tired

Other Meds: Fenofibrate Protonix

Current Illness: None

ID: 1027009
Sex: F
Age: 26
State:

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

Lab Data:

Allergies:

Symptoms: Headache - intermittent lasting from 2/2/21 - 2/5/21; worst 2nd day, 2/3/21 Body aches - lasting from 2/2/21 at 11:00 p.m. - 2/5/21 (afternoon) Symptoms occurred at home.

Other Meds:

Current Illness:

ID: 1027010
Sex: M
Age: 45
State: SC

Vax Date: 01/22/2021
Onset Date: 01/30/2021
Rec V Date: 02/12/2021
Hospital: Y

Lab Data: 1/31/21 - Flu Ag negative 2/2/21: - Mycoplasma IgM negative - EBV Ab panel consistent with prior infection 2/4/21: - Blood cultures negative - CRP > 320 mg/dL - D-dimer 3.53 - Troponin 7.05 - BNP 3, 583 2/5/21: - SARS CoV2 Ab: positive - Transthoracic Echo: Interpretation Summary o The left ventricular systolic function is decreased (35 - 40%). o There is mild concentric left ventricular hypertrophy present. o Left ventricular global hypokinesis. o Indeterminate left ventricular diastolic function. o The right ventricular systolic function is normal. o The left atrium is mildly dilated. o The right atrium is mildly dilated. o Mild mitral valve regurgitation. o Mild tricuspid valve regurgitation. o Procedure performed with the patient in a supine position. 2/5/21 CTA Chest: IMPRESSION: 1. No evidence of acute pulmonary embolus through the segmental level. 2. Multifocal nodular airspace disease of the right upper lobe and right middle lobe is suspicious for pneumonitis. More masslike appears of consolidation in the lower lobes left greater than right may also be secondary to pneumonitis although other etiologies possible including aspiration. Radiographic follow-up to resolution recommended. 3. Small pleural effusions. 4. Nonspecific mediastinal edema. This may be result of vascular congestion but inflammatory change (i.e. mediastinitis) is not excluded on the basis of imaging appearance and clinical correlation is recommended. 5. Nonspecific solitary pericardial adenopathy visualized. This is of uncertain etiology or significance. 2/6/21 ANA, CMV PCR, Adenovirus PCR, Echovirus AB panel, Parvovirus PCR, HHV6 PCR negative; Coxsackie Ab panel weakly positive for multiple strains 2/6/21 Left heart cath: Conclusion 1-PRESENTATION WITH CARDIOGENIC SHOCK 2-PAP 59/29, PW 30, LVEDP 25-28 3-NORMAL CORONARY ARTERIOGRAM 4-SUCCESSFUL PLACEMENT OF IABP 2/11/21 Cardiac MRI: o Normal left ventricular chamber size and systolic function, LV EF 67%. Focal point of subepicardial delayed enhancement in the basal inferolateral segment. Differential diagnosis inlcudes subacute myocarditis or sarcoidosis. o Normal right ventricular chamber size and systolic function. o No significant valvular abnormality. o No evidence of hypertrophic cardiomyopathy or prior myocardial infarction. o Small circumferential pericardial effusion.

Allergies: No known allergies

Symptoms: Pt received vaccine on 1/22/21. On 1/31/21 he presented to urgent care with fever and morbiliform rash. He tested negative for the flu and was given empiric oseltamivir. He had persistent fever and was given doxycycline and ceftriaxone by urgent care on 2/2. On 2/4 at urgent care he was noted to be hypotensive and referred to ER. He had findings of cardiogenic shock and intra-aortic balloon pump was placed. He was treated for acute heart failure with improvement in symptoms. He was also treated for pneumonia with piperacillin/tazobactam as well as amoxicillin / clavulanic acid. He was discharged with resolved fever, resolved rash, and improvement in EF based on cardiac MRI. Workup for other viral causes of myocarditis was negative.

Other Meds: Zinc, Vitamin C, and Vitamin D3

Current Illness: COVID-19, 12/30/21

ID: 1027011
Sex: F
Age: 79
State: NY

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

Lab Data:

Allergies:

Symptoms: Vaccine injection site cellulitis

Other Meds:

Current Illness:

ID: 1027012
Sex: F
Age: 35
State: CA

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

Lab Data:

Allergies: No Known Allergies

Symptoms: She presented with itching and rash a few hours after injection. Relieved by ice and antihistamine oral medication.

Other Meds: Levothyroxine, Xyzal, Metformin

Current Illness: NA

ID: 1027013
Sex: F
Age: 95
State: OH

Vax Date: 01/28/2021
Onset Date: 01/30/2021
Rec V Date: 02/12/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: A burning/itching rash and blisters started on 1/30/21. It completely covered her backside/buttocks. She was prescribed Acyclovir 800mg on 2/2/21. The rash has subsided however, because of the location of the blisters, they still haven't completely healed.

Other Meds: Glipizide, Pioglitizone, Atenolol, Lisinopril, Citalopram, Calcium w/D, Simvistatin

Current Illness: None

ID: 1027014
Sex: F
Age: 66
State: PA

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

Lab Data: SARS CoV 2 Serology (COVID19) Ab (IgG), IA SARS CoV 2 Ab (IgG) Negative SARS CoV 2 Serology (COVID19) Ab (IgM), IA SARS CoV 2 Ab (IgM) Positive *

Allergies: unknown

Symptoms: patient reports vaccine was given in SQ tissue not deltoid muscle. patient states vaccine was given posterior mid upper arm. Pfizer recommended antibodies be checked. CDC website does not recommend re-vaccination.

Other Meds: unknown

Current Illness: unknown

ID: 1027015
Sex: F
Age: 51
State: TX

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

Lab Data: no

Allergies: NSAIDS

Symptoms: A red, hot rash on face, back, and both arms

Other Meds: Spironolactone, Tylenol

Current Illness: no

ID: 1027016
Sex: M
Age: 55
State: MO

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

Lab Data: unknown

Allergies: nkda

Symptoms: Ct felt dizzy, fell forward out of his chair, was unconscious for approximately 2-3 seconds, was not in respiratory distress, was able to answer questions. Ct was transfer to his back, then to sitting position, c/o nausea, paramedics arrived. B/P was 220/113, Blood sugar was 215.

Other Meds: unknown

Current Illness: none

ID: 1027017
Sex: F
Age: 37
State: NM

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

Lab Data: EKG and Labs

Allergies: Sulfa - Rash/Hives, Compazine - Anaphylaxis, Hydrocodone - Rash/Hives, Generic Percocet (Brand Percocet OK) - Rash/Hives, Generic Zonegran - (Brand Zonegran OK) - Rash/Hives, Neosporin (Neomycin) - Tissue Breakdown, Lovenox - Severe bleeding, Ertapenem - Rash, Lasix - Vertigo, and Metronidazole - Causes peripheral neuropathy to spread.

Symptoms: Patient started throwing premature ventricular contractions (PVCs).

Other Meds: Allegra Dosage: 180 mg Frequency: At bedtime Reason Taking: Allergies Began On: January 21, 2008 Baclofen Dosage: 20 mg Frequency: Three times a day Reason Taking: Reflex Sympathetic Dystrophy (RSD) now CRPS Began On: September 30, 2007 C

Current Illness:

ID: 1027018
Sex: F
Age: 71
State: NY

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

Lab Data:

Allergies:

Symptoms: Vaccine injection site red/warm to touch

Other Meds:

Current Illness:

ID: 1027019
Sex: F
Age: 72
State: NY

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

Lab Data: N/A

Allergies:

Symptoms: Patient received 2nd dose of Pfizer vaccine felt tingling on tongue. No swelling. Pt took 50mg of own Benadryl. Observed for total 45min. No progression of symptoms.

Other Meds:

Current Illness:

ID: 1027020
Sex: U
Age: 72
State: UT

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

Lab Data:

Allergies: Lortab

Symptoms: Sharp pain to back between shoulder blade and waist on right side, pain initially took breath away and made it difficult to breathe. Pain most intense between 0000-0800. Took Tylenol at 0800 and then an anti-inflammatory at 1130. Client reports pain is improving now and is not currently experiencing shortness of breath. Recommended client follow-up and be seen by physician, recommended to be seen urgently for any shortness of breath/difficulty breathing.

Other Meds: Levothyroxine, simvastatin, Gabapentin

Current Illness:

ID: 1027021
Sex: F
Age: 31
State: HI

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

Lab Data: no

Allergies: no

Symptoms: Around noon after getting vaccine, I was getting dizzy spells and a headache. My arm was tender. I went to bed around 7 pm and I woke up around 10 pm. I was dripping in sweat and shivering. My back was sore. It felt like my back was on fire. It felt hot and sore. My arm was still sore. I didn't go to work. I got my kids ready and around 8:00 am I threw up. And throughout the day, until around 3 pm, I was sweating, no fever, I had a headache and I was extremely tired. I wanted to sleep all day. My arm was still sore. After around 3 pm, I felt fine. Pregnancy history - my third pregnancy. I have two children already. Date of Delivery: August 27, 2021. With each pregnancy, I get a little more nauseous and a little more sore.

Other Meds: Prenatal vitamins

Current Illness: Just a sore arm and diarrhea and vomiting the day after the first dose of the vaccine (COVID 19) - one day only.

ID: 1027022
Sex: F
Age: 70
State: WA

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

Lab Data: none

Allergies: sulfa

Symptoms: lightheadedness immediately after injection, 6:30pm 02/02/21 periods of dizziness 02/04/21 til present severe vertigo on laying down 02/06/21 - no repeat since site of injection still red 10 days later, but not still sore. Soreness dissipated by the 2nd or 3rd day dizziness and vertigo could possible be a result of a physical activity, but because of the lightheadedness at the time of the vaccine, I thought I should report as possible vaccine adverse event.

Other Meds: Levothyroxine "AlgaeCal" calcium complex supplement "Strontium Boost" Strontium supplement Vit D, Vit C, curcumin

Current Illness: none

ID: 1027023
Sex: M
Age: 55
State: WA

Vax Date: 01/19/2021
Onset Date: 01/25/2021
Rec V Date: 02/12/2021
Hospital:

Lab Data: 21 Jan at Holy Family ED, patient received a head CT. it came back clean.

Allergies: Aspirin Bactrim Ciprofloxacin Mefloquine Nitrofurantoin oxaprozin quinidine quinine sertraline sulfa drugs

Symptoms: Patient complained of burning sensation and achiness from left deltoid up to left side of neck and behind left ear. Patient complained of left ear clogged, numbness, swelling, with swelling and tingling of lips. Patient took ibuprofen. Went UC and ED, was prescribed prednisolone.

Other Meds: fluoxetine omeprazole fexofenadine fluticasone nasal

Current Illness: N/A

ID: 1027024
Sex: U
Age:
State:

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

Lab Data:

Allergies:

Symptoms: None stated.

Other Meds:

Current Illness:

ID: 1027025
Sex: F
Age: 46
State: IL

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

Lab Data: None

Allergies: While not medically diagnosed, I have had negative reactions to coffee and perfumed products, including facial products.

Symptoms: After I received the shot, I went to the waiting area. While sitting down, I started to feel chest pain. Then, I felt dizzy. The dizziness lasted a very short period of time. Nevertheless, the chest pain lasted for about 30 to 40 minutes. The pain did decrease over that period of time to the point where it just felt like heartburn. About 20 to 30 minutes and while still having a little chest pain, I began to feel a tingling sensation with pain on my right hand. The tingling sensation did not last long, but the pain lasted for about 15 minutes. I did share my symptoms closer to 30 minutes after experiencing them because I thought they were typical side effects. After I got home, I still felt heartburn and pain in my left arm where I received the shot. At around 8 p.m., I remembered that I still had the bandaid that was put on my arm. I took it off in the dark. But, I decided to turn on the light because my arm still hurt. This is when I saw a huge, red, oval-shaped rash on the area where I got the shot. Again, it hurt but did not itch. The next day (today), I called my doctor. He said I got a local reaction and it would be okay as long as it did not increase. To my knowledge, it did not increase. I did take pictures of my rash today. I did not take any additional action since this is the only side effect that has remained. And, my doctor said that I would be okay.

Other Meds: None

Current Illness: None

ID: 1027026
Sex: F
Age: 50
State: CA

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

Lab Data:

Allergies: Quinolones, bactrim

Symptoms: Developed flush feeling and redness approximately 5 minutes after vaccination, then developed headache, dizziness, nausea. Tylenol 650mg PO x 1 given, benadryl 50mg PO x 1 given. Vital signs as follows, checked at 5-10 minutes intervals: BP 153/71, HR 94, SpO2 100% on RA; BP 187/88, HR 100, SpO2 100% RA; BP 136/70, HR 96, SpO2 100% RA. Pt discharged under stable condition with ER precautions.

Other Meds: Gabapentin, Wellbutrin

Current Illness:

ID: 1027027
Sex: F
Age: 75
State: CA

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

Lab Data:

Allergies:

Symptoms: Patient said that about 8 days after receiving the Moderna Covid 19 vaccine she noticed that her arm had a red rash in a circular formation measuring 2 by 2 1/2 inches in diameter at the location of vaccine administration. She said it did NOT itch nor was it painful, but she said it felt different. She reported that the area did not seem to be changing in size, but it was getting more red. She also reported developing a minor headache the morning after the vaccination and it lasted until noon. The headache resolved itself and has not come back.

Other Meds:

Current Illness:

ID: 1027028
Sex: F
Age: 86
State: MN

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

Lab Data:

Allergies: augmentin, bacitracin, Celebrex, cephalexin, septra

Symptoms: Patient is currently in a long term care facility that had a Moderna Vaccination clinic on 2/11/2021. The staff said the vaccine would be the first dose for the patient and a COVID vaccination card was created. After returning from the clinic the Walgreens staff enters in the prescriptions and scans in VARs. Upon a compliance report stating the vaccine was the patient's second dose and not the first. Upon looking at the patient's central profile it was determined that the patient did receive a dose of Pfizers vaccine 1/25/2021. The facility the patient resides in was called and was informed. They stated they had no documentation or paperwork from the patient's previous facility informing of the covid vaccination. The DON said the patient was not experiencing any issues. So the patient received Pfizer on 1/25 and then the moderna on 2/11.

Other Meds:

Current Illness:

ID: 1027029
Sex: F
Age: 68
State: NY

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

Lab Data: Treated with course of oral antibiotics

Allergies:

Symptoms: Vaccine injection site cellulitis

Other Meds:

Current Illness:

ID: 1027030
Sex: F
Age: 36
State: WV

Vax Date: 02/03/2021
Onset Date: 02/05/2021
Rec V Date: 02/12/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Tested positive for Covid 12/18/2020. Was advised that I could get the vaccine so long as I hadn?t received the antibody treatment. I was notified that there was only one vial left for employees at my FQHC and that it was open and would expire that day. I chose to be vaccinated due to the severity of my initial illness. I got the typical fever, extreme body aches, chills, injection site pain, and swollen left armpit lymph node. The third day, I started vomiting and having awful diarrhea. The other side effects dissipated but the swollen lymph node and severe diarrhea remain. I have lost 8 lbs in just over a week. I cannot eat food without extreme GI pain.

Other Meds:

Current Illness:

ID: 1027031
Sex: F
Age: 27
State: GA

Vax Date: 01/25/2021
Onset Date: 01/25/2021
Rec V Date: 02/12/2021
Hospital:

Lab Data:

Allergies:

Symptoms: At 4:57pm patient reports her tongue feels tingling, and throat feels dry and "itchy or tingly". Patient states she also feels dizzy. At 5:03pm administered 50mg Diphenhydramine, IM. After injection patient reports tongue and throat feel better, but states she is still dizzy. Patient monitored, supine and vitals monitored every 5 minutes. At 5:50 patient states she continues to feel dizzy. EMS called. EMS evaluated patient she states she is unsure if she wants to transported to ER. Patient stands and walks out of clinic escorted by her Husband and EMS.

Other Meds: METOPROLOL

Current Illness:

ID: 1027032
Sex: M
Age: 36
State:

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

Lab Data: None

Allergies: None

Symptoms: Vaccine given 1 week earlier than usual

Other Meds: Sildenafil

Current Illness: None

ID: 1027033
Sex: F
Age: 57
State: TX

Vax Date: 02/10/2021
Onset Date: 02/11/2021
Rec V Date: 02/12/2021
Hospital:

Lab Data: I TOOK TYLENOL

Allergies: no

Symptoms: STARTED HAVING AXILLARY PAIN NEXT DAY AND FELT SOME NODE SWELLING BUT IT SLOWLY WENT AWAY. THEN I HAD THE SECOND DOSE IN THE SAME ARM AND STARTED PAIN ANS SOME SWELLING BACK TO THE SAME LEFT AXILLA.I HAD BODY ACHES AND TIRED NESS THE NEXT DAY, I TOOK TYLENOL ES 2 TABS.

Other Meds: Synthroid

Current Illness: had some lymphadenopathy after the first dose

ID: 1027034
Sex: F
Age: 42
State: NY

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

Lab Data: Evaluated by physician, treated with course of oral antibiotics.

Allergies:

Symptoms: Vaccine injection site Cellulitis

Other Meds:

Current Illness:

ID: 1027035
Sex: F
Age: 49
State: KY

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

Lab Data:

Allergies:

Symptoms: 1st vaccine 12/29/20; 2nd dose 2/11/21; developed visual changes 12/12/21, seen and referred to ED, admitted to Hospital.

Other Meds:

Current Illness:

ID: 1027036
Sex: F
Age: 93
State: SC

Vax Date: 01/08/2021
Onset Date: 01/09/2021
Rec V Date: 02/12/2021
Hospital:

Lab Data:

Allergies: aspirin, tetracycline, Zithromycin

Symptoms: 24 hours after the vaccination, was a "zombie" did not drink or eat or take morning medications. Did not know if she had taken any meds (she had not). After getting her to drink fluids, eat some food, and take morning blood pressure medications, about 6 hours later, she started to act more normal.

Other Meds:

Current Illness:

ID: 1027037
Sex: F
Age: 55
State: KY

Vax Date: 01/29/2021
Onset Date: 02/12/2021
Rec V Date: 02/12/2021
Hospital:

Lab Data: NEGATIVE COVID 19 TEST (BOTH RAPID AND PCR) ON 02/12/2021.

Allergies: PENICILLINS

Symptoms: RECEIVED MODERNA VACCINES ON 01/29/21 AND 01/05/21. CALLED EMPLOYEE HEALTH HELP LINE AND REPORTED SYMPTOMS AND HIGH RISK EXPOSURES 02/12/21. REPORTED TO COMPANY ON 02/12/21 WITH RUNNY NOSE, CHILLS, AFTER A HIGH RISK EXPOSURE. NEGATIVE COVID 19 TEST (BOTH RAPID AND PCR) ON 02/12/2021. DIAGNOSED WITH COVID19 EXPOSURE.

Other Meds:

Current Illness:

ID: 1027038
Sex: F
Age: 39
State: WI

Vax Date: 01/21/2021
Onset Date: 01/28/2021
Rec V Date: 02/12/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Itchy, red, swollen, and 4 inch in diameter rash at site of injection starting 7th day after injection and lasting 5 days. Also on the seventh day began aching legs at evening and through the night, disrupting sleep. This lasted 7 days. Also on Seventh day started extreme fatigue, and anxiety. Symptoms of anxiety included shallow breathing, Heaviness in chest, fleeting thoughts. These symptoms are continuing through now being the 22nd day.

Other Meds: None

Current Illness: None

ID: 1027039
Sex: F
Age: 49
State: CT

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

Lab Data: Blood pressure blood oxygen level EKG blood sugar

Allergies: Pseudoephedrine, amoxicillin

Symptoms: I am the patient and within five minutes I got extremely hot my hearing started to leave me and then I passed out I don?t know how long I was out for but staff that were there said I was having a seizure shaking and making gurgling sounds in my throat when I came to I could see people but my hearing took longer to come back. I was then brought to Midstate hospital via ambulance at Midstate I had an EKG and blood work done as well as blood pressure monitored and blood oxygen levels

Other Meds: Levothyroxine Minocycline

Current Illness:

ID: 1027040
Sex: F
Age: 65
State: IL

Vax Date: 02/04/2021
Onset Date: 02/12/2021
Rec V Date: 02/12/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: At injection site, arm is red, warm and sore.

Other Meds: None

Current Illness: None

ID: 1027041
Sex: F
Age: 61
State: NY

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 02/12/2021
Hospital:

Lab Data: None

Allergies: Sulfa medications Oysters, scallops, mussels

Symptoms: 101 degree fever for 2 days Chills, bodyaches Headache for 3 days All food and drink had "bad" taste. Water was only fluid or solid without impaired flavor. Mild pain at injection site

Other Meds: ESTRADIOL

Current Illness: None

ID: 1027042
Sex: F
Age: 56
State: MI

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 02/12/2021
Hospital:

Lab Data: SEE ABOVE

Allergies: NONE LISTED

Symptoms: ONSITE EMS WAS REQUESTED TO HER VEHICLE. POSSIBLE ALLERGIC REACTION. BP 134/80 HR 99 PATIENT REFUSED ADDITIONAL EVALUATION AGAINST MEDICAL ADVISE AND ALLOWED TO GO HOME. She has since returned for her 2nd Covid-19 vaccination on 2/23/20201 and no reaction reported

Other Meds: NONE LISTED

Current Illness: NONE LISTED

ID: 1027043
Sex: F
Age: 65
State: FL

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 02/12/2021
Hospital:

Lab Data:

Allergies: cephalosporin, penicillin, ibuprofen, shellfish

Symptoms: Had a red, itchy arm (injection sight, upper arm and palm of left hand developing on 2/5/21 at 4;30pm. Took benadryl and used hudrocortisone cream for 4 days through 2/8/21. Rash and itching was gone. On 2/11/21 at about 9pm, the injection site started itching again with a red rash measuring about 2 in by 2 in. I have started on benadryl and hydrocortisone again. The outcome is unknown.

Other Meds: 5mg atorvastatin, flonase, calcium, vitamin D, multivitamin, vitamin c

Current Illness: none

ID: 1027044
Sex: F
Age: 39
State: CA

Vax Date: 01/17/2021
Onset Date: 01/18/2021
Rec V Date: 02/12/2021
Hospital:

Lab Data:

Allergies:

Symptoms: about a day after vaccination date, left arm is sore and has been sore since (4 weeks later) . it is painful when I lift up my arm , as if a muscle was torn. nothing has changed in daily activity to cause that.

Other Meds:

Current Illness:

ID: 1027045
Sex: F
Age: 26
State: MA

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 02/12/2021
Hospital:

Lab Data: None

Allergies: oats; sulfa-containing antibiotics

Symptoms: Persistent migraine. My headache began about 3 hours after and stayed mild until about 30 hours later where it grew to a migraine. It is not day 8 since the vaccine and it has not gone away. In addition to the migraine I am experiencing light sensitivity, blurred vision, and yesterday I experienced some heart palpitations. I went to urgent care on 2/8 and was prescribed IC Butalb-Acetamin-Caff for the migraine symptom. In addition I have been taking tylenol and advil which are not helping. My injection site pain and brain fog have resolved while the headache has persisted.

Other Meds: IUD- kyleena

Current Illness: NA

ID: 1027046
Sex: F
Age: 69
State: CA

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

Lab Data: None.

Allergies: Unknown

Symptoms: Patient stated that she went to sit down , sat on the tip of the chair and fell to the floor. Patient had no respiratory distress , no loss of consciousness, but cut her left elbow. Elbow cleaned and bandage. Patient had a neck brace due to falling 5 weeks ago and fracturing her spine per patient.. Patient refused other medical care-didn't want paramedics called.

Other Meds: Unknown

Current Illness: Fractured spine.

ID: 1027047
Sex: M
Age: 44
State: IL

Vax Date: 01/12/2021
Onset Date: 01/15/2021
Rec V Date: 02/12/2021
Hospital:

Lab Data: None were ordered in ED. We ordered MRI

Allergies: NKDA

Symptoms: Patient presents w/ PMHx of GERD presented to pain clinic by referral from primary care with new, sudden onset 8/10 sharp pain and tingling in lower extremities bilaterally terminating rostrally at the level of the coccyx. These symptoms began 3 days after receiving the first Moderna COVID-19 vaccine of the two-part series. The pain is refractory to acetaminophen and three sessions of physical therapy. The pain and numbness make it difficult for the patient to fall asleep. The b/l leg pain was so disturbing that the patient presented to the ED where she was noted to be ?slightly ataxic? and was treated by the ER physician for lumbar radiculopathy with one Norco that did not help.

Other Meds: Pantoprazole 40 mg qd

Current Illness: None

ID: 1027048
Sex: F
Age: 31
State: MI

Vax Date: 02/04/2021
Onset Date: 02/12/2021
Rec V Date: 02/12/2021
Hospital:

Lab Data:

Allergies: Allergic to bivalve shellfish (oysters, mussels, clams, etc.)

Symptoms: Delayed skin irritation, redness around injection site. Approximately 1.25 inches in diameter. Slightly raise, itchy and radiating heat.

Other Meds: Albuterol as needed, Allegra daily.

Current Illness: None

ID: 1027049
Sex: F
Age: 48
State: CA

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

Lab Data: not applicable

Allergies: None

Symptoms: Patient received 2nd dose of Moderna vaccine at around 12:15 pm Patient is also working with the Covid vaccine team in Facility thus was still here when event happened, An hour after she received her vaccine, she complained of shortness of breath, lightheadedness and chest tightness. Vital signs taken and was stable. Patient rested for 10 minutes and had PO hydration and felt better after .

Other Meds: none

Current Illness: none

ID: 1027050
Sex: F
Age: 43
State: IN

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

Lab Data:

Allergies: None

Symptoms: 8 days after the 1st injection a warm red rash showed up 3-4 inches and slight swelling.

Other Meds: Levothyroxine 88mg, Zyrtec, vitamin D, biotin

Current Illness: None

Date Died: 02/12/2021

ID: 1027051
Sex: F
Age: 78
State: CA

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

Lab Data:

Allergies: No known allergies

Symptoms: Few minutes post vaccination, after moving to observation area via wheelchair, the patient complained of dizziness. She took glucose tabs she had brought with her. Staff wheeled her to Triage # 1. Her eyes rolled back in her head and she lost consciousness. Staff (paramedics on site) transferred her to gurney and started compressions. AED placed, V- Fib was rhythm, Shock # 1 given, CPR resumed. Shocked again. Fire truck and additional EMT arrived on site and took over care. Epinephrine was given 3 times via intra-osseous route, Amiodarone given intra-osseous route. Additional defibrillation with on site AED for a total of 6-7 times. Patient had good chest rise with ambu-bag, no airway obstruction or peri-oral edema noted. Code called at 12:40 PM.

Other Meds: Humulin 70/30 B 12 Aspirin 81 mg Hydralazine Plavix Isosorbide MN ER Metoprolol Simvastatin Lisinopril Women's 1 a Day vitamin Calcium with D3 Iron Glucose Tablets

Current Illness: Patient not feeling well this morning prior to arrival, complaints of shortness of breath

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm