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: 0926886
Sex: F
Age: 50
State: CT

Vax Date: 01/01/2021
Onset Date: 01/04/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data:

Allergies: Sulfa

Symptoms: Soreness at injection site

Other Meds:

Current Illness:

ID: 0926887
Sex: F
Age: 59
State: MS

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

Lab Data: None

Allergies: None

Symptoms: 1508- Patient complains of itching on arms and face, red palms, red watery eyes, and mild clearing of throat. RN x3 at patient's side. Pulse: 60BPM, Resp: 20, O2 Sat 100% RA. 1510- Benadryl 50mg PO given. Pt anxious and crying at present. Itching and redness of face, arms, and chest continues. Denies Shortness of breath, trouble swallowing, or itchy throat. 1516- Pt sipping on water with fan blowing on patient. Resp.18, O2 Sat 100% RA, Pulse 48-50BPM. Palms remain red and pt. continues to complain of itching on arms and chest. Denies trouble swallowing, itchy throat, or shortness of breath. 1528- BP 158/92, Pulse: 50, Resp. 16. Pt is calm and states is "feeling much better". Denies itching of face or arms, shortness or breath. 1535- BP:138/96, Pulse: 52. 1540- Respirations even and unlabored at 16 BPM. No acute distress noted at present. Denies shortness of breath or itching. Pt released from the vaccination clinic and returned to her department walking with another RN. Instructed patient to seek medical attention or go to the emergency department immediately if symptoms return.

Other Meds:

Current Illness:

ID: 0926888
Sex: M
Age: 17
State:

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

Lab Data:

Allergies:

Symptoms: Patient is 17 years old, and signed up for vaccination with Pfizer vaccine, however decided to attend an earlier clinic with his Mother. At the earlier clinic, only the Moderna vaccine was available, and the vaccinator did not realize his age, and administered Moderna vaccine. It was not realized until after vaccination that he was due to receive the other vaccine because of his age. Patient attended the vaccine clinic with his Mother both were aware of the mistake. Patient had no ill effects after receiving the vaccination.

Other Meds:

Current Illness:

ID: 0926889
Sex: F
Age: 47
State: CA

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

Lab Data:

Allergies: Salmon - wheezing, required IM epi: anaphylaxis Pistachio Nut: anaphylaxis

Symptoms: Patient received 2nd dose of the Pfizer vaccine. Within 12 minutes patient began to complain of dizziness and nausea. She complained of dry mouth and sweating. Patient was placed supine onto gurney. Her BP read 162/101. PO2:94%. MD stat was notified and patient was later escorted to the ER. She was received per ER staffing for treatment and evaluation.

Other Meds: Albuterol 90 mcg Ciclesonide 80 mcg Montelukast 10mg Benzonatate 100mg

Current Illness: none

ID: 0926890
Sex: F
Age: 64
State: NY

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

Lab Data:

Allergies: PCN, Demerol, iodine

Symptoms: redness/swelling at injection site

Other Meds:

Current Illness:

ID: 0926891
Sex: F
Age: 41
State: OR

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data:

Allergies: sulfa antibiotics

Symptoms: Pain and swelling at the injection site, approximately 36 hours' duration after onset. Nausea and diarrhea, approximately 18 hours' duration after onset.

Other Meds: none

Current Illness: none

ID: 0926892
Sex: M
Age: 55
State: WA

Vax Date: 12/30/2020
Onset Date: 01/02/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data: EKG, chem panel, CT

Allergies: none

Symptoms: Patient received 0.5mL Moderna Covid19 vaccine at mass vaccine clinic on 12/30. This patient was a walk thru and not a patient of HP at this time. Daughter reported to ARNP,RN Director Clinical Support on 01/03 the following outcomes: Patient first exhibited the first signs of reaction started about 60 hours after vaccine: hives only (no difficulty breathing, dizziness, lightheadedness); applied hydrocortisone cream, took diphenhydramine. Patient slept for a few hours then woke up for lunch. Around 12:30-1:00 the patient exhibited three episodes of syncope. Emergency services was called after the first. Firefighters couldn't find BP, was in 70s by doppler only. Patient taken to hospital for care. Discharged from ED around 5, suspecting hypotension 2/2 to diphenhydramine use. Monitored vitals at home; became severely hypotensive (BP 70s/40s both with automatic monitor and manual read) and lethargic again about an hour or so after, but normotensive again right before about to call ambulance. Pt claimed to be okay and had some dinner. Fourth episode of syncope, ambulance was called. Patient remains at hospital ED since, still in observation unit. BP's normalized but itching returns periodically. IV steroids and diphenhydramine. Took head CT yesterday; no word on the results. Stable and alert enough since yesterday to communicate with us with his phone. Patient is scheduled for an echo to be done today. No hx of severe allergic reaction. Treated for active TB 30 years ago, shingles x2 in the past few years; otherwise healthy 55 y/o male. Pt discharged 01/04 to home with fatigue and malaise. Not additional symptoms reported since then. Provider doing full cardiac and neurologic work up.

Other Meds: Patient received 0.5mL Moderna Covid19 vaccine at mass vaccine clinic on 12/30. This patient was a walk thru and not a patient of HP at this time. Daughter reported to ARNP,RN Director Clinical Support on 01/03 the following outcomes:

Current Illness: none

ID: 0926893
Sex: F
Age: 36
State: TX

Vax Date: 12/17/2020
Onset Date: 12/29/2020
Rec V Date: 01/07/2021
Hospital:

Lab Data: n/a

Allergies: none

Symptoms: mucosal erosions and hives

Other Meds: ocps, nsaids x 1

Current Illness: none

ID: 0926894
Sex: F
Age: 34
State: TN

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

Lab Data: None at this time

Allergies: NKA

Symptoms: Dose was administered at 10:16am. Pain at injection site as well as redness and swelling began around 5:00pm on the same day. Pain, redness, and swelling have continued for 24 more hours and has not yet gone away. The swelling is like a hard knot below the skin?s surface, but it protrudes a bit at the injection site.

Other Meds: Fluoxetine 10mg

Current Illness: None

ID: 0926896
Sex: F
Age: 30
State: AR

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

Lab Data: none

Allergies: none

Symptoms: 13hrs post vaccination fever of 101, body aches,fatigue. today just fatigue

Other Meds: ACT

Current Illness: none

ID: 0926898
Sex: F
Age: 51
State: UT

Vax Date: 12/30/2020
Onset Date: 01/06/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Red itchy warm swollen rash to left upper arm and vertigo which started one week after injection

Other Meds: Multivitamin, biotin, l-lysine, vitamin d

Current Illness: None

ID: 0926899
Sex: F
Age: 28
State: CA

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

Lab Data:

Allergies:

Symptoms: Patient received the covid vaccine on 1/26/2021 Two hrs post injection c/o pain/soreness at site. Four hrs post injection c/o general body ache, slight headache, fever 99.7. Denies any respiratory, ocular, or GI symptoms. Note - injection lot # not available.

Other Meds:

Current Illness:

ID: 0926900
Sex: F
Age: 47
State: IL

Vax Date: 12/30/2020
Onset Date: 01/06/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data: n/a

Allergies: cloves, clams and seasonal allergies

Symptoms: Initially my arm was sore for about 36 hours. Yesterday on day 7 after my shot, the injection site was increasing in tenderness. By today the injection spot is swollen and I am unable to lift my arm over my head. No fever, or chills. I do have body aches which originally I was thinking was from moving snow and ice.

Other Meds: n/a

Current Illness: n/a

ID: 0926901
Sex: F
Age: 44
State:

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

Lab Data:

Allergies:

Symptoms: Generalized Weakness, arm sore, sore throat, runny nose

Other Meds:

Current Illness:

ID: 0926902
Sex: F
Age: 40
State: MT

Vax Date: 01/05/2021
Onset Date: 01/05/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Headache at the "back of the skull" that occurred 2 hours after the vaccine and went away by the afternoon

Other Meds:

Current Illness:

ID: 0926903
Sex: M
Age: 39
State: WA

Vax Date: 01/05/2021
Onset Date: 01/06/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data:

Allergies: None unknown

Symptoms: Very sore arm at site. Mild headache, tired, slight itchy throat. 1 day after getting the shot. Head alittle foggy.

Other Meds: Modafinil.

Current Illness: None

ID: 0926904
Sex: F
Age: 23
State: TX

Vax Date: 12/28/2020
Onset Date: 12/28/2020
Rec V Date: 01/07/2021
Hospital:

Lab Data:

Allergies: N/A

Symptoms: Fast Heart rate after an hour and half of injection and shortness of breath . Next morning i woke up sweating and my heart rate was 130 and shortness of breath followed. I then developed a rash the same day which was red and bumpy i also felt really lethargic and fatigued. Day three the rash had a line straight through the middle of it and was itchy the rash was spreading horizontally. After day three I felt better with the only side effect being shortness of breath from time to time. Now on the 7th of Jan I develop the rash again except its raised, the line is back and it itches internally. I don't feel bad , it's just concerning that it came back stronger all the sudden. I don't know if I will be allowed to get the second dose.

Other Meds: N/A

Current Illness: N/A

ID: 0926905
Sex: M
Age: 50
State: CT

Vax Date: 12/30/2020
Onset Date: 01/07/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data:

Allergies: lactase

Symptoms: localized raised redness, rash

Other Meds: Probiotic, creatine

Current Illness: neg

ID: 0926906
Sex: F
Age: 34
State: TX

Vax Date: 01/04/2021
Onset Date: 01/05/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data: I tested positive on Thursday (1/7) at hospital with a Rapid nose swab test.

Allergies:

Symptoms: I believe I had the Virus already a few days before I received the vaccine. I felt fatigue on Monday after receiving the vaccination. On Tuesday I woke up with sinus issues and felt fatigue all day. Wednesday evening, I lost sense of smell and taste.

Other Meds: Adderall

Current Illness: I believe I was exposed to COVID a few days before my vaccination. I just tested positive on 01/07/21

ID: 0926907
Sex: F
Age: 70
State: FL

Vax Date: 12/30/2020
Onset Date: 01/07/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data: no

Allergies: no

Symptoms: Size of penny at shot site. Another one beside it, warm, itchy, bubbly or dry skin.

Other Meds: Lorazepam, Lisinopril, baby aspirin, calcium, fish oil.

Current Illness: no

ID: 0926908
Sex: F
Age: 33
State: IL

Vax Date: 12/29/2020
Onset Date: 12/30/2020
Rec V Date: 01/07/2021
Hospital:

Lab Data: no

Allergies: no

Symptoms: Estimated due date: 02/16/2021 Essentially I just had tiredness, body aches and fever (101.8F), the reason I could not go to work is because I was extremely tired and unable to focus. Symptoms lasted 12-18 hrs.

Other Meds: prenatal vitamin and daily stool softener

Current Illness: no

ID: 0926909
Sex: M
Age: 34
State: MN

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

Lab Data:

Allergies: None

Symptoms: Immediate pain and loss of range of movement of left shoulder. Physical examination today demonstrates a healing injection site which is fairly superior on the left shoulder, and abduction of the left shoulder which is limited secondary to pain. Patient's physician's impression is that he has a subdeltoid bursitis which was temporally associated to the COVID-19 vaccination. (SIRVA)

Other Meds: None

Current Illness: No acute illness

ID: 0926910
Sex: F
Age: 42
State: AZ

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 01/07/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Employee was being observed right after vaccine and B/P 146/104, started having left sided head, neck, ear, jaw throbbing pain and a headache, then pain went into left groin area-employee stated, "It's like I can feel it moving all through my lymphatic system. Then after about another 5 minutes employee became lightheaded and "fainty" like feeling and then was nauseated with continued left sided pain as listed above. After about 10 minutes B/P 146/116, employee was transported to the emergency department for further evaluation. 2nd day-12/30/2020-employee had body aches all over, extreme fatigue and headache. 3rd day-12/31/2020-employee was just tired and fatigued. 4th day-1/1/2021-employee had no symptoms and felt much better.

Other Meds:

Current Illness:

ID: 0926911
Sex: F
Age: 62
State: AZ

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data:

Allergies:

Symptoms: None stated.

Other Meds:

Current Illness:

ID: 0926912
Sex: M
Age: 73
State:

Vax Date: 01/01/2021
Onset Date: 01/05/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: BPPV moderate, nothing else

Other Meds: Several, basically I developed BPPV of moderate severity, otherwise I am fine.

Current Illness: None

ID: 0926913
Sex: F
Age: 35
State: CA

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

Lab Data:

Allergies: na

Symptoms: tachycardia, sweating, dizziness and nausea.

Other Meds:

Current Illness: na

ID: 0926914
Sex: F
Age: 40
State: NY

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

Lab Data: Sent to emergency room for evaluation.

Allergies: States various seasonal, medication, and other unidentified allergies

Symptoms: Anxiety, hives, tingling

Other Meds: Unknown

Current Illness: None known

ID: 0926915
Sex: F
Age: 29
State: TX

Vax Date: 12/29/2020
Onset Date: 01/06/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data: NONE

Allergies: NO KNOWN

Symptoms: RED CIRCULAR RASH AND LUMP UNDER SKIN. SKIN IS VERY ITCHY

Other Meds: QUETIAPINE / VENLAFAXINE . ORAL CONTRACEPTIVE (CYRED)

Current Illness: NONE

ID: 0926917
Sex: F
Age: 52
State: LA

Vax Date: 01/03/2021
Onset Date: 01/03/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data: Bloodwork, EKG, urinalysis, CT scan, MRI. All negative

Allergies: Possibly penicillin

Symptoms: Extreme dizziness/ vertigo with difficulty walking

Other Meds: N/A

Current Illness: N/A

ID: 0926918
Sex: F
Age: 17
State: MO

Vax Date: 01/05/2021
Onset Date: 01/05/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data:

Allergies: NKA

Symptoms: No adverse event noted. Patient is 17 years old (17.5) and the approved age for this vaccine is 18. This was inadvertently missed at check-in. Patient suffered no untoward effects

Other Meds: unknown

Current Illness:

ID: 0926919
Sex: M
Age: 37
State: OR

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

Lab Data: Gave Benadryl 25mg po recommendation.

Allergies: None known

Symptoms: Rash warm to touch at injection site

Other Meds: N/a

Current Illness: None known

ID: 0926920
Sex: F
Age: 17
State: CA

Vax Date: 12/18/2020
Onset Date: 12/18/2020
Rec V Date: 01/07/2021
Hospital:

Lab Data: EKG and orthostatic vitals (12/18/2020)

Allergies: penicillin

Symptoms: Syncope

Other Meds: none

Current Illness: none

ID: 0926921
Sex: F
Age: 35
State: CO

Vax Date: 01/04/2021
Onset Date: 01/05/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data: No

Allergies: PCN (anaphylaxis) , Neomycin (infection)

Symptoms: Rash left arm, shoulder, stomach - very itchy

Other Meds: Zaleplon, Escitalopram, Estarylla

Current Illness: No

ID: 0926922
Sex: M
Age: 45
State: AZ

Vax Date: 01/04/2021
Onset Date: 01/07/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data:

Allergies:

Symptoms: None stated.

Other Meds:

Current Illness:

ID: 0926923
Sex: M
Age: 56
State: CO

Vax Date: 01/01/2021
Onset Date: 01/04/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Headache. Fever. 103.5 temperature. Sleepy. Chills. Sore at injection site. Eyes hurt.

Other Meds: None

Current Illness: Covid 19 on 12/7/20

ID: 0926924
Sex: F
Age: 64
State: MA

Vax Date: 01/03/2021
Onset Date: 01/04/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data: Covid PCR rapid swab 1/4 - Negative

Allergies: Erythromycin

Symptoms: Woke morning after, 1/4/21 with nausea and headache; by 10:30 a.m. body aches, chills and temp 100.3; Tylenol at that time; To bed at 11:30 a.m. Woke at 5pm with body aches, chills and fever 102.4; Motrin at that time; Morning of 1/5/21 temp 100 most of date with headache, body aches and fatigue; Afebrile by that evening; Morning of 1/6 woke with headache and fatigue; shortness of breath and tachycardia with exertion. Normal HR w/rest. Morning of 1/7 woke with headache that resolved w/Motrin - worked all day

Other Meds: Trazodone, Fluoxetine, Raloxifene, Singulair, Topamax, Levothyroxine, Calcium, Vit D

Current Illness: None

ID: 0926925
Sex: F
Age: 31
State: FL

Vax Date: 12/31/2020
Onset Date: 01/07/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data: no

Allergies: no

Symptoms: Today redness, swelling, pain. Redness is very big.

Other Meds: birth control

Current Illness: no

ID: 0926926
Sex: F
Age: 26
State: MD

Vax Date: 01/05/2021
Onset Date: 01/06/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data: None

Allergies: Seasonal Allergies

Symptoms: Vomitting, Fever, Chills, Headache

Other Meds: Valcyclovir Biotin Vitamin C Olly Stress Gummies Cranberry Supplement L-Lysine Women's Multivitamin Women's Probiotic Spironalactone

Current Illness: N/A

ID: 0926927
Sex: F
Age: 50
State: NC

Vax Date: 12/31/2020
Onset Date: 12/31/2020
Rec V Date: 01/07/2021
Hospital:

Lab Data: None

Allergies: NONE

Symptoms: Red rash over entire body. Not raised but itchy. Mottled appearance. Started on arm of injection site then spread to both arms, both legs and torso. Approximately 45 minutes after reaction started took diphenhydramine 25 mg x 1 dose. Reaction started to ease off within 1 hour but did not completely resolve until the next morning.

Other Meds: progesterone, estradiol 0.75 mg patch, Vit D3, Calcium Carbonate, Ashwagandha, MVI, fish oil, collagen powder, fiber, red ginseng, Vit C, Best Rest (made by PURE),

Current Illness: NONE

ID: 0926928
Sex: F
Age: 31
State: SC

Vax Date: 01/05/2021
Onset Date: 01/07/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data:

Allergies: Hydrocodone/acetaminophen - Itchy/Nausea

Symptoms: Patient reported to COVID Vaccine administration site two days post vaccination for Pfizer COVID vaccine to report an itchy red, raised bump/hard nodule at the vaccine site. Vitals were as follows: BP 137/74 O2 Sat on RA 99.9% HR 93 Physician evaluated the patient and instructed to apply compress and report to ER if symptoms worsen.

Other Meds: Citalopram 20mg; Take two tablets by mouth daily

Current Illness:

ID: 0926929
Sex: F
Age: 38
State: TX

Vax Date: 12/28/2020
Onset Date: 12/28/2020
Rec V Date: 01/07/2021
Hospital:

Lab Data:

Allergies: CLINDAMYCIN, BIAXIN, FENTANYL

Symptoms: ABOUT 5 HOURS AFTER THE IMMUNIZATION, PATIENT STARTED TO HAVE A HEADACHE. THEN PATIENT STARTED EXPERIENCING NAUSEA, LOSS OF APPETITE, FEVER, BODYACHES, AND COUGH AND HAS BEEN HAVING THESE SYMPTOMS EVERY DAY.

Other Meds: ADDERALL, WELLBUTRIN XL, CLONAZEPAM, HCTZ, FLUOXETINE, DICYCLOMINE, LISINOPRIL, FIORICET

Current Illness: NONE

ID: 0926930
Sex: F
Age: 30
State: TX

Vax Date: 12/02/2020
Onset Date: 12/07/2020
Rec V Date: 01/07/2021
Hospital:

Lab Data: Ultrasound ordered today 01/07/2021 - Results pending

Allergies: None

Symptoms: Physician reported today 01/07/2020 that patient seen today for left arm pain, complained of reaction worsening and affecting her work. On exam she had a large 5x5cm tender mass in posterior upper arm triceps area, consistent with possible sterile abscess. Ordered an ultrasound to be sure and the extent and to determine treatment if any.

Other Meds: None

Current Illness: NA

ID: 0926931
Sex: F
Age: 27
State: TX

Vax Date: 12/20/2020
Onset Date: 12/21/2020
Rec V Date: 01/07/2021
Hospital:

Lab Data: N/A

Allergies: Zofran

Symptoms: Redness, warm to touch, and swelling at injection site. Treatment-Benadryl and cold compresses

Other Meds: None

Current Illness: Type 1 Diabetes

ID: 0926932
Sex: F
Age: 41
State: NY

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

Lab Data:

Allergies: NKA

Symptoms: Rash upper chest, light headed, hypertensive, tachycardic

Other Meds: Unknown

Current Illness: none disclosed

ID: 0926933
Sex: F
Age: 50
State: OR

Vax Date: 01/05/2021
Onset Date: 01/06/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data: none

Allergies: allergic to wheat, soy, dairy, lavendar, pine trees, cats,

Symptoms: 3 hours after injection- headache and dizziness. 8 hours post injection; nausea, diarrhea, temperature, chills, muscle pain, malaise, worsening headache. Flet like flu like symptoms. AE's lasted into the late afternoon with some relief of most symptoms but diarrhea every 30 minutes.. The next day 1/7/2021; fever still present at 100.9, and malaise as well as fatigue and muscle pain- though decreased from the day before. About 30 hours after injection- vomiting started ocurring. Vomiting subsided about 5 hours later with continued nausea. As of 1/7/2021 @16:04 temperature, nausea, muscle pain, fatigue, and malaise still continuing.

Other Meds: sonota, celebrex, vitamin D, probiotics, flexeril (prn)

Current Illness: FMS, OA, IBS

ID: 0926934
Sex: M
Age: 37
State: MT

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

Lab Data: Unknow

Allergies: Amoxicillian

Symptoms: Pt awoke and had seizure like activity, went to hospital in neighboring county.

Other Meds: Unknown

Current Illness: unknown

ID: 0926935
Sex: F
Age: 38
State: TX

Vax Date: 01/05/2021
Onset Date: 01/05/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: Pt states the she developed facial swelling a couple of hours after injection. Pt took benadryl and swelling resolved. Pt never complained of tongue or lip swelling or difficulty breathing.

Other Meds: unknown

Current Illness: none

ID: 0926936
Sex: F
Age: 64
State: CA

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

Lab Data:

Allergies:

Symptoms: Patient felt cold, lightheaded and had tingling sensation. Followed by chest pain and shortness of breath. Patient was transferred to stretcher for monitoring. Dose of Solumedrol 125mg was given at 13:42. Dose of Benadryl was given at 13:45. Dose of Epi-pen was given at 14:06 and patient showed some improvement. Then ambulance arrived and patient was taken to hospital.

Other Meds:

Current Illness:

ID: 0926937
Sex: F
Age: 37
State: CA

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

Lab Data:

Allergies: none

Symptoms: itchiness below injection site 15 minutes after the injection

Other Meds: none

Current Illness: none

ID: 0926938
Sex: F
Age: 29
State: IN

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

Lab Data:

Allergies: Bactrim - anaphylaxis

Symptoms: Severe chills with shivering Sweating Severe back and neck pain Headache Nausea

Other Meds: Sprintec

Current Illness: No

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm