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: 0926939
Sex: F
Age: 56
State: WI

Vax Date: 12/29/2020
Onset Date: 01/05/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data: empiric treatment for possible cellulitis with keflex x5 days, starting 1/7/21

Allergies: sulfadiazine

Symptoms: swelling, heat, redness, itching, pain at injection site with onset 7 days after injection.

Other Meds: citalopram, esomeprazole, lorazepam, multivitamin

Current Illness: none

ID: 0926940
Sex: M
Age: 6
State: MN

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

Lab Data: None.

Allergies: No Known Allergies

Symptoms: HISTORY OF EVENT: Patient is experiencing numbness and tingling in his fingers and toes upon waking this morning. He received his flu shot yesterday in his left leg. He describes it as tickling around his fingertips, and feels like there is dirt under his fingernails; he reports a similar sensation in his feet. He has a low-grade fever of 100.0, a tummy ache, and states that his chest and throat area might be a little sore. Patient's mother is a nurse and reports his heart rate to be around 110. Overall Patient is eating, sleeping, and voiding well and seems to be himself. Denies shortness of breath, coughing, wheezing, dizziness, lightheadedness, loss of appetite, fatigue, and syncopal episodes. TREATMENT: Patient is a 6 y.o. male presenting via video visit with his mother today for evaluation for numbness and tingling in his hands and feet following flu immunization. Family counseled that this is likely a systemic reaction with fever, with a hyperventilation and/or anxiety component. Instructed parents to provide Patient with a paper bag, and have him breathe in and out slowly, to rebreathe his air and normalize his carbon dioxide levels. He may continue to repeat this maneuver if the symptoms should continue throughout the day. Following initial breathing exercise, Patient's numbness and tingling resolved. Parents advised to keep patient home from school in the event that repeated breathing exercises are needed today. In the event that numbness and tingling do not resolve with breathing exercise, family instructed to bring Patient into clinic for further evaluation; additional workup may include evaluation of electrolyte imbalances. Case discussed with Dr. who was in agreement and provided breathing exercise instruction. Reviewed symptomatic care, signs and symptoms of danger, and reasons to seek care emergently or return for evaluation. If there are any further concerns, they may contact the clinic. Will report vaccine reaction to VAERS.

Other Meds: None

Current Illness: None.

ID: 0926941
Sex: M
Age: 83
State: CO

Vax Date: 12/28/2020
Onset Date: 01/05/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data: None

Allergies: Sulfa drugs

Symptoms: Reaction occurred 9 days after injection: injection site pink and swollen; no fever, pain, other symptoms. No previous complaints Doctor visit on 1/7

Other Meds: Levothyroxine 75 mcg Escitalopram 10mg Vitamins & Minerals Curcumin, MSM, SAMe, PS100, Alpha Lipoic Acid

Current Illness: None

ID: 0926942
Sex: F
Age: 0
State: VA

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

Lab Data:

Allergies:

Symptoms: Site of injection became very itchy today and noticed large sore knot about the size of a small apple.

Other Meds: Birth control pill , women?s multivitamin, zinc

Current Illness:

ID: 0926943
Sex: F
Age: 55
State: FL

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

Lab Data:

Allergies: Sulfa, penicillin, aspartame, phenylketonurics artificial sweetener,

Symptoms: Injection site swollen, raised, itchy, red, hot. Ice pack, benedryl, advil. Slowly went away and then came back again on 01/04/21 woke up 6:00 am injection site raised, itchy, red, hot, swollen. Used hydrocortisone cream and benedryl.

Other Meds: Multi Women's Vitamins, Vitamin D, Vitamin B complex

Current Illness:

ID: 0926944
Sex: F
Age: 33
State: LA

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

Lab Data: Treated with IV solumedrol and IV benadryl. Continue to monitor B/P 178/92 then rechecked 170/92. Will be D/C to home when B/P in range as determined per MD.

Allergies: NKDA or food allergy known

Symptoms: Staff member received vaccine .At the 15 minute mark, she reported a headache with pressure behind right eye,slight dizziness. It was described as a rapid onset migraine headache with photosensitivity .She was escorted to empty room with staff and laid down. she was examined per Dr.At the 20 minute mark, she developed a light red rash and began itching. The itching began at the face, radiated to arms and legs and then trunk. No c/o SOB, chest pain or increased heart rate. She reported that it felt like someone poking a finger to her left chest wall for 5 minutes-gently.B/P elevated and monitored by staff for 3.5 hrs and was able to go home with staff/family.

Other Meds: Adipex 37.5mg on saturday and Topmax 50 mcg x 2 days.

Current Illness: Sinusitis last week

ID: 0926945
Sex: F
Age: 24
State: IL

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

Lab Data:

Allergies:

Symptoms: Stated she felt nauseated and threw up. then began to feel itchy and noticed rash on back, stomach, and right foot. Everything else was fine. Denied difficulty breathing.

Other Meds:

Current Illness:

ID: 0926946
Sex: F
Age: 36
State: WA

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

Lab Data: None

Allergies: None

Symptoms: About 24 hours after receiving the vaccine, I had a fever of 100.4 and chills. This lasted for about 6 hours before bed. I woke up in the morning and the fever and chills were gone. I feel like this was a normal immune response but my employer asked me to fill this out.

Other Meds: Gianvi (birth control), Claritin, multivitamin

Current Illness: None

ID: 0926947
Sex: F
Age: 36
State: NY

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

Lab Data: None. Waiting to see response. If doesn?t get better will go to ED.

Allergies: No

Symptoms: Fever 101.3 with severe body aches and terrible headache since last night until now. It has been more than 24hrs since I received a vaccine.

Other Meds: Tylenol and time to time Motrin 400mg.

Current Illness: No

ID: 0926948
Sex: F
Age: 0
State: NY

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

Lab Data: CT scan?-sent to DEM- code stroke

Allergies: none reported

Symptoms: post vaccine syncope episode rule out out cva

Other Meds: none reported

Current Illness: none reported

ID: 0926949
Sex: F
Age: 38
State: NH

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

Lab Data:

Allergies: None

Symptoms: Woke up this morning, a week after vaccination. Localized reaction at injection site, itchy, blotchy, swollen and firm slightly larger than the size of a baseball. Also running low grade fever of 100.2. Had been feeling completely normal for the 48 hours prior.

Other Meds: Aspirin

Current Illness: None

ID: 0926950
Sex: F
Age: 47
State: FL

Vax Date: 12/28/2020
Onset Date: 01/06/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data:

Allergies: n/a

Symptoms: 12/28/2020- received 1st vaccine 12/29/2020- very sore noticed around the 31st redness and swelling appeared 01/05/2021- while in the shower it became extremely itchy, I scratched it. Then forgot about it. 01/06/2021- woke up it was significantly swollen, significantly redder felt like a ball, a little warm to the touch. did not itch it, 01/06/2021 around 4:30 pm s/w Dr. she put me on Benedryl and Keflex. 01/07/2021 swelling and redness have gone done but size has increased. the diameter of the redness is about 3 to 4 inches.

Other Meds: Adderall and prozac

Current Illness: possible cold or sinus infection

ID: 0926951
Sex: F
Age: 30
State: ID

Vax Date: 12/28/2020
Onset Date: 01/06/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Soreness in right shoulder and wrist night of injection, swelling of right wrist overnight 12/28. Symptoms resolved by mid-day 12/19. Soreness in shoulder and wrist returned evening of 1/6 and persisted through daytime 1/7. Have not yet resolved.

Other Meds: None

Current Illness: None

ID: 0926952
Sex: F
Age: 34
State: LA

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

Lab Data:

Allergies: None

Symptoms: Myalgia all over the body, headache, nausea, vomiting x1, intermittent sheivering and feeling hot

Other Meds: None

Current Illness: None

ID: 0926953
Sex: F
Age: 50
State: IL

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

Lab Data: none

Allergies: PCN

Symptoms: Nausea, Chills, Achiness, pain from head to toes

Other Meds: MULTIVITAMINS, ESTROGEN

Current Illness: NONE

ID: 0926954
Sex: F
Age: 46
State: CA

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

Lab Data: Yes

Allergies: no

Symptoms: Tingling in arm, vision was blurry, Dizziness, difficulty breathing, head spinning. Weakness, body aches, fast heartbeat. Speech slurred, jaw locking. Taken to ER where she works.

Other Meds: no

Current Illness: no

ID: 0926955
Sex: M
Age: 31
State: CA

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

Lab Data:

Allergies: None

Symptoms: Pt called and stated that he has had a severe headache since vaccine 2 days ago, one episode of nausea and vomiting. Pt spoke to Dr. and provider recommended Tylenol 500 mg TID. Also told pt he he can take ibuprofen, or benadryl sparingly. Report to ER if symptoms worsen. Call and make appt at clinic if symptoms persist for more than 7 days post vaccine.

Other Meds: None

Current Illness: None

ID: 0926956
Sex: F
Age: 25
State: SC

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

Lab Data:

Allergies: NKDA

Symptoms: Patient receive the Pfizer COVID Vaccine earlier in the day. She called the Clinic line at 1500 and spoke with a nurse. She said she went to sleep and awoke with numbness in her right hand with pain. She complained of pain radiating from her biceps to her elbow. She states she has a headache along with lower back pain. She states she has nausea, vomiting, and that she feels really bad. She is able to move her right hand but states " it hurts". Reported to physician and patient instructed to call Emergency Services.

Other Meds:

Current Illness:

ID: 0926957
Sex: F
Age: 25
State: WI

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

Lab Data: BP 134/89, HR 88, Temp 98.3, Resp 16,

Allergies:

Symptoms: Itching on arms, legs, & back began within 5 minutes of administration. Writer noticed patient itching. No rash appeared. No additional symptoms appeared. Patient kept for additional observation x 2 hours total. MD also assessed patient, recommended Benadryl 25mg to be given which patient took. Patient reported that Itching continued for about 48 hours and then stopped, never worsening. No rash or any other symptoms.

Other Meds:

Current Illness:

ID: 0926958
Sex: F
Age: 47
State: OR

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

Lab Data: Bo 115/70, glucose 161

Allergies: None

Symptoms: Mild throat swell, nausea, blurred vision

Other Meds: Vitamins & ibuprofen

Current Illness: NA

ID: 0926959
Sex: F
Age: 59
State: NC

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

Lab Data: Epipen administered and pt transported to Emergency Room

Allergies: shellfish

Symptoms: Patient felt dizzy quickly progressed to hoarse voice, cough and expressed difficulty breathing

Other Meds:

Current Illness:

ID: 0926960
Sex: F
Age: 29
State: MA

Vax Date: 12/17/2020
Onset Date: 01/03/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: On 1/3 I developed a rash along my right side, under my right arm pit and along right breast. This progressed the following days, became itchy and painful. The pain was shooting. I saw my PCP office on 1/6 and was diagnosed with Shingles.

Other Meds: Multivitamin

Current Illness: None

ID: 0926961
Sex: F
Age: 58
State: OR

Vax Date: 12/22/2020
Onset Date: 12/27/2020
Rec V Date: 01/07/2021
Hospital:

Lab Data: Covid test negative 12/27/20

Allergies: adverse to promethazine - involuntary muscle movement allergies to citrus hives adverse effect -Marcaine- hypotension

Symptoms: Vaccinated on December 21, 2020. No arm pain, nothing. On December 27th at 4:00 PM sudden onset worst bone pain ever unrelieved with Tylenol, malaise and nausea. December 28th at 1:00 AM awoke in pain and "on fire" I have never been so hot, truly felt like my skin was on fire. Tympanic thermometer 99.0F. Awoke feeling fine and went to work thinking this was SE however symptoms recurred later that morning so I went for testing as I could not differentiate between SE vs illness. Covid negative. If this was a delayed response to vaccine, wanted to report: severe bone pain unrelieved w Tylenol , malaise, nausea, 48 hours. thanks, NP

Other Meds: none

Current Illness: none

ID: 0926962
Sex: M
Age: 69
State: MO

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

Lab Data: none

Allergies: No known allergies

Symptoms: Patient described redness and tenderness around left orbital area starting a few hours after administration. Tenderness and swelling progressively worsened and moved to lower left eye. Patient claimed area was tender when pressure was applied. Area around left orbital appeared erythematous and swollen.

Other Meds: glimepiride 4 mg pioglitazone 30 mg

Current Illness: unknown

ID: 0926963
Sex: F
Age: 51
State: WI

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

Lab Data: Covid test will be on 01-08-2021

Allergies: Nickel, morphine

Symptoms: Fever 103.3 Dizziness Nausea Left arm pain Fatigue

Other Meds: None

Current Illness: None

ID: 0926964
Sex: F
Age: 30
State: AZ

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

Lab Data:

Allergies:

Symptoms: muscle aches, confusion, fatigue, lymph nodes tenderness in underarms and jaw 1/7/20

Other Meds:

Current Illness:

ID: 0926965
Sex: F
Age: 63
State: HI

Vax Date: 12/30/2020
Onset Date: 01/04/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data:

Allergies: mahi mahi (fish)

Symptoms: Vaccine area warm to touch, red and itchy. lump is size of width of orange.

Other Meds: vitamin d

Current Illness: none

ID: 0926966
Sex: F
Age: 66
State: IN

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

Lab Data: none

Allergies: no

Symptoms: Awoke in the middle of the night with spiking fever 101.5, headache, muscle aches, diarhea, In bed from Monday night to Wednesday morning started feeling better.

Other Meds: Cymbalta, Trazadone, Tramadol, Premarin,

Current Illness: none

ID: 0926967
Sex: F
Age: 55
State: TN

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

Lab Data: none

Allergies: Tetanus/Diptheria, Honey, Latex

Symptoms: Initially arm sore and swollen on 2nd day. Had body aches, chills, diarrhea, tiredness day 3-5 with continued arm site swollen and sore. On 1/5/20, swelling was decreased to about size of nickel and less sore. On 1/6, arm became more sore, noticed increased swelling and now redness to arm site 1/6 evening. 1/7 Arm remains swollen, red, warm to touch. No drainage. Reported to superviser 1/7 am.

Other Meds: Lisinopril, Atorvastatin, ASA, Fish Oil, Magnesium, Zinc, Vit D, MVI, St John's Wart, Proair MDI PRN

Current Illness: None, I was fine until had immunization

ID: 0926968
Sex: F
Age: 45
State: MN

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

Lab Data: I'm an ER Physician so I'm monitoring myself.

Allergies: None

Symptoms: DIffues hives over chest, abdomen, back, arm

Other Meds: Birth Control Pills

Current Illness: None, but significant side effects from the vaccine (fever, chills, body aches, severe headache)

ID: 0926969
Sex: F
Age: 59
State: GA

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

Lab Data: none

Allergies: none

Symptoms: VERY RAPID HEART BEAT, PULSE, 5:30PM .Lasting now about 45 mins

Other Meds: Singular, Zyrtec

Current Illness:

ID: 0926970
Sex: F
Age: 27
State: OR

Vax Date: 12/30/2020
Onset Date: 12/31/2020
Rec V Date: 01/07/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Stomach pain to the point of vomit, extreme nausea, lasting for over a week and a half, dizziness, swollen arm, itchy arm up to 10 days latter.

Other Meds: Prozac

Current Illness:

ID: 0926971
Sex: F
Age: 28
State: MA

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

Lab Data: Pt seen by EMS HR 90 BP 142/80 O2 sat 98% CO2 44

Allergies: NKA

Symptoms: Pt reported difficulty breathing, tightness in her throat and felt very dizzy. She was noted to be red faced along with redness in her throat and chest. Pt given Benadryl 25 mg liquid po at 0925 am and coaching for slowed breathing and symptoms recovery. She reported feeling better gradually and with in 15 minutes pt felt much better she declined ER transport

Other Meds: Lamictal daily for epilepsysy

Current Illness:

ID: 0926972
Sex: F
Age: 62
State: NY

Vax Date: 12/28/2020
Onset Date: 01/05/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data: No test taken

Allergies:

Symptoms: Under the injection site there was a large raised red spot. Approximently 2"x5". it was itchy and my arm was swollen. As of today 01/07/2021 it is still visible but not as bad.

Other Meds: Biotin

Current Illness:

ID: 0926973
Sex: F
Age: 52
State: IL

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

Lab Data: none

Allergies: Sulfonamides

Symptoms: Temp 101, Oral Chills, body aches.

Other Meds: Synthroid, Prempro, Lunesta, levofloxacin, ProAir, fluticasone, promethazine

Current Illness: none

ID: 0926974
Sex: M
Age: 54
State:

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

Lab Data:

Allergies: penicillins

Symptoms: localized swelling, hand/wrist numbness, anxious

Other Meds:

Current Illness:

ID: 0926975
Sex: F
Age: 37
State:

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

Lab Data:

Allergies: augmentin

Symptoms: c/o tickle in throat, lump on throat and headache

Other Meds:

Current Illness:

ID: 0926976
Sex: F
Age: 44
State: CA

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

Lab Data:

Allergies: eggplant

Symptoms: Patient began experiencing fuzzy tongue and itchiness all over within 15 minutes of receiving vaccination. Patient was provided 50mg Benadryl and observed for 15-20 minutes at which point they began improving. Patient was checked in on after about an hour and was doing okay.

Other Meds:

Current Illness:

ID: 0926977
Sex: F
Age: 34
State: TX

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

Lab Data: None

Allergies:

Symptoms: Currently pregnant. The patient was being observed, and after 10 minutes, she reported being lightheaded, dizzy, and nauseated. Stated did not eat, Vital signs were within normal limit, no c/o of breathing difficulty. The patient was offered some snacks, and cold water. A few minutes later, the patient felt a little better, continued to monitor the patient. The patient was stable, escorted to the car, ate more snacks, felt better, and was released. The patient was educated to register for V-Safe and to call PCP. Followed up later, she got home safely. 12/30/2020: followed on the patient, reported doing much better. Informed nurse that she felt better.

Other Meds:

Current Illness:

ID: 0926978
Sex: F
Age: 46
State: OR

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

Lab Data:

Allergies: nkda

Symptoms: Patient received 1st dose Moderna Vaccination at 1405, went to sit in observation area and began to feel lightheaded and faint within first few minutes. Escorted to cot to lie down at 1412. 1415 VSS: BP 140/82 HR: 98 steady, RR:18 98% on RA with no visual rash, or difficulty breathing. Pt. reported that she was rushing in to clinic to get the vaccination and was often hot, face flushed at this time though pt reported that this was her baseline. Reported that she continued to feel faint, ABC all within normal limits. VSS continued to be stable with no signs of trouble breathing. Pt remained A&Ox5. 1425: pt reported tingling in hands bilaterally. VSS remained stable, tingling grew stronger in left FA dissipated in the R FA. Pt reported that she continued to feel as if she was unable to sit up, that this would cause her to pass out and that this sensation came in waves. Pt. was monitored for 20 minutes prior to receiving 50mg IM Benadryl in LUA and Code Green was called. Patient taken to ED for further observation.

Other Meds: Reported that she took Zyrtec, medication for DM, medication for HTN and Celebrex for the first time this AM under the instruction of her PCP to prepare for the COVID Vaccine.

Current Illness: none currently, historical over the past month is unknown

ID: 0926979
Sex: F
Age: 54
State: ID

Vax Date: 12/31/2020
Onset Date: 01/06/2021
Rec V Date: 01/07/2021
Hospital:

Lab Data:

Allergies: Yes, unknown allergy, but needs EpiPen

Symptoms: Arm from top of shoulder to elbow is very swollen, hot, painful, itchy. Swollen Glands, We have pictures, wont let them load

Other Meds: Trulicity

Current Illness: none

ID: 0926980
Sex: F
Age: 29
State: IL

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

Lab Data: none

Allergies: none

Symptoms: moderate pain at injection site, feels like she cannot lift arm

Other Meds: none

Current Illness: none

ID: 0926981
Sex: F
Age: 59
State: WA

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

Lab Data:

Allergies: NKDA

Symptoms: Pt received .5ml Moderna vaccine in left deltoid at approximate 0915. At 0920 noticed tingling in lips, notified RN at 0930, also reported thickness of tongue. Pt denies difficulty swallowing, denies changes in heart rate/heart palpitations, denied difficulty breathing and dizziness. Pt calm but concerned of symptoms.0940 - Notified health care provider, completed patient assessment, ordered Benadryl 25mg p.o. to be picked up at the pharmacy. 0950 - Vital signs BP 124/80, HR 69, Resp 16, Temp 98.1, O2 sat 97%, 0955 - Escorted to pharmacy to pick up medication. 1005 - Observed patient self-administer 25mg Benadryl by mouth, escorted patient to her office. Pt monitored for 2.5 hours - 1220 symptoms resolved.

Other Meds: cymbalta, synthroid

Current Illness: None

ID: 0926982
Sex: F
Age: 29
State: MT

Vax Date: 12/23/2020
Onset Date: 12/30/2020
Rec V Date: 01/07/2021
Hospital:

Lab Data: N/A

Allergies: Morphine- seizures

Symptoms: erythema, swelling, heat- increased to size of entire upper arm from shoulder to elbow

Other Meds:

Current Illness: N/A

ID: 0926983
Sex: F
Age: 43
State: CA

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

Lab Data: n/a.

Allergies: Contrast dye- itchy

Symptoms: ED Note: This is a 43-year-old female with history of asthma who presents for evaluation of chest tightness. The patient is an employee and received her COVID-19 vaccine, first dose 20 minutes prior to ED arrival. She subsequently developed chest tightness and wheezing. She used he albuterol r inhaler and now feels improved. She says that she has been having increased asthma exacerbations lately because of the change in weather. She has had no prior allergic reaction to any vaccine. She denies any hives. Denies any throat tightness. Her symptoms at this point have resolved. Monitored in ED x 4 hrs. No treatment.

Other Meds: Albuterol, citalopram

Current Illness: n/a.

ID: 0926984
Sex: F
Age: 47
State: TN

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

Lab Data: none

Allergies: Codeine Keflex

Symptoms: Tongue swelling, face felt funny, and throat pain. See above in report for times. Dexamethasone 10mg IM in clinic. Benadryl OTC as directed. Pepcid 20mg daily po x 7 days

Other Meds: Pt received COVID 19 Vaccine, Moderna 025L20A at Health Department Vitamin D2 10mcg po daily Levothyroxine Sodium 137mcg po daily

Current Illness: None noted

ID: 0926985
Sex: F
Age: 63
State: MI

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

Lab Data:

Allergies:

Symptoms: Injection site soreness started the evening of the date the vaccine was given. Inflammation about the size of an avocado was noticed 24 hours after injection. Soreness and redness increased over the next 24 hours along with mild swelling. The redness started to improve 48 hours after injection, and it resolved about 60 hours post injection. No treatment was necessary.

Other Meds:

Current Illness:

ID: 0926986
Sex: F
Age: 37
State: MN

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

Lab Data: None

Allergies: None

Symptoms: Quarter sized, hard, swollen, warm to touch area to left arm at injection site

Other Meds: None

Current Illness: None

ID: 0926987
Sex: F
Age: 16
State: GA

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

Lab Data:

Allergies: No known allergies

Symptoms: Administered vaccine to a 16yr old

Other Meds: Outpatient Medications at End of Encounter on as of 8/4/2020 Disp Refills Start End Carbamide Peroxide (DEBROX) 6.5 % Otic Drop 15 1/1 11/25/2019 Sig - Route: USE AS DIRECTED 7 drop once day for 7 ?min for 5 ?days prior to ear cleaning -

Current Illness: as of 8/4/2020 ICD-10-CM Priority Class Noted - Resolved ECZEMA L30.9 8/2/2013 - Present CONGENITAL BILAT FLAT FOOT Q66.51, Q66.52 8/15/2016 - Present

ID: 0926988
Sex: F
Age: 59
State: WA

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

Lab Data:

Allergies: NKDA

Symptoms: Pt received .5ml Moderna vaccine in left deltoid at approximate 0915. At 0920 noticed tingling in lips, notified RN at 0930, also reported thickness of tongue. Pt denies difficulty swallowing, denies changes in heart rate/heart palpitations, denied difficulty breathing and dizziness. Pt calm but concerned of symptoms.0940 - Notified health care provider, completed patient assessment, ordered Benadryl 25mg p.o. to be picked up at the pharmacy. 0950 - Vital signs BP 124/80, HR 69, Resp 16, Temp 98.1, O2 sat 97%, 0955 - Escorted to pharmacy to pick up medication. 1005 - Observed patient self-administer 25mg Benadryl by mouth, escorted patient to her office. Pt monitored for 2.5 hours - 1220 symptoms resolved.

Other Meds: cymbalta, synthroid

Current Illness: None

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm