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: 1030430
Sex: F
Age: 12
State: VA

Vax Date: 01/16/2019
Onset Date:
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: patient was given the first dose of MENACTRA on 16JAN2019 then a second dose of MENACTRA on 19FEB2019, she should have gotten the first dose then 4-5 years later the second dose with no adverse event; patient was given the first dose of MENACTRA on 16JAN2019 then a second dose of MENACTRA on 19FEB2019, both were expired on 20-May-2020, no AE; Initial information received on 29-Jan-2021 regarding an unsolicited valid non-serious case from a other health professional. This case involves a 14 years old female patient who was given 0.5 ml first and second dose of MENINGOCOCCAL A-C-Y-W135 (D CONJ) VACCINE [MENACTRA] (lot number lot U6207AA and expiration date 20-May-2020) via intramuscular route in the left deltoid for prophylactic vaccination on 16-Jan-2019 and 19-Feb-2019 respectively. The patient's past medical history, medical treatment(s), vaccination(s) and family history were not provided. Concomitant medication included INFLUENZA VACCINE INACT SPLIT 4V (FLUZONE QUADRIVALENT) (lot number: UJ041AB Expiration date: 30-Jun-2019) on 16-Jan-2019 and On 19-Feb-2019 no concomitant vaccines was given. Also reported that health professional was aware she should have gotten the first dose then 4-5 years later the second dose. The nurse and provider have been talked to. This happened two years ago so they cannot remember why this happened. And was now there with the question anything long term and they need to be on the look out for? Does the patient need a second vaccine? If a second vaccine was needed do they use the date of the first vaccine or second vaccine? Asking for the email of the CDC (Centers for Disease Control and Prevention) link to the missed dose information and the MENACTRA PI (Prescribing Information)? It was an actual medication error due to extra dose administered and expired vaccine used [extra dose administered, extra product administered (same day latency)]. It was not reported that the patient experienced any adverse event. This suspected adverse reaction report is submitted and classified as a medication error solely and exclusively to ensure the marketing authorization holder's compliance with the requirements set out in the Directive 2001/83/EC and Module VI of the Good Pharmacovigilance Practices. The classification as a medical error is in no way intended, nor should it be interpreted or construed as an allegation or claim made by the marketing authorization holder that any third party has contributed to or is to be held liable for the occurrence of this medication error.

Other Meds:

Current Illness:

ID: 1030431
Sex: M
Age: 78
State: FL

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data: if symptoms worsen, referred to primary provider

Allergies:

Symptoms: rash at the injection site, non-painful, non-pruritic

Other Meds: Crestor, omeprazole, losartan

Current Illness:

ID: 1030432
Sex: F
Age: 27
State: UT

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

Lab Data: None

Allergies: None

Symptoms: Headache with intermittent nausea throughout the day (4am until asleep at 10pm) that limited my daily activities. The headache was severe enough to wake me from sleeping at 4am, kept me from going back to sleep, made me feel intermittently nauseous, and was not completely relieved by a 650 mg dose of Tylenol taken in the afternoon. I didn't feel well enough for my daily tasks, and took a 2 hour nap without headache relief. I was 22 weeks 4 days pregnant the day of the headache/nausea, estimated due date 06/13/2021. This is my first pregnancy that is considered low-risk with a healthy course so far (and regular prenatal care). I had nausea the first 12 weeks of pregnancy, followed by about 6 weeks of daily mild headaches (weeks 12-18). This headache was more severe than I had experienced thus far during my pregnancy, but still manageable. This event was unusual as I have been feeling well since week 19 of pregnancy.

Other Meds: Prenatal vitamin, vitamin C supplement, unisom, tylenol, Tums

Current Illness: None, just pregnancy symptoms

ID: 1030433
Sex: F
Age: 35
State: MD

Vax Date: 02/10/2021
Onset Date: 02/11/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data: None, calling doctor today

Allergies: Latex

Symptoms: Day after: chills, fever not controlled by Tylenol and ibuprofen, body aches, lymph node area painful, painful at injection site, fatigue Ongoing (day 5 today): Severe pain in back and hips, shooting pain in lymph node areas, severe fatigue, low grade fever off and on

Other Meds: Albuterol as needed

Current Illness: None

ID: 1030434
Sex: M
Age: 18
State: VA

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

Lab Data: Bloodwork- Hemeglobin A1C, CBC, TSH, CMP, UA ordered as well as further urine testing

Allergies: omnicef

Symptoms: 2/5- received 2nd dose of Gardasil - later that night he started feeling light-headed -not dizzy. Over the next few days he says it started to feel this way over his whole body, his mind now feels "fuzzy" and as if he is "stuck in a dream". Trouble focusing.

Other Meds: Insulin- humalog

Current Illness: none

ID: 1030435
Sex: F
Age: 67
State: GA

Vax Date: 02/06/2021
Onset Date: 02/12/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data: None to date

Allergies: Adhesive tape

Symptoms: Mild swelling and redness and itching around injection site in upper left arm

Other Meds: Qvar, multiple vitamin, calcium, choindroitin/glucosamine, vitamin d, Eye vitamin, fish oil

Current Illness: None

ID: 1030436
Sex: F
Age: 50
State: WI

Vax Date: 01/25/2021
Onset Date: 01/25/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: COVID-19 Moderna vaccine (Lot #011L20A) Patient received vaccination, after 10 minutes of waiting patient notified writer that she was very nausea and felt like "bee stings" to her lower back.(0745) VS-164/82, HR 98, RR 18, 98% RA. 25mg PO Benadryl given. Writer assessed, crusted over scabs located to lower back. Patient states she must scratch in her sleep. Patient became diaphoretic, blotchy redness to chest and lower back. Dr. came and assessed from ER. No further medications ordered. (0755-) BP 149/94, HR 92, RR 18, 98% RA. Patient resting on and off nausea. (0815) BP 137/83, HR 88, 98% RA, RR 18. Ate graham crackers, tolerating water. Vital signs improved. Blotchy/redness subsiding. (0830)- Ambulated hallway with writer. Feeling much better. Patient feels safe to drive home, going to go home and rest for a bit before going to work. Instructed patient if she felt worse to go to the ER, or call 911.

Other Meds:

Current Illness:

ID: 1030437
Sex: M
Age: 20
State: MN

Vax Date: 02/05/2021
Onset Date: 02/12/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies: Cefzil

Symptoms: Red and itchy rash around injection site, noticed morning of Feb 12th, as of Feb 15th is still present.

Other Meds:

Current Illness:

ID: 1030438
Sex: F
Age: 43
State: CA

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

Lab Data: Unsure of tests performed, if any at all.

Allergies: None noted

Symptoms: Patient was vaccinated at 11:06 AM with Pfizer vaccine then headed out to the observation area to sit for 30 minutes. At approx 11:45 AM, Patient s/w observer medical staff and c/o throat tightness. She was then moved to another area for further assessment while 911 was called. Nurse and Dr. stayed with patient until paramedics arrived at approx 11:48 AM. Patient was triaged by Paramedics then transported to Emergency Department at 11:55 AM. Patient was assessed and found not to be having an adverse event but possibly anxiety expisode. Patient was released to go home at 12:55 PM.

Other Meds: None noted

Current Illness: None

ID: 1030439
Sex: M
Age: 47
State: MI

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data: SEE ABOVE

Allergies:

Symptoms: Patient reported Syncope/Fainting on site EMS was required. SBP 118, Oximetry 98, EMS/on site physician decided No treatment was needed transported to local hospital.

Other Meds:

Current Illness:

ID: 1030440
Sex: F
Age: 34
State: IL

Vax Date: 02/05/2021
Onset Date: 02/14/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Swelling and itchy red lump

Other Meds: Duloxetine, microgestin

Current Illness:

ID: 1030441
Sex: F
Age: 38
State: OH

Vax Date: 02/11/2021
Onset Date: 02/13/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Swelling of lips and mouth

Other Meds: Cymbalta 60mg QD buspar 15mg BID

Current Illness: No

ID: 1030442
Sex: F
Age: 72
State: ME

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

Lab Data: none

Allergies: amlodipine sulfa

Symptoms: Patient became lightheaded and pale. No syncope. No symptoms/signs of anaphylaxis. Vital signs remained stable. Symptoms resolved within 45 minutes with laying supine, water, and carbohydrate. Completely asymptomatic before leaving building.

Other Meds: losartan rosuvastatin levothyroxine montelukast budesonide-formoterol benralizumab prednisone albuterol

Current Illness: chronic cough, chronic sinusitis, and probable asthma

ID: 1030443
Sex: F
Age: 66
State: FL

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

Lab Data:

Allergies: Allergic to Sulfa No allergies to food

Symptoms: A few hours after receiving the shot I was experiencing lightening bolts in my right eye, then it felt like bugs were flying in the right eye, now there are two black floaters that look like spiders and my eye feels tired. I've used tear drops, and will contact my ophthalmologist for an appointment. After a while it gives me a headache. The shot was given on my left arm, but the eye issues are just on the right side, the right eye.

Other Meds: Levothyroxine

Current Illness: None

ID: 1030444
Sex: F
Age: 34
State: NY

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

Lab Data:

Allergies: None

Symptoms: Uveitis in left eye developed a few hours after COVID vaccine. Currently being treated with steroid eye drops. Symptoms: red eye, pain, blurry vision in left eye. Still being treated.

Other Meds: Prenatals

Current Illness: None

ID: 1030445
Sex: F
Age: 66
State: IL

Vax Date: 02/07/2021
Onset Date: 02/14/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Red itchy rash around injection site

Other Meds: D3, biotin, flaxseed oil

Current Illness:

ID: 1030446
Sex: F
Age: 73
State: OH

Vax Date: 02/05/2021
Onset Date: 02/12/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data: Moderna COVID-19 vaccine injection

Allergies: none

Symptoms: Redness, hardness, warm feeling, sensitivity at injection site, 7 days after injection

Other Meds: Atorvastatin, 10 mg; Atenolol, 25 mg; Losartan, 100 mg; furosemide, 40 mg; fluticasone propionate, 50 mg; calcium, 1200 mg; Multi vitamin

Current Illness: none

ID: 1030447
Sex: F
Age: 46
State: OH

Vax Date: 01/25/2021
Onset Date: 02/04/2021
Rec V Date: 02/15/2021
Hospital: Y

Lab Data: Medical records available from treating hospital

Allergies: NKA

Symptoms: 02/04/21-groin pain/burning, buttocks and thighs muscle tightness, unable to sit for extended period of time due to groin discomfort 02/05/21-continued groin pain, new bilateral arm/bicept muscle pain with right side worse than left 02/06/21- headache, loss of appetite, chills, shoulder/neck/jaw/hips joint pain 02/07/21-back and ribs pain with sitting or lying- unable to sleep due to extreme pain, unable to transition from lying to sitting to standing due to pain, fever 101.8, worsening of all symptoms. Employee Health contacted, instructed to obtain Covid test, results negative. 02/08/21-First day missed work. Continued worsening of pain, groin and hip pain radiating down the back of both legs to back of both knees 02/09/21- Excruciating pain, difficulty with ambulating. Seen at Emergency Department, labs and imaging obtained, informed of bilateral Pulmonary Embolisms, admitted for treatment.

Other Meds: Lisinopril, Lipitor, Fish Oil, D3, Black Cohosh, Melatonin

Current Illness: none

ID: 1030448
Sex: F
Age: 75
State:

Vax Date: 02/14/2021
Onset Date: 02/14/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Patient called. She stated she had vaccine yesterday and last evening startted to get the chills. She stated she has a temperature of 100.8 this morning and headache.She asked what medication she could take. RN staaed she can take Acetaminophen or Ibuprofen. She asked if she could take Acetaminophen and RN stated yes. She stated she heard if her temperature does not go down in three hours she can take another dose. RN stated do not do that and to follow the directions on the bottle. Reviewed increasing hydration, monitoring tempersture. RN advised to call her provider if her fever does not go down or if increases. RN reviewed to call 911 if any SOB or chest pain. She stated understanding.

Other Meds:

Current Illness:

ID: 1030449
Sex: F
Age: 66
State: NY

Vax Date: 02/03/2021
Onset Date: 02/11/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: swelling, itching, rash, warm to the touch, 8 days after injection

Other Meds: simvastatin, amolodipine, metropolol, prolia, ibuprofen, laxative, lurtein, b12, zinc, multivitamin, elderberry, vitamind3

Current Illness:

ID: 1030450
Sex: F
Age: 54
State: FL

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

Lab Data:

Allergies:

Symptoms: f/u to caller. pt had facial and throat swelling , coughing, voice changes, went to er 1.5 hour after vaccine and was obs for 4 hours sx resolved today. has sore arm today er gave her epi pen , no drugs in the er not a reason to avoid next vaccine but talk to your PCP..he might premedicate you.

Other Meds: Symbicort ibuprofen omeprazole cyclobenzaprine simvastatin bupropion albuterol

Current Illness:

ID: 1030451
Sex: F
Age: 48
State: MI

Vax Date: 01/25/2021
Onset Date: 02/04/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data: n/a

Allergies: n/a This reaction has me thinking back to the last Tetnus shot I had in 2000. My arm swelled at the spot of injection, was very red, very sore, very hot to the touch for about a week. I didn't report it at the time and really thought it was somewhat normal, until I showed it to a friend a week later and she said it wasn't normal. But, I was young and didn't think/know to do anything about it.

Symptoms: 10 days after the injection, I woke up with an itchy, red, warm, sore to touch rash on my arm at the sight of injection. It lasted about 36-48 hours. I did not treat it in any way. Symptoms were mostly mild. Oakland County nurse on call suggested Benadryl and Motrin as needed and not to get the 2nd shot. 11 days later, I am so extremely tired. No idea if it is related. Plan to follow up with my doctor.

Other Meds: Multi-Vitamin, Vitamin D3, probably Motrin during the 10 day time period

Current Illness: n/a

ID: 1030452
Sex: F
Age: 69
State: MI

Vax Date: 02/05/2021
Onset Date: 02/13/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies: Codiene Demoral Latex sensitiity

Symptoms: 9 days after my injection of moderna covid 19 I developed a palm (hand) size red solid rash at the injection site. Very itchy, sensitive to the touch and burning rash. Today is the 3rd day and I still have the rash but symptoms seem to be slowly subsiding.

Other Meds: estradoil 0.5 eliquis 0.5 preservision areds 2 osteo biflex D31000

Current Illness:

ID: 1030453
Sex: F
Age: 73
State: MI

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies: non

Symptoms: sweats, joint pain, nausea, chills, fatigue

Other Meds: pravocol, vit D&C, amlodipine; Natural mineral

Current Illness: non

ID: 1030454
Sex: F
Age: 26
State: PA

Vax Date: 02/10/2021
Onset Date: 02/13/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies: Lactose intolerance, hornet stings

Symptoms: Abdominal rash/hives that is itchy, hives on neck, back and Left elbow crease. SOB with daily activities. Lightheadedness. Symptoms began 3 days post 2nd vaccine and continue to progress.

Other Meds: Multi-vitamin

Current Illness: None

ID: 1030455
Sex: M
Age: 64
State: NJ

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Onset 12-16 hours after injection: extremely sore arm at site of injection, chills and body aches & pains. No fever. Treatment- 800mg Ibprofen/rest/fluids. Symptoms lasted about 12-14 after onset.

Other Meds: Nexium / Pravastatin / Multi Vitamins

Current Illness: None

ID: 1030456
Sex: F
Age: 72
State: CO

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

Lab Data: None

Allergies: Dairy, gluten, soy

Symptoms: The person giving vaccine injected into posterior head of humerus into joint or lagament.... exquisitely painful with pain going down right arm and into right hand, right palm right thumb

Other Meds: Dulera 200/5 2 puffs BID for asthma

Current Illness: None

ID: 1030457
Sex: M
Age: 56
State: NY

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies: unknown

Symptoms: extreme headache, extreme chills,high fever that fluxuated from 100 - 104 during the night. joint pain in hands.face turned red from neck up looking like a sunburn. duration approx 48 hours,primary notified no visit was needed per MD

Other Meds: flo vent, multivitamins

Current Illness: hemachromatosis, asthma

ID: 1030458
Sex: F
Age: 71
State: GA

Vax Date: 01/14/2021
Onset Date: 01/15/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: Intense itching mostly in torso and upper body. Has not stopped as of today"s date

Other Meds:

Current Illness: none

ID: 1030459
Sex: M
Age: 43
State: KS

Vax Date: 01/06/2021
Onset Date: 01/07/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies: PCL

Symptoms: The next morning after injection there was some discomfort at the injection site. At 3:30 am CST I woke with a 100.8 fever, muscle and joint aches, chills, and headache. I took acetaminophen and ibuprofen for the fever and pain throughout the day with rest. The symptoms cleared around 9:30 pm CST that evening.

Other Meds: omeprazole, lisinopril

Current Illness: Tested positive for Covid -19 December 1 2020.

ID: 1030460
Sex: F
Age: 76
State: PA

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

Lab Data: None

Allergies: No known allergies

Symptoms: Got awake morning following vaccination feeling much like I did when I first became ill with COVID. Spent whole day in bed. No appetite. Felt a little better next day but knew I was about to pass out so laid down in hallway where my husband found me. Got better as day went on and feel fairly well today. Also had a mild case of night sweats last night. They were awful when I actually had COVID - for about 2 weeks.

Other Meds: Amlodipine besylate 2.5 mg, women?s multi- vitamin, biotin 1000 mg, vitamin D, vitamin B12

Current Illness: No illness at time of vaccination. Had had COVID in November 2020.

ID: 1030462
Sex: F
Age: 56
State: NY

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

Lab Data: None

Allergies: Vancomycin, Penicillin

Symptoms: Generalized macular rash after 15 minutes. No SOB, wheezing. Noted partial improvement of rash after dose of Benadryl 50 mg

Other Meds: None

Current Illness: None

ID: 1030463
Sex: M
Age: 81
State: MO

Vax Date: 02/08/2021
Onset Date: 02/09/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: The following day I had soreness in my left shoulder. Then two days after that the 11th I had a really bad headache. The following day I started feeling like my equilibrium was out of balance. I can not even walk a straight line. The headache and soreness in my shoulder went away but I am still experiencing equilibrium issues. This is making it hard for me to walk. It feels I have been on ship. I called in to my ARNP this morning; She and I are waiting on a return call from her.

Other Meds: Aspirin 81 MG once a day

Current Illness:

ID: 1030464
Sex: F
Age: 48
State: IA

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

Lab Data:

Allergies: lasix, sulfa, tape, cephalosporins

Symptoms: Hives. This did not happen in our office but occurred where she worked. I believe treated with benadryl. Did not require epipen. Resolved with treatment and no further symptoms.

Other Meds: diclofenac, hydroxyzine pamoate 25, sertraline 100, trazodone 50

Current Illness:

ID: 1030465
Sex: F
Age: 23
State: FL

Vax Date: 02/08/2021
Onset Date: 02/10/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data: PC calling to FU with pt at home, hives have improved with Zyrtec and Benadryl. Went to urgent care who sent her home with that regimen. Can I still get the second shot? I also had a exposure to a covid positive person. Adv: -Review with PCP, likely ok to get the next shot despite mild hives (contraindications at this time are anaphylaxis and active covid) but would suggest longer monitoring time, but best to review with someone who has a fully history -Call and inform vaccine provider of the reaction (they may need clearance from provider) -Also reviewed symptoms for ?s about contraindications and quarantine length. Adv call back with ?s concern

Allergies:

Symptoms: generalized pruritic hives

Other Meds:

Current Illness: recent covid exposure (tested yesterday)

ID: 1030466
Sex: M
Age: 47
State: MA

Vax Date: 02/11/2021
Onset Date: 02/13/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data: none

Allergies: penicillin

Symptoms: Extreme rash all over body. Very red, very itchy. Hands and eyes very swollen. Alternating Benedryl and Claritin to lessen itch and swelling.

Other Meds: none

Current Illness: none

ID: 1030467
Sex: F
Age: 78
State: TN

Vax Date: 02/06/2021
Onset Date: 02/13/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data: none

Allergies: Benadryl, Nortriptyline,

Symptoms: Itching at injection site

Other Meds: Pradaxa, Effexor XR 75mg, Lorazepam 1 mg, Rosuvastatin 5mg, Metoprolol ER 5 mg, B complex, Vitamin E,

Current Illness: none

Date Died: 02/13/2021

ID: 1030468
Sex: M
Age: 76
State: NE

Vax Date: 02/11/2021
Onset Date: 02/12/2021
Rec V Date: 02/15/2021
Hospital: Y

Lab Data: potassium 7.2, creatinine 4.3, CRP 50. BNP 3230. WBC 10,200.

Allergies: none

Symptoms: Pt presents to ER with increased weakness, hypoxia, history of COPD, but not oxygen dependent., hypotension. Acute Kidney failure noted in labs, not previously diagnosed , new hyperkalemia. BP 73/39, HR 67. dopamine initiated, and switched to Levophed. Oxygen Sat 86%, requiring 10 L O2. Transferred from this critical access hospital to another Hospital. Expires later 2-13-2021

Other Meds: Lisinopril, Flomax, Sotalol, simvastatin, Xarelto, Requip, Omeprazole, symbicort, Albuterol Aerosol, Furosemide.

Current Illness: ACUTE KIDNEY FAILURE, QUESTION SEPSIS, CHF, ATRIAL FIBRILLATION, COPD, GERD, RESTLESS LEG SYNDROME, HISTORY OF PROSTATE CANCER, HYPERTENSION, CURENT TOBACCO USAGE

ID: 1030469
Sex: F
Age: 70
State: AZ

Vax Date: 02/06/2021
Onset Date: 02/06/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies: All NSAID

Symptoms: Event: Sudden onset blocked eustacean tube (bilateral) and dizziness. No fever. Otherwise asymptomatic. Treatment: Pseudoephedrine HCL (extended release) 240 mg tablets p.o. Outcome: One ear cleared within 48 hours. Blockage completely resolved within 96 hours. Dizziness gradually resolved within 7 days.

Other Meds: Estradiol 1 mg daily Levothyroxine 100 mcg daily

Current Illness: None

ID: 1030470
Sex: F
Age: 77
State: MA

Vax Date: 02/07/2021
Onset Date: 02/10/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies: penicillin

Symptoms: local reaction (redness, soreness, itching) @ site, treated with ice, Acetaminophen, monitoring. no systemic signs of allergic reaction

Other Meds: acetaminophen , multivitamin

Current Illness: hx goiter

ID: 1030471
Sex: M
Age: 82
State: MI

Vax Date: 02/11/2021
Onset Date: 02/13/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: 101 temp, loss off appetite, fatigue, thirst

Other Meds: Aspirin 81mg

Current Illness: No

ID: 1030472
Sex: M
Age: 78
State: DE

Vax Date: 02/13/2021
Onset Date: 02/14/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data: N/A

Allergies: None

Symptoms: Fever of 104.3. Legs heavy. Occasional cold chills until 10:00 PM. Drank fluids. Covered up with blanket

Other Meds: Gabapentin,metoprolol, allopurinol, atorvastatin, arthritis strength Tylenol, pro renal-D multivitamin

Current Illness: None

ID: 1030473
Sex: M
Age: 77
State: KS

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data: None

Allergies: Penicillin

Symptoms: Patient reports approximately 12 hours post vaccination, he woke up with fever, sweating and unaware of his surroundings x 3 days. Patient reports his wife helped him with cares. Pt reports he was "out of his mind" for 3 days and cannot remember anything during that time. Pt reports it was a total of 5 days before he was back to normal.

Other Meds: Fish oil, Vitamin D3, Vitamin B12, multivitamin, hydrocodone (as needed), tramadol (as needed),

Current Illness: Possibly Covid. Wife had covid about 4 weeks ago. Patient had mild symptoms and tested negative. Patient reports his doctor thinks he may have tested too early.

ID: 1030474
Sex: F
Age: 78
State: NC

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

Lab Data: EKG, Cardiac Stress test, Holter Monitor, Cardiac MRI

Allergies: codeine

Symptoms: Premature Ventricular Contractions, Tachycardia. Has lasted 4 weeks.

Other Meds: carvedilol

Current Illness: -0-

ID: 1030475
Sex: M
Age: 71
State: PA

Vax Date: 02/10/2021
Onset Date: 02/14/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies: Statins, iodine

Symptoms: Chills, nausea, tiredness, body aches. Treated with electric blanket, chicken noodle soup, aspirin/tylenol, antacids and rest. Chills lasted approx. 3-4hrs. Nausea etc. lasted apprx. 12hrs.

Other Meds: lisinopril 10mg : fenofribrate 48mg ; krill omega-3 1000mg ; Vitamins B-12 and D3; simethicone 250mg

Current Illness:

ID: 1030476
Sex: F
Age: 27
State:

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

Lab Data:

Allergies:

Symptoms: Patient complained of left arm itching. Was monitored for 30 minutes. Presents to BYLAS HL CT Pharmacy on 02/12/21 12:00 Said she had itching from Moderna vaccine received in San Carlos at drive thru. Given 1 dose of diphenhydramine now, checked and monitored by nurses. Said she was filling better and wanted to leave. Given prescription for diphenhydramine to take home. Medications: DIPHENHYDRAMINE 25MG CAP #12 (3 days) TAKE ONE (1) CAPSULE BY MOUTH FOUR TIMES A DAY AS NEEDED FOR ALLERGIES

Other Meds:

Current Illness:

ID: 1030477
Sex: F
Age: 62
State: IN

Vax Date: 01/28/2021
Onset Date: 01/29/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data: None

Allergies: Erythromycin

Symptoms: Headache that lasted for 5 days with no relief

Other Meds: None

Current Illness: None

ID: 1030478
Sex: F
Age: 56
State: NJ

Vax Date: 02/10/2021
Onset Date: 02/15/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Vertigo and nausea on day 6

Other Meds: Cymbalta

Current Illness: None

ID: 1030479
Sex: F
Age: 78
State: AZ

Vax Date: 02/03/2021
Onset Date: 02/11/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies: sulfa drugs, celebrex, zetia, gold, &other trace metals

Symptoms: Swollen upper right arm 3-4 inches in diameter, raised, bright red, itchy and the onset was Thursday, 2-11-2021...8 days post injection. Adverse symptoms beginning to recede today, 2-15-2021

Other Meds: none

Current Illness: none

ID: 1030480
Sex: F
Age: 25
State: NC

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

Lab Data:

Allergies:

Symptoms: Patient's left arm went numb for about an hour following vaccination. pt was given Benadryl. after an hour feeling (along with pins and needles sensation) came back

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm