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: 1030481
Sex: F
Age: 44
State: IN

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

Lab Data:

Allergies: No

Symptoms: Pain, large red raised circle taking up large portion of arm lasting 4 days, low grade fever, headache, nausea

Other Meds: Multi vitamin

Current Illness: No

ID: 1030482
Sex: F
Age: 38
State: KY

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

Lab Data: None

Allergies: no true allergies just intolerances to medications

Symptoms: on 2/12/21 within 12 hours, severe headache, fever, myalgias, fatigue, leg pain, difficulty walking, and shortness of breath occurred. on 2/15/21 patient still experiencing all symptoms except shortness of breath. symptoms have persisted and not improved.

Other Meds: biotin, emgality, tresiba, lyrica, cymbalta, glipizide, metoprolol, ascorbic acid, apple cider vinegar, percocet, tizanidine, phenergan, ibuprofen, trazodone, rosuvastatin, famotidine, vitamin D3, vascepa

Current Illness:

ID: 1030483
Sex: F
Age: 53
State: VA

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

Lab Data: N/a

Allergies: Benzoyl peroxide (produces a skin rash if topically applied)

Symptoms: Nearly blacked out/passed out after I woke up on 2/14 Sluggish with chills and aches the rest of the day Noticed enlarged lymph node in the left arm pit region on 2/15

Other Meds: 125 mcg Levothyroxine 2500 mcg Biotin (chewable supplement) 100 mg Nature's Way Hair and Skin supplement Multivitamin

Current Illness: N/a

ID: 1030484
Sex: F
Age: 71
State: NC

Vax Date: 02/10/2021
Onset Date: 02/12/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data: Urine culture - UTI positive. C-scan - diverticulitis affirmed

Allergies: Valium

Symptoms: Severe UTI and severe diverticulitis

Other Meds: Atenolol, primadone, norvasc, atorvastatin, Fiber suppletment, hydrochlorithiaside, potassium, Coq-10, latanoprost, cumiden, calcium

Current Illness: Radiation for uterine cancer

ID: 1030485
Sex: F
Age: 30
State: IL

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

Lab Data:

Allergies: Gluten allergy (celiac disease) Morphine (anaphylaxis)

Symptoms: 02:00 am: hot flashes, bounding heart (rate 119 at rest), sore & stiff right arm, headache, body aches. 09:00 am: chills, sweats, headache, fever 101.6, fatigue, malaise, lower back pain, dizziness, nausea. 05:00 pm: persistent fever, chills, dizziness, nausea, bounding heart (rate 110s), fatigue, malaise, sweating, almost impossible to move right arm. 2/12/2021 05:00 am: intractable headache, fatigue, brain fog, mucous membrane blisters, fever blisters. 06:00 pm: feelings lifted. Mild body aches. Tiredness.

Other Meds: Pre-natal daily vitamin with DHA Diazepam 5 mg Vitamin D 50,000 Units

Current Illness: No

ID: 1030486
Sex: F
Age: 86
State: FL

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

Lab Data: Took tylenol 500 mg qd or BID pt still c/o of site being red, itchy and hot. The itching is constant. pt called her dr who told her took take 2 tylenol, she took it today at 12pm, but sx persists. ADVD: may allpy a cold compress, perhaps hydrocortisone cream or calamine lotion. Described effects are among the common s/e reported with the Moderna vaccine, they will resolve. f/u with your pcp. call back w/q

Allergies:

Symptoms: Started happening the day after, swelling, heat, pain, and redness. Swelling has went down(still slightly swollen) but the rest of the symptoms are still present.

Other Meds: BP meds Parkinson's Carbidopa levodopa BID propranolol BID Aspirin Lysine Multivitamin Gabapentin for nerve damage Herbs turmeric cilium for constipation omeprazole vitamin d potassium b12 escitalopram amlodipine quinapril levothyroxine

Current Illness:

ID: 1030487
Sex: M
Age: 78
State: VA

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

Lab Data:

Allergies: None

Symptoms: slight headache and body ache

Other Meds: METOPROLOL SUCCINATE ER; ROSUVASTATIN CALCIUM; LISINOPRIL; AMLODIPINE BESYLATE; ASPIRIN; CLOPIDOGREL; Glucosamine HCL; Chondrotin Sulfate; Probiotic; Resveratrol; Ubiquinol; Fish Oil; Calcium Citrate; Vitamin C; Vitamin D3; Multi-vitamin

Current Illness: None

ID: 1030488
Sex: M
Age: 17
State: MD

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

Lab Data: n/a

Allergies: NKA

Symptoms: Patient is under 18 years old and currently is an employee at a supermarket, we did not realized his age until after we gave him the shot. Pt experience no abnormal adverse effects.

Other Meds: n/a

Current Illness: n/a

ID: 1030489
Sex: F
Age: 38
State: OH

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

Lab Data: none

Allergies: penicillin

Symptoms: Severe body aches, fever as high as 102.4; jaw pain, blister on roof of mouth, headache, fatigue

Other Meds: wellbutrin, buspirone, tri cyclen lo

Current Illness: none

ID: 1030490
Sex: F
Age: 14
State: PA

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

Lab Data:

Allergies:

Symptoms: Error: Patient Too Young for Vaccine Administered

Other Meds:

Current Illness:

ID: 1030491
Sex: M
Age: 28
State: MI

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

Lab Data: SEE ABOVE

Allergies: Penicillin

Symptoms: Approximately 17 minutes after recieving vaccine his throat became scratchy. On site EMS requested. BP 131/70 HR 63 99% 02 on room air. He refused to go to hospital, released against medical advise.

Other Meds: Albuterol Inhaler- Not Used

Current Illness: None

ID: 1030492
Sex: F
Age: 68
State: NC

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

Lab Data: NA

Allergies: No

Symptoms: Muscle soreness. Fatigue. Fever 12 hours after injection. Highest temp 101.0 by 8:00 pm Saturday, 2/13. Fever broke midnight on 2/14.

Other Meds: Omega 3.Turmeric. Multi vitamin. Calcium. Vitamin E. C.

Current Illness: None

ID: 1030493
Sex: M
Age: 25
State: NY

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

Lab Data:

Allergies: Penicilin

Symptoms: at 240am i woke up with a fever of 101.2 and had a major headache along with aches. this lasted until 1030 when the fever broke and then i had minor symptoms and a dull headache until later that night.

Other Meds: none

Current Illness: none

ID: 1030494
Sex: U
Age:
State: FL

Vax Date: 01/19/2021
Onset Date: 02/08/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Date and time of vaccination: (list both if they received both shots): 12/31/20 (first dose)- 01/19/21 (second dose) Date and time adverse event started: 02/08/21- Patient complaining of headaches. She states that she the headaches typical are worse in the morning. She rates them a 8/10 with 10 being the most painful.

Other Meds:

Current Illness:

ID: 1030495
Sex: F
Age: 81
State: FL

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

Lab Data: None

Allergies: flu shot (last taken in 1998) and my arm got swollen

Symptoms: I just noticed when I took a step it hurt and the more I walked the more it hurt. The pain is in the back of the thigh/backside. I am unable to walk on it, but it hurts.

Other Meds: sinemet (for Parkinson's) gabapentin 800 mg 2x tablets 3x daily potassium pot cl micro 10 2x daily evoxac 30 mg 4x daily trabastatin 60 mg daily synthroid 50 mcg 2 on thursday, tuesday, saturday, 1 the other days of the week rorirole e

Current Illness: None

ID: 1030496
Sex: F
Age: 52
State: MI

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

Lab Data: na

Allergies: none

Symptoms: nausea with diarrhea, body aches, sweats, increase body temp, redness, swelling, itching, sore at injection site.

Other Meds: none

Current Illness: none

ID: 1030497
Sex: F
Age: 84
State: NC

Vax Date: 01/18/2021
Onset Date: 01/20/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data: INR for warfarin monitoring was within therapeutic range 2.0-3.0

Allergies: Codeine and statin medications

Symptoms: Patient with significant bruising following Immunization. Patient with blue/ purple colored ecchymosis extending down her right arm to the elbow and wrapping around her upper arm, except the axilla.

Other Meds: warfarin

Current Illness:

ID: 1030498
Sex: M
Age: 43
State: KS

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

Lab Data:

Allergies: PCL

Symptoms: At 11:00 pm CST on the same day as the injection I felt body aches, muscle pain, headache, and exhaustion. I woke up at 05:00 am CST on 2-13-2021 with a fever of 100.8, increased pain of body aches, muscles, headache, and chills. These symptoms lasted all day long. I did take acetaminophen and ibuprofen to aid with the fever and pain. The majority of symptoms (all but headache) faded the next day (2-14-2021) around 10:30 am CST. The headache lasted until around 10:00 pm CST 2-14-2021.

Other Meds: omeprazole, lisinopril

Current Illness: none

ID: 1030499
Sex: F
Age: 30
State: OK

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

Lab Data:

Allergies: None

Symptoms: Chills, fever, headache, bodyaches , racing heart, Heart racing lasted 12hrs Chills, body aches, headache and fever lasted 36hrs Took Tylenol and ibuprofen to help symptoms

Other Meds: None

Current Illness: None

ID: 1030500
Sex: M
Age: 78
State: FL

Vax Date: 01/19/2021
Onset Date: 02/05/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data: None

Allergies: Non-Shell Fish

Symptoms: On 2/5/21 I noticed a rash on the upper right portion of my back. I confirmed with Doctor that this was the shingles virus and he prescribed Valacyclovir HCL 1 Gram,1 tablet 3 times per day, which has now begun to clear up the rash.

Other Meds: Altace Atorvastatin Allopurinol Lexapro

Current Illness: None

ID: 1030501
Sex: F
Age: 67
State: PA

Vax Date: 01/30/2021
Onset Date: 02/09/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies: PCN

Symptoms: Local skin reaction

Other Meds: Levothyroxine Ventolin HFA

Current Illness:

ID: 1030502
Sex: F
Age: 30
State: MA

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies: Demerol

Symptoms: Low-grade fever, chills, body aches, headache all presented abruptly 12 hours after the injection. Fever, chills, body aches persisted for about 12 hours after onset. Headache persisted for about 24 hours after onset. Fatigue presented after the chills and body aches subsided (~24 hours after injection) and lasted about 12 hours.

Other Meds: Lo Loestrin Fe, Spironolactone, Zyrtec

Current Illness: none

ID: 1030503
Sex: F
Age: 77
State: FL

Vax Date: 01/27/2021
Onset Date: 02/07/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data: unable to take the rest of hx--caller claimed that she had to disconnect the call as the RN is coming to her to get a report

Allergies: none

Symptoms: jan 6 first dose--jan 27 second dose calling to report arm swelling after the second dose of vaccine vaccine--went down with ice--started this Sunday Feb. 7--subsided on Wednesday Feb. 10----claims to day she got a big red/rash mark underneath the naval--no other s/s she went to the hospital today

Other Meds: detrol--amlodipine--pantoprazol--atorvastatin--gabapentin

Current Illness:

ID: 1030504
Sex: F
Age: 78
State: MA

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

Lab Data: no

Allergies: sulfer tetanus

Symptoms: I noticed my arm/injection site was swelled up and red. it was painful and itching. it aches in the morning. its warm to the touch.

Other Meds: metformin gabapentin propafenone atorvastatin Metoprolol tartrate alendronate clq10 Fish oil supplement calcium magnesium zinc Vit D 2000

Current Illness: no

ID: 1030505
Sex: F
Age: 61
State: MD

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

Lab Data: None

Allergies: none

Symptoms: On February 4, 2021, I started to itch and feel like pins were sticking me on the front of my neck under my chin. On February 5, 2021 I started taking benedryl 25mg to combat the itching. By February 8, I had a fine rash, small raised all around my neck and very itchy and again I took benadryl without improvement. Benadryl would have a short term effect and just made me sleepy. This continued for 3 more days until February 15 when I was able to see my doctor who has now listed me as having a reaction and allergic to the Covid 19 Vaccine. I am prescribed topical steroid cream and hopefully it will improve.

Other Meds: Multivitamin, Vitamin D, Calcium, Vitamin B complex, Nutrolful (for hair loss)

Current Illness: none

ID: 1030506
Sex: F
Age: 66
State: NH

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

Lab Data:

Allergies: None

Symptoms: I just noticed that I have redness around the area of the shot. I have no pain in the arm.

Other Meds: Simvastatin Fish Oil B12 D3 Women?s One-A-Day 50+

Current Illness: None, but got 2nd Shingles vaccine in January, more than 14 days before COVID19 shot. Got these two shots in different arms.

ID: 1030507
Sex: M
Age: 70
State: MN

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

Lab Data:

Allergies: none (other than ancient history of my mother's recollection that I 'might' have had a reaction to penicillin as a child)

Symptoms: Slight swelling of toes (first on right foot and ca. one week later of a couple on left foot) accompanied by blotchy appearance and tenderness and inflammation. Blistering sort of phenomenon (although no open sores). Looks the same as what I see on internet as "COVID-toes", although I've not seen any sign of it as a reaction to the vaccine itself.

Other Meds: aspirin, daily vitamin supplement, occasional sildenafil

Current Illness: slight peripheral neuropathy in toes

ID: 1030508
Sex: M
Age:
State: FL

Vax Date: 02/09/2021
Onset Date: 02/11/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Date and time of vaccination: (list both if they received both shots): first jan 19th, second feb 9 coughing is occasional, slightly more than usual started 2/11

Other Meds:

Current Illness:

ID: 1030509
Sex: M
Age: 36
State: WI

Vax Date: 12/22/2020
Onset Date: 02/04/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: After completion of series, 2 weeks following 2nd dose, client tested positive for Covid-19 by PCR (positive on 2/4/2021)

Other Meds:

Current Illness:

ID: 1030510
Sex: F
Age: 81
State: PA

Vax Date: 02/04/2021
Onset Date: 02/10/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies: Codeine

Symptoms: Itchy rash developed around the site of the shot 6 days after receiving the vaccine. (2/10) Still present on 2/15. 3-4 inches wide, 5 inches length.

Other Meds: Coreg 25mg, Entresto 24-26 mg, xarelto 15 mg, Crestor 40 mg, lasix 20 mg occasionally, Prolia (last injection in August) Multivitamin, magnesium, vit D3, coq10, vit c , melatonin, theonine

Current Illness: None

ID: 1030511
Sex: F
Age: 43
State: ID

Vax Date: 02/07/2021
Onset Date: 02/08/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data: COVID test- negative 02/13

Allergies: No

Symptoms: Body aches, mouth sores, swollen soar glands, difficulty swallowing

Other Meds: Mo

Current Illness: No

ID: 1030512
Sex: F
Age: 27
State: OH

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

Lab Data: n/a

Allergies: Sulfa

Symptoms: Nausea, head ache, cold chills, fever, body aches, severe from 7:30 pm to 2:30pm on 2/13, symptoms slowly faded. Have had sore R heel since 7:30 pm the day of the injection. Mild arm soreness

Other Meds: Yaz, prenatal vitamin, digestive enzymes, probiotic

Current Illness: n/a

ID: 1030513
Sex: F
Age: 76
State: MT

Vax Date: 02/04/2021
Onset Date: 02/11/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: REDNESS ON THE ARM WHERE VACCINE SHOT WAS GIVEN, ITCHINESS, SWELLING - SEVERAL DAYS

Other Meds:

Current Illness:

ID: 1030514
Sex: F
Age: 68
State: ME

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

Lab Data:

Allergies: Unknown

Symptoms: The client was given the Moderna COVID vaccine on 02/12/2021, having signed a consent form attesting to (and also verbally attesting to) the fact that she had never received a COVID vaccine. When the vaccine was being entered into Immpact it showed that the client had received a Pfizer COVID vaccine on 02/01/2021. When asked, the client continues to not remember receiving the Pfizer vaccine. The client reports feeling fine and, other than a sore arm, is not experiencing any adverse reactions to either vaccine. Her PCP was notified via phone, as well.

Other Meds: Unknown

Current Illness: Unknown

ID: 1030515
Sex: F
Age: 80
State: FL

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

Lab Data:

Allergies: Steroid Dose Pak

Symptoms: Fever, Headache, Nausea, Whole Body Ache, Weakness Inability To Sit Up In Bed, 40 Hours, Have developed red spots on arms several days later, which now seem to be fading

Other Meds: levothyroxine 10mg, allopurinol 200mg, protonix 40mg, singulair 10mg, Prolia 60MG/ML, 2Xper year Tylenol when needed Biotin, B12, D3, Zinc, Magnesium, Multi Vitamin

Current Illness: None

ID: 1030516
Sex: F
Age: 69
State: AZ

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

Lab Data: None

Allergies: NKDA

Symptoms: 6 days after receiving the 2nd Moderna shot, she developed an itchy, red, and swollen area in the shape of a rectangle on her right upper arm. It resolved after 3 days.

Other Meds:

Current Illness:

ID: 1030517
Sex: F
Age: 61
State: MI

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

Lab Data:

Allergies: sulfa

Symptoms: Arm sore, swollen, pink blotches, eventually one large swollen pink blotch by site of injection, painful, yet somewhat itchy. Used cold compresses to sooth.

Other Meds: Nortriptylin, Losartan, Equate Complete Multivitamin, Spring Valley Calcium, Live Well Omegawell(3), Spring Valley Echinacea & Goldenseal Extract Blend, Spring Valley L-Lysine, Spring Valley Magnesium, BioOptimal Collagen Capsules

Current Illness:

ID: 1030518
Sex: F
Age: 42
State: FL

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

Lab Data:

Allergies: None known

Symptoms: Moderna COVID-19 Vaccine

Other Meds: Valsartan-HCTZ 320-12.5 mg

Current Illness: None

ID: 1030519
Sex: F
Age: 94
State: WI

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

Lab Data: None.

Allergies: None.

Symptoms: When she woke up around 7:00 AM, she was so called. Around 9:00 AM she was very weak, hurting all over, had diarrhea. She did not take anything for it. Had fatigue, muscle pain, chills, nausea and vomiting. Today, 2/15/21 she is feeling better and is back to normal. Tried calling her doctor but could not get through to them.

Other Meds: Eliquis, Furosemide, Synthroid, Lisinopril, Crestor. Zinc, magnesium, probiotic.

Current Illness: None.

ID: 1030520
Sex: M
Age: 36
State: WI

Vax Date: 01/14/2021
Onset Date: 02/04/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Client tested positive for Covid-19 following completion of vaccine series (2 weeks following last dose)

Other Meds:

Current Illness:

ID: 1030521
Sex: M
Age: 77
State: WI

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

Lab Data: Seen by the vascular team at Hospital where surgical procedures were done plus all the tests they recommended .

Allergies: NSAIDS Indocin augmentum

Symptoms: I am 77 yrs old, male , , 150# and 5ft 6inches...Within 24 hours of receiving the shot, my body thru-up clots in my left leg. and I spent 4 days in the hospital ( 3 days in surgical ICU), breaking up the clots to save the leg. This is too much of a coincidence to ignore and I will not receive the 2nd shot.

Other Meds: none

Current Illness: none

ID: 1030522
Sex: U
Age:
State: CA

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

Lab Data:

Allergies: none

Symptoms: Moderna COVID-19 Vaccine Covid Arm?redness, swelling, itch, tenderness, hardness at injection site; mild nausea

Other Meds: Omega-3 salmon oil, 1000 mg; Flonase

Current Illness: none

ID: 1030523
Sex: M
Age: 93
State: OH

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

Lab Data:

Allergies: NKA

Symptoms: Patient received his second dose of the Pfizer vaccine. He was accompanied by his daughter. Per daughter prior to receiving his vaccine he was his "normal" self. He was sitting in a chair next to the vaccinator. He did walk in with a walker and minimal assistance from his daughter. He did have a gait belt on around his waist. When I came to patient he was looking straight ahead with his left eye open - right eye s/p surgery to his right eye per daughter. He did not respond to questions asked. His daughter stated mentally he is normally intact. His pulse was faint but palpable. His color was pale with slight dusky skin to hands. 911 was called. Undetectable blood pressure initially with his faint pulse. Initially his heart rate was 105. He was shallow breathing. BP was undetectable sitting - with oxygenation low 80's on room air. He was lifted to a bed/cart with legs elevated. He was given supplemental oxygen. After laying down with legs up he started to look around. He was able to tell me his name and respond to questions. His blood pressure was 117/68 with heart rate 55 and oxygenation on 6L nasal cannula 87-88%. Patient's daughter stated that patient was recently at hospital with low blood pressure and questionable seizure activity. No obvious seizure activity noted today. Parametics - updated with patient history and events. Blood sugar checked at 183. Patient neurologically improved with ability to state name, his daughters name and his age. No injury noted. Dr phoned and updated on patient condition and events. Patient transported without injury on oxygen. Two daughters with patient to emergency room. Pt being evaluated by cardio on admission for sycope/possible seizure. Still admitted

Other Meds:

Current Illness: History of seizures/syncope

ID: 1030524
Sex: F
Age: 60
State: NJ

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

Lab Data:

Allergies: none

Symptoms: intense pain in upper thigh. from hip to mid thigh. maybe muscular pain.

Other Meds: multi-vitamin and calcium

Current Illness: none

ID: 1030525
Sex: F
Age: 61
State: GA

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

Lab Data: None

Allergies: Sesame allergy, carry epi pen Demerol

Symptoms: Severe migraine headache with pain behind eyes with uncontrolled tearing, ringing in head, pain and pressure lasting about 12 hours. No treatment. Dull headache with numb forehead lasting several days. Took Advil for 3 days Wheezing and shortness of breath lasting 6 hours and the same symptoms the following day lasting about 6 hours. No treatment Did call the doctor with my reaction and concerns for second dose recommendation.

Other Meds: Benazapril HCL 20 mg 1xday Prolia shot 1 every 6 months for osteoperosis Vit D 2,000 IU Calcium Citrate 500 Epi Pen for severe food allergy Flonase for seasonal allergy

Current Illness: None

ID: 1030526
Sex: F
Age: 82
State: FL

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

Lab Data:

Allergies:

Symptoms: rash ight on thighs , shoulders , and back states she feels okay today. feeling fatigue. rash is about the same and didnt take any benadryl.

Other Meds:

Current Illness:

ID: 1030527
Sex: F
Age: 49
State: MN

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

Lab Data: none

Allergies: no

Symptoms: 1. rash below the vaccine site covering lower upper arm , erythematous and mild elevated 2. petechial spots over left 4th and 5th finger

Other Meds: multivitamin

Current Illness: no

ID: 1030528
Sex: F
Age: 48
State: KS

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

Lab Data:

Allergies:

Symptoms: Severe pain starting in left hip then spreading to entire low back. Then entire body aches and heavy lasting through 2/14. On the morning of 2/15 pain was localized back in left hip and left thigh.

Other Meds:

Current Illness:

ID: 1030529
Sex: F
Age: 62
State: SC

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

Lab Data: None

Allergies: Codeine, sulpha drugs, tobacco, raw onions,

Symptoms: I experienced intense pain in my upper back between my shoulder blades beginning approximately 24 hours after the injection. I put extra strength topical CBD cream on the affected area which alleviated the pain and allowed me to sleep that night. I had been advised not to use any anti-inflammatory NSAID medications for pain, so I did not ingest any pain medication. The pain persisted for about 30 hours, manageable by using the CBD cream every eight hours until Sunday evening when it s suddenly stopped around 6 pm.

Other Meds: L-Thyroxene

Current Illness: None

ID: 1030530
Sex: F
Age: 29
State: CA

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

Lab Data:

Allergies:

Symptoms: 103.8 fever , rapid heart beat, vomiting , diarrhea , headache. Advil brings fever down

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm