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: 1031572
Sex: F
Age: 52
State: CA

Vax Date: 01/13/2021
Onset Date: 02/11/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data: COVID-19 test

Allergies: none

Symptoms: Second dose 02/10/2021-Severely disabled. 101.9 fever. unable to move due to severe headache and muscular pain. Currently experiencing severe headache and intelectuall fog.

Other Meds: chlorthalidone 25 mg daily

Current Illness: none

ID: 1031573
Sex: M
Age: 88
State:

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

Lab Data:

Allergies:

Symptoms: fatigue, body aches,

Other Meds:

Current Illness:

ID: 1031574
Sex: F
Age: 4
State: WA

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

Lab Data: none

Allergies:

Symptoms: 99 in armpit. 102 orally. Fever started 1130am. Chills and tired. Low appetite. Now vomiting 1x just now. Discussed using APAP/ibuprofun for fever and to rehydrate with pedialyte or watered down gatorade. Not worried about vomiting 1x. Told mom to go to ER/urgent care if still vomiting tomorrow, acting lethargic, or fever spikes above 104 despite tylenol.

Other Meds: NONE KNOWN

Current Illness: NONE NOTED

ID: 1031575
Sex: F
Age: 47
State: NY

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

Lab Data: None

Allergies: PCN's

Symptoms: Pt states stiff neck radiating to bilateral shoulders beginning 24 hours after injection. This continues five days later. In addition pt reports chills and nasuea

Other Meds: clonidine, xanax, trazadone, adderall

Current Illness: None

ID: 1031576
Sex: F
Age: 46
State:

Vax Date: 01/30/2021
Onset Date: 02/03/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies: Flu vaccine, sulfa, Diflucan

Symptoms: Brain fog, diarrhea, and headache.

Other Meds:

Current Illness:

ID: 1031577
Sex: F
Age: 65
State: VA

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

Lab Data: N/A

Allergies: Darvon possibly avacodo

Symptoms: One week after vaccine my right arm got red, noticed a small knot under my injection site, arm was warm to touch and itching. Am assuming, since it wasn't an immediate reaction, it was "covid arm". Today (Feb. 15) redness in arm is still visible but diminishing - still some itchiness but not all the time. Taking benedryl as needed.

Other Meds: Ramipril levothyroxine Centrum vitamin Caltrate (calcium)

Current Illness: N/A

ID: 1031578
Sex: F
Age: 48
State:

Vax Date: 01/21/2021
Onset Date: 01/29/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data: N/A

Allergies: Sulfa

Symptoms: Bruise at injection site with large, round area that is swollen and tender to touch after day 8. Today, still with injections site bruise and swollen, painful area below injection site that feels like pin pricks when touching it.

Other Meds: Zyrtec

Current Illness: none

ID: 1031579
Sex: F
Age: 76
State: WA

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

Lab Data: NONE

Allergies: penicillin

Symptoms: MODERNA COVID-19 Vaccine. "COVID Arm" Itching and red swelling appearing on arm after 10 days covering an area of approximately 2" x 4 1/2". Lasted for 3 days and then diminished.

Other Meds: omeprazole, toprol, crestor, levocetirizine, cozaar, B-12, Vit D, magnesium, tylenol

Current Illness:

ID: 1031580
Sex: F
Age: 27
State: NY

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

Lab Data:

Allergies: N/A

Symptoms: 8/10 pain at the injection cite. Started 12 hours following the vaccine administration and resolved around 24 hours following administration of the vaccine.

Other Meds: N/A

Current Illness: N/A

ID: 1031581
Sex: M
Age: 70
State: CO

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

Lab Data:

Allergies: N/A

Symptoms: Overall extreme fatigue, total body weakness with inability to ambulate without assistance, suggestive of Guillain barre syndrome. Time course over the span of 72 hours.

Other Meds: Seroquel 125 mg Melatonin 10 mg Nexium Coconut Oil D3 Zinc Tadalafil Acyclovir Flomax Matter Better Brain

Current Illness: N/A

ID: 1031582
Sex: F
Age: 35
State: WI

Vax Date: 01/13/2021
Onset Date: 01/25/2021
Rec V Date: 02/15/2021
Hospital: Y

Lab Data:

Allergies: hydromorphone - hives

Symptoms: 35 yo woman with new onset pericarditis. Possibly related to the covid vaccine - had second dose 1/13/21. There are case reports of pericarditis with the covid virus, but none so far with covid vaccine. No known covid exposure recently. Covid test on 1/24/21 (date of admission) = not detected. Or more likely presentation could be related to Humira (started December 2020 for psoriatic arthritis and had 3 doses total). There have been case reports of pericarditis with Humira. Also, pt was on a medrol dose pack for radicular symptoms after injuring her neck, she finished the dose pack on 1/17/21. Since stopping solumedrol she has had increasing hip pain and also has costochondral pain. Per H&P, It is possible that weaning off of solumedrol dose pack caused a flare up in her psoriatic arthritis leading to increase hip pain, costochondritis and pleuritis and/or pericarditis. Pt was admitted for further treatment and monitoring.

Other Meds: Humira albuterol diclofenac gel fluticasone inhaler (flovent) Probiotic Multivitamin Sumatriptan Medrol dose pak (finished on 1/17/21) Weaned off Lexapro ~ 1 month prior

Current Illness: Psoriatic Arthritis and Cervical DJD

ID: 1031583
Sex: F
Age: 51
State: NY

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

Lab Data: cbc, cmp, bhcg,covid ab, tryptase, ch50, c3-c9, cytokine

Allergies: sulfa, doxycyclin, shell fish

Symptoms: enlarged lymph node r axilla, no rash, no face/mouth swelling, afebrile, no swelling of extremity

Other Meds: synthroid, insulin, albuterol, advair, losartan, klonopin,

Current Illness:

ID: 1031584
Sex: F
Age: 29
State: NY

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

Lab Data:

Allergies:

Symptoms: Following receipt of vaccine, the patient felt very warm, lightheaded, and felt as if we was going to pass out. The patient was also tachycardia at the time.

Other Meds:

Current Illness:

ID: 1031585
Sex: F
Age: 49
State: PA

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

Lab Data: N/A

Allergies:

Symptoms: Patient had inflammation and pain and injection site that spread down most of her left arm. Swollen lymph nodes in the armpit and groin prompted a call to her PCP who told her it was most likely an immune response reaction to the COVID 19 vaccine.

Other Meds:

Current Illness:

ID: 1031586
Sex: F
Age: 63
State: HI

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

Lab Data:

Allergies:

Symptoms: Symptoms: pruritic chest Intervention: VS stable. Monitored. Stayed an additional 15 minutes due to appointment at the hospital, total 30 min. Instructed patient to go to the nearest ED if s/sx worsens. No SOB noted. Denies pain. States may take Benadryl at home.

Other Meds:

Current Illness:

ID: 1031587
Sex: F
Age: 69
State: FL

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

Lab Data:

Allergies: SSI, anti inflammatories, tylenol, prevacid, abilify, compazine, betadine, lanolin, tar, thermisol ( on allergy test, but not in flu shots) opiates, fragrance.

Symptoms: Moderna. Sore, swelled, pain. Much better today.

Other Meds: Prilosec, zofran, calcium, prolia, hay fever shots, vit D, Famotidine, iron.

Current Illness: None.

ID: 1031588
Sex: F
Age: 64
State: CO

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

Lab Data:

Allergies: percodan, sulfa, nickel

Symptoms: fast heartbeat, dizziness and weakness, excessive fatigue/tiredness, chills, joint and muscle pain, back of the neck/headaches and pain, disoriented, injection site swelling, tenderness, and hot to the touch, fever, sinus infection like symptoms ( stuffiness, difficulty breathing, ear pain, sinus/facial pain )

Other Meds: Pravastatin, Letrozole, vitamin D3, fish oil, calcium, , pazeo eye drops, latanaprost eye drops,,vitamin B-12,vitamin C, glucosamine-chond-msm complex,

Current Illness:

ID: 1031589
Sex: F
Age: 49
State:

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

Lab Data:

Allergies:

Symptoms: Pt had 2nd of Vaccination today and presented with dizziness, anxious and palpitations 10 minutes after the injection. She relates at history of HTN on HCTZ, no cardiac history or diabetes. She works as a Medical Staff and her nurse manager happened to be present and is staying with her. Her initial VS were very tachycardic and hypertensive. 1437 EKG was applied VS 163/114 HR 145 RR 24 sats 100% she does not know her baseline BP. She continues to be lightheaded and dizzy despite sitting in chair and resting with the RN manager. Called Doctor and he recommended to call the RN stat however a code campus was already in process. Second VS at 1449 191/97 HR 145 RR 20 and sats 100% very lightheaded. An IV was placed 22 G to right hand by RN. THe RN stat Team now also at bedside.1500 ER RN with wheelchair to take pt to the ER with RN manager accompaning pt. In ER BED 18 report given to RN same RN who transported pt last VS 174/93 HR 142 RR 18 sats 100%. Having a STAT 12 lead at 1507 in the ED. Doctor informed of pts admit to the ER and sent report and pts MRN to him.

Other Meds:

Current Illness:

ID: 1031590
Sex: F
Age: 32
State: AK

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

Lab Data:

Allergies: Formaldehyde, Latex, Gold, Clioquinol, Lanolin, Garlic, Onion, Wheat, Dairy, Beef, Chicken, Turkey, Pork, Oats,

Symptoms: Day 1: Fatigue, Arm Sore/ Swollen, Feeling unwell, Raised temp 99.3, Brain Fog, Puffy Cheeks, Day 2: Arm so sore I could not lift above my head, Fatigue,Headache, Day 3: Severe Lower Back Pain, Arm soreness subsided, Day 4: Severe Lower Back Pain, Hip Pain, Knee Pain, Day 5: Severe Lower Back Pain, Hip Pain, No appetite Day 6: Injection Site and Surrounding Area Swollen/Itchy/Sore/Raised Rash, Chills, Fatigue, Waves of Nausea, No appetite< No fever> Day 7: Chills, Exhaustion, Arm is Same as Day 6, Brain Fog, Raised Temp 99.4

Other Meds: Fish Oil, Sam-E,Ashwagandha,Women's Multi Vitamin, Vitamin D, Emergen-C, Magnesium, Venflaxine, Concerta,

Current Illness: n/a

ID: 1031591
Sex: F
Age: 53
State: NC

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

Lab Data:

Allergies: Sulfa drugs, sulfites, anything from ocean, moldy cheeses, pine, spruce, juniper, rosemary, eggplant, chard, rhubarb, arugula.

Symptoms: Started pink about 1cm first day post. 3cm second day post. Fifth day post was 8cm-10cm and 9n sixth day post was grayish with red ring around it. I have pictures.

Other Meds: The list is about 20 long. I can fax if you need it.

Current Illness:

ID: 1031592
Sex: M
Age: 74
State: MD

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

Lab Data: None needed.

Allergies: None known.

Symptoms: Soreness around the injection site (left deltoid), lasting approximately 36 hours. I was also told to enter: ?Moderna COVID-19 Vaccine EUA?

Other Meds: Tamsulosin, Simvastatin, low-dose aspirin, Metoprolol, Vit. D, Vit. B12, Claritin

Current Illness: None.

Date Died: 02/13/2021

ID: 1031593
Sex: M
Age: 81
State: GA

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

Lab Data:

Allergies:

Symptoms: On February 11, 2021 around 10:15 am, patient was given the Moderna brand COVID-19 vaccination. After his vaccination, he was instructed to wait around for 15 minutes after the administration of the vaccine. During this time, there were no reported issues with the patient. On February 15, 2021 around 9:15am, patient's wife called the pharmacy and spoke with the pharmacist informing her that patient had passed away in his sleep on Saturday evening. Patient's wife inquired about whether death may have been caused by an adverse reaction to the vaccine. During the call patient's wife mentioned that patient slept a lot the day of the vaccine and the day after. patient's wife mentioned that patient woke up Saturday to eat breakfast and lunch. She states that later that evening, she found patient asleep and cold which she then realized that he'd passed away.

Other Meds: Calcitriol 0.25mcg, glyburide 2.5mg, atorvastatin 40mg, nitroglycerin 0.4mg, furosemide 40mg, isosorbide ER 60mg, warfarin 5mg, gabapentin 300mg, allopurinol 100mg

Current Illness:

ID: 1031594
Sex: F
Age: 44
State: IL

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

Lab Data: None

Allergies: None

Symptoms: Rash and itchy arm around injection site.

Other Meds: Lexapro; Omega-3 Fish Oil; Vitamin D; Flonase

Current Illness: None

Date Died: 02/07/2021

ID: 1031595
Sex: M
Age: 84
State: KY

Vax Date: 12/29/2020
Onset Date: 02/05/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data: Resident was sent to hospital for further evaluation. Medical records not available to this facility since resident did not return to us.

Allergies: NKDA

Symptoms: Unresponsive, Increase BP and H. Hospital Dx Renal Failure

Other Meds: Lasix, Digoxin, Eliquis, Metoprolol, Celexa, Plavix, Namenda

Current Illness: Covid + 1/6/2021

ID: 1031596
Sex: F
Age: 51
State: VA

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

Lab Data: Dr app scheduled for Feb. 16th.

Allergies: none that I know of

Symptoms: Started with a high temp, exploding headache, upset stomach, and extreme back ache and shivers/ tremors. After 18 hours, all side effects had went away except for a slight headache and the tremors Tremors are over the body and happen about 4/5 times a minute,

Other Meds: Vitamins B12, C, D, zinc, THRIVE supplements

Current Illness: none

ID: 1031597
Sex: M
Age: 54
State:

Vax Date: 01/11/2021
Onset Date: 02/04/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies: Augmentin, gabapentin, Latex

Symptoms: Patient received first dose of Pfizer/BioNTech COVID-19 vaccine on 12/21/20 and second dose on 1/11/21. Patient tested positive for COVID-19 on 2/4/21.

Other Meds: albuterol, armodafinil, ASA 81mg, duloxetine, prednisone (chronic), montelukast, eszopiclone, fentanyl patch, furosemide, lorazepam, methocarbamol, morphine IR prn, trazodone

Current Illness:

ID: 1031598
Sex: M
Age: 63
State: NJ

Vax Date: 01/21/2021
Onset Date: 01/22/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data: See all above Same No medical tests have been performed but I am considering a brain MRI

Allergies: Yes. Allergy to Insulin

Symptoms: Morning after Could not go to work And I have worked 30 years without one sick day. Low grade fever in am with shaking but not cold. Started around 6 AM by 9 AM couldn't stand very weak slightly lightheaded Threw up till almost choking. At noon my temp hit 103.7 Took tylenol all AM and wasn't lowering temp. That was the highest temp Then gradually began to come down At 5:00 PM temp at 100 and able to put soup down. Woke up 4 AM next day in total sweat that had to move to other side of bed Soaked but felt OK On 23rd Got headache above right eye to side of frontal lobe, Not any strong headache at all Dull Like a 2 out of 10. My concern is I still have the exact same headache as I did three weeks ago Not a smidgen lower at all SAME. And I booked second vaccine for Sat 2/27th I am concerned as I have heard second can be worse. I have never had the flu and this was my first ever vaccine of any kind Please advise

Other Meds: Insulin Fiasp. Clarinex. Thyroid med and HBP pill

Current Illness: Diabetic Insulin dependent

ID: 1031599
Sex: U
Age: 31
State:

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

Lab Data:

Allergies:

Symptoms: No adverse event to a patient. Vaccine administration error: Additional diluent was added to the Pfizer vaccine vial allowing administrator to withdraw an additional dose from 3 different vials.

Other Meds:

Current Illness:

ID: 1031600
Sex: M
Age: 72
State: CA

Vax Date: 01/29/2021
Onset Date: 02/12/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: Feb. 12, 2021 6:30 am headache-headache pills Feb. 14, 2021 Headache-headache pills Feb15, 2021 Headache, chills-headache pills All above symptoms went away within 15 to 20 mins.

Other Meds: Levothyroine 150MCG -Equate headache relief tablets - Centrum silver once a day vitamin - Mega Food Blood builder (iron) tablets

Current Illness: none

ID: 1031601
Sex: F
Age: 81
State: LA

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

Lab Data: None mio

Allergies: Mostly sulfa,and lots of pain relief meds

Symptoms: Extreme chills andfever. Dry mouth,edema, of etrmities,weakness,loss of appitite,sleepiness

Other Meds: Imdur,eliquis,avostation,,vit a b,c,d,zinc&,multi,&cds.uloric,harmones,momentan,breo,potassium,lasix,calcium,protonix,nexium,gabipentun,chrondition/glucosamn,predisone

Current Illness: Had heart Cath 5weeks before. 29of december

ID: 1031602
Sex: F
Age: 43
State:

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

Lab Data:

Allergies:

Symptoms: Pt at vaccine clinic for 2nd dose covid vaccine with a history of anaphylactic reaction to immunotherapy. Pt presented with rash/itching on chest, tingling around ears and runny nose 20 minutes after vaccine administered.(0828) Doctor notified and Benadryl 25mg PO given VS at time 169/98, 60, 100%. 0847 pt c/o slight chest tightness, slight labored breathing, feeling of periorbital swelling,VS at time 173/91, 51, 99% Doctor again notified and an RN stat called, pt taken to the ER and report given to ER RN, pt appeared to be comfortable and feeling somewhat better

Other Meds:

Current Illness:

ID: 1031603
Sex: M
Age: 79
State: FL

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

Lab Data: Went into a pharmacy and had a COVID-19 test that came out negative.

Allergies: None mild hay fever

Symptoms: My arm got sore within an hour of me driving home and got progressively worse throughout the day, I took advil. The next day I had severe chills, and tired, fatigued, and then my body aches. I had a bit of a sore throat. I also had joint pain. I had symptoms for three to four days.

Other Meds: centrum silver flaxseed oil fish oil advil/ibuprofen levothyroxine 50 mg daily

Current Illness: None

ID: 1031604
Sex: F
Age: 74
State: CT

Vax Date: 01/28/2021
Onset Date: 02/04/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data: none

Allergies: penicillin

Symptoms: Large red hive itchy. lasted about 1 week. no treatment

Other Meds: Fenofibrate, Atorvastatin, Olmasartan, Fluoxetine, Advair, Spiriva, Albuterol Sulfate, Montelukast Sod, Cromolyn Sodium, Ipratropium Bromide and Albuterol Sulfate, Azlasine Hydrochloride nasal spray, Mybertiq, Vitamin D3

Current Illness:

ID: 1031605
Sex: F
Age: 85
State: OH

Vax Date: 12/05/2020
Onset Date: 12/19/2020
Rec V Date: 02/15/2021
Hospital:

Lab Data: no

Allergies: no

Symptoms: pt stated that 2 weeks after the shringrix vax that she was experiencing itching and redness under the right breast and around the torso towards the back. She visiting her PCP and was prescribed some oral medication. These symptoms lasted about 5-6 weeks and was told not to take her second dose by her PCP.

Other Meds: lisinopril 10mg, x 1 daily, aspirin 81 mg x 1 daily, amlodipine 2.5 mg x 1 daily, Simbrinza eye drops 1.02 %x 2 daily, Latanoprost eye drops .005% x 1 daily

Current Illness: no

ID: 1031606
Sex: F
Age: 61
State:

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Vasovagal resulting hitting head and causing a concussion.

Other Meds:

Current Illness:

ID: 1031607
Sex: F
Age: 77
State: FL

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

Lab Data: Yesterday she saw her pulmonologist, and she began taking Tylenol and using the affected area per his recommendation. Patient was recommended hydro cortisone or calamine lotion.

Allergies:

Symptoms: On Wednesday, arm was itchy near injection site. It grew warm, swollen, and red. By Thursday, the affected area was growing. By Friday, symptoms were felt from the shoulder to the elbow.

Other Meds: Levothyroxine, atenolol, Losartan, ezetimibe, alprazolam,

Current Illness:

ID: 1031608
Sex: F
Age: 73
State: MI

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

Lab Data: SEE ABOVE

Allergies:

Symptoms: After receiving the vaccine, she complained of an allergic reaction. The onsite EMS was requested. Her vitials were BP 172/84 HR 76 O2 99% on room air. Patient refused additional evaluation and released home against medical advise

Other Meds:

Current Illness:

ID: 1031609
Sex: F
Age: 45
State: MA

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

Lab Data:

Allergies: Amoxicillin

Symptoms: First shot required antibiotics 10 days after injection for subcutaneous infection Second shot required antibiotics 2 days after injection for similar subcutaneous infection

Other Meds: Birth control

Current Illness: None

ID: 1031610
Sex: M
Age: 71
State: SC

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

Lab Data: Blood work and antibiotics.

Allergies: None

Symptoms: Welt over artery on right side of face between eye and ear. Current diagnosis unclear as whether it auto immune reaction in the artery or infection in the skin above the artery. Blood drawn and placed on antibiotic (Cephalexin). Additional follow up depending on results of the blood work.

Other Meds: Finasteride,hydrochlorothiazide,montelukast,levocetrizine,tamsulosin, methimazole, Flonase, Symbicort,pravastatin

Current Illness: None

ID: 1031611
Sex: F
Age: 70
State: MI

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

Lab Data:

Allergies:

Symptoms: Patient reported nausea, vomiting, weakness, chills, unable to keep food down, face broke out in rash around eyes and rash on hand. Patient reported symptoms lasted over a week. Went to ED, given IV fluids and discharged home.

Other Meds:

Current Illness:

ID: 1031612
Sex: F
Age: 85
State: TN

Vax Date: 02/01/2021
Onset Date: 02/10/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data: None

Allergies: Augmentin

Symptoms: 2nd vaccine ?2nd day Blood pressure dropped to 88/55 Fainted Hit head. Couldn?t get up Bruised, sore Early evening 2 days later Raynauds developed on finger on left hand

Other Meds: Chlothalidone Eliquis Sertraline Levothyroxine Vitamin D Centrum silver vitamin Potassium Rosuvastatin

Current Illness:

ID: 1031613
Sex: F
Age: 65
State: LA

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

Lab Data: N/A

Allergies: None

Symptoms: Woke up with 100 degree temperature, feeling bad and headache. Took Tylenol then a few hours later Advil. About 18 hours later felt much better.

Other Meds: Levothyroxine 88 mg

Current Illness: None

ID: 1031614
Sex: F
Age: 38
State: CA

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

Lab Data:

Allergies: Bactrim, peppers

Symptoms: Swelling, warmth, redness, induration, pain, itching increasing on 02/11/2021 and 02/12/2021, no improvement since, tightness overnight 02/14/2021

Other Meds: Naltrexone, bupropion, sertraline, gabapentin, cetirizine

Current Illness: Depression, seasonal allergies

ID: 1031615
Sex: F
Age: 65
State: IN

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

Lab Data:

Allergies: Sulfa drugs, AZO for UTI, general anesthesia

Symptoms: 2 inch diameter hives-like with itching and slight swelling. Started next day and I still have it at area of injection.

Other Meds: Levothyroxine, Atorvastatin and vitamin D3 that morning on Feb 6 2021.

Current Illness: None

ID: 1031616
Sex: M
Age: 33
State:

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

Lab Data:

Allergies:

Symptoms: 11:25am- Pt found rash @ left arm and return to covid vaccination station after 15 minutes observation (pt had 2nd pfizer covid vaccination). Pt denied SOB and difficulty to breath. VS stable. Continue to monitor pt 30 minutes per Doctor's order. 11:55am- rash noted @right thigh, pt denied SOB, report given to Doctor, Benadryl 25mg po given per Doctor's order

Other Meds:

Current Illness:

ID: 1031617
Sex: M
Age: 17
State: OR

Vax Date: 01/23/2021
Onset Date: 01/23/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies: Unknown-VAR is not in front of me

Symptoms: Patient was inadvertently administered the Moderna vaccine before the age of 18. Patient and parent did not report any adverse effects following vaccination.

Other Meds: Unknown

Current Illness: Unknown

ID: 1031618
Sex: F
Age: 25
State: OR

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

Lab Data: Unknown if labs performed at ER visit\.

Allergies: abilify, ativan, benadryl, haldol, latuda, morphine, zyprexa

Symptoms: Tightening of throat, raspy throat, facial and tongue swelling, rash on chest.

Other Meds: Pepcid, Zantac, Chlorpromazine, gabapentin, guanfacine, levothyroxine, lithium, prazosin, trazodone

Current Illness: N/A

ID: 1031619
Sex: F
Age: 77
State: CA

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

Lab Data: None.

Allergies: Sulfamethoxazole, cephalexin, Clindamycin, Augmentin, Cipro, Erythromycin, Rocephin, Lyrica, Neosporin and aloe vera give rashes, or stomach pains to all medicine listed.

Symptoms: On 2/12/21 noticed that she had some itching in the area of the vaccine, a week after the vaccine. Now she has a red, roundish rash, looks like covid arm from the internet. No other problems. She put some cortisone cream on it as it itches at times.

Other Meds: Fioricet, Pantoprazole, Hydrochlorothiazide, vitamin D, Gabapentin.

Current Illness: None.

ID: 1031620
Sex: F
Age: 22
State: KY

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

Lab Data:

Allergies:

Symptoms: Fever (highest- 102.5 F), dizziness, muscle aches/soreness, chills, fatigue, chest pain, shortness of breath, muscle weakness, night sweats, vomiting, fainting

Other Meds: Daysee birth control, nuvigil, spronalactone, zyrtec, singulair, famotidine, albuterol inhaler as needed, symbicort, flonase, amitiza, allergy injections

Current Illness:

ID: 1031621
Sex: M
Age: 82
State: NE

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

Lab Data: NONE

Allergies: mediations penicillin and cepro

Symptoms: TONGUE PAIN AND BLISTERS, LIP SORES, SORES INSIDE CHEEK, DIFFICULTY EATING AND CHEWING

Other Meds: mouth and tongue blisters or sores similar to cold sores - general pain when eating hot, spicy or hard to chew food

Current Illness: none

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm