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: 1036178
Sex: F
Age: 79
State: AL

Vax Date: 02/02/2021
Onset Date: 02/03/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data: no

Allergies: no

Symptoms: I had a moderate reaction. I was slightly dizzy. I was weak. I had a low grade fever for a few days. I had a headache for a few days. I had "covid arm". It was red, sore, it had some swelling, and intense itching. I am still tired. I have diarrhea as well.

Other Meds: duloxetine

Current Illness: no

ID: 1036179
Sex: F
Age: 30
State: GA

Vax Date: 02/15/2021
Onset Date: 02/15/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Pain and erythema at injection site started 2.5 hours after injection. Erythema continued 24 hours post injection. Pain was severe (10/10) 18-24 hours after injection. Pain mild still 48 hours post injection. Systemic reactions included chills and fever 18-36 hours post injection, myalgia and fatigue 24-36 hours post injection, and nausea and dry heaving 48 hours post injection. Treatment included acetaminophen and ibuprofen until 48 hours post injection, diphenhydramine 48 hours after injection.

Other Meds: Yasmin, vitamin D 5000 units, zinc 30 mg, probiotic, omega 3, vitamin C 1000 mg

Current Illness: None

ID: 1036180
Sex: M
Age: 76
State: NY

Vax Date: 02/10/2021
Onset Date: 02/12/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Tiredness chills joint pain

Other Meds: losartan tamsulosan

Current Illness:

ID: 1036181
Sex: F
Age: 70
State: AZ

Vax Date: 02/01/2021
Onset Date: 02/17/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data:

Allergies: Benadryl, and aspirin sensitive

Symptoms: Rash on arm around injection began today 2/17/21

Other Meds: Alendronate 70 mg 1x week, Fluoxetine 10 mg 3x week, Simvastatin 40 mg daily, Toprol XL 12.5mg daily, Calcium, multivitamin, fish oil, sumatriptan as needed for migraines.

Current Illness:

Date Died: 02/13/2021

ID: 1036182
Sex: M
Age: 80
State: CO

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 02/17/2021
Hospital: Y

Lab Data: CT Head w/o contrast - extensive subarachnoid & intraventricular hemorrhage most probably related to a bleeding anterior communicating artery aneurysm.

Allergies: NKA

Symptoms: Patient received 2nd dose of the COVID-19 Pfizer vaccine, was observed in office x 15+ minutes, and released home. Pt and his son exited the building and when they got to the car, the pt shouted out "oh no!" and collapsed to the ground. The patient was unconscious experiencing agonal respirations, and unresponsive to painful stimuli. There is an Emergency Room at the same location. Their staff came out and helped to transfer the pt to the ED for further evaluation. It was found that the patient had a known Anterior communicating artery aneurysm (7/28/2017) that seemed to have ruptured. The patient was stabilized and transported to our local hospital and upon arrival, he was effectively comatose with a GCS 3. CT Head notated an extensive subarachnoid and intraventricular hemorrhage most probably related to a bleeding anterior communicating artery aneurysm. Neuro-Interventional Radiologist dictation reads "Hunt Hess 5 Fisher grade 4 extensive subarachnoid hemorrhage with intraventricular hemorrhage and early hydrocephalus secondary to rupture of a known anterior communicating artery aneurysm. Initial ICP after EVD placement noted to be in the 120s now 68 treatment complicated by aneurysm rerupture after admission and increased volume of blood although large volume of hemorrhage was seen on initial scan and no change in the patient's clinical exam on her scale was noted due to this rerupture. Patient's exam and prognosis are poor giving extensor posturing lack of extraocular movements to doll's maneuver and weak pupillary reflex as well as cough and gag. Follows no commands or instructions at this time with no spontaneous movement on ventilator set at 12 overbreathing at 14-16 at this time without any sedation." The family opted to discontinue any further treatment to include surgical intervention given the findings. The patient was given comfort care with son and daughter at the bedside. The patient was extubated and expired at 1545h on 2/13/2021.

Other Meds: Not verified. EMR states 1/4/2021 SINEMET 25-100 mg tablet.

Current Illness: Unknown

ID: 1036183
Sex: F
Age: 33
State:

Vax Date: 02/16/2021
Onset Date: 02/16/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Body aches and chills.

Other Meds:

Current Illness:

ID: 1036184
Sex: F
Age: 40
State: CA

Vax Date: 02/03/2021
Onset Date: 02/04/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data:

Allergies: Dust, Shellfish

Symptoms: Had a Migraine the following day to include sensitivity to light, headache, nausea.

Other Meds: None

Current Illness: None

ID: 1036185
Sex: F
Age: 86
State: IL

Vax Date: 01/29/2021
Onset Date: 01/30/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data: n/a

Allergies: sulfa drugs

Symptoms: day after vaccine, pt woke w/ a swollen upper lip that lasted a couple of days after that had swelling and redness at the injection site.

Other Meds: atorvastatin mirtazepine Toprol pepcid melatonin MVI topical estrogen vit D glucosamin

Current Illness: unknown

ID: 1036186
Sex: M
Age: 73
State: NC

Vax Date: 02/13/2021
Onset Date: 02/14/2021
Rec V Date: 02/17/2021
Hospital: Y

Lab Data: Potassium 2.9, creatinine 1.84, AST 74, 2+ blood in urine, SOB: 88% O2 sat. Chest xray normal.

Allergies: none

Symptoms: Altered Mental Status, Fever, Lethargy

Other Meds: Cardura, Tambocor, Lasix, Avapro, Synthroid, Crestor, Coumadin

Current Illness: Hospitalized 11/23/20 to 12/24/20 with heart issues

ID: 1036187
Sex: M
Age: 60
State: MI

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data: See Above

Allergies:

Symptoms: Patient had a Seizures Without Status Epilepticus after the vaccine. Onsite EMS was called vitals were taken BP 164/100 BG 154 HR 93. Patient Treated and Transported by the EMS to the hospital.

Other Meds:

Current Illness:

ID: 1036188
Sex: F
Age: 62
State:

Vax Date: 02/13/2021
Onset Date: 02/13/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Red, painful flat rash, upper arm anterior to injection site. Severe anterior upper arm pain

Other Meds:

Current Illness:

ID: 1036189
Sex: F
Age: 44
State: NY

Vax Date: 02/02/2021
Onset Date: 02/02/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data: Exam by ortho

Allergies: None

Symptoms: Shoulder injury related to vaccine administration Rotator cuff type pain starting 2 hours after vaccine and persisting 2 weeks later. Pain in shoulder daily despite ibuprofen every 6 hours. Range of motion limited severely.

Other Meds: None

Current Illness: None

ID: 1036190
Sex: F
Age: 60
State: CA

Vax Date: 02/15/2021
Onset Date: 02/16/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data:

Allergies: Microbid, Amocycillin.

Symptoms: Extreme pain with every bone and joint. My spine and pevic bone hurt. Every inch of my skin hurt. I could differentiate the difference between body parts. Dizziness barely able to use the restroom without falling. The pain stated to lessen around 8:30 pm the next night. The weird part is the pain started to lessen in parts. For instance a section of my upper leg then a section of my forearm. I woke up around 7:30 am two days later after the injection with no pain. Exhausted.

Other Meds: Metoprplol 25mg

Current Illness:

ID: 1036191
Sex: F
Age: 73
State: CA

Vax Date: 02/11/2021
Onset Date: 02/11/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Felt arms swelling, dizzy, and had difficulty breathing. Patient was very nervous about leaving house for COVID-19 vaccine and had several layers of mask and clothing. Refused water. Stabilized and sent home. BP 134/69, pulse 68, and O2 sat 96%.

Other Meds:

Current Illness:

ID: 1036192
Sex: F
Age: 58
State: CA

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data: See above. MRIs of the brain twice, cervical and then full spine. Extensive lab tests. Dates of MRIs unknown but approximately January 20 and February 10.

Allergies: Allergies to various trees and grasses. Taking allergy shots.

Symptoms: That evening a mild tremor began in my left calf. It progresses to my entire left leg, left hand. My left hand began to curl up, the tremor continued to increase. Although I have full ROM in the hands at rest the fingers are curled and my index finger points outward. The worsening occurred each day. I had electric type pain in the left foot. The previous double vision worsened in the left side. The symptoms then spread to the right side. My balance worsened. I had an MRI of the brain and neck, contrast and non-contrast approximately a week after symptoms began. I went to the ER as the symptoms worsened. My left leg was dragging, I had trouble walking. IV toridol decreased symptoms. I was given Motrin at home with no result, then another anti-inflammatory, then a steroid, all with no results. I had several blood panels. After a month of symptoms we did another brain MRI and full spine MRI's all negative. We did extensive blood work for autoimmune, inflammatory and eight or so other items such as Lyme, Syphillis, arsenic and I'm not sure what else. The nuero exam showed normal reflexes and strength. He did some nerve conduction tests. The right calf was normal. He couldn't assess the left because of the tremor. I feel my legs will 'give out' and feel weak when performing activities and was told it's from the tremor. I have cramps and spams in the left foot and lateral calf. My balance is much worse, I fell over today while walking. These are all symptoms that are similar to the brain tumor in that it mostly affected the left side, but they are much, much worse. The deficits I had from the tumor in 2008 have been completely stable. A year or so after the surgery stress could increase the double vision or balance but not since 2009.

Other Meds: Lamotrigine 300 mg, Climara (estrogen) Patch, progesterone, singulair, zyrtec, magnesium, zinc, ashwagandha, turmeric, ginger, attivan prn (very occasionally), Advair/albuterol as needed.

Current Illness: Seasonal hayfever

ID: 1036193
Sex: M
Age: 52
State: MN

Vax Date: 01/17/2021
Onset Date: 01/18/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data: Was COVID + on 8/15/2020

Allergies:

Symptoms: On 1/18 developed fever 102.5, upon waking, around 8am. Fever climbed to 103.5 in the afternoon. Acetaminophen 1000mg taken and fever dropped to 102.5 in evening of 1/18. Severe night sweats and chills at night of 1/18 and 1/19, 1/20. Was advised by employer to go to ED due to elevated fever >12hrs. Pt declined due to cost of ED visit.

Other Meds:

Current Illness:

ID: 1036194
Sex: M
Age: 68
State: GA

Vax Date: 02/17/2021
Onset Date: 02/17/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data: None

Allergies: unknown

Symptoms: patient wasn't given a 3rd dose of the Covid vaccine. No symptoms or adverse events have been noticed but I wanted to report this. The facilitator was notified and they will continue monitoring patient. Received 1st dose on 1/6, second dose 1/27, and third dose today (2/17)

Other Meds: none given

Current Illness: unknown

ID: 1036195
Sex: F
Age: 53
State: FL

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data:

Allergies: Iodine

Symptoms: Severe flu symptoms, chills, nausea, joint pain that kept me in bed for a day. Very sore arm. Lymph nodes under shot arm swollen almost golf ball size ..2 big balls and a few smaller ones. They have went down but not completely as of today...almost 2 weeks later.

Other Meds: None

Current Illness: None

ID: 1036196
Sex: M
Age: 60
State: MD

Vax Date: 02/11/2021
Onset Date: 02/11/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data:

Allergies: NKA

Symptoms: Fever (102.7), headache, soreness of arm, lymphnode swelling (axilary), tea colored urine (prior to rehydration), cotton mouth. Tx: ACTM PRN over 3 days for fever, Increased fluids

Other Meds: None

Current Illness: None

ID: 1036197
Sex: F
Age: 72
State: GA

Vax Date: 02/17/2021
Onset Date: 02/17/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data: N/A

Allergies: No known allergies

Symptoms: No adverse event, patient received an extra dose of the Pfizer Covid-19 vaccine. Patient received first dose on 1/6/21, second on 1/27/21, and the third on 2/17/21.

Other Meds: unknown

Current Illness: N/A

ID: 1036198
Sex: M
Age: 61
State: WA

Vax Date: 02/15/2021
Onset Date: 02/16/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: Fever, muscle aches, tenderness at injection site, swelling of lymph nearest site of injection

Other Meds: none

Current Illness: none

ID: 1036199
Sex: F
Age: 79
State: NV

Vax Date: 02/16/2021
Onset Date: 02/16/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data: None

Allergies: sulfur medicines, K-flex

Symptoms: Temperature 99.3 F (unusual for the patient even when ill). Sore Arm. Chills, headache,

Other Meds: Over the counter - Lansoprazole every other day

Current Illness: None

ID: 1036200
Sex: M
Age: 57
State:

Vax Date: 02/03/2021
Onset Date: 02/06/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Patient developed chest pain and was admitted to ED with pulmonary embolism.

Other Meds:

Current Illness:

ID: 1036201
Sex: F
Age: 67
State: OH

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data: Vital signs: BP 132/80, pulse 85, respiratory rate 16, non labored, SPO2 98% on room air- 02/12/2021

Allergies: latex, banana, peas, lentils, buckwheat, avocado, nuts, hazelnuts, brazil nuts, shellfish, all fish and all seafood, avelox, codeine, penicillin, sulfa, cephalosporins

Symptoms: Patient began experiencing a tingling feeling to the roof of her mouth shortly after receiving the 1st dose of Pfizer covid vaccine. Patient stated that she had anaphylactic reactions in the past and this feels like past experiences. Patient has an epi pen available if needed. Patient was given 25 mg Benadryl with symptoms resolving. Patient refused transport to the emergency room. Patient was stable and released to the care of her husband. Patient was advised to go to the ER later if symptoms persist or worsen.

Other Meds: Restasis, flonase

Current Illness: Non reported

ID: 1036202
Sex: F
Age: 80
State: NC

Vax Date: 02/12/2021
Onset Date: 02/15/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data: None. self care with care giver.

Allergies: Latex, Doxycycline, Dust Mites, Mold, Mildew, Strong Smells

Symptoms: Sore and swollen gums, tongue and roof of mouth; fatigue, low grade fever, aches, head ache

Other Meds: Aspirin 81mg, Calcium-Vitamin D 1200mg, Vitamin D3 4000mg, Donezepil 10mg, Furosemide 40mg, Gabapentin 1000 mg, Levothyroxine 50mg, Potassium Chloride 80mg, Raloxifene 60mg, Simvastatin 40mg, HumaLOG 8 units

Current Illness: None.

ID: 1036203
Sex: F
Age: 68
State: MI

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data: None

Allergies: Sulfa drugs

Symptoms: By evening I felt like my tongue was thick as well as the back of the throat. I could still swallow and drink/eat but the feeling was definitely real. The tongue felt thick, especially towards the back for 4-5 days and the back of my throat didn?t feel more ?normal? for at least 9-10 days. It stills feels a little ?thicker? still but much better.

Other Meds: No e

Current Illness: None

ID: 1036204
Sex: F
Age: 77
State: NY

Vax Date: 02/03/2021
Onset Date: 02/07/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data: Sonogram done on lump, can't tell if it is solid mass or fluid. Scheduled for CT scan on the 25th. Throbbing on neck stopped. Still have pressure on head, left side. Lump sore and painful.

Allergies: none

Symptoms: Extreme shaking and chills, large lump appeared on left leg thigh, Pressure of top of head (left side) and painful throbbing on right side of neck.

Other Meds: Warfarin, Bisoporolol, Enalapril, Digoxin, Lovastatin, Theralith XR, Tylenol Arthritis. Vitamin C, Multi Vitamin

Current Illness: none

ID: 1036205
Sex: F
Age: 29
State: MD

Vax Date: 01/05/2021
Onset Date: 01/08/2021
Rec V Date: 02/17/2021
Hospital: Y

Lab Data:

Allergies:

Symptoms: Hospital 1/8-01/21/2021. Hospital for pneumonia and sickle cell crisis.

Other Meds: Folic acid, Vitamin D

Current Illness:

ID: 1036206
Sex: F
Age: 49
State: NM

Vax Date: 02/09/2021
Onset Date: 02/11/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data: no

Allergies: lactose sensitive

Symptoms: Extremely painful to the touch. After about 2 days I developed red splotch around the injection site - was not perfectly round. About 2 to 3 days after that the redness and most of the soreness was gone but the site is now very itchy (it is now 8 days since I received the shot)

Other Meds: Omega 3. probiotic and antioxidant (from LifeVantage)

Current Illness: no

ID: 1036207
Sex: M
Age: 54
State: IA

Vax Date: 02/11/2021
Onset Date: 02/11/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: "Covid Arm" redness increased daily with soreness, itching and hardness. on day 5 still has redness and hardness, no itching or soreness.

Other Meds: atorvastin meloxicam benicar amitryptylline amlodipine pantoprazole budesonide zyrtec

Current Illness: none

ID: 1036208
Sex: F
Age: 22
State: CA

Vax Date: 02/16/2021
Onset Date: 02/16/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data: none

Allergies: None

Symptoms: Shortness of breath, nasal drainage, fatique, generalized body pain

Other Meds: None

Current Illness: None

ID: 1036209
Sex: F
Age: 46
State: MN

Vax Date: 01/18/2021
Onset Date: 01/18/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data: Was COVID + 11/3/2020

Allergies:

Symptoms: Significant shortness of breath requiring medical treatment (inhaler and steroid rx) Shortness of breath for 3 days moderate/significant extent. Shortness of breath improved by 1/23/2021 per pt.

Other Meds:

Current Illness:

ID: 1036210
Sex: F
Age: 55
State: CA

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data: 1/28/21 @ VA Emergency: Covid Test- Negative Strep: Negative Chest X-ray: Normal UA: Normal

Allergies: none

Symptoms: 1/22pm: Sore throat, muscle aches, chills, temperature 102 F, nausea and vomiting, diarrhea, fatigue, couldn't focus at work. 1/28: Was seen in the Emergency room and treated with amoxicillin

Other Meds: none

Current Illness: none

ID: 1036211
Sex: M
Age: 45
State: MN

Vax Date: 02/04/2021
Onset Date: 02/10/2021
Rec V Date: 02/17/2021
Hospital: Y

Lab Data: incidental findings of small aneurism in his brain pending follow ups

Allergies: NKDA

Symptoms: complaint of chest pain, patient sent to ER and hospital admission 2/10/21 to 2/11/21. advanced cardiac imaging found old arterial occlusion with collateral perfusion,no stent ,no surgical intervention.

Other Meds: tylenol as needed

Current Illness: FABRY HTN

ID: 1036212
Sex: F
Age: 46
State: OH

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data: 2/12/21 O2 sat is 97% on room air at 1658 2/12/21 EKG-12 lead at 1700 2/12/21 Zofran 4mg injection at 1726

Allergies: minocycline, latex

Symptoms: Patient presented to the emergency room approximately 45 min after receiving her 2nd dose of Moderna COVID-19 vaccine (2/12/21 at 1652). About 15 min after receiving the vaccine, she began having a rash to her upper chest, she stated that she felt very shaky and had heart palpitations. Nurses in the vaccine clinic gave her a dose of 25mg of Benadryl, 975mg of Tylenol and 20mg of Pepcid. Patient was shaky, but breathing easily and able to speak in complete sentences without difficulty, denied any difficulty in swallowing and her O2 saturation was within normal limits as well as her heart rate is normal sinus rhythm. She states that her only allergy is to minocycline and she currently treats for depression, bipolar disorder and has a platelet storage pool disorder. She is currently on Symbicort, zinc, Vit C, and Vit D because she had COVID-19 several months ago. She still gets residual shortness of breath from it. She denies any chest pain, nausea or vomiting

Other Meds: Symbicort inhaler, trazodone, bupropion, zinc oxide, vitamin C, vitamin D

Current Illness: sticky platelet syndrome storage pool deficit disorder

ID: 1036213
Sex: M
Age: 15
State: TX

Vax Date: 02/17/2021
Onset Date: 02/17/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: gave the pfizer vaccine to a person under 15. Patient reported no problems

Other Meds: none

Current Illness: none

ID: 1036214
Sex: M
Age: 30
State: CA

Vax Date: 01/17/2021
Onset Date: 01/17/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data:

Allergies: Allergic Rhinitis

Symptoms: Admin Error - Pt received second dose of Moderna COVID vaccine at day 20 outside of standing order and CDC recommendations. Note pt received 1st dose of Moderna COVID vaccine on 12/28/20 (Lot # 025J20-2A) and second dose accidentally on 1/17/21. Per ID pt was given a third dose on 2/14/21 (Lot #011M20A

Other Meds: Triamcinolone Acetonide 0.1% Dent Paste

Current Illness: None known

ID: 1036215
Sex: F
Age: 38
State: MN

Vax Date: 01/22/2021
Onset Date: 01/23/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data: Tested COVID + 12/15/2020

Allergies:

Symptoms: 01/23/2021 to 1/23/20201, swollen lymph nodes in throat which causes pain. Saw urgent care 1/27, ENT on 1/29 d/t ongoing side effect. No rx provided, resolved on own

Other Meds:

Current Illness:

ID: 1036216
Sex: F
Age: 76
State:

Vax Date: 02/09/2021
Onset Date: 02/09/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data: To be determined.

Allergies: allergic to statin medication allergic to doxocycline medication

Symptoms: lightheadedness - 1 week and continuing. Have appointment 2/18/2021 with primary care doctor.

Other Meds: pantaprazole elavil Multiple vitamin

Current Illness: mild aortic, mitral, and transcuspid valve regurgitation heart mjurmur - inactive acid reflux irritable bowel syndrome macular degeneration

ID: 1036217
Sex: F
Age: 55
State: WA

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Mild headache, injection site pain, fatigue, swelling in lymph nodes

Other Meds:

Current Illness:

ID: 1036218
Sex: F
Age: 24
State: CA

Vax Date: 02/10/2021
Onset Date: 02/11/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Received Moderna Vaccine Dose #2: 2/10/21 at 12:45pm. 2/11-2/14: Chills, fatigue, fever (38.4C), headache, muscle ache, nausea, vomiting Took Tylenol for fever; fever resolved on 2/14/21. 2/15/21: all symptoms resolved. No additional medical attention needed.

Other Meds:

Current Illness:

ID: 1036219
Sex: F
Age: 38
State: MI

Vax Date: 02/10/2021
Onset Date: 02/14/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data: Blood Panel Completed

Allergies: Cillins & Pineapple

Symptoms: Had vaccine on Wednesday woke up Sunday morning with Vertigo. I have never had or experienced naything like this. Came home and went to Doctor on Monday.

Other Meds: No

Current Illness: No

ID: 1036220
Sex: F
Age: 26
State: IL

Vax Date: 02/11/2021
Onset Date: 02/11/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data:

Allergies: Amoxycillin

Symptoms: Fast onset of fatigue, joint pain, headache, pain of lymph nodes. Quickly worsening over 5 hours, remaining for approximately 30 hours.

Other Meds: Lamotrigine, Sertraline, norethindrone, iron supplement

Current Illness: None

ID: 1036221
Sex: F
Age: 78
State: SC

Vax Date: 01/25/2021
Onset Date: 01/25/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data:

Allergies: NKA NKDA

Symptoms: blister developed on left foot 4 hours after 1st vaccine 01/25/2021. blister formed on left great toe 4 hours after 2nd vaccine 02/15/2021

Other Meds:

Current Illness: N/A

ID: 1036223
Sex: F
Age: 37
State: OH

Vax Date: 01/26/2021
Onset Date: 01/27/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data: Mono test-negative

Allergies: NKDA

Symptoms: Received 2nd dose of Moderna COVID-19 vaccine on 1/26/21 at around 1300 (unknown lot info). Had a headache that lasted 5 days, resolved. This past Monday headache reoccurred and felt fatigued with body aches and nausea. On Wednesday developed non painful sores (x2) at the back of mouth with LUQ pressure. No trauma or injury. Currently not pregnant.

Other Meds: multivitamin

Current Illness: n/a

ID: 1036224
Sex: F
Age: 43
State: NJ

Vax Date: 02/06/2021
Onset Date: 02/06/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data:

Allergies: Lactose intolerant

Symptoms: Localized upper arm/shoulder pain in the area of injection, and muscular and joint weakness of the upper arm for 5-7 days

Other Meds: Vitamin C Pro and Prebiotics

Current Illness: N/A

ID: 1036225
Sex: F
Age: 46
State: PR

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data: NONE

Allergies: QUINOLONES, SULFA

Symptoms: DEVELOPED FACE AND THORAX PRURITIS AND ERYTHEMA. ON 1/26/2021 3:35PM. WAS GIVEN SOULMEDRO 125MG IVP, BENADRYLS 50MG IV SLOWLY

Other Meds: UNKNOWN

Current Illness: NO

ID: 1036226
Sex: F
Age: 73
State: NJ

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Ache at vaccine site; slight vertigo; diarrhea [one day 2/13/21]

Other Meds: Hydrochlorothiazide 12.5mg; Losarton 50mg; Carvedilol 6.25mg; Attorvastatin 80mg.; Ezetimibe 10mg Nature Made Multi Vitamin w/Omega 3 Gummies, Flaxseed Oil Capsule 1200mg; Vitamin D3 1000IU; Turmeric Capsule 450 mg; Bayer Low Dose Coated As

Current Illness: None

ID: 1036227
Sex: M
Age: 79
State: OK

Vax Date: 01/21/2021
Onset Date: 01/31/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data: none

Allergies: Dye

Symptoms: Had chills/shakes night of1/31st, on 2/1st, had fever that day plus dizziness and off balance. Next day was better but still kind of dizziy and off balance. The third day,2/2nd seem better.

Other Meds: Bisoprolol-Finasteride-Omeprazole-Isosorbide Mononitrate-Folbee Tab-Tamsulosin HCL-Vit C-Vit D.

Current Illness: N/A

ID: 1036228
Sex: F
Age: 65
State: MI

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data: See Above

Allergies: Allergy status to other drugs, medicaments and biological subs

Symptoms: Patient felt funny. Onsite EMS was called vitals were taken BP 108/68 98% O2 room air BG 108 HR 72. General Malaise unknown cause patient refused evaluation/care. Left aginst medical advice.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm