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: 1036518
Sex: F
Age: 72
State: OH

Vax Date: 02/07/2021
Onset Date: 02/15/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data:

Allergies: Chantix, Zyban, Pravachol, Augmentin, Bupropion, Norvasc

Symptoms: 2 inch red, raised, warm, itchy area at injection site appeared on the 8th day following 1st dose Moderna vaccine. This reporting is on the 3rd day of the reaction with no improvement yet noted to area. Will notify physician if no improvement on the 4th day. I was given the yearly flu vaccine approx 2 wks prior to the Covid vaccine. I do not know the vac name or lot #

Other Meds: Aldactone 25mg, Lipitor 40mg, Eliquis 5mg, Lasix 20mg, Lisinopril 5mg, Toprol ER 125mg, Tikosyn 250mg, Buspirone hcl 15mg, Spiriva Respimat, Symbicort 160/4.5. Nasonex, Colace 100mg, Aspirin 80mg.

Current Illness: None

Date Died: 02/17/2021

ID: 1036519
Sex: M
Age: 65
State: IN

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

Lab Data:

Allergies: NKDA

Symptoms: Received first SARS-CoV2 vaccination yesterday at local store Experienced new symptoms of chills, nausea as well as worsening from baseline dyspnea at night. Wife states he had rough morning breathing and had sudden loss of consciousness and unresponsiveness and failed to respond to bystander CPR. He expired at his home.

Other Meds: Albuterol-ipratropium, warfarin, hydrochlorothiazide-triamterene, budesonide-glycopyrroltate-formoterol, atorvastatin.

Current Illness:

ID: 1036520
Sex: F
Age: 31
State: VA

Vax Date: 11/12/2019
Onset Date: 11/12/2019
Rec V Date: 02/17/2021
Hospital:

Lab Data: none

Allergies: novacaine: oral edema acyclovir: oral edema No history of intolerance or allergy to any foods, natural rubber latex or stinging insects.

Symptoms: The patient is a healthy 32 yo female with a history of continued left shoulder pain s/p IIV. She received Afluria (SEQ P100136349) on 12 NOV 2019. She recalls her arm being unusually sore. She states placement was OK, and still has a bluish discoloration at the site. She was sitting and the vaccinator was standing. She states she had a PT test 2 or three days after receipt. She had practiced pushups the day before and then performed her test. She states the day after her test she awoke with severe shoulder pain, 9/10, burning, sharp, worse motion (which was severely limited) radiating to her fingertips, with numbness, but no paresis . She had difficulty dressing, reaching. She denies any previous or new specific injury. She did self care with ROM, home PT and NSAIDS. She saw PCP day 14 and requested acupuncture and again on 30 JAN with minimal improvement. COVID disrupted followup. She was in school and is now. She currently has 85-90% of function, most of her ROM. She did not pursue a profile and her subsequent PT tests have been delayed, but thinks she could pass. PCP note 26 NOV states w/ onset following immunizations though increased shoulder muscle use in prep for and doing PRT more likely the precipitating cause. Has mixed picture of findings. Several findings suggest rotator cuff impingement, also w/ + scarf but no AC joint tenderness. Accupuncture note 27 NOV 20 Exam shows tenderness on the distal biceps tendon and worsening pain with resisted biceps action, suggesting a distal biceps tendinopathy. Follow up late January stated Minimally improved over the last few months. Suspect pain is isolated to the anterior deltoid based on physical exam.

Other Meds: Tylenol PRN Ketoconazole shampoo PRN dandruff Tretinoin 0.025 cream for ace Ibuprofen PRN Rizatriptan PRN Cetirizine daily Mometasone daily Concerta 18MG daily Ritalin short-acting dosing when needed.

Current Illness: none

ID: 1036521
Sex: F
Age: 39
State: IN

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

Lab Data:

Allergies:

Symptoms: Pfizer was administered as a second dose vaccine instead of Moderna

Other Meds:

Current Illness:

ID: 1036522
Sex: M
Age: 72
State: GU

Vax Date: 02/12/2021
Onset Date: 02/16/2021
Rec V Date: 02/17/2021
Hospital: Y

Lab Data:

Allergies: Zoloft, Ambien, Lisinopril, Gabapentin

Symptoms: Patient had vaccine on the 12th, Stelara shot on 15th, and symptoms of diffuse erythroderma on the 16th. Seen in ER on 18th and admitted for further treatment.

Other Meds: Stelara, amlodipine, aspirin, paroxetine, buspirone

Current Illness: Psoriasis Had COVID-19 in November of 2020

ID: 1036523
Sex: F
Age: 28
State: RI

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

Lab Data: NA

Allergies: NKA

Symptoms: lightheaded Tachycardia

Other Meds: amitryptiline

Current Illness: N/a

ID: 1036524
Sex: F
Age: 39
State: IN

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

Lab Data:

Allergies:

Symptoms: Pfizer was administered as a second dose vaccine instead of Moderna

Other Meds:

Current Illness:

ID: 1036525
Sex: F
Age: 43
State: FL

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

Lab Data: 3 MEDICATION SCRIPTS AND LAB WORK DONE ON 2/17.

Allergies: NON

Symptoms: PATIENT CALLED AT 9AM 2/17 NUMBNESS TO FINGERS, VEINS IN HANDS EXPOSED AND SWOLLEN. BURNING SENSATION TO HANDS. REDNESS TO UPPER LEFT ARM.

Other Meds: NON

Current Illness: NON

ID: 1036526
Sex: F
Age: 39
State: IN

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

Lab Data:

Allergies:

Symptoms: Pfizer was administered as a second dose vaccine instead of Moderna.

Other Meds:

Current Illness:

ID: 1036527
Sex: M
Age: 46
State: GA

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

Lab Data:

Allergies:

Symptoms: LEFT ARM PAIN, OVER ALL MUSCLE WEAKNESS AND PAIN, & FATIGUE.

Other Meds:

Current Illness:

ID: 1036528
Sex: F
Age: 22
State: MA

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

Lab Data:

Allergies: Amoxicillin and penicillins

Symptoms: I vomited 4 times the day following the vaccine.

Other Meds: Minipill birth control

Current Illness: None

ID: 1036529
Sex: U
Age: 87
State:

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

Lab Data:

Allergies:

Symptoms: Nausea, lightheaded, malaise

Other Meds:

Current Illness:

ID: 1036530
Sex: M
Age: 69
State: FL

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

Lab Data: N/A

Allergies: none

Symptoms: Received the vaccine on 2/15/21 at 10:15 am in Left upper arm. Went to bed at approximately 11:00 pm. Started with body chills at approx. 11:00 pm. off and on during the night. Woke up the next morning with muscle and joint aches and feeling weak. Took an Arthritis Strength Tylenol at approx. 8:30 am. on 2/16/21. Felt better but still weak and some muscle aches. So took another Tylenol Arthritis Strength at appprox. 4:30pm. Improved that evening. The next morning symptoms of slight weakness only. Did not take any more medication other than regular daily meds.

Other Meds: Pioglitazone/Metformin15/500mg. 1 tab. daily, Atorvastatin 20mg. 1 tab. daily Telmisartan 20mg. q tab. daily Complete MVI for Men over 50 once daily Glucosamine/Chondroitin 1500/1200mg.

Current Illness: none

ID: 1036531
Sex: F
Age: 39
State: IN

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

Lab Data:

Allergies:

Symptoms: Pfizer was administered as a second dose vaccine instead of Moderna

Other Meds:

Current Illness:

Date Died: 02/16/2021

ID: 1036532
Sex: F
Age: 93
State: MA

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

Lab Data:

Allergies:

Symptoms: Patient was found unresponsive the following day and then pronounced deceased

Other Meds:

Current Illness:

ID: 1036533
Sex: F
Age: 73
State: IL

Vax Date: 02/09/2021
Onset Date: 02/16/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data: none

Allergies: No known allergies

Symptoms: COVID Arm as identified in the literature. 1 week( 2/17/21) after shot reddened raised area about 3x5 oval shape on the R upper arm where shot was given. it is very itchy. not painful

Other Meds: Aspirin 81 mg, Vitamin C 100mg. B12 3000mcg Irbesartan 150 mg B Stress complex Vitamin D Citracal with Vitamin D

Current Illness: none

ID: 1036534
Sex: M
Age: 67
State: KS

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

Lab Data:

Allergies:

Symptoms: Administered Pfizer 2nd dose. Needed Moderna 2nd dose. No adverse effects noticed.

Other Meds:

Current Illness:

ID: 1036535
Sex: F
Age: 40
State: KY

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

Lab Data:

Allergies: Gastric Allergy to zucchini

Symptoms: Days 1-2 after injection: tightness and ache in chest, collar bones, and ribs. Day 3: rash in left armpit Day 4: rash grew, swollen lymph node in left armpit noticeable Day 5: swelling and rash receding, still notable

Other Meds: Wellbutrin, Valium

Current Illness: None

ID: 1036536
Sex: F
Age: 85
State: MA

Vax Date: 01/30/2021
Onset Date: 02/03/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data:

Allergies: NKA

Symptoms: Left arm developed itchiness at site of injection on 4th day after vaccine with swelling and rash. 2/13 - bilateral leg rash, had some swelling to BLE. Pt states used compression stockings, and that it helps with swelling, pt states has bilateral leg swelling at baseline. Pt reports rash is improving, but still present, not spreading. Denies any fevers, red streaks, spreading redness/swelling, CP, SOB, dizziness/weakness, drainage, open areas, or any other associated symptoms. Pt states has been using cool compresses

Other Meds: metoprolol xl 100 mg warfarin 1 mg diltiazem 180 mg XR pravastatin 40 mg multiple vitamins calcium - vit D

Current Illness: n/a

ID: 1036537
Sex: F
Age: 46
State: AL

Vax Date: 02/04/2021
Onset Date: 02/13/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data: Patient is cash pay, uninsured and declines to go to ER or have any further testing. Did give decadron in office on 2/17 to see if it would help. Declines any additional testing.

Allergies: None

Symptoms: Vaccination right deltoid on 2/4/2021. Reports awakened on 2/13/2021 and right arm was tingling and was unable to lift. Seen in office 2/17/2021 and had improved some, can raise arm but unable to grasp pen, significantly weaker than left hand. Reports right hand dominant and unable to type or write at work. Reports some nausea and diarrhea initially following vaccine given on 2/4 that resolved a few days later/

Other Meds: None

Current Illness: None

ID: 1036538
Sex: F
Age: 0
State: WI

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

Lab Data:

Allergies: Penicillin, sulfa

Symptoms: Sore arm, headache, fatigue for 28 hours and self resolved. However I have had what can only be described as ?brain fog? since getting the vaccine. I am normally very on top of my game and have just noticed minor but very atypical changes in my thought processes.

Other Meds: Mesalamine

Current Illness: NA

ID: 1036539
Sex: M
Age: 29
State: IN

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

Lab Data:

Allergies: Penicillins

Symptoms: Stiff arm started one hour after injection. Woke up this morning with chills but no fever. Have had chills and fatigue all day.

Other Meds:

Current Illness:

ID: 1036540
Sex: F
Age: 32
State: WA

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

Lab Data: None

Allergies: NKDA

Symptoms: Fatigue (onset: 10 hours post-dose; length of AE: 12 hours) Body Ache (onset: 10 hours post-dose; length of AE: 12 hours) Headache, severe (onset: 10 hours post-dose; length of AE: 12 hours, took 600mg ibuprofen which relieved the headache)

Other Meds: None

Current Illness: None

ID: 1036541
Sex: F
Age: 43
State: PR

Vax Date: 02/03/2021
Onset Date: 02/05/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data:

Allergies: Dairy products dust, grass

Symptoms: 4 days with increased heartbeat and blood pressure under the normal values, with shortness of breath and dizziness. Felt tingling on left arm and face. Also bone pain and tiredness extreme.

Other Meds: Atenolol 25 mg Loratadine 25 mg Vitamin D 2000 mg Zinc 50 mg Vitamin C 1000 mg Echinacea 1200 mg

Current Illness:

ID: 1036542
Sex: F
Age: 54
State: NY

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

Lab Data: none

Allergies: none

Symptoms: Developed itchy red welt at injection site on day7 post injection.

Other Meds: metoprolol 12.5 QD, lexapro 20mg QD, ASA 81mg QD

Current Illness: none

ID: 1036543
Sex: F
Age: 44
State: NY

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

Lab Data:

Allergies: I am allergic to shellfish Penicillin Bees Iodine

Symptoms: I have had a headache that will not subside, my temperature is currently at 101. My temp was at 102, I took some over the counter Tylenol to try and break my fever. I have had the chills, it seems as if I can't get warm, and my legs are aching really, really bad.

Other Meds: Over the counter Tylenol.I have take 2000 MG in an 9 hour span of time. I also take Phentermine on a daily basis (30 MG 1 capsule per day).

Current Illness: I have no other illnesses that I am aware of.

ID: 1036544
Sex: M
Age: 67
State: NC

Vax Date: 02/05/2021
Onset Date: 02/09/2021
Rec V Date: 02/17/2021
Hospital: Y

Lab Data: CBC, peripheral smear 02/16/2021

Allergies: No Known Allergies

Symptoms: Immune thrombocytopenia

Other Meds: None

Current Illness: Covid-19 on 01/01/2021

ID: 1036545
Sex: M
Age: 66
State: WA

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

Lab Data: Paramedics came 02 17 2021 at about 8am and checked vitals Was told i was having a reaction to the vaccine

Allergies: Quetiapine

Symptoms: Terrible pain left shoulder (deltoid) terrible flu like symptoms, felt like throwing up. .. bad enough symptoms that I called 911 fever of 103.1 for a few hours. This woke me up at 2:30 am Now at about 12:30 pm arm still sore but most other symptoms gone away, but still feel like I got hit by a truck.

Other Meds: Amlodapine meloxicam gabapentin lamotrim bupropion low dose asprin multivitamin 50+

Current Illness:

ID: 1036546
Sex: M
Age: 1
State: WA

Vax Date: 03/21/2019
Onset Date: 03/31/2019
Rec V Date: 02/17/2021
Hospital:

Lab Data: Influenza A positive by NAAT

Allergies: NKA

Symptoms: At 1 year check up on 3/21/19 received MMR, Varicella and Hep A. On 3/31/2019 had a cough and febrile seizure with fever up to 102 F and was diagnosed in ER with Influenza A and febrile seizure (mother had been sick with known influenza as well). Barack's seizure was felt to be a simple febrile seizure in the setting of influenza A infection. He has not had any more febrile seizures since that episode. Mom reports though that she is sure the MMR was the cause and would like it reported.

Other Meds: Multivitamin

Current Illness: Had a mild viral cough at time of vaccination x 1 week was getting better.

ID: 1036547
Sex: F
Age: 67
State: DC

Vax Date: 02/09/2021
Onset Date: 02/15/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data: None

Allergies: none known

Symptoms: On Day 5 (2/14/21), I experienced mild itchiness in the area of the injection. I applied a generic antihistamine cream to the spot. Gained some relief from the irritation. On Day 6 (2/15/21), I still had mild itchiness and noticed swelling and hardness in the area of the vaccine injection. There had not been any changes in diet or use of medication. This irritation did not impede my ability to engage in daily activities. On Day 7 (2/16/21) The area of the injection was now swollen and itches. The area was hard. Why am I having a reaction 7 days after the initial injection. That night, I took 600 mg of generic ibuprofen. On Day 8, today, the swelling has subsided. The hardness has eased. Itchiness is not apparent.

Other Meds: Alendronate

Current Illness: None

ID: 1036548
Sex: F
Age: 82
State: IN

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

Lab Data:

Allergies:

Symptoms: Pfizer vaccine was administered as the second dose vaccine instead of Moderna that was administered as first dose.

Other Meds:

Current Illness:

ID: 1036549
Sex: F
Age: 63
State: OH

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

Lab Data:

Allergies: none

Symptoms: About 20 hours after second dose, I had a fever (4 degrees higher than normal), aching joints and a very sore arm. The fever and aches cleared by 36 hours after the injection.

Other Meds: Vitamins Fluoxetine Trazadone

Current Illness: none

ID: 1036550
Sex: F
Age: 81
State: CT

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

Lab Data: none

Allergies: none

Symptoms: shortness of breath, heavy chest, rapid heartbeat, skipping heartbeat, talked to cardiologist

Other Meds: n/a

Current Illness: heart disease

ID: 1036551
Sex: M
Age: 76
State: IN

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

Lab Data: None

Allergies: Shellfish

Symptoms: 2 days after vaccination, at about 8pm, I felt a shortness of breath. A very uneasy, scary feeling. Slept through the night and have not had any problems since that incident.

Other Meds: Flomax, Centrum Silver Multi-Vitamin, Vitamin C, Vitamin D3, Zinc, Potassium and occasionally 2 Aleve PM before bedtime

Current Illness: None

ID: 1036552
Sex: M
Age: 39
State: GA

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

Lab Data: NA

Allergies:

Symptoms: Was fine after shot and waiting 15 minutes. Later on in the night around 7:30pm felt nauseas and vomited slightly. Next day felt better but continued to feel "drained" like I had the cold of flu. Eventually by the 3rd day symptoms had subsided.

Other Meds: Adderall XR and Multi Vitamin

Current Illness:

ID: 1036553
Sex: F
Age: 87
State: WA

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

Lab Data:

Allergies:

Symptoms: Patient was in the observation area and started to feel strange and her eyes started watering. EMS was on site and initiated blood pressure monitoring. Patients BPwas 174/95 and RR 77. Her blood glucose was 106. Patient stated she didnt take her morning meds. She was monitored for 15 minutes and felt better and went home with her daughter.

Other Meds:

Current Illness:

ID: 1036554
Sex: F
Age: 81
State: MN

Vax Date: 02/11/2021
Onset Date: 02/12/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data:

Allergies: lisinopril

Symptoms: Pt reports incontinence and loss of memory

Other Meds: Complete Medication List (at conclusion of visit): 1) Ventolin Hfa 108 (90 Base) Mcg/act Inhalation Aerosol Solution (Albuterol sulfate) .... Take 2 puffs every four hours as needd for wheezing 2) Incontinence Brief Large (Incontinence su

Current Illness: N/A

ID: 1036555
Sex: F
Age: 44
State: MA

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data:

Allergies: Yes (doesn't wish to provide)

Symptoms: I had a fever over 101,nasal congestion ,headaches, body pain and joint pain lasted 24 hours.The nasal congestion lasted for 2 weeks.

Other Meds: No

Current Illness: No

ID: 1036556
Sex: F
Age: 52
State: FL

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

Lab Data: n/a

Allergies: pomegranate, walnuts, flagyl, motrin, latex, raspberries,

Symptoms: Staff member felt muscle twitching sporadically 1-2x starting 10 minutes after vaccination. 1.5 hours after vaccination, staff felt tingling/numbing sensation from injection site down into fingers. No adverse events felt above injection site at this time.

Other Meds: topomax, zyrtec, trintelix, minipres, omega3, vit b 12 complex, balance of nature

Current Illness: n/a

ID: 1036557
Sex: F
Age: 71
State: PA

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

Lab Data:

Allergies: NONE

Symptoms: faces swell dizzy

Other Meds: LEVOTHYROXIN

Current Illness: NONE

ID: 1036558
Sex: M
Age: 69
State:

Vax Date: 02/08/2021
Onset Date: 02/15/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data:

Allergies:

Symptoms: severe fatigue a week after injection for several days

Other Meds:

Current Illness:

ID: 1036559
Sex: F
Age: 34
State:

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

Lab Data:

Allergies:

Symptoms: ?Moderna COVID-19 Vaccine EUA? Red, raised rash on arm near injection site.

Other Meds:

Current Illness:

ID: 1036560
Sex: F
Age: 75
State: FL

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

Lab Data: None

Allergies: None known

Symptoms: Low grade fever Chills Mild headache Tiredness

Other Meds: Restasis - drops for dry eyes Multiple vitamin Supplement of vitamin C and D

Current Illness: None

ID: 1036561
Sex: F
Age: 39
State: CT

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data:

Allergies: Covid-19 Vaccine, Mrna-1273, Lnp-s (moderna) Anaphylaxis Walnut Anaphylaxis Penicillins Swelling Zofran [Ondansetron Hcl (pf)] Other (See Comments) Felt throat closing last time, but resolved on its own. Codeine Tongue Swelling

Symptoms: Pt has h/o HTN (not on medication) and occasional asthma(no hospitalizations), and allergies to Penicillin (tongue swelling), tree nuts (throat swelling), and Bees (local swelling); Pt notes she only takes benadryl for these reactions; she has never been prescribed or used epinephrine. Pt denies heart disease, strokes, diabetes, increased bleeding tendency. No early heart disease in family. LMP in the last week. Pt notes she was supposed to see allergist in past, but has not. Pt was feeling well this morning before she came to COVID vaccine clinic. Pt had received first Moderna Vaccine shortly before 0918am here. At 0938 Pt noted feeling "heaviness" in head and "lump in throat." Pt denied itching/swelling to mouth, itching/hives to body, dyspnea, chest pain, nausea. No lightheadedness/dizziness. Pt walked to stretcher. BP at right forearm was 223/151 and then 221/132 on repeat. Heartrate in 90s. Sao2 on RA 100%. RR 18. Pt notes having high BPs at times, but not often as high here. Pt speaking is slightly hoarse voice. No strider. Pt speaking in full sentences. No oropharyngeal edema. No urticaria. No tachypnea or wheeze. HRT RRR. 2+ left rad pulse. A/P: given Pt's h/o severe allergies and now new Globus sensation and change to voice I discussed with Pt that she was likely having allergic reaction. Given involvement of airway I recommended epi administration to neutralize reaction and transfer to ED for observation. I advised Pt that epi would increase heartrate and blood pressure. I determined benefit of treating anaphylaxis outweighed risk of elevating BP, even though she has hypertensive urgency BP values. Pt has some headache; she could be bordering on hypertensive emergency. I asked pharmacist to call 911 indicating early anaphylaxis and request of paramedic. ~5 minutes after Epi (given at 0942) Pt notes lump sensation and voice improved. I had RN place IV to left AC and gave verbal order for benadryl 25mg IV. Pt notes some nausea and dizziness. Lump sensation continues to improve. EMS arrived ~0950. I gave report to paramedic. I discussed with Pt that I would place referral to Allergy and Immunology; they will determine if and when Pt could receive second moderna vaccine.

Other Meds: norethindrone (MICRONOR) 0.35 mg tablet Sig - Route: Take 1 tablet (0.35 mg total) by mouth daily. - Oral

Current Illness: None

ID: 1036562
Sex: F
Age: 48
State: CA

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

Lab Data:

Allergies:

Symptoms: received 1100 pruritis all over body 1110. pt took benadryl 15-20 minutes prior to arrival due to similar symptoms with first vaccine pt reports improved symptoms at 1140. no sob, throat swelling, lip swelling or visible hives.

Other Meds: benadryl 50mg

Current Illness:

ID: 1036563
Sex: M
Age: 67
State: ME

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

Lab Data:

Allergies:

Symptoms: I experienced the following symptoms beginning approx. 12 hours after receiving the 2nd vaccination shot: Fever of 100.6, chills, nausea, body aches, and overall sluggishness. Symptoms were over within 24 hours. Outcome included loss of 3 pounds!

Other Meds: Rosuvastatin (10 mg), Fenofibrate (48 mg)

Current Illness:

ID: 1036564
Sex: F
Age: 43
State: CA

Vax Date: 02/06/2021
Onset Date: 02/16/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data:

Allergies: Sulfa meds Amoxicillin Foods containing sulfites/nitrites

Symptoms: Itchy large rash on arm formed at injection yesterday and rash on neck today. Rash on arm is still there today. Hydrocortisone cream, my daily Zyrtec (taking previously already for hay fever), cold compresses?helps but doesn?t go away completely

Other Meds: Symbicort Singular Zyrtec Lo loestrin fe Multivitamin Calcium

Current Illness:

ID: 1036565
Sex: F
Age: 74
State: AZ

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

Lab Data:

Allergies: none

Symptoms: low fever chills aches nausea lasted 3 hours

Other Meds: low dose aspirin daily multi vitamin daily

Current Illness: none

ID: 1036566
Sex: F
Age: 29
State: IL

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

Lab Data: n/a

Allergies: amoxicillin

Symptoms: slight fever, swollen arm, and rash

Other Meds: none

Current Illness: none

ID: 1036567
Sex: F
Age: 34
State: MA

Vax Date: 01/27/2021
Onset Date: 01/29/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data: 2/1/21 Fetal US reported as showed fetal demise during week 8, which is the same week as she received the #2 COVID vaccine

Allergies: NKDA, NKA

Symptoms: reports that she was approximately 8 weeks pregnant at the time of her #2 COVID vaccine on 1/27/21. She reports she had a normal prenatal US at 7 weeks. She reports on 1/27/21, she had vaccine side effects of fever/chills, headache, and nausea. She notes on 1/29/21 most of her vaccine side effect symptoms resolved, but she is still suffering from headaches. She also notes that her morning sickness was gone on 1/29/21. She reports she called her OB, he brought her in for a repeat US on 2/1/21. Notes that she has two healthy children and suffered a miscarriage in May 2020.

Other Meds: Pre-natal vitamin and Bonjesta

Current Illness: Reports only morning sickness, related to pregnancy.

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm