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: 1036969
Sex: M
Age: 72
State: CA

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

Lab Data: none

Allergies: UNKNOWN

Symptoms: Gave pt COVID vaccine yesterday morning. Was using a different syringe than normal and accidentally gave pt 1 mL instead of 0.5. Called pt 2/16/21 at 3 pm said he was doing fine just had a sore arm. Told him to call me back if he is having any issues.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1036970
Sex: M
Age: 78
State: CA

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

Lab Data: None

Allergies: No known drug or food allergies

Symptoms: Patient received 2nd dose Pfizer COVID 19 vaccine today. The patient was observed for 15 minutes without incident. After he left the facility, it was discovered that the patient received undiluted 0.3ml Pfizer COVID 19 Vaccine. Physician contacted tried to contact patient immediately after discovery of the incident X 2. Voice mail was left. At 6:15, physician was able to reach patient who reported that he felt fine. He was advised to contact physician or his primary care physician for any minor symptoms. For significant symptoms he is to contact 911 for immediate assistance. Doctor reached out to him again today, 2/17. Per patient, he feels fine.

Other Meds: PGE1-Papaverine-Phentolamine 10 mcg-12 mg-1 mg/mL Inj Inj Abiraterone (ZYTIGA) 250 mg Oral Tab predniSONE (DELTASONE) 5 mg Oral Tab insulin syringe-needle U-100 (BD Insulin Ultra-Fine) 1 mL 30 gauge x 1/2" Misc Syringe Container (BD

Current Illness: None

ID: 1036971
Sex: F
Age: 86
State: CA

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

Lab Data:

Allergies: Aspirin

Symptoms: She had the injection with no effect until a week later. The vaccine site became red and hot to the touch and tender. The redness and swelling traveled down her arm to her elbow. She went to the hospital and received some medication. Her arm is still inflamed and will see her Dr on Friday

Other Meds: Levi thyroxine

Current Illness:

ID: 1036972
Sex: M
Age: 68
State: HI

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

Lab Data:

Allergies: Penicillin, Lisinopril, sulpha drugs, seafood

Symptoms: C/o dizziness post-vaccination. VS@12:55 BP 137/91, pulse 66, RR 16. Referred to EMT: systolic BP 124; EKG showed irregular heartbeat, unspecified. Recommended further assessment by participant's cardiologist. Bottled water given. Client reported feeling better. Stood up and walked a few steps. Coherent, pleasant, answered questions appropriately, appropriate eye contact.

Other Meds:

Current Illness:

ID: 1036973
Sex: F
Age: 27
State: CA

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

Lab Data: N/A

Allergies: Chocolate

Symptoms: Migraine - Resolved within 8 hours Fever - On and off from night of vaccination to present (2/17) Rash on Arm - Appeared within 24 hours after vaccination. Continued to grow over the course of a few days, raised and hot to the touch. I went to urgent care for my fever and rash and was given antibiotics and steroids. I was given Keflex and Prednisone. I am currently on day three of taking both meds. My rash has gone down significantly however I am still feeling dizzy and feverish.

Other Meds: Lexapro, Xanax, Vitamin D3, Biotin, Vitamin B12

Current Illness: N/A

ID: 1036974
Sex: M
Age: 77
State: FL

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

Lab Data:

Allergies: Penicillin, bees

Symptoms: Mini seizure, jerking limbs , eyes rolling in back of head, choking.

Other Meds:

Current Illness: Diabetes, HBP, Obesity

ID: 1036976
Sex: F
Age: 65
State: WA

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

Lab Data:

Allergies: Penicillin, Talwin, Doxycycline

Symptoms: Tennis Ball sized lymphadenopathy right axilla times 5 days before swelling began to resolve

Other Meds: Zyrtec, Famotidine, Omeprazole, Singulair, Estring

Current Illness:

ID: 1036977
Sex: F
Age: 73
State: OH

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data:

Allergies: Penicillin

Symptoms: Fever, chilled and no appetite when waking in the morning. Took Tylenol and rested. Okay by the evening.

Other Meds: Metform

Current Illness:

ID: 1036978
Sex: F
Age: 33
State: CT

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

Lab Data:

Allergies: Banana, almonds, egg, gluten

Symptoms: Pt developed an anaphylaxis reaction to vaccine with resultant "throat tightening" and voice changes. Epi administered. EMS was alerted and patient was transported to the hospital. Of note, prior to leaving she received benadryl.

Other Meds:

Current Illness:

ID: 1036979
Sex: F
Age: 22
State: MI

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

Lab Data: I have had 3 sets of labs and an MRI tomorrow however my doctor says its all in my head please help me. I dont feel right i need to be able to take care of my husband and kids

Allergies: None

Symptoms: I can not think or remember things my arms go to sleep i cant feel hot and cold i cant drive and i get very winded

Other Meds: Iron Zolof 25mg

Current Illness: None

ID: 1036980
Sex: F
Age: 61
State: AZ

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

Lab Data:

Allergies:

Symptoms: Systemic: Allergic: Anaphylaxis-Medium, Systemic: Allergic: Difficulty Breathing-Severe, Systemic: Allergic: Difficulty Swallowing, Throat Tightness-Severe, Systemic: Confusion-Medium, Systemic: Dizziness / Lightheadness-Medium, Additional Details: 5 minutes after taking the vaccine pt stated that she felt dizzy and lighheaded. After about 10minutes later she started grabbing her throat indicating she cannot breath. we gave her 2 epipens 5 minutes after the 1st dose and called the ambulance

Other Meds:

Current Illness:

ID: 1036981
Sex: F
Age: 70
State: ID

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data:

Allergies: Compazine, demerol, statins and citrus.

Symptoms: Arm pain, diarrhea, syncope, fatigue, rash.

Other Meds: None reported

Current Illness: Runny nose

ID: 1036982
Sex: M
Age: 22
State: WA

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

Lab Data:

Allergies: Golden Kiwi

Symptoms: Chills and sweating, general soreness throughout the body, difficulty catching breath, migraines, lethargy.

Other Meds: Concerta

Current Illness: None

ID: 1036983
Sex: F
Age: 62
State: VA

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

Lab Data:

Allergies:

Symptoms: Error: Wrong Dose of Vaccine - Too Low

Other Meds:

Current Illness:

ID: 1036984
Sex: F
Age: 67
State: VA

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

Lab Data:

Allergies: None

Symptoms: Itchy rash that started one week after injection

Other Meds: Multivitamin, Viactive, turmeric, cinnamon, Claritin, hydroclorothyazide

Current Illness: None

ID: 1036985
Sex: F
Age: 68
State: GA

Vax Date: 01/26/2021
Onset Date: 01/28/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data: None

Allergies: penicillin, epiniphrine, sulfa,

Symptoms: Extreme red swollen knot, itching that could not be tolerated, encompassing whole upper arm. Things done to allieve: ice pack, cortizone cream (which burned so had to be cleaned off). Started when patient woke up in the morning, got progressively worse as the days wore on. Lasted approximately a week.

Other Meds: aspirin, calcium, claritin, coumadin, crestor, folic acid, neurontin, prednisone, prozac, singulair, trelegy ellipta, vitamin b12, lasix, potassium.

Current Illness: covid

ID: 1036986
Sex: F
Age: 68
State: AL

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

Lab Data: None noted

Allergies: NKDA

Symptoms: Patient received COVID-19 vaccination and waited her 15 minutes. As she was walking out to her car her throat and tongue started itching and she was having trouble swallowing. She came back to pharmacy and made us aware. I (the administering pharmacist) went out to her and assessed the situation. I instructed staff to call 911 due to the difficulty swallowing and called for a CODE WHITE. I moved pt to IMZ booth where I further assessed the situation. I did determine that epi-pen was not needed due to the pt breathing well. I did give an oral benadryl . EMT arrived and assessed the situation and instructed pt to go to the ER with them, although the pt refused stating they would go home and go to their MD if needed. I called pt later in the day to check and she was doing ok, but the throat itching did come back after the benadryl wore off, so she took another. I instructed pt that if it has not resolved in by tonight she would need to be seen, she agreed.

Other Meds: None noted

Current Illness: None

ID: 1036987
Sex: F
Age: 81
State: RI

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Error: Booster Given Too Early

Other Meds:

Current Illness:

ID: 1036988
Sex: F
Age: 46
State: CO

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

Lab Data: Feb. 16, 2021 Covid Antibody test to see if had previously and asymptomatic Feb. 17,2021 Antibody test came back negative for Covid antibodies

Allergies: Seasonal allergies and phenobarbitol

Symptoms: Developed rash on lower left back within a day of shot. Rash continued to get worse in pain and spread some, went to doctor?s office 3 days after vaccine for continued severity of rash and waking up that day with a slight droop on right side of mouth and tingling Sensations. Doctor identified rash as shingles and possible bells palsy episode. Mouth droop and tingling went away next day, shingles still present.

Other Meds: Vitamin C and vitamin D

Current Illness: None Checked at obgyn for irregular mensuration premenopausal findings

ID: 1036989
Sex: F
Age: 80
State: CA

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

Lab Data: EKG, Chest X Ray, Cath Lab procedure

Allergies: Sulfa

Symptoms: This person received the 1st dose COVID-19 vaccine Pfizer @ 08:13am. Then @0930 am, c/o "feeling something on top of her chest, heaviness of chest", sweaty hands, clammy, chest pain. Rapid Response Team called at 09:35 am. Transferred to Emergency Room. In ED: Diagnosis included but not limited to STEMI, NSTEMI, unstable angina, anxiety. At 10:04am- based on EKG, code STEMI was called. Consultation with cardiologist. Then the patient was sent emergently to Cath Lab. The patient was admitted to ICU, intensive care, following Cath Lab

Other Meds: Unknown

Current Illness: Unknown

ID: 1036990
Sex: F
Age: 37
State: NM

Vax Date: 01/22/2021
Onset Date: 02/08/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data: Covid-19 PCR via nasal swab on 2/12 was negative. I haven't been to see a Dr as none of these things have been an emergency, but I am really miserable. I will be seeing my pcp or going to a local ED soon if not feeling better, as I suspect I am getting dehydrated and maybe other tests should be run at this point.

Allergies: Honey bees

Symptoms: For 3 days after the injection I had fever, fatigue, headache, chills, muscle/ joint pain, nausea, diarrhea and injection sit pain, redness, and swelling. Then all the symptoms except for diarrhea went away for 2 weeks. I have a history of IBS, so diarrhea isn't uncommon for me, but I don't typically have it everyday like I am now. On February 8 I began having fatigue and headache. On February 10, my left arm became red, swollen, painful and hot again, just like after the injection. By Feb 11, I started having nausea, more severe fatigue/ headache, chills and I developed a low grade fever @ 100.9. Since then, I have continued to have these symptoms. They are intermittent as far as severity. When my arm really hurts, I'm very nauseated, fatigued, my headache is severe and I typically have a low grade fever. I've also noticed hives on my arm, chest and neck intermittently since Feb 11. I have a history of hives too, but this is usually after eating certain foods. On Feb 11 when I got hives, I hadn't eaten for many hours (I was nauseated) and that is very atypical for me. For treatment, I got a covid for test done on 2/12 that was negative, and I took motrin yesterday for increasing headache, arm pain and fever.

Other Meds: Adderall, gabapentin, xanax, multivitamin/ mineral, vitamin d

Current Illness:

ID: 1036991
Sex: F
Age: 97
State: RI

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Error: Booster Given Too Early

Other Meds:

Current Illness:

ID: 1036992
Sex: F
Age: 81
State: FL

Vax Date: 01/29/2021
Onset Date: 02/03/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Jaw bone popping and sometimes out of place, lower back pain . Reporting for your side effect information only. No need for medical attention ar this time

Other Meds: Jaw pain with popping of jaw bone, lower back pain, hot flashes, low on and off headache pain.

Current Illness: Only glaucoma. I use only eye drops at night. No prescription drugs. I go to gym 3 or 4 times a week.

Date Died: 02/16/2021

ID: 1036993
Sex: M
Age: 73
State: IA

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

Lab Data: Daughter said there was going to be an autopsy because there was no apparent cause

Allergies: noted on admin form: Ibuprofen

Symptoms: Patient reported at review of questionnaire had headache that day. Temp was taken, 97.8, okay. proceeded. Conversing customer friend in store afterward. When timer went off, said he was fine, he and his wife left. Daughter called to store Wednesday morning, said Pt had passed away Tuesday, that it was unknown the cause, and just wanted to let us know. We did not take down her phone number and last name. The patient was a long time customer.

Other Meds: Known Prescription Meds dispensed at pharmacy: Oxycodone/Acet Prn, Gabapentin, Metoprolol, Pantoprazole, Tamsulosin, Atorvastatin, Clopidogrel, Montelukast, Trazodone, Do not have info on OTC or Dietary supplements

Current Illness:

ID: 1036994
Sex: F
Age: 22
State:

Vax Date: 02/08/2021
Onset Date: 02/09/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data:

Allergies:

Symptoms: At spot of injection, red and hot skin, sensitive to touch and clothing, swollen, sometimes itchy.

Other Meds: Effexor and Wellbutrin

Current Illness:

ID: 1036995
Sex: F
Age: 81
State: RI

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

Lab Data:

Allergies:

Symptoms: Error: Booster Given Too Early

Other Meds:

Current Illness:

ID: 1036996
Sex: F
Age: 16
State: CA

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

Lab Data: None

Allergies: Bee stings

Symptoms: 1917 patient reported dizziness, tightness in chest , hyperventilating and pulse rate of 118 bpm.

Other Meds: None reported

Current Illness: Anxiety/panic attacks

ID: 1036997
Sex: F
Age: 47
State: UT

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

Lab Data: none

Allergies:

Symptoms: Tenderness under right arm began on Fri. Feb. 12. The next day, the pain had increased enough that I looked in the mirror, to find a moderately large swelling. It increased in size overnight Sat. Feb. 13. Sunday, the swelling reduced a bit, to the same size I found it originally. It has remained that size - a decent golf ball - since then, Sun. Feb., 13. Though localized tenderness in lymph nodes has decreased quite a bit, I'm now in a significant Fibromyalgia flare (which could also be explained by a change in weather).

Other Meds: Depakote, Celebrex, Duloxetine, Flax Seed Oil, Vitamin

Current Illness:

ID: 1036998
Sex: F
Age: 79
State: IL

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

Lab Data:

Allergies:

Symptoms: Error: Wrong Dose of Vaccine - Too High

Other Meds:

Current Illness:

ID: 1036999
Sex: M
Age: 68
State: WA

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

Lab Data:

Allergies: Comparing, Demerol

Symptoms: Severe pain and swelling in prosthetic left knee times 24 hours

Other Meds: Singulair, Omeprazole, Famotidine, Simvastatin, Flomax

Current Illness:

ID: 1037000
Sex: F
Age: 24
State: GA

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

Lab Data: COVID-19 nasal swab 1/11

Allergies: None

Symptoms: From 3:00pm on 1/8 to the morning of 1/12, experienced high fevers, severe body aches, chills, fatigue, night sweats, and headache. My heart rate was consistently in the 110s-120s and my blood pressure was in the 100s/40s. My highest temperature was 103.5. My fianc? is a nurse who took care of me at home. I alternated Tylenol and ibuprofen for the aches and fever. I slept the majority of each day and was unable to perform my activities of daily life or exercise. I lost my appetite for about 1 week. I had no sense of taste in Sunday, which slowly returned over the next week. I was concerned about the loss of taste so I scheduled a COVID-19 swab which came back negative on 1/11.

Other Meds: Escitalopram 10mg daily, Minastrin 24fe birth control, Floraster probiotic daily

Current Illness: None

ID: 1037001
Sex: F
Age: 81
State: VA

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

Lab Data:

Allergies:

Symptoms: Error: Wrong Dose of Vaccine - Too High

Other Meds:

Current Illness:

ID: 1037002
Sex: M
Age: 76
State: CA

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

Lab Data: None

Allergies: None

Symptoms: Extreme fatigue and weakness; very mild headache

Other Meds: Lisinopril/HCTZ Lipitor

Current Illness: None

ID: 1037003
Sex: F
Age: 17
State: CA

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

Lab Data:

Allergies: NONE

Symptoms: PATIENT GOT THE VACCINE BY MISTAKE AS HER DATE OF BITH WAS 2003 AND ASSUMED SHE IS 18 AND WE CONULTED THE CDC AND THEY TOLD US TO GIVE THE SECOND DOSE OF MODERNA

Other Meds:

Current Illness:

ID: 1037004
Sex: F
Age: 40
State: CA

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

Lab Data: NA

Allergies: Penicillin

Symptoms: nausea, body aches, fever

Other Meds: Levoxyl, Vitamin D

Current Illness:

ID: 1037005
Sex: M
Age: 71
State: FL

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

Lab Data:

Allergies: NKA

Symptoms: Developed shingles the next day. Didn't realize that was what had occurred for several days but it gradually got worse. Not saying the vaccine caused it, as it probably just lowered his resistance, but he is never sick and this has really been hard. Just wanted to to make you aware. His physician did verify that it was shingles but too late to do anything so just waiting it out.

Other Meds: Vitamins

Current Illness: None

ID: 1037006
Sex: M
Age: 72
State: WA

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

Lab Data: None. Right now I am living with it and started taking an antihistamine yesterday.

Allergies: Lipitor

Symptoms: On-and-off tingling in shoulder, upper left arm near area of injection, extending a bit to the left neck area. Also experiencing some itchiness in those areas.

Other Meds: Naproxen, ibuprofen for aches and pains that active people have.

Current Illness: None

ID: 1037007
Sex: F
Age: 57
State: AZ

Vax Date: 02/14/2021
Onset Date: 02/15/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data: N/A

Allergies: None

Symptoms: 14 hours after second shot, I became fatigued, achy and ran a low grade fever

Other Meds: Vitamin C Vitamin D Turmeric

Current Illness: None

ID: 1037008
Sex: F
Age: 58
State: PA

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

Lab Data:

Allergies:

Symptoms: Systemic: Allergic: Anaphylaxis-Severe, Systemic: Allergic: Difficulty Breathing-Severe, Systemic: Allergic: Difficulty Swallowing, Throat Tightness-Severe

Other Meds:

Current Illness:

ID: 1037009
Sex: F
Age: 56
State: OH

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: Vaccine #1- 4 hrs post injection- arm tenderness, 6 hrs post injection severe chills, severe body aches, severe headache, moderate nausea that lasted overnight. aches did not respond to ibuprofen. Mod to severe Headache fatigue and mild body aches remained day 2. Woke day 3 with fever of 101.2 for half the day, and headache persisted for the next 5 days. Large local injection site reaction on Day 4 that persisted for 4- 5 days. Vaccine #2- 4 hrs post injection- arm tenderness, 6 hrs post injection severe chills, severe body aches, severe headache, moderate nausea that lasted overnight. aches did not respond to ibuprofen. Mod to severe Headache fatigue and mild body aches remained day 2. Day 3 large local reaction at injection site, very hot and tender to touch for 4 days. no fever. Headache was only 30 hours.

Other Meds: Pepcid 40 mg bid Vit D 50,000 weekly MVI chewable daily Vit C 1000 daily ibuprofen 800mg PRN

Current Illness: none

ID: 1037010
Sex: F
Age: 69
State: IN

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

Lab Data:

Allergies:

Symptoms: Tinnitus constantly now where previously to vaccine, was rare.

Other Meds: Atorvastatin20 mg

Current Illness:

ID: 1037011
Sex: F
Age: 69
State: NY

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

Lab Data: None

Allergies: Penicillin, Sulfa drugs, CT Scan dye, Dust, Pollen, Mold, Grass, Ragweed, Trees

Symptoms: I had a very sore arm and hand that I could not use. A sore shoulder and neck with a headache and swollen lymph nodes in back of my head and neck.

Other Meds: Levothyroxin, Azelastine eye drops, Azelastine HCI nasal solution, Latanoprost ophthamlic solution, Atrovent HFA

Current Illness: None

ID: 1037012
Sex: M
Age: 62
State: GA

Vax Date: 02/17/2020
Onset Date: 02/17/2020
Rec V Date: 02/17/2021
Hospital:

Lab Data:

Allergies:

Symptoms: About 30 minutes or so after injection, patient had reaction. The patient had really bad tremors, blood pressure was ok but pulse was fluctuating. Nurse was at bedside providing oxygen through mask. He was given aspirin and didn't need EpiPen. 911 was called and patient was transported

Other Meds:

Current Illness:

ID: 1037013
Sex: F
Age: 41
State: CA

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

Lab Data: N/A

Allergies: NKDA

Symptoms: RASH ON INJECTION SITE

Other Meds: Multi vitamins

Current Illness:

ID: 1037014
Sex: F
Age: 81
State: PA

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

Lab Data:

Allergies:

Symptoms: Swelling and redness in left toes causing discomfort when walking.

Other Meds:

Current Illness:

ID: 1037015
Sex: F
Age: 21
State: PA

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

Lab Data:

Allergies: Latex, shellfish, stone fruit

Symptoms: Onset of fever of 101-102 degrees Fahrenheit approximately 45 minutes post administration; poorly controlled with oral acetaminophen. Nausea was also present, but subsided ~5 hours post-administration. Arthralgia, myalgia, and migraine headache severely limiting activities of daily living which were not present prior to administration sustained at time of report. Suspected SIRVA to be evaluated by PCP in one week.

Other Meds: Aimovig 70 mg autoinjector, cetirizine 10 mg, flute alone propionate 59 mcg/actuation, magnesium oxide 400 mg, omeprazole 20 mg, riboflavin 400 mg, cholecalciferol 5,000 IU

Current Illness: N/A

ID: 1037016
Sex: F
Age: 38
State: NV

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

Lab Data:

Allergies: None

Symptoms: Headache, right arm soreness I took Tylenol for pain relief. Symptoms subsided after about 24 hours.

Other Meds: None

Current Illness: None

ID: 1037017
Sex: M
Age: 92
State: MI

Vax Date: 02/08/2021
Onset Date: 02/12/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data: not yet

Allergies: penicillin

Symptoms: rash on chest and arms itches . Dr prescribed methylprednisolone 4 mg

Other Meds: vitamins

Current Illness:

ID: 1037018
Sex: F
Age: 88
State: LA

Vax Date: 01/13/2021
Onset Date: 02/02/2021
Rec V Date: 02/17/2021
Hospital:

Lab Data:

Allergies: Allergic to penicillin,certain tape adhesives

Symptoms: Patient developed severe rash similar to Shingles and has subsequently been diagnosed as Shinglesafter both injections.

Other Meds: Metformin 1000 bid/Gabapentin 300 mg tid/Reloxifene 60 od/Metoprolol 25 od/Levothyroxine 50 mcg Sat,Sun only/Levothyroxine 75mcgMon-Fri/

Current Illness: none

ID: 1037019
Sex: F
Age: 27
State: FL

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

Lab Data:

Allergies:

Symptoms: Fever up to 103 degrees before needing to take Tylenol to reduce symptoms and fever. Full body aches and chills x 6 hours. Throwing up x 4. L side flank pain. Fever from 8 pm to 6 am following day.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm