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**
PLEASE CHECK BACK SOON
Download the files above while you wait.







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: 1038616
Sex: F
Age: 75
State:

Vax Date: 02/15/2021
Onset Date: 02/17/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Hives neck, shoulders, back, chest, waist. Took Benadryl allergy liquigels pm Feb.17. AM Feb. 18, hives were reduced to only a rash and redness.

Other Meds:

Current Illness:

ID: 1038617
Sex: F
Age: 29
State: CA

Vax Date: 02/05/2021
Onset Date: 02/10/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data:

Allergies: bactrim, tetra

Symptoms: Symptoms reported: headache grand mal seizure. Was transferred to ER on 2/10/21. Per staff report ? I was sitting on the couch, and my partner noticed I have having a seizure, he lowered to me to the ground and called the ambulance. My seizure lasted for 1 minute. When I was in the ER, they gave me 2 bags of fluids, they did an X-ray, CT scan, blood work, and UA, they reported to me that all the result were normal. They did not send me home with any medications. However, they did not clear me to drive. They said that I need to get cleared by a neurologist before I can drive, so that?s why I have not been back to work?

Other Meds: wellbutrin, adderall as needed

Current Illness: none

ID: 1038618
Sex: F
Age: 50
State: NJ

Vax Date: 02/16/2021
Onset Date: 02/17/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data: N/A

Allergies: Allergic to Factive

Symptoms: SORENESS IN LEFT SHOULDER NEXT DAY, RED DOTS ON NECK APPEARED NEXT DAY

Other Meds: Victoza per day, Meformin (4 pills per day), Armour Thyroid

Current Illness:

ID: 1038619
Sex: M
Age: 74
State: FL

Vax Date: 02/12/2021
Onset Date: 02/14/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data: none taken prior to call, recommended he go to a local ER for possible cardiac MI r/o. recommended he go to an ER for reported issues (clammy, SOB, CP). informed him the fatigue can happen post vaccine and can linger for up to 3 days with no real life threating concern; rest would help that issue. However, the other mentioned issues would require immediate eval for a potential MI. He asked if he could see his PCP for this, i recommended against it due to PCP not always having in-house radiographic images, in-house lab testing, and EKG capability. The most appropriate place to go would be an ER. Verbalized understanding.

Allergies: NKA

Symptoms: Date and time of vaccination: (list both if they received both shots): 1-8-21 @ 1:30pm Moderna LOT # 011J20A 2-12-21 @ 1:10pm Moderna LOT # 029K20A SOB 2-14-21 @ about 11:59AM, on 2-15 felt fatigue, 2-16 @ 2-3am felt very clammy, hot without fever, and SOB, CP. reports the issue with the SOB has resolved.

Other Meds: Metformin 100mg BID doxazosin 4mg Daily valsartan 320mg Daily hydrochlorothiazide 25mg Daily lisinopril 10mg Daily ASA 81mg Daily Lantus insulin 75units Daily

Current Illness:

ID: 1038620
Sex: F
Age: 51
State: CA

Vax Date: 02/16/2021
Onset Date: 02/16/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data:

Allergies: nka

Symptoms: chills, slight dizziness, extreme tiredness all the following day.

Other Meds: naproxen

Current Illness: none

ID: 1038621
Sex: F
Age: 45
State: CA

Vax Date: 02/03/2021
Onset Date: 02/04/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data: Had to increase insulin doses

Allergies:

Symptoms: High blood sugar 350-400 for 3 days

Other Meds:

Current Illness:

ID: 1038622
Sex: F
Age: 48
State: MD

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data: None

Allergies: Sunscreen Watermelon, cantaloupe

Symptoms: Hives on chest Rapid heart beat Hands shaking Elevated blood pressure 198/98 All symptoms within 5 minutes of shot Overall shaky feeling the remainder of the day Dull Headache for three days after

Other Meds: Nexium Multi vitamin Nature?s Bounty Stress Comfort

Current Illness:

ID: 1038623
Sex: M
Age: 67
State: MA

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

Lab Data:

Allergies:

Symptoms: Error: Wrong Dose of Vaccine - Too Low

Other Meds:

Current Illness:

ID: 1038624
Sex: M
Age: 68
State: ID

Vax Date: 02/12/2021
Onset Date: 02/14/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data: Eye test, referral to eye doctor.

Allergies: No

Symptoms: Blurry vision

Other Meds: Plavex, linisapril, metropolol, aeztimide, hydrochlorathyazide, gabepentin, aspirin, kril oil

Current Illness: None

ID: 1038625
Sex: M
Age: 54
State: MI

Vax Date: 02/15/2021
Onset Date: 02/16/2021
Rec V Date: 02/18/2021
Hospital: Y

Lab Data: inital CMP 2/16, Daily BMP, Daily CBC, CPK, lactic acid 2/16, Procalcitonin 2/16, Coagulation labs. Warfarin reversal medications 2/16. Blood cultures 2/16, COVID test 2/16.

Allergies: Penicillin VK, Cyclodrine, Tetracycline.

Symptoms: Pt resides at an facility, normally communicative and interactive. Received his second dose of the Moderna COVID-19 vaccine 2/15 and complained of a head ache after. The morning of 2/16 he was found to have a fever of 104.8, altered mental status, possible seizure like activity and taken to ED. ID consulted due to high fever, AMS, LP recommended to rule out meningitis. Due to the patient being on warfarin he needed to be reversed first which was done. The following day he was back to his baseline and afebrile. LP was canceled at that time.

Other Meds: Amiodarone 200mg BID, atorvastatin 80mg daily, benztropine 0.5mg HS, Buspar 15mg TID, Tegretol 300mg TID, Depakote DR 1000mg TID, Famotidine 20mg BID, Synthroid 50mcg daily, Mag OX 400mg bid, Metformin 500mg daily, lopressor 50mg BID, Mira

Current Illness: Leg Swelling, onset 2 years but getting worse. hand Pain, numbness.

ID: 1038626
Sex: M
Age: 56
State: CA

Vax Date: 02/11/2021
Onset Date: 02/15/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data: Lucira test - negative for active Covid 19 infection

Allergies: none

Symptoms: fever,chills and arthralgias days #1-3 post vaccination then - Bilateral eye redness with c onjunctivitis both eyes onset days #4 post vaccination

Other Meds:

Current Illness:

ID: 1038627
Sex: F
Age: 87
State: IL

Vax Date: 02/12/2021
Onset Date: 02/17/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data: N/A

Allergies: NKA

Symptoms: Rash/pustules observed on scalp, shoulders, and chest.

Other Meds: Lexapro, daily

Current Illness: N/A

ID: 1038628
Sex: F
Age: 38
State: MI

Vax Date: 01/30/2021
Onset Date: 02/02/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Body Aches

Other Meds:

Current Illness:

ID: 1038629
Sex: F
Age: 69
State: CA

Vax Date: 02/08/2021
Onset Date: 02/14/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data: none

Allergies: Azytromycim

Symptoms: Joint pain from behind left shoulder to left elbow, tingling and numbness in left hand. Discomfort travels throughout arm

Other Meds: Gemfibrozil

Current Illness: Mild cold two weeks prior

ID: 1038630
Sex: F
Age: 36
State: ME

Vax Date: 01/16/2021
Onset Date: 01/16/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data:

Allergies: Bee stings

Symptoms: Patient reported localized rash to injection site and upper chest/arms starting within minutes of receiving vaccine. With history of anaphylaxis to bee stings, case was transported via ambulance to Hospital ED. Case received Benadryl PO during transport. Upon evaluation at ED, case received steroids and amlodipine, case declined use of epinephrine. Denied breathing or airway difficulties. Rash turned into full body rash once at ED. Case experienced pain at injection x 1 week. Case was not admitted to hospital and was discharged home. Case followed up with her physician who recommends second dose with steroid use prior to receiving.

Other Meds:

Current Illness:

ID: 1038631
Sex: F
Age: 58
State: MA

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

Lab Data:

Allergies:

Symptoms: Error: Wrong Dose of Vaccine - Too Low

Other Meds:

Current Illness:

ID: 1038632
Sex: M
Age: 70
State: VT

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

Lab Data: N/A

Allergies: N/A

Symptoms: During vaccine delivery, the seal between the needle and the syringe failed causing the vaccine fluid to ?squirt out? from the base of syringe all over the patient and the pharmacist who was administering the vaccine resulting in an unknown amount of vaccine?or possibly none at all?being delivered to the patient. Uncertain what to do, the pharmacist called Moderna and was instructed to start over and administer a ?half dose? of instead of a full dose of to the patient, which was completed with no further problems. However, the administration of only the ?half dose? was NOT noted on the patient?s vaccine card at the time, although this seems like very important information.

Other Meds: N/A

Current Illness: N/A

ID: 1038634
Sex: M
Age: 53
State:

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

Lab Data:

Allergies:

Symptoms: Cramping, diarrhea

Other Meds:

Current Illness:

Date Died: 02/07/2021

ID: 1038635
Sex: F
Age: 97
State: SD

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data:

Allergies: Erythromycin Codeine

Symptoms: The patient fell the day after receiving the Moderna COVID-19 vaccine. She broke her hip in this fall. During surgery to correct the broken hip, she went in to sudden and unexpected cardiac arrest. The anesthetist did not notice any ST changes or A fib; dysrhythmia was very unexpected. The patient had a DNR. She died at 13:00 on 02/07/2021. Causes of death are listed as 1. Cardiac Arrest 2. Recent hip fracture with hip placement 3. History of Breast Cancer 4. Hypothyroid and 5. Dementia

Other Meds: Aspirin 81 mg enteric-coated q a.m. Plavix 75 mg po at bedtime Iron, Ferrex-150 25/1/150 tid with meals Folic acid 1 mg bid Metoprolol tartrate 25 mg bid MiraLAX 8.5 gm daily Synthroid 100 mcg a day Tamsulosin 0

Current Illness: A fall occurred on the day after vaccination; she fractured her hip in this fall. The physician reports she went into sudden and unexpected cardiac arrest during surgery and died. Patient had COVID-19 approx 11/06/2020. Possible urinary tract infection on admit for the fall

ID: 1038636
Sex: F
Age: 40
State: KY

Vax Date: 02/14/2021
Onset Date: 02/15/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data:

Allergies: Tape

Symptoms: 1st dose Vaccine 1/9/21; 2nd dose vaccine 2/14/21; developed hives/rash 2/15/21, resolved with Benadryl; developed chest pain, SOA, HA, jaw/teeth pain , and nausea 2/17/21; seen at Clinic 2/17/21 and sent to ED same day for eval; was d/c'd home from ED 2/17/21.

Other Meds:

Current Illness:

ID: 1038637
Sex: F
Age: 75
State:

Vax Date: 02/11/2021
Onset Date: 02/17/1955
Rec V Date: 02/18/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Caller stated she got vaccine on 2/11 and has been fine. She stated last night at injection site it was itchy and she noticed a black and blue mark. She denies fever, redness, SOB and chest pain. She denies she has any other reactions before this. RN reviewed with her to use a cool compress on the the site as it could help with itchy area. RN Advised to call her provider to ask what she could take for to help with itchy arm. RN stated will follow up with her tomorrow.

Other Meds:

Current Illness:

ID: 1038638
Sex: F
Age: 69
State: FL

Vax Date: 02/04/2021
Onset Date: 02/10/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data: took a course of antibiotics as we did not know at the time this was a reaction to be expected

Allergies:

Symptoms: Lymph nodes became inflamed and sensitive around collar bone specifically left side where i had the vaccine

Other Meds: levothyroxin .088 vitamin d c Silver multi vitamin

Current Illness:

ID: 1038639
Sex: M
Age: 62
State: MA

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

Lab Data:

Allergies:

Symptoms: Error: Wrong Dose of Vaccine - Too Low

Other Meds:

Current Illness:

ID: 1038640
Sex: M
Age: 89
State: MN

Vax Date: 02/11/2021
Onset Date: 02/12/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data: NONE

Allergies: NKA

Symptoms: WEAKNESS, BODYACHES, FATIGUE

Other Meds: UNKNOWN

Current Illness: COVID

ID: 1038641
Sex: M
Age: 53
State: FL

Vax Date: 02/13/2021
Onset Date: 02/16/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data:

Allergies: NKA

Symptoms: Acute allergic reaction with skin rash all over the body, intense itching, mildly swollen upper lip. Treated c Solu-Medrol 125 mg IM, went home c Prednisone (20mg) 2 tabs PO qd,, and Benadryl (25mg) 1 tab PO tid; F/U with PCP.

Other Meds: Centrum multivitamins, Fish oil.

Current Illness: None

ID: 1038642
Sex: F
Age: 78
State: AL

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

Lab Data: no

Allergies: no

Symptoms: sore arm, and last night both aching.

Other Meds: asthma medication, acid reflux , Zyrtec

Current Illness: no

ID: 1038643
Sex: F
Age: 38
State: CA

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

Lab Data:

Allergies:

Symptoms: Numbness in left arm. Improving. Acetaminophen 650 mg given.

Other Meds:

Current Illness:

ID: 1038644
Sex: F
Age: 51
State: CA

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

Lab Data:

Allergies: NSAIDS

Symptoms: Left arm felt flush, arm turned reddish pink, left hand felt numb, arm became very warm to to the touch, left hand fingers became itchy. Kept in observation for a couple hours given Benadryl 25mg injection in right arm. Itching stopped. Under observation for additional 20 minutes after Benadryl. Arm was still pink and warm. Given instructions if reaction leaves localized area to go to ER and instructed to use ice pack on hand if itching begins again then sent home. 2/18/21 injection site tender to touch and warmer than other arm with no itching.

Other Meds: Metformin, Insulin

Current Illness: N/A

ID: 1038645
Sex: M
Age: 82
State: MA

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

Lab Data:

Allergies:

Symptoms: Error: Wrong Dose of Vaccine - Too Low.

Other Meds:

Current Illness:

ID: 1038646
Sex: F
Age: 21
State:

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

Lab Data:

Allergies:

Symptoms: patient is experiencing tingling/numbess in RIGHT arm immediately after injection. Patient denies SOB, difficulty breathing or swallowing, swelling of mouth, tongue or lips. RN observed unequal grip strength L>R. Patient reports intermittent lightheadedness, dizziness. RN notified MD to evaluate patient. Around 17.25 patient reports rash has appeared on mid arm. MD notified. CMA, RN or MD remained with patient during entirety of episode. RN recommended patient have a family member or friend transport her home; patient voiced agreement and contacted mother. Patient's mother came to clinic to transport home. Patient transported to lobby at 17.50 in wheelchair.

Other Meds:

Current Illness:

ID: 1038647
Sex: F
Age: 86
State: MN

Vax Date: 02/11/2021
Onset Date: 02/12/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data: NONE

Allergies: NKA

Symptoms: CONFUSION, WEAKNESS, LETHARGY, FEVER

Other Meds: UNKNOWN

Current Illness: DIABETES, HTN

ID: 1038648
Sex: F
Age: 54
State: FL

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data: CBC, CMP, TSH all were normal. EKG also normal . ESR, CRP, IL6 pending

Allergies: none

Symptoms: after 2nd dose Pfizer vaccine got fevers 104, myalgias, atypic chest pain. Fever resolved.' But for several weeks feeling severe fatigue, malaise, still having atypical intermittent CP with intermittent low level tachycardia (low 100?s).

Other Meds:

Current Illness: none

ID: 1038649
Sex: F
Age: 68
State: MA

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

Lab Data:

Allergies:

Symptoms: Error: Wrong Dose of Vaccine - Too Low

Other Meds:

Current Illness:

ID: 1038650
Sex: F
Age: 34
State: WA

Vax Date: 02/16/2021
Onset Date: 02/16/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data: N.A

Allergies: Bananas, all cephalosporins

Symptoms: On Tuesday evening I experienced chills. The following day I had a fever and felt flu like symptoms along with a slight fever. In the middle of the night my fever broke. However, this morning I am really weak, I have a headache and I am nauseous.

Other Meds: One Benadryl, 10 mg Hydroxyzine (As needed), Venlafaxine HCL 75 mg once daily.

Current Illness:

ID: 1038651
Sex: F
Age: 38
State: KY

Vax Date: 02/14/2021
Onset Date: 02/14/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data: None.

Allergies: No known allergies

Symptoms: Around 4-5 hours after the vaccine I developed hives on my neck, chest, face, and legs. I continued to get new hives for about 72 hours, although I developed fewer over time. My right eye also swelled up within 4-5 hours of receiving the vaccine. It went back to normal after about 10-12 hours.

Other Meds: Omeprazole 40mg daily, Had finished a course of Bactrim three days prior to vaccination

Current Illness: Had UTI the week prior to the vaccine

ID: 1038652
Sex: F
Age: 37
State: WI

Vax Date: 02/16/2021
Onset Date: 02/17/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: 1 1/2" hard, hot, red, puffy circle at injection site. Very itchy. Feels like a giant mosquito bite.

Other Meds: MVI, Levothyroxine, Norethindrone acetate and ethinyl estradiol (birth control)

Current Illness: none

ID: 1038653
Sex: F
Age: 85
State: CA

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

Lab Data: none

Allergies: none

Symptoms: Injection site reaction after several hours : pain, tenderness and swelling of the lymph nodes in the same arm of the injection, swelling, (hardness) and redness

Other Meds: none

Current Illness: osteoarthritis in knees

ID: 1038654
Sex: F
Age: 45
State: MO

Vax Date: 02/10/2021
Onset Date: 02/11/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data:

Allergies: No

Symptoms: Was woken up by severe all over body aches and chills. Took temp 101.7. I had extreme fatigue, temp, body aches, and nausea all through the 11th.

Other Meds: Tumeric, Multi vitamin, Vitamin C, Cosamin, Fish oil

Current Illness: None

ID: 1038655
Sex: F
Age: 77
State: MA

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

Lab Data:

Allergies:

Symptoms: Error: Wrong Dose of Vaccine - Too Low

Other Meds:

Current Illness:

ID: 1038656
Sex: F
Age: 50
State: RI

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

Lab Data:

Allergies: Tylenol, citronella, soap, metronidazole

Symptoms: Throat swelling , difficulty swallowing, diff breathing

Other Meds: Ibuprofen, multivitamins, queatepine, melatonin, neodymium, one destroy, gabapentin, ventolin

Current Illness: Asthma, anxiety

ID: 1038657
Sex: M
Age: 31
State: NY

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data: I have not yet had the opportunity to get seen by a provider but I plan on doing so.

Allergies: NA

Symptoms: The vaccine was given in the wrong spot in my arm. It was given on the inside of my shoulder higher than my armpit by the nurse. I sent them a picture and they stated that they think the vaccine hit the deltoid muscle but this does not mean it was in the right spot. I consulted two MD's and multiple other vaccinators who all agree this is not the correct location for administration.

Other Meds: NA

Current Illness: NA

Date Died: 02/08/2021

ID: 1038658
Sex: F
Age: 86
State: DC

Vax Date: 02/01/2021
Onset Date: 02/08/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data: Unclear if the Moderna vaccine was #1 or #2. Vaccination form states is was vaccine #1. But patient checked the box that she had received a vaccine in the past 2-8 weeks on the form. Patient had gone to hospital around 1/4/2021 for fever and had a negative covid test per nursing notes in chart.

Allergies: none

Symptoms: 86yo female alert, stable with ankle abrasion eating 100% prior to vaccine in assisted living facility. On 2/1/2021, received Moderna vaccine. Starting thereafter, eating 50% on 2/2/21. Temperature was 98 tympanic. On 2/3, the leg abrasion started having moderate bleeding. On 2/4, the caregiver noted patient "not looking good, unable to talk, arms moving aimlessly, grasping". BP 95/41, temperature 98, oxygen on room air 92-93%. POA did not want hospital transfer. 2/5 Hospice started, oxygen given, morphine given. 2/5-2/8 comfort care given, patient responsive to tactile stimuli, resting, not taking oral medications or food. 2/8/2021 patient expired.

Other Meds: atenolol, docusate, calcium/vitamin D, furosemide, tamoxifen, multivitamin, trazodone, vitamin b12, vitron C

Current Illness: ankle/leg wound healing and being treated topically

ID: 1038659
Sex: F
Age: 70
State: NJ

Vax Date: 02/10/2021
Onset Date: 02/17/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data: n/a

Allergies: penicillin yellow jacket bees

Symptoms: 7 days post vaccine patient noticed "covid arm" mild-moderate redness, swelling itchy, warm approx sixe 1.5 inches

Other Meds: anaprozole Calcium , vit D, fish oil, mushroom supplements

Current Illness: n/a

ID: 1038660
Sex: F
Age: 75
State: WA

Vax Date: 02/16/2021
Onset Date: 02/16/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data:

Allergies: Quinolone, Azithromycin, Bactrim, Erythromycin, Levaquin, Oxycodone, Penicillin, Tetracycline, Vicodin, Doxycycline, Baclofen

Symptoms: Within 8 hours of administration, experienced fever of 103, nausea, vomiting, diarrhea, and fatigue. Fever resolved with acetaminophen within next 8 hours. Diarrhea, nausea, and vomiting resolved as well within 12 hours.

Other Meds: amlodipine, descovy, edurant, losartan, lovastatin, mirtazapine, gabapentin

Current Illness:

ID: 1038661
Sex: F
Age: 39
State: NM

Vax Date: 02/15/2021
Onset Date: 02/17/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data: None

Allergies: Robaxin Penicillin Lithium

Symptoms: Baseball size knot at injection site with heat and pain present. Swelling and pain in armpit as well. Unable to place arm at side due to pain. Also had systemic: fever, chills, muscle pain, joint pain, fatigue

Other Meds: Ambien Oxicodone Cymbalta Wellbutrin XR Vitamin D3 Omeprazole Gabapentin Ropinerol

Current Illness:

ID: 1038662
Sex: F
Age: 75
State: MA

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

Lab Data:

Allergies:

Symptoms: Error: Wrong Dose of Vaccine - Too Low

Other Meds:

Current Illness:

ID: 1038663
Sex: F
Age: 22
State: MI

Vax Date: 01/30/2021
Onset Date: 01/30/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Headache, fatigue, Temp.102 shaking, chills, heartburn

Other Meds:

Current Illness:

ID: 1038664
Sex: F
Age: 25
State: NY

Vax Date: 02/15/2021
Onset Date: 02/17/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Facial rash

Other Meds: Prozac, Flonase, Levocetirizinedehydro, Estaryla

Current Illness: None

ID: 1038665
Sex: M
Age: 72
State: MA

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

Lab Data:

Allergies:

Symptoms: Error: Wrong Dose of Vaccine - Too Low

Other Meds:

Current Illness:

ID: 1038666
Sex: F
Age: 56
State: MD

Vax Date: 02/14/2021
Onset Date: 02/16/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data: no

Allergies: no

Symptoms: pt stated that she started feeling bad and vomited. She noticed a lump under her left armpit. She stated she had a mammogram a little over a month ago and she did not have any lumps under her armpit at that time. Pt will contact her PCP to make them aware of her symptoms but there are getting better at this time.

Other Meds: no

Current Illness: no

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm