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: 1039221
Sex: M
Age: 76
State: NY

Vax Date: 01/25/2021
Onset Date: 01/29/2021
Rec V Date: 02/18/2021
Hospital: Y

Lab Data:

Allergies: NKDA

Symptoms: Pt is a 76-year old with SIDEROBLASTIC ANEMIA that had been mild and without need for treatment, and IgM MGUS. Presented to ED with newly diagnosed AML, in MDS with WBC counts ~250, 000. He had a normal (EX ANEMIA) CBC on Jan-21. He had COVID vaccine #1 on Jan-25. About 4-days later he developed diffuse dermititis and severe fatigue. He had an ED visit on Feb-8 for these issues and was prescribed Prednisone and Cefalexin (completed Feb-15). CBC was NOT done at that ED visit. He called HEME clininc on Feb-16 (see also the Hematology Note) stating that he was just NOT feeling well in general with increased fatigue and DOE. He noted that the dermatitis was mostly resolved. We rechecked CBC on Feb-17 (results available about 4-PM) that indicated ACUTE LEUKEMIA. Presents to the MC with MDS on FEB18.

Other Meds: Levothyroxine

Current Illness: sideroblastic anemia, BCC. Hypothyrodism, and prostatecancer, SCC

ID: 1039222
Sex: F
Age: 42
State: NJ

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 02/18/2021
Hospital: Y

Lab Data: Patient tested negative for a urinary tract infection on 2/12 at both primary care physician and emergency room. In the emergency room, labs revealed S.creatatine of 1.23 and U/A revealed pyuria. She received CTX and Ativan. Urine and blood cx were sent. Tested positive for UTI based upon receipt of urine via catherization. Patient was admitted to the hospital for further evaluation and management. Blood panels administered since hospital admission show stable white blood cell counts within normal range. Lymphocytes continue to increase and are above what is considered a normal range.

Allergies: None noted.

Symptoms: Rapid onset of obsessive compulsive behavior - rearranging of items, movement of items from one place to another, fixation on colors, fixation on color red (fire, danger), sleeplessness, confusion, irritability, jumbled memory recall Sunday 2/15 - Manic episode experiencing behavior above plus confusion, anxiety related to events. Episode required call to 911 and assistance of EMS to transport patient to the hospital emergency room for evaluation.

Other Meds: Aripiprazole (ABILIFY) 30 MG tablet 1 daily Fluoxetine (PROZAC) 20 MG capsule 1 daily

Current Illness: Possible urinary tract infection - diagnosed 02/15/21 in emergency room visit

ID: 1039223
Sex: F
Age: 43
State: MI

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

Lab Data: Blood Pressure 140/110 on 02/18/2021

Allergies:

Symptoms: The patient received her vaccine but after few minutes she said that she is feeling dizzy. Blood pressure checked and it was 140 over 110. We kept monitoring the patient for 15 more minutes but she said I am feeling okay after that. At 3:20 PM, we called her and she said she left early from her job to home and she is feeling fine now.

Other Meds:

Current Illness:

ID: 1039224
Sex: F
Age: 74
State: UT

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

Lab Data:

Allergies:

Symptoms: Pt was given the Moderna vaccine as the second dose in the covid series, however they received the Pfizer vaccine as their first vaccine

Other Meds:

Current Illness:

ID: 1039225
Sex: F
Age: 70
State: CA

Vax Date: 02/09/2021
Onset Date: 02/16/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data: None

Allergies: PCN Celexa

Symptoms: Red blotchy rash, near injection site. Slightly raised, warm and itchy.

Other Meds: Losartan L-thyroxine Liothyronine Lexapro Hydrochlorothyazide Vitamin D3

Current Illness: None

ID: 1039226
Sex: F
Age: 81
State: NC

Vax Date: 01/14/2021
Onset Date: 01/17/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data: None

Allergies: Penicillin

Symptoms: Three days after receiving vaccine, patient noticed rash, which turned to whelps on joint areas. This included patient's wrists, knees, buttocks and ankles. She noticed that where pressure was applied and bending was occurring, the itchy whelps would show. Patient took oral Benadryl which calmed itching and redness and saw primary care Dr. as well as rheumatologist for reaction. Triamcinolone was prescribed and patient used to calm itch. This reaction continued to occur for two weeks after the first vaccine. She received her second dose and the same reaction occurred and continues to occur at this time. Lot# for second Moderna vaccine is 013M20A, given on 2/12/2021.

Other Meds: Crestor, Singulair, Synthroid, Leothyronine, Olmesartan, Flovent, Xopenex, Multi Vitamin, Vit D3, Fish Oil, Baby Aspirin, Volteren Cream

Current Illness: None

ID: 1039227
Sex: F
Age: 71
State: NM

Vax Date: 02/09/2021
Onset Date: 02/17/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data: none

Allergies: sulfa sensitivity to tsetse fly bites after several visits to game parks in East Africa

Symptoms: Delayed reaction to vaccine. On day 8 developed an very itchy, red, hot, slightly raised, inflamed area on left upper arm where injection was given approximately 6" x 5" in size. I still have it 2 days later. Called doctor's office to see if I should get my second shot but have not heard back yet.

Other Meds: fluoxetine

Current Illness: none

ID: 1039228
Sex: F
Age: 78
State: CA

Vax Date: 02/06/2021
Onset Date: 02/09/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data:

Allergies: Bactrum

Symptoms: I had a room spinning dizzy spell on the 3rd day after the shot but didn't think too much of it after it passed. The 4th day I remember thinking I felt dizzy again, and the next thing I knew I was on the floor and hit my head really hard. I think I must have passed out for a nano second. (The first time in my life!) On the 8th day, Feb. 14th, I got a rash on the injection site. It was red, swollen, hot and shaped like a square about 2 inches diameter. I haven't had an event since.

Other Meds: none

Current Illness: none

ID: 1039229
Sex: F
Age: 66
State: PR

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

Lab Data:

Allergies: Aspirin Codeine MSG

Symptoms: 2 hours after receiving the vaccine I had a nosebleed on the left side of my nose.

Other Meds: Singulair 10mg Neurontin 100mg Breo Ellipta Vit C 1000mg Omega 3 Vit D3 Turmeric 800 mg capsules Moringa capsules

Current Illness: Colitis Asthma Diverticulosis Arthritis

ID: 1039230
Sex: F
Age: 57
State: CA

Vax Date: 02/12/2021
Onset Date: 02/15/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data: Eye exam to be performed on 2/19/2021

Allergies: Penicillin

Symptoms: 3 days post vaccine I began showing signs of shingles on the left side of my face, about 10:00 am-confirmed by Dr. Began treatment of Valacyclovir HCL 1gram, Methylprednisolone 4mg, & gabapentin 300mg

Other Meds: Vyvanse, Dexilant, Armour Throid, Levocetirizine, paroxetine, quercetin with bromelain, vitamin D,C,B12, sinuplex, inflavonoid intensive care, metabolic synergy, zinc, probiotics

Current Illness: None

ID: 1039231
Sex: F
Age: 31
State: IL

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

Lab Data:

Allergies: None

Symptoms: I had facial numbness only on my left side of my face. I also had some facial swelling on my left side of my face and my left eye has blurry vision.

Other Meds: JUNEL FE TABLET

Current Illness: None

ID: 1039234
Sex: F
Age: 35
State: WI

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

Lab Data:

Allergies:

Symptoms: LIGHTHEADED, DIZZY

Other Meds:

Current Illness:

ID: 1039235
Sex: F
Age: 49
State: ID

Vax Date: 02/09/2021
Onset Date: 02/13/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Dose 2- Severe Gastrointestinal discomfort, inducing nausea Neurological effects - headache, disassociation

Other Meds: Astelin Nasal

Current Illness: None

ID: 1039236
Sex: F
Age: 36
State: IL

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

Lab Data: none

Allergies: none

Symptoms: 22 weeks pregnant. rigors, fevers, body aches, fatigue, headache

Other Meds: pre natal vitamins, zinc, vitamin C

Current Illness: none

ID: 1039237
Sex: F
Age: 42
State: ID

Vax Date: 02/04/2021
Onset Date: 02/13/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Itching and feeling off over a week post second dose. The following day I was extremely tired and weak. By that evening, day 9 or 10, I began vomiting followed by horrible diarrhea that lasted about 12 hours. I never thought it was related to the vaccine until I heard from others that had the same symptoms days after their vaccine.

Other Meds:

Current Illness:

ID: 1039238
Sex: F
Age: 43
State: IL

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

Lab Data:

Allergies: none

Symptoms: lips swollen for 5 days and a rash on neck.

Other Meds: birth control

Current Illness: none

ID: 1039239
Sex: F
Age: 79
State: NC

Vax Date: 06/30/2020
Onset Date: 07/01/2020
Rec V Date: 02/18/2021
Hospital:

Lab Data:

Allergies:

Symptoms: HIVES, RASH

Other Meds:

Current Illness:

ID: 1039240
Sex: F
Age: 40
State: WI

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

Lab Data:

Allergies:

Symptoms: HEADACHE, HOT FLASH, "BUZZED TYPE FEELING"

Other Meds:

Current Illness:

ID: 1039241
Sex: F
Age: 71
State: GA

Vax Date: 01/27/2021
Onset Date: 01/29/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data: Blood work - normal, physical exam including heart, lungs, abdomen. Normal

Allergies: None known

Symptoms: Tremors, chills, night sweats, headache, fatigue,

Other Meds: Myrbetriq, ezetimibe, vitamins Bcomplex, D, C, Multi vitamin, COQ10, Biotin

Current Illness: None

ID: 1039243
Sex: M
Age: 67
State: PA

Vax Date: 02/13/2021
Onset Date: 02/14/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data:

Allergies: N/A

Symptoms: Left ankle, right knee swollen and painful, Difficulty standing up Left Knee is swollen and painful. Injection sight left arm is very sore Fever: 101 Primary care physician contacted by phone. Maybe a flair up of gout or arthritis?? 2/17/2021 - Fever gone. Walking painful but not as severe. 2/18/2021 - Ankles and knees still sore

Other Meds: Metformin, Glipizide, Multi-Vitamin, Vit. C, OPC Antioxidant

Current Illness: One prior - gout &/or arthritis flare-up

ID: 1039244
Sex: F
Age: 24
State: MA

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

Lab Data:

Allergies: Azythromicin

Symptoms: Overnight experienced fever, chills, fatigue. In morning experienced fatigue, lightheadedness, headache, and nausea

Other Meds: Cetirizine, vitamin D, vitamin C, echinacea, zinc

Current Illness: N/A

ID: 1039245
Sex: F
Age: 46
State: HI

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

Lab Data:

Allergies: Contrast dye, Gadolinium containing compounds

Symptoms: After receiving first dose of COVID-19 vaccine patient began experiencing jaw numbness on both sides and numbness of the arm. Was brought into ED where she denied any slurred speech, headache, chest pain, or shortness of breath. Denied any hives or itchiness, dizziness, or syncope. Blood pressure in the ED was 186/99 30 minutes after shot.

Other Meds: Lisinopril

Current Illness:

ID: 1039246
Sex: F
Age: 85
State: DE

Vax Date: 02/01/2021
Onset Date: 02/09/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data:

Allergies:

Symptoms: The patient received her first dose of COVID 19 vaccine at her living facility on 2/1/21 and did not remember this. She received the vaccine at our office on 2/9/21 which was only 8 days after the first one. Pt did not have any SE but the vaccine's were not given the recommended 21 days apart.

Other Meds:

Current Illness:

ID: 1039247
Sex: F
Age: 72
State: IA

Vax Date: 02/12/2021
Onset Date: 02/15/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data:

Allergies: sulfa antibiotics

Symptoms: Patient describes a rash on a majority of her body. It is tolerable during the day but is quite itchy at night. Has taken diphenhydramine to help with itch.

Other Meds:

Current Illness: Had finished antibiotic (unknown) therapy the day before vaccination

ID: 1039248
Sex: F
Age: 26
State: NE

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

Lab Data: n/a

Allergies: None

Symptoms: -Fever off and on, chills, body aches treated with Tylenol, resolved within 48 hours -Sore lymph nodes in armpit and neck, still present -Fatigue gone within 48 hours -Difficulty breastfeeding (very slow or no letdown) for 24 hours, resolved now

Other Meds: Daily prenatal vitamin

Current Illness: None

ID: 1039249
Sex: F
Age: 43
State: CA

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

Lab Data: Blood pressure, pulse, O2 within normal

Allergies: SSRIs

Symptoms: Fever 100.5 x 16 hrs Body aches, mild x 16 hrs

Other Meds: Propranolol

Current Illness: None

Date Died: 02/18/2021

ID: 1039250
Sex: M
Age: 93
State: WA

Vax Date: 01/30/2021
Onset Date: 02/14/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data: Medical Examiner's Office will perform postmortem COVID-19 testing at this time.

Allergies: unknown

Symptoms: Daughter of decedent reported that he quickly declined within 2 weeks of receiving vaccine and developed shortness of breath. Decedent received vaccine 1/30/2021 and died 2/15/2021. Only received first dose of series.

Other Meds: unknown

Current Illness:

ID: 1039251
Sex: F
Age: 46
State: IL

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

Lab Data: None

Allergies: Sulfa

Symptoms: Raised, hard, red patch at site of injection. Approximately 2 inches in diameter. Itchy.

Other Meds: Lexapro 10 mg; vitamin D 5000mg; vitamin B complex

Current Illness: None

ID: 1039253
Sex: M
Age: 86
State: MN

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

Lab Data:

Allergies:

Symptoms: Weak, tired, not feeling well. Admitting to the hospital

Other Meds:

Current Illness:

ID: 1039254
Sex: F
Age: 31
State: IL

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

Lab Data:

Allergies:

Symptoms: Fever, chills, fatigue, redness and swelling of injection site, aches

Other Meds:

Current Illness:

ID: 1039255
Sex: M
Age: 86
State: SD

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data: none

Allergies: simvastatin, lovastatin morphine, codiene, hydroxyzine,

Symptoms: Patient reports having flu like symptoms after receiving vaccination for 3 days

Other Meds: ASA , fish oil, vitamin e,b, Kphos, thyroid tab, ezetemibe, amlodopine, Dm 10 guaifenefen, benzonatate, Vit D2, potassium chloride, nitro gycerin, isosorbide

Current Illness: none

ID: 1039256
Sex: F
Age: 18
State: MI

Vax Date: 11/16/2020
Onset Date: 11/18/2020
Rec V Date: 02/18/2021
Hospital:

Lab Data: X-ray conducted on 12/21/20 by Dr. at, Orthopedics.

Allergies: allergic to amoxicillan

Symptoms: Shot was administered too high into left arm, causing pain within first few days. Pain grew worse and was reported to Facility on 11/24/20. Went to see pediatrician on 11/30/20 and she reviewed condition. Pediatrician referred Patient to Orthopedic speicalist. Visited Orthopedic on 12/21/20 and was prescribed two medications. X-ray was taken on 12/21/20. This helped pain until 2/16/21, extreme pain is recurring now when left arm is moved back. May have permanent damage to arm due to improper placment of injection.

Other Meds: Concerta XR

Current Illness: n/a

ID: 1039257
Sex: F
Age: 77
State: MO

Vax Date: 02/03/2021
Onset Date: 02/11/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data:

Allergies: asa, codeine, sulfa

Symptoms: local site redness and tenderness that went away after a few days, then approx 8 days later developed a rash under initial site, described by pt as round rash size of a large orange, red rash had red dots in it, denied fever, pain, itching

Other Meds: buspirone, calcium, vitamin d, hctz, levothyroxine, melatonin, mvi

Current Illness: none

ID: 1039258
Sex: F
Age: 94
State: WI

Vax Date: 02/12/2021
Onset Date: 02/15/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data: ekg

Allergies: n/a

Symptoms: weak, sick, chest pains

Other Meds: losartan 100mg, hydrochlorothiazide 12.5mg,

Current Illness: n/a

ID: 1039259
Sex: F
Age: 59
State: WA

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

Lab Data:

Allergies: per pt report: Eggs (angioedema), iodine (anaphylaxis), penicillin (hives), prednisone (hives), shellfish (anaphylaxis)

Symptoms: Pt received Moderna Covid dose IM in left deltoid approximately noon on 2/17/21. Pt contacted clinic on 2/18/21 around 1030am and c/o onset the evening of 2/17 (day of shot) of low grade fever and hot rash on face that consisted of purple dots. No other rash on body but endorsed itching at injection site. Pt reports feeling lightheaded/ dizzy and very nauseous. Answering (also reporting) provider was concerned for possible ITP, and advised pt to go to ED for labs including CBC and physical exam. At this time we have not heard further from the pt, they are expected to go to the ED today. Labs have not yet been performed/ reported. The outcome is not yet known in terms of what care will be needed.

Other Meds: Mirtazapine, suboxone,

Current Illness:

ID: 1039260
Sex: M
Age: 68
State: FL

Vax Date: 01/09/2021
Onset Date: 01/10/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data: no

Allergies: Pril family meds, bee stings

Symptoms: Later that night I developed significant ataxia, fever and a significant headache. It felt as if I was paralytic. I treated it with ibueprophen and tylenol. I was given a liter of fluid because I felt dehydrated which did make me feel better and the symptoms lasted about 6hrs but the headache and chills lasted about 24 hr and symptoms subsided after that.

Other Meds: HCTZ, Protonics, Losartan, Metformin, Multivitamin, Aglemibride, Plavix, Atorvostatin, baby aspirin

Current Illness: no

ID: 1039262
Sex: F
Age: 60
State: DC

Vax Date: 01/18/2021
Onset Date: 02/03/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data:

Allergies: sulfa drugs

Symptoms: Rash on torso consistent with shingles; treated with valacyclovir

Other Meds: acylovir and vitamin D

Current Illness: multiple myeloma

ID: 1039263
Sex: M
Age: 94
State: MN

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

Lab Data:

Allergies:

Symptoms: Falls, weakness

Other Meds:

Current Illness:

ID: 1039264
Sex: F
Age: 74
State: FL

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

Lab Data:

Allergies: Sulfa drugs, morphine

Symptoms: I woke up with a swollen and red and itching around the injection site one week after getting the Moderna COVID 19 Vaccine . I'm taking Benadryl, icing the area, and using benadryl gel. I read online that this is considered COVID arm and is "delayed cutaneous hypersensitivity" according to what I've read. Supposedly this should subside within 2 days....

Other Meds: Atenolol 25 mg, Synthroid/L-Thyroxine 75 mg, Hydrochlorothiazide 25 mg, Protonix/pantoprazole Sod Dr 40 mg, Simvastatin 20 mg, Vit D3 20000 IU

Current Illness: None

ID: 1039265
Sex: F
Age: 60
State: IL

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 02/18/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Numbness and tingling in the right lower leg that is occasionally felt in the toes.

Other Meds:

Current Illness:

ID: 1039266
Sex: F
Age: 45
State:

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

Lab Data:

Allergies:

Symptoms: Chills, low grade fever, Massive headaches and bodyaches

Other Meds:

Current Illness:

ID: 1039267
Sex: F
Age: 72
State: MA

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

Lab Data: n/a

Allergies: flonase, gluten

Symptoms: large welt (5-6 inches), red, hard, hot, itchy, painful

Other Meds: synthroid

Current Illness: none

ID: 1039268
Sex: F
Age: 73
State: VA

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

Lab Data: None

Allergies: Sulfa

Symptoms: Chills. Exhausted, pins and needles in legs, sore leg muscles

Other Meds: Atorvastatin. Lyvothyroxine rizatriptan

Current Illness: None

ID: 1039269
Sex: F
Age: 52
State: CA

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

Lab Data: Observation

Allergies: Beef jerky ( anaphylaxis) Penicillin Cristallin ( dilutant) NOT penicillin

Symptoms: Delayed allergic reaction on injection site . ?COVID Arm ? Popular round lesion, edema, redness aprox 5 cms diameter.

Other Meds: Excedrin 500mg Benazepril 20mg Synthroid 75 mcg

Current Illness: Asthma Hypertension Autoimmune Hypothyroidism

ID: 1039270
Sex: F
Age: 38
State: WA

Vax Date: 02/01/2021
Onset Date: 02/14/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data: Seeing allergist today, and have been seen by 2 doctors in the hospital as of today.

Allergies: Adhesive tape (medical), Codeine (nausea).

Symptoms: Full body rash, wide spread raised welts, hives, rashes, hot to touch. Temperatures between 100-102, tightness of throat, Benadrly and Zyrtec in double doses no to alleviate the throat tightness and full body rashes. The rashes and throat tightness began at day 5, and have worsened each day. Today is day 10, Starting Prednisone in hopes to get relief, as well as inhaler and Epi-pen prescribed as each night it seems to get worse. No history of any adverse reactions to any other vaccines or shots.

Other Meds: Celexa, Strattera, Probiotic over the counter, Adult multi-vitamin.

Current Illness: none.

Date Died:

ID: 1039271
Sex: M
Age: 90
State: WI

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

Lab Data:

Allergies:

Symptoms: Gentleman received his 1st Moderna dose on Thu. 2/11 at 0849. Vaccination protocol was completed. Pt reported feeling fine, no fever, and that he had no allergies which would prevent him from getting the vaccine. Pt played cards with friends later that day 2/11, but left at 1930 (normally plays late into evening) telling his companions he didn't feel well and his neck hurt. A welfare call was completed on Sat. 2/13, and the patient was found deceased in the bathroom by his son. It appears patient fell off toilet and hit his head on the tub. Pressure ulcer present under injection site. The presumed time of death was Thur. evening.

Other Meds:

Current Illness:

ID: 1039272
Sex: F
Age: 72
State: GA

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

Lab Data: none

Allergies: Iodine

Symptoms: Swollen, red arm, warm to touch with arm pain

Other Meds: statin

Current Illness: none

ID: 1039274
Sex: F
Age: 72
State: GA

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

Lab Data: vital signs were monitored.

Allergies: nka

Symptoms: ~ 10 minutes after receiving the vaccine, patient began feeling dizzy and then felt hotter than normal with facial flushing noted. Vital signs were taken. Initially B/P 132/84, pulse 97, O2 sat. 97%. No loss of conciousness. Remained awake, alert, responsive and oriented x 3. Husband in vehicle during entire time. Staff assisted patient in reclining seat. Continued to monitor vital signs. B/P 126/82, pulse 74, O2 sat 97% 5 minutes later. ~ 10 minutes later, vital signs were B/P 120/72, Pulse 70, O2 sat 97%. Patient felt "back to normal self" about 5 minutes after feeling first signs. Patient states 120/70 is her baseline.

Other Meds: none

Current Illness: no

ID: 1039275
Sex: F
Age: 77
State: CA

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

Lab Data: none

Allergies: epinephrine. niacin.

Symptoms: Fever started within a couple of hours the first night, didn't take temp during night but could feel that it was VERY hot. Extreme arm pain thru night and achy. Next day, fever of just under 100o (my normal is 97.6) all day (didn't take any pain relievers or fever reducer), exhaustion, achy, felt yucky. fever started to go down very slightly until normal by bedtime. Next morning: no appetite, fever gone, exhaustion and less arm discomfort. Today

Other Meds: none. didn't take my dietary supplements that morning

Current Illness: none

ID: 1039276
Sex: F
Age: 80
State: MN

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

Lab Data:

Allergies:

Symptoms: Falls, weakness

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm