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: 1040266
Sex: F
Age: 33
State: WA

Vax Date: 12/28/2020
Onset Date: 01/03/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data: Labs and wore a heart monitor for 4 days.

Allergies:

Symptoms: One week after the shot, I started having heart palpitations. Still continues. After the second shot it increases in frequency.

Other Meds: Vitamin C, nyacicin, prerenolactone (acne)

Current Illness:

ID: 1040267
Sex: F
Age: 31
State: SC

Vax Date: 01/20/2021
Onset Date: 01/26/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data: None

Allergies: Sulfa

Symptoms: After one week of shot being administered, injection site was itchy, hard and hot to the touch. Bright red and swollen.

Other Meds: Synthroid , metformin, multi vitamin

Current Illness: None

ID: 1040268
Sex: F
Age: 72
State: CA

Vax Date: 02/08/2021
Onset Date: 02/15/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data:

Allergies:

Symptoms: One week after the vaccine, (on 2/15/21) I began to have a headache and and back and joint pain. I took ibuprofen for relief. Later I noticed a 2" red, raised spot on the injection site. The headache and body aches were gone by the next morning, but the red rash was larger, the area felt warm, and it had started to itch. I used a cortisone cream to relieve the itching. Today (1/18/21) the red spot measures 4" x 3" and the area still is warm and continues to itch. I'm continuing with the cortisone cream. I contacted my primary care doctor and told her of my experience.

Other Meds:

Current Illness:

ID: 1040269
Sex: F
Age: 39
State: PA

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

Lab Data:

Allergies: Haldol

Symptoms: Diarrhea

Other Meds:

Current Illness:

ID: 1040270
Sex: F
Age: 47
State: CA

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

Lab Data: February 3,2021 @ 230pm had a CT scan appt. Results came back normal

Allergies:

Symptoms: On February 2,2021 Tuesday around 1030pm I was sitting on the couch I started to cough and then my hands curled up I started shaking, my eyes rolled back and I lost consciousness, after I came to I didn't remember anything. After it happened I couldn't swallow

Other Meds:

Current Illness:

ID: 1040271
Sex: F
Age: 66
State: SC

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

Lab Data: None.

Allergies: penicillin shrimp seasonal allergies

Symptoms: First I saw spots and then zig- zag lines across the tv-like a visual migraine-this lasted about 10 minutes. During that time I could not comprehend what I was reading on my phone. Shortly after I got a phone call and I could not pronounce three or four words no matter how hard I tried to form those words. Then I was OK. The whole incident lasted around thirty minutes.

Other Meds: Multi vitamin Vitamin D

Current Illness: allergies

ID: 1040272
Sex: M
Age: 70
State: MI

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

Lab Data:

Allergies: None

Symptoms: Chills & shivering

Other Meds: Vascepa, Metaprolol ER, Xarelto, Fenofibrate Nano, Ezetimbe, Cardia XL

Current Illness: None

ID: 1040273
Sex: F
Age: 52
State: IL

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

Lab Data:

Allergies: N/a

Symptoms: Headache, fatigue, body aches all day; chills and fever of 100 starting at 4 pm

Other Meds: Relizen, melatonin, multivitamin, calcium

Current Illness: I might have had a minor cold last week

ID: 1040274
Sex: F
Age: 47
State: NY

Vax Date: 01/23/2021
Onset Date: 01/30/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data:

Allergies: Allergies to fruits like apples, nectarines, pears and raw nuts like almonds Contrast dye during an MRI?

Symptoms: Hives initially in the area of the injection- then became red and very itchy, somewhat raised- about 2 inches by 4 inches

Other Meds: Zyrtec D Multivitamin CoQ10 Prozac

Current Illness:

ID: 1040275
Sex: F
Age: 54
State: CA

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

Lab Data:

Allergies: Pt. reports Mast Cell Activation Syndrome - which she states can cause severe allergic reactions to ?anything?

Symptoms: Pt. request to be lowered to the ground after she ?felt an attack? coming. Reports to having Mast Cell Activation syndrome causing severe allergic reactions & muscle spasms at random. VS 128/86, HR-88, O2 - 98%, 18 - Resp, pt. remained A&O able to answer all questions appropriately, no loss of consciousness. Reports she is currently on medications for syndrome, with last ?attack? 12/2020. EMS activated, pt. & husband refused. Pt. assisted up to chair, monitored for additional 15 min. Reassessment - pt. reports no spasms, no spasms assessed by writer. Pt. states she has returned to her ?normal? other than ?weakness? which she reports is ?normal after attack?. Pt. left to home with spouse.

Other Meds: Cromolyn Sodium - unk. dose QID HCTZ - 25mg QD Atenolol 25mg QD Zoloft 40mg QD Claritin - OTC, unk. QD Zyrtec - OTC, unk. QD Pepcid - OTC, unk. QD

Current Illness: None

ID: 1040276
Sex: F
Age: 70
State: CT

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

Lab Data: n/a

Allergies: NKA

Symptoms: Patient experienced swelling on the left side of her face about 5 hours after the vaccination, went to the ER , was advised to take Tylenol, reported the adverse effect to the pharmacy on 2/18,was still experiencing the swelling of the face and is scheduled to see her PCP on 2/19.

Other Meds: Not known

Current Illness: NOT KNOWN

ID: 1040277
Sex: F
Age: 61
State: PA

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

Lab Data: None needed

Allergies: Zest soap, and epinedrine

Symptoms: Chills for 2 hours but no fever

Other Meds: After vaccination for dental root canal work 2 - 500mg generic acetaminophen, 2 acetaminophen/caffeine tension headache pills, 1 vitamin B6 100mg,some kind of epinephrine free numbing agent for root canal of 3.5 hours approx 5 doses carbon

Current Illness: Right flank pain, sludge in gall bladder

ID: 1040278
Sex: F
Age: 36
State: KY

Vax Date: 01/08/2021
Onset Date: 02/05/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data: Breast ultrasound 2/9/21

Allergies: NKA

Symptoms: Did her Covid the day after my second shot, which was the date listed above. A very mild case. I discovered I was Pregnant between the 2 shots. On Friday 2/5 I noticed my right breast was very tender and had a red quarter sized area under my nipple where there as also a bean sized tender mass. Saw my OB Monday 2/8 after the redness spread and it was more tender, and Ducati discharge. Started on dicloxicillin x2 weeks. US of the right breast showed severe mastitis. Redness increased 2 days later with pain increasing. Still no fever or feeling bad. Started on Bactrim DS and started improving. Today 2/18 still With very mildly tender mass below the nipple back to quarter size. Pregnancy is normal this far.

Other Meds: Prenatal vitamins Zyrtec

Current Illness: N/a

ID: 1040279
Sex: F
Age: 24
State: CA

Vax Date: 01/08/2021
Onset Date: 01/15/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data:

Allergies: NKDA

Symptoms: h/o latent TB of the lung got her 1st dose of Moderna Vaccine at clinic and a week later developed a rash at the injection site associated with itching. Per derm, irritant vs contact dermatits which could be related to the shot. Treated with Lidex ointment and Zyrtec. dermatologist Dr.: Favored Diagnosis: irritant vs contact dermatitis which could be related to the shot

Other Meds: none

Current Illness: none

ID: 1040280
Sex: F
Age: 56
State: IA

Vax Date: 02/03/2021
Onset Date: 02/17/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data: n/a

Allergies: penicillin, latex,

Symptoms: red raised rash around the injection site, hot to the touch, painful

Other Meds: n/a

Current Illness: n/a

ID: 1040281
Sex: F
Age: 32
State: CA

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

Lab Data:

Allergies: Gluten

Symptoms: Persistent Headache, dizziness, disoriented,light headed, nausea, fatigue, body ache, chills, blurred vision, loss of appetite. I was advised to take otc pain relievers, but didn't help. Headaches still have not gotten better yet. Body aches and chills went away after 48 hours.

Other Meds:

Current Illness:

ID: 1040282
Sex: F
Age: 75
State: OR

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

Lab Data: None

Allergies: Codeine, Cipro

Symptoms: 10 hours after vaccination I had chills, fever of 101, aches all over. 12 hours later fever was down to 99 but very tired and no appetite that lasted another day. Today, 2/18/2021) I am still tired and now short of breath.

Other Meds: Eliquis, Estradiol, Multi Vit, Calcium Citrate, Tumeric, D3, Krill Oil, Folic acid.

Current Illness: Sore throat

ID: 1040283
Sex: F
Age: 90
State: MN

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

Lab Data:

Allergies:

Symptoms: Immediately post COVID vaccination to left deltoid site developed bleeding and noted a 5.5 cm hematoma. Guaze wrap and ice pack applied. Patient denied discomfort. Observed for 10 minutes and no other adverse effects noted. Patient instructed to monitor for worsening of hematoma. Notify provider of any concerns.

Other Meds:

Current Illness:

ID: 1040284
Sex: M
Age: 50
State: NY

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

Lab Data: N/A

Allergies: none

Symptoms: Feverish, nausea

Other Meds: Lenvima, everlimonus, oxycontin, gabapentin, omeprazole

Current Illness:

ID: 1040285
Sex: F
Age: 69
State: MD

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

Lab Data:

Allergies: Latex Bentyl Penicillin

Symptoms: The day after the injection I experienced shortness of breath and a pounding heart, especially going upstairs. After several days, it became so severe that I had to lie down to catch my breath after climbing stairs or doing anything remotely strenuous. It would resolve itself after a few minutes of rest. It continued for 6 days and then stopped on the 7th day. I felt fine the day of the injection. I plan to follow up with my primary doctor. As of now, it appears to be completely resolved but I will not take the second dose for fear of a bad reaction.

Other Meds: Metoprolol, 81 mg aspirin Vitamin D, Vitamin B

Current Illness: Autoimmune - Lichen Planus (chronic) w/ alopecia

ID: 1040286
Sex: F
Age: 77
State: CA

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

Lab Data:

Allergies:

Symptoms: Dizziness/lightheaded after getting vaccine. BP 181/111; repeat 174/82 (pulse 73). Given water and crackers. Patient has a history of anxiety and panic attacks.

Other Meds:

Current Illness:

ID: 1040287
Sex: F
Age: 67
State: CA

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

Lab Data:

Allergies:

Symptoms: s/p vaccine administration c/o dizziness, chills, chest tightness. No intervention required

Other Meds:

Current Illness:

ID: 1040288
Sex: F
Age: 24
State: IN

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

Lab Data: n/a

Allergies: unknown

Symptoms: Vasovagal syncope after first dose of Moderna Covid-19 vaccine. After event patient informed staff she routinely has this reaction to medical procedures (lab draws, etc).

Other Meds: unknown - form completed by vaccine clinic nurse

Current Illness: Unknown

ID: 1040289
Sex: F
Age: 45
State: IL

Vax Date: 02/08/2021
Onset Date: 02/15/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data: None

Allergies: Non-severe to dairy and egg

Symptoms: A week after vaccination, I woke with a rash that was itchy, hot and swollen at the injection site. I ended up going to urgent care as advised by my doctor. They are treating it as a puncture wound with steroid and antibiotics, which I have yet to finish and see complete resolution of the reaction.

Other Meds: Hydrochlorothyazide 25mg

Current Illness: None

ID: 1040290
Sex: M
Age: 80
State: MA

Vax Date: 02/08/2021
Onset Date: 02/15/2021
Rec V Date: 02/18/2021
Hospital: Y

Lab Data: CBC revealing low platelet count, WBC and hgb normal.

Allergies: Pravastatin

Symptoms: Severe thrombocytopenia with platelet count of 1,000.

Other Meds: Tramadol, diazepam, finasteride, pancrelipase, allopurinol, hydrochlorothiazide, ezetimibe, Lupron, rivaroxaban, insulin

Current Illness: Prostate cancer, urethral polyp biopsy on 2/4/21.

ID: 1040291
Sex: F
Age: 87
State: NV

Vax Date: 01/01/2021
Onset Date: 01/20/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data:

Allergies: No

Symptoms: Bells palsey left side of face

Other Meds: Synthrode Mexotexate

Current Illness: None

ID: 1040292
Sex: M
Age: 36
State: NY

Vax Date: 01/23/2021
Onset Date: 01/23/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data:

Allergies: Acetaminophen, aspirin, dipyrone

Symptoms: Joint pain, headache, nausea, tiredness, fever

Other Meds: Biktarvy

Current Illness: No.

ID: 1040293
Sex: M
Age: 65
State: CA

Vax Date: 02/08/2021
Onset Date: 02/13/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data: As a precaution, I am having a COVID test administered tomorrow.

Allergies: Solarcaine

Symptoms: Initial reaction was mild: stiffness in my left arm and a runny nose. That passed after two days. Then, five or six days after the injection, I began experiencing chills. They progressed to violent shivering by Feb. 16. On that day, I had a fever of 102. The next day, the fever topped out at 103. Today, my temperature has been dropping. I also have been experiencing itching all over my body.

Other Meds: Prilosec OTC

Current Illness: None

ID: 1040294
Sex: M
Age: 62
State: CT

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

Lab Data: n/A

Allergies: IVP dye

Symptoms: Weakness, flushing, difficulty standing up, Nausea, lightheadedness, rapid heart beat

Other Meds: Lisinopril,, Amlodipine, atorvastatin..metformin

Current Illness: none

ID: 1040295
Sex: F
Age: 51
State: GA

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

Lab Data:

Allergies: unknown

Symptoms: "Pfizer-Bio-Tech COVID-19 Vaccine EUA" Individual received the Pfizer Covid-19 vaccine at 7:00 pm. She began to feel flushed and tingling feeling to her hands and behind her ears. Individual was given Benadryl 50 mg IM. Individual was later discharge home with her husband at 7:55 pm. She appear to be stable and in no further distress.

Other Meds: unknown

Current Illness: unknown

ID: 1040296
Sex: F
Age: 61
State: PA

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

Lab Data: None

Allergies: Zest soap, and epinedrine

Symptoms: Severe chills for 2 hours

Other Meds: After vaccination for dental root canal work 2 - 500mg generic acetaminophen on 02/17/2021, 2 acetaminophen/caffeine tension headache pills on 2/18/2021, 2 500mg generic acetaminophen, 1 vitamin B6 100mg,some kind of epinephrine free numbi

Current Illness: Right flank pain, sludge in gall bladder

ID: 1040297
Sex: F
Age: 39
State: CA

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data:

Allergies: hydromorphone, morphine and hydroxychloroquine

Symptoms: She received 1st dose of Moderna COVID19 vaccine on 1/20. At clinic, around 11:00. Stayed for 30 minute monitoring. Around 25 min felt tightness in her neck, slight shortness of breath, chest pain, and dizzy. Described as mild. Became somewhat worse. Stood up and was dizzy. Took BP, was a little higher than usual. Had some difficulty standing; was advised to go to ED / did not want to go though. Took benadryl and zyrtec. 30-40 min later felt much better. 4 hours later took some add'l antihistamine. Still feeling some chest discomfort intermittently, mild dizzy feeling. She went to ED triage area, appearing as mild at that time (d/n check in though). Went home. Felt much better overnight. (then next 1-2 days had body aches, joint pain etc). symptoms of dizziness, chest tightness, throat tightness after 1st covid vaccine dose (Moderna). Derm rec NOT to receive 2nd dose and allergy updated

Other Meds: unknown

Current Illness:

ID: 1040298
Sex: F
Age: 72
State: GA

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

Lab Data: none

Allergies: Sulfa

Symptoms: Patient stated she has had a reoccurring headache since the day after she got her 2 Covid shot. She also stated she still has some soreness and redness around the site of injection. She stated she has taking some Tylenol and it has helped some.

Other Meds:

Current Illness:

ID: 1040299
Sex: F
Age: 78
State: SC

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

Lab Data: General checkup by a physician

Allergies: Sulfa

Symptoms: Extreme dizziness, it felt like the room was spinning

Other Meds: Atenolol 25mg, atorvastatin 20mg, duloxetune 60mg, hydroclora 12.5 mg, isosorbide, losartin 100, metoprolol 25 mg, omeprazole 20mg

Current Illness: None

ID: 1040300
Sex: M
Age: 41
State: CT

Vax Date: 01/26/2021
Onset Date: 01/31/2021
Rec V Date: 02/18/2021
Hospital: Y

Lab Data: 01/31/2021 through 02/09/2021 Blood tests largely normal 01/31/2021 repeated 02/05/2021Head CT - diffuse subarachnoid hemorrhage 01/31/2021CTA no obvious aneurysms 02/01/2021US transcranial Doppler no vasospasm 02/05/2021 Urinary metanephrines showed elevated normetanephrine and total metanephrines 02/12/2021 CT abdomen --no evidence of pheochromocytoma, but ? renal mass 02/15/2abdominal MRI-hemorrhagic cyst in the kidney, no solid masses Angiogram 02/03/2021 New "beaded appearance" of the bilateral PCAs, SCA, and L PICA. Note is again made of mild narrowing the intradural R vertebral artery. These findings are suggestive of reversible cerebral vasoconstriction (RCVS) syndrome. SAH-associated vasospasm and primary CNS vasculitis are considered less likely.

Allergies: none known

Symptoms: Patient is a 41 y.o. male on no AC/AP with no pmhx reported presents 1/31 PM initially to Hospital for acute onset 10/10 headache refractory to 800mg motrin which started in occipital region then spread to whole head and neck, nausea and vomiting x 3. Symptoms started around 5pm when he was on a conference call and reports he got bad news so was stressed out. Denies any recent trauma. Pt received toradol 30mg, dexamethasone 10mg, benadryl 25mg and reglan 10mg at hospital prior to transfer. CT showed diffuse SAH and CTA showed no signs of obvious aneurysms. He then received 1g IV keppra and was started on Cardene for BP goal <140. He was transferred to NICU for further monitoring. While in the NICU, his exam and imaging remained stable. He underwent CTA which was unrevealing, and DSA which showed evidence of vasculopathy. BPs came down to <160 and he came off of cardene, did not require additional meds. He was transferred to the floor. Upon transfer, he had another thunderclap HA, accompanied by HTN to the 200s systolic, tachycardia to the 120s, diaphoresis, and blotchy macular rash over the anterior shoulders. Imaging was negative for vasospasm or recurrent bleed, and it was felt that patient's presentation was most c/w RCVS. Trigger felt either 2/2 caffeine intake (patient reported drinking 60 oz coffee daily) vs. Sympathetic discharge syndrome such as pheochromocytoma or carcinoid syndrome. LP was performed, which revealed no nucleated cells and protein elevated in proportion to blood, which confirmed the diagnosis of RCVS. Studies were sent off to diagnose carcinoid syndrome and pheo. Patient was started on nimodipine/gabapentin with standing tylenol and PRN oxycodone for breakthrough pain. Within days, the HAs had markedly decreased in intensity. He was taken off of keppra after 1 week with stable exam and no e/o seizures. He was briefly switched from nimodipine to verapamil but switched back prior to discharge. He was discharged with outpatient followup.

Other Meds: none

Current Illness: none

ID: 1040301
Sex: M
Age: 15
State: MN

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

Lab Data:

Allergies:

Symptoms: patient was 15 at time of receiving the dose. He received both doses before age was caught on 1/21 & 2/11. Tried to contact the patient's guardian, but they didn't answer after 3 attempts.

Other Meds:

Current Illness:

ID: 1040302
Sex: F
Age: 50
State: GA

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

Lab Data: Sed rate, (pos) CRP, (pos), ANA (neg), Antistrep (neg), uric acid (neg), cbc, Chem 7, covid (neg). Jan 15 and 23rd I believe.

Allergies: Demerol IM, severe nausea and dizziness requiring hospitalization Hydrocodone severe nausea and dizziness.

Symptoms: Please see weekly and daily updates. They are about 1 week behind timeline. Sxs started same day. Various sxs from high fever 103.1, body pains to complete spine, hips, various toes and left lower back over kidney felt sore.. Now shoulders hurt. Asked job for FMLA forms.

Other Meds: Flonase, Lexapro, Singulair, zyrtec

Current Illness: Not ill.

ID: 1040303
Sex: F
Age: 67
State: NJ

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

Lab Data: After nine days, a red rash in a circular form what is evident around the injection site. The area of the skin seems either swollen or hard and is tender to the touch, as if it were a bruise or punch in the arm.

Allergies: Tetracycline Kiwi

Symptoms: After nine days, a red rash in a circular form what is evident around the injection site. The area of the skin seems either swollen or hard and is tender to the touch, as if it were a bruise or punch in the arm.

Other Meds: Levothyroxine Progesterone

Current Illness: None

ID: 1040304
Sex: F
Age: 43
State: AK

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

Lab Data:

Allergies: Depo-provera

Symptoms: Patient developed itching and pain involving the posterior pharynx. Treated with bendryl liquid 50mg PO. Resolved within 45 minutes.

Other Meds: Armour Thyroid

Current Illness: None

ID: 1040305
Sex: F
Age: 17
State: UT

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Pt. had no adverse reactions to vaccine, vaccine is authorized to 18 and older and pt is 17 years old.

Other Meds:

Current Illness:

ID: 1040306
Sex: M
Age: 56
State: FL

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

Lab Data: Exam by dermatologist - histamine reaction. 2-10-21

Allergies: None

Symptoms: Itching at injection site, soreness at injection site for over one week. Tired and joint pain, itching began to get worse in the next 3 days and moved to my back, legs and soles of my feet. The second week I went to my dermatologist for exam and began taking Zyrtec for allergies which alleviated the symptoms after 5 days.

Other Meds: B-6, B-12, Zinc, Vitamin C

Current Illness: None

ID: 1040307
Sex: F
Age: 31
State: WA

Vax Date: 02/05/2021
Onset Date: 02/07/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data: none

Allergies: NKA

Symptoms: Early miscarriage occurred on Sunday, 2/7/2021. No previous pregnancies

Other Meds: Endometrin, progesterone in oil IM shots, Estrogen pills

Current Illness: none

ID: 1040308
Sex: M
Age: 83
State:

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

Lab Data: COVID PCR and respiratory pathogen panel negative on 2/14/21

Allergies: none

Symptoms: Pfizer-BioNTech COVID-19 Vaccine EUA Patient presented to the ER on 2/14/21 after experiencing night sweats, fevers, urinary incontinence, flank pain, and generalized fatigue for 5 days. Admitted and treated empirically for sepsis. No source of infection found, fevers continued on IV antibiotics.

Other Meds: Metformin, cyclobenzaprine, ciprofloxacin, acyclovir, acetaminophen, larotrectinib, senna, pantoprazole, finasteride, lorazepam, ondansetron

Current Illness: Sepsis, Generalized muscle weakness, hematuria, Acute respiratory failure, hypoxia, cough, congestion, night sweats, flank discomfort, urinary incontinence

ID: 1040309
Sex: F
Age: 67
State: CA

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

Lab Data: None

Allergies: None

Symptoms: 9 days after injection, developed lump with itching and redness. Was warm to touch. Narly a week later symptoms are subsiding.

Other Meds: Losartan, Metformin

Current Illness: None

ID: 1040310
Sex: F
Age: 36
State: CA

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

Lab Data: None

Allergies: Unknown

Symptoms: Per MD, 35 year old female receiving second dose of Moderna Vaccine COVID-19 today. Approximately 10 minutes after vaccination patient complains of lightheadedness, increased by standing. PMH: Anemia, plus h/o vasovagal reactions after blood draws. Allergies NKA, VS-90/60, R 16, P 60, HEENT- WNL. Skin temp- cool. Heart and lungs WNL. Extended observation 45 minutes, given skin temp normal. Symptoms quit. Vasovagal reaction to vaccination resolving. Discharge home no other treatment.

Other Meds: Unknown

Current Illness: Unknown

ID: 1040311
Sex: F
Age: 35
State: AZ

Vax Date: 01/08/2021
Onset Date: 01/09/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data: COVID, but it was negative.

Allergies:

Symptoms: It started with muscle aches and stiffness. Couldn't move my head from side to side. I then got hot and cold flashes, nausea, extreme fatigue and nausea. All of those symptoms lasted about 5 days. I had absolutely no symptoms after Dose 2 besides a headache.

Other Meds: Wellbutrin Celexa Multi-vitamin Ibuprofen

Current Illness:

ID: 1040312
Sex: M
Age: 44
State: CA

Vax Date: 02/10/2021
Onset Date: 02/13/2021
Rec V Date: 02/18/2021
Hospital: Y

Lab Data: EEG: notable for FIRDA lumbar puncture: 5 WBCs, 95% lymphs, glucose 60, protein 62

Allergies:

Symptoms: expressive aphasia. Improved without directed therapy

Other Meds:

Current Illness:

ID: 1040313
Sex: F
Age: 70
State: FL

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

Lab Data:

Allergies: Cipro,Leviquin,sulphuric drugs,Compuzine

Symptoms: Fever of 102.3, very sore arm, nauseous very fatigued, hurt all over, lasted 36 hours.

Other Meds: Nexium,Claritin,krill oil,Lexapro

Current Illness:

ID: 1040314
Sex: M
Age: 65
State: CA

Vax Date: 01/31/2021
Onset Date: 02/02/2021
Rec V Date: 02/18/2021
Hospital:

Lab Data: Hearing test - I had a hearing test on 2/10/2021. They concluded that my hearing is still within the normal range.

Allergies: penicillin

Symptoms: 1) Tinnitus - The principal adverse event was a significant increase in my tinnitus, to levels I hadn't experienced since I originally developed the condition following a viral infection in May 2006. I first noticed mild tinnitus the day after the injection and it gradually became worse over two weeks. [not recovered] 2) Sore arm - I had a hard time lifting my arm the evening of the injection. I recovered in a day. [recovered] 3) "COVID arm" - My right arm became red swollen and itchy for about three days, starting a week after the injection. [recovered]

Other Meds: Rosuvastatin 20mg Ezetimibe 10mg Losartan 25mg Metoprolol 25mg aspirin 81mg

Current Illness: none

ID: 1040315
Sex: U
Age: 74
State: CA

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

Lab Data:

Allergies:

Symptoms: Headache on left side, and blurry left eye; BP 180/100; repeat 174/104. Sent to ED.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm