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: 1041150
Sex: F
Age: 22
State:

Vax Date: 01/28/2021
Onset Date: 02/17/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Delayed menstrual cycle. Typical cycle is 28 days. My cycle after both doses was 47 days.

Other Meds:

Current Illness:

ID: 1041151
Sex: F
Age: 39
State:

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

Lab Data:

Allergies:

Symptoms: swollen lymph area around where she had her lymph nodes removed for masectomy. Swelling goes from her axillia and coming up towards her collar bone-per pt report

Other Meds:

Current Illness:

ID: 1041152
Sex: F
Age: 71
State: TX

Vax Date: 02/09/2021
Onset Date: 02/16/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: NONE

Allergies: NKA

Symptoms: LEFT ARM WITH MODERATE RASH, PT CLAIMS REACTION STARTED A WEEK LATER AFTER VACCINATION. INJECTION SITE RED, WARM TO TOUCH AND IS ITCHING. PT CLAIMS HAS APPLIED OTC CREAMS TO SITE, AND CLAIMS SEEMS A LITTLE BETTER.

Other Meds: FIBER/OTC

Current Illness: NONE

ID: 1041153
Sex: F
Age: 46
State: AR

Vax Date: 01/21/2021
Onset Date: 02/01/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies:

Symptoms: sought treatment at urgent care clinic and was diagnosed with Bell's Palsy

Other Meds:

Current Illness:

ID: 1041154
Sex: F
Age: 60
State: NC

Vax Date: 01/14/2021
Onset Date: 01/27/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies: penicillin, latex

Symptoms: Burning on my skin and itching, not at the site of injection but my whole body. you couldn't see anything . temp was the highest 99.7. we saw regular dr. and then to a rumatologist and he told them that the vaccine caused issue with her RNA. He advised waiting 11 days after the 2nd vaccination to start on prednisone which they will start on Monday. The burning goes away for a few days and then comes back up again all over her body. when her skin touches something it hurts. She describes the feeling lik a very bad sunburn.

Other Meds: hydroxichlorican, Keflex, Lyrica, primero, ibuprofen

Current Illness:

ID: 1041155
Sex: F
Age: 70
State: MN

Vax Date: 02/11/2021
Onset Date: 02/12/2021
Rec V Date: 02/19/2021
Hospital: Y

Lab Data: CSF MRI BRAIN MRI SPINE CBC/ELECTROLYTES

Allergies: NONE

Symptoms: ACUTE LEFT SIDED COSTOPHRENIC PAIN AND NAUSEA WITH RAPID DEVELOPMENT OF BILATERAL NUMBNESS WITH ATAXIA STARTING AT FEET RISING TO GROIN IMMEDIATELY. NUMBNESS AND PARAPLEGIA PERSISTED AND AROSE TO RIBS WITHIN 12 HOURS TWO ER VISITS. HOSPITALIZED AND MONITORED FOR FOUR DAYS DX: ACUTE GUILLAIN-BARRE SYNDROME per NEUROLOGY Received 4 infusions of IViG. 1 infusion per day X 4 days.

Other Meds: ATORVASTSTIN 10 MG q DAY

Current Illness: NONE

ID: 1041156
Sex: M
Age: 76
State: PA

Vax Date: 02/15/2021
Onset Date: 02/15/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: Pt will return to Facility on 3/1/21 to have lab work completed.

Allergies: NKDA

Symptoms: Pt possibly received normal saline diluent instead of the Pfizer vaccine. There was an error in preparation. Pt was contacted on 2/16/21. No adverse reaction reported.

Other Meds: amlodipine 5 mg oral tablet 12/16/2020 take 1 tablet (5 mg) by oral route once daily for 90 days ammonium lactate 12 % topical lotion 07/28/2020 apply to affected area twice daily atorvastatin 40 mg oral tablet 12/17/2020 take 1 tablet (4

Current Illness: Unknown

ID: 1041157
Sex: F
Age: 31
State: MN

Vax Date: 02/17/2021
Onset Date: 02/18/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies:

Symptoms: SWOLLEN ARM, HEADAHCE, NAUSEA, BODY ACHES, FATIGUE, CHILLS

Other Meds:

Current Illness:

ID: 1041158
Sex: F
Age: 74
State: MI

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

Lab Data: SEE ABOVE

Allergies:

Symptoms: Patient Syncope / Fainting unknown cause . Onsite EMS was called vitals were taken BP 132/90 HR 88. Patient refused evaluation/care. Left aginst medical advice.

Other Meds:

Current Illness:

ID: 1041159
Sex: F
Age: 66
State: CA

Vax Date: 02/11/2021
Onset Date: 02/12/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: First 24 hours: Chills, fever, vomiting, unable to keep anything down (even water) for the entire day after the vaccine was given, body aches Second 24 hours: Chills, nausea, fever, body aches Third 24 hours: fatigue, some nausea, occasional chills, body aches Fourth 24 hours: fatigue Finally ALL better!

Other Meds: Humira Baby asprin Atorvastatin Carvedilol Vit. D3 Clopidogrel folic acid Leflunomide Losartan

Current Illness: RA Microscopic Colitis

ID: 1041160
Sex: F
Age: 41
State:

Vax Date: 02/02/2021
Onset Date: 02/05/2021
Rec V Date: 02/19/2021
Hospital: Y

Lab Data: Ultrasound and bloodwork done on 2/ 6/2021. Surgery done on 2/6/2021. Follow up with surgeon was 2/11/2021; he told me the pathology confirmed appendicitis with no additional findings.

Allergies: Shellfish, penicillin, ciprofloxacin, torodal (possible), dogs, cats, dust mites, trees

Symptoms: I started with severe bloating and constipation. Then it progressed over a 12-15 hour period to vomiting and abdominal pain. I went to the emergency room of Hospital, and was diagnosed with appendicitis. I had an emergency appendectomy. I have never previously experienced constipation or symptoms related to appendicitis. After reading about a possible increase in Bell's palsy and appendicitis in the clinic trials, I wanted to err on the side of caution and submit this incident for data purposes and tracking.

Other Meds: Fish Oil, Vitamin D3 (2000 IU), melatonin 6 mg, zinc 12.5 mg, chlorthalidone 25 mg, Potassium CL 20 MEQ

Current Illness: None

ID: 1041161
Sex: F
Age: 30
State: CO

Vax Date: 02/11/2021
Onset Date: 02/12/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Fever, body aches x 3 days, red/painful injection site.

Other Meds:

Current Illness:

ID: 1041162
Sex: M
Age: 67
State:

Vax Date: 02/08/2021
Onset Date: 02/18/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies: Sulfa drugs

Symptoms: Red rash, both arms, small hive-like bumps in rash. Treated with OTC antihistamine.

Other Meds: Diltiazem 120mg, aspirin 80mg, Atorvastatin 20mg.

Current Illness:

ID: 1041163
Sex: F
Age: 54
State: CA

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: EKG- results within normal limits

Allergies: none

Symptoms: The patient received the vaccine at approximately 1:00pm. During the standard observation time, the patient reported that she developed palpitations, dizziness, and headache. She was transferred to the urgent care clinic within the health center approximately 1 hour after receiving the vaccine (2:00pm). Upon arrival to urgent care, the palpitations had resolved, but she continued to have a headache. An EKG was done, and did not demonstrate any acute issues. She was observed in urgent care and discharged home about 2 hours later (4:00pm).

Other Meds: Atorvastatin, Baclofen, Diclofenac, Duloxetine, Loratadine

Current Illness:

ID: 1041164
Sex: F
Age: 49
State: UT

Vax Date: 01/29/2021
Onset Date: 02/05/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: Labs done 2/19/21: vitamin D, vitamin B12, folic acid, TSH, lipid, CBC, COMP

Allergies: none

Symptoms: Severe hair loss

Other Meds: Cyanocobalamin, metformin, vitamin D, ferrous sulfate, levothyroxine

Current Illness:

ID: 1041165
Sex: F
Age: 55
State: AZ

Vax Date: 02/17/2021
Onset Date: 02/18/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: I felt very sick but had no one to drive me to the ER. I took my daily meds, rested, and checked my blood pressure a few times throughout the day.

Allergies: Ciprofloxin, Tequin, pollen, mold, smoke

Symptoms: Ran a fever for 18 hours. It was 103 degrees for the first 12 hours, then dropped to 101. Had body aches including an ear and head ache. My blood pressure went up to 159/60. I was very tired and thirsty all day.

Other Meds: Losartran-HCL, Allegra, Astovastatin, Vitamin D, Aleve

Current Illness:

ID: 1041166
Sex: F
Age: 52
State:

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies:

Symptoms: During the 15 min observation period state 'not feeling right.' When evaluated, patient was tachycardic, diaphoretic, hyperventilating, continued this way for several minutes. Tried to stand but felt dizzy. Medical emergency was called and patient was sent to the emergency room for further observation.

Other Meds:

Current Illness:

ID: 1041167
Sex: M
Age: 77
State: FL

Vax Date: 02/13/2021
Onset Date: 02/14/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: N/A

Allergies: no

Symptoms: I had the shot late afternoon on Saturday and woke up Sunday morning with a major ringing and I would guess 90% loss of hearing in my left ear, to day is Friday and I still am unable to hear anything in my left ear I saw my Docter on Monday and she indicated my ear was a little swollen and gave me a prescription for Methylprednisolone 4 MG and after two days on it I still am unable to hear anything in the left ear

Other Meds: Amlodipine, Pravastin, Clopidogrel, Cyanocbalamin

Current Illness: none

ID: 1041168
Sex: F
Age: 78
State: FL

Vax Date: 02/01/2021
Onset Date: 02/09/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: no

Allergies: Penicillin Sulfa Drugs Codeine Reclast

Symptoms: My arm was sore. there was a little itching. It was later in the evening that I felt very tired. I felt warm but I didn't have a fever. I developed chills. it lasted for several hours.

Other Meds: Synthroid prevacet Januvia vitamin D

Current Illness: No

ID: 1041169
Sex: F
Age: 73
State: FL

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: pending - CBC, CMP + antibody test and neg COVID test s/p vaccine

Allergies: Propofol, tramadol, wheat dextrim

Symptoms: persistent headache, extreme fatigue, nausea and loss of appetite for two weeks s/p vaccine

Other Meds: enalapril, Ibuprofen, Maxalt, hydrochlorothiazide, atenolol

Current Illness: none

ID: 1041170
Sex: F
Age: 67
State: VA

Vax Date: 02/10/2021
Onset Date: 02/18/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies:

Symptoms: large, 4 by 5 inch area, red itchy rash developed nine days after rash on arm below injection site.

Other Meds: synthroid 75 mg, , simvastain 20mg, ramipril 5mg, baby asa, multivitamin,

Current Illness:

ID: 1041171
Sex: F
Age: 0
State: FL

Vax Date: 02/18/2021
Onset Date: 02/19/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: Lab tests are still pending

Allergies: none

Symptoms: Bloody stools

Other Meds: Tylenol, vitamin D supplement

Current Illness: none

ID: 1041172
Sex: F
Age: 63
State:

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Within 1.5 hours of vaccine #1: Eye pain (both), itching without visible rash (left buttock only), thumb pain, brief leg "heaviness" (both) and fatigue, brief RLQ pain, increased tinnitus. The next evening: low back and neck (bone?) pain while attempting to sleep, out of character to usual back pain. By day 3 post injection, left nose tingling similar to onset of cold sore, which included left side of mouth the next day. By 7 days post injection, entire mouth area felt tingly similar to Novocaine wearing off. This lasted 3 days. Now improved. (took B-12 p.o.) Other brief episodes of chest discomfort, gum irritation, and anxiety. Vaccine #2 scheduled for 2/19/2021

Other Meds:

Current Illness:

ID: 1041173
Sex: F
Age: 45
State: OR

Vax Date: 01/22/2021
Onset Date: 02/17/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: 12 hours after vaccine administration developed arthralgia, myalgia, mild fever, stomach queeziness. Nearly 1 month later, developed arthralgia, myalgia, mild fever, stomach queeziness.

Other Meds: Gabapentin, Buproprion, Diazepam, Nikkie (contraceptive), Synthroid, Folic Acid, 81 mg aspirin, Vitamin D (2000 ug),

Current Illness: None

ID: 1041174
Sex: F
Age: 78
State: NJ

Vax Date: 02/17/2021
Onset Date: 02/18/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Fever. Chills As of today 2/19 100 was as high as 101.8 Took advil

Other Meds:

Current Illness:

ID: 1041175
Sex: M
Age: 17
State: CO

Vax Date: 02/13/2021
Onset Date: 02/13/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: None

Allergies: Amoxicillin

Symptoms: Patient was 17 years old. Under the age of 18 and should not have been given the vaccine

Other Meds: Zantac, Flonase inhaler

Current Illness: None

ID: 1041176
Sex: F
Age: 69
State: MN

Vax Date: 02/16/2021
Onset Date: 02/16/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: heavy fatigue, achy

Other Meds:

Current Illness: none

ID: 1041177
Sex: F
Age: 56
State: MI

Vax Date: 02/17/2021
Onset Date: 02/18/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: None stated.

Other Meds: Benadryl and motrin

Current Illness: none

ID: 1041178
Sex: M
Age: 93
State: MN

Vax Date: 02/17/2021
Onset Date: 02/18/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies:

Symptoms: swelling. redness and itching at injection site and surrounding area

Other Meds:

Current Illness:

ID: 1041179
Sex: F
Age: 39
State: MH

Vax Date: 02/05/2021
Onset Date: 02/10/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies:

Symptoms: On the 3rd/4th day AFTER I was vaccinated with Pfiser, I became very swollen all over my body, but ankles and legs, arms and writst, face (not throat) were effected. I also had a rash on my arms and upper chest area. I was told to start taking 10 mg a day of prednisone and it has finally cleared up.

Other Meds:

Current Illness:

ID: 1041180
Sex: F
Age: 54
State: NV

Vax Date: 02/16/2021
Onset Date: 02/16/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: N/A

Allergies: Unkown

Symptoms: Pt received Pfizer vaccine as first vaccine. On 2/16/2021 pt received Moderna for second vaccine. Pt aware and CDC immunization record given to pt. Pt counseled to see physician with any side effects or call 911 with emergency.

Other Meds: Unknown

Current Illness: Unknown

ID: 1041181
Sex: M
Age: 65
State: GA

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

Lab Data:

Allergies: Penicillin

Symptoms: Fever and chills, ear aches both ears, fatigue

Other Meds: Valsartin, pregabalin, simvastatin, xolair, montelukast, baby aspirin

Current Illness: None

ID: 1041182
Sex: M
Age: 71
State: NM

Vax Date: 02/18/2021
Onset Date: 02/19/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Tightness of the left shoulder & stiffness of the necks left side.

Other Meds: Pravastatin, Diltiazem

Current Illness: None

ID: 1041183
Sex: F
Age: 68
State: ME

Vax Date: 02/12/2021
Onset Date: 02/14/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: Stated above

Allergies:

Symptoms: I did experience some headache and lethargy on Sat. so laid low. I did go for a walk about 3:30 walking up hill at times as is usual. I did have an appetite and prepared dinner. I did not go to work (child play therapist). Sunday I felt more myself and did notice the soreness in my arm was surely not as bothersome as with the first shot. Had a very active day, no walk but yoga class. Prepared a nice dinner for VD and settled in to view television later in the evening. Strangely, the memory of the exact nature of how this started eludes me, but I do recall experiencing discomfort in the very upper extremities of my chest. Sharing this with my husband he wondered if it may have had something to do with sleeping on my right side cramping the rib area due to not sleeping on my left side because of the shot. I also pondered if it might be related to my gym workout on Thursday ? I recall feeling tired and headed to bed. I recall awakening to use the bathroom and feeling a slight brief bout of dizziness. When I did awaken the next morning the chest discomfort was still present to I called the Health Center and was advised to go to the ER. The EKG was fine. The troponin level was elevated to 0.19 so I was told I had suffered a mild myocardial infarction and I was going to the ICU.

Other Meds:

Current Illness:

ID: 1041184
Sex: F
Age: 46
State: OK

Vax Date: 02/18/2021
Onset Date: 02/18/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies: azithromycin, penicillin, cefdimir, erythromycin, sulfa drugs

Symptoms: Approximately 5 minutes after the vaccination, felt a heaviness come over whole body, felt anxious. Approximately 50 min after mouth felt fuzzy/tingly, face felt tingling; had a lightening pain go across body.

Other Meds: metformin 1000mg BID, calcium vit D 600/400units daily; gabapentin 100mg two at bedtime; omeprazole 20mg daily; hydrocodone-acetaminophen 7.5/325 one tab BID; morphine sulfate ER 15mg one tab BID; spironolactone 25mg 2 tabs daily; cetirizi

Current Illness:

Date Died: 01/18/2021

ID: 1041185
Sex: M
Age: 86
State: IL

Vax Date: 01/04/2021
Onset Date: 01/18/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: Unknown

Allergies: No Known Allergies

Symptoms: Death within 30 days

Other Meds: Levadopa; colace; lorazepam and morphine

Current Illness: COVID + 12/10/2020 recovered. Placed on Hospice care 10/2020

ID: 1041186
Sex: M
Age: 87
State: MN

Vax Date: 02/17/2021
Onset Date: 02/18/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Temp 99.7, chills and muscle aches.

Other Meds:

Current Illness:

ID: 1041187
Sex: F
Age: 74
State: CA

Vax Date: 02/02/2021
Onset Date: 02/16/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: none. Healing

Allergies: Varied but not really annoying or serious.

Symptoms: Covid arm. Healing

Other Meds: Thyroid, High blood pressure meds, Vitamin D, Zinc, B-12 Estrogen

Current Illness: NONE

ID: 1041188
Sex: F
Age: 64
State: NJ

Vax Date: 02/10/2021
Onset Date: 02/11/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: The day after the first Moderna shot, I noticed small bumps all over my thighs. The next day the bumps were all over my torso, spreading to my arms, and a week later to my neck. It didn't itch at first but 5 days after getting the rash it itches. While noticeable if you look, you can feel it, and it turns red in the shower. I am about to call my family doctor for help with the itching and advice on whether I should have the second dose of vaccine.

Other Meds: Lexapro, Cardizem CD

Current Illness: None

ID: 1041189
Sex: F
Age: 71
State: IA

Vax Date: 02/10/2021
Onset Date: 02/18/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies: Sulfa, Duricef, Niacin, Erythromycin, Levaquin, Morphine, Tape/Steri Strips

Symptoms: Starting 2/18/2021 vaccination site got red and itchy and somewhat warm to touch. A bit raised also .

Other Meds: Amlodipine, Pindolol, Protonix, Fenofibrate, Pravastatin, Vitamin D, Vitamin C, Fish Oil, Folic Acid

Current Illness: None

ID: 1041190
Sex: F
Age: 76
State: AZ

Vax Date: 02/18/2021
Onset Date: 02/19/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: swollen face, sinus pain, sore arm

Other Meds: linvima

Current Illness: cancer

Date Died: 01/27/2021

ID: 1041191
Sex: M
Age: 99
State:

Vax Date: 01/24/2021
Onset Date: 01/25/2021
Rec V Date: 02/19/2021
Hospital: Y

Lab Data:

Allergies:

Symptoms: Decedent had unwitnessed fall out of wheelchair 1/25/21 around 9:43am, denied head strike, pain, discomfort. Around 10:02pm, 1/25/21, decedent noted to have slurred speech and fluctuating HR, transported to Hospital and made cmo.

Other Meds:

Current Illness:

ID: 1041192
Sex: F
Age: 62
State: DE

Vax Date: 02/17/2021
Onset Date: 02/18/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: N/A

Allergies: NKA

Symptoms: Fever , Body aches, Dizziness,Weakness x24 hours

Other Meds: Lisinopril 10 mg PO daily Omeprazole 20 mg PO daily Vitamin D 3 25 mcg PO daily Zyrtec 10 mg PO daily

Current Illness: None

ID: 1041193
Sex: F
Age: 42
State: NJ

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: Blood Work CBC 2/18/21

Allergies: MSG, pollen, dust, mold, sensitive to seafood, nuts

Symptoms: Clammy hands/feet early 5am on 2/13/21, went to ER 2/13/21 due to numbness on R side of face with tingling on R side of head and tightness of neck. 2/14 thrush in mouth 2/15 - achiness L arm 2/16- pain swollen lymph r side, clammy hands persist with foul smell Ongoing tingling in my Whole Back, Fluctuating BP , tachycardia

Other Meds: Cetricine, B complex, Vitamin D, Probiotics

Current Illness: None

ID: 1041194
Sex: F
Age: 64
State: MI

Vax Date: 01/15/2021
Onset Date: 02/05/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: See Item #18 for details

Allergies: Keflex PCN

Symptoms: 3 weeks after the first dose I developed sudden onset severe myalgias in the cervical neck, shoulders, deltoid, gluteal, and hamstring muscles. These were my only symptoms at onset. No fever, No Sand S of infection, etc. VItals were stable. Lab work, including complete chemistries CBCD, ESR, and CRP, was all WNL. However, 5 days after onset with no improvement in the myalgias, my creatinine kinase (CK)was 402 ( normal up to 175). Over a period of an additional 8 days, the myalgias have gradually decreased, and my current CK level, as of 2/17, is 275. My physician is terming it autoimmune myositis and believes it is from the vaccine. I have also had some mild tingling in my hands and feet intermittently that started soon after the myalgias. No true neurological deficits. No other symptoms. I am the patient but also a docotrally prepared nurse practitioner, so that is why this patient report is in medical terminology.

Other Meds: Sprycel 80 mg 1 qd Lisinopril 10 mg 1 qd Hydrochlorithiazide 12.5 mg 1 qd

Current Illness: No acute illnesses or infections

ID: 1041195
Sex: M
Age: 49
State: IL

Vax Date: 02/17/2021
Onset Date: 02/18/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: fatigue noted at 7pm that evening (2/17/21) injection site soreness noted at 12am (2/18/21) extreme fatigue, body aches, headache, chills noted from 12am throughout day of 2/18/21, subsiding with the exception of headache by 2/19/21 in early AM

Other Meds: none

Current Illness: none

ID: 1041196
Sex: M
Age: 76
State: ND

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

Lab Data: unknown

Allergies: No known allergies

Symptoms: 0945 Client related he is having difficulty breathing and is showing signs of cyanosis within 2 minutes of receipt of 2nd dose Pfizer vaccine. Epinephrine 0.3mg administered per auto inject pen IM to left thigh. Ambulance called. Nursing staff and medics on site. SPO2 55 pulse 133 client has Ventolin inhaler 2 puff administered .0949 BP 76/52. 0952 Sp02 64 Pulse 104. Client relates improved breathing. Audible wheezes. 0956 ambulance arrived Pulse 103 SpO2 76. Client remained conscious and continued to communicate. Client taken by ambulance to Hospital. Wife is with client.

Other Meds: unknown

Current Illness: Client denies

ID: 1041197
Sex: F
Age: 62
State: AL

Vax Date: 02/18/2021
Onset Date: 02/18/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies: No

Symptoms: The vaccine was given to high. Very close to my shoulder joint. Shot hurt when given and still hurting! Pain in joint!

Other Meds: Synthroid Carvedilol

Current Illness: High blood pressure Hypothyroidism Arthritis Pre diabetes

ID: 1041198
Sex: F
Age: 62
State: MI

Vax Date: 02/18/2021
Onset Date: 02/19/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Felt fine for first 12 hours. Went to bed. Woke up at 3am with chills and headache. Couldn't sleep. Got up at 5:30am. Fatigued. Went back to sleep until 9am. Feeling better. Lingering headache.

Other Meds: None

Current Illness: None

ID: 1041199
Sex: F
Age: 69
State: LA

Vax Date: 02/08/2021
Onset Date: 02/13/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies: amoxicillin

Symptoms: injection site began to itch about 5 days after injection. It has begun to cease after about 10 days.

Other Meds: multi vitamin Caltrate with vitamin D B-12 vitamin estradiol CBD oil denosumab

Current Illness:

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm