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: 1042164
Sex: F
Age: 17
State: WA

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

Lab Data: None

Allergies: None reported

Symptoms: Patient had an appointment to receive her first COVID-19 vaccine. She was screened by Sound RFA, per policy, and one full dose (0.5 mL) of the Moderna vaccine was given. It was subsequently discovered that the patient was only 17 years old, and therefore should not have received Moderna COVID-19 dose. Patient was monitored for 15 minutes, per policy. No adverse reaction occurred. Clinical site supervisor was notified, patient and guardian were notified, and incident report was created and submitted. This report is being completed due to the age recommendations.

Other Meds: Unknown

Current Illness: Unknown, none reported

ID: 1042165
Sex: F
Age: 66
State: SC

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

Lab Data:

Allergies: NKA

Symptoms: When administering vaccine, the needle malfunctioned. The needle was securely attached to syringe and vaccine spilled out the side of syringe

Other Meds: Unknown

Current Illness: None

ID: 1042166
Sex: M
Age: 68
State: FL

Vax Date: 02/15/2021
Onset Date: 02/16/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: none

Allergies: nKa

Symptoms: Developed flu like symptoms. Lasted 4 days. No nausea. Dizziness, headache diarrhea. I had a positive test reported to Florida health department. In January on the 11th. You can call me if you need additional info!

Other Meds: Gabapentin, carvedilol, valsartin, tramadol

Current Illness: Covid 19

ID: 1042167
Sex: M
Age: 62
State: PA

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

Lab Data: none, notable but nothing serious

Allergies: peanut butter, statins, hayfever, vitamin c/ascorbic acid

Symptoms: Flush sensation, elevated heart rate immediately and lasting 1.5 hours

Other Meds: metformin, jardiance, eliquus, metoprolol, gabapentin, aspirin, tylenol, daily vitamin

Current Illness: none

ID: 1042169
Sex: M
Age: 47
State: TN

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

Lab Data:

Allergies: None

Symptoms: Fever, headache, aches, fatigue

Other Meds: Motrin, atorvastatin,

Current Illness: None

ID: 1042170
Sex: F
Age: 83
State: MD

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

Lab Data:

Allergies:

Symptoms: Peripheral neuropathy - pain in feet. Started in toes, moved down foot, eventually changed to numbness. Tingling pain in hands. 2 week duration.

Other Meds: Levoxine, Vitamin D, AlReds, Melatonin

Current Illness:

ID: 1042171
Sex: F
Age: 78
State: NY

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

Lab Data:

Allergies: none

Symptoms: came down with shingles day after the vaccine

Other Meds: methotrexate, Xeljaz, calcium, cranberry, b-12, D3. Aleve,areds, folic, gabapentin

Current Illness:

ID: 1042172
Sex: M
Age: 78
State: OR

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 02/19/2021
Hospital: Y

Lab Data: EKG-Afib with RVR. CBC, CMP generally OK. viral panel negative. CXR normal. BNP elevated, Troponin I mild elevation at 0.07

Allergies: clonazepam

Symptoms: myalgia/arthralgia, significant weakness followed by reactivation of rapid ventricular rate w/ his chronic Atrial Fib leading to angina and hospitalization w/i 2 days of vaccine. symptoms have not yet recovered, resulting in SNF placement

Other Meds: Vit B12, Eliquis, finasteride, fludrocortison, levothyroxine, lasix, potassium, sinemet, venclexta

Current Illness: None

ID: 1042173
Sex: F
Age: 39
State:

Vax Date: 01/26/2021
Onset Date: 01/27/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies: Amoxicillin

Symptoms: Extreme fatigue

Other Meds:

Current Illness:

ID: 1042174
Sex: M
Age: 36
State:

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

Lab Data:

Allergies: None available

Symptoms: Pt had second dose of vaccine. Moderna. Pt felt tingles in figures, pt felt light headed. Pt was moved to medical room and checked out. Vs taken and stable . Pt felt better after 20 mins. Pt was released to observation area. Checked out.

Other Meds: None available

Current Illness: No illness

ID: 1042175
Sex: M
Age: 53
State: IL

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

Lab Data:

Allergies:

Symptoms: Swollen lymph node near injection site

Other Meds:

Current Illness:

ID: 1042176
Sex: F
Age: 49
State: UT

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

Lab Data:

Allergies: none

Symptoms: approximately 5 minutes after the injection my upper lip went numb along with my left side of my face, primarily my upper cheek below my eye. Then it slowly moved to the top of my head and the top of my left hand. My heart was racing a bit, but that could be due to me being nervous about my face going numb. An attendant stayed with me until it started to subside, approximately 15 minutes later. Other side effects were mild the following day. A bit of a headache, fatigue and chills. Fatigue lasted a couple days but all minor.

Other Meds: Vitamin D, Zinc

Current Illness: none

ID: 1042177
Sex: M
Age: 59
State: MD

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

Lab Data:

Allergies: none

Symptoms: Patient reported on schedule and by registration as a first dose Moderna. Pt reported via phone and in person to providers as needing Moderna. Pt was given Moderna vaccine. After leaving clinic and returning home patient contacted provider and reported first dosing was with Pizer.

Other Meds:

Current Illness: none

ID: 1042178
Sex: M
Age: 44
State: CA

Vax Date: 01/05/2021
Onset Date: 01/06/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Headache, chills, muscle ache

Other Meds: None

Current Illness: None

ID: 1042179
Sex: M
Age: 63
State: IL

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

Lab Data:

Allergies: Sulfa

Symptoms: Right ankle pain and swelling starting 8-10 hours after inhection

Other Meds: Prednisone methotrexate sulindac Flecainide allopurinol Nadolol tadalafil alfuzosin lyrica vicodin Alprazolam

Current Illness:

ID: 1042180
Sex: F
Age: 80
State: TX

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

Lab Data:

Allergies:

Symptoms: A third dose of Pfizer Biontech administered to patient on 2-19-21. First dose was 1-8-21, second dose 1-29-21, third dose 2-19-21.

Other Meds:

Current Illness:

ID: 1042181
Sex: F
Age: 41
State: CA

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

Lab Data: n/a

Allergies: n/a

Symptoms: fever, fatigue, nausea, lymph node swollen under rt arm, body aches

Other Meds: vitamins

Current Illness: n/a

ID: 1042182
Sex: F
Age: 65
State: CA

Vax Date: 02/09/2021
Onset Date: 02/17/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies: Wax, chloramphenicol, lysol

Symptoms: Patient developed bruising on day 2 after the vaccine, with increasing pain each day. Redness and swelling appeared on day 8. Patient was diagnosed with cellulitis at the injection site and placed on antibiotic treatment (cephalexin).

Other Meds: Losartan, Metoprolol, Allegra, Cingular, Baby Aspirin, hydrochlorothiazide, tamoxifen, lipitor, vitamins

Current Illness: None

ID: 1042183
Sex: M
Age: 27
State: OH

Vax Date: 01/12/2021
Onset Date: 02/04/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: I had complete loss of smell and taste November 26th and tested positive for Covid-19 on the 28th. At the time, it started as my smell and taste fading out. Day one of noticeable symptoms also included a slight fever at approximately 99.7 degrees, full body aches as if I'd been in a car accident, chills, a headache, shortness of breath and fatigue. The fever and chills and body aches had gone away after only two days but the shortness of breath and fatigue persisted at least 3 weeks or late December. By January, I was slowly having my smell and taste back to normal. Early in February, around Feb. 4th, after my first vaccine and approximately 5 days before my second one, my smell and taste became horribly distorted. It started with mint and toothpaste. It started tasting/smelling like mold with pottery clay. After about 2 or three days, almost all foods began tasting and smelling like it was musty, moldy and rotten. Like dead fish or expired meat. I first noticed with food but now it's other things as well. Cleaning agents like disinfectant wipes smell the exact same as a jar of peanut butter which is a strong, musty, moldy smell. A pot roast bought the day of at Kroger was cooked by my fiance and it smelled so rancid to me I almost vomitted. Almost everything smells and tastes horrible and it's been about two weeks. The only things that seem normal are bubblegum, fruity pebbles and most beverages although not all. Coffee has the same pungent smell. I have has to switch my diet almost completely to yogurt, fruity pebbles and meal replacement shakes. Along with a multivitamin so I don't miss anything.

Other Meds:

Current Illness: Tested positive for Covid-19 November 28th

ID: 1042184
Sex: M
Age: 70
State: CA

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

Lab Data: 2/16/21: WBC 17.69 2/18/21: chemistry-7 showed low potassium (2.7) even though the patient had not experienced any emesis or diarrhea or on any diuretic (corrected to 4.6 before discharge)

Allergies: Penicillins

Symptoms: Hospitalization- admitted on 2/14 for appendicitis and peritonitis; had appendectomy. Discharged on 2/18

Other Meds: Atorvastatin 20mg daily, topical psorasis med, OTC Vit B12 1000mg daily, Ibuprofen PRN for back pain (stopped 1 week prior to vaccination)

Current Illness: n/a

ID: 1042185
Sex: F
Age: 32
State: CO

Vax Date: 02/11/2021
Onset Date: 02/18/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Arm itches and is swelling around injection site. Delayed reaction (started 8 days after)

Other Meds: Prenatal vitamins and birth control

Current Illness: None

ID: 1042186
Sex: F
Age: 84
State: MN

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

Lab Data:

Allergies: No

Symptoms: 6 hours after I had vaccine I developed A fib which lasted for 3 hours before I converted. I haven?t had an episode of a fib in over a year.

Other Meds: Eliquis, Atorvastin,Atenolol,Trazadone, Vit.D,Areds, Calcium, Fozamax

Current Illness: No

ID: 1042187
Sex: F
Age: 54
State: SC

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

Lab Data:

Allergies: none known

Symptoms: Patient received vaccine at 16:05 and at approximately 16:15, the patient reported blurred vision in her right eye.

Other Meds: Azelastine Valium Vyvanse Jardiance Doxepin Zafirlukast Estrace

Current Illness: none

ID: 1042188
Sex: F
Age: 45
State: ME

Vax Date: 02/09/2021
Onset Date: 02/17/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: None

Allergies: Bacitracin

Symptoms: Sore, swollen, red upper arm, extending outward from injection site, developed 2/17/21, following a couple days of feeling extremely fatigued. Arm still sore, but swelling seems to be decreasing; the area is still noticeably discolored in an oval shape covering the deltoid region. No treatment, monitoring only. PCP is out of the country and office closed.

Other Meds: Ortho-tri-cyclen Cholecalciferol Pataday

Current Illness: None

ID: 1042189
Sex: F
Age: 50
State: CA

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

Lab Data: 2/17/21-Scripps clinic Urgent Care ran EKG and bloodwork. Both results negative.

Allergies: Amoxicillin, sulfa (hospitalized with thrombocytopenia), erythromycin, mollusks (FPIES-GI issues).

Symptoms: Experienced feeling of heart racing and sustained tachycardia 85-110 even while sleeping. Had pulsometer and Fitbit to track pulse. Called Scripps covid Nurseline next day and was advised to go to urgent care since increased heart rate was a possible allergic reaction. Other symptoms included chills, fever, fatigue, extreme headache, which began ~8 hr after shot. Identical twin sister also has tachycardia from her second Moderna shot and still has one week after second shot. For me, pulse lowers in response to Benedryl for about 5 hrs.

Other Meds: Women?s one a day, atorvastatin, vitamin D3 1000 IU, qu ok mega coq10 ubiquinol 100 mg, evening primrose oil 500 mg

Current Illness: None

ID: 1042190
Sex: F
Age: 38
State: UT

Vax Date: 12/28/2020
Onset Date: 01/06/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies: Novocain

Symptoms: Sometime in the middle of the night/early am Jan 6 I rolled over in bed and had vertigo, it felt like I was doing flips. The whole day I had to be careful I would get vertigo so bad it I moved to quick. I went to my Chiropractor, he thought it was the benign and had me do a specific maneuver. It made me nausea for an hour then went away. As long as I didn't bend over funny I though I was ok. On the 9th and 10th I felt general dizzy, I would turn and just kind of felt like I was spinning. I took Sudafed because my ears felt full. Then the vertigo was just gone.

Other Meds: Zyrtec Flonase Zinc/Calcium

Current Illness:

ID: 1042191
Sex: F
Age: 19
State: VA

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

Lab Data:

Allergies: PCN

Symptoms: Patient developed a fever to 102.3 and had a decreased level of responsiveness with rigors. An infectious evaluation including COVID 19 testing, respiratory viral panel, basic lab evaluation (including CBC and CMP), and physical exam were all unremarkable. She was provided PR acetaminophen which reduced her fever and she returned to normal. After clinical improvement, she mentioned that she has developed similar reactions to previous medications (PCN) and vaccines (unknown which type) that always improve with acetaminophen. She did not annotate this on her vaccine screening form. She was provided acetaminophen and had no further symptoms. Will plan to provide her with scheduled acetaminophen after dose 2.

Other Meds: Oral contraceptive pill

Current Illness: None

ID: 1042193
Sex: M
Age: 70
State: DC

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

Lab Data: This is a report of NO adverse event, since I read that CDC is trying to keep statistics of adverse events COMPARED to the total number of vaccinations. I have received both the 1st and 2nd doses of the Pfizer vaccine. No side effects from either the first or the second. Healthcare company failed to enroll me in CDC's program of individual statistical reporting when I received my first dose. I was told about it at the second dose but not enrolled. So I am providing the NO REACTION data here.

Allergies:

Symptoms: None stated.

Other Meds:

Current Illness:

ID: 1042194
Sex: F
Age: 19
State: GA

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

Lab Data:

Allergies:

Symptoms: Patient states she feels nauseous after receiving vaccine and developed a headache. b/p 144/76,p-83, R 18, 02 sat 99% Temp 96.1. After observing patient for 20 minutes patient c/o sever left sided abd pain and was taken to ED for further evaluation

Other Meds:

Current Illness:

ID: 1042195
Sex: F
Age: 34
State: CA

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

Lab Data:

Allergies:

Symptoms: Pain at injection site for Moderna vaccine #2 left upper arm. continues >16 days

Other Meds:

Current Illness:

ID: 1042196
Sex: M
Age: 58
State: CA

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

Lab Data: NONE

Allergies: NONE

Symptoms: MEDICAL ASSISTANT GAVE 1ML INSTEAD OF 0.5 ML. SHE DID NOT NOTIFY US UNTIL AFTER THE LAST PATIENT WAS GIVEN THE SHOT. SHE OPENED A NEW VIAL TO COMPLETE THE PATIENTS. EMPLOYEE WAS TERMINATED AND WE CONTACTED PATIENTS TO SEE IF THEY WERE FIND AND TO ADVISE THEM ABOUT GOING TO E.R. IF CONDITION WORSENED. CALLED DAILY TO VERIFY WELL-BEING.

Other Meds: NONE

Current Illness: NONE

ID: 1042197
Sex: M
Age: 50
State: NC

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

Lab Data:

Allergies: oxycodone-itching

Symptoms: Started with tightness of chest, (under the lower part of ribcage); sporadic hot flashes and dizziness; pulse going up to 95,( when normal is in the 60's). Then sat down an hour later and almost immediately a deep tiredness. got off work early, went home and had no other problems until I attempted to go to sleep. Somewhere around nine o'clock, I started getting muscle cramps so I went to the couch. Shortly after, my right arm, (vaccinated arm) became extremely sore; shortly after, my total body ached; no relief from lying on my left, right, stomach or back; hurt to even sit upright. Then, I started getting cold chills; which alternated with hot flashes and periods of nausea. My mouth went extremely dry, so when I struggled to go use the bathroom, I would wobble my way to the kitchen and want to take a big drink of water, attempted to swallow two tylenol, gagged and started throwing up. Went back to bed and started getting continuous headaches that would move to different places. This happened the rest of the night and most of Thursday when most of the worst symptoms happened. Was able to sleep Thursday night and thought I was feeling better, until I stood up. Today, I was not able to stand longer than one half an hour at any one point; had to lie down and rest while doing any kind of activity. I haven't been able to keep anything down; either vomiting or diarrhea. Have been slowly feeling better with occasional headache.

Other Meds: acetaminophen, ibuprofen, apple cider vinegar, zinc, vitamin C, losartan potassium, amitriptyline

Current Illness:

ID: 1042198
Sex: F
Age: 55
State: AZ

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

Lab Data:

Allergies: None

Symptoms: Left arm was very sore at injection site for four days. I had a large lump on the arm at the injection site for four days. Mild fatigue for two days.

Other Meds: One a Day women's vitamin, iron, zyrtec, Salagen, Plaquenil

Current Illness: None

ID: 1042199
Sex: F
Age: 41
State: CA

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

Lab Data:

Allergies: PCN, Unasyn, Advair, Meloxicam, Torodol, Zithromax, Cephalexin

Symptoms: respiratory distress (new), audible wheezing, shortness of breath, sensation of throat swelling or closure

Other Meds:

Current Illness:

ID: 1042200
Sex: F
Age: 45
State: WA

Vax Date: 01/08/2021
Onset Date: 01/09/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: COVID test - on January 11th - negative

Allergies: supha

Symptoms: Severe arm pain in the middle of the night - woke me up (the arm pain lasted at least a week); Saturday morning- nausea and headache and I took Motrin. As the day progressed, 4-6pm fever started - went to 102.8 and Motrin lowered to about 101. Very fatigued, body aches, nauseated and headache got worse. I didn't want to keep my eyes open. Fever lasted until Monday and I felt very unwell. I called Clinic Monday morning - Advice nurse -and she suggested I get a COVID test. I felt so miserable - I laid in bed for whole week. It took all my energy to get to the bathroom. I went to work on that Wednesday to deliver my rounds of meds and went back home to bed. Friday, Jan 22nd - Doctor - redness wrapped all around my arm (from the inch down from shoulder and two inches above elbow) and it was warm to the touch (it wasn't painful at that point) but it itched like mad and he ordered an anti-nausea medication for me. Arm recovered before second dose. Nausea lasted to the second dose. I was anti-nausea medication - Andanzitron - 8 mg tablets (Clinic) - to get through my days. Nausea has gotten a little better but still have to take medication from time to time. Second dose received 5th of February.

Other Meds: Zofran - blood pressure; Hydrochorothorizide

Current Illness: No

ID: 1042201
Sex: F
Age: 54
State: NY

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

Lab Data: none

Allergies: No allergies known to date

Symptoms: Erythematous circular rash with surrounding white clearing close to injection site

Other Meds: atorvastatin, levothyroxine

Current Illness: none

ID: 1042202
Sex: F
Age: 71
State: WI

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

Lab Data:

Allergies:

Symptoms: Received complaint call 2/19/21 from patient regarding administration site being anterior arm for 1st dose of Covid-19 vaccine on 2/16/21. Submitted photos with band-aid placement towards anterior mid-upper arm. Complaints of pain/discomfort to arm (whole arm) also in shoulder area. Discussed that arm discomfort can come with vaccination as an expected outcome. Describes that she did not have pain in arm during injection when administered. Clients concern is regarding administration and if administered in tissues versus muscle if vaccine will still be absorbed by body and be effective. Consulted with "medical professionals" regarding technique and was encouraged to call vaccine administration site.

Other Meds:

Current Illness:

ID: 1042203
Sex: M
Age: 68
State: CA

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

Lab Data: none

Allergies: none

Symptoms: Abdominal Cramps, mild diarrhea, slight fatigue 20210216, 6:30 PM Cold Sweats, fatique 20210217, 2:00 AM Abdominal Cramps, mild diarrhea, fatigue 20210216, 8:00 AM - 8:00 PM No treatment

Other Meds: Berberine, Ginger, DHEA, Malic Acid, L-Glutamine, Salmon Omega, Vitamin D 500mg, Coenyme Q10 200mg, Vitamin B, ChomeMate, Acetyl-L-Cairtine, MK7, Red Yeast Rice, Probiotic,Baby Aspirin, DHEA, Tumeric, Vitamin C, Alpha Lipoic, Famil-E, Kelp,

Current Illness: none

ID: 1042204
Sex: M
Age: 72
State: KY

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: None

Allergies: Tetanus toxoid,

Symptoms: Cellulitis left arm, fever, body aches, chills, ?feels like I have covid again?, headache. Fatigue, lethargy, All sympotoms x 3-4 days,

Other Meds: Glimepirade, metformin, pioglitazone, amlodipine, losartan, pravastatin, omeprazole, ventolin, fluticazone, claritin

Current Illness: None

ID: 1042205
Sex: F
Age: 45
State: NY

Vax Date: 02/14/2021
Onset Date: 02/15/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies: Ceclor, ampicillin, novahistine, codeine, levaquin, valium, mucinex, Sudafed, dimetapp, sodium sulphanide, phenergan

Symptoms: Enlarged painful lymph nodes near collarbone in the crevice of neck, treated with warm compress, acetametaphine, and 14 days of doxycycline

Other Meds: Alprazolam, synthroid, vitamin D, protonix, montelukast

Current Illness: N/a

ID: 1042206
Sex: F
Age: 35
State: MA

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies: Amoxicillin and penicillin

Symptoms: Tiredness, muscle aches, joint pain, headache, and stomach cramps.

Other Meds: Birth control

Current Illness:

ID: 1042207
Sex: F
Age: 74
State: GA

Vax Date: 01/28/2021
Onset Date: 01/29/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: none

Allergies: None

Symptoms: Severe headache, persistent intermittent cough everyday. Some days only in the AM. Other days only in the PM. Currently headache is more PM and nagging intensity with cough mostly evening.

Other Meds: PARoxetine HCL40mg, Lisinopril-HCL 20-12.5mg, amLODIPine BESYLATE 5mg, CLOPIDOGREL 75mg, ROSUVASSTATIN CALCIUM 40mg

Current Illness: None

ID: 1042208
Sex: F
Age: 69
State: WI

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

Lab Data:

Allergies:

Symptoms: When Lead Vaccinator drew the 1.8 ml diluent from the vial, she inadvertently injected it back into the diluent vial. She then withdrew the COVID vaccine dose from the Pfizer vial. Patient received 0.3 ml of undiluted vaccine in left deltoid. Error was not realized until after patient left and the vaccinator realized there were no other doses available to draw from the COVID vaccine vial. Looked at diluent vial and saw diluent was in bottle. Clinic contacted Physician contact and was informed that patient should be informed of error and may experience more soreness in arm but no serious adverse reactions from overdose. Patient informed and informed as directed. Reeducation given to Lead Vaccinator. Diluent vial removed from draw area once diluent was removed from vial after incident to prevent further incidents from occurring.

Other Meds:

Current Illness:

ID: 1042209
Sex: F
Age: 81
State: PA

Vax Date: 02/12/2021
Onset Date: 02/15/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies: Zoledronic Acid-mannitol-water Sulfonamide Antibiotics

Symptoms: Diffuse erythematous macular rash. itchy, non tender.

Other Meds: Atenolol, Calcium phosphate-Vit D 3, Cartia XT, Citalopram, fludrocortisone, hydrochlorothiazide, hydrocortisone, irbesatran, magox, omeprazole, Zofran (as needed),potassium chloride, sodium chloride nasal spray, synthroid.

Current Illness:

ID: 1042210
Sex: M
Age: 48
State: CA

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

Lab Data: NONE

Allergies: NONE

Symptoms: MEDICAL ASSISTANT GAVE 1ML INSTEAD OF 0.5 ML. SHE DID NOT NOTIFY US UNTIL AFTER THE LAST PATIENT WAS GIVEN THE SHOT. SHE OPENED A NEW VIAL TO COMPLETE THE PATIENTS. EMPLOYEE WAS TERMINATED AND WE CONTACTED PATIENTS TO SEE IF THEY WERE FIND AND TO ADVISE THEM ABOUT GOING TO E.R. IF CONDITION WORSENED. CALLED DAILY TO VERIFY WELL-BEING.

Other Meds: NONE

Current Illness: NONE

ID: 1042212
Sex: F
Age: 65
State: CO

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

Lab Data:

Allergies: Thimerosal and cortisone injection

Symptoms: Tingling lips and tongue. Oral Benadryl 25 mg at 2:45 p.m. Second 25 mg Benadryl at 3:40 p.m. Tingling has subsided somewhat

Other Meds: None

Current Illness: None

ID: 1042213
Sex: F
Age: 54
State: IN

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

Lab Data: N/A

Allergies:

Symptoms: Vaccine supposed to be mixed with adjuvenated solution prior to administration. Instead of mixing with solution, APRN gave just the adjuvenated solution without the live vaccine.

Other Meds:

Current Illness:

ID: 1042214
Sex: U
Age: 89
State: KY

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

Lab Data:

Allergies:

Symptoms: RECEIVED BOTH COVID VACCINES 01/27/21 & 02/17/21. ON 02/19/21 WENT TO ICC RASH ON ARMS X1 MONTH, AND ABDOMINLA PAIN AND WAS SENT TO THE ER. ON 02/19/21 REPORTED TO ER AND ADMITTED INPATIENT AFTER BEING DIAGNOSED WITH ABDOMINAL PAOIN, UNSPECIFIED LOCATION, ABDOMINLA DISTENTION, CONSTIPATION, FECAL IMPACTION, AND MALROTATION OF CECUM.

Other Meds:

Current Illness:

ID: 1042215
Sex: F
Age: 29
State: UT

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

Lab Data:

Allergies:

Symptoms: Patient reports that at the time of injection she felt numbness in her left thumb and tingling in her arm. It quickly resolved but over the past few hours has been on and off numb for the past few hours. She says at one point her pinky felt numb, then the side of her arm but strength is normal. Her arm is also sore.

Other Meds:

Current Illness:

ID: 1042216
Sex: M
Age: 75
State: PA

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

Lab Data: do not know

Allergies: none

Symptoms: patient says he developed a lump in arm that was growing and had itching. he called md and doctor told him to take Benadryl. Benadryl resolved symptoms

Other Meds: not known

Current Illness: do not know

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm