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: 1042668
Sex: F
Age: 51
State: AK

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

Lab Data:

Allergies: COVID Vaccine

Symptoms: 1245; Scratchy throat, nausea, tongue feels fat, nausea; Dipenhydramaine administered , Epi Pen administered. Patient alert 1256 - gagging, throat tightness, tongute better, tight throat, nausea; second Epi Pen administered 1258 - EMS arrived, pateint alert and transported to Emergency Department via EMS

Other Meds:

Current Illness: previous reaction to first dose COVID vaccine

ID: 1042669
Sex: F
Age: 78
State:

Vax Date: 02/16/2021
Onset Date: 02/18/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: None

Allergies: some antibiotics

Symptoms: slightly achy body and head. 3 large hives (welts) on forehead

Other Meds:

Current Illness: none

ID: 1042670
Sex: M
Age: 68
State: MN

Vax Date: 01/21/2021
Onset Date: 01/22/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Under fingernails of left hand all fingers turned purple. This lasted about 10 days. Same thing happened after second shot. It has been 7. days since second dose, still purple. No other effects

Other Meds: Atorvastatin 20mg, losartan 100mg, d3 1009iu, aspirin 162 mg, insulin humalog, clobetasol propionate.05 topical

Current Illness: None

ID: 1042671
Sex: F
Age: 85
State: CA

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

Lab Data:

Allergies: Flagyl

Symptoms: Upper back pain, stomach cramps, fatigue

Other Meds: Various

Current Illness: None

ID: 1042672
Sex: F
Age: 34
State: IL

Vax Date: 01/11/2021
Onset Date: 01/12/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies: Protonix and Reglan

Symptoms: Moderna COVID-19 Vaccine Significant swelling of axillary lymph nodes and surrounding breast tissue on the side of injection, large area of redness and firmness that increased after 24 hours post-injection

Other Meds: Tizanidine, Methotrexate, Cymbalta, Amitriptyline

Current Illness: None

ID: 1042673
Sex: F
Age: 69
State: AZ

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

Lab Data:

Allergies: ALLERGIES Fentanyl/Midazolam Codeine Levaquin Augmentin Lyrica Dexamethasone Betamethasone Clobetasol

Symptoms: I have photos. It's now a week + hours since dose 1 of Moderna Vaccine. On day 2: felt like a bad bee sting in vaccination site Days 3-8: Excessive Swelling, extreme itchiness and redness in and around vaccine site. On Day 4- two pea-sized purple subcutaneous circles appeared on the lower under-side of the vaccinated arm. On Day 5: Two more pea-sized purple subcutaneous appeared on the lower under-side of the vaccinated arm. As of today, I now have 4. I went to my dermatologist today (Feb 19th) who thinks the condition may be Senile Purura. He also prescribed Lidocaine for the continuous and disruptive itchiness. I have to contact the dermatologist after the weeke I have photos.

Other Meds: multi vitamins cymbalta Levothroxine trazadone/xanax at bedtime for sleep

Current Illness: NONE

ID: 1042674
Sex: F
Age: 68
State: MI

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

Lab Data: None

Allergies: All shellfish NSAIDs Sulfa drugs Many blood pressure medicines

Symptoms: Headache, nausea, body aches, slight trembling, skin eruption on forearms, fever blister, loose stool, lethargy, continuing through day five after onset illness.

Other Meds: Nasacort Vitamin D3 Bystolic Pantoprazole Nortriptyline Hydroxyzine Triamterene Glyburide Lipitor Estradiol Lorazepam Pioglitazone Tylenol xtra strength

Current Illness: Zero

ID: 1042675
Sex: F
Age: 37
State: WA

Vax Date: 02/06/2021
Onset Date: 02/17/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: none

Allergies: NKDA

Symptoms: Erythema nodosum apparent 11 days after Moderna dose #2 (although I think more likely related to new ocp prescription, but vaccine relationship possible).

Other Meds: Norethindrone

Current Illness: None, but felt generally unwell with abdominal bloating, breast pain, and weight gain after starting ocp (norethindrone) on 15 JAN 2021 - between Moderna vaccination #1 and #2.

ID: 1042676
Sex: F
Age: 40
State: CA

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

Lab Data: None

Allergies: Chamomile, almonds, hay fever

Symptoms: I feel as if I am tipsy, as if I am in a dream and a little dizzy. When I look at an object, it's a little out of focus and it takes 2-3 seconds to focus.

Other Meds: Claritin every day, 2 times a week: multivitamin, calcium, iron

Current Illness: Asthma, allergy (hay fever)

ID: 1042677
Sex: F
Age: 27
State: NJ

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

Lab Data:

Allergies:

Symptoms: What others describe as ?covid arm?. Red blotchy rash around injection site that appeared today (7 days later). So no itching or pain, just red and warm to touch.

Other Meds:

Current Illness:

ID: 1042678
Sex: F
Age: 42
State: CO

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

Lab Data: None

Allergies: Cephlaxin Allegra-D

Symptoms: Significant Fatigue and moderate stomach ache starting at about 10 am. Slight body aches and sore left arm at injection site. No fever. No redness or swelling at injection site. Treated by laying down and drinking water. Didn?t take additional medication since I?m pregnant and there is no fever.

Other Meds: Pepcid 10mg daily Aspirin 162mg daily Prenatal vitamin daily Levothyroxine 25mcg daily

Current Illness: No other illnesses

ID: 1042679
Sex: M
Age: 67
State: CA

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

Lab Data: None

Allergies: None

Symptoms: Woke up with medial aspect of right eye sclera hemorrhaged. The bloody look increased throughout the day. but never spread further than medical aspect of right eye. There was no pain, swelling or vision changes. There was no treatment.

Other Meds: Daily Vitamin and iron supplement

Current Illness: None

ID: 1042680
Sex: M
Age: 43
State: MN

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

Lab Data: None

Allergies: None

Symptoms: Woke up the following morning with nausea and chills followed by muscle stiffness and joint pain.

Other Meds: Lisinopril, sertraline, atorvastatin, wellbutrin, vitamin D, magnesium, omega 3, CoQ10, aspirin, metamucil and folic acid.

Current Illness: None

ID: 1042681
Sex: M
Age: 73
State: GA

Vax Date: 02/05/2021
Onset Date: 02/17/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: None

Allergies: X-ray contrast dye

Symptoms: After the initial soreness and mild itching at the injection site, the symptoms subsided for two weeks. Two days ago (2/17/2021) the symptoms returned along with redness at the injection site. The area is also warm to the touch.

Other Meds: Levothyroxin Citalopram Atorvastatin Vitamin D

Current Illness: None

ID: 1042682
Sex: F
Age: 46
State:

Vax Date: 01/30/2021
Onset Date: 01/31/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Awoke the next morning with very swollen, sore eye lids. The swelling began during the night, so unsure when but approximately 12-20 hours post injection. Took Benadryl. Swelling improved slowly throughout the day and was almost resolved the following morning. Also had approximately 24 hours of expected fatigue, low grade fever, and chills.

Other Meds: Norvasc Aspirin Vitamin D, Zinc, Vitamin C

Current Illness: None

ID: 1042683
Sex: F
Age: 40
State: KY

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: None. I have yet to see my PCP. Egg intolerance is not a pressing or immediate care issue as far as I am concerned. I do have an annual checkup scheduled in June, 2021.

Allergies: Amoxicillin- rash No other known food/drug allergies (prior to Covid vaccine)

Symptoms: For me, an egg intolerance resulted within 1 day of receiving the second Pfizer Covid vaccine. I have never had any food allergies or intolerance prior to the date of my (second shot of the Pfizer Covid) vaccine. I?m in the routine of making myself egg and cheese omelets at home each day. Beginning the morning of 1/26/21 (the day after my second Covid vaccine) I ate my omelet as usual and within 2 hours developed stomach cramping, feeling bloated, nausea and severe diarrhea. In the now 4 weeks since getting the vaccine I have never been ill (stomach cramps, bloating, nausea, diarrhea) when refraining from eating eggs. When I do eat eggs now, I simply can not tolerate them, immediately (if I consume the yolk) or within 2 hours (if eating just the egg whites) I will have all the GI issues listed previously. Symptoms typically last for 1-2 hours and are relieved quicker with ibuprofen, I have found.

Other Meds: Turmeric creamer and Performance Mushroom blend Multi vitamin

Current Illness: None

ID: 1042684
Sex: F
Age: 29
State: WI

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

Lab Data:

Allergies:

Symptoms: Headache: every morning I wake up with a headache goes away by the after noon Increased fatigue: once in a while I?ll feel very lethargic Muscle weakness: I notice that It takes a lot to do a simple task

Other Meds:

Current Illness:

ID: 1042685
Sex: F
Age: 49
State: CA

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

Lab Data:

Allergies: tegretol

Symptoms: Noticed bruising and spots on left leg

Other Meds: Prednisone, Hydroxycloroquine, Amlodipene, Folic Acid, Vit. B12, Vit. D

Current Illness:

ID: 1042686
Sex: F
Age: 50
State: NM

Vax Date: 02/03/2021
Onset Date: 02/04/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: none

Allergies: penicillin, compazine, phenothiazine, walnuts, latex

Symptoms: 2/04/21, 1:00 PM, chilled "to the bone", temp of 101 degrees, very tired, nauseous - at 3PM took Advil and got a little relief - fever broke early morning of 2/05/21, remained nauseous for two days and exhausted for two weeks with brain fog Sore throat off and on, swollen glands off and on, occasional ear pain - this could be related to drainage, cause unknown 2/15/21 (about) sores began showing up - first two on the back of my left hand, then one on my left upper arm, today one on my right upper arm

Other Meds: none

Current Illness: none

ID: 1042687
Sex: F
Age: 53
State: OR

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

Lab Data:

Allergies: Wheat bran, Latex, penicillin, aspirin

Symptoms: Day 1 evening - dizziness, headache, mild body aches, insomnia Day 2 - major headache, severe body aches not helped by ibu/tylenol, insomnia, fever 100.8, nausea - missed work Day 3 - slightly better - headache, body aches, nausea, fever 100.3- 100.6, missed work

Other Meds: Gabapentin 300mg 1 x day, Allegra 1 x day, acetaminophen, ibuprofen

Current Illness: Vertigo, nausea, ears ringing, headache, body aches - all from first vaccine

ID: 1042688
Sex: F
Age: 60
State: CA

Vax Date: 01/18/2021
Onset Date: 01/28/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies: Penicillin, tetracycline, sulfa, duricef

Symptoms: Ten days after receiving the vaccine at the injection site, a little hard mass under the skin grew harder and larger, to the size of my fist. It was itchy , red and painful. It slowly went away over the next 2 days.

Other Meds: Methotrexate Metopropol Rosuvastatin

Current Illness: I have Scleroderma

ID: 1042689
Sex: F
Age: 24
State: NC

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

Lab Data: None

Allergies: ndka

Symptoms: Dizziness 3 days after shot. Rash on injection site day 8 after injection!

Other Meds: none

Current Illness: none

ID: 1042690
Sex: F
Age: 29
State: PA

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

Lab Data: None (yet)

Allergies: None

Symptoms: Onset of itchiness and redness exactly one week post injection, which quickly evolved into a large, hard lump at injection site. Itchy and hot to the touch.

Other Meds: None

Current Illness: None

ID: 1042691
Sex: F
Age: 58
State: NY

Vax Date: 02/07/2021
Onset Date: 02/18/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: None

Allergies: Opiates, codeine, cipro

Symptoms: Eleven days after the vaccine I noticed a rash on my upper right arm that was itchy when wet in the shower.

Other Meds: Baby Aspirin, Aleve, Vitamin D3, Vitamin C, Calcium, Magnesium, Lutien, Omega 3, B complex

Current Illness:

ID: 1042692
Sex: F
Age: 40
State: MO

Vax Date: 01/21/2021
Onset Date: 01/23/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: Insurance physicians, my personal rheumatologist Labs just ordered, have not been drawn yet

Allergies: Dairy intolerance

Symptoms: Sever joint pain, headache Hives on the backside of not of my legs with itching that turned into large welts a few hours later that then turned into 2 large welts on the side/back of my upper thighs. 2 days later and ever since I have severe nerve pain that is constant and is affecting my ADLs.

Other Meds: Taltz, Gabapentin, tramadol, Advil

Current Illness: Nothing acute

ID: 1042693
Sex: F
Age: 38
State: CA

Vax Date: 02/06/2021
Onset Date: 02/07/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: None

Allergies: None, insect venom

Symptoms: Systemic pruritus, generalized hives, lymph edema face and tongue

Other Meds: Amoxicillin clavulanic Acetaminophen Ibuprofen

Current Illness: Cut/wound

ID: 1042694
Sex: F
Age: 38
State: OH

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

Lab Data: I had a bunch of tests and my d-dimmer was double what it was supposed to be and they couldn?t find a clot but said I have one somewhere.

Allergies: Cipro, Seroquil, Somma, IV Dye, Morpine

Symptoms: Sever left side flank pain and very tired. Out of work for a week and went to emergency room.

Other Meds: Gabapenton, atrovastaton, Lipitor, xarelto, Zoloft, atarax, tramadol, Topomax, hydroxyzine, amlobitopen

Current Illness: Fibromyalgia, Sleep Apnea

ID: 1042695
Sex: F
Age: 70
State: CA

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

Lab Data: none

Allergies: none

Symptoms: Beginning 9.5 days after my injection, for three days, I experienced a variety of skin ailments at different times and places on my body, and various intensities from mild to severe. These included a blotchy red face and redness, swelling and itching : of the inner left arm , all of my extremities, in particular areas such as wrists and ankles, around one shoulder. The itching around my right shoulder was sudden and intense, requiring two Benedryl pills to calm enough that I could sleep. On the third morning, my right wrist itched and swelled but responded to an OTC cream. The second day my legs felt sore to the touch. No symptoms occurred on my core.

Other Meds: Levothyroxine, vitamins D and B's, Ubiquinol, fish oil, Red Yeast Rice

Current Illness: none

ID: 1042696
Sex: F
Age: 37
State: VA

Vax Date: 02/05/2021
Onset Date: 02/12/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Itchy little bumps all over, all over body pain, headache

Other Meds: Aleve

Current Illness: None

ID: 1042697
Sex: F
Age: 63
State: MT

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

Lab Data: did not go in for any medical or laboratory tests.

Allergies: shellfish, codeine, iodine are my known allergies, fragrances

Symptoms: I seemed to have some itching on my scalp, and there was a little rash under my arms, along my stomach area and a little on my face, the same as when I have been exposed to shellfish of some type, I took 2 benadryl that eve and was able to sleep, the itch went away, felt better on saturday by the afternoon started to feel itchy again took another benadryl and that helped. Had some puffiness in my hands and feet during the week, and stiffness not bad. Just wanted to let you know of the reaction.

Other Meds: none were taken at the time of the vaccination, I took a multi-vitamin, 81mg bayer, fish oil, 50mg losartan, and a .075mg levothyroxine in the am. Then that evening at bedtime I take 750mg gaba, eve primrose, 10mg paroxetine,5mg buspirone.

Current Illness: no illness prior to the vaccine.

ID: 1042698
Sex: F
Age: 31
State: CT

Vax Date: 02/03/2021
Onset Date: 02/13/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: Lung X-ray - 2/15, Aspen Virtual assessment by doctor - 2/15 In-person assessment by doctor, received antihistamine drops - 2/18 Virtual assessment by eye-doctor, received antibiotic eye drops - 2/19 In-person assessment by doctor, received 1mg cortisone shot, 500MG antibiotic In-person assessment by doctor, received Prednisone 90mg/3 days 60mg/3 days 30mg/3 days - 2/19

Allergies: Walnuts, anaphylaxis

Symptoms: -Initially I had moderate side effects to my 2nd shot, shortness of breath/increase of asthma symptoms, severe joint pain, flu-like symptoms (slight fever, chills, loss of appetite, inability to sleep) lasting for a total of 4 days. I have anaphylaxis to Walnuts (2x needed epipen and hospitalization) and asthma, many seasonal allergies, and am highly biologically sensitive (have broken out in hives several times), -8 days later I traveled to a high altitude location (Aspen, CO), and had 4 glasses of wine over a 8 hour period. For the next two days I skiied for 5 hours, going up to 12,500 ft in altitude. On the first morning after arrival I started feeling badly, with symptoms including dizziness, asthma symptoms (unusual for me as it is only exercise-induced), a headache in the front of my head, and a slight redness in my left eye. As the days increase my symptoms increased to the point of inability to leave the house. After 3 days I received an IV, oxygen, that did not help. On day 4 I went to the hospital after a virtual appointment with a clinician and had chest xrays taken as Hospital (never received the results) and was put on Diamox 250MG 2x/day, this helped slightly. Day 6 I left and traveled back to CT at low altitude, my symptoms did not improve immediately and got worse (eyes became significantly more red by this point), asthma and dizziness increased). Two days after arriving home I went to two doctors who misdiagnosed me with a sinus infection, water in my middle left year and left lung, and conjunctivitis. I was given antibiotic eyedrops that had no improvement for 36 hours. Upon receiving a 1mg cortisone shot these symptoms improved, I was also given 500MG of a Z-pack type antibiotic 1x day/4 days. I went to my PCP, doctor who was able to accurately diagnose my symptoms as an immune response to being unable to acclimatize due to my moderate immune response to the 2nd shot. My body went through significant inflammation. He treated me with Prednisone and continued my antibiotic.

Other Meds: None

Current Illness: Moderate immune response to Moderna 2nd shot delivered 2/3. Lasted 3 days, shortness of breath, intense joint pain hips, flu-like symptoms. Received two negative PCR tests two days later.

ID: 1042699
Sex: M
Age: 71
State: CA

Vax Date: 01/29/2021
Onset Date: 02/09/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: On going rash in vaccine area

Other Meds: Vitamin B,C,D, Losartin, Calcium and Mitoxantrone for prostate cancer

Current Illness: Prostate Cancer

ID: 1042700
Sex: M
Age: 67
State: AK

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

Lab Data:

Allergies: Sulfasalazine, cephalosporins

Symptoms: Pt spiked a fever of 102.2. Treated with fluids, apap, ibuprofen. Pt received vaccine @ roughly 1100, I believe he stated fever started around 1500. When reported the next afternoon, his fever had subsided down to 99.

Other Meds:

Current Illness:

ID: 1042701
Sex: F
Age: 24
State: UT

Vax Date: 01/22/2021
Onset Date: 01/30/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies: Shellfish, penicillin, doxycycline, monocycline, trimethoprim

Symptoms: Red, swollen, itchy rash on and around injection site starting on day 8 and lasting 3 days. Worst on the second day.

Other Meds: Microgestin 1/20

Current Illness:

ID: 1042702
Sex: F
Age: 60
State: MA

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

Lab Data:

Allergies: Sulfa drugs

Symptoms: Itching and red rash at vaccine site

Other Meds: Zinc, vit C, took Mirilax on 2/17 and 2/18

Current Illness: None

ID: 1042703
Sex: M
Age: 41
State: AL

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

Lab Data: None

Allergies: None

Symptoms: Woke up to use the restroom. Passed out and fell multiple (~5) times while trying to return to bed. I have never experienced that before.

Other Meds: None

Current Illness: None

Date Died: 02/19/2021

ID: 1060522
Sex: M
Age: 86
State:

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

Lab Data:

Allergies:

Symptoms: death Narrative: 86 year old MALE with PMH of Afib s/p AICD/PPM, HFrEF (EF< 20% 10/2019), DM2, HTN, HLD, BPH, Depression. Was stable and feeling well when he was administered Covid-19 vaccine on 02/17/2021- Pfizer COVID-19 Vaccine 0.3 ml IM. MVX (Manuf); PFR; Lot#; EL9267; Exp Date:05/31/2021 Administration Anatomic site: Right Deltoid; Pt was monitored for 30 minutes after administration and had no adverse effects. He was called later in the day and reports he feels well and has had no adverse reactions, he endorsed his arm is a little sore at injection site. ON 02/19/2021- his dghter found him on the floor, next to his bed, dead. She reported on 2/19/2021- that she was out with him to dinner on 2/18/2021, and he stated he did not feel well, that his insides did not feel right. He proceeded to have dinner and 2 drinks. HE was doing ok, when she took him home.

Other Meds:

Current Illness:

Date Died: 01/25/2021

ID: 1060523
Sex: M
Age: 92
State:

Vax Date: 12/31/2020
Onset Date: 01/25/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies:

Symptoms: contracted covid after first dose Narrative: First covid vaccine dose 12/31/2020, tested positive for covid 1/7/2021, died from complications 1/25/2021

Other Meds:

Current Illness:

ID: 1261993
Sex: M
Age: 68
State: MI

Vax Date: 02/04/2021
Onset Date: 02/10/2021
Rec V Date: 02/19/2021
Hospital: Y

Lab Data: Brain MRI

Allergies: Allopurinol

Symptoms: Ocular Issue--had vision change at 9:30am on 2 /10/21, could not focus on his computer screne, esp right eye, central focus and had a right eye stabbing pain, patient has had 3 day migraines years ago with vomiting etc. On the day of hospital admission, 2-11-21 after a walk in the bright snow, then sex and a nap, patient was disoriented for 15 minutes, then it mostly resolved. But his memory was a bit off for the next 6 hours. It took him 3 tries to get his wife's name correct. Briefly he didn't know where he was and did not recognize his cat. So he went to the ER.

Other Meds: Vitamin C, Aspirin, Lipitor, Singulair

Current Illness: none

ID: 1261994
Sex: M
Age: 72
State:

Vax Date: 02/11/2021
Onset Date: 02/15/2021
Rec V Date: 02/19/2021
Hospital: Y

Lab Data:

Allergies:

Symptoms: fever, chills Narrative: Patient is 72 years old. He has a past history of hypertension, hyperlipidemia, diabetes mellitus, end stage renal disease due to hypertensive / diabetic nephrosclerosis. Who was COVID + on November 10 and received COVID vaccination Feb 11. After his vaccination he developed fever chills and body aches to the point where he felt unable to come to his dialysis session. After missing dialysis he became more short of breath and came in to be seen in the ED. In ED he was clearly volume overloaded and hyperkalemic. He was then admitted to MICU service and urgent dialysis

Other Meds:

Current Illness:

ID: 1261995
Sex: M
Age: 81
State:

Vax Date: 01/11/2021
Onset Date: 01/15/2021
Rec V Date: 02/19/2021
Hospital: Y

Lab Data:

Allergies:

Symptoms: UTI, urinary/bowel incontinence Narrative: first COVID19 vaccine 1.11.21, ER visit with hospitalization 1.15-1.18.21 for SIRS/Sepsis, initially thought to be urosepsis but post discharge UA and blood cultures were negative; source was not identified. Beyond symptoms listed, patient just reported he "felt terribly bad" prior to spouse calling EMS. VAERS reported by hospitalist as well from the facility where he was treated. He was discharged home with Augmentin for UTI and Physical Therapy for strengthening. Patient follows local PCP and this facility PCP. Responsible physician listed on this form is this provider's facility Medical Director.

Other Meds:

Current Illness:

ID: 1261996
Sex: F
Age: 63
State:

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

Lab Data:

Allergies:

Symptoms: Narrative: HPI: Patient is a 63 who presents for evaluation of itching eyes, feelin of nasal swelling immediately after receiving COVID-19 vaccination. Patient reports approximately 15 minutes after receiving vaccination, she started feeling as if her nostrils were swelling, her eyes were itching and her tongue "started to feel funny." Patient reports prior history of anaphylactic reactions to multiple allergens. She was given diphenhydramine 25mg IM once and transported to ER. At ER she was given diphenhydramine 50mg oral, famotidide 40mg oral, and acetaminophen 925mg oral. At ER patient reported 20 minutes after COVID vaccine her lips and tongue began to feel tingly and larger inside her mouth. She reported she has had reactions before to some immunotherapy drugs some years ago. She denied any symptoms of difficulty swallowing, wheezing, difficulty breathing, chest tightness, abdominal pain, nausea, vomiting, diarrhea, sweating, runny nose, eye itching, or any other symptoms at this time. Physical exam was unremarkable, no obvious swelling noted, no rash or hives noted, no secondary signs of allergic reaction, vitals remained stable, no hypotension or tachycardia. She was discharged home with instructions to continue taking diphenhydramine every 8 hours for 24 hours and to follow-up with primary care in 1-2 days.

Other Meds:

Current Illness:

ID: 1261997
Sex: M
Age: 73
State:

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

Lab Data:

Allergies:

Symptoms: malaise Narrative: Patient with ESRD on dialysis, HIV and h/o of positive COVID 19 in 7/2020. COVID vaccine 2/5/21 Reaction on 2/6/21 - fever, cough, malaise, confusion Admitted to hospital on 2/7/21 * Fever at home 101-102, fever causing patient to miss dialysis session Fever in ER of 102.1, Gram positive cocci found in blood during admission

Other Meds:

Current Illness:

ID: 1284994
Sex: F
Age: 55
State: FL

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

Lab Data: 0 N/A

Allergies: 0

Symptoms: on 2/16/2021 by 2pm, extreme pain Left arm including knuckles + fingers, neck, shoulders. By 4pm same day, headache, nausea, extreme fatigue, no temp at this time. That evening same symptoms and during night. on 2/17/2021 all the same and at night 99.2 temp. (shortnessofbreath both days)

Other Meds: 0

Current Illness: 0

ID: 1284995
Sex: F
Age: 76
State: FL

Vax Date: 02/03/2021
Onset Date: 02/10/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data: none/ wanted to see the doctor but was told different side effects were normal

Allergies: sulfa based drugs

Symptoms: My reactions started on Feb 10, Wed nite, with pain going from the left shoulder to right shoulder. Next day pain was in the right lung, severe, (could not take a breath). Next day the pain and discomfort traveled dow my right leg, extreme cramps, soreness, etc. The next day it was my left lung in severe pain. By Monday my breathing is very shallow and my cough is much worse, each cough produces its own package of phlem. Breathing is diffiicult I HAVE AN APPOINTMENT TO RECEIVE SECOND SHOT ON FEB. 24. I DO NOT THINK I SHOULD

Other Meds: armour thyroid 90mg; diclofenac 150mg; telmisartin; dulox-e

Current Illness:

ID: 1284996
Sex: U
Age:
State: NJ

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

Lab Data:

Allergies: CATS

Symptoms: 8 MINUTES AFTER COVID 19 VACCINE THE PATIENT COMPLAINED OF "THROAT TIGHTNESS." NO C/O SHORTNESS OF BREATH 170/95 P. 80 P.O 99% EMS EVALUATED THE PATIENT 2/19/21 2PM. THE PATIENT WAS ABLE TO TOLERATE WATER. REST, COOL AIRD AND THE PATIENT IMPROVED. THE PATIENT WAS DISCHARGED IN CARE OF HIS WIFE. HX ANXIETY HYPERTENSION LOSARTAN 25MG NORVASC 10MG

Other Meds: NORVASC 1OMG LOSARTAN 25MG

Current Illness: 0

ID: 1284997
Sex: F
Age: 63
State: AL

Vax Date: 02/04/2021
Onset Date: 02/14/2021
Rec V Date: 02/19/2021
Hospital:

Lab Data:

Allergies: glue in bandages

Symptoms: Fiery red spot approximately two inches across at the site of injection. This started ten days after vaccination. It stung and itched. It was very uncomfortable. It still stings but it looks and feel much better better now. I called my family doctor, they said report it to the health department. I called they said report to Moderna.

Other Meds:

Current Illness: none

ID: 1284998
Sex: F
Age: 44
State: TX

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

Lab Data: Tylenol (samples given)

Allergies: N/A

Symptoms: It WAS A Mix-up ON My VACCiNE. IN My ChArt ANd the system it SAiD PfiZER I eNded up getting ModerNA. ThursdAy wheN I Awoke I hAd Chills, felt lightheAded NASUSeA, NO Appetite

Other Meds: TyleNol, HuMliN 70/30 INsuliN Lisonoprol

Current Illness: DIAbetEs

ID: 1391336
Sex: F
Age: 86
State: VT

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

Lab Data:

Allergies: None

Symptoms: 2 minutes after vaccine administratios started Saying she did not feel right. She stated to develop Pallor, blue immediately went to her couch where she lAid down, she expressed feeling dizzy. Cold cloth to heAd, OJ given. VS 130/74 BP P70 colored returned within 40 miN . VS stable started she felt better

Other Meds:

Current Illness: Stated none

ID: 1391340
Sex: F
Age: 44
State: CA

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

Lab Data:

Allergies:

Symptoms: Waited for 15 minutes after the 15 minutes and felt fine. Left and approximately 25 minutes after leaving, patient started to have tightness all down her left side of her body (chest, jaw, face and throat). Took 50mg of Benadryl and waited in the ER parking lot for 1 hour until she felt okay to go home. Patient was still having tightness in her chest when seen on 3/16 with a slight wheeze (non-asthmatic). Felt very winded x3 days. Dr. recommended not getting 2nd dose and consider booster of J & J vaccine when available.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm