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: 1046822
Sex: F
Age: 39
State: CO

Vax Date: 02/13/2021
Onset Date: 02/16/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data: N/A

Allergies: amoxicillin

Symptoms: 3 days after vaccine I woke up with nausea, upset stomach. Symptoms resolved within 6 hours. 1 week after vaccine, woke up at 3:00am with nausea and heat wave/chills, resolved within an hour

Other Meds: occasionally take melatonin for sleep Mirena IUD

Current Illness: N/A

ID: 1046823
Sex: F
Age: 68
State: OR

Vax Date: 02/03/2021
Onset Date: 02/04/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data: Sputum sample - not collected Covid Test- negagtive

Allergies: no

Symptoms: pt stated that the day after her vax she had 100 degree fever and was not feeling well. The second day she did not have a temp. She was feeling bad about every other day. About a week later she is still feeling bad, coughing and has lost her taste. She contacted her infectious disease doctor. He stopped her taking the Sevixtro medicine. He ordered her to take a sputum sample to have tested which she has not collected yet. Pt talked to her supervisor at work and they asked to get a covid test so she went to an Urgent Care where she tested negative. Pt has appt w/ her infectious disease doctor on 3/9/2021.

Other Meds: clofazimine 200mg x2 daily, Sivextro 200 mg x 1 daily, Arikayce 500mg per vial (dose 1/2 vial x 3 per week - nebulized) Sp17 Sleep Aide, Gaba 500mg, melatonin 5mg, Vitamin C 1000mg x3 daily, Multivitamin w/ folate, B6 100mg, Ashwagandha 38

Current Illness: no

ID: 1046824
Sex: M
Age: 74
State: NH

Vax Date: 02/20/2021
Onset Date: 02/21/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: Soreness at injection site when pressure is applied. Do not notice unless pressure applied.

Other Meds: atorvastatin 20 mg, metoprolol 50 mg, lisinipril 2.5 mg. baby aspirin, Vitamin D 2000 IU

Current Illness: none

ID: 1046825
Sex: M
Age: 66
State: IL

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

Lab Data: None

Allergies: NKDA

Symptoms: This patient received his first Moderna COVID vaccine on 2/5/21. He was scheduled for a COVID Vaccine 1st dose appointment today in error and received the Moderna COVID vaccine today, 2/22/21. He did not experience any immediate adverse events with today's vaccination. His PCP will be calling him daily for the next 48 hours to monitor for adverse events.

Other Meds: Amlodipine 10 mg daily Atorvastatin 40 mg daily Telmisartan 40 mg daily

Current Illness: None

ID: 1046826
Sex: U
Age: 86
State: AZ

Vax Date: 02/20/2021
Onset Date: 02/21/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data: n/a

Allergies: codene sensitive

Symptoms: None stated.

Other Meds: metamucil

Current Illness: n/a

ID: 1046827
Sex: F
Age:
State: AL

Vax Date: 02/18/1921
Onset Date: 02/19/1921
Rec V Date: 02/22/2021
Hospital:

Lab Data: None

Allergies: Penicillin, sulfa

Symptoms: Swelling and redness covering upper arm for 3dYs. Cold compresses, Zyrtec. Singular, ipubrophen

Other Meds: Lisinopril, nexium, zetia,

Current Illness: None

ID: 1046828
Sex: F
Age: 68
State:

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

Lab Data:

Allergies:

Symptoms: PT stated that she has severe itching all over her body including arms. Pt denies any airway issues. Pt did not display any hives but arms were red due to pt scratching. Pt stated this happened the first vaccine but did not tell healthcare workers at screening nor did she annotate it on form. Pt was not given epi but EMS assist was called and pt was escorted to Emergency Room.

Other Meds:

Current Illness:

ID: 1046829
Sex: F
Age: 32
State: CA

Vax Date: 02/11/2021
Onset Date: 02/11/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Injection site pain, body aches, fatigue

Other Meds:

Current Illness:

ID: 1046830
Sex: F
Age: 69
State: FL

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

Lab Data:

Allergies: Milk products, "mycins" drugs, contrast dye, Oxycodone (Hallucinations)

Symptoms: A few hours after getting the vaccine, my arm became sore. It got worse as the night went on. It was extremely achy. It was still happening as of Saturday, I also felt lightheaded. I felt like a was on a merry-go-round, it felt like it kept getting faster and faster. I felt dizzy all day Saturday. I had to rest all day. I lost my appetite. Anytime I got up to go to the bathroom, I had to hold something to walk. I also had a mild headache. I felt better on Sunday. My arm was still a little sore as of yesterday but it is better today.

Other Meds: Triamterene 37.5 MG daily, HTCZ 25 MG daily, Losartan 25 MG daily, Latanoprost .005% eye drops in both eyes, another eye drop name unknown, Aspirin 81 MG, Calcium supplement, One day vitamin, Align one a day.

Current Illness:

ID: 1046831
Sex: M
Age: 42
State: FL

Vax Date: 02/09/2021
Onset Date: 02/09/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data: CT scan of brain- normal

Allergies: NKDA

Symptoms: Headache, low grade fever, chills, body aches, and injection site pain.

Other Meds: Lisinopril Singular Lipitor

Current Illness: N/A

ID: 1046832
Sex: F
Age: 27
State:

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

Lab Data:

Allergies:

Symptoms: Near syncope, evaluated by EMS -dizzy, lightheaded. BP 128/72. Monitored for 30 minutes, symptoms resolved. Discharged home at 1:30 pm.

Other Meds:

Current Illness:

ID: 1046833
Sex: F
Age: 78
State: NC

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

Lab Data: unknown

Allergies: dextromethorphan (anaphylaxis), guaifenesin (anaphylaxis), ol dextromethorphan (anaphylaxis), guaifenesin (anaphylaxis), olmesartan (itching), erythromycin (unknown), hydrocodone (unknown), atorvastatin/pravastatin/rosuvastatin (muscle pain), codeine (throat swelling), shrimp (hives, itching)

Symptoms: On 2/19/2021, 78yr old female with history of asthma, diverticulitis, GERD, hiatal hernia, HTN, and hyperlipidemia was administered second dose of COVID-19 Pfizer vaccine 0.3mL in left deltoid (LOT # EN6201). Patient has several documented allergies including dextromethorphan (anaphylaxis), guaifenesin (anaphylaxis), olmesartan (itching), erythromycin (unknown), hydrocodone (unknown), atorvastatin/pravastatin/rosuvastatin (muscle pain), codeine (throat swelling), shrimp (hives, itching). Patient received first dose of COVID-19 Pfizer vaccine on 1/27/21 without any documented issues. Patient initially tolerated injection without incident and was sent for post-injection 15min observation. During 15min observation period, patient became dizzy, diaphoretic, nauseated, and unable to walk with steady gait, hypertensive and endorsed hives. EMS called and patient sent to ED. During initial presentation to ED, BP 180/80, HR 85, and 97% on RA. Patient given Benadryl 25mg PO and ondansetron 4mg IVP at 2055. 1L LR bolus given at 2059. BP lowered during ED observation (BP 160/80 on 2/20 at 0442). Acetaminophen 650mg PO given at 0442 prior to discharge. Patient discharged home in stable condition ~ 0500 on 2/20 with plan for patient to follow up with outpatient provider. EpiPen was not prescribed at discharge. No update to EPIC allergies noted at this time. Of note, reporter notes unable to check POC BG at clinic (glucometer unavailable). Patient has no history of diabetes, but noted that has similar "episodes" with low BG. EMS checked BG (POC = 144).

Other Meds: acetaminophen, amlodipine, albuterol, fluticasone nasal spry, lidocaine patch, senna, pantoprazole, rosuvastatin, tramadol, triamterene-hydrochlorothiazide

Current Illness: unknown/none

ID: 1046834
Sex: M
Age: 71
State: WA

Vax Date: 02/16/2021
Onset Date: 02/16/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Fatigue 2-16-21 : 2-18-21

Other Meds: Synthroid Flomax Omeprazole Mirtazapine

Current Illness:

ID: 1046835
Sex: M
Age: 65
State: VA

Vax Date: 01/22/2021
Onset Date: 01/25/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data: 02-12-2021 PLT 119

Allergies: tetracycline sensitivity

Symptoms: experienced epistaxis 2-3 x daily for approx 3 weeks, self ordered platelet count and it dropped significantly since 12-31-2020 and last blood work. Currently the frequency has slowed down.

Other Meds: lipitor

Current Illness:

ID: 1046836
Sex: F
Age: 50
State: AK

Vax Date: 02/10/2021
Onset Date: 02/17/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: Arm turned red, swelled, and itched like a bug bite around the injection site that happened about 7 days after 1st shot and lasted about 72 hours . I have three red marks remaining that look like scratched.

Other Meds: vitamin d, probiatic, levothyroxine, sertraline. Lisinopril

Current Illness: none

ID: 1046837
Sex: F
Age: 95
State: CA

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

Lab Data:

Allergies:

Symptoms: patient complained stomach pain, responsive but lethargy and slightly clammy. Vital Signs: BP 112/45; pulse 41; O2 Sat 99 - 100%. Bradycardia patient put on gurney, heart monitor, started IV lock. transferred to ED for further evaluation.

Other Meds:

Current Illness:

ID: 1046838
Sex: M
Age: 75
State: IN

Vax Date: 02/15/2021
Onset Date: 02/20/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data:

Allergies: No known allergies

Symptoms: Local redness and warmth at injection site, about 2-3 inches in radius around the site. Occurred approx. 5 days after injection.

Other Meds: fenofibrate 48 mg PO daily, loratadine 10 mg PO daily, losartan potassium 50 mg PO daily, metoprolol tartrate 20 mg PO once in AM and twice in PM, nystatin 100000 units/gm ointment applied BID, omeprazole 40 mg daily, tizanidine 4 mg PO da

Current Illness: GERD

ID: 1046839
Sex: M
Age: 81
State: KY

Vax Date: 02/18/2021
Onset Date: 02/19/2021
Rec V Date: 02/22/2021
Hospital: Y

Lab Data: 2/19 Creatinine 2.14, 2/19 WBC 15.97, 2/19 COVID swab (+)

Allergies: ibuprofen, latex

Symptoms: Patient is a 81 y.o. gentleman with a history of smoldering multiple myeloma, urinary retention for which he self catheterizes twice daily, as well as recently diagnosed atrial fibrillation that presents complaining of increasing weakness and falls. Patient fell 2/18 pm trying to get out of bed and he took about 20 minutes to get himself to a position where he could pull himself back up. Again 2/19 he was trying to get up and his legs were too weak to carry him and he fell to the ground. He needed assistance to get up and family asked him to come to emergency room for evaluation. He has been feeling poorly for about a month, with poor appetite and has lost about 15 pounds. He is not nauseated or short of breath and has no cough. He was apparently treated for UTI about 4 to 6 weeks ago after a visit to urgent care. He has since been to a different urgent care and was diagnosed with atrial fibrillation which was new in onset and was referred to a cardiologist who is planning to do a stress test in a few weeks. I believe he is on Eliquis now. In ER he was found to have significant pyuria and bacteriuria and was given a dose of Rocephin. Renal function shows worsening from levels in December although it is pretty stable over the past month from looking through other labs.

Other Meds: Apixaban 2.5mg PO q12h, cholecalciferol 2000units po qday, Cyanocobalamin, Fluticasone 220mcg/act 1 puff qam, ipratropium 0.06% 2 sprays each nostril bid, loratadine 10mg qday, Montelukast 10mg qhs, oxymetazoline 0.05% 2 sprays each nostril

Current Illness:

ID: 1046840
Sex: F
Age: 60
State: CA

Vax Date: 02/20/2021
Onset Date: 02/21/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Rash and itchiness at site. Chills and body aches

Other Meds: None

Current Illness: None

ID: 1046841
Sex: F
Age: 51
State: OH

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

Lab Data:

Allergies: pcn, erythromycin, inderal, sunthetic hormones

Symptoms: Difficulty swallowing within minutes of vaccination. no progression of this symptom and also developed a mild headache to base of skull. chest feels a little tight. 12.5 mg of Benadryl given about 30 minutes in to observation. After another 50 minutes, headache gone, chest pressure less, and swallowing improved. patient advised to return to ED if symptoms returned or worsened.

Other Meds: vitamins

Current Illness: platelet deficiency

ID: 1046842
Sex: F
Age: 65
State: AZ

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

Lab Data:

Allergies: Codeine

Symptoms: Began feeling an itchy throat

Other Meds: Metformin, atorvastatin,

Current Illness:

ID: 1046843
Sex: F
Age: 56
State:

Vax Date: 02/13/2021
Onset Date: 02/16/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data:

Allergies:

Symptoms: 2nd covid vaccine afterward extremely fatigued and arm soreness for days. On 2/16/21 at 5am, left side weakness in my arm tingling and numbness in my fingers and toes very weak.

Other Meds:

Current Illness:

ID: 1046844
Sex: F
Age: 76
State: NM

Vax Date: 02/03/2021
Onset Date: 02/04/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data: None

Allergies: Allergic to compazine

Symptoms: The following day after my injection, I had bright RED hives all over my body except for my face and hands. It was very uncomfortable. I tried to calm my skin with lotions. As the days progressed, the color receded and all of my skin started to peel. It was terrib ly itchy and difficult to wear clothing. It took about a week for it to calm down, and the peeling continued for another week.

Other Meds: Lisinopril 10 MG, Letrozole 2.5 MG ; Atorvastatin 20 MG, Levothyroxine .075 MG; Vitamin D3 125 mcg, Centrum Silver, 2/3ay, Calcium 600 mg + D3 10 mcg

Current Illness: Had Covid-19 at into December. Was not hospitalized.. Test confirmed diagnosis..

Date Died: 02/18/2021

ID: 1046845
Sex: F
Age: 84
State: VA

Vax Date: 02/17/2021
Onset Date: 02/18/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Deceased 02/18/2021 with an unknown cause of death

Other Meds:

Current Illness:

ID: 1046846
Sex: F
Age: 59
State: MD

Vax Date: 02/11/2021
Onset Date: 02/17/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data:

Allergies: Benadryl, Vicodin

Symptoms: Rash with severe itching to L upper arm that started approximately 6 days after receiving the vaccine. I continue to have the rash and itching . Today is 2/22.

Other Meds: Lipitor, Vit D, Fyavolv, Zyrtec

Current Illness:

ID: 1046847
Sex: F
Age: 44
State: AZ

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data: none

Allergies: minor milk and pork allergy

Symptoms: Several hours after shot, arm soreness and redness - next few days very sore arm, large red round raised splotch on arm - hot to the touch - 3rd day arm was less sore, red turned to black and blue bruise looking, 4th day arm clear. On 8th day, large red round splotch re-appeared is hot to the touch and itchy - still there day 10.

Other Meds: Propranolol Zyrtec Vitamin C Vitamin D Vitamin B12 Magnesium

Current Illness: none

ID: 1046848
Sex: M
Age: 65
State: IL

Vax Date: 02/18/2021
Onset Date: 02/18/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data:

Allergies: Unknown

Symptoms: Long term care facility closely monitoring patient. Given three doses of Covid - Pfizer dose, 01/07/21, 01/28/21, 02/18/21.

Other Meds: Unknown

Current Illness: Unknown

ID: 1046849
Sex: F
Age: 48
State: MI

Vax Date: 02/18/2021
Onset Date: 02/18/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data:

Allergies: cephalexin celexa contraceptives pcn shellfish

Symptoms: Patient phoned pcp office Clinic to inform: receipt of 2nd Moderna vaccination at HD on 2/18/21, patient states on 1st evening felt numbness and tingling in tongue, as well as fatigue, body aches, chills, but took benadryl and no worsening s/s. Typical side effects of body aches, chills, sore joints continued throughout day 2 and day 3. On day 3 patient reports she developed a rash on her neck and swollen eyes. Reported information to pcp NP for advisement today.

Other Meds: Berberine complex metformin 500 mg BID albuterol hfa 108 prn flaxseed oil 1000 mg daily flonase NS prn zyrtec 10 mg daily prn b complex daily cayenne pepper po daily multivitamin daily vitamin c 1000 mg tab daily iron every other day vitami

Current Illness: none noted

ID: 1046850
Sex: M
Age: 73
State: NY

Vax Date: 02/18/2021
Onset Date: 02/19/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data: no

Allergies: No

Symptoms: It started with shaking and feeling cold. it lasted about an hour. I could not stop shaking. my temperature was 103.5. I had trouble walking, I had fatigue and tiredness. My arm hurt up to the base of my neck. I had pain urinating. my fever lasted about 12 hours. It did go away by 2/21.

Other Meds: Norvasc Ramipril Gabapentin alopurinol Simvastatin Vitamins: D C Zinc

Current Illness: No

ID: 1046851
Sex: F
Age: 70
State: OK

Vax Date: 02/19/2021
Onset Date: 02/20/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data:

Allergies: antibiotics

Symptoms: night after injection I got rash and hives all over the body. Neck eyes, arms legs, thighs and butt, back, pretty much everywhere. I have taken Benadryl and it is not helping a whole lot. Called the Dr but i have not heard back yet.

Other Meds: thyroid meds, allergy meds, Cingular, astatine, Prilosec, Pepcid,

Current Illness:

ID: 1046852
Sex: F
Age: 87
State: LA

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data:

Allergies: Codeine

Symptoms: No problems after shot until 12 hrs later. Then chills, fever bad headache, nausea for 2 days. Took Tylenol and stayed in bed

Other Meds: Synthroid, valsartan 80 mg,eliquis 2.5 mg, metropolol 25 mg, pantoprazole 40, vitamins B,C, D,

Current Illness: Slight cold

ID: 1046853
Sex: F
Age: 34
State: TX

Vax Date: 02/02/2021
Onset Date: 02/03/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data: UNK

Allergies: UNK

Symptoms: site pain and headache

Other Meds: UNK

Current Illness: UNK

ID: 1046854
Sex: M
Age: 60
State: MA

Vax Date: 12/18/2020
Onset Date: 01/06/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data: no

Allergies: no

Symptoms: 1/6 18 days after the vaccination I woke up with floaters in my right eye. Much more developed throughtout the day. The next day Thursday I had a visual deficite in my eye along with the floaters. By Friday evening I went up to see the eye doctor while at work and was advised I had 5 tears to the retina of my right eye and was advised it needs to be repaired immediately. On 1/9 I had a vitrectomy and the tears in the retina were repaired as well. I was advised the surgery had an 85% success rate but advised I will develop a cataract in the eye within 6months but within 6 weeks it developed. 2/22 I had the cataract removed and a lense replaced in my right eye.

Other Meds: Aspirin 81mg, 80mg Lipitor, 5mg Amlodipine, Liviotyrozine, Losartan 100mg

Current Illness: no

ID: 1046855
Sex: F
Age: 68
State: AZ

Vax Date: 02/13/2021
Onset Date: 02/20/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Just before falling asleep on day seven, my left upper arm was itchy, but thought nothing of it and went to sleep. The next morning I noticed a large red, oval lesion around the place where I had the vaccine shot. The rash appears to be fading slowly from the center out.

Other Meds: Bio-identical hormones: estrogen, progesterone, testosterone, DHEA Sumatriptan as needed for migraine. I can't remember, but I might have taken this the night the itchy rash started. Vitamins: Multi-vitamin, Hyaluronic Acid, B-complex with

Current Illness:

ID: 1046856
Sex: M
Age: 87
State: MD

Vax Date: 02/11/2021
Onset Date: 02/12/2021
Rec V Date: 02/22/2021
Hospital: Y

Lab Data:

Allergies: Sulfa antibiotics (itching)

Symptoms: Patient was admitted for AMS, possible UTI. Patient also tested positive for COVID-19 at this time. He stayed overnight, was felt to be stable and was discharged. He was readmitted 1 day later under observation for weakness, treated, and discharged to a nursing home

Other Meds:

Current Illness:

ID: 1046857
Sex: F
Age: 70
State: TX

Vax Date: 02/06/2021
Onset Date: 02/07/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data: n/a

Allergies: Potentially another statin, probably Crestor

Symptoms: Felt fine at first, but then suffered flu-like symptoms including extreme fatigue, stomach discomfort, gas, nausea, loss of appetite, acid reflux. Some symptoms have ceased or lessened, but extreme fatigue, lack of appetite and some stomach discomfort and acid reflux discomfort continues.

Other Meds: Irbestartan/hctz 300-12.5mg, Lovastatin 10 mg, Restasis emu 0.05%, potassium CL ER 10 MEQ Micro tab, D 1000iu, Calcium 600mg, B-12

Current Illness: Food poisoning one or two weeks before.

ID: 1046858
Sex: F
Age: 33
State: IL

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

Lab Data: None

Allergies: Cephalexin, Cyclobenzaprine, Meloxicam, traMADol

Symptoms: Patient was being held for monitoring after receiving the COVID-19 vaccine. Within 1-2 minutes, patient developed facial redness and itching. She then started to feel as if her throat was itchy and started coughing uncontrollably. Denied lip or tongue swelling. Was feeling normal prior to receiving the vaccine. Was not recently seen/assessed for other medical care. No similar symptoms previously. Patient was taken to the Emergency Department. Ptaient did have a few red splotches on her chest, but these did not appear consistent with urticaria per the ED physician's report. ED physician felt patient's symptoms may be secondary to anxiety. However, given history of anaphylaxis and feeling of throat itching it was felt necessary to treat for possible allergic reaction. Patient was given epinephrine, Benadryl, famotidine, and Solu-Medrol. She was then monitored in the ED for 4 hours. During this time, she developed no new symptoms. She continued to breathe easily with normal and stable vital signs. She was discharged with instructions to buy OTC Benadryl 25mg PO to take every 8 hours for 48 hours. Prednisone 20mg, 3 tablets orally daily for 5 days weas prescribed. An EpiPen was also prescribed. Patient advised not to receive second dose of the vaccine and to follow up with her primary care provider.

Other Meds: Omeprazole

Current Illness: None

ID: 1046859
Sex: F
Age: 73
State: CA

Vax Date: 01/23/2021
Onset Date: 01/25/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: Large red swelling and itching in arm where injection was given. lasted about 3 days

Other Meds: no

Current Illness: no

ID: 1046860
Sex: M
Age: 41
State: CA

Vax Date: 02/20/2021
Onset Date: 02/20/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Pain at injection site, High Fever 101.5 lasting 24 hours, Whole body pain, Barely able to walk

Other Meds:

Current Illness:

ID: 1046861
Sex: M
Age: 46
State: KY

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

Lab Data:

Allergies: no

Symptoms: A few hours after injection, injection site became very sore, started running a fever, HA, body aches, malaise, inability to sleep well. The worst lasting for 3 days. Could not go to work. Loss of appetite.

Other Meds: citalopram

Current Illness: no

ID: 1046862
Sex: M
Age: 75
State: NY

Vax Date: 02/20/2021
Onset Date: 02/21/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data:

Allergies: kefllex

Symptoms: chills, fever, severe weakness, nausea, incontinence - began approcimately 12 hours following the vaccine and were severe for approximately 20 hours

Other Meds: fish oil. calcium, potassium, b-12, memantine, donepezil, metoprolol

Current Illness: no

ID: 1046863
Sex: F
Age: 48
State: CT

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data:

Allergies: asprin, motrin

Symptoms: Chills, fever, severe body pain, severe fatigue, light-headed, symptoms lasted for about 36 hours

Other Meds: singulair,advair,dupixent,multivitamin,calcium,iron,vit d

Current Illness:

ID: 1046864
Sex: F
Age: 33
State: OH

Vax Date: 02/15/2021
Onset Date: 02/15/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data: 2/22/21. I had a covid test, strep and influenza done. All were negative.

Allergies: None

Symptoms: First 2 days I had high fever, nausea, vomiting, chills, shaking, migraine, fatigue, and body aches. It is one week after my second injection and I still have severe fatigue, body aches, sore throat, nausea, headache, and swollen lymph nodes.

Other Meds: None

Current Illness: None

ID: 1046865
Sex: M
Age: 84
State: OH

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

Lab Data:

Allergies: None

Symptoms: Lightheadeness, BP 159/97 - my normal is ca. 120/87, Pulse 57 my normal 51. O2 - 92 my normal ca.96, belching,, difficulty keeping balance, slight fever 98.4, nausea, feeling miserable - un-comfortable sitting or standing,, chills

Other Meds: Acetominpphen,Amlodipine,Vit..C, 8mg. Aspirin,Calcium Citrat +D, Coenzyme Q-10,Fluticasone Proprionate,FolicAcid,,Glucoamine Chondroitin,Latanapost,Levocetrizine,Lisinopril, Mg,, Metoprolol,Omega 3, Porvigil,B12, B6,Vit.D3, Vit. E

Current Illness: Osteoarttirtis, Incontinence treated with implant, narcolepsy, apnea

ID: 1046866
Sex: F
Age: 66
State: VA

Vax Date: 02/11/2021
Onset Date: 02/20/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data: none

Allergies: sulfur

Symptoms: Rash beginning on upper left arm near injection site, spreading to face, chest, right art, hands and back. Much like an allergic reaction to poison ivy. I cannot pinpoint to any other change in diet, laundry detergent, soap, etc. I am treating with Benadryl and cortizone cream but some whelps are still itchy 2 days later. I am better but not completely gone.

Other Meds: Fenofibrate Tabs 145mg, Hydrochlorithiazide 12.5mg, Amlodopine Besylate 10mg, Fish Oil 1000mg, Aspirin 81mg, Melatonin 6mg, Vitamin D3 50 mg, Calcium 1200 mg

Current Illness: none

ID: 1046867
Sex: M
Age: 45
State: KY

Vax Date: 02/16/2021
Onset Date: 02/17/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data: PATIENTS STATES THAT HE HAS SEEN HIS PCP. HE STATES THAT HE IS ORDERING ADDITIONAL TESTING. STATES THAT THE MD FIRST SAID IT MAY BE RELATED TO A SEIZURE BUT IS NOW THINKING NOT SINCE HIS WIFE WAS ABLE TO WAKE HIM UP. TO DATE, PATIENT HAS HAD NO OTHER LABS/TEST PERFORMED BUT IS WAITING FOR THOSE TO BE SCHEDULED.

Allergies: PCN AND STATINS

Symptoms: PATIENT STATES HE CAME HOME FROM WORK. STATES HE SAT DOWN IN THE RECLINER WITH A GATORADE TO DRINK. STATES HE GOT CHOKED ON THE GATORADE AND STARTED COUGHING. STATES THAT THE NEXT THING HE REMEMBERS IS HIS WIFE TRYING TO GET HIM AWAKENED. STATES THAT HE FEELS FINE NOW. HE SAYS THAT HE FEELS TIRED BUT HAS BEEN SINCE HE HAD COVID.

Other Meds: FENOFIBRATE, BLOOD THINNER (UNKNOWN NAME), PRILOSEC, LISINOPRIL, METFORMEN, ZYRTEC, INVOKANA

Current Illness: DX WITH COVID ON 01/20/2021; HOSPITALIZED ON 01/25/2021; RELEASED ON 02/01/2021.

ID: 1046868
Sex: F
Age: 60
State: TX

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data:

Allergies: NKDA

Symptoms: Communication Comment: "Patient present in clinic for COVID-19 vaccine. Patient reported feeling something" going up and down her neck" about 15 mins after vaccines was administered. Blood pressure reading was obtained, elevated at 188/100, HR 100. She reported new symptoms of dry throat causing tightness sensation and numbness in tongue. Patient was given Benadryl 25mg PO and water and observed for an additional 40minutes. Her symptoms resolved including throat dryness, tongue tingling, throat tightness. Denies dizziness, rash, difficulty swallowing, hoarseness, chest pain. Vital signs improved. She reports she has blood pressure medicine at home that she was advised to take only when needed. She did not take medication today. She does not know the name of medication. Declined prescription of blood pressure medication today, agreed to take medicine she has at home and return to clinic for appointment Friday, 2/12/2021. Patient given strict ER precautions if her symptoms continue, worsen or if she develops new symptoms."

Other Meds: None

Current Illness:

ID: 1046869
Sex: U
Age:
State:

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

Lab Data:

Allergies:

Symptoms: None stated.

Other Meds:

Current Illness:

ID: 1046870
Sex: F
Age: 70
State: FL

Vax Date: 02/09/2021
Onset Date: 02/15/2021
Rec V Date: 02/22/2021
Hospital: Y

Lab Data: Medical record at Hospital; Tests included CXR, CT head , CT Chest for PE . Labs: Thyroid panel, Chest pain panel, c reative protein, ESR, NT Pro BNP, D-dimer and UDS. Test EKG.

Allergies: PCN

Symptoms: 5-7 days after injection Rash, altered mental statues, shortness of breath

Other Meds: synthroid150 mcg , oxycodone 10 mg , gabapentin 3000 mg , benadryl, ROSUVASTATIN 10 MG ORAL TAB, albueral ,

Current Illness: None

ID: 1046871
Sex: F
Age: 64
State: NC

Vax Date: 02/11/2021
Onset Date: 02/20/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data: None

Allergies: NKDA:NKFA

Symptoms: "Swollen, delayed, red, hive type but not a hive, grew bigger as time went by and lighter in color." Size description: "Length and width of a dollar bill. Started where the shot was and spread. By Sunday the color was gradually fading. No burning or itching. Wouldn't have noticed if I hadn't looked in the mirror. Up until 02/20/2021 there had been no reaction of any kind." As of today, 02/22/2021, she states" it is a pinkish color and has spread from shoulder to elbow. I went on the internet and found out that it's called "COVID ARM""

Other Meds: Estradiol 1 mg po QHS Fexophenadine 180 mg po QD Tylenol 650mg ER 2 tabs po Q AM; Metamizole 10mg 1 tab PO QAM

Current Illness: Denies illness

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm