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: 1047327
Sex: F
Age: 58
State: IL

Vax Date: 01/19/2021
Onset Date: 02/03/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data:

Allergies:

Symptoms: HOTNESS, SWELLING OF LEFT ARM, AND PAIN IN NECK.

Other Meds:

Current Illness:

ID: 1047328
Sex: F
Age: 26
State: AZ

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

Lab Data: see above

Allergies: unknown

Symptoms: Individual comes to mass vaccine administration clinic .Consent form and risks were reviewed with the individual prior to receiving vaccination. Individual received 1st dose of Moderna Vaccine, Lot # 015M20A, NDC 80777-273-10, 7/29/21 expiration. Individual was given 0.5ml of Moderna Vaccine IM and then escorted to waiting room for monitoring for 30 minutes. Individual had no reactions to the vaccine or complaints but after 13 minutes at 3:53 pm she started with a seizure and was unconscious. 911 was called and her vitals monitored. 3:59 pm pulse 62, O2 98%, BP 125/77 blood sugar 77.Smelling stick was used and individual slowly woke up. Staff from the center she came from came over and states that individual does have a history of seizures. Paramedics on the scene asses individuals vitals and share that she had a seizure and left since individual signed not to go to the hospital 4:05 individual took a clonaepam 0.125 from her purse and took it po. Individual remained stable and alert 4:14 individual was assessed again vital 110/83, pulse 60, O2 96% Patient was stable the rest of her 30 minutes post vaccine administration individual left stable with staff. Individual motioned that she was feeling better since she does not speak Individual was given follow up vaccine appointment in 30 days but was told she needed to get a note from her provider that she is able to have a second vaccine.

Other Meds: patient is taking prescription medication - we do not have a list of her medication. She is not our patient. She attended a mass vaccine clinic here

Current Illness: hx of seizures per clinic driver she came with unknown rest of medical history

ID: 1047329
Sex: F
Age: 70
State: FL

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

Lab Data:

Allergies: none

Symptoms: itchy pink rash at site of injection, rash size approximately 5 inches by 3 inches

Other Meds: rosuvastatin- 10mg calcium- 500mg

Current Illness: none

ID: 1047330
Sex: M
Age: 45
State: AZ

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

Lab Data: troponin - negative WBC - normal Potassium 3.3 Sodium 134

Allergies: None

Symptoms: Patient received his first dose on 2/1/21 and was observed for 15 minutes. He reported that after returning home he has dizziness and weakness that lasted 45 minutes and then resolved without treatment. He did not seek care. On the day of his second shot (2/22/21) he said he had not taken his blood pressure medication that morning. His blood pressure was143/98 and pulse 70 prior to vaccination. At 10 minutes after the injection he reported feeling dizzy and having shortness of breath and feeling dry mouth. His O2 sat was 98%. Pulse had increased to 82 and then several minutes later was 110. He was placed on a monitor but a large size cuff was not available at the vaccination site. He continued to feel weak and more short of breath, so he was given a dose of epinephrine by autoinjector and EMS was called to transport him to the ER. At the ER, he was given diphenhydramine and his condition continued to improve. He was observed in the ER for 3 hours and discharged home.

Other Meds: amlodipine, lisinopril, omeprazole

Current Illness: none

ID: 1047331
Sex: F
Age: 94
State: AR

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

Lab Data:

Allergies:

Symptoms: ADMINISTRATION OF THIRD DOSE BY NURSING HOME STAFF

Other Meds:

Current Illness:

ID: 1047332
Sex: F
Age: 50
State: MT

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

Lab Data:

Allergies: garlic, onions, dust, pollen

Symptoms: 05:00 pm slept 15 hours over night. Slept through 2 alarm clocks. Arrived at work on time but cognition was significantly slower all day. Brain got tired with mild headache after 7 hours on shift and went home early, due to could not mentally function to complete work shift.

Other Meds: tri-cyclen birth control, B-complex vitamin, coconut oil capsules

Current Illness: none

ID: 1047333
Sex: M
Age: 81
State:

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

Lab Data:

Allergies: none

Symptoms: Chills, headache, tiredness for 30 hours

Other Meds: blood pressure medicines

Current Illness: none

ID: 1047334
Sex: F
Age: 73
State:

Vax Date: 02/04/2021
Onset Date: 02/17/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data:

Allergies: Penicillin

Symptoms: Mildly itchy vaccination site, face, and hands. This lasted approximately 2 days. I also noticed a rash developed (apx 4"X3") at the vaccination site. The rash is now, (6 days later) reduced significantly.

Other Meds: Triamterene, HCZ, Atenolol, Paroxetine, simvastatin, tramadol as needed Calcium, vitamin D, krill oil 9omega 3), 81 mg aspirin

Current Illness: none

ID: 1047335
Sex: F
Age: 73
State: FL

Vax Date: 02/01/2021
Onset Date: 02/20/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Red, warm rash at injection site 8 days following vaccination

Other Meds: Levothyroxine Atorvastatin Citalopram

Current Illness: None

ID: 1047336
Sex: M
Age: 48
State: NY

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

Lab Data:

Allergies: None

Symptoms: Headache, nausea, light sensitivity, muscle aches, fatigue

Other Meds: Telmisartan and Omeprozold

Current Illness: None

ID: 1047337
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: None

Symptoms: Feeling flush, dryness in throat, tongue feeling thick. Dr. evaluated client. Assessed and noted lungs to be clear. No medication additionally given. Client observed for extra 30 minutes. Patient was noted to feel better and released out to family.

Other Meds:

Current Illness: None

ID: 1047338
Sex: F
Age: 77
State: CO

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

Lab Data:

Allergies:

Symptoms: Chills, slight fever, fatigue on 2/17/2012, mild achyness, fatigue 2/18/21. Rash on inside of left arm lasted 3 days after injection . Took ibuprofen to help relieve symptoms. Soreness and tenderness at injection site lasting 4 days.

Other Meds:

Current Illness:

ID: 1047339
Sex: F
Age: 72
State: MI

Vax Date: 02/08/2021
Onset Date: 02/21/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data: none

Allergies: none known

Symptoms: Noticed large rash on left upper arm on Feb. 21 about 10 pm. On Feb. 22 still a rash but doesn't seem to be any larger. Minor warm feel to the area. Haven't really done anything to treat other then some Neosporin ointment.

Other Meds: Vitamin D (1,000IU), Potassium 99mg, Tylenol Pravastatin 40mg Hydrochlorothiazide 25mg Diltiazem ER 240mg

Current Illness: none

ID: 1047340
Sex: F
Age: 36
State: MO

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

Lab Data:

Allergies:

Symptoms: Pt reported nausea/vomiting, headache after first dose

Other Meds:

Current Illness:

ID: 1047341
Sex: F
Age: 54
State: WY

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

Lab Data:

Allergies: "SOME FRUITS"

Symptoms: At 1333 I was called to lobby. Upon arrival, pt states she is feeling light headed and dizzy. VS 108/68, 97.6, RR 16, o2 98% on RA, and HR 45. Pt AOx4. Pulses thready. Patient?s skin is moist and clammy. Called for a WC and took pt to exam room where she sat in a reclining chair. VS taken every 5 minutes. She kept mentation through her stay. She states she felt slightly nauseated but was able to hold down water. VS started to improve once she was reclined in exam room. Education provided about f/u with PCP as HR fluctuated between 57-85. Educated about monitoring for symptoms the rest of the day and when to go in for evaluation is symptoms reappear. Pt verbalizes understanding. At 1400, pt states she is feeling better and feels well enough to leave facility. She has no one in town to come get her. VS= 02 98% HR 60, T97.8, BP 120/74, RR 16. Time of leaving, pulses were strong and equal, cap refill WNL. Will call at 1700 for F/U call.

Other Meds: NONE

Current Illness: NONE

ID: 1047342
Sex: F
Age: 64
State: CA

Vax Date: 02/09/2021
Onset Date: 02/20/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: This issue happened 1 1/2 weeks after receiving my 1st vaccine. I have redness around injection site, itchy and hard to the touch. Upper arm is a little sore. I did not have any reaction until now.

Other Meds: none

Current Illness: none

ID: 1047343
Sex: F
Age: 68
State: IL

Vax Date: 02/03/2021
Onset Date: 02/17/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data: Swab of area sent to lab on 2/18/2021, to test for Shingles. Positive lab result reported on 2/21/2021.

Allergies:

Symptoms: 1 week after injection, February 10th, 2 itchy red spots appeared on back of left thigh. Thought they were bites, as I had no other symptoms. The itching and size of spots increased over a week, but did not find blisters until February 17th. Saw Nurse Practitioner on Feb. 18th, who sent swab to lab for verification of Shingles and started me on antiviral, valACYclovir (Valtrex), for 7 days. By Feb. 21. no new outbreaks, and 2 of 4 areas of outbreak were drying.

Other Meds:

Current Illness: none

ID: 1047344
Sex: F
Age: 17
State: AZ

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

Lab Data:

Allergies: No

Symptoms: Pt Age is 17, Clinic age requirement 18.

Other Meds:

Current Illness: No

ID: 1047345
Sex: F
Age: 15
State: WA

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

Lab Data:

Allergies: None

Symptoms: Patient collapsed following the vaccine. She was caught by MA and placed into a chair. She started convulsing for roughly 30 seconds to 1 minute then was placed onto the floor on her side. Convulsions stopped and supplemental oxygen was applied. We were advised by 911 dispatch to administer epinephrine. This was done in left thigh. EMTs arrived. Patient was evaluated and advised by EMTs that they were clear to go home.

Other Meds: None

Current Illness: None

ID: 1047346
Sex: M
Age: 42
State: AZ

Vax Date: 12/23/2020
Onset Date: 12/26/2020
Rec V Date: 02/22/2021
Hospital:

Lab Data: Low TSH with elevated free thyroxine and extremely low 24 hour radioactive iodine uptake

Allergies:

Symptoms: Within 3 days of receiving the vaccine develops symptoms and findings consistent with subacute thyroiditis. Pain in the neck area, clear evidence of hyperthyroidism.

Other Meds:

Current Illness:

ID: 1047347
Sex: F
Age: 24
State:

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

Lab Data:

Allergies:

Symptoms: Pt reported being dizzy/light headed day after vaccination

Other Meds:

Current Illness:

ID: 1047348
Sex: M
Age: 34
State: CA

Vax Date: 12/23/2020
Onset Date: 12/24/2020
Rec V Date: 02/22/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: My muscles were stiff the next day. On 12/24/2020, while playing tennis, I completely tore my achilles.

Other Meds: None

Current Illness: None

ID: 1047349
Sex: F
Age: 40
State: OH

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

Lab Data:

Allergies: Bactrim, Cipro, Zithromax, Trimox, Coconut

Symptoms: Patient felt light headed 5 minutes after receiving the vaccine. Patient had an episode of syncope, which was attended by EMS. Patient regained consciousness within 30 seconds of episode. Patient has had previous episodes of syncope, but not with vaccinations. All vitals were normal when checked by EMS. Her BG was 121 mg/dl. Patient recommended to go to the hospital to get checked out but patient refused. Waited for husband to come pick her up - 5:45pm.

Other Meds: N/A

Current Illness: N/A

ID: 1047350
Sex: F
Age: 70
State: MI

Vax Date: 02/08/2021
Onset Date: 02/09/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data:

Allergies: Reglan, Supartz, penicillin

Symptoms: After first vaccination on Jan. 11th, 2021 I had muscle weakness in legs lasting only about an hour. I just didn?t feel right. After one hour I was fine. Second vaccine was administered on Feb. 8th at noon. By 3:30 AM Feb 9th I could barely get out of bed because of severe joint pain and aching. I was nauseated, had a mild fever, mild headache and very tired. This lasted until February the 10th at which time I felt better. By Feb. 11th I had return of deep aching pain in my hips and pelvic bones. ( I have arthritis and know what joint pain is). This was much worse. I felt ill from about one week after receiving my 2nd dose of Moderna. I started feeling much better with the occasional return of mild symptoms. I go to physical therapy for arthritis pain and had taken a week off. I returned to physical therapy on Thursday. February 18th. I was unable to complete my usual workout due to weakness in my legs and joint pain. I returned on Feb. 22nd and the same thing happened I felt weak, diaphoretic, nauseated, after exercising a short time. This has never happened before.

Other Meds: Levothroxone Combigan eye drops Vicodin as needed for pain Vitamin D

Current Illness: None

Date Died: 02/17/2021

ID: 1047351
Sex: M
Age: 55
State: OK

Vax Date: 01/29/2021
Onset Date: 02/17/2021
Rec V Date: 02/22/2021
Hospital: Y

Lab Data: Sars PCR 2/2/21

Allergies: Morphine, Zosyn, Piperacillin

Symptoms: Patient was tested for covid on 2/2/21 with positive resulted. Presented to Hospital ER on 2/10/21 with c/o of abdominal pain. Diagnosed with gastritis, prescribed metoclopromide and famotidine and dc home. Returned to ER on 2/13/21 with c/o of weakness, diarrhea, foot ulcer, and loss of appetite. Diagnosed: 1) Dyspnea and hypoxia secondary to Covid-19 2) Extensive bilateral lung infiltrates secondary to Covid-19 3) Increased Cr 4) Increased LFTs, ferritin, d-dimer, troponin secondary to Covid-19 5) Elevated procalcitonin placing the patient at high risk for sepsis 6) Chronic appearing Right foot wound without signs of secondary infection Patient transferred to a different hospital in another city.

Other Meds: 2/10/2021: Metoclopromide, Famotidine, 2/13/2021: Remdesivir, Lovenox, Azithromysin, Meropenem

Current Illness: Covid-19 positive on 2/2/2021

ID: 1047352
Sex: F
Age: 38
State: MN

Vax Date: 02/13/2021
Onset Date: 02/21/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Itchy, red, hard bump appeared

Other Meds:

Current Illness:

ID: 1047353
Sex: M
Age: 79
State: AL

Vax Date: 01/26/2021
Onset Date: 01/28/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data:

Allergies: tavist-D(migraines) ; statins; Pacerone(Amioderone)

Symptoms: Upper respiratory infection 26 days

Other Meds: multivitamins, B12, coumadin, torsemide, KCl, magnesium, bisop

Current Illness: none

ID: 1047354
Sex: F
Age: 69
State: AL

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

Lab Data: BG reading

Allergies: Unknown

Symptoms: Patient received first dose of Pfizer Covid vaccine at 13:00 at vaccination clinic on 2/21/2021. Patient began to complain about feeling tired and wanted to take a nap later in the afternoon. Patient's husband found patient at 16:30 almost unresponsive and checked a BG reading which resulted at 25. Husband gave patient oral forms of sugar and transported to ER where he BG slowly normalized. Husband reports patient has been a well controlled diabetic and has never has an incident like this happen previously.

Other Meds: Diabetic medications

Current Illness:

ID: 1047355
Sex: F
Age: 29
State: SC

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

Lab Data: None.

Allergies: None

Symptoms: Vertigo. Sporadic onset. Anywhere from 1-5 minutes. Head fog lasting longer

Other Meds: None

Current Illness: None

ID: 1047356
Sex: F
Age: 49
State: CA

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

Lab Data:

Allergies:

Symptoms: Had 2 days of arm ache, chills, muscle aches & joint aches until 2/14/21. Then on 2/17/21 experienced severe joint ache & muscle aches to the point of tears, lasted until 2/19/21, then back to baseline late Friday into Sat. 2/20/21. Self treated with rest, heating pad, and Aleve.

Other Meds:

Current Illness:

ID: 1047357
Sex: F
Age: 63
State: OH

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

Lab Data: None

Allergies:

Symptoms: Sudden numbness, dizziness on and off, numbness receded. Pt encourage to stay but refused and left facility. Instructed to follow up with PCP. 1520 BP 108/58, HR 76, OSat 98% 1540 BP 110/64, HR 76, OSat 97%

Other Meds:

Current Illness:

ID: 1047358
Sex: F
Age: 83
State: FL

Vax Date: 02/12/2021
Onset Date: 02/15/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data: ESR, uric acid level drawn in office today

Allergies: None

Symptoms: Patient developed severe gout in L foot 3 days post vaccine. Seen in office and treated. Hadn't had episode for 30 years. Was not on chronic gout medication. No other precipitating events. No change in foods or meds.

Other Meds: Metoprolol Succinate 100 mg/day, Vit B12 2500 ug/day, Vit. D 1000 IU/day, Ofloxacin eyedrops prn.

Current Illness: None

ID: 1047359
Sex: F
Age: 67
State: MN

Vax Date: 02/10/2021
Onset Date: 02/18/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data:

Allergies: Sulfa

Symptoms: Hives at site of injection 8 days later - headache

Other Meds: Levothyroxine, Ocuvite, Vit K2, Vit D, Quercetin

Current Illness: None

ID: 1047360
Sex: F
Age: 60
State: HI

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

Lab Data: n/a

Allergies: none

Symptoms: onset slightly itchy, redness and swelling applied ice pack

Other Meds: Multi Vitamin, Fish Oil

Current Illness: none

ID: 1047361
Sex: F
Age: 78
State: NJ

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

Lab Data:

Allergies: PCN - 40 yrs ago Had hives at the time not related to PCN

Symptoms: Woke up this morning with a rash that ran from side to side under breast half way to waist and from side of arm pits to top of breasts. Just red but not itchy.

Other Meds: L-Thyroxine, Atorvastatin, Famotidine, Salmon Oil, CO Q10, D3, Probiotic, C, Zatidor,

Current Illness:

ID: 1047362
Sex: M
Age: 55
State: AL

Vax Date: 02/12/2021
Onset Date: 02/20/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data: no medical intervention required.

Allergies: Had past allergic skin rash reaction to anti-biotic Clindamycin. A specific brand of sunscreen also gave me a similar rash but I was not able to figure out which ingredient caused the reaction.

Symptoms: Rash on upper arm at site of injection. Itchy, redness patch. Lasting 2-3 days so far. Using some topical cream helps.

Other Meds: None.

Current Illness: None.

ID: 1047363
Sex: F
Age: 29
State: SC

Vax Date: 02/12/2021
Onset Date: 02/19/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Swelling and pain in arm 7 days after Injection

Other Meds:

Current Illness:

ID: 1047364
Sex: F
Age: 62
State: TX

Vax Date: 02/11/2021
Onset Date: 02/13/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data: None

Allergies: Penicillin Doxycycline Coban

Symptoms: Red, hard, feverish, sore injection site on left arm approximately 4 inches x 3 inches. It began on February 13, 2021, which was 2 days after injection. Redness subsided some, but on day 8 after injection, area became more red, hard, feverish and sore. Also, I have soreness under arm near lymph nodes. I visited my Primary Care Physician today and was prescribed a steroid pack.

Other Meds: Toviaz Triampterene Singular Pravastatin 81 mg aspirin Magnesium Zinc Vitamin C Zyrtec Vitamin D3

Current Illness: None

ID: 1047365
Sex: M
Age: 58
State: MS

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

Lab Data: None other than routine vital signs

Allergies: Unknown

Symptoms: Client reported almost immediate severe pain at injection site (approx. 11:15 a.m.). Was monitored by RN. At 11:18 BP was 140/90, HR 82. Injection slightly warm to touch. No redness or edema noted. Client denied dizziness, nausea, SOB or other symptoms. At 11:30 BP was 130/92, HR 72. At 11: 35 BP 122/92. No further progression of symptoms. Pt reported she felt fine and was allowed to leave site and instructed to monitor symptoms, report to her provider if pain persists or other symptoms develop.

Other Meds: Unknown

Current Illness: Unknown

ID: 1047366
Sex: F
Age: 51
State: IL

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

Lab Data: none

Allergies: Hx of anaphylaxis 1 year ago after having a colonoscopy

Symptoms: Pt developed rash on chest, tingling in abdominal area, and anxiousness. Pt given zyretec 10mg PO with water, monitored closely for 1 hr. Instructed per Dr. not to have the second dose administered and to discuss with her physician. Symptoms subsided and pt sent home.

Other Meds: Lasarton 10 mg daily, asa 91mg daily, vit D

Current Illness: denies

ID: 1047367
Sex: M
Age: 92
State: AR

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

Lab Data:

Allergies:

Symptoms: ADMINISTRATION OF EXTRA DOSE BY NURSING HOME STAFF

Other Meds:

Current Illness:

ID: 1047368
Sex: F
Age: 41
State: AZ

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

Lab Data:

Allergies:

Symptoms: During the 15 minute observation period, pt reported upper lip swelling and hives on face.

Other Meds:

Current Illness:

ID: 1047369
Sex: M
Age: 50
State: CA

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

Lab Data: Per Observer RN; Vital signs taken. Rapid Response Team summoned. Caregiver transported to ER. Caregiver remained responsive throughout, no distress oriented x4, speaking full sentences. Today; Caregiver contacted. States was given "tylenol, benadryl, and pepcid" in ER and was discharged same night. States SX all resolved. States had "flushing" with 1st dose as well but cleared to receive 2nd dose by his MD.

Allergies: NKA to medication

Symptoms: Per Observer RN; Caregiver reported feeling "flushed." Observer noted facial flushing. Caregiver reported "blurred vision, itchiness all over body as well as dizziness." Approx. 10 minutes later also reported "chills."

Other Meds: Caregiver states on "Humira."

Current Illness: Caregiver states HX of "psoriasis."

ID: 1047370
Sex: U
Age:
State:

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

Lab Data:

Allergies:

Symptoms: RED RASH TO BOTHARMS FLEXOR ASPECT AND ABDOMEN TREATED WITH HYDROCORTISONE AND BENDRYL

Other Meds:

Current Illness:

ID: 1047371
Sex: F
Age: 28
State: CA

Vax Date: 02/11/2021
Onset Date: 02/19/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: I had arm soreness the day of the vaccine (2/11/21). The following day I noticed an erythematous round lesion that was very tender and when palpated felt like a lump. The pain went away 2-3 days after the vaccine and the erythema/lump went away on 2/21/21. On 2/19/21 my left internal arm felt sore. I thought I pulled a muscle perhaps. On 2/21/21 the arm pain was worse and didn't feel like typical soreness that would come from exercise or sleeping in the wrong position. It was painful when I pulled my arm close to my body, as if something were being compressed. I palpated in the armpit and found a large lump slightly smaller than a golf ball. It was extremely tender and sent me into a panic. Someone pointed out it was the same arm as my vaccination, so I looked it up and learned about this side effect. Today (2/22/21), the pain is gone and the lump is smaller (feel like a typical enlarged lymph node).

Other Meds: None

Current Illness: None

ID: 1047372
Sex: U
Age:
State:

Vax Date: 02/02/2021
Onset Date: 02/05/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data: none

Allergies: none...although some adverse effects

Symptoms: 3 weeks after second dose...still extreme malaise, headache and muscle aches I have had the flu shot, and have not been around other individuals that were not also vaccinated

Other Meds: none

Current Illness: type 1 diabetes

ID: 1047373
Sex: F
Age: 54
State: MD

Vax Date: 02/06/2021
Onset Date: 02/10/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data: None. Photos of rash sent to primary care

Allergies: Milk, Sulfa, Erythromycin

Symptoms: Hot red rash first appeared behind knees, then on elbows, the on knees and shins, then by sitting bones and then ankles over the course of a week. Prednisone was prescribed and helped.

Other Meds: Claritin, Multivitamin, Vitamin C, Calcium

Current Illness: none

ID: 1047374
Sex: F
Age: 57
State: PA

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

Lab Data:

Allergies:

Symptoms: Swelling and itching at injection site. Seemed to subside but then reemerged a week after vaccination.

Other Meds: Atorvastatin Muliti Vitamin Vitamin D3 Omega Oil Magnesium

Current Illness:

ID: 1047375
Sex: F
Age: 61
State: OR

Vax Date: 02/06/2021
Onset Date: 02/19/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data: None

Allergies: Septra

Symptoms: Not until 2 weeks later I got a very red somewhat itchy and painful arm at injection site

Other Meds: Aripiprazole, Levothyroxine, Bupropion , Propranolol, Montelukast, Vitamin D3, Lamotrigine, Trazaodone, Lorazepam, Omeprazole, Pseudoephedrine, Allertec, Ketacanozole shampoo, Pulmicort , & Stool softener

Current Illness: None

ID: 1047376
Sex: M
Age: 0
State: IA

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

Lab Data:

Allergies: No known allergies

Symptoms: Patient states that he got dizzy and fell off exam bed. Patient can't recall if he lost consciousness. No injuries noted, patient denied pain. Dr. examined patient prior leaving clinic.

Other Meds: No known medications

Current Illness: No known

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm