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: 1047427
Sex: F
Age: 73
State: KY

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

Lab Data:

Allergies: Propylene Glycol; tincture of Benzoin; carbamates (adhesives) Cipro, Biaxin, maybe Amoxicillan Dust, dander, mold, some grasses

Symptoms: This is not a critical reaction but want to report in order to help build up the information available to healthcare professionals going forward. Morning after chills, neck stiffness, pain back of head left side. Applied heating pad to neck. By late morning I was nauseous , and weak as a kitten. Took a 500 mg Tylenol and slept for about 4 hours. Woke up in a sweat but chills gone and am now able to eat a little bit. Back of head and neck still very sore. The injection site is sore but no rash; right arm seems to have "phantom pain" as well ( I experienced this with Shingles shot in December 2020 too).

Other Meds: Claritin (1x 2/21/21 to prevent allergic reaction) Osteo-Biflex Vit D3 Estyradiol insert 2x/week Refresh tears OTC for dry eyes

Current Illness: Left big toe infection and removal of toenail on 2/2/2021 completed Cephalexin 2/11/2021

ID: 1047428
Sex: F
Age: 89
State: WY

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

Lab Data: none

Allergies: ct stated "too many to list", states she is allergic to alot o Additional information for Item 10: allergic to a lot of things, meds, food, takes alot of antihistamines i.e., hydroxine

Symptoms: During screening for the vaccine at a mass clinic, ct said she had 'too many allergies' to list. RN escorted client to the local hospital and gave her the COVID vaccine there so she could be monitored there. Two hours after client received vaccine when she was at home she became very itchy, was uncomfortable for 4 days, stated this happens to her all the time. Then was ok. 02/03/2021-ct reported PCP told her not to get the second dose of Moderna to wait until the other brand vaccine was available then get it since it will only be one dose.

Other Meds: Hydroxyzine, Zyrtec, Benadryl, Singular antihistamine

Current Illness: allergies all the time, limited diet

ID: 1047429
Sex: F
Age: 40
State: CA

Vax Date: 01/11/2021
Onset Date: 01/12/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data:

Allergies: unknown

Symptoms: After first dose on 1/11/2021 employee mentioned she had sinus congestion and a head ache for 2-3 days. She also experienced numbness of her left hip and swelling of her wrist. She was seen by her PCP and they did not associate the condition with the vaccine. After her 2nd dose on 1/28 she had a slight cough for 3 day and swelling of the arm and leg. She went to urgent care on 2/19 due to swelling and pain of her arms and legs. She was prescribed gabapentin, and pain medications. Employee developed left sided facial pain paralyses and went to the ED on 2/21 diagnosed with Bells Palsy and given acyclovir, norco and she is taking antibiotics for an ear infection. Currently still symptomatic.

Other Meds: unknown

Current Illness: unknown

ID: 1047430
Sex: F
Age: 75
State: CA

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

Lab Data:

Allergies:

Symptoms: Woke up about 1:00 am in delirium and feverish. No control over thought process or able to get up. Managed to get out of bed at 9:00 am but was so weak could barely make it up a flight of stairs. And when I did ended up in bathroom vomiting. Laid on floor to get some strength back. Went back to bed and slept restlessly until 4:00 pm. Still feverish and weak but not as bad as earlier. Ate some cold grapes and went back to bed until the following morning. Tried to stay hydrated and took ibuprofen several times. My upper arm was red and blotchy for 3 days. Overall I?d say the severest part of the event lasted 48 hrs and another 24 hrs of tiredness and nausea but not vomiting.

Other Meds:

Current Illness:

ID: 1047431
Sex: F
Age: 17
State: CO

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

Lab Data: None

Allergies: None

Symptoms: Client was 17 years old at the time of administration.

Other Meds: None

Current Illness: None

ID: 1047432
Sex: M
Age:
State: OR

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

Lab Data:

Allergies: grass

Symptoms: fatigue x 5 days, eye swelling, dizziness

Other Meds: Restasis Medication to sleep

Current Illness:

ID: 1047433
Sex: F
Age: 68
State: OH

Vax Date: 02/10/2021
Onset Date: 02/11/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data:

Allergies:

Symptoms: headache and stomachache for 3 days, passed out at 1:30 AM Feb. 11. Life squad called BP 90/60. Swelling of left upper arm, swollen lymph node under left arm that lasted 4 days

Other Meds: Chlorthalidone, Eperelone, Nifedipine, Lansoprazole, Dicyclormine HCL, Tizanidine HCL, Flurosemide, Tramadol, HydrOXYzine HCL, Venlafaxine, Budesonide, Bupropion, Tazarotene, Doxazosine, Carvedilol, Celecoxib, Citrucel, Caltrate+D, Vitamin

Current Illness:

Date Died: 02/13/2021

ID: 1047434
Sex: M
Age: 88
State: WA

Vax Date: 02/10/2021
Onset Date: 02/13/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: Patient died 3 days after receiving his first dose of the Covid vaccine. He saw his doctor 2 weeks prior to his death with absolutely no complaints, very healthy. He had no prior heart conditions and was pronounced dead of a heart attack.

Other Meds: none

Current Illness: Completely healthy check-up 2 weeks prior to vaccination and death.

ID: 1047435
Sex: F
Age: 41
State: OR

Vax Date: 02/14/2021
Onset Date: 02/15/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data: vascular ultrasound left leg D-Dimer electrolyte panel all performed 02/20/21

Allergies: none known

Symptoms: deep vein thrombosis in lower left leg; mild fever; fatigue; body aches all in the day following injection DVT persists and was diagnosed 6 days later; all other symptoms resolved within 24 hours

Other Meds: combination birth control pills

Current Illness: none known

ID: 1047436
Sex: F
Age: 70
State: NY

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

Lab Data:

Allergies: IVP

Symptoms: Onset of vaccine: 17:19 Onset of symptoms at 17:25 with tongue tingling to entire tongue Onset of other sx at 17:27: red hands Patient opted to stay in waiting room until hand concern She ambulated without assistance to medical center She was given Benadryl 25 mg po with water, tolerated well at 17:47 VS taken and stable 128/74 RR: 14 Pulse 82 At 18:00, sx of tongue tingling improved, but tinnitus BL worsened - this is common for patient She was discharged to home at 18:07 with her partner Instructed to call PCP in AM, and watch for other developing sx of allergy/anaphylaxis overnight

Other Meds: None

Current Illness: Current dental oral infection on amoxicillin 500 mg TID, tetracycline oral swish BID x 10 days

ID: 1047437
Sex: F
Age: 42
State: OH

Vax Date: 02/04/2021
Onset Date: 02/12/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data:

Allergies: Sulfa

Symptoms: I experienced soreness in my arm the same day and night of the vaccine that continued for a few days. Then, a week and a day after receiving the vaccine, I developed "Covid Arm" with a red, itchy rash that was hot to the touch developing. The rash has faded significantly, but is still itchy and has last at least 9 days.

Other Meds: Blood pressure medications (Spironolactone, Amlodipine), birth control pills, Claritin D 12 hour.

Current Illness:

ID: 1047438
Sex: M
Age: 77
State:

Vax Date: 02/11/2021
Onset Date: 02/18/2021
Rec V Date: 02/22/2021
Hospital: Y

Lab Data:

Allergies:

Symptoms: Autoimmune hemolytic anemia

Other Meds:

Current Illness:

ID: 1047439
Sex: M
Age: 39
State: PA

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

Lab Data:

Allergies: None

Symptoms: Slurred speech, disorientation, uncoordinated movement, tingles at fingertips and toes

Other Meds: Fluoxetine 40mg/daily

Current Illness: None

ID: 1047440
Sex: F
Age: 73
State: CA

Vax Date: 02/08/2021
Onset Date: 02/14/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data: 02/18/2021-POCT GLUCOSE, POCT HEMOGLOBIN, ECG 12 LEAD, Blood Pressure 156/76, Temp. 97.2, Pulse 73, Respiration 14, Oxygen Saturation 96%

Allergies:

Symptoms: Unsteadiness, dizziness

Other Meds: Lisinopril Azathioprine Rosuvastatin Align Eyedrops: dorzolamide-timolol, restasis, travoprost

Current Illness:

ID: 1047441
Sex: M
Age: 60
State: NJ

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

Lab Data:

Allergies: Flexeril, Cyclobenzaprine

Symptoms: During our 3rd clinic, the facility registered this patient to receive their second dose of the Pfizer COVID-19 Vaccine, and they did not produce the record card. We administered the dose as requested. Upon returning to the Pharmacy to process the VAR, our records indicated that this patient had already received 2 doses of the vaccine at previous clinics.

Other Meds:

Current Illness: Epiliepsy, HIV

ID: 1047442
Sex: F
Age: 47
State: WA

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

Lab Data: None at this time

Allergies: Gluten, history of reactions to erythromycin, benzodiazapenes

Symptoms: Was fine immediately after, lips felt tingling several hours later and have not stopped tingling (48-hours later, sense of numbness and tingling in fingertips, increased awareness of sounds, brain fog, onset of pain at injection point later day of vaccine sore but manageable, excessive fatigue, deep muscle and joint aches, nerve sensations continuing.

Other Meds: Statin, COQ10, Multi-vitamin, vitamin D, Zinc, B-Complex, Probiotic

Current Illness: None

ID: 1047443
Sex: F
Age: 59
State: CT

Vax Date: 12/28/2020
Onset Date: 01/06/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data: None

Allergies: Demerol, Latex, Avocado and walnuts

Symptoms: A large raised red rash that was painful, itchy and hot to the touch over the vaccination site.

Other Meds: Atenolol/Chlorthalidone, Singular, Symbicort, Multivitamin, Calcium and Vitamin D

Current Illness: None

ID: 1047444
Sex: F
Age: 34
State: AZ

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

Lab Data:

Allergies: Environmental allergies

Symptoms: Vaccination was at 9:17am. Injection site arm pain and stiffness was noticeable by 12pm, and gradually worsened to incredibly painful by 8 pm, especially in muscles between left shoulder blade and spine. Chills began around 9:30pm at which point I took one 500mg Tylenol and went to sleep. I woke up with severe chills around 1:45 am and pushed off taking more 500mg Tylenol until 2:45 am. Afterwards I began to feel heartburn and slight nausea but was able to fall back to sleep. I woke up around 3:45 am to vomit. Afterwards, the nausea subsided and I was able to go back to sleep until 6:45am. I woke up with a headache which got worse and I took one Aleve at 9 am. By late afternoon I was feeling much better.

Other Meds: Tirosint Xyzal Birth control

Current Illness: Allergic rhinitis

ID: 1047445
Sex: F
Age: 80
State: MI

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

Lab Data: no

Allergies: Ether

Symptoms: My mother was given dose 1 and dose 2 of the covid 19 vaccine on 2/17/2021 against the POA's wishes. She seemed to have her right foot very swollen which is not normal, she stated she felt her heart was going to jump out of her chest and she was very anxious.

Other Meds:

Current Illness: no

ID: 1047446
Sex: F
Age: 70
State: MN

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

Lab Data: Nothing

Allergies: Wheat

Symptoms: Excessive fatigue, nauseated, body aches, dizzy, and possible Covid Tongue? Although I asked my CNP today, and she did not feel I needed to worry about these blotchy, red areas on my tongue. The red color is lessening however.

Other Meds: Lisinopril, Atorvastatin, Metoprolol, Florastor, Candibactin AR, Candibactin BR, D Mannose, L-Glutamine, Betaine HCL, MultiVitamin, baby aspirin, Calcium+D3, Melatonin,

Current Illness: Nothing

ID: 1047447
Sex: M
Age: 78
State: MI

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

Lab Data:

Allergies:

Symptoms: Patient got 3 doses of Moderna vaccine by mistake. 1st dose on 01/06, 2nd dose on 01/26 and 3rd dose on 02/22

Other Meds:

Current Illness:

ID: 1047448
Sex: F
Age: 27
State: KY

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

Lab Data: Transported to Hospital/ ER

Allergies: nuts, tree nuts, milk soy, amox

Symptoms: Reported generalized pruritus, diffuse rash: face, neck, BUE, torso. Lethargic anxious HR 90, RR 20, Administer Epi injector right thigh. Given IM Benadryl. Transported to ER.

Other Meds: Flonase, montelukast, Ivabradine

Current Illness: None

ID: 1047449
Sex: F
Age: 58
State: OK

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

Lab Data: none

Allergies: sulfur based drugs, shell fish

Symptoms: soreness at injection site. then a mild migraine the following evening.

Other Meds: none

Current Illness: none

ID: 1047450
Sex: F
Age: 76
State: WY

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

Lab Data: none

Allergies: KNA

Symptoms: RN giving injection of Moderna vaccine to client noted vaccine leaking out at the hub, RN determined the leur lock connection between the needle and syringe was loose. Unknown amount of vaccine injected into the client, rest of vaccine in syringe discarded. New dose of vaccine with new needle/syringe injected into the client at that time. RN drawing up vaccine, and RN administering the vaccine need to double check the leurlock connection is tight prior to injecting the vaccine. Syringe/needle used-Smiths Medical jelco, Hypodermic NEEDLE-PRO EDGE, Safety Device with Syringe was used, most likely from lot #432510, 3 ml/LL 25G x 1in, that was provided in the ancillary kit that came with the vaccine.

Other Meds:

Current Illness:

ID: 1047451
Sex: M
Age: 70
State: CA

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

Lab Data: N/A

Allergies: N/A

Symptoms: Patient received 2 doses at the same day (dose #2 and #3 by mistake). No reaction.

Other Meds: Tamsulosin 0.4 mg 1 rab QD Metiprolo 50 mg 1/2 tab QD

Current Illness: Hypertension Prostate Enlargement

ID: 1047452
Sex: M
Age: 73
State: AR

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

Lab Data:

Allergies: unknown

Symptoms: patient describes total body aches/ pains, diarrhea, upset stomach, nausea the night/early morning the vaccine was given

Other Meds: unknown

Current Illness: unknown

ID: 1047453
Sex: M
Age: 53
State: AZ

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

Lab Data: -complete 10 point review of systems, EKG at visit, complete lab work-up

Allergies: not known

Symptoms: 53-year-old male who received the Covid 19 vaccination today and after 10 minutes developed dyspnea and pain in his left arm. He denies rash or swelling in his mouth, throat, lips. He has a history of asthma. No hypoxemia. Anxiety

Other Meds: not known

Current Illness: asthma

ID: 1047454
Sex: M
Age: 17
State: CA

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

Lab Data: NA

Allergies: KNA

Symptoms: 17 YO M, received Moderna Covid-19 vaccine (1st dose) on 01/19/21. Pt falls under the unauthorized age group for Moderna vaccine administration. On 02/22/21, pt returned to vaccination site for 2nd dose, 2nd dose was not administered d/t age requirements. Nurse Manager spoke to pt and father regarding deviation of vaccine administration. Pt nor father reported any adverse s/s after pt received 1st dose of Moderna on 01/19/21.

Other Meds: Non stated.

Current Illness: Non stated

Date Died: 02/21/2021

ID: 1047455
Sex: F
Age: 93
State: MT

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

Lab Data: n/a

Allergies: NKDA

Symptoms: Resident deceased

Other Meds: Amlodipine 10 mg qday, Iron Sulfate 325 mg bid, Lisinopril 20 mg bid, Metoprolol Tartrate 25 mg bid, Milk of Magnesia prn, Tylenol 650 mg prn, Senna Plus prn, Vitamin B 12 1000 mg qday, Vitamin D 50, 000 units qweek

Current Illness: Multiple falls, HTN, TIA, mild cognitive impairment, Gait abnormality, hearing loss, major depressive disorder, osteoporosis, central pontine myelinolysis

ID: 1047456
Sex: F
Age: 74
State: FL

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

Lab Data: Noe

Allergies: Penicillin; pineapple

Symptoms: 2/16/21 - 7:30pm: Chills, fever, nausea, body pain and weakness, dizziness began. One episode of dry heaves; one episode of diarrhea. I could not eat, but could drink small sips of water. Symptoms continued until 5:00AM on 2/19/21. I was able to drink a cup of hot tea at approximately 9:00AM on the 19th. Body weakness and regular sensations of nausea continued until approximately 12PM on 2/20/21. Loss of appetite and sensation of familiar food tasting "different." As of 2/22/21 (6PM), I am continuing to feel overall weakness. Other symptoms have subsided.

Other Meds: Omeprazole; Levothyroxin; Clonidine; Atorvastatin

Current Illness: None

ID: 1047457
Sex: M
Age: 86
State: ID

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

Lab Data: None

Allergies: None

Symptoms: Diahhrea got very bad

Other Meds: Eliquis,

Current Illness: Prostate cancer, slow heart rate (possible pace maker in near future)

ID: 1047458
Sex: M
Age: 79
State: FL

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

Lab Data:

Allergies: NKA

Symptoms: Currently waiting for dental work (crown removal and replacement to treat cavity). 2/18/21 Started to experience toothache (R) which got worse as the day progressed. Tylenol didn't help. Took one tab of Percocet (5-325) to allow me to sleep. 2/19/21 Contacted dentist and was prescribed Penicillin VK 500 mg. Started Penicillin around 3 pm. 2/19/21 ~6 pm onset shakes, chills, sweating, low grade fever (~100.2), nausea, headache, weakness, difficulty in standing. Took more tylenol, lay down, fell asleep for approximately 3 hours. Woke briefly took my nighttime meds (atrovastatin, metoprolol, ranolazine, baby aspirin.) Additional information for Item 18: 2/20/21 Felt better when I woke up. Temp normal. Ate breakfast. Mild stomach ache. Around 3 pm onset of sweating and chills, shakes. Low grade temp (~100) 2/22/21 Fully recovered. No lingering issues. Not sure whether what I experienced is related to the Moderna vaccine or a reaction to the Percocet I took to alleviate the severe pain associated with my toothache.

Other Meds: Clopidogrel,pantoprazole,atrovastatin,ranolazine,aspririn

Current Illness:

ID: 1047459
Sex: F
Age: 51
State: TX

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

Lab Data:

Allergies: Penicillin

Symptoms: Flu-like. Headache, sweats/chills, fever (100.1), tired, body aches - for 2 days Body aches/tired - continuing for 1 week Tired/low energy - for 2 weeks.

Other Meds: B12

Current Illness: None

ID: 1047460
Sex: F
Age: 78
State: FL

Vax Date: 02/14/2021
Onset Date: 02/22/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data: None at this time

Allergies: slight allergy to shellfish

Symptoms: Sore arm day of injection. No problem after. Eighth day following injection experienced redness, hard lump in arm 2-3 in diameter around site of injection, warm to touch and itchy.

Other Meds: premarin .625 mg, multi vitamin, D3

Current Illness: none

ID: 1047461
Sex: M
Age: 85
State: NJ

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

Lab Data:

Allergies:

Symptoms: During our 3rd visit to the facility this patient was registered to receive their second dose of the Pfizer COVID-19 Vaccine. The Nurse did not produce the vaccination record card. We administered the dose as requested. Upon returning to the pharmacy to process the VAR our records indicated that the pt received 2 previous doses at previous clinics.

Other Meds:

Current Illness: Diabetes Type 2, HTN, TIA,

ID: 1047462
Sex: F
Age: 80
State: NV

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

Lab Data: n/a

Allergies: NKDA

Symptoms: Pt develop redness around the injection site, about 1.5 inch in diameter. It is getting itchy the last couple day. Pt took benadryl to help with ichiness.

Other Meds: UNKNOW

Current Illness: NKDA

ID: 1047463
Sex: F
Age: 61
State: TX

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

Lab Data: BP 162/82; HR 88; O2 sat 89%, O2 applied, increased to 95%

Allergies: Pneumonia Vaccine, Flu vaccine, PCN

Symptoms: Pt with marked hoarseness, SOB, & Wheezing. O2 sat 89%, O2 applied. Benadryl 25mg given PO, Solumedrol 125mg given IM, Epi pen administered x2 doses. Transported via ambulance to hospital.

Other Meds: Unknown

Current Illness: Unknown

ID: 1047464
Sex: F
Age: 19
State: NY

Vax Date: 02/18/2021
Onset Date: 02/21/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data: None

Allergies: None know

Symptoms: Swollen eyes, hives on face, neck wrists

Other Meds: None

Current Illness: None

ID: 1047465
Sex: F
Age: 28
State: AZ

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

Lab Data:

Allergies: None

Symptoms: Fever of 103 for 2 days Could not lift left arm - significant pain and swelling Join aches Muscles aches Fatigue Loss of appetite Headache

Other Meds: None

Current Illness: Covid-19, January 01-14 Negative reaction to dose 1, January 21-24 (103 fever, body aches, significant pain and swelling in arm) Strep-throat like illness January 28-February 4th

ID: 1047466
Sex: F
Age: 68
State: CT

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

Lab Data: None. Did not go to md.

Allergies: Penicillin

Symptoms: Intense headache from temple across eyes to temple. Severe eye pain. Totally unlike my migraines. Lasted two days Also body aches. Lasted two days

Other Meds: Nortriptyline, tylenol 3, Cingular, levocetirizine, anoro, lorazepam

Current Illness: Chronic migraine Seasonal allergies Arrythmia IBC

ID: 1047467
Sex: F
Age: 37
State: NJ

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

Lab Data:

Allergies:

Symptoms: Large red rash on the left arm that is warm To the touch. Low grade fever, headache and all over body aches.

Other Meds: Multivitamin and probiotic.

Current Illness:

ID: 1047468
Sex: F
Age: 33
State: MD

Vax Date: 02/09/2021
Onset Date: 02/18/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data: None

Allergies:

Symptoms: Started with raised red rash circling the injection site, and has been getting bigger everyday. Pain and itchy in rash area, pain deep inside my armpit, (maybe swollen lymph noid) frequent sweating under arms and hands

Other Meds: Birth control (lo loestrin)

Current Illness:

ID: 1047469
Sex: F
Age: 43
State: NM

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

Lab Data: none

Allergies: none

Symptoms: Patient passed through booster event of covid-19 Pfizer was told at check in she was not elidable for booster due to her first vaccine in series being Moderna. Since she was in same vehicle with her husband (who's first dose was Pfizer and there for booster dose) Misinformed vaccine staff she had moderna as primary dose and received Pfizer as second shot in her Covid series. Patient had no adverse reaction during her 30 minute observation period. Dr notified.

Other Meds: unknown

Current Illness: unknown

ID: 1047470
Sex: F
Age: 52
State: AR

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

Lab Data:

Allergies:

Symptoms: Itching, swelling at injection site, pain, heart palpitations, lymph node swelling

Other Meds: Patient was taking allergy shots

Current Illness:

ID: 1047471
Sex: M
Age: 84
State: NJ

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

Lab Data:

Allergies: NKA

Symptoms: During our 3rd visit to the facility this patient was registered to receive their second dose of the Pfizer COVID-19 Vaccine. The Nurse did not produce the vaccination record card. We administered the dose as requested. Upon returning to the pharmacy to process the VAR our records indicated that the pt received 2 previous doses at previous clinics.

Other Meds:

Current Illness:

ID: 1047472
Sex: M
Age: 45
State: CA

Vax Date: 01/18/2021
Onset Date: 02/19/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: large mass under the armpit. possible swollen lymph nodes. muscle pain, fatigue, tingling feeling on the lower lip left hand side,

Other Meds: None

Current Illness: None

ID: 1047473
Sex: F
Age: 63
State: WV

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

Lab Data: None

Allergies: none

Symptoms: Chills 2 Days of Fever over 102.5 1 Day of Fever over 100 3 Days fever above normal Itchy Arm (after around 5 days) Severe headache and body aches for around 3-4 days Stomach issues - could not eat for 2 days - made me sick Very weak for about 3 days Took a week to feel almost normal, but still not 100% Arm still hurts Chest pain (note - had 3 stents put in on Dec 11 due to cardiovascular blockage). Had a shooting pain the first night. Not sure if related to the vaccination or not.

Other Meds: Brilinta aspirin - low dose atorvastatin - lipitor lininopril. - prinival

Current Illness: no

ID: 1047474
Sex: F
Age: 65
State: AZ

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

Lab Data: None

Allergies: None

Symptoms: Intermittent severe pain in lumbar spine and hip joints. I tried heat, ice, and OTC NSAIDs with no improvement. Hydrocodone (left over from knee surgery in 2018) relieves pain for 3-4 hours.

Other Meds: Losartan, furosemide, citalopram, bupropion, levothyroxin, potassium chloride, fish oil, multivitamin

Current Illness: None

ID: 1047475
Sex: M
Age: 69
State: MN

Vax Date: 01/28/2021
Onset Date: 02/15/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data: No tests indicated.

Allergies: Atorvastatin, pravastatin, lisinopril, losartan

Symptoms: Started having unilateral facial paralysis on 2/15/21, Presented in clinic on 2/17/21 with: R sided facial paralysis with smiling, frowning, raising eyebrows. No other systemic symptoms: no rash, no right sided body weakness - diagnosed with Bells Palsy and sent home with steroids and valacyclovir.

Other Meds: Hydrochlorothiazide 25mg QD, Paxil 20mg QD, Amlodipine 10mg QD, Atenolol 100mg

Current Illness: None

ID: 1047476
Sex: M
Age: 75
State: NE

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

Lab Data: None

Allergies: None

Symptoms: 24 hours: Severe chill, low grade temperature (99.5 deg. F.) generalized acts and pains, one episode nausea with vomiting, fatigue. Rx: rest, fluids

Other Meds: Pantoprazole Sod. 40mg tabs. 1 qd. Losartan 50mg 1 qd. ASA tabs 81mg 1 q other day. Amlodipine Besylate 5 mg. 1 tab. qd. Atorvastatin (generic Lipitor) 1 tab daily Bimatoprost (Lumigan) Opth. Sol. 1 gtt. OL/OD daily (PM)

Current Illness: None

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm